UBAR 4 URBAN DISTRICT OF BARNET. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH to the BARNET URBAN DISTRICT COUNCIL. by Charles F. Hardie , M.A., M.B., B.C., (Cantab.) Medical Officer of Health. together with the ANNUAL REPORT of the ACTING SANITARY INSPECTOR. by Wm Plumpton, A.R.San.I. 1918. BARNET URBAN DISTRICT COUNCIL. MEDICAL OFFICER'S REPORT. Health. Department., Municipal Offices, Barnet. March, 1919. To the Chairman & Members of the Barnet Urban District Council. Gentlemen, I beg to present my Ninth Annual Report on the Health of the District for the year 1918. 1 returned iron Active Service in March, 1918. In accordance with instructions from the Local Government Board, I am furnishing a short interim report and many of the usual details are omitted. The Infantile Mortality Rate has been 98 per 1,000. The number of Infantile Deaths has been 10 - of these 4 were due to premature birth, 1 to congenital heart disease, 1 to jaundice and 3 to diseases usually styled "preventible," that is, 2 to pneumonia, and 1 to convulsions. The average infantile mortality rate for the last 5 years has been 73. Birth Rate, This has been 10.4 per 1,000. Total births 125 Boys 61 - Girls 64. The number of births is about half the prewar number and is due largely to war conditions, and the limitation of families associated with high prices and difficult conditions of life. Illegitimate Births. Boys 4 - Girls 3. Death Rate. The Death Rate has been 14.5. Total deaths 156 - Men 74 Women 80. Influenza'deaths were 20, Women 16 - Men 4. Cancer deaths 15, Women 6-Men 9, Infectious Diseases. During the year there were 168 cases of Infect- ious Disease. The number of deaths from diseases of this class was 11 - Tuberculosis 9, Scarlet Fever 1, Diphtheria' 1. The following cases were notified Measles 35 Tuberculosis 37 Chicken-pox 71 Scarlet Fever 11 Diphtheria 9 Cerebro Spinal 1 Fever Erysipelas 3 Para-Typhoid 1 The following Diseases are now notifiable in this District:- Measles & German Measles. Scarlet Fever. Diphtheria & Membranous Croup. Typhoid Fever. Puerperal Fever. Cholera. Plague, Cerebro-Spinal Fever, Acute Poliomyelitis,, Acute Polio-encephalitis. Encephalitis Lethargica. Erysipelas, Ophthalmia Neonaterum. Pulmonary Tuberculosis, Other Forms' Tuberculosis. Chicken Pox, Small-pox. Typhus Fever, Relapsing Fever, Continued Fever. Pneumonia. Dysentery, Malaria, Trench Fever, Influenza. The deaths from influenza -in the-district occurred as follows:- No. No. 1st week. - 27th week. - 2nd " - 28th " - 3rd " - 29th " - 4th " 1 30th " - 5th " - 31st " — 6th " - 32nd " - 7th " - 33rd " - 8th " 34th " - 9th " - 35th " - 10th " - 36th " - 11th " - 37th " - 12th " - 38th " - 13 th " 1 39th " — 14th " - 40th " 6 15 th " - 41st - 2 16th " 42nd " 4 17th " 43 rd " 3 18th " - 44 th " 1 19 th " - 45 th 2 20th " 46 th " - 21st " - 47th " — 22nd " M 40th " - 23 rd " 49th " — 24th " — 50th " _ 25th " 51st " - 26 th " - 52nd - Ages Under 1 year No. 2 to 10 years,; 3 11 to 21 years, 1 21 to 30 years 5 31 to 40 years, 4 41 to 50 years,. 5. 51 to 60 years 1 61 to 70 years 1 Over 70 years. Males 4 Females 16 There was an outbreak of moderate severity in june end July, from October to Christmas it was very prevalent and of a severs type. Pneumonia was present in a considerable number of cases, (1) of the lobar type, (2) "Septic" with death following within a few hours of onset almost invariably. There was a great shortage of doctors to cope with the epidemic in the district. Of the six resident normally, two were in the Army, one was seriously ill, and two "locume" were incapacitated by the disease. The remaining three were too overworked to do any pathologioal or other investigations into the cause and nature of the disease. It is estimated that there were about 4,000 cases, including mild ones, though no actual figures are available, A post-mortem was done in one case, in which the lungs were found to consist of scattered patches of solid lung with generalised purluent bronchitis. There was no evidence on the means of introduction of the disease, though it was definitely transmitted by close contact. The period of incubation was short, probably two or three days only. Infectivity appeared to cease with subsidence of fever. Previous attacks did not appear to give protection, The disease started amongst school-children, was very prevalent and more severe amongst healthy young adults and was almost entirely absent amongst elderly, weakly people. Advice and warnings were published in the local Press, All day and Sunday-schools were closed, and the Cinema was closed at short intervals for ventilation and disinfection. The only hospital treatment available was the Workhouse Infirmary. It is doubtful if any scheme of hospital treatment could have dealt with so large a number of cases. As was to be expeoted, there was a great shortage of nurses. Vaccine treatment was attempted in several cases with doubtful success. Measles. it is noteworthy that only 35 oases of lieasles, with no deaths occurred, as against 198, with 2 deaths, in 1917. Troops. Very few troops have been billeted in the district. The new Workhouse Infirmary has been used as a Military Hospital, and the Ewen Hall, Wood Street, as a V.A.D. Hospital, with 70 beds. Maternity & Child Welfare. "A dent re has been carried on during the year at the Church House. The work is growin; steaaily. 