BRE 12 BOROUGH OF BRENTFORD & CHISWICK INTERIM REPORT ON THE HEALTH OF THE DISTRICT AND SCHOOL MEDICAL SERVICE DURING THE YEAR 1944 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. Borough of Brentford and Chiswick. O. C. DOBSON M.D., D.P.H., D.P.A. Town Hall Chiswick, W.4 MEDICAL OFFICER OF HEALTH. SCHOOL MEDICAL OFFICER. Telephone—CHISWICK 1255 With the Medical officer of Health's Compliments -1- BOROUGH OF BRENTFORD & CHISWICK PUBLIC HEALTH nEPARTMENT, TOM HALL, CHISWICK. To the Mayor, Aldermen and Councillors of the Borough of Brentford and Chiswick. LADIES AND GENTLEMEN, I have the honour to submit a war-time report on the health and conditions affecting health in the Borough and Schools during 1944. The "blitz" in February and the attack by VI's brought about the evacuation of many mothers and children which naturally affected the attendances at the Clinics. The reduction in the figures of the immunisation clinc, viz. 4361 as against 5634 in 1943 was due partly to this reason, partly to the fact there were fewer unimmunised children in the area and partly to alterations in technique requiring fewer attendances. The incidence and distribution of infectious and notifiable disease is shown in tables on pages 17,19, and 25. Scarlet Fever was sporadic only, and there were no deaths. Ten cases of Diphtheria (two not confirmed) were notified with one death. There were mild spidemics of Chicken-pox and Mumps at the beginning of the year, and of Measles in the Spring. There were no deaths from these diseases but there were 50 deaths from Pneumonia. One case of Malaria was notified. The Infantile Mortality Rate was a record for the Borough being 36 as against 48 & 67 in 1943 and 1942 respectively. There were no Maternal deaths from sepsis but two died from other causes Tuberculosis The figures for the last 4 years are:- 1941-83 cases notified with 42 deaths 1942- 87 cases „ „ 28 deaths 1943- 89 cases „ „ 37 deaths 1944- 106 cases „ „ 34 deaths As requested by the Ministry special notes are included on; (1) Premature Infants (2)Illegitimate Infants (3) Louse Infestation These will be-found, on pages 21 to 24 inclusive. I am. Ladies and Gentlemen, Your obedient Servant, R.C.LEANING. Medical Officer of Health. - 2 - 1-GENERAL STATISTICS-1944 Area in acres (including 116 acres of foreshore of River Thames & 24 acres of inland water) 2,449.5 Population-Census, 1931 62,617 Population-Registrar General's estimate for area (mid 1944) 48,880 2-VITAL STATISTICS LIVE BIRTHS Total Male Female Legitimate 897 442 455 Birth rate per 1,000 of the estimated resident population = 19.9. Illegitimate 76 45 31 Total 973 487 486 STILL BIRTHS Total Male Female Legitimate 21 11 10 Rate per 1,000 total (live and still births)=26 Illegitimate 5 3 2 Total 26 14 12 DEATHS Total Male Female 718 367 351 Death rate per 1,000 of the estimated resident population =14.6 Deaths from puerperal causes:- Puerperal Sepsis Rate per 1,000 total (live and still) births=2.0. Other puerperal causes 2 DEATHS OF INFANTS UNDER 1 YEAR OF AGE Total Male Female Legitimate 31 17 14 Illegitimate 4 4 - Total 35 21 14 Death rate of all infants per 1,000 live births 36 „ „ of all legitimate infants per 1,000 31 „ „ of all illegitimate infants per 1,000 illegit. live births 52 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) Nil Deaths from Diarrhoea (under 2 years of age) 4 Deaths from Cancer (all ages) 98 -3- TABLE I. PARTICULARS OF DEATHS AS SUPPLIED BY THE REGISTRAR GENERAL FOR THE YEAR 1944. CAUSES OF DEATH. MALES FEMALES All Causes 367 351 1. Typhoid Fever, etc. - - 2. Cerebro-Spinal |Fever - 1 3. Scarlet Fever - - 4. Whooping Cough - - 5. Diphtheria 1 - 6. Tuberculosis of respiratory system 16 11 7. Other forms of Tuberculosis 3 4 8. Syphilitic Diseases 1 2 9. Influenza 4 2 10. MeasIes - - 11. Acute Polio-Myelitis and Polio-Encep¬halitis - - 12. Acute Iinf. Encephalitis - - 13. Cancer b, Cav; & Oesophagus (M) Uterus (F) 3 9 14. Cancer of Stomach and Duodenum 7 7 15. Cancer of Breast - 3 16. Cancer of all other sites 43 21 17. Diabetes 4 5 18. Intra-Cranial Vascular lesions 37 43 19. Heart Disease 93 71 20. Other disorders of circulatory system . 