A c 4378 Cat P.c.Ack. 21.11.55 CAC BER67 METROPOLITAN BOROUGH OF BERMONDSEY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1954 D. M. CONNAN, M.D., D.P.H., Medical Officer of Health BER 67 METROPOLITAN BOROUGH OF BERMONDSEY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1954 D. M. CONNAN, M.D., D.P.H., Medical Officer of Health TABLE OF CONTENTS PUBLIC HEALTH DEPARTMENT— PAGE Public Health Committee 4 Staff 5 VITAL STATISTICS— Area 7 Population 7 Births 7 Deaths 8 Marriages 8 Infantile Mortality Rates 9 Deaths from Tuberculosis 9 Vital Statistics of District 10 Causes of Death 11 Infantile Mortality, Causes of Deaths 13 Extracts from Vital Statistics, 1954 14 INFECTIOUS DISEASES— Diseases Notifiable 15 Food Poisoning 15 Disinfection 16 Cleansing Station 16 Typhoid Carrier 17 Cases Notified in 1954 18 Cases Notified for last ten years 19 TUBERCULOSIS— New Cases and Deaths 20 Notification Register 20 Summary of Notifications 21 SANITARY—Circumstances of the Borough Housing 22 Housing Act, 1936—Overcrowding 22 Eradication of Bed Bugs 23 Inspections and Proceedings 23 Registered Premises 25 Smoke Nuisances 25 Water Supply to Tenement Houses 25 Sale of Food 25 Rag, Flock and other Filling Materials Act, 1951 25 Dramage Work 25 Housing Repairs and Rents Act, 1954 26 Work of the District Inspectors 28 Factories and Workshops —Homework 29 Factories and Workshops —Inspections 30 Bakehouses 31 House, Trade and Market Refuse 31 Offensive Trades 31 Pet Animals Act, 1951 31 Catering Establishments 32 Work of Factories and Shops Inspector 32 Rodent Control 33 FOOD CONTROL— Imported Food Regulations—Samples taken 34 Section 14, Food and Drugs Act and Dairies 37 Disposal of Unsound Food 37 Food Premises and Types of Business 37 Unsound Food —Shops and Stalls 38 Pharmacy and Poisons 38 Milk Premises 38 Milk Licences 39 Milk Sampling 39 Ice Cream 40 Food and Drugs—Samples Taken 41 Unsound Food —Wharves, etc 43 Legal Proceedings 45 Work of the Wharves and Food Inspectors 46 MISCELLANEOUS SERVICES— Old People's Welfare 47 National Assistance Act, Section 50 49 National Assistance Act, Section 47 50 Mortuary 51 Water Supply 52 Free Washing Facilities 53 International Certificates of Vaccination and Inoculation 53 Street and Open Markets 53 Public Health Laboratory Service 55 PUBLIC HEALTH DEPARTMENT MUNICIPAL OFFICES, SPA ROAD, S.E.16. PUBLIC HEALTH COMMITTEE, 1954 Chairman Alderman E. J. GIBSON Vice-Chairman Councillor Mrs. A. M. HATCHER, 1953/54. Vice-Chairman Councillor W. H. WARDELL, 1954/55. Councillor W. M. Leahy Councillor F. J. Ackland „ A. Adkins „ Jos. Mahoney „ J. A. Mahoney „ Mrs. E. V. Coyle „ Mrs. A. E. Martin „ T. J. Eagle „ 'W. A. Mynott „ W. L. Ellis „ J. H. Newbery „ F. W. Florance „ L. H. George „ W. E. Nicklin „ P. J. Quirk „ C. R. Hand „ T. Hendy Ex-officio. Councillor W. L. ELLIS, J.P., Mayor of Bermondsey, 1953/54. Councillor P. J. GEOGHEGAN,J.P., Mayor of Bermondsey, 1954/55. STAFF: MEDICAL OFFICER OF HEALTH. D. M. Connan, M.D., B.S. (Lond.), M.R.C.S., L.R.C.P., D.P.H PUBLIC ANALYST. A Prideaux Davson, A.R.C.Sc, F.R.I.C., F.C.S. SANITARY INSPECTORS : F. L. Richardson, Chief Sanitary Inspector. W. A. Campbell, Factories and Shops Inspector and Deputy Chief Sanitary Inspector. G. F. J. Toll, Wharves and Food Inspector. H. E. Butcher, Wharves and Food Inspector. W. C. Tapsfield, Wharves and Food Inspector. H. J. Bailey, Food and Drugs Inspector. A. W. Hancock, Food Inspector. W. A. Pilson, Drainage Inspector. L. T. Knott, District Inspector. W. F. Smith, District Inspector. J. L. Springett, D.P.A. (Lond.), District Inspector. S. R. Weightman, D.P.A.(Lond.) District Inspector. E. H. Kerridge, District Inspector. G. A. Mahoney, District Inspector (Resigned September 1954). CLERICAL STAFF. F. W. Smith, Chief Clerk (Retired July 1954) J. A. Blake, M.B.E., G.M. (Transferred to Town Clerk's Department, July 1954) J. W. J. Saward, A.F.C. (Appointed Chief Clerk, September 1954) H. D. White A. E. Gambrell E. T. Hodgkins G. A. Hunt G. A. Blake A. J. Kiddell C. H. Harris (Retired March 1954) E. M. Watkins M. W. Bridgman PROPAGANDA SECTION. Senior Technical Officer —C. F. Lumley. STREET AND OPEN MARKETS Market Collectors and Supervisors—J. A. Hart, C. E. Featherstone DISINFECTING AND CLEANSING STATION. A. Manning, Supervisor. INVESTIGATOR, RODENT CONTROL H. E. Staples Borough of Bermondsey. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. To the Mayor, Aldermen and Councillors of the Borough of Bermondsey. Sir, Ladies and Gentlemen, I have the honour to submit my Annual Report for the year 1954. There is nothing of outstanding interest upon which comment is required, but I may perhaps be permitted to express sorrow at the death of two members of the Council, Councillor S. R. Weightman and Alderman E. J. Gibson, each of whom had served the Public Health Committee for many years and each of whom had been both Chairman and Vice-Chairman. I am, Sir, Ladies and Gendemen, Your obedient Servant, D. M. CONNAN. VITAL STATISTICS. AREA. The area of the borough (exclusive of area covered by water) is 1,336 acres. POPULATION. Estimate of Registrar-General Census to 30th June, 1953 to 30th June, 1954 1931 1951 111,542 60,640 59,350 58,590 BIRTHS. The total number of births belonging to the borough registered during 1954 was 986 consisting of 489 males and 497 females. The number for 1953 was 994. The birth-rate for 1954 was 16-8 per thousand persons living, compared with 16-6 for 1953. DEATHS. The total number of deaths belonging to the borough registered during 1954 was 573, consisting of 317 males and 256 females. The number for 1953 was 585. The death-rate for 1954 was 9.7 per thousand persons living, compared with 9-9 for 1953. MARRIAGES. The total number of marriages in the borough in 1954 was 475, being 45 below the number for 1953, and 107 below the average for the last 10 years. The figures have been supplied by the Superintendent Registrar. Year No. Rate 370 16.52 1944 1945 737 31.4 1946 665 23.62 1947 684 23.17 1948 595 19.70 1949 609 20.15 1950 545 18.23 582 19.28 1951 516 17.26 1952 1953 520 17.52 Average for years 1944 —1953 582 20.67 1954 475 16.21 INFANTILE MORTALITY London Whole Borough Year Rate per 1,000 Births Rate per 1,000 Births No. of Deaths No. of Deaths 1944 56 66 2,250 51 1945 44 52 2,011 44 1946 53 39 2,527 38 1947 50 33 2,454 34 1948 20 16 1,869 31 1949 33 29 1,517 27 1950 23 20 1,372 26 1951 27 25 1,333 25 1952 20 1,189 23 20 1953 27 27 1,216 24 Average for years 1944-1953 33 1,774 32 35 1954 23 24 1,047 21 TUBERCULOSIS OF THE RESPIRATORY SYSTEM. In the following Table will be found particulars of deaths from Tuberculosis of the Respiratory System since the year 1944. Whole Borough London Year No. Rate No. Rate 0.84 1944 47 1.05 2,073 1945 45 0.96 2,033 0.78 1946 32 0.57 1,940 0.62 1947 0.88 2,044 0.62 52 1948 45 0.74 1,900 0.57 1949 41 0.68 1,585 0.47 1950 23 0.38 1.225 0.36 1951 21 0.35 1,154 0.34 0.28 1952 20 0.35 933 1953 14 0.24 690 0.21 Averages for years 1944-1953 1,558 0.51 34 0.62 0.24 0.18 1954 14 596 VITAL STATISTICS OF WHOLE DISTRICT DURING 1954 AND PREVIOUS YEARS. Year 1 Births Net Deaths at all Ages belonging to the District Total Deaths registered in the District Deaths of Non- Residents registered in the District 10 Deaths of Residents regisstered beyond the District 11 Population estimated to Middle of each Year 2 Total Deaths in Hospitals in the District 9 No. 3 Rate 4 Under 1 Year of Age At all Ages Rate 13 No. 5 Rate per 1,000 Births registered 6 No. 7 Rate 8 No. 12 1944 44,800 846 18.9 28 33 722 16.1 453 209 296 809 18.1 1945 47,040 18.0 13 15 582 12.4 357 147 251 686 14.6 848 1946 56,320 1,353 24.0 18 13 728 12.9 424 191 242 779 13.8 1947 25.9 22 14 13.0 421 198 209 777 13.2 59,040 1,531 766 1948 60,410 1,218 20.2 16 13 676 11.0 332 166 200 710 11.8 1949 60,440 1,140 18.9 16 14 664 11.0 301 108 170 726 12.0 1950 59,810 1,146 19.2 10 9 731 12.2 413 181 175 725 12.1 1951 60,380 1,062 17.6 10 9 723 11.9 417 180 200 743 12.3 1952 16.7 5 5 771 12.9 510 216 183 738 12.5 59,780 998 1953 59,350 970 16.3 28 664 214 585 9.9 28 11.2 445 135 Averages for years 1944-1953 56,737 1,111 19.6 17 15 703 12.5 407 181 206 728 13.0 CAUSES OF, AND AGUS AT, DEATHS DURING THE YEAR 1954. Causes of Death Deaths at the subjoined ages of "Residents" whether occurring in or beyond the District All Ages Under 1 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and under 75 75 and upwards Tuberculosis, respiratory 14 - - 1 - 4 4 3 2 Tuberculosis, other - - - - - - - - - Syphilitic disease 1 - - - - - - - 1 Diphtheria - - - - - - - 1 - Whooping Cough - - - - - - - - - Meningo-coccal infections 1 - - - - - 1 - - Acute poliomyelitis - - - - - - - - - Measles - - - - - - - - - Other infective and parasitic diseases 1 - - - - 1 - - - Malignant neoplasm, stomach 21 - - - 1 7 8 5 - Malignant neoplasm, lung, bronchus 31 - - - 3 16 7 5 - Malignant neoplasm, breast 14 - - - - 1 9 2 2 Malignant neoplasm, uterus 5 - - - - 1 2 2 - Other malignant and lymphatic neoplasms ...... 55 - - - - 6 22 15 12 Leukaemia, aleukasmia 3 - - - - 1 1 - 1 Diabetes 7 - - - 1 - 2 4 - Vascular lesions of nervous system 52 - - - - - 12 16 24 CAUSES OF, AND AGES AT, DEATHS DUBING THE YEAR 1954—continued. Causes of Death Deaths at the subjoined ages of " Residents " whether occurring in or beyond the District All Ages Under 1 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and under 75 75 and up-wards 9 - - - - 1 10 4 5 Hypertension with heart disease 63 - - - - 1 10 19 33 Other heart disease 43 - - - - - 5 15 23 Other circulatory disease 1 - - - - - - 1 - Influenza 1 1 - 2 5 7 16 36 4 Pneumonia - - - - 16 9 18 44 1 Bronchitis Bronchitis 4 1 - - - - 2 1 - 4 4 Ulcer of stomach and duodenum 12 - - — 2 2 - Ulcer of stomeach and duodenum 2 - - - 1 7 2 1 - Gastritis, enteritis and diarrhœa 5 - - - 1 1 2 1 - Nephritis and nephrosis 9 - - - - - - 3 6 Hyperplasia of prostate 9 - - - - 1 - - Pregnancy, childbirth, abortion 8 6 - - - 1 1 - 7 Congemital malformations 44 11 1 - 1 2 11 11 7 Other defined and ill-defined diseases 4 - 1 1 - 1 - 1 1 Motor vehicle accidents 13 - - 1 - 2 4 1 5 All other accidents 4 - - - - 1 2 1 - Homicide and operations of war - - - - - - - - - - 573 23 3 3 2 32 156 190 164 Total Certified Deaths INFANTILE MORTALITY. Deaths from Stated Causes at Various Ages under One Year of Age, 1954 Under 1 week 1—2 weeks 2—3 weeks 3—4 weeks Total under 1 month 1—3 months 3—6 months 6—9 months 9—12 months Total under 1 year Cause of Death Measles - - - - - - - - - - Scarlet Fever and Streptococcal Sore Throat - - - - - - - - - - Whooping Cough - - - - - - - - - - Diphtheria - - - - - - - - - - Influenza - - - - - - - - - - Meningococcal Infections - - - - - - - - - - Tuberculous Meningitis - - - - - - - - - - Non-Meningococcal Infections - - - - - - - - - - Tuberculosis of Respiratory System - - - - - - - - - - Other Tuberculous Diseases - - - - - - - - - - Syphilis and its Sequelæ - - - - - - - - - - Bronchitis - - - - - - 1 - - 1 Pneumonia 1 - 1 - 2 1 - 2 - 5 Other Respiratory Diseases 1 1 - - 2 - - 1 - 3 Gastro Enteritis and Colitis - - - - - - - - - - 4 4 - - - - 4 Congenital Malformations - - - Birth Injuries, Post-Natal Asphyxia and Atelectasis 4 2 6 1 - - 7 - - - Infections of the Newborn - - - - - - - - - - Other Diseases peculiar to Early Infancy and Immaturity Un-qualified 1 - - 1 - - - - 1 - - 1 1 - Other Causes 1 - - - - 2 12 3 1 - 16 3 1 3 - 23 Totals EXTRACTS FROM VITAL STATISTICS, 1954. Births. Registered— Total Males Females Live Births Legitimate 934 463 471 Illegitimate 33 18 15 Total Males Females Stillbirths Legitimate 18 7 11 Illegitimate 1 1 - Rate per 1,000 total (live and still) births 23.3 Notified within 36 hours of birth — (1) Live Births, 967 (2) Stillbirths, 19 (3) Total, 986 Total Males Females Deaths 579 323 256 Maternal Deaths. Deaths. Rate per 1,000 total (live and still) births Deaths from complications of pregnancy, childbirth and the puerperium 1 1.14 Death Kate ol Infants under I year of age. All Infants per 1,000 live births 23.8 Legitimate infants per 1,000 legitimate live births 21.4 Illegitimate infants per 1,000 illegitimate live births 93.9 Day Nurseries. Number of day nurseries 4. Deaths from Malignant Neoplasms (all ages) .. .. 126 INFECTIOUS DISEASES. NOTIFICATION OF INFECTIOUS DISEASES Every medical practitioner attending on, or called in to visit a patient, shall, as soon as he becomes aware that the patient is suffering from a notifiable infectious disease, send to the Medical Officer of Health of the district in which the disease occurs a certificate stating the name and address of the patient and the disease from which the patient is suffering. Books of certificates are available free of charge from this Department. The following diseases are notifiable : — Acute Encephalitis Malaria Acute Influenzal Pneumonia Measles Acute Primary Pneumonia Membranous Croup Acute Poliomyelitis Meningococcal Infection Anthrax Ophthalmia Neonatorum Cholera Plague Continued Fever Puerperal Pyrexia Diphtheria Relapsing Fever Dysentery * Scabies Enteric Fever (includes Typhoid and Paratyphoid) Scarlatina or Scarlet Fever Erysipelas Small-pox Food Poisoning Tuberculosis Glanders Typhus Fever Hydrophobia in Man Whooping Cough Leprosy (to be notified to Chief Medical Officer, Ministry of Health) *A notification is not required where to the knowledge of the medical practitioner, a case of scabies has occurred in the house and has been notified within the four weeks immediately preceding the date on which he first became aware of the disease in the case he is attending. FOOD POISONING Seven cases of food poisoning were notified to me during the year under The Food and Drugs Act, 1938, Section 17. DISINFECTION. The figures showing the work done in the disinfecting station are set out below. Pillows 341 Beds 20 Blankets 1,493 Pillows (cases) 216 Bolsters 10 Quilts 210 „ (cases) 2 Sheets 406 Miscellaneous 1,699 Books 296 Cushions 4 Verminous Clothing 1,229 Overlays 296 Number of rooms disinfected 345 Number of mattresses and other articles destroyed 504 Furniture, Floorcloth, etc., destroyed 75 Loads CLEANSING STATION. Verminous persons cleansed Adult Females 36 Adult Males 124 Children 665 Persons treated for Scabies : — Number treated Number of baths given Adult Females 9 24 9 18 Adult Males 12 39 Children, Females (School Age) Children, Males ( „ „) 5 14 Children, Females (Under School Age) 1 3 Children, Males ( „ „ „) 1 3 (16) TYPHOID CARRIER In 1943 following a small outbreak of Typhoid Fever in Bermondsey, involving 3 persons and resulting in 1 death, the source of the infection was traced to a Mrs. A. M., a relative of those infected. She received treatment in hospital for about three months but was discharged as a chronic fæcal carrier of B. Typhosus. Nothing further happened until December, 1954. It was then found that Mrs. A. M., whose husband had recently died, had been forced to go out to work to support herself and her son, aged 12 years, and that she had obtained employment at a restaurant. As soon as this was discovered she was asked to attend St. Olave's Hospital and I later received a report that B. Typhosus had been isolated from her fæces. It was therefore necessary to apply the provisions of the Public Health (Infectious Disease) Regulations, 1953, and notices were sent to Mrs. A. M., and to her employers prohibiting her employment in a food trade for the time being. The Public Health Committee also agreed to the payment of compensation for loss of earnings for a limited period while Mrs. A. M., obtained work not concerned with the handling of food. This was done under the provisions of Section 278 of the Public Health Act, 1936. Shortly after this a cholecystogram, taken at St. Olave's Hospital, showed that gall-stones were present and it was considered that if a cholecystectomy was performed, it might eliminate the focus of infection. With the consent and co-operation of Mrs. A. M., a cholecystectomy was performed and since then no typhoid bacilli have been cultured from the stools and it is possible that the carrier state has been remedied. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1954. NUMBER OF CASES NOTIFIED Saints Central Raymouth South NOTIFIABLE DISEASE Neckinger Tunnel Dockyard Park Willow Walk South West Abbey Thorburn Total Total Cases removed to Hospiral Leather Market At all Ages At Ages—Year 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 & up-wards 1 - 1 1 Diphtheria (including Membranous Croup) - - 1 - - - - - - - - - 1 - - - - - - - - - - 7 - 2 - - - 2 - 1 2 - - 2 1 1 1 - - - 1 1 - - 7 3 Erysipelas - - - 17 43 2 - - - - - - - 1 3 3 5 4 2 8 3 9 7 5 62 Scarlet Fever 6 6 8 62 Meningococcal Infection 6 2 - 1 - - - - - 1 1 - 1 - - 2 — - - - - - 2 6 6 1 1 Dysentery 56 2 16 10 1 2 6 6 4 2 3 4 4 1 16 18 5 1 2 - 4 - 1 4 65 4 - Paratyphoid Fevers 2 - 1 1 - - - - - - - - - - - - 2 - - - - - - 2 2 - - Puerperal Pyrexia 1 - - - - - - - 1 - - - 1 - - 1 1 - - Food Poisoning 7 - - - - - 1 1 1 3 1 - - - 2 1 - 2 2 - - 7 - - Ophthalmia Neonatorum 1 1 - - - - - - - - - 1 - - - - - - - - - - - 1 - - - Pneumonia (Acute Primary and Acute Influenzal) 2 4 19 - 2 4 - 2 1 2 3 1 1 - 1 - - 1 1 1 2 2 4 4 19 - - Whooping Cough 135 14 57 58 6 - - - - 3 16 11 22 9 4 13 13 - 5 4 6 29 135 2 - - - Measles 183 11 89 76 5 1 - 1 - - - 2 6 2 11 10 14 29 22 9 10 32 8 28 183 8 - Scabies 5 - 2 1 - 1 1 - - - - - 1 - - - - - - - - 1 - 1 2 5 - Tuberculosis— Respiratory System 5 2 2 3 7 17 6 12 9 4 10 4 3 7 5 2 4 10 4 3 63 63 - - 3 4 - - 1 - 10 - 10 Other forms of Tuberculosis - 2 - - - - 2 1 - - - - 1 2 - 1 3 2 5 - - 15 29 14 25 35 39 61 32 34 51 558 19 Totals 558 30 187 17 8 57 49 20 46 32 77 39 204 13 22 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEARS 1945-1954. Notifiable Disease. 