In addition to smallpox, measles and whooping cough were also serious lethal diseases in earlier centuries in the UK. Although these are now conquered in the developed world they remain a serious threat to life in Third World countries where, it has been estimated, 17 million people die annually from infectious diseases. Conditions there, with poor nutrition and inadequate medical services approximate to life in England in the 17th and 18th centuries, where fatality rates fell only towards the end of the 19th century. Thus, in many underdeveloped countries today, malnutrition and infectious diseases can occur in the same unfortunate children and together they play a major role in causing high child mortality and morbidity rates (James, 1972; Glasziou & Mackerras, 1993). In particular, measles remains as a significant threat to life in those regions of Africa and Asia where nutrition is inadequate (Fraser & Martin, 1978).

The dynamics of measles and whooping cough in London are studied by time-series analysis in this chapter and the possible effects of seasonal driving and malnutrition are correlated with the mathematical modelling presented in section 9.3.

Measles epidemics in London, 1630–1837

Bolker & Grenfell (1992) wrote of measles epidemics: