Written by Nathan Lee and Hussan Gill
Lice have been an immense problem throughout the history of the United Kingdom. They have affected young and old, as well as all classes in society. Many boroughs throughout London were affected with lice, but the numbers of people afflicted by the pests varied from borough to borough and over time.
Lice in Westminster (by Hussan Gill)
The Medical Officers of Health in Westminster documented the incidence of head and body lice in the borough throughout the 20th century. Westminster is an Inner London borough and occupies much of the main area of Greater London. Westminster is a historic borough, where people have resided for over a millennium. It is also a very diverse borough, and includes a variety of races and religions. Because of the high populations and proximity to the central part of the country, Westminster has always been a very highly educated, and wealthy borough according to London’s Poverty Profile. It has always had a wide spectrum of classes, with a very wealthy, noble class as well as working class and poor residents.
The population of 20th-century Westminster was large and compact. Because of the high density of people living in close contact, lice were common easily spread. They were regarded as a major health problem, and were tracked accordingly.
Lice are spread widely in crowded, stressed areas; thus Westminster was an ideal location for the spread of lice (Velten 37). Working-class living conditions were more crowded and unsanitary than those of the middle and upper classes. Bathing and house cleaning were more difficult in working class and poor parts of Westminster. Another aspect of the spreading of body lice in Westminster was that of clothing. Scientific American showcases that a lot of body lice resides in clothing, and is a good environment for them. Many working class and poor people in Westminster were unable to change their clothing regularly, so the spread of lice was very easy.
The MOHs in Westminster borough were deeply invested in the reporting of incidents of lice infestation. Beginning in the early 20th century they started reporting the occurrence of lice in children and adults. They started this reporting as early as 1912 (Westminster 1912). In this early report, the MOH recorded the total number of lice for citizens of Westminster. As this was an early report, it did not designate whether children or adults had the ailment, it only recorded the overall amount of head and body lice in both. It was a relatively small amount as there were only 17 body lice cases and 33 head lice cases. This was a relatively small amount of reported cases, as compared to later years. Starting in 1921, Westminster health officials started reporting adult and children lice cases separately, as well as separating head and body lice cases. From 1921 to 1924 there was a substantial increase in the incidents of head and body lice. Children were much more likely to get head lice than body lice. Adults, by contrast, were much more likely to get body lice than head lice. In fact, children got head lice at over a ten times higher rate than body lice, and adults got body lice at over a ten times rate than head lice.
Lice cases continued to stay the same from 1921 until the mid-1940s. In the 1940s, during World War II, there was a large outbreak of cases of head and mainly body lice as recorded in Westminster 1944. In the report Westminster 1948, the Westminster MOH started to include a distinction in adult cases of lice. They separated the cases between male and female cases. There were a larger amount of male cases of both head and body lice compared to female cases. This could be due to more men than women working outside the home, and regularly interacting with others and coming into contact with people with lice. Or it could have been due to men spending time in army barracks, places known to have high rates of transmission of lice.
In the aftermath of World War II, the amount of head and body lice cases declined in both children and adults. From 1948 on, there was large decrease in the amount of head and body lice in both children and adults. Westminster is an ideal borough to study the spread of lice, because of its large population and their record keeping of the number of incidents of lice. It is truly one of the most unique boroughs in London because of its diversity and social stratification. Much can be learned about the ailment that is lice, by studying its progress in Westminster over the years.
Velten, Hannah. Beastly London: a history of animals in the city. London: Reaktion Books, 2016.
Lice in boroughs outside of central London (by Nathan Lee)
The outskirts of London did not have as many case reports of lice, compared to central London. Higher reports of lice could have been due to central London’s higher population density, or to a lack of medical professionals outside of central London. Medical officials in London started reporting an increase in patients with lice later in the 19th century and early in the 20th century. The figures gathered by Medical Officers of Health often included reports of sterilization, cleansing, and treatment of people, household items, and articles of clothing. Most cases, as we see today, resulted from head lice in children. When entering the wealthier parts of central London, such as Westminster, results of cases from 1924 shared similarities with cases reported near the lower-income region of Hammersmith, and its neighboring boroughs of central London. In 1924 the number of patients in Westminster suffering from head and body lice treated at the cleansing station was 584. A 1923 study showed that the number of cases of children reported with head lice was far more than that of adults reporting incidents of lice. These results found in Westminster suggest how lice spread through different groups in the city. Westminster mainly dealt with head lice on school children, while bordering boroughs experienced higher numbers of adults contracting body lice.
