BRE 11 BOROUGH OF BRENTFORD & CHISWICK INTERIM REPORT OF THE HEALTH OF THE DISTRICT AND SCHOOL MEDICAL SERVICE AND DURING THE YEAR 1943. R.C. LEANING, M.B., B.S.,(Lond), M.R.C.S., L.R.C.P., D.P.H., R.C.S., (Eng). Medical Officer of Health, School Medical Officer, -1- BOROUGH OF BRENTFORD & CHISWICK PUBLIC HEALTH DEPARTMENT, TOWN-HALL, CHISWICK. To the Mayor, Aldermen and Councillors of the Borough of Brentford and Chiswick. LADIES AND GENTLENMEN, I have the honour to submit a war-time report on the health in the Borough and the work undertaken in the Health Departments and Schools. It will be noted there was a general increase in the attendances at all clinics as children returned from evacuation. It will be noted however that there was a smaller attendance at the Immunisation Clinics. This was largely due to the fact that there were fewer children untreated in the Borough than in 1942. The incidence and distribution of infectious and notifiable diseases is shown in tables on pages 17 and 21 Scarlet Fever was present in a mild speradic form during the year. 59 cases were notified with one death. Only 11 cases of Diphtheria were notified of whom four died. None of these cases had been immunised. Measlea, Whooping Cough and Chickenpox appeared in epidemic degree during the first half of the year. There were no deaths from Measles, but three deaths from Whooping Cough were recorded. A mild epidemic of Mumps occurred in February and March. The Infantile Mortality Hate (calculated on 45 deaths under one year) showed a decrease from 67 in 1942 to 48. There were five maternal deaths, three being from Puerperal Sepsis. Tuberculosis. The figures for the last three years of new notified cases and of deaths are as follows:- 1941-83 cases with 42 deaths. 1942-87 cases with 28 deaths. 1943-89 cases with 37 deaths. As required by the Ministry a special report on Louse Infestation is included and will be found on pages 19 and 20. I am, Ladies and Gentlemen, Your obedient Servant, R.C. LEANING. Medical Officer of Health. -2- SECTION 'A' EXTRACTS FROM VITAL STATISTICS: The number of live-births, still-births, and deaths are those REGISTERED (but excluding re-registered) during the calendar year, adjusted for inward and outward transfers. Non-civilian deaths and non-civilian notifications are excluded. BIRTHS LIVE BIRTHS j MALE FEMALE 1 TOTAL TOTAL 471 459 930 Legitimate 441 437 878 Illegitimate 30 i 22 52 STILL BIRTHS MALE FEMALE TOTAL TOTALS 9 23 Legitimate 8 13 21 Illegitimate 1 2 DEATHS From all causes: Male 324 - Female 343 — TOTAL 667 Deaths from Puerperal causes: 3 DEATHS OF INFANTS UNDER 1 YEAR OF AGE MALE FEMALE TOTALS Legitimate 21 20 41 Illegitimate 3 1 4 TOTAL 24 21 45 DEATH RATE OF INFANTS UNDER 1 YEAR OF AGE. All infants per 1,000 live births 48 Legitimate infants per 1,000 legitimate births 46 Illegitimate infants per 1,000 illegitimate births 77 Deaths from Cancer ( all ages) 121 Deaths from Measles (all ages) Nil Deaths from Whooping Cough 3 Deaths from Diarrhoea (under 2 years of age) 8 Total deaths from the seven principle zymotic diseases 16 -3- TABLE 1. PARTICULARS OF BIRTHS AND DEATHS AS SUPPLIED BY THE REGISTRARGENERAL FOR THE YEAR 1943. Cause of death MALES FEMALES All Causes 324 343 1. Typhoid Fever, etc. - - 2. Cerebro-Spenal Fever - - 3. Scar let Fever - 1 4. Whooping Cough - 3 5. Diphtheria 2 2 6. Tuberculosis of respiratory sys 25 11 7. Other forms of Tuberculosis - 1 8. Syphilitic Diseases 5 2 9. Influenza 3 7 10. Measles - - 11. Acute Polio-Myelitis and Polio-Encephalitis - - 12. Acute Inf. Encephalitis 1 - 13. Cancer b, Cav; & Oesophagus (M) Uterus (F) 7 6 