13 24 21. Bronchitis 15 19 22. Pneumonia 28 22 23. Other Respiratory Diseases 8 6 24. Ulcer of Stomach or Duodenum 3 2 25. Diarrhoea under 2 years 3 6 26. Appendicitis 1 1 27. Other digestive diseases 7 7 28. Nephritis 10 11 29. Puerperal and Post Abortive Sepsis - - 30. Other Maternal Causes - 2 31. Premature Births 4 3 32. Congenital Malformation, Birth Injury Infantile disorders 7 7 33. Suicide 6 1 34. Road Traffic accidents 3 4 35. Other violent causes 23 28 36. All other causes 24 29 ALL CAUSES 367 351 -4- TABLE II. INFANTILE MORTALITY DURING THE YEAR 1944. Net deaths from stated causes at various ages under 1 year. CAUSE OF DEATH Under l 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 - - - - - - - - - - 6. Diphtheria or Croup - - - - - - - - - - 7. Erysipelas - - - - - - - - - - 8. Tuberculous Meningitis - - - - - - - - - - 9. Abdominal Tuberculosis - - - - - - - - - - 10. Other Tuberc.Disease - - - - - - - - - - 11. Meningitis (non T.B.) - - - - - - - - 1 1 12. Convulsions - - - - - - - - - - 13. Laryngitis - - - - - - - - - - 14. Bronchitis - - - - - - - - - - 15. Pneumonia (all forms) - - 1 - 1 2 2 2 - 7 16. Diarrhoea - - - - - - - - - - 17. Ehteritis - - - - - 1 3 - - 4 18. Gastritis - - - - - - - - - - 19. Rickets - - - - - - - - - - 20. Suffocation,overlying - - - - - - - - - - 21. Injury at Birth 2 - - - 2 - - - - 2 22. Atelectasis 1 - - - 1 - - - - 1 23. Conjenital Malformation 1 3 1 - 5 - - - - 5 24. Premature Birth 5 2 - - 7 - - - - 7 25. Atrophy,Debility and Marasmus - - - - - 2 - - - 2 26. Pemphigus Neonatorum - - - - - - - - - - 27. Other Causes - 1 1 - 2 2 - - 2 6 TOTALS 9 6 3 - 18 7 5 2 3 35 -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 conveyahco of maternity cases. Work of the Ambulance during the year 1944 Number of public calls dealt with during 1944=890 Number of private calls dealt with during 1944=439 Total 1229 Maternity & Child Welfare (Table attached) Ante-Natal (Table attached) Supply of Milk and Food (Table attached) Maternal Mortality Deaths from Puerperal Causes:- Puerperal Sepsis - 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 1935 - - 1936 2 3 1937 - - 1938 2 2 1939 - 2 1940 - - 1941 - - 1942 - 2 1943 3 2 1944 - 2 TOTALS 7 13 SUMMARY OF WORK AT THE MATERNITY AND CHILD WELFARE CLINICS, 1944-4. BRENTFORD CLINICS CHISWICK CLINICS Grand Totals 1944. Grand Totals 1943 Number of new Members enrolled during the year:- Under 1 year 223 523 746 684 Over 1 year 17 131 148 159 Totals 240 654 894 843 Number of children attending and weighed:- Under 1 year 3785 6913 10698 11915 Over 1 year 2248 1916 4164 4433 Totals 6033 8829 14862 16348 Number of children seen by Doctors:- Under 1 year 964 1364 2328 2418 Over 1 year 532 703 1235 1158 Totals 1496 2067 3563 3576 -6- -7- ANTE-NATAL CLINICS. Number of Clinics held during year. Number of expectant mothers attending for the first time. Total number of expectant mothers attending. Number of pest-natal mothers attending. Total number of attendances made. Average attendances per session. BRENTFORD 51 198 252 2 998 19 CHISWICK 102 425 465 8 2457 24 TOTALS. 