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Rheumatic
fever
Deaths in London from rheumatic fever in 1955 were 17, of which three were
children under 15. Account must also be taken of all deaths under 45 years assigned to
heart disease since apart from deaths due to congenital heart disease, the vast majority
of these deaths are rheumatic in origin.

Under the age of 15 the number of deaths is so small that considerable random
fluctuations must be expected.
Scabies
Scabies became notifiable in London in August, 1943. Notifications in 1955 numbered
660, as compared with 699 in 1954.
Scarlet fever
Notifications of scarlet fever during the year numbered 2,070, the lowest figure
ever recorded. Incidence of the disease has been low during the last year or two but it
may also be that as a result of the prevailing mildness of the disease notification is less
complete than formerly. The most striking feature of scarlet fever at present, compared
with 30 or more years ago, is its mildness. Low mortality and lack of serious complications
are due in part to improved modern treatment, but a change in the nature of the
disease towards a milder form of illness has also contributed. It would be a mistake to
assume that this change is permanent, for scarlet fever has fluctuated between great
severity and mildness several times in the last 300 years.
Smallpox
There were no notifications of smallpox during the year.
Tuberculosis
Details relating to tuberculosis appear in the section which follows.
Whooping
cough
There were 4,709 notifications of whooping cough during the year. There were
only seven deaths, six of them of children under five years of age giving a fatality ratio
of 0.149 per cent.
Infectious
diseases in
schools
The number of cases of certain infectious diseases involving exclusion or absence
reported from schools in 1955 and previous years is shown on page 114,
TUBERCULOSIS
Introductory
in my report for the year 1950 I included a review of the disease in London, and of the
services provided to deal with it, during the preceding fifty years. Such periodic
detailed studies serve the very useful purpose of focusing attention on the trends taken
by this disease and on the measures employed for its control, and provide an opportunity
for reassessing aspects which require special action. It may be possible in this way to
focus attention on areas of persistently high incidence or mortality or of inadequate
provision or acceptance of control facilities. Groups of the population still providing
the main contributions to notification or to deaths are revealed, acting as a pointer to
the inadequacy of treatment or of ascertainment in these cases. Changes in the rates of
tuberculin reaction among children in different parts of London provide evidence of
the distribution and persistence of infection risks in these areas.
Measures taken to protect the public health against the inroads of tuberculosis must
keep close pace with the deviations and changes in the pattern and character of the
disease among the various groups comprising our community.
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