14. Cancer of Stomach and Duodenum 8 11 15. Cancer of Breast - 13 16. Cancer of all other sites 40 36 17. Diabetes 3 2 18. Intra-Cranial Vascular lesions 18 29 19. Heart Disease 73 92 20. Other disorders of circulatory system 14 16 21. Bronchitis 23 15 22. Pneumonia 25 22 23. Other Respiratory Diseases 5 3 24. Ulcer of Stomach or Duodenum 6 2 25. Diarrhoea under 2 years 4 4 26. Appendicitis 2 1 27. Other digestive diseases 6 5 28. Nephritis 5 3 29. Puerperal and Post Abortive Sepsis - 3 30. Other Maternal Causes - 2 31. Premature Births 4 1 32. Congenital Malformation, Birth Injury, Infantile disorders 6 8 33. Suicide 3 1 34. Road Traffic accidents 2 2 35. Other violent causes 9 9 36. All other causes 25 30 ALL CAUSES 324 343 -4- TABLE 11. INFANTILE MORTALITY DURING THE YEAR 1943. Net deaths from stated causes at various ages under one year. CAUSE OF DEATH. Under 1 week. 1-2 weeks 2-3 weeks 3—4 weeks Total under 4 weeks. 1-3 months. 3-6 months. 6-9 months. 9-12 months Total under 1 year. 1. Small-pox — — — — — — — — — — 2. Chicken-pox — — — — — — — — — — 3. Measles — — — — — — — — — — 4. Scarlet Fever — — — — — — — — — — 5. Whooping Cough — — — — — — — 1 — l 6. Diphtheria or Group — — — — — — — — — — 7. Erysipelas — — — — — — — — — — 8. Tuberculous Meningitis. — — — — — — — — — — 9. Abdominal Tuberculosis. — — — — — — — — — — 10. Other Tuberc. Diseases. — — — — — — — — — — 11. Meningitis (non T.B) — — — — — — — — — 12. Convulsions — — — — — — 1 — — 1 13. Laryngitis — — — — — — — — — — 14. Bronchitis — — — — — 1 1 — — 2 15. Pneumonia (all forms). — — — — — 3 4 2 — 9 16. Diarrhoea — — — — — — — — — — 17. Enteritis — — 1 — 1 2 3 1 1 8 18. Gastritis — — — — — — — — — — 19. Rickets — — — — — — — — — — 20. Suffocation, overlying. — — — — — — — — — — 21. Injury at Birth 2 — — — 2 — — — — 2 22. Atelectasis 3 — — — — — — — — 3 23. Congenital Malforrnation 4 1 — 1 6 1 1 — — 8 24. Premature Birth 4 1 — — 5 — — — — 5 25. Atrophy,Debility and Marasmus — — — — — 1 2 — — 3 26. Pemphigus Neonatorum — — — — — — — — — — 27. Other Causes — — — — — 1 — 1 1 3 TOTALS 13 2 1 1 17 9 12 5 2 45 BIRTHS - Legitimate 878 DEATHS-Legitimate 41 Illegitimate 52 Illegitimate 4 INFANTILE MORTALITY RATE PER 1,000 BIRTHS=48 -5- SECTION B GENERAL PROVISION OF HEALTH SERVICES IN THE BOROUGH. CIVIL AMBULANCE SERVICE. The normal complement of vehicles in this Service is three, two manned fully at all times with one vehicle in reserve. The use of female attendants-drawn from the Civil Defence personnel-has proved a satisfactory arrangement especially when the ambulances were in use for the conveyance of maternity cases. Work of the Ambulances during the year 1943. Number of public calls dealt with-during 1943=729 Number of private calls dealt with during 1945=59 Total 1288 Maternity & Child Welfare (Table attached) Ante-Natal (Table attached) Supply of Milk and Food (Table attached) Maternal Mortality Deaths from Puerperal Causes:- Puerperal Sepsis 3 Other Causes 2 The, following table shows the number of maternal deaths connected with pregnancy during the last 10 years:- Died from Sepsis Died from other causes connected with pregnancy. 1934 1 3 1935 - - 1936 2 3 1937 - - 1938 2 2 1939 - 2 1940 - - 1941 - - 1942 - 2 1943 3 2 TOTALS 8 14 -6- SUMMARY OF WORK AT THE MATERNITY AND CHILD WELFARE CLINICS, 1943. BRENTFORD AREA CHISWICK AREA Grand Totals 1943 Grand Totals 1942 Monday Clinics Wednesday Clinics TOTAL Wednes. Clinics Thurs. Clinics Friday Clinics TOTAL. Number of new Members enrolled during the year:- Under 1 year 112 114 226 — 272 186 458 684 557 Over 1 year 13 17 30 — 73 56 129 159 207 Totals 125 131 256 — 345 242 587 843 764 Number of children attending and weighed:- • Under of children 1755 1972 3727 — 4948 3240 8188 11915 8771 Over 1 year 916 1404 2320 — 1052 1061 2113 4433 4927 Totals 2671 3376 6047 — 6000 4301 10301 1634.8 13698 Number of children seen by Doctor:- Under 1 year 414 544 958 — 812 648 1460 2418 2139 Over 1 year 244 317 561 — 305 292 597 1158 1386 Totals 658 861 1519 — 1117 940 2057 3576 3525 -7- ANTE-NATAL CLINICS. DISTRICT Number of Clinics held during year. Number of expectant mothers attending for the first time. Total number of expectant mothers attending. Number of post-natal mothers attending. Total number of attendances; made. Average attendances per session. BRENTFORD 52 213 265 - 998 19 CHISWICK 103 516 640 28 2895 28 TOTALS 155 729 905 28 3893 25 —8— SUPPLY of MILK AND FOOD. (other than under the National Milk and Vitamins Scheme). Terms of Supply Milk Mea]g supplied at Dining Centres. Other Food.* Expectant Mothers. Nursing Mothers. Children under 5 years of age. Expectant Mothers. Nursing Mothers. Children under 5 years of age. Expectant Mothers. Nursing Mothers. Children under 5 years of age. Free, or at less than cost price in necessitous cases. YES YES YES NO NO NO YES YES YES At cost price in other cases (e.g., sale of dried milk at Centres). YES YES YES NO NO NO YES YES YES * Cod liver oil end malt, Virol, Bemax, etc. -9- Health Visitors.- Five Nurses and one temporary are on the start for this and the School Medical Service. The following table sets out a brief summary of the work of the Health Visitors during the year:- (a) To expectant anothers: First visits 274 Total visits 431 (b) To children under 1 year ox age: First visits 752 Total visits (c) To children between the ages off 1 and 5 years: Total visits 2240 (d) Ophthalmic visits 8 (e) Other visits: Measles and German Measles 15 Whooping Cough 3 Infant Life Protection visits 132 Post-Natal 5 Infant Mortality 6 TOTAL 4483 Child Life Protection (under the Public Health Act, 1936). The following table sets out particulars of registration during the year:- (1) Number of foster-parents on the Registers:- (a) At the beginning of the year 23 (b) At the end of the year 22 (2) Number of children on the Registers:- (a) At the beginning of the year 27 (b) At the end of the year 38 (c) Who died during the year - (d) On whom inquests were held during the year. - Bennett Street Day Nursery:- Record of attendances daring the year 1943:- 12,111 War-time Day Nurseries:- Clifden Road equipped for 60 children 12,914 War-time Day Nursery Schools:- Beverley Road equipped for 25 children 5,658 Strand-on-the-Green equipped for 50 children 9,622 Lionel Road equipped for 50 children 10,801 -10- SECTION 'C' The figures set put in the tables included in this section give details of work directly connected with Public Health. (1) SANITARY INSPECTION OF THE AREA: Tabular Statement of the Work of the Sanitary Department 1943. INSPECTIONS. Number of Premises inspected on complaint 1051 Number of Premises inspected in connection with infectious disease 71 Number of primary inspections 2642 Number of re-inspections 1036 Total number of inspections and re-inspections 3678 ACTION TAKEN (other than Housing Act, 1936). Cautionary or intimation notices served 623 Statutory Orders issued (under Public Health Acts) - Summonses served - Number of Certificates under Rent & c.