1945 1946 1947 1948 1949 1950 1951 Small Pox - - 1 - - - - Diphtheria (including Membranous Croup) 31 22 34 37 65 3 2 Erysipelas 14 15 12 13 7 9 9 Scarlet Fever 95 82 152 199 85 72 82 Meningococcal Infection - 5 3 1 - 1 6 Acute Polio-Myelitis and Acute Polio-Encephalitis 2 4 27 7 4 3 2 Ophthalmia Neonatorum 4 10 2 5 3 - 1 Anthrax - - 1 1 - - - Enteric Fever 2 - 1 - - - Puerperal Pyrexia 7 8 4 5 5 4 Puerperal Fever 2 - 4 - - - Food Poisoning 32 12 - - - - Dysentery 32 12 4 2 1 4 131 Paratyphoid Fevers - - - - - - 131 Malaria 1 4 - 1 1 - - Malaria (Induced) 1 - - - - - - Pneumonia (Acute Primary and Acute Influenzal) 66 54 57 43 16 52 28 Whooping Cough 42 233 297 237 40 267 75 Measles 544 521 334 899 771 367 1197 Scabies 366 253 81 42 7 2 6 Tuberculosis— ... XAj 2 100 Respiratory System 126 105 89 129 100 105 120 Other forms of Tuberculosis 14 14 16 27 12 10 9 Totals 1,349 1,366 1,125 1,638 1,164 863 1,656 TUBERCULOSIS. In Table I are set out particulars of new cases and deaths during the year, and Table II shows the state of the Notification Register. TABLE I. TUBERCULOSIS, 1954—NEW CASES AND DEATHS. AGE PERIODS NEW CASES DEATHS Pulmonary Non- Pulmonary Pulmonary Non- Pulmonary M. F. M. F. M. F. M. F. 0 - - - - - - - - - 1 - - - - - - - 2 - - 2 - - - - - 2 5 2 5 1 - - - 2 - 10 - - - - - - 1 - 15 2 - - - - - 5 20 8 - - - - - - 12 25 16 1 - 2 - - - 7 35 2 1 - - - 1 - 10 45 3 1 1 3 - - - 9 55 1 1 - 1 - - - 65 3 2 - 2 1 - - - 75 and upwards 2 - - - 2 - - - 53 36 5 6 9 5 - - TABLE D. TUBERCULOSIS, 1954—NOTIFICATION REGISTER Respiratory System Other Forms Males Females Males Females Number of Cases on Register at commencement of Year 324 245 38 39 Number of Cases Notified during Year 41 22 4 6 Inward Transfers, Un-notified Deaths, etc., during Year 12 14 1 1 Number of Cases Removed from the Register during Year 49 30 3 6 Number of Cases Remaining on the Register at end of Year 328 251 40 40 Summary of Tuberculosis Notifleations during the period from the Ist January, 1954, to the 31st December, 1954. Age Periods Formal Notifications Number of Primary Notifications of New Cases of Tuberculosis 0 to 1 1 to 2 2 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 and upwards Total (all ages) Pulmonary, Males - - 2 2 1 3 7 6 9 8 2 1 41 - - - - 1 - 2 4 10 - 3 1 1 - 22 Females Non-Pulmonary Males - - 2 - - - - - - 1 1 - - 4 - - - 5 - - - - - 1 - - - 6 Females New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the above-mentioned period, otherwise than by formal notification: — 2 to 5 45 to 55 0 to 1 1 to 2 5 to 10 10 to 15 15 to 20 20 to 25 35 to 45 55 to 65 65 to 75 75 and upwards Age Periods . 25 to 35 Total Pulmonary, Males - - - - - - 2 5 1 1 1 1 1 12 - - 4 - - 1 - - 6 2 - - 1 14 „ Females - - - - - - - 1 - - - - - 1 Non-Pulmonary Males - - - - - „ Females - - - 1 - - - 1 - SANITARY CIRCUMSTANCES OF THE BOROUGH HOUSING. During the year 3 Clearance Areas were represented in Abbey Street (North), Abbey Street (South) and Kinross Street/Tanner Street. A total of 109 flats was completed at Pynfolds, Ainsty Estate and Longfield Estate, and a further 32 flats were erected in co-operation with the Gomm Housing Association. A further 4 two year hutments were closed and accommodation for 222 familes was provided in properties controlled by the Council. 326 families were accommodated by the London County Council. 17 Bermondsey families were accommodated in new towns. HOUSING ACT, 1936—OVERCROWDING. The following new cases of overcrowding have been encountered during the year:— In private dwellings 10 In Bermondsey Borough Council dwellings — In London County Council dwellings 1 Total 11 Total number of cases of overcrowding at present on the Register 495 ERADICATION OF BED BUGS. The following table shows the fumigations carried out during 1954 :— Disinfested Council houses or flats 39 Other houses or flats 114 INSPECTIONS, PROCEEDINGS, ETC. Hereunder will be found particulars of Inspections, Proceedings, etc., for the year 1954 : — Inspection of Dwelling-Houses during the Year : — (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 4,555 (b) Number of Inspections made for the purpose 23,275 (2) (a) Number of dwelling-houses (included unde: sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 565 (b) Number of Inspections made for the purpose 1,181 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 11 (4) Number of dwelling-houses (exclusive of those referred to under the preceding subhead) found not to be in all respects reasonably fit for human habitation 470 Remedy of Defects during the Year without Service of Formal Notices :— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 1,492 Action under Statutory Powers during the Year :— (A) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936 (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices :— (a) By owners Nil (b) By Local Authority in default of owners Nil (B) Proceedings under Public Health Acts : — (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 2,396 (2) Number of dwelling-houses in which defects were remedied after service of formal notices :— (a) By owners 904 (b) By Local Authority in default of owners 5 (C) Proceedings under Sections 11 and 13 of the Housing Act, 1936: — (1) Number of dwelling-houses in respect of which Demolition Orders were made 4 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (D) Proceedings under Section 12 of the Housing Act, 1936 : — (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 27 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil (E) Proceedings under the Local Government (Miscellaneous Provisions) Act, 1953 :— (1) Number of dwelling houses in respect of which Closing Orders were made under Section 10 (1) 7 (2) Number of dwelling houses in respect of which undertakings were received not to use for human habitation 2 Prosecutions Under the Public Health (London) Act, 1936 :— (1) Number of prosecutions 38 (2) Fines imposed £7 0 0 (3) Costs awarded £91 7 0 REGISTERED PREMISES— Number on Register at end of 1953 Premises Number of Inspections Number of Prosecutions - Common Lodging Houses 2 44 Seamen's Lodging Houses - - - - Milkshops 121 217 Ice Cream Premises 188 77 - Offensive Trades (including Poultry Slaughter-houses - 8 58 SMOKE NUISANCES — Number of observations 439 Number of notices 5 Number of complaints 6 Number of summonses Nil WATER SUPPLY TO TENEMENT HOUSES— Premises supplied Nil Prosecutions Nil SALE OF FOOD— Number of premises used other than ice-cream premises, milk-shops and cowsheds 617 Number of inspections 1,413 RAG, FLOCK AND OTHER FILLING MATERIALS ACT, 1951 :- Number of premises registered 3 DRAINAGE WORK. Particulars of work carried out by the Drainage Inspector curing 1954 : — Drains Tested 641 Visits to Conveniences and Urinals 1502 Other Visits 279 Total visits 2422 (25) HOUSING REPAIRS AND RENTS ACTS, 1954. This Act has been in operation during the last four months of the year under report and has brought additional responsibilities to the Public Health Committee mainly in connection with the following:— Unfit Houses: Proposals for dealing with unfit houses must be submitted to the Minister by the 30th August, 1955. The information to be supplied is under three headings:— 1. Estimated number of houses unfit for human habitation and suitable only for clearance and individual demolition and the estimated period in years considered necessary for dealing with these houses. 2. Number of houses in clearance areas already covered by operative clearance or compulsory orders or owned by the Council and the number included in clearance areas and for clearance or compulsory purchase orders which have been submitted to the Minister but not yet confirmed. 3. Details of proposed action for the first five years. To obtain the required information it has been necessary to carry out a certain amount of survey work to augment the general knowledge of the conditions in the Borough. The proposals to be submitted to the Minister are required to be submitted jointly with the London County Council. Repairs Increases: The Act permits an increase in the rents of houses let under a controlled tenancy or occupied by a statutory tenant. This increase is subject to the following conditions —that the house is in good repair and reasonably suitable for occupation having regard to the standard of fitness laid down in the Act and that the landlord has produced satisfactory evidence that work of repair to the value specified in the Act has been carried out during the requisite period. The standard of fitness requires that regard shall be had to the condition of the house in respect of the following matters: —(a) repair; (b) stability; (c) freedom from damp; (d) natural lighting; (e) ventilation; (f) water supply; (g) drainage and sanitary conveniences and (h) facilities for storage, preparation and cooking of food and for the disposal of waste water. The amount of the rent increase is related to the gross value of the house and where the landlord has elected not to be responsible for internal decoration the permitted rent increase is reduced by one-third. No increase is recoverable unless the landlord has served on the tenant the prescribed form of notice. Certificates of Disrepair: A tenant served with a notice of increase may apply to the local authority for a certificate that the conditions justifying an increase are not fulfilled. The local authority if satisfied that the house fails to fulfil either or both of the conditions shall certify accordingly in the prescribed form. The Certificate gives details of the defects of repair and defects as to suitability for occupation where applicable. The Certificate is deemed to be in force as from the date of the application therefore and during the period it is in force and provided a copy has been served on the landlord, no repairs increase or the 40 per cent permitted increase under the Increase of Rent and Mortgage Interest (Restrictions) Act, 1920 is recoverable. Where the landlord has executed to the satisfaction of the local authority such work as is required to remedy the defects specified in the certificate, the landlord may make application to the local authority for the certificate to be revoked. When the certificate is revoked the permitted increases become recoverable by the landlord. The same provisions apply to the increases permitted by the Increase of Rent and Mortgage Interest (Restrictions) Act, 1920 which means that where a tenant is paying the increase under this Act he may apply for a Certificate of Disrepair. From the date of the operation of the Act until the end of the year 12 applications for a Certificate of Disrepair were granted and one application was refused. Arrangements were made for members of the public to