172 children under 5 attended in 1918, with a total number of attendances of 1,049, as against 586 in 1917. There was only one death amongst these children. The mothers attend very regularly, and the weekly number of children who are brought varies from 30 - 40. Practically no ante-natal work has been done during the year, There is no suitable accommodation for this and the local midwifes do not appear to be interested in the Maternity Welfare Work, Dr, Swatman of the Herts, County Council is in charge. Small-pox Accommodation. Small-pox accommodation has been provided at Cheshunt. Housing. It has not been possible for the Council tr deal with the unsatisfactory Housing conditions existing in parts of the district, although attention has repeatedly been called to various property by the Sanitary Inspector and myself. Overcrowding has been taking place with its resultant bad effects. As soon as suitable accommodation can be provided several houses will have to be closed. It is anticipated that the passing of a new Housing Bill will enable local authorities to deal more stringently with this important question rnd that it will be incumbent upon authorities to provide adequate housing accommodation to meet the needs of the District. The present Estato is to be developed further, witty 8 houses to the acre. 113 new houses are to be added to the existing 5£. This matter is receiving the most urgent and constant attention of the Council. I am 'Yours faithfully, CHAS.F. HARDI M,A, M,,B, B.O. Hedi Officer of Health. Cantab, BARNET URBAE DISTRICT COUNCIL. ACTING SANITARY INSPECTOR'S REPORT. 1 Health Department, Munici pal Offices, Barnet. March, 1919. To The Chairman & Members the Barnet urban District Council. Gentlemen, I have pleasure in presenting report giving brief particulars with regard to the Sanitation of the District for the year 1918. During this year health work has materially increased, and it has been extremely arduous to cope with the duties involved, especially with a much depleted staff, due to officials being engaged on more important "Active Service." Meat &. Food Inspection. The control of food has greatly assisted in securing more efficient, inspection of food supplies, more particularly regarding meat and milk supplies, and it is hoped control, in so far as pure food supplies may be effected, Will be retained. The system of calling attention for inspection cy the Health Department, of articles of food of which the tradesman may have suspicion as to soundness, is now well established and operates in the interests of all concerned. I submit list showing the quantities of food condemned as unfit for human consumption:- Name. no. Carcase & Offal??? of Cows &- heifers. 4 meal???. 32 lbs. Liver. 56 " Herrin??? 1 box. Kipe??? . 8 boxes, Skate 17 lbs. Rabbit. 19 Butter. 3½lbs. Certificates have been granted and the retailers have been able to 'secure full compensation. Legal Proceedings. It has only been necessary to institute proceedings in one case for non-compliance of notice served under Sec. 41 of the P.H.A. 1875. The Council carried out the work of laying new drainage to a Factory in the District, the old drains being in bad condition and injurious to the health of the workers at this Factory. The proceedings were successful and payment is now being enforced. Sale of Food .& Drugs Acts. The above Acts are enforced by the County- Authority in this District, The following Table shows the number and nature of the samples taken in the Urban District during the past year, with the results of analysis:- . Sample. No. milk. 14 Butter. 1 Lard. 1 Cocoa. 1 Self-raising Flour. 2 Total 19 all of which were genuine with the exception of one scrapie of Sell'-raising Flour, which contained 1% of calcium of sulphate, Proceedings were taken, Taut the case was dismissed. The large number of samples of milk were taken as I had received several complaints as to the poor quality. The number of samples taken, although an increase on previous years, is considered insufficient and representation is being made to the County Council by Cr, Fern, The Board of Agriculture suggest the minimum number of samples taken should be 3 per thousand. Dairies, Cowsheds & Milkshops. Syatemmatic inspection has been made of the above premises, in order to ascertain compliance with the Council's Byelaws is being adhered to. Attention has had to be drawn to the Owners in a few instances, which has had the desired effect. Pure Milk. She present supply and defective distribution of milk calls for proper attontion. The bringing into operation of the Milk & Dairies (Consolidation) Act, 1915, together with the Tuberculosis Order, 1914, will help oonsiderably to solve this question, Both of these Orders have been suspended during the War. Insanitary Property, Housing. The provision of adequate housing accommodation has engaged the Council's careful consideration, and tentative proposals for the further development of the Council's Housing Estate have been approved by the Local Government Board, It has not been possible to deal properly with the unsatisfactory and slum houses, although a large number have been scheduled as unfit for human habitation. Closing Orders have been delayed because there was nowhere else for the people to bo housed. A "House to House" inspection will be proceeded with in order to fully ascertain the con-, dition of property in the Town, Pull report on Housing has been submitted to the Council, Much assistance is afforded by the Medical Practitioners and individual members of the Council in calling my attention to property. I am, Mr, Chairman & Gentlemen, Yours obediently, Wm. PLUMPTON. A.R.San.I. Acting Sanitary inspector