153 623 717 10 3455 22 —8— SUPPLY OF MILK AND FOOD (Other than under the National Milk and Vitamins Scheme). Terms of Supply Milk Meals 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 and Malt, Virol, Bemax, etc. -9- Health Visitors:- Five Nurses and one temporary are on the staff for this and the School Medical Service. The following table sets out a brief summary of the work of the Health Visitors during the years:- (a) To expectant mothers: First visits 289 Total visits 511 (b)To. children under 1 year of, age: First visits 881 Total visits 2092 (c) To children between the ages of one and five years: Total visits 2405 (d) Ophthalmic .visits (including "sticky eye" cases) 35 (e) Other, visits: Measles and German Measles 30 whooping Cough 17 Infant Life Protection visits 89 Post-Natal - Infant Mortality - TOTAL 5179 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 Register:- (a) At the beginning of the year 22 (b) At the end of the year 19 (2) Number of children on the Registers:- (a) At the beginning of the year 31 (b) At the end of the year 25 (c) Who died during the year Nil (d) On whom inquests were held during the year Nil Bennett Street Day Nursery:- Record of attendances during the year 1944: Whole days 8653 Half-days 642 War-time Day Nurseries: * Clifden Road equipped for 60 children War-time Day Nursery Schools: * Beverley Road equipped for 25 children Strand-on-the-Green equipped for 50 children 5797 Lionel Road equipped for 50 children 8330 * Records of attendances at these Nurseries were kept at the Nursery and were destroyed by enemy action. Throughout the year bookings were always to full capacity, with a moderate waiting list. -10- SECTION 'C' The figures 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 in 1944. INSPECTION: Number of Premises inspected on complaint 726 Number of Premises inspected in connection with infectious disease 54 Number of primary inspections 2839 Number of re-inspections 832 Total number of inspections and re-inspections 3671 ACTION TAKEN (other than Housing Act, 1936). Cautionary or intimation notices served 418 Statutory Orders issued under Public Health Acts) - Summonses served - Number of Certificates under Rent & c. (Restrictions) Acts. issued to tenants 6 Number of Clearance Certificates issued to owners - Particulars 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 other wise improved 94 Percentage of houses provided with water closets 100% DRAINS: Tested (smoke) 14 Unstopped, repaired, trapped, etc. 58 Waste pipes, rainwater pipes disconnected, repaired etc. 30 New soil pipes and ventilating shafts fixed 9 New sinks provided 11 Disconnecting traps and chambers inserted 14 Reconstructed (whole system) 1 Reconstructed (connections) 10 Percentage of houses draining into sewers 99.9% Surface water-drains-reconstructed - Surface water drains-repaired 4 (b) WATER SUPPLY AND WATER SERVICE: Draw taps on main. 7 Percentage of houses supplied from Public Water Service 100% (c) REFUSE: New bins provided 86 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) Accumulation of refuse 1 Foul ditches, ponds etc. and. stagnant. water 3 Dampness 77 Yards repaired or repaved 4 Leaky roofs and eaves guttering 110 Defective flooring, joists and Skirtings 49 Defective plaster to walls and ceilings 1ll Rooms cleansed and re-decorated 156 Other defects 154 (e) DISINFECTON: Premises disinfected: Ordinary notifiable diseases 53 Phthisic 7 Other diseases 8 Rooms stripped and cleansed (Section 167, Public Health Act, .(1936) - Premises treated for vermin 54 Premises treated for other pests (Wasps, moths, ants, beetles, etc). 23 (f) SLAUGHTERHOUSES: Number on Register (including one Knacker's Yard) 5 Contraventions of bye-laws - Slaughter of Animals Act, 1933. Number of licences to slaughter animals issued during the year:- New Licences - Renewed Licences - Number of animals slaughtered (under licence) within the Borough 68 pigs FOOD & DRUGS ACT: 1938 MILK (SPECIAL DESIGNATIONS) ORDER, 1936. MILK & DAIRIES ORDER, 1936. Number of premises on register 19 Number of Dealer's 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 17 Contraventions of Factory Acts. - -12- UNSOUND FOOD: Summary of Food Surrendered & Condemned General Provisions Sugar 93½ lbs. Bacon 431½ lbs. Biscuits 1238 lbs. Eggs 1042 Dried Egg Powder 114 lbs. Cocoa Powder 3¾ cwts Albume Substitute 112 lbs. Cheese 246 lbs. Tea 6¼ lbs. Jam and Marmalade l50 lbs. Rabbits 282½ lbs. Butter 33¼ lbs. Margarine 1¾ lbs. Porridge Oats 2 lbs. Cooked Ham l lbs.10 ozs. Bread 12 lbs. Rolls 22 Buns 124 Breakfast Sausage 13 lbs. Pork Sausage 77½ lbs. Luncheon Sausage 26 lbs. Lard 2 lbs. Golden Syrup 3 tins. Pickles & Sauces 21 Jars. Shrimps 1 Jars. Oats 48 lbs. Blue Peas 62 lbs. Egg Sub. and Cereal Sweepings 10 cwts. Milk Sub. Powder. 12¼ cwts. Cows Milk 7 galls. Curry Powder 70 lbs. Paste 3 Jars. Dried Eggs 16 Pkts. Dessert Powder 273 lbs. Jelly Powder 94 lbs. Breakfast Food 154 Pkts. Creamola 1 Pkt. Baking Powder 76 lbs. Spice 70 lbs. Pudding Mixture 42 lbs. Chocolate Pudding 2546 Pkts. Tinned Foods Dried Milk. 5 Tins Skimmed Milk 24 „ Evaporated Milk 950 „ Crayfish 9 „ Mackerel 7 „ Salmon 49 „ Minced Beef Loaf 22¾ lbs. Luncheon Meat 845½% lbs. Soups 127 tins Pears 21 tins Savoury Lunch 2 lbs. Mustard 85 tins Potatoes 24 tins Sausage Meat 46 lbs. Horseradish 2 tins Plums 27 tins Pilchards 458 tins Sardines 41 tins -13- Tinned Foods (Contd) Herrings 15 tins Brisket 42 lbs Ox Tongue 42 lbs Chopped Ham 126¼ lbs Stewed Steak 76 tins Prepared Meals 3 tins Carrots 7 tins Pease Pudding 8 tins Baked Beans 53 tins Spiced Anchovies 720 tins Mixed Vegetables 4 tins Plums 30 tins Prunes 1 tin Meat Roll 1 tin Meat Galantine 1 tin Pears 4 tins Fruit & Vegetables — Greens Approx 5 tons 15 cwts. Oranges 183½ lbs. Swedes 200 bags Mushrooms 601bs. approx. Peas 137 bags Damsons 4½ lbs. Figs 28 lbs. Dates 264 lbs. Carrots 115 bags Onions 96 lbs Cauliflowers 54 bags Celery 300 bdls. Spaghetti 166 lbs. Rape Seed 300 bags • Fresh Meat Pork 42½ lbs. Beef 47¾ lbs. Pigs Head 15 lbs. Fresh Fish Cod Roe 3 stones Skate 34½ stone Mixed Fish 6½ stones. Lemon Soles 6 stones Fillets 3 stones 53 Confectionery Chocolates 10½ lbs. Mars Bars 6 Sweets 6 lbs. 6 ozs. -14- Food Condemned as result of Enemy Action Fruit & Vegetables Pears 20 lbS. Mustard & Cress 8 punnet Carrots 16 lbs. Leaks 42 lbs. Cauliflowers 5 lbs. Sprouts 84 lbs. Mushrooms 4 lbs Turnips 56 lbs. Potatoes 3 cwts. Artichokes 7 lbs Swedes l6 lbs. Greens 56 lbs. Dates 7 lbs. Broad Beans 140 lbs. Spaghetti 25 lbs. Marrows 25 lbs. Beetroot 4 lbs. Apples 40 lbs. Meats Lamb 73 lbs. Mixed meat 138 lbs Pork 52¼ lbs. Stewing Steak 3 lbs. Rissoles 50 Sausages 45 lbs. Fresh Fish Salmon 15½ lbs. scollops 2½ doz. Smoked Filets 2 stone Shrimps 1½ galls. Skate ½ stone Herrings (fresh) 13 stones Cod 21 stones Crabs 2 stones Winkles 15 galls Red Herrings 13 boxes. Tinned Foods Luncheon Meat 25¼ lbs. Evaporated Milk 16 tins Pilchards 7 tins. Soups 177 tins Parsnips 8 tins Minced Beef Loaf 2 tins Sardines 5 tins Beetroot 14 tins Peas 3 tins Baked Beans 6 tins Stewed Steak 1 tin -15- General Provisions Butter 106½ lbs. Lard 156 lbs. Coffee 94½ lbs. Jams and Marmalade 525¼ lbs. Tea 201 lbs. Bacon 598 lbs. Margarine 385¼ lbs. Cheese 185 lbs. Biscuits 49 lbs. Sugar 220 lbs. Cocoa 1½ lbs. Peanut Butter 4 Jars. Miscellaneous Flour (including Pudding & Cake Mixtures etc) l600 lbs (approx) Soya Flour 116 lbs. Semolina 34 lbs. Dried Milk 50 tins Sultanas 202 lbs. Prunes 3 lbs. Currants 36 lbs. Dried Peas 273 lbs. Beans 14 lbs. Lentils 116 lbs. Pearl Barley 141 lbs. Oatmeal 295 lbs. Oat Flakes 280 lbs. Dried Eggs 184 pkts. Raisins 120 lbs. Cakes, Sponges 657 lbs. Buns, Scones 224 lbs. Pastry,Pies etc 35 lbs. approx. Bread 334 lbs. Flaked Barley 21 lbs. Rice 98 lbs. Split Peas 26½ lbs. Rolled Oats 52 lbs. Yeast 7 lbs. Dried Mint 3 lbs. Pepper 33 lbs. Spice 160 lbs. Various Cereals 64 pkts. Egg Substitute 23 pkts. Mustard 34 lbs. Oxo Cubes 472 Vermicella 32 lbs. Chopped Potatoes 3 cwts.2 stone. Ryvita 11 lbs. Golden Syrup 10 lbs. Macaroni 50 lbs.. Baking Powder 2 pkts. Toast Slices 40 Jam Tarts 185 Welsh Cheese 10½ lbs . Fish Cakes 43 Salt 250 lbs. Noodles 5 lbs. -16- 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 4l8 PETROLEUM