be given advice on matters connected with repairs increases and Certificates of Disrepair and 96 people were so advised. Inspections in connection with the survey and applications for Certificates of Disrepair have taken up much of the Inspectors' time and the administrative work has increased correspondingly. WORK OF DISTRICT INSPECTORS, 1954 Mr. Kerridge Mr. KNOTT Mr. WEIGHTMAN Mr. SPRINGETT Mr. SMITH Mr. MAHONEY TOTALS 1 House-to-House 105 323 194 121 272 166 1181 2 Special Inspections 2 656 850 292 519 869 520 3706 Complaints 3 776 505 752 481 560 389 3463 Infectious Diseases 4 51 68 78 68 109 65 439 Rats 36 5 32 81 29 41 20 239 Outworkers' Inspection 22 36 6 28 20 27 43 176 Drains Tested 36 7 33 36 45 43 52 245 8 Other Calls and Visits 1458 2825 2103 2950 2708 2027 14071 Chimneys watched 1 3 9 47 - 151 3 205 - - 10 Bakehouses 2 1 - 19 22 Common and Seamen's Lodging - 6 11 1 1 - 36 44 6 12 Butchers 26 12 48 112 11 82 285 - 22 - 13 Fishmongers, Friers and Curers 7 21 3 53 94 98 34 14 Food Stores 64 68 25 383 Fruiterers and Greengrocers - 22 5 15 3 15 - 45 - - Pet Animals 16 3 - - 3 - 49 3 17 Markets 4 35 58 2 151 Restaurants and Eating Houses - 3 - 18 40 4 18 65 7 Destruction of Food 19 10 10 24 54 4 109 Totals Visits Intimation Notices 4026 424 5213 441 4185 483 4334 331 4369 404 2758 313 24885 2396 20 FACTORIES AND OTHER PREMISES. HOMEWORK. Section 110 Section 111 Number of out-workers in August list required by Section 110 (1) (c) Number of cases of default in sending lists to the Council Number of prosecutions for failure to supply lists Number of instances of work in unwholesome premises Notices served NATURE OF WORK Prosecutions Wearing Apparel— Making 44 - - - - - (29) Cotton Bags 8 - - - - - Sacks - - - - - Paper Bags - - - - - - The making of Boxes or other Receptacles or parts thereof made wholly or partially of paper 9 - - - - - Brush making - - - - - - Publishers 5 - - - - - Artificial Flowers 1 - - - - - Carding of Buttons, etc. - - - - - - Christmas Crackers 1 - - - - - Fancy Goods 2 - - - - - Total 70 - - - - - FACTORIES AND OTHER PREMISES. INSPECTION. Number of Number on Register Premises Written Notices Occupiers Prosecuted Inspections 272 191 1 - Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 2135 - 502 10 52 (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers premises) 18 - - 792 - Total 2378 11 DEFECTS FOUND. Number of Cases in which Defects were found Number of defects in respect of which Prosecutions were instituted Particulars Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector - Want of Cleanliness (5.1.) - - - - ture (S.3.) 1 1 - - - Overcrowding (S.2.) Unreasonable Temperature - - - - - Inadequate Ventilation (5.4.) Ineffective Drainage of 1 1 - - - Floors (S.6.) - - - - - Sanitary Conveniences (S.7.)- Insufficient - - - - - Unsuitable or Defective 9 9 - 2 - Not separate for Sexes - - - - - Other Offences (Not including offences relating to Home Work) - - - - - Total 11 11 - 2 - BAKEHOUSES. In Use Not in Use Underground Above ground Above ground Underground - 25 1 - 26 of these are Factory Bakehouses HOUSE, TRADE AND MARKET REFUSE. The following table shows the amount of house, trade and market refuse disposed of during 1954 :— Loads cwts. Disposal tons qrs. 9,711 - House Refuse to Barge 15,516 12 2,942 3 Trade Refuse to Barge 5,112 2 Street and Open Markets Refuse to Barge 475 15 - 608 13,128 10 2 Totals 21,237 OFFENSIVE TRADES. The offensive trades on the Register are as follows :— Fellmongers — 3 Dresser of Fur Skins 4 Glue and size makers 1 PET ANIMALS ACT, 1951. During the year 12 licences to keep a pet shop were granted. Five of these were in respect of stalls in market places. Inspections are made to ensure that the terms of the licence are complied with. CATERING ESTABLISHMENTS Inspections 582 Notices served 35 Re-visits 161 During the year 9 lectures with film shows were given to managements and staff of catering establishments ; the total number attending was 223. WORK OF THE FACTORIES AND SHOPS INSPECTOR. Shops. Visits 68 Notices served under Shops Act, 1934 Notices served under Public Health (London) Act, 1936 2 Factories (with mechanical power). Visits 321 Notices under Factories Act, 1937 10 Notices under Public Health (London) Act, 1936 1 Factories (without mechanical power). Visits 59 Notices under Factories Act, 1937 1 Notices under Public Health (London) Act, 1936 Workplaces. Visits 52 Notices under Public Health (London) Act, 1936 1 Visits to Offensive Trade premises 58 Smoke observations 234 Visits to Conveniences and Urinals 197 Other calls and visits 470 (33) RODENT CONTROL Prevention of Damage by Pests Act, 1949. Type of Property Local Authority Dwelling Houses All other (including Business and Industrial) Total number of properties in Local Authorities District 33 15,160 2,297 (a) 6 322 Number of properties inspected by the Local Authority during 1953 as a result of (a) of notification or (b) otherwise. 122 (6) 12 2 386 Major — - 34 Number of properties (under II) found to be infested by rats. 202 Minor 12 246 Number of properties (under II) found to be seriously infested by mice 2 122 84 324 Number of infested properties (under 111 and IV) treated by the Local Authority 14 259 Number of Notices served under Section 4 :— 1. Treatment - - - 2. Structural Works (i.e. Proofing) - - - Total - - - Number of cases in which default action was taken by Local Authority following issue of Notice under Section 4 - - - - Legal Proceedings - - Number of " block " control schemes carried out FOOD CONTROL. PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1931/48. FOOD AND DRUGS ACT, 1938. Sixty-nine samples were taken during the year by the Wharves Inspectors. Article Examined No. of Samples Purpose of Examination Result Action Acetic Acid 1 To ascertain composition Satisfactory Released Anchovy Paste 1 For presence of preservatives „ „ Apricots, Dried 3 „ „ „ Sulphur Dioxide 2,000 parts per million „ Released with warning to importer 1 „ „ „ Carrots, Dried 1 Satisfactory Released „ „ Corned Beef Loaf 1 For presence of preservatives and metallic contamination „ „ Corned Beef with Cereal 4 For metallic contamination „ „ Crab, Canned, Dressed 2 For presence of metals and preservatives „ „ Crab Paste 1 To ascertain composition Fish content 66% instead of not less than 70% as required by Food Standards (Fish Paste) Order, 1951 Re-exported Cream, Tinned 3 For fat content Satisfactory Released Cucumbers, Pickled 1 For presence of preservatives „ „ Article Examined No. of Samples Purpose of Examination Result Action Released Egg, Frozen 1 To ascertain condition Satisfactory Ham and Pork Liver Spread 1 To ascertain composition „ „ Jam, Plum 1 „ „ „ „ „ Raspberry 1 „ „ „ „ „ Strawberry 1 „ „ „ „ To ascertain condition Lard 1 Re-exported (Imported without Official Certificate) „ „ „ Released Lard 2 „ 1 To ascertain composition Margarine „ „ 2 For preservatives and metals „ Mayonnaise „ 2 For presence of preservatives „ Mustard, French „ 2 „ „ German „ „ 5 Oranges, Spanish „ „ „ Re-exported 1 „ „ Thiourea found in rind and juice „ „ Detained for correct labelling and released with warning to importers 1 „ „ Piccalilli Benzoic acid 350 parts per million, not declared. Maximum permitted —250 parts per million 1 Detained for correct labelling and released Pickles, Mixed „ „ Benzoic acid 100 parts per million, not declared 3 To ascertain condition Released Prunes Satisfactory Butter Beans cleaned and released Powder-contaminated Butter Beans To ascertain composition Powder harmless 2 To ascertain condition Rice Satisfactory „ Article Examined No. of Samples Purpose of Examination Result Action 1 For presence of preservatives For metallic contamination Satisfactory Sardella Paste Released „ Sardines 14 „ 1 For presence of preservatives Sauce containing Meat and Ham „ „ 1 „ „ „ Sausage, Tea „ 1 To ascertain composition Tomato Sauce with Meat Meat present so small that it could only be regarded as flavouring Released with warning to importers 1 „ „ Bacon present so small that it could only be regarded as flavouring Tomato Sauce with Bacon „ „ 1 For metallic contamination Satisfactory Tomato Paste Released 1 „ Vegetables, Dried For presence of preservatives „ SECTION 14, FOOD & DRUGS ACT AND DAIRIES Inspections Ice Cream Premises 188 77 Preserved Food, etc. 79 338 Dairies 4 24 DISPOSAL OF UNSOUND FOOD Condemned food suitable for animal feeding is disposed of for this purpose under supervision. Condemned food for destruction is collected by Council's van and barged with household refuse. FOOD PREMISES AND TYPES OF BUSINESS Restaurants, cafes and snack bars 163 Factory Canteens 95 Groceries and Provisions 69 Butchers 55 Greengrocers and Fruiterers 58 Fishmongers 32 Bakers 31 Confectioners 35 Public Houses: — (a) Selling food 114 (b) Not selling food 39 Food Factories 178 Wholesale Food Stores 115 Food Wharves and Depots 53 UNSOUND FOOD. The general inspection of food in shops and on stalls forms part of the duty of the District Sanitary Inspectors. Food, in the quantities stated, came under the notice of the Inspectors during the year, and being found unfit for human consumption was destroyed or disposed of for purposes other than human food. Description of Food Weight tons cwts. qrs. lbs. Meat — 9 2 12 Meat, Canned -3 1 4 F i sh - - 1 14 Fish, Canned — — — 18 Fruit, Canned — 3 — — Milk, Canned - - 2 - Eggs — — 2 18 Vegetables, Canned - - 1 1 27 Various — 1 — 27 Total 1 — 1 8 PHARMACY AND POISONS ACT, 1933 AND PHARMACY AND