(Restrictions) Acts issued to Tenants 3 Number of Clearance Certificates issued to owners Nil Particulate of Sanitary Defects referred to in Notices served, and other matters. (a) DRAINAGE OF EXISTING BUILDINGS: New W.C's provided, repaired, supplied with water or otherwise improved 130 Percentage of houses provided with water closets 100% DRAINS: Tested (smoke) 14 Unstopped, repaired, trapped, etc. 47 Waste pipes, rainwater pipes disconnected, repaired etc. 63 New soil pipes and ventilating shafts fixed 4 New sinks provided 2 Disconnecting traps and chambers inserted 20 Reconstructed (whole system) - Reconstructed (connections) 18 Percentage of houses draining into sewers 99.9 Surface water drains reconstructed - Surface water drains repaired 9 (b) WATER SUPPLY AND WATER SERVICE: Draw taps on main 3 Percentage of houses supplied from Public Water Service 99.9 (c) REFUSE. New bins provided l6l Frequency of refuse removed from each house weekly Number of complaints received - Dealt with by Engineer's Department. Method of disposal; Barging away to controlled tip. -11- (d) SUNDRY NUISANCES. Overcrowding (Urgent cases reported to Housing Committee) Smoke-Minor complaints only Accumulation of refuse - Foul ditches, ponds etc., and stagnant water 3 Dampness 139 Yards repaired or repaved 6 Leaky roofs and eaves guttering 229 Premises repaired and cleansed 176 Other nuisances 311 (e) DISINFECTION: Premises disinfected: Ordinary notifiable diseases 70 Phthisis 11 Concer 12 Other diseases 5 Rooms stripped and cleansed (Section 167, Public Health Act, (1936)) - Premises treated for vermin 47 Premises treated for other pests (Wasps, moths, ants, beetles etc) 15 (f) SLAUGHTERHOUSES: Number on Register (including one Knacker's Yard) 5 Contraventions of bye-lawsx Slaughter of Animals Act, 1933. (vide Livestock (Restriction or Slaughter) Order 1940) Number of licences to slaughter animals issued during the year:- New Licences Nil Renewed Licences 2 FOOD & DRUGS ACT, 1938. MILK (SPECIAL DESIGNATIONS) ORDER, 1936. MILK & DAIRIES. ORDER,. 1926. Number of premises on register 21 Number of Dealers Licences issued to sell:- (a) Tuberculin Tested Milk 5 (b) Accredited milk - (c) Pasteurised milk 14 Number of Supplementary Licences issued to sell:- (a) Pasteurised milk 2 (b) Tuberculin Tested Milk 2 Bakehouses. Number in district in use 16 Contraventions of. Factory Acts - -12- UNSOUND FOOD: List of Food Condemned during the Year 1943. Fruit & Vegetables (Fresh) Cabbages 3 tons 13 cwts 3qrs Cauliflowers 3 tons 14 cwts 2qrs Sprouts 12 cwts Peas 3 tons 4 cwts Carrots 1 ton 17 cwts 12 lbs Apples 53 1bs Fresh Fish. Herrings 20 stones Whiting 30 stones Roker 11 stones Smoked Fillets 3 stones Cod Fillets 26 stones Kippers 12 stones General Provisions etc. Rabbits l6l lbs Bacon 91 lbs Tea 6 lbs Eggs 1355 Biscuits 10 Sugar 4 lbs Butter 9½ lbs Margarine 2½ lbs Egg Substitute 784 lbs Cheese 338 lbs Rice 6 lbs Duck 1 Chicken 8½ lbs Pork Sausages 125 lbs Beef Sausages 23 lbs Breakfast Sausage 6 lbs Luncheon Sausage 6 lbs Black Pudding 6 lbs Pastries 16 Pies 36 Swiss Rolls 112 Sweets 29¼ lbs Tinned Foods - Miscellaneous. Luncheon Meat 470½ lbs Spiced Ham 6 lbs Chopped Ham 20½ lbs Meat Roll 4 lbs Tongues 81¾ lbs Beef Hash 7 tins Fish and Potato Roll 3 tins Pressed Beef 8 lbs Picnic Roll 1 tin Galantine 9 lbs Minced Beef l tin Brisket 4 lbs Soups 158 Stewed Steak 45 Pease Pudding 185 Beef and Potatoes 18 tins Pilchards 164 tins Herrings 17 tins Sardines 53 tins -13- UNSCUND FOOD: (Contd) Tinned Foods-Miscellaneous. Salmon 71 tins Mackerel 5 tins Crayfish 2 tins Peas 133 tins Tomatoes 24 tins Carrots 32 tins'-' Baked Beans 109 tins Potatoes 2 tins Parsnips 2 tins Beetroot 5 tins Spinach 2 tins Rhubarb ,6 tins* Celery 1 tin Spiced Anchovies 15 tins Spaghetti 1 tin Evaporated Milks 840 tins Skimmed Milk 46 tins Household Milk 1 tin Jam & Marmalade 87^ lbs Golden