ACTS: Number of applications received for licences to store and sell petroleum spirit 87 Number of applications received for licences to store and sell petroleum mixture 15 Number of applications received for licenceS to store and sell carbide of calcium 9 Number of gallons of petroleum spirit covered by licences 166.033 Number of gallons of petroleum mixture covered by licences 8,230 Quantity of carbide of calcium covered by licences 42,504 lbs HOUSING Owing to the difficulty experienced by buiiders in obtaining labour and necessary materials the usual routine house-to-house inspection in the Borough was suspended. Housing Act. 1936. The position in regard to the progress of programmes under this. Act is exactly the same as that shown for the preceding war years. Were cases of over-crowding have occurred these have been referred to the Council's "special Housing Department and satisfactorily dealt with. - 17 - PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. A. - NOTIFIABLE DISEASES DURING.THE.YEAR. Disease Total Cases. notified Gases admitted Hospital Total Deaths Small-pox - - - Scarlet Fever 44* 28# - Diphtheria 4 6# 1 Ophthalmia Neonatorum 3 13 - Pneumonia (all forms) 6 3 50 Erysipelas 8 1 - Measles 35 3 - Whooping-cough 55 - - Malaria 1 \; - - Puerperal Pyrexia 10 10 - * Includes one case non-civilian. # includes three cases of scarlet. Fever and -two cases of Diphtheria removed to Hospital who were discharged ''diagnosis not. confirmed". B. - OPHTHALMIA NEQNATORUM. Cases Notified Cases treated at - Home Cases treated in Hospital Vision impaired Vision impaired Total no.??? Deaths 3 - 3 3 Nil Nil Nil SECTION 'D' - 18 - C. - AGES OF C:,SES OF INFECTIOUS DISEASES NOTIFIED DURING THE YEAR 1944. At all Ages NUMBER OF CASES NOTIFIED. At Ages - Years Under 1 l 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 f- 65 and over Scarlet Fever 44* 1 l 1 1 3 25 7 1* 1 3 - - Diphtheria 4 - - - - - 1 l - 1 1 ■■ - Malaria. 1 - - - - - - - - 1 - - - Ophthalmia Neonatorum. 3 3 - - - - - - - 1 - - . - Pneumonia 6 l - - - - - - - - - 3 2 Erysipelas 8 - - - - - 1 - - - - 4 2 Cerebro-Spinal Fever - - - - - - -- - - - - - - Measles 35 2 - 3 4 5 15 - 4 l 1 - - Whooping Cough. 55 5 10 6 7 7 19 l - - - - - Puerperal Pyrexia 10 - - - - - - - - 9 1 - - * Includes 1 case noncivilian. ~ - 19 - D. CASES OF INFECTIOUS DISEASES NOTIFIED DURING THE YEAR 1944 CLASSIFIED IN WARDS NOTIFIABLE DISEASES. NUMBER OF O.vSEb NOTIFIED Brentford West Brentford Central Brentford East Bedford Park Chiswick Park Grove Park Gunnersbury Old Chiswick Turnham Green Scarlet Fever 6 9 3 5 2 2 3 10 3 Diphtheria 2 - - - - - l - 1 Ophthalmia Neonatorum - - - 1 1 1 - - - Pneumonia 1 2 - 1 1 - - - 1 Erysipelas 2 - - 1 - 3 - - 2 Malaria - - - - 1 - - - - Measles 7 4 2 2 2 7 3 - 8 Whooping Cough 6 14 1 2 11 5 5 5 6 Puerperal Pyrexia - - - - 1 - - 9 - Tuberculosis: Respiratory 8 11 16 9 8 9 12 13 5. ' 10 Non-respiratory 2 2 - - 1 - - 2 3 T E. TUBERCULOSIS NEW CASES DEATHS Respiratory Respiratory Respiratory Respiratory Male Female Male Female Male Female Male Female Under 1 year - 1 - - - - - - 1 to 5 years 1 - - - - - - - 5 to 15 years 3 1 - 2 - - - 1 15 to 25 years. 16 14 2 1 - 3 1 1 25 to 35 years. 5 11 1 1 2 4 - - 35 to 45 yeas 8 5 - 1 4 - 1 - 45 to 55 years 11 4 - - 5 1 1 - 55 to 65 years 11 2 - 1 4 3 1 1 65 and over 2 1 - .. 