London's Pulse: Medical Officer of Health reports 1848-1972
View report page
Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Dagenham 1930
[Report of the Medical Officer of Health for Dagenham]
This page requires JavaScript
95
it is decided arc to be admitted. Admission being decided
primarily on clinical grounds, some cases remain at home in overcrowded
circumstances, with risk of spread of disease. A further
factor occurs in the internal administration of the hospital:
shortage results in overcrowding, with its frequent high complication
rate. These patients, on discharge, develop infections
discharges and give rise to return eases.
So far as concerns the district for the last two years, all
these factors have operated in the case of scarlet fever, though
hardly at all in the eases of diphtheria, for which disease there has
all along been nearly always sufficient accommodation.
The following table shows the distribution of the two infections
in each year. It shows that during 1927, which was the peak year
of relative incidence, although there were numbers of secondary
cases, thev were not attributable to shortage of isolation hospital
accommodation, because during that year there was little home
treatment for the greater part of the year. In 192S, when over
60% of scarlet fever cases were at home, there was actually a
slight reduction in the percentage of infection occurring as
secondary or return cases. In 1929, when the same proportion of
cases were detained at home, there was a slight increase in the
percentage of these infections. These figures then, while not
disclaiming that the totals were increased by secondary and return
eases, show that they do not explain the excessive incidence for
the years it, occurred: —
Secondary and Return Cases.
| Diphtheria. | Scarlet Fever. | |||||
|---|---|---|---|---|---|---|
| Primary. | Secondary. | Return. | Primary. | Secondary. | Return and Recovery. | |
| 1927 | 113 | 21 | 4 | 154 | 29 | 9 |
| 1928 | 170 | 17 | 7 | 267 | 36 | 11 |
| 1929 | 195 | 19 | - | 341 | 64 | 15 |
| 1930 | 283 | 40 | 9 | 380 | 53 | 20 |
(4) A large population at the susceptible ages, coinciding with
a generally high prevalence throughout the country.
If for any reason, one particular year of age were especially
represented in the population, one would expect this age-group to
show a relative excessive incidence of infection. This excess
should, in the following year, appear in the next age-group. When
the year of age coincides with the year which the infection especially
favours, the combination should result in a much greater incidence
for that particular year.