MEDICINES ACT, 1941. Sixty-five premises were entered on the Council's list for the year under report. As a result of samples being purchased, it was found that two contraventions of the Act occurred, poisons being sold wrongly by unlisted vendors. Warning was given in both cases. MILK PREMISES. FOOD AND DRUGS ACT, 1938/50. MILK AND DAIRIES REGULATIONS, 1949. Thirteen milk sellers were registered under the above Acts during 1954, and 9 were removed from the Register. There were 117 milk sellers on the Register at the end of the year. MILK (SPECIAL DESIGNATION) (RAW MILK) REGULATIONS, 1949. MILK (SPECIAL DESIGNATION) (PASTEURISED AND STERILISED) REGULATIONS, 1949. During the year under report the following licences were granted: — Dealers' Licences. To sell Tuberculin Tested Milk 48 To sell Pasteurised Milk 79 To sell Sterilised Milk 115 Supplementary Licences. To sell Pasteurised Milk 16 To sell Tuberculin Tested Milk 16 To sell Sterilised Milk 21 All premises used for the sale of milk are regularly inspected to ensure that the standard of cleanliness laid down is maintained. MILK SAMPLING. Samples of milk, both for bacteriological and chemical examination, are taken from milksellers, and special arrangements are made for the sampling of the milk supplied to all schools, school meals services and hospitals in the borough. The total number of samples submitted for analysis during 1954 was 515, of which number 214 were taken from schools, hospitals, etc. For Chemical (i.e., Fat and non-Fatty Solids) Analysis. Condensed Mill 11 Sterilised Milk 47 Pasteurised Milk 195 Tuberculin Tested (Pasteurised) Milk 20 Channel Islands Milk 19 South Devon Milk 1 Liquid Milk, undesignated 3 296 For Bacteriological Examination. For tubercle bacilli 4 For brucella abortus 2 6 For Examination under Milk (Special Designations) Regulations Pasteurised Milk (from schools, hospitals, etc.) 107 Pasteurised Milk (other than from schools) 47 Tuberculin Tested (Pasteurised) Milk 33 Sterilised Milk 32 219 (39) ICE CREAM. 80 samples of ice cream have been examined, with the following results: — 1. Bacterial Count. Up to 500 per 1 c.c. 22 Over 500 to 1,000 per c.c. 7 Over 1,000 to 5,000 per 1 c.c. 16 Over 5,000 to 10,000 per 1 c.c. 9 Over 10,000 to 50,000 per 1 c.c. 10 Over 50,000 to 100,000 per 1 c.c. 1 Over 100,000 to 200,000 per 1 c.c. 3 Over 200,000 to 400,000 per 1 c.c. - Over 400,000 to 600,000 per 1 c.c. - Over 600,000 to 1,000,000 per 1 c.c. 2 Over 1,000,000 per 1 c.c. - 70 2. Presence of B. Coll. B. Coli present in 1 c.c. and 1 10th c.c. and 1 100th c.c. B. Coli present in 1 c.c. and 1 10th c.c. 1 B. Coli present in 1 c.c. 1 B. Coli absent in 1 c.c., 1 10th c.c. and 1 100th c.c. 68 70 3. Methylene Blue Grading. Grade 1 41 2 14 A 3 2 4 12 Doubtful result 1 70 4. CHEMICAL ANALYSIS. Ten samples of ice cream were submitted for chemical analysis under the Food Standards (Ice Cream) Order, 1951. All samples were satisfactory. (41) FOOD AND DRUGS. During the year 900 samples were submitted by the Food and Drugs Inspector. In 23 cases the analysis disclosed an infringement of the law. No. Date purchased Sample Infringement Remarks 16.2.54 Dripping Contained 4.9% of Free Fatty Acid instead of not more than 1.5% 791 Letter to manufacturer Pork Sausages 15.3.54 874 Meat content 50% instead of not less than 65% Prosecution Fine £10 Costs £10 10s. 16.3.54 Pork Sausages Meat content 46% instead of not less than 65% 879 Prosecution Fine £5 Costs £4 4s. 19.3.54 Pork Sausages Meat content 60% instead of not less than 65% 899 Manufacturer warned 6.4.54 Milk Contained 8.22% of Milk Solids other than Milk Fat instead of notless than 8.50% 949 Letter to supplier Milk 6.4.54 Contained 8.27% of Milk Solids other than Milk Fat instead of not less than 8.50% 950 Letter to supplier 6.4.54 Milk 951 Contained 8.25% of Milk Solids other than Milk Fat instead of not less than 8.50% Letter to supplier Dripping 6.5.54 Contained 4.5% of Free Fatty Acid instead of not more than 1.5% 67 Letter to manufacturer Non-brewed Condiment 24.5.54 Contained 2.1% of Acetic Acid instead of at least 4.0% 137 Prosecution Fine £4 Costs £3 3s. 13.7.54 Meat content 59.3% instead of not less than 65% Pork Sausages 282 Letter to manufacturer 6.8.54 Non-brewed Condiment Contained 3.1% of Acetic Acid instead of at least 4.0% 373 Prosecution Fine £2 Costs £2 2s. 6.8.54 Machineskimmed Condensed Milk, Sweetened Equivalent pints 1.72 instead of 1.875 as stated on label 377 Letter to manufacturer Date purchased Remarks No. Sample Infringement Pork Sausages Meat content 60% instead of not less than 65% Letter to manufacturer 380 9.8.54 11.8.54 Pork Sausages Meat content 60% instead of not less than 65% Letter to manufacturer 383 Letter to manufacturer 495 20.9.54 Pork Sausages Meat content 57% instead of not less than 65% Meat content 61% instead of not less than 65% Letter to manufacturer 508 23.9.54 Pork Sausages Meat content 53% instead of not less than 65% Prosecution Summons dismissed 568 9.10.54 Pork Sausages Contained 686 International Units of Vitamin A per ounce instead of not less than 760 Verbal warning to importers 589 14.10.54 Margarine with 10% Butter Letter to manufacturer 25.10.54 Pure Butter Brazils Contained 3.2% of Butter Fat instead of not less than 4.0% 617 Meat content 61% instead of not less than 65% Letter to manufacturer 660 5.11.54 Pork Sausages Deficient in Tincture of Ipecachuana to the extent of 4.3 minims per ½ fl. oz. Letter to Dispenser 783 10.12.54 Prescription Plain Flour Deficient in Calcium to the extent of 7½ ozs. of Creta Preparata per 280 1bs. sack Letter to manufacturer 790 15.12.54 Alcoholic Strength 32.26° instead of 35° under proof Letter to Distillers and Brewers 815 22.12.54 Whisky (43) PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1937/48. Disposed of for purposes other than human food Weight T. C. Q. L. Removed for sorting under Sanitary Authority Weight T. C. Q. L. Destroyed Weight T. C. Q. L. Re-exported Weight T. C. Q. L. Arrowroot - 3 2 18 - - - - - - - - - - - - Bacon 4 15 1 3 - 2 - 3 2 13 4 - - - - - 92 - 14 21 - Beans 15 2 19 2 20 15 - - - - - Butter - 16 - 14 83 1 10 - - - - - - - - - Cake - - 1 16 - - - - - - - - - - - - Cake Mixture 2 - - 1 1 - - 5 - - - - - - - - Casings - - 2 5 - - 17 12 - - - - - - - - Caviare - - - 1 18 - - - - - - - - Cereals - 13 - - - - - 1 - - 2 8 - - - - Cheese 1 1 12 2 1 2 3 8 - - - - - - - - Cocoa Beans - - - 14 2 26 9 2 1 17 - 10 2 20 - - Crumb 9 15 - 2 - - - - - - - - - - - - „ Powder - 5 3 15 - 2 23 6 3 7 13 2 - - - - Coconut 6 5 2 - 7 3 3 6 13 2 3 - - - - - Coffee Beans - - 2 2 21 - - - - - - - - - - - Confectionery - 7 15 1 5 - - - - - - - - - - - Cooking Fat - - 2 22 2 17 4 - - - - - - - - - Cream, Tinned - - - - 1 13 6 5 2 9 - - - - - - Custard Powder - - 20 - 11 1 - - - - - - - - - - Egg Albumen - - - - - 7 3 16 - - - - - - - - Eggs, Dried - - - 7 3 17 - - - - - - - - - - „ Frozen - - - 12 2 10 - - - - - - - - - - „ Powder - - - - 1 1 8 - - - - - - - - - „ Shell - - - - 7 3 - 2 - - - - - - - - Farinoca - 2 2 1 - - - - - - - - - - - - Fish - 4 1 16 - - - - - - - - - - - - Fish, Canned 2 - 2 9 3 4 - - - - - - - - - - Flour 9 7 21 1 12 - - - - - - - - - - - Fondant - - 10 - - - - - - - - - - - - - - - - 1 12 - - - - - - - - - - Fruit - Fruit, Bottled - - - - - - - 12 - - - - - - - - „ Canned - 5 - 9 30 13 - 11 - - - - - - - - „ Dried 2 12 2 16 5 16 1 3 25 16 3 4 - - - - „ Juice & Pulp - - - - 18 13 3 7 3 7 - - - - - - Gherkins - - - - - 8 3 3 - - - - - - - - Ginger - - - - - 27 - - 1 17 - - - - - - Margarine - - - -I - 1 1 13 - - - - - - - - Meat - 5 3 14 - 7 2 26 - - - - - - - - „ Canned 2 12 - 8 33 1 3 - - - - - 2 18 1 20 Milk, Canned - - - 4 1 16 1 17 - - - - - 18 - - „ Powder 1 10 - - - - - - - - - - - - - - Nuts 4 11 2 11 1 3 3 19 25 4 10 - - - - 1 Offals - - - - - 3 - 27 - - - - - 8 - - Olives - - - - - 2 2 - - - - - - - - - Onions - - - - 70 10 2 - - - - - - - - - Paprika - - - - - - 22 - - 3 - - - - - - (44) PUBLIC HEALTH IMPORTED FOOD REGULATIONS, 1937/48—continued. Disposed of for purposes other than human food Weight T. C. Q. L. Destroyed Weight T. C. Q. L. Removed for sorting under Sanitary Authority Weight T. C. Q. L. Re-exported Weight T. C. Q. L. Peas 73 - - - 18 2 2 - - - 16 2 - - - Peel - - 2 - - - - - - - - - - - - Potatoes - - 4 - - - - - - 15 - - - - - - - - - 15 - - Poultry 2 - - - - - - - - Preserves:— Jam - - 3 20 - - - - - - - - - - - Jelly Lemon - - - - - - - 20 - - - - - - - Curd - - - 1 - - - - - - - - - - - Marmalade 1 1 2 19 - - - - - - - - - - - Mincemeat - - - - 2 2 7 - - - - - - - - Rice 16 18 3 22 - 13 6 4 13 3 2 - - - - Sago - 2 3 10 - - - - - - - - - - - Salad Cream - - - - - 6 - - - - - - - - - Sauerkraut - 2 2 6 - 1 1 16 - - - - - - - Sausages - 1 3 16 2 1 24 - 10 14 - - - - - Soups - - - - - 14 1 13 - - - - - - - Soya Lecethin - 16 - 5 - - 2 1 - - - - - - - Suet - 2 1 16 - 2 1 - - - - - - - - Sugar 3 6 2 - - 2 1 - - - - - - - - Tapioca 3 6 2 1 - 2 3 - - 5 5 - - - - Tea 4 18 2 1 - - - - 5 5 1 17 1 15 2 24 Tomatoes, Canned - 14 16 - 6 13 2 32 3 - - - - - - Tomato Concentrate - - - - - 2 20 - - - - - - - - Tomato Juice - 12 7 - - 3 - - - - - - - - - „ Paste - - - - - 14 1 - - - - - - - - - „ Puree 7 5 19 28 13 2 16 - 5 6 2 2 - - - Various 14 10 2 19 23 5 1 8 - - - - - - - Vegetables - 35 18 7 - - - - - - - - - - - „ Canned - 2 1 1 - - - - - - - - - - - „ Frozen - 2 3 - - 29 - - - - - - - - - Whalemeat 29 - - - - - - - - - - - - - - FOOD AND DRUGS ACT, 1938 Legal proceedings taken as result of complaints made by members of the