1 1 - - '1 TOTALS 57 39 3 17 16 11 3 4 - 20 - 8 non-notified 'tuberculous deaths were recorded and are included in -the number of New Cases. (b) Laboratory Work. The following Table sets out a record of the bacteriological work during the year, all of which was carried out in the ??? Laboratory. Laboratory. Suspected Disease. Result Totals Positive Negative Diphtheria 1 181 182 Tuberculosis 3 44 47 Cerebro-Spinal Meningitis - - - Other Diseases 1 2 3 - 21 - CARE OF PURPETURE INFANTS Ministry of Health circular 20/44 March 1944. The instructions - from the Ministry of Health issued in the above ciroular were carried out by this Authority. . (l) Procuring Information (a) A personal letter was sent to each practitioner asking for notification of all infants whose birth weight,, was 51/2 pounds or under. (b) The Birth. Notification forms were altered to include this information. (d) Medical Officers of Health of neighbouring areas were asked to notify of any such cases born in their districts belonging to this Borough. (d) 'Similar information was asked for from' Queen' Charlotte's Hospital who undertake the Domiciliary Midwifery service in this Borough. (e) Midwives practising in the Borough were also informed of this requirement. (f) A Home Help service was. started. (g) Health Visitors were instructed to give special attention to these cases. (2) Provision of Apparatus This Authority approved of the purchase of:5 Draught-proof cots with detachable lining. 5 Electric Blankets 5 Maximum and Minimum Cot Thermometers 10 Rubber Hot Water Bottles. 12 Special Feeding Bottles. 6 Glass Mucus Catheters. Oxygen Tubing. (3) Arrangements were made for the conveyance (if necessary) of the infants to Hospital in the Borough Ambulances with a nurse in attendance and adequate hot water bottles. The majority of infants of this Borough are born in Institutions, and those weighing 51/2 pounds and under are notified to us. Similarly those born in Chiswick Hospital are immediately notified to Medical Officer of Health of District concerned. - 22 - THE CARS OF ILLEGITIMATE CHILDREN Ministry of Health Circular 2866 May 1944, In order* to facilitate the carrying out of instructions and suggestions of the Minister, a conference of all Welfare Authorities in Middlesex was called by the County Medical Officer. The County Medical Officer stated that "Investigations "carried out before calling the conference indicated that the problem was "at present largely a County concern in" that it was being encountered by "the Almoners in the Maternity Departments of the County Hospitals "where-50% of the births occur), by the public Assistance Department, "in the County V.D.Clinics, and in the County's Maternity and Child "Welfare area by the County Midwives and Health Visitors. " The cases to be. dealt with fall into three classes: " (a) .those in which, the girl is able to return home to her " parents with her baby, " (b) those in which adaption of the child is advisible on " account of the extreme youth of the mother, or of the * fact that she is a married woman, and " (c) those for which there is need of shelter to which the " mother after confinement, may go with her baby and stay " for a time in an atmosphere of. security until with " sympathy and help she is able to re-establish herself " and make a permanent home for herself and child." (a) and (b) are dealt with by special attention by Health' Visitors in co-operation with the Hammersmith Moral Welfare Society; as regards (c) this Authority joined in the County scheme in which a spccial services almoner (Miss Myer) was appointed to visit and investigate cases on the lines laid down in the Circular and consult with Health Visitors and other workers. The County also overcame perhaps the most difficult problem of finding accommodation for the expectant mother, and for the mother and child,by making arrangements with the British Red Cross for beds in two hostels:- (1) Before the birth of child at l6, The Park, Golders Green. (2) After the birth of child at B.R.C.Hostel "Maryland", Hendon. The charge is 35/- per week at each hostel, and this charge includes the baby at "Maryland". -23- STEPS T.KEN TO COMBAT INFESTATION: A report on the incidence and treatment of infestation was included in the annual Report for 194-3 and there is little fresh to mention this year. Consequently the yellowing is largely a repetition of the previous