Syrup 12 lbs Plums 384 tins Apples 12 tins Pineapple 15 tins Blackberries 1 tin Pears 24 tins Peaches 6 tins Grape Fruit '3 tins . Damsons 2 tins Fruit Salad 1 tin Raspberries 1 tin Prunes 16 tins* Rice 1 tin Dried Egg 1 pkt Pickles 11 jars Fish Cakes 38 Rabbit 1 tin Coffee Extract 2 Bottles Paste 11 Jars OFFENSIVE TRADES Number of premises in district 3 Nature of Trades: One soap boiler, 2 rag and bone dealers. CANAL BOATS Number of Boats on Register Motor propelled boats 97 Other Boats 418 PETROLEUM ACTS:- Number of applications received for licences to store and sell petroleum spirit- 90 Number of applications received for licences to stored and sell petroleum mixture 13 -14- PETROLEUM ACTS (contd) Number of applications received for licences to store and sell carbide of calcium 9 Number of gallons of petroleum spirit covered by licences 166,358 Number of gallons of petroleum mixture covered by licences 7,830 Quantity of carbide of calcium covered by licences 42,524 lbs HOUSING. Owing to the difficulty experienced by builders in obtaining labour and necessary materials, the usual routine house-to-house inspection in the Borough was suspended. Housing Act, 1916. The position in regard to the progress of programmes under this Act is exactly the same as that shown for the preceeding war years. Where cases of over-crowding have occurred these have been referred to the Council's special Housing Department and satisfactorily dealt with. -15- SECTION 'D' PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. A. - NOTIFIABLE DISEASES DURING THE YEAR. Disease. Total Cases notified. Cases. admitted to Hospital. Total Deaths. Small-pox - - - Scarlet Fever 59 35 1 Diphtheria 11 11 4 Enteric Fever (including Paratyphoid) - - - Ophthalmia Neonatorum 8 8 - Pneumonia (all forms) 13 1 47 Erysipelas 8 4 - Measles 217 4 - Whooping-Cough 108 5 3 Cerebro-Spinal Fever 11 l - Acute Polio-encephalitis - - - Dysentery - - - Puerperal Fever 1 1 - Puerperal Pyrexia 6 6 - B. OPHTHALMIA NEONATORUM. Cases Notified. Cases treated at Home Cases treated in Hospital. Vision unimparied Vision impaired. Total Blindness. Deaths 8 Nil 8 Nil Nil Nil Nil -16- C.-AGES OF CASES OF INFECTIOUS DISEASES NOTIFIED DURING THE YEAR 1943. At all Ages NUMBER OF CASES NOTIFIED. At Ages - Years Under 1 1 2 3 4 5 and under 10 10 and under 15 15 and under 20 20 and under 35 35 and under 45 45 and under 65 65 and over Small—pox - - - - - - - - - - - - - Scarlet Fever 59 - 1 8 7 10 27 5 - l - - - Diphtheria 11 - - - - 2 6 - - l - 2 - Enteria Fever (including Paratyphoid) - - - - - - - - - - - - - Ophthalmia Neonatorum 8 8 - - - - - - - - - - - Pneumonia 13 1 - - - l 2 - - - 1 5 3 Erysipelas 8 - - - - - - 1 - - 1 3 3 Cerebro-Spinal Fever l - - - - - 1 - - - - - - Acute Polio-encephalitis - - - - - - - - - - - - - Dysentery - - - - - - - - - - - - - Measles 217 - 19 30 23 38 76 - 6 2 - - - Whooping Cough 108 14 11 10 16 15 39 2 - 1 - - - Puerperal Pyrexia 6 - - - - - - - - 3 3 - - Puerperal Fever 1 - - - - - - - - 1 - - - -17- D. CASES OF INFECTIOUS DISEASES NOTIFIED DURING THE YEAR 1943. CLASSIFIED IN WARDS. NOTIFIABLE DISEASES. NUMBER OF CASES NOTIFIED. Brentford West Brentford Central Brentford East Bedford Park Chiswick Park Grove Park Gunners bury 0ld Chiswick Turnham Green. Scarlet Fever 14 18 4 3 3 3 2 5 7 Diphtheria 2 - - 1 4 - 1 1 2 Enteric Fever (including Paratyphoid) - - - - - - - - - Ophthalmia Neonatorum - 1 3 - 2 1 - - 1 Pneumonia - 4 2 - - - 1 4 1 Erysipelas 1 2 - - 2 1 - 2 - Cerebro-Spinal Fever - - - - - - - - - Measles 29 19 26 23 15 21 38 18 28 Whooping Cough 29 27 7 3 14 4 8 11 5 Acute Polio-encephalitis - - - - - - - - - Puerperal Fever 1 - - - - 1 - - - Puerperal Pyrexia - 1 - - 1 1 - 1 2 Tuberculosis: Respiratory 3 9 6 6 12 11 10 6 8 Non-respiratory 2 - 1 1 1 2 1 - - -18- E. TUBERCULOSIS. NEW CASES DEATHS Respiratory Non- Respiratory. Respiratory NonRespiratory Male. Female Male Female. Male Female Male Female. Under 1 year - - - - - - - - 1 to 5 years 1 1 - - - - - - 5 to 15 years 4 2 - 2 - - - 1 15 to 25 years 12 10 - 2 5 3 - - 25 to 35 years 7 12 2 1 3 1 - - 35 to 45 years 14 3 - - 8 1 - - 45 to 55 years 7 1 1 - 3 3 - - 55 to 65 years 6 - - - 5 2 - - 65 and over 1 - - - 1 1 - - TOTALS 52 29 3 5 25 11 - 1 During the year 7 non-notified tuberculous deaths were recorded. (b) Laboratory Work. The following Table sets out a record of the bacteriological work during the year, all of which was carried out vin the Council's Laboratory. Suspected Disease. Result Totals Positive Negative 6 301 307 Tuberculosis 4 50 54 Cerebro-Spinal Meningitis - 2 2 Other Diseases - 1 1 -19- CONTROL OF HEAD-LICE Ministry of Health Circular 2811, July/43 & Memo 230A Med. This matter has always been given great attention in this Borough and the fight against these pests was intensified in the first instance by the circulars sent out by the Ministry on Typhus and again by the above circular. (1) All children, especially 2-5 age groups are inspected by the Health Visitors at the Maternity and Child Welfare Clinics. (2) All children attending Day Nurseries are examined for nits each day on admission. (3) At the schools an average of 15.3 visits were made to each school by theSchool Nurses for Hygiene Inspections. During the year 16,472 examinations were made. (4) Cases referred: from factories; etc., Findings at these Inspections. (1) At the M & C W. Clinics any degree of contamination was very rate. Perhaps the usual type of mother who will trouble to take her children to these Clinics will also take the trouble to see that their children are clean. (2) At the Bay Nurseries, especially the war-time Nurseries, the incidence of infestation was higher. In these cases the mothers, being engaged in Factory work etc., had less time and leisure to pay the necessary attention to their children. (3) In the schools 318 children were found to have nits. The majority of these were cases of very mild infestation, but there were a few who were always found to have nits and who after cleansing thoroughly quickly became infected again. (4) No cases were referred from Factories in 1943. Methods of Dealing with Cases. Agents used - (1) Durbac Soap and Sacca comb (2) Lethane Hair Oil. The vast majority of the cases were treated with Durbac soap and Sacca comb or some other form of small tooth comb. Lethane Hair Oil wrs never extensively used and was unpopular partly because it die not remove the nits and partly because the hair was not allowed to be washed for a week after application of the oil. (l) M & C.W Clinic Cases. As mentioned the cases were few and mild and the infestation was quickly remedied by the mothers themselves who willingly used the treatment advised by the Health Visitors. The mothers of these children were net examined in the Clinic as such a course would probably have caused considerable resentment, but where it was thought to be advisable the 21 Health Visiter made a special visit to the home. (2) Pay Nursaries. (a) Mild Cases - were cleansed and nits removed before they were 'allowed to mix with the other- children. (b) Severe Cases - Were not to be admitted. The rule is that the Health Visitor must be notified and she would visit the home and give the necessary advice and help for the child, or