public. Date Offence Result Absolute discharge. Costs £3 3s. Od. 24.5.54 Selling loaf of bread containing cigarette end. Selling Jam Sandwich, the filling of which was decomposing. Fine £5 Os. Od. Costs £5 ss. Od. 4.8.54 Selling Presta Cola containing particles of film of mould. Absolute discharge. Costs £3 3s. Od. 12.8.54 Selling Margarine containing rubber finger stall. Absolute discharge. Costs £5 ss. Od. 6.8.54 Five warning letters were sent to manufacturers in respect of other articles of food complained of by members of the public. (46) WORK OF THE WHARVES AND FOOD INSPECTORS, 1954 VISITS Mr. Toll Mr. Butcher Mr. Tapsfield Mr. Bailey Mr. Hancock Totals 1 Food Wharves and Depots 1451 1878 1486 344 - 5159 2 Food Factories 143 154 183 123 105 708 3 Food Stores 321 533 485 320 82 1741 4 Catering Establishments - - - - 743 743 5 Various 56 134 14 523 809 1536 Ice Cream Premises - - - 77 - 77 6 7 Milksellers - - 217 7 224 8 Pharmacy and Poisons - - - 80 - 80 Consignments of Imported Food Detained 145 60 109 6 - 320 9 10 Condemnation of Food 357 781 124 72 1690 356 11 604 558 242 71 2394 Certificates issued for Unsound Food 919 Intimations Served 2 1 - 3 35 41 12 Number of Samples taken for analysis Bacteriological Chemical Food and Drugs - - - 900 3 903 13 Imported Food Regulations 17 11 - 69 33 8 Milk (Special Designations) Regulations - - - 219 - 219 Milk for T.B. - - - 4 - 4 - - - 2 Milk for Bac. Abortus - 2 Ice Cream - - - 70 - 70 2 Canned Meat 12 11 - - 25 MEALS SERVICE IN OPERATION MISCELLANEOUS SERVICES OLD PEOPLE'S WELFARE The staff of the Department have continued to undertake responsibility for the administrative and secretarial work of the Council for the Welfare of Old People, and their duties have been many and varied. CLUBS: The activities of the Clubs have continued throughout the year and classes have been arranged for handicrafts and singing. Film shows are provided in most clubs once a month by the Borough Council. Each club has held a Christmas Party and Club Leaders have arranged outings to the seaside and to pantomimes and ice shows. The Entertainments Committee of the Borough Council has very kindly arranged entertainment at the afternoon clubs and this has been very much appreciated by the members. These clubs play a great part in providing occupation of one kind or another for their members and many old folk enjoy a new lease of life by becoming members of the Clubs. In addition, these clubs provide a means of information by which a large number of old people can be kept informed of current events and matters of national and local importance. The value of the work done by Club Leaders cannot be over-estimated, and we thank them and those who help them in this work. OUTINGS TO WOMEN'S INSTITUTES: During the summer nineteen visits were paid to Women's Institutes in and around the Home Counties. There is no doubt that these are much enjoyed by the Club members and our thanks are extended to the Women's Institutes for their hospitality and generosity. Several of the clubs have entertained parties from Women's Institutes at their clubs and this strengthens the happy associations with the Women's Institutes. HOLIDAYS: Arrangements were made for 110 people to spend holidays at Ramsgate, Margate and Heme Bay. This was the first year that arrangements had been made for people to go away in any number and from the reports received there seems to be no doubt of the success of the scheme. It is hoped that during the coming summer it will be possible to increase the scope of the holiday scheme. MEALS SERVICE: The operation of the Meals Service was undertaken by this Department and the costs were met by the Council for the Welfare of Old People. During the year the daily average number of meals delivered to the homebound had increased from 42 to 52. This increase has necessitated the use of a second unit in order to meet the demand, and it was also decided to deliver meals on Monday and the service now operates from Monday to Friday. The total number of meals delivered during the year was 10,001. With the advent of Christmas the Meals Organiser was again approached by a firm of popular caterers who offered to supply a 3-course frozen Christmas Dinner comprising soup, chicken, brussels sprouts, baked potatoes, stuffing and Christmas Pudding at very reasonable cost. The offer was accepted and on Christmas Eve, in addition to the ordinary daily meal, 48 of these special Christmas Dinners were distributed by the Secretary of the Council for the Welfare of Old People, who was accompanied by a member of the staff. Owing to the closure of the local London County Council restaurant it became necessary to find an alternative source of supply and the Meals Organiser was able to make arrangements with the firm undertaking the catering at the Municipal Offices. In the autumn a quantity of packet tea and sugar was received from a Bermondsey school for distribution to homebound old people, the Headmaster of the school having recommended his pupils to bring such gifts to the school for their Harvest Festival in place of the customary fruit, flowers, and vegetables. The commodities were distributed to the old folk a little at a time and were greatly appreciated. OUTINGS: It was decided during the summer to arrange for afternoon outings for homebound old folk. It was known that many old people very rarely have the opportunity, by reason of physical incapacity, of getting outside the four walls of their homes and it was felt that something might be done for them. A letter was sent to local practitioners and others who might have knowledge of these people, outlining the scheme and asking them to furnish names and addresses. As a result of this it was possible to arrange four afternoon coach trips around the countryside with tea provided en route. Thanks are due to those helpers who took charge of the parties and for the co-operation of the District Nursing Association for arranging for a nurse to accompany each party, particularly the male nurse who was of great assistance in carrying many of the old folk in and out of the coaches. Many letters of appreciation were received from those who went on the trips and it is hoped that a similar venture can be undertaken during the coming summer. During the spring, gifts of flowers were received from the Hampshire Girl Guides' Association and distributed to the old folk. This has brought a great deal of pleasure to them and this kindness shown by the Guides is much appreciated. NATIONAL ASSISTANCE ACT, 1948. NATIONAL ASSISTANCE (Amendment) ACT, 1951. SECTION 50. Section 50 of this Act imposes on the Council the responsibility to bury or cremate any person found dead in the borough where there are no relatives or friends to make the necessary arrangements. It is also incumbent upon the Council to make extensive inquiries, with the aid of the Coroner and the Police, to ensure that there are no monies or estate from which the cost can be met. On its North side, the borough is bounded for 3½ miles by the River Thames and, during 1954, 8 male and 2 female bodies were recovered on the foreshore. It is interesting to note that of these only two were ultimately indentified as Bermondsey residents, the remainder coming from as far away as Dublin, Liecester, and Folkestone. In the majority of these cases, however, the bodies were identified by relatives who made arrangements for burial. The four cases reported below were also dealt with under this Section of the Act: — 1. Mr. G., aged 74 yrs., who lived alone in a large block of flats and was known by the Superintendent to be extremely ill had refused to go to hospital and was in need of care and attention. A member of the staff who called at Mr. G's address within ten minutes of the case being reported, found the front door unlocked but barricaded on the inside by a chair. After entry was effected, the occupant of the flat was found to be dead in bed, fully clothed. The room and the bed were both very dirty and it was obvious that Mr. G., had been incapable of looking after himself for some time. The police were informed and as there was no evidence of foul play, the matter was referred to the Coroner, who issued a certificate following a post mortem, it having been found that death was due to natural causes. No relatives could be traced and the Department arranged for the burial, the cost of which was met by cash in the deceased's possession and sums recovered from the National Assistance Board. 2. The death of Mr. S., aged 68 yrs., was reported to us by his landlady, who requested the Department to arrange for his burial. No National Assistance or Retirement Pension payments were due, and no money or articles of value were found among the deceased's effects. The cost of the interment was borne by the Council. 3. The Department was notified that a female body in a decomposed condition had been discovered in a flat in one of the tenements in the borough. On inquiry it was found that the woman had been living in the flat at intervals whilst acting as housekeeper to the tenant who had been in hospital for some weeks. All that could be ascertained was that the deceased was a native of Ireland and no relatives could be traced, either by the police or by this Department. The cost of interment was bourne by the Council. 