report with the necessary alterations in the statistical figures:- (1) 11 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, 226.visits were made with an average of 11.9 visits to each school by the School Nurses for Hygiene Inspections. During the year 23,380 examinations and re-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 rare. Perhaps the usual type of mother who will. trouble to take her children to these Clinics will also take the trouble to see that her children are clean. (2) At the Day 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 necessar; attention to their children. (3) In the schools, 403 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 infested again. . . (4) Four cases were referred from Factories in 1944. Methods, of Dealing, with Cases; agents used- (1) Durbac Soap and Saqaerre Comb, (2) Lethane Hair Oil, The vast majority of the cases were.treated with Durbac soap and Saquerre comb or some other form of small tooth comb. Lethane Hair Oil was never extensively used and was unpopular partly because it did not remove the nits and partly because the hair was not allowed to be washed for a week after application of the oil. (I) M. & C.W. 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 not examined in the Clinic, as such a course would probably have caused considerable resentment, but where it was thought to be advisable ??? Health Visitor made a special visit to the home. -24- (2) DAY NURSERIES; (a) Mild Gases - were cleansed, and nits, removed "before . they were-allowed to mix with other children. (b) Severe Gases - were not to be admitted. The rule is that the Wealth Visitor mast 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, (Mo cases of this degree were found during the year). (3) SCHOOLS: Each child found to be affected is given a note for its parents, stating the fact and giving simple instructions as to how it might be treated. It also states that Durbac Soap and a Saquerre 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 gives 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 arc present in the household, the child is cleansed at the School Clinic. There were 12 of these cases during the year. (4) FACTORY CASES wore seen by a Nurse, exact instructions given, Durbac Soap provided and a Saquerre comb lent or purchased. I would like to repeat that it would seem that the incidence 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. - 25 - BOROUGH OF BRENTFORD & CHISWICK EDUCATION ACT, 1921. REPORT OF THE MEDICAL INSPECTION AND TREATMENT OF ELEMENTARY SCHOOL CHILDREN FOR THE YEAR ENDING 3let DECEMBER, 1944*. To the Chairman and Members of the Education Committee. Ladies and Gentlemen, I beg to submit tables indicating the work of the School Medical Service during 1944. The incidence of Infectious Disease in the schools is indicated in the following table:- 1944 ACTUAL CLOSES. Jan • Feb .Mar. Apr. May. Jne, J\Y .Aug. Sept. Oct. Nov. Dec. Total* Scarlet Fever. 8 5 10 10 5 5 3 - - - 1 1 48 Diphtheria . 1 - - 1 - - 1 - - - 1 - 4 Chicken-pox 5 24 32 13 11 11 7 - - - - 3 106 Measles 2 7 78 139 154 96 36 - 1 - - 4 517 Whooping Cough 16 14 19 17 20 11 2 - - 5 9 10 123 Mumps 9 46 68 27 13 2 - - 2 - 1 3 171 Ringworm 1 1 - - - - - - 1 - - 1 4 Impetigo 7 10 6 7 8 2 4 - 5 11 19 8 87 Fc.zema - - - 3 - - - - - - - - - Verminous 13 7 18 7 15 5 4 — 2 8 4 - 85 Scabies 18 13 20 10 6 6 l - 7 5 12 16 114 Other. Skin Diseases - 1 - - - - - - 1 - 1 - 3 Conjunctivitis - - 2 - - - - - - - - - 2 Totals 80 128 253 234 232 138 58 • - 19 29 48 48 1267 —26 — The following figures,and tables of work in this service are in addition to the Statutory Tables issued to the Board of ORTHOPASDIC CLINIC Total number of attendances 806 Nufriber of individual children 6l Surgeon Total number of 'attendances 207 Number of individual children 116 SUN-RAY CLIN I C Total number of attendances 1066 Number of individual children 72 RHEUMATISM CLINIC Total number of attendances 2 90 Number of individual children 102 MINOR AILMENT CLINIC Total number of attendances 9926, Number of, individual children. 