for any others of the household who might be similarly affected. (No cases of this degree were found during the year). Schools. Each child found to be affected is given a note for it's parents stating the fact and gives simple instructions as to how it might be treated. It also states that Durbac Soap and a Sacea comb could be obtained from the Clinic. (a) In the mild cases of infestation this is quite effective. (b) In the more severe cases the School Nurse calls and give instructions regarding the cleansing of all persons in the house who may be suffering from the infestation. (c) In certain cases where it is found that special difficulties are present in the household, the child is cleansed at the School Clinic. There were 19 of these cases during the year. Notes. An ad hoc Gas-cleansing Station was built by the County in the Brentford Hospital Grounds and with their permission this was equipped for the treatment of scabies and Louse Infestation. (It was not found to be necessary to use this during the year). It is the intention to try out the Lethane treatment in those few households where this infestation seems to be always present. It would seem that the incidence of' the infestation would be much lessened if the custom of wearing the hair short in girls was more prevalent. Unfortunately the tendency seems to be to allow the hair to grow much longer than some years ago and it is often difficult to persuade mothers not to follow the general fashion. / JOINT COMMITTEE FOR EDUCATION IN BRENTFORD & CHISWICK. ANNUAL REPORT ON THE MEDICAL INSPECTION OF ELEMENTARY SCHOOL CHILDREN FOR THE YEAR ENDING 31ST DECEMBER, 1943. R. C. LEANING., M.B., B.S., (Lond), M.R.C.S., L.R.C.P., D.P.H., R.C.S (Eng) School Medical Officer. -21- BOROUGH OF BRENTFORD & CHISWICK. EDUCATION ACT, 1921. REPORT OF THE MEDICAL INSPECTION AND TREATMENT OF ELEMENTARY SCHOOL CHILDREN FOR THE YEAR ENDING 31ST DECEMBER, 1943. To the Chairman and Members of the Education Committee. Ladies and Gentlemen, I beg to submit tables indicating the work of the School Medical Servioe during 1943. The incidence of Infectious Disease in the schools is indicated in the following table:- 1943 ACTUAL CASES. Jan. Feb. Mar. Apr. May. Jne . Jly. Aug. Sept. Oct. Nov. Dec. Total. Scarlet Fever 2 4 5 3 1 2 3 - 8 8 11 9 56 Diphtheria 4 3 2 3 1 - 1 - 2 - - - 16 Chicken-pox 107 24 63 138 40 26 43 - 6 2 7 6 462 Measles 27 52 99 91 17 5 6 - - 2 - - 299 Whooping Cough 15 26 40 51 31 17 18 - 4 - 2 6 210 Mumps 16 5 3 1 2 4 1 - 3 14 17 4 70 Ringworm 1 - - - - - - - - - 1 1 3 Impetigo 9 7 5 3 8 8 8 10 18 20 9 107 Exzema - - - - - - - - - 1 1 - 2 Verminous 7 6 7 7 5 10 12 - 16 16 16 3 105 Scabies 30 24 23 15 15 16 14 - 18 13 19 11 198 Other Skin 1 2 4 3 4 4 1 - 2 1 1 1 24 Jaundice - - - - - - - - - 1 - - 1 Totals 219 153 251 315 124 92 107 - 69 76 95 50 1553 -22- The following figures and tables of work in this service are in addition to the Statutory Tables issued to the Board of Education:- ORTHOPAEDIC CLINIC.- Total numer of attendances 627 Number of individual children 137 Surgeon.- Total number of attendances 226 Number of individual children 227 SUN-RAY CLINIC.- Total number of attendances 1537 Number of individual children 82 RHEUMATISM CLINIC. - Total number of attendances 275 Number of individual children 88 MINCE AILMENT CLINIC.- Total number of attendances 12203 Number of individual children 1890* Total number of exclusions 836 Total number of re-admissions 669 Number of special cases 1152 Number of special cases re-inspected 650 OPHTHALMIC CLINIC.- Number of attendances 474 New cases 171 Retinoscopy 133 Glasses prescribed 82 Glasses issued 61 Other cases 157 Individual children 222 IMMUNISATION CLINIC.