London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Heston and Isleworth 1949
[Report of the Medical Officer of Health for Heston and Isleworth]
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There has been an overall reduction in infant deaths from all causes but the reduction has been
greatest in preventable infections as is shown in the table below:—
Causes of Infant Deaths
| Cause of death | Percentage of total infant deaths | Rate per 1,000 live births | ||||
|---|---|---|---|---|---|---|
| 1911-15 | 1940-44 | 1945-49 | 1911-15 | 1940-44 | 1945-49 | |
| Prematurity | 20.0 | 27.1 | 23.9 | 22.4 | 15.2 | 8.0 |
| Congenital defects, birth injury and infantile diseases | 17.2 | 23.6 | 39.0 | 19.3 | 13.2 | 13.0 |
| Gastro-enteritis | 24.1 | 20.0 | 11.0 | 27.0 | 11.2 | 3.7 |
| Pneumonia and bronchitis | 20.0 | 15.7 | 12.1 | 22.0 | 8.8 | 4.1 |
| Tuberculosis | 2.3 | 1.0 | 0.4 | 2.6 | 0.6 | 0.1 |
| Other infections | 10.0 | 8.1 | 6.6 | 11.8 | 4.6 | 2.2 |
| Other causes | 6.4 | 4.5 | 7.0 | 6.9 | 2.5 | 2.4 |
Deaths from preventable infections are still too frequent but there are indications that the hard
core of deaths from prematurity and congenital defects is being reduced.
Maternal Mortality.—The number of deaths due to causes associated with pregnancy and childbirth
was three. This gives a maternal mortality rate per 1,000 total (live and still) births of 2.0 as compared
with 1.0 for England and Wales. Maternal deaths are usually divided into those due to septic
infection and those due to diseases and other conditions associated with pregnancy and labour, and the
local trend of deaths from these two causes is shown below:—
Maternal deaths per 1,000 total (live and still) births.
| Sepsis | Other causes | Total | |
|---|---|---|---|
| 1930-34 | 2.6 | 1.7 | 4.4 |
| 1935-39 | 1.0 | 2.1 | 3.1 |
| 1940-44 | 0.7 | 1.2 | 1.9 |
| 1945 | 0.6 | 1.3 | 2.0 |
| 1946 | 0.5 | 1.6 | 2.2 |
| 1947 | — | 0.5 | 0.5 |
| 1948 | — | 0.6 | 0.6 |
| 1949 | — | 2.0 | 2.0 |
Here, as throughout the country, advances in the prevention and treatment of septic infections
can be measured by the considerable reduction in deaths from septic abortion, puerperal fever, etc.
Fluctuations in the number of maternal deaths due to causes other than sepsis serve to remind us of the
need for improving ante-natal and obstetric care.
INFECTIOUS DISEASE
Incidence of Notifiable Diseases.—The number of cases notified during the last ten years are shown below:—
| 1940 | 1941 | 1942 | 1943 | 1944 | 1945 | 1946 | 1947 | 1948 | 1949 | |
|---|---|---|---|---|---|---|---|---|---|---|
| Smallpox | — | — | — | — | — | — | — | — | — | — |
| Scarlet fever | 96 | 117 | 190 | 280 | 130 | 124 | 67 | 62 | 159 | 138 |
| Diphtheria | 73 | 37 | 11 | 5 | 11 | 24 | 16 | 3 | 2 | — |
| Erysipelas | 35 | 20 | 16 | 21 | 16 | 16 | 19 | 19 | 21 | 26 |
| Pneumonia | 200 | 124 | 72 | 116 | 50 | 25 | 47 | 56 | 41 | 52 |
| Cerebro-spinal fever | 43 | 34 | 12 | — | 3 | 11 | 13 | 8 | 2 | 2 |
| Epidemic encephalitis | 1 | 1 | — | — | — | 1 | — | — | — | — |
| Poliomyelitis and polioencephalitis | 1 | 1 | — | — | 3 | 7 | 1 | 43 | 29 | 14 |
| Typhoid fever | 3 | 2 | 4 | 1 | — | — | 1 | 1 | — | — |
| Paratyphoid fever | 1 | 30 | 1 | — | — | — | — | — | 3 | — |
| Dysentery | — | — | 2 | — | 22 | 28 | 6 | — | 5 | 2 |
| Tuberculosis— Pulmonary | 121 | 157 | 177 | 165 | 167 | 128 | 200 | 160 | 147 | 208 |
| Non-Pulmonary | 9 | 17 | 25 | 25 | 17 | 29 | 17 | 20 | 21 | 11 |
| Ophthalmia neonatorum | 2 | 5 | 3 | — | 5 | 3 | 2 | — | — | — |
| Puerperal pyrexia | 42 | 22 | 58 | 105 | 87 | 45 | 54 | 60 | 23 | 16 |
| Measles | 1,109 | 580 | 1,085 | 636 | 219 | 1,109 | 170 | 840 | 571 | 523 |
| Whooping cough | 123 | 286 | 243 | 134 | 171 | 110 | 170 | 142 | 227 | 173 |
| Malaria | — | — | — | — | 1 | 2 | 1 | — | — | 1 |
| The age distribution of notifiable disease during 1949 is shown in Table V. | ||||||||||
Scarlet Fever.—This disease continued to be of a mild type. No death from this disease has
occurred in the Borough since 1937. Of the 138 cases, 54 were admitted to hospital.
Diphtheria.—For the first time in the Borough no case of diphtheria occurred during the year
and this is a tribute to the persistent campaign of immunisation during the last 20 years. Recently some
evidence has been forthcoming to suggest that inoculations against diphtheria, whooping cough, etc., may
influence the occurrence of paralysis when poliomyelitis is prevalent. This is particularly disquieting
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