4. The body of Mr. A. G., was found in his flat and, on the Coroner's instructions, was removed to Southwark Mortuary where, following a post mortem, death was found to be due to aortic incompetence and stenosis. The Coroner's Officer made extensive inquiries, but no relatives could be traced and, therefore, this Department arranged for the burial. Certain furniture and effects of no value were collected from the deceased's address and destroyed. A National Health Insurance Card was recovered, however, and an amount of £6 was received from the Ministry of Pensions in this case. SECTION 47. Under Section 47 of the Act, the Council are empowered to apply to a Court for an Order for the removal to hospital, or other institution, of a person who is aged, infirm or physically incapacitated, who is living in insanitary conditions and who is "unable to devote to himself, and is not receiving from other persons, proper care and attention". In addition, the National Assistance (Amendment) Act, which came into force in 1951, authorises a magistrate to order the emergency removal of such people to an institution on certification by the Medical Officer of Health and another practitioner, for periods not exceeding three weeks. Twelve cases were brought to our notice during the year, but only in the three cases reported below was it necessary to use the powers under the Act: — 1. At the request of the District Sanitary Inspector I visited a flat in one of the Council's tenements occupied by Mrs. R., aged 86 yrs., and her son, aged 62 yrs. Mrs. R., who was incontinent, had been looked after and kept clean by the son. Unfortunately, he was a cripple and in failing health, and he had reached a state where the worry and physical effort of looking after his mother was causing him nervous disorder. Attempts were made to persuade Mrs. R., to enter an institution voluntarily, but she refused and, in the circumstances, it was necessary to take action under the Acts. I therefore signed a certificate in accordance with Section 1 of the National Assistance (Amendment) Act, 1951, which was countersigned by Mrs. R's medical practitioner. Application was then made by the Town Clerk to one of Her Majesty's Justices of the Peace for an Order committing Mrs. R., to to an institution for a period not exceeding 14 days. Mrs. R., was subsequently removed to Newington Lodge, Westmoreland Road, S.E.17, where, I regret to report, she died ten days after being admitted. 2. Following a number of complaints of smells from a cottage in the borough, I paid a visit to Mr. A., aged 61 yrs., the tenant. The cottage was in a filthy state and there was evidence that Mr. A., was disposing of his excreta and waste food by throwing it out of the door and windows. The medical practitioner attending Mr. A., was consulted and he agreed that application should be made for an Order committing Mr. A., to an institution for a period not exceeding 14 days. Mr. A., was subsequently admitted to Newington Lodge, Westmoreland Road, S.E.17, after having been bathed in the Council's Cleansing Station and supplied with a complete outfit of clothing. Although some difficulty was experienced in persuading Mr. A., to enter an Old People's Home, when the statutory 14 days had expired he expressed a desire to remain in residence at the Home, where he died six months after admission, the cause of death being certified as Huntington's Chorea. 3. After neighbours' complaints of smells emanating from one of the Council's flats occupied by Mrs. Y., I paid a visit and found both Mrs. Y., and the flat in a filthy condition. There was evidence that Mrs. Y., was incontinent, infested with fleas, and unable to devote to herself proper care and attention. Her medical adviser agreed to sign a joint declaration that she should be admitted to an institution for a period not exceeding 14 days. During this period her flat was disinfested, her clothing and bedding cleaned and laundered, and a Home Help thoroughly cleaned the flat. Mrs. Y., returned home and with the aid of neighbours and regular supervision by members of the staff, has kept herself clean and is living a normal happy life. MORTUARY This Council maintained a mortuary, complete with post-mortem rooms and chapel, until October, 1935, when, owing to the decreasing use made of these facilities, which was partly due to the Coroner's decision in 1930 to hold no more inquests in this borough, and coincident with the retirement of the then Mortuary Keeper, the Council decided to close the mortuary premises and to enter into an agreement with the London County Council for the reception of bodies into the mortuary attached to St. Olave's Hospital, at a fee of £1 1s. 0d. for each body accommodated. This arrangement worked satisfactorily, and the Council's mandatory function under Section 234 of the Public Health (London) Act 1936 has been discharged in this manner ever since. Consequently, since 1935, in all cases where the Coroner has ordered a post-mortem to be performed the bodies have been taken by the Coroner for that purpose to the mortuary maintained by the borough council in which his Court for this area is situated. For many years inquests on persons dying in Bermondsey were held at Lewisham, but owing to a redistribution of coroners' areas they have been held at Southwark for the past few years. Not only are those bodies removed to Southwark for whose accommodation in St. Olave's Hospital we are responsible, but in addition a far greater number are removed from the Hospital to Southwark as a result of deaths in the Hospital. Other isolated cases of removal to Southwark may take place arising from police instructions. Early in the year, the Southwark Borough Council approached this Council with the proposal that Bermondsey, in company with Lambeth and Camberwell, should make a contribution towards the cost of their mortuary premises which include cottage, office, mortuary and viewing room, doctor's room, post-mortem room, and the Coroner's Court. The expenditure, apart from the Coroner's Court which is the London County Council's responsibility, should be borne by the four authorities on the basis of the total number of bodies accommodated on behalf of the four boroughs concerned and the expenditure incurred by Southwark, and it was agreed to contribute year by year our proportion of the expenditure incurred. The number of bodies removed to Southwark from Bermondsey for post-mortem or inquest purposes during the year 1953 was 186, out of a total of 1,504 accommodated from all the boroughs concerned. During the year under review, 207 bodies from Bermondsey (66 from private addresses and 141 from hospitals) were accommodated. WATER SUPPLY The water for industrial and domestic use for the borough is supplied by the Metropolitan Water Board. During 1954 the Board took 1,585 samples for chemical examination and 3,604 for bacteriological examination. No complaints were received during the year. The water is derived from the River Thames at intakes at Walton, Laleham and Staines; stored in the Board's reservoirs at Walton, Littleton and Staines; and filtered and chlorinated at the Board's works at Surbiton, Walton and Hampton. The water is pumped into supply from these works to service reservoirs at Nunhead and Brixton thereby affording a constant supply of water. Contact tanks are provided at Walton and Hampton works to ensure that chlorine completes its action before the water is pumped into supply; plans for the installation of a similar contact tank at Surbiton works are in the process of being prepared. Chlorination treatment is now fully automatic, the dose being adjusted for changes in quality of the water as well as for changes in rates of flow. All sections of new and repaired mains are disinfected with chlorine before being restored to supply and 99.4 per cent of samples collected from new and repaired mains from the whole of the Board's area during 1954 were of first class bacteriological quality namely free from Bacterium coli in 100 ml. volumes. FREE WASHING FACILITIES In the early part of the year a wash-basin was installed at Joiner Street (Male) Convenience for the washing of hands, and in consequence to the demand for its use, similar facilities have now been made available at all the public sanitary conveniences in the borough, both male and female. The number of persons using this free service:— Males 12,976 Females 3,244 These considerable and increasing figures are encouraging. INTERNATIONAL CERTIFICATES OF VACCINATION AND INOCULATION At the request of the Ministry of Health and in order to comply with the International Sanitary Regulations 51 certificates were dealt with during the year. STREET AND OPEN MARKETS Number of licences in operation during 1954: — Street markets 181 Open markets 237 Total 418 Income for 1954: — £ s. d. Street markets 2,571 0 0 Open markets 3,836 4 6 Total £6,407 4 6 Number of prosecutions during 1954 .. Nil Southwark Park Road Market. The land owners of the Open Market site in Southwark Park Road informed the Council in 1953 that they would require the site for development at the end of January 1954. The Council was therefore compelled to look for another site in order to accommodate the existing permit holders on the Open Market. Having considered all possibilities for the accommodation of the traders and heard representations on their behalf by the Federation of Street Traders' Unions, the Council felt that there was no alternative but to license the traders to trade in a portion of the south side of Southwark Park Road. In view of the prevailing traffic conditions, however, it was decided that there should be a trial period, in