- Number of attendances (School) 2400 Number of attendances (Welfare) 3184 PERSONAL HYGIENE.- Number of visits to schools 249 Average number of visits to schools 12.5 Number of examinations 26504 Number of individual children defective 301 Number of re-examinations 1002 VISITS.- ....... Total number by School Nuses 737 * This number includes all children attending the Clinic. The number of those actually treated was 427. The remainder were those referred to other clinics, to their own doctor, to hospital - those given advice or kept under observation. -23- BOARD OF EDUCATION MEDICAL INSPECTION AND TREATMENT RETURNS FORYEAR ENDED 31-ST DECEMBER, 1943. TABLE 1. MEDICAL INSPECTIONS OF CHILDREN ATTENDING PUBLIC ELEMENTARY SCHOOLS. A.- ROUTINE MEDICAL INSPECTIONS (1) No. of Inspections: Entrants 754 Second Age Group- Third Age Group 319 TOTAL 1073 (2) No. of other Routine Inspections 318 GRAND TOTAL 1391 B.- OTHER INSPECTIONS. No. of Special Inspections and Re-inspections 2117 TABLE 11. CLASSIFICATION OF THE NUTRITION OF CHILDREN INSPECTED DURING THE YEAR IN THE ROUTINE AGE GROUPS. Number of Children Inspected (Excellent-) B. (Normal) c. (Slightly subnormal) D. (Bad) No. %. No. % No. % No. % Entrant 754 269 35.8 438 58.1 46 6.1 1 .13 Second — — — — — — — — — Third 319 116 36.4 166 52.0 37 11.6 — — Other 318 140 44.0 159 50.0 18 5.6 1 .31 Total 1391 525 37.7 763 54.1 101 7.2 2 .14 TABLE III. GROUP I. Treatment of Minor Ailments (excluding uncleanliness). Total Number of Defects treated or under treatment during the year under the Authority's Scheme 427 GROUP II.- Treatment of Defective Vision and Squint. Under the Authority's Scheme. ERRORS OF REFRACTION (including squint) 133 Other defect or disease of the yes (excluding those recorded in Group I) Nil No. of Children for whom spectacles were Under the Authority's Scheme. (a) Prescribed 82 (b) Obtained 61 -24- GROUP III.- Treatment of Defects of Hose and Throat. Under the Authority's Scheme. Received Operative Treatment 157 Received other forms of Treatment 67 Total number treated 224 TABLE IV DENTAL INSPECTION AND TREATMENT. (1) Number of children inspected by the Dentist (a) Toutine age-groups 3162 (b) Specials 622 (c) TOTALS (Routine and Specials) 3784 (2) Number found to require treatment 2560 (3) Number actually treated 1875 (4) Attendances made by children for treatment 5092 (5) Half-days devoted to:- Inspection 32 Treatment 674 706 (6) Fillings:- Permanent Teeth 2858 Temporary Teeth 846 3704 (7) Extractions:- Permanent Teeth 530 Temporary Teeth 1658 2188 (8) Administrations of general anaesthetics for extractions 1096 (9) Other Operation:- Permanent Teeth 834 Temporary Teeth 470 1304 TABLE V. (1) Average number of visits per school made during the year by the school nurses 12.5 (2) Total number of examinations of children in the Schools by school Nurses 26504 (3) Number of individual children found unclean 301 (4) Number of individual children cleansed under Section 87(2) and (3) of the Education Act, 1921. 2 (5) Number of cases in which legal proceedings were taken:- (a) Under the Education Act, 1921 Nil (b) Under School Attendance Byelaws 2 -25- TABLE VI Number of totally or almost totally blind and deaf children who are not at the present time receiving education suitable for their special needs. The return should relate to all such children including evacuees resident in the authority's area. I. At a Public Eelementary School. 2. At an institution other than a Special School. 3. at no School or Institution. Blind Children - - - Deaf Children - - -