BEX 5 £ Health Department 14, Brampton Road Bexleyheath, Kent. My Ref. (please quote) Your REF G. F. B R A M LEV. M.D..D.P.H. MEDICAL OFFICER OF HEALTH. TELEPHONE, BEXLEYH EATH 224-4-/5. 9th September, 1940. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1939. This report of the Medical Officer of Health is confined to essential and urgent matters in accordance with the Ministry of Health Circular 2067 of the 19th July, 1940. The Registrar General's figures for 1939 have not yet been received,"but from information in the possession of the Department,1939 can be classed as a healthy year. There was an increase in the incidence of Scarlet Fever up to the middle of the year, but following the outbreak of war very few cases were notified as with the other infectious diseases. Developments were held up for various reasons, but the calls of civil defence on all members of the staff and the calling up of two clerks and an assistant sanitary inspector at the outbreak of war placed a great strain on the resources of the staff. Complaints generally fell off with the declaration of war and housing work came to a standstill, but the Department had additional work in dealing with matters of evacuation, arrangements for decontamination of clothing and material, disposal of war dead, and decontamination of foodstuffs. Food and Drugs Act, 1938, came into operation in this area on the 31st October, 1939, and sampling was commenced. Maternity and Child Welfare, From the outbreak of war the clinics opened as previously, and mothers were advised to bring children at less frequent intervals to prevent large numbers being present at one time,and so with smaller attendances the Health"Visitors were able to concentrate more on home visiting. At the Maternity Home there were more admissions as women who had booked for other institutions which closed at the outbreak of war were admitted where possible, and owing to the difficulty of getting antenatal and abnormal intra-natal cases into a maternity hospital some of these cases were dealt with at the Home under the care of the Consultant Obstetrician. GEO. F. BRAMLEY, M.D. , Ch.B. , D.P.H. , Medical Officer of Health. SUMMARY OP VITAL STATISTICS, 1939. England and Wales. County Boro's' and Great Towns including London. Smaller Towns (Resident Populations 25,000 to 50,000 at 1931 Census.) London Administrative County. Borough of Bexley.  Rates per 1,000 Population. Births - Live 15.0 14.8 15.6 12.3 17.76 Still 0.59 0.59 0.57 0.44 0.51 Deaths - All Causes 12.1 12.0 11.2 11.9 7.98 Typhoid and Paratyphoid Fevers 0.00 0.00 0.00 0.00 0.00 Measles 0.01 0.01 0.01 0.00 0.00 Scarlet Fever 0.01 0.00 0.00 0.00 0.00 Whooping Cough 0.03 0.03 0.02 0.03 0.02 Diphtheria 0.05 0.05 0.04 0.02 0.01 Influenza 0.21 0.19 0.20 0.18 0.07 Notifications - Smallpox 0.00 0.00 0.00 — - Scarlet Fever 1.89 1.96 1.78 1.53 3.60 Diphtheria 1.14 1.21 1.16 0.98 0.36 Enteric Fever 0.04 0.03 0.04 0.03 0.03 Pneumonia 1.0,2 1. 21 0.89 0.99 0..22 Erysipelas 0.34 0.40 0. 31 0.37 0.17 Rates per 1,000 Live Births. Deaths under one year of age 50 53 40 48 40.1 Deaths from Diarrhœa & Enteritis under two years of age 4.6 6.3 3.0 8.2 2.8 Maternal Mortality - Puerperal Sepsis 0.77 Not available — Others 2.16 0.7 Total 2.93 0.7 Rates per 1,000 Total Births (i.e. Live and Still). Puerperal Sepsis 0.77 Others 2.16 Not available Total 2.93 Notifications - Puerperal Fever 14.35 17.26 12.99 Puerperal Pyrexia 14.22 7.65