the first instance, of six months, to take effect from the 1st February ,1954. The Council later decided that licences should be renewed on an annual basis. I am pleased to say that the new market has been worked satisfactorily and has been trouble-free throughout the year. Tower Bridge Road Market. In September, 1954 a deputation from the Bermondsey Street Traders' Protection Association and the Federation of Street Traders' Unions attended before the Public Health Committee in support of a request by the Bermondsey Street Traders that they should be licensed to trade in Tower Bridge Road (west side) between the existing designated section and Rothsay Street. The deputation pointed out that the traders in Bermondsey Street, who had originally been moved from Tower Bridge Road as the result of a Home Office Enquiry, found business in Bermondsey Street very poor. They also stated that the conditions which obtained when the compulsory removal took place were now changed and that the traffic congestion in Tower Bridge Road had been greatly minimised by the abolition of the trams. The Committee considered that there was justification for the application and recommended that the necessary licences be granted for the portion of Tower Bridge Road in question, but that the views of the Home Office be first obtained. The Home Office, on being consulted, had no observations to offer, and 13 licences were accordingly granted. The traders took up their new positions on 13th November, 1954. London Bridge Area. The market in Railway Approach, which was designated in 1952, continues to run smoothly, and I am pleased to report that there have been no prosecutions for unlicensed trading during 1954. The New Caledonian Market. To the people of Bermondsey today, the term "Cally", signifying the New Caledonian Market, Bermondsey Square, has become as common as the "Blue", a term affectionately applied to the street market in Southwark Park Road. To an older generation of Londoners, however, the "Cally" meant the fifteen acres of ground lying off the Caledonian Road, Islington, where, on Tuesdays and Fridays in pre-war years, as many as 40,000 people would swarm around the 2,000 stalls, looking for bargains. The old "Cally" is no more—it was closed down on the outbreak of hostilities in 1939, and, in spite of a vigorous campaign by the former stall-holders, has never been re-opened (it is scheduled for a children's playground under the L.C.C. Development Plan). But some of the THE NEW CALEDONIAN MARKET spirit of the old market remains notwithstanding the fact that there are on the Bermondsey site only 180 stalls as compared with the pre-war 2,000. The New Caledonian Market was formally opened on 3rd February, 1950, by Miss Valerie Hobson, the actress. In spite of its small size it has attracted visitors from all over the world. Hollywood film stars make a point of seeing it when they come to England, and a recent visitor was the evangelist—Billy Graham. The market is open on Fridays and visitors are greeted with a varied array of articles. Gleaming silverware lies next to carvings from the African jungle, and old china next to antiquated firearms; the discerning collector can still occasionally make a "find". Pitches are in great demand and the Council keeps a long list of traders who are awaiting a vacancy. PUBLIC HEALTH LABORATORY SERVICE At the request of numerous medical practitioners, I have pleasure in presenting the following notes regarding this service. The nearest laboratory is:— The Public Health Laboratory Service, Room 617, The County Hall, Westminster Bridge, S.E.1. (Director: Dr. A. J. H. Tomlinson). The Public Health Laboratory Service is a free national laboratory service for England and Wales, designed to assist all those, including the medical departments of the Defence Services, concerned in the diagnosis, prevention and control of communicable diseases. The benefits are not limited by health authority, hospital region or other administrative boundary. Its laboratories are open to all doctors both for the submission of specimens and for consultation. GENERAL SCOPE OF THE SERVICE. Routine Laboratory Work. The routine work falls under two main heads: the bacteriological examination of (a) "medical" specimens from general practitioners, infectious diseases hospitals and local authorities and (b) "sanitary" specimens from local food authorities. The laboratories of the Service normally do not undertake work which is rightly the province of the hospital or clinical pathologist, but they are prepared to offer all help within their power when facilities for such work are not available elsewhere. Distribution of Biological Reagents. The Service performs a useful function in distributing a number of reagents for prophylactic immunization and for certain intracutaneous diagnostic tests. PROPHYLACTICS Smallpox vaccine Diphtheria prophylactics Gamma globulin for prevention or modification of measles. Anti-rabic vaccine Anti-typhus vaccine Prophylactic anti-anthrax serum. Available at most P.H.L.S. laboratories for issue to individual doctors or clinics. Available at all P.H.L.S. laboratories for issue to public health departments. Available to individual doctors —limited stocks in most P.H.L.S. laboratories for issue under strictly defined conditions. Available to individual doctors from Liverpool, London, Newcastle and Cardiff laboratories only. Available to individual doctors from Birmingham, Bristol, Cambridge, Exeter, Leeds, Liverpool, London, Manchester, Newcastle, Oxford, Sheffield and Cardiff laboratories. Available to individual doctors from Bradford, Hull, Liverpool, London, Newcastle, Northampton, Taunton, Worcester and Cardiff laboratories. SKIN TEST ANTIGENS Brucellin Available to individual doctors directly from Central Public Health Laboratory, Colindale. Trichina Casoni Frei Cat-Scratch Fever The Service does not issue any therapeutic sera or anti-toxins, neither does it issue T.A.B. or cholera vaccine, Schick-test toxin, or prophylactics other than those noted above. T.A.B. and most other vaccines are available commercially. Yellow fever vaccination is carried out only in special centres designated by the Ministry of Health. COLLECTION AND TRANSMISSION OF SPECIMENS Responsibility for collecting and transmitting specimens to the laboratory lies with the clinician. The laboratory cannot undertake this except under special conditions. Ideally, all specimens should be sent by hand. LABORATORY AIDS IN THE DIAGNOSIS OF INFECTIOUS DISEASES Respiratory Infections. The bacterial infections of the respiratory tract in which laboratory help is most useful and sometimes essential for diagnosis are sore throat, acute and chronic chest infections, including lobar pneumonia, tuberculosis and whooping cough. Of the virus diseases, influenza, psittacosis and a typical pneumonia are the only ones that can be readily diagnosed by laboratory. Swabs from cases of sore throat are cultured for diphtheria bacilli, hæmolytic streptococci and other pathogens; stained smears are examined for the organisms of Vincent's angina. A provisional report on any positive result is telephoned on the morning of the day after receipt of the specimen. When a specimen is received late in the day, diphtheria bacilli may not be found until the afternoon of the following day. Rarely, the bacilli may grow so slowly that a provisional negative report telephoned within 24 hours may have to be corrected at 48 hours to a positive report. Intestinal Infections. The two main groups of specific infections causing diarrhœa with or without vomiting in this country are bacillary dysentry and food-poisoning. Bacillary dysentery due to Sonne's bacillus, which usually causes a mild type of diarrhœa (often unaccompanied by blood or mucus), is common and widespread. With selective media, dysentery bacilli may be readily isolated from faeces during the acute and often the convalescent stages of the disease. Specimens should also be submitted from the other members of the household when a case of dysentery has been diagnosed, since symptomless excreters among intimate contacts are common. In such circumstances a carefully taken rectal swab may be preferred, because it ensures against "pot" contamination, although as a general rule a sample of fæces is more satisfactory. A provisional positive report can usually be made after 24 hours, but the full examination of a specimen may take 2 to 3 days. Food poisoning (excluding Botulism) may be defined as an acute gastro-enteritis, typically chacterized by vomiting and diarrhæa, but on occasion with these symptoms considerably modified. The illness can generally be associated with the consumption, within a reasonably short period of time, of a particular meal. The bacteria most commonly responsible for food poisoning are members of the Salmonella group (excluding the typhoid-paratyphoid organisms), Staphylococcus aureus, and Cl. welchii. The practitioner, who may be the first to recognise a foodpoisoning outbreak, should collect feces, and vomit of available, from all affected persons. Even in the toxic type of food poisoning the examination of fecal specimens may often yield valuable information. Any remains of the suspected articles of food should be obtained and sent to the laboratory. Cases of food poisoning are notifiable, and an outbreak or a suspected case should be reported as soon as possible to the medical officer of health, who will carry out further investigations. R7/67