Early in the 20th century, medical officials developed cleansing and sterilization stations looking to contain a variety of medical issues. A rapid spike in residents reporting lice was one of the issues that kept these stations busy. Notably, Hammersmith Borough Cleansing Station was a sanitation hub for the Hammersmith Borough, and surrounding Boroughs in the west and central-west London. At Hammersmith Cleansing Station, Boroughs such as Southall used the cleansing facilities to aid its population affected by lice. In 1957, although 3,000 fewer children were examined, the number of those infected rose from 28 in 1956, to 68 in 1957. Outside of school children, it is interesting to note in 1962 only 12 cases of lice, from two families, required treatment. It has yet to be seen if this was due to sanitary success, or the failure of some families to take their children to the doctor. In 1965, of the 247 treatments that were given at the Cleansing and Sterilization Center, the largest number came from the nearby Borough of Ealing. Furthermore, other boroughs and related facilities used Hammersmith’s station, including West London Hospital, Fulham Hospital, Richmond, Ealing, and Hounslow.
Interestingly, there are several references to hostels and other group facilities in many MOH reports. At one point in 1965, approximately two-thirds of treatments given in Hammersmith were for men from a large hostel in the borough. Reports from the medical office of Hammersmith in 1967, show results from hostels and welfare service centers. Welfare services at the elderly assistance community, Southway Close, reported the outbreak led to 32,244 articles of clothing processed through the system. An infamous hostel, Hurlingham Lodge, laundered 5,916 articles. Both locations described above were said to be the result of individuals who struggle keeping their sanitary environment in check.
Later in the 20th century, residents of London still had issues controlling the spread of lice. London’s Boroughs in the late 1950s and early 1970s reported some unique figures when comparing their results. Other reports show the fascinating ability of lice to evolve into new strains, resistant to poisons and insecticides used for treatment during this time. By 1964, Westminster had their situation more or less under control, as men experienced zero cases of head lice, and women showed only 10 cases of lice in total. Just to the east of Westminster, cases among low income and immigrant households seemed slightly higher. East of central London, the Tower of Hamlets 1970 Medical Office Report stated that treatment of ‘vermin and nits’ increased from 707 to 717 for school children. Officials claimed: “The schools principally affected are those with high ratios of immigrant children on their rolls, some of whom move on before adequate treatment can be completed.”
Just a bit farther east of Borough Tower of Hamlets, Greenwich showed evidence of lice evolving into new strains around the end of the 1960s. Stations reported verminous conditions in 1,020 school children and 138 adults. Numbers that saw a 40% increase from 1970, and 264% higher than 1968. Evidence from these reports, and other cases around central London during this time show the increase was likely related to the evolving head lice into a strain resistant to the mid-19th-century concoction of insecticides and gamma treatments. A recent study in 2010, supported this claim. Scientists found that most forms of body lice evolve from head lice, resulting in their agreement on lice having the ability to evolve its form from its first stage on the head. Farther east east of downtown London, cases were not as prevalent. This could have been due to population, or a low unemployment rate. Borough Barking, in east London, had an unemployment rate of 1.4% in 1953. Furthermore, a professional who was hired to inspect the school children of the borough, respectfully commented he was wasting his time. The inspector claimed, “these inspections need to stop, because of 20,559 inspections, 136 pupils were infested.”
Reports from London’s Medical Officers of Health present a dynamic story of the medical history of England’s capital and largest city. A dense and well blended population of cultures, people, and medical issues are well documented. Lice played a prominent role in London’s medical history. Large groups of London’s populations gained the benefits of sanitation, although some Londoners still couldn’t access sanitation for themselves.
Wenjun Li et al., “Genotyping of Human Lice Suggests Multiple Emergences of Body Lice from Local Head Louse Populations” PLOS Neglected Tropical Diseases, March 23, 2010