1721* Total number of exclusions 692 Total number of re-admissions 529 Number of special cases 1066 Number of special cases re-inspected 546 OPHTHALMIC CLINIC Number of attendances 524 New cases 159 Retinoscopy 138 Glasses prescribed 71 Glasses issued 86 Other cases 22 Individual children 321 DIPHTHERIA IMMUNISATION CLONIC Number of attendances (School) 2294 Number of attendances (Welfare) 2067 PERSONAL HYGIENE , Number of visits to schools 226 Average number of visits to. Schools. 11.9 Number of examinations 2,420 Number of individual- children defective 403 Number of re-examinations 960 VISITS Total number by School Nurses 617 * Ihis number includes all children attending the Clinic. The number of those actually treated was 367. remainder were those referred to other clinics, to their own doctor, to hospital - those given advice or kept under observation. - 2 7 - BOARD OF EDUCATION MEDICAL INSPECTION uND TREATMENT RETURNS FOR YEAR ENDED 3IST DECEMBER 1944 Table 1 MEDICAL INSPECTIONS OF CHILDREN ATTENDING PUBLIC ELEMENTARY SCHOOLS. A.- ROUTINE MEDICO INSPECTIONS, (1) No. of Inspections: Entrants 51 Second ??? 310 Third Age Group 345Total 56 (2) No.of-other Routine Insspections 277. GRAND Total 1433 B.- OTHER INSPECTIONS. No. of Special Inspections and Re-inspections 2008 TABLE 11. CLASSIFICATION OF THE NUTRITION OF CHILDREN INSPECTED DURING THE YEAR IN THE ROUTINE AGE GROUPS. Number of Children Inspected A. B. C. D. (Excellent) (Normal) (Slightly subnormal) (Bad) No. No. %. No. %. No. %. Entrant 501 184 36.7 266 53.1 51 10.2 - - Second 310 79 25.5 203 65.5 27 8.7 1 3 Third 345 155. 44.9 170 49.3 18 5.2 2 6 Other 2 77 111 40.1 152 54.9 14 5.1 - - Total 14,13 529 36.9 721 55.2 110 7.7 3 2 Table 111 GROUP I. Treatment of Minor Ailments,(excluding uncleanliness). Total Number of Defects treated or under treatment during the year under the Authority's Scheme 367. GROUP II. Treatment of Defective and and Squint. . « Under, the Authority's Scheme ERRORS OF REFRACTION (including squint) 138 Other defect or disease of the eyes (excluding those recorded in Group I) Nil No* of Children for whom spectacles were Under the Authority's Scheme (a) Prescribed 7 86 - 28 - GROUP III. - Treatment of Defects of Nose and Throat. Under the -Authority's Scheme. Received Operative Treatment 17 Received other forms of Treatment 21 Total number .treated 38 TABLE' IV . DENTAL INSPECTION TR^iTMENT (1) Number of chil.dren inspected by the Dentists (a) Routine age-groups 3123 (b) Specials 842 (c) Total (Routine and Specials) 3965 (2) Number found to require treatment 2863 (3) Number actually treated 1564 (4) Attendances made by children for treatment 3767 (5) Half-days devoted tot- Inspection 43 Treatment 519 562 (6) Fillings:- Permanent Teeth 2099 Temporary Teeth 967 3066 (7) Extractions:- Permanent Teeth 301 Temporary Teeth 1486. 1787 (8) Administrations of general anaesthetics for extractions 792 (9) Other Operations:- Permanent Teeth 533 Temporary Teeth 715 1248 TABLE V (1) V. '1 ■ Average number of visits per school made during the year by the School Nurses 11.9 (2) Total number of examinations of children in the Schools by School Nurses. 23380 (3) Number of, individual children found unclean 403 (4) Number of individual children cleansed under Section 87(2) and (3) of the Education Act, 1921. 12 (5) Number of cases in which legal proceedings were taken:- (a) Under the Education Act, 192 Nil (b) Under School Attendance Byelaws 1 - 29 - . 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. 1. 2. 3. At a Public Elementary School. At an Institution other than a Special School, At no School or Institution Blind Children - - - Deaf Children - - -