CHICT 10 AC 4411 (3) CH1 Chigwell Urban District Council Annual Report of the MEDICAL OFFICER OF HEALTH including the Report of the SENIOR SANITARY INSPECTOR For the Year ending December 31st, 1946 WEST ESSEX PRINTING CO. LTD., GAZETTE OFFICES, EPPING CHIGWELL URBAN DISTRICT COUNCIL. To the Chairman and Members of the Chigwell Urban District Council. Mr. Chairman, Ladies and Gentlemen, I beg to present the Annual Report for the year 1946 upon the health and sanitary circumstances of the district. I take this opportunity of thanking the staff of the Public Health Department for their help and co-operation and the members of the Public Health Committee for their support during the year. L, S, FRY, M.D., D.P.H. CHIGWELL URBAN DISTRICT COUNCIL. PUBLIC HEALTH COMMITTEE. Chairman : Councillor H. Spurr. Members: Councillor Mrs. G. V. Cross C. T. Davie C. F. Housden K. F. Jefferys W. A. Nichols E. G. Perry Mrs. L. M. Scott W. H. Wilson The Chairman and the Vice-Chairman of the Council ex-officio. PUBLIC HEALTH STAFF: Medical Officer of Health : L. S. Fry, M.D. (Camb.), D.P.H. Senior Sanitary Inspector and Petroleum Inspector : To 4.8.46 : J. T. Heath, M.R.San.I., M.S.I.A. Royal Sanitary Institute's Certificates for :— (i) Sanitary Inspector. (ii) Inspector of Meat and Other Foods. From 4.8.46 : W. H. Digweed, A.R.San.I., M.S.I.A. Royal Sanitary Institute and Sanitary Inspectors' Joint Board Certificate. Royal Sanitary Institute Certificate for Inspector of Meat and Other Foods Sanitary Inspectors : To 4.8.46: W. H. Digweed, A.R.San.1., M.S.I.A. From 1.6.47 : E. A. Ellis, A.R.San.I., M.S.I.A. Royal Sanitary Institute and Sanitary Inspectors' Joint Board Certificate. Royal Sanitary Institute Certificate for Inspector of Meat and Other Foods. Clerk: Miss J. Warmer SECTION A. Statistics and Social Conditions of the Area. Area (in acres) 8,970 (14 sq. miles approx.) Population 28,190 Number of inhabited houses 7,947 Rateable value £249,205 Sum represented by a penny rate £996 The rate in the pound for 1946/47 is 15s. 2d. Development is proceeding on extensive L.C.C. Estates at Chigwell (Hainault estate) and Loughton (Oakwood estate) and in lesser degree on the Council's Roding Valley Housing Estate (permanent) and four temporary bungalow sites. The Greater London Plan, however, makes extensive reservations for a regional and local green belt and the eventual population of the district will be about 55,000. An approach to this figure must be expected within a few years. This development foreshadows big socials changes in the district, and, for a time at least, the problems of providing schools, child welfare centres and clinics for the new population are likely to be acute. Existing clinics in Loughton and Chigwell are already overcrowded and resort will probably have to be made to temporary buildings on the new estates themselves. An area for selected Light Industry has been allowed adjoining the L.C.C. Loughton housing estate and similar provision, but in a neighbouring borough, is envisaged adjoining the L.C.C. Hainault Estate. Page 2 Vital Statistics. Male Female Total Live births : Legitimate 274 257 531 Illegitimate 20 24 44 Total 575 Birth rate per 1,000 estimated resident population 20.0. Male Female Total Still births : Legitimate 11 5 16 Illegitimate 1 — 1 Total 17 Rate per 1,000 (live and still) births 28.7. Male Female Total Deaths 140 155 *295 *Registrar General's figures. Death rate per 1,000 estimated resident population 10.4. Deaths from sepsis and other maternal causes 0. Deaths of infants under 1 year: Male Female Total Legitimate 8 5 13 Illegitimate — 2 2 Total 15 Death rate of infants under 1 year : All infants per 1,000 live births 26 Legitimate infants per 1,000 legitimate live births 24 Illegitimate infants per 1,000 illegitimate live births 45 Deaths from Cancer (all ages) 58 Deaths from Measles (all ages) 0 Deaths from Whooping Cough (all ages) 0 Deaths from Diarrhoea (under 2 years) 0 Page 3 Comments on Vital Statistics for 1946. The population, according to the Registrar General's estimate, increased during the year by 3,020. The birth rate rose from 17.7 to 20.0. The death rate fell slightly and the infantile mortality rate was lowest since 1938. Analysis of Deaths according to age incidence. Age 1946 1945 1944 1943 1942 Number of Deaths Under 1 year 15 16 25 16 16 1 and under 2 — 3 — 1 — 2 „ „ 5 3 1 — — — 5 „ „ 15 1 3 7 2 6 15 „ „ 25 4 5 — 7 4 25 „ „ 35 10 7 3 10 8 35 „ „ 45 12 15 13 8 10 45 „ „ 55 19 18 20 24 18 55 „ „ 65 43 31 47 42 40 65 „ „ 75 79 69 62 62 66 75 and upwards 110 111 89 95 80 Total 296 279 266 267 248 The following table shows the vital statistics for district for the six years 1941—46 :— Year Birth Rate per 1000 of Population Number of Illegitimate Births Infantile Mortality Rate. Per 1000 (Live Births) Death Rate Estimated Population 1941 13.2 13 52 11.7 25,070 1942 16.7 23 38 10.0 24,860 1943 19.4 37 33 10.8 24,680 1944 20.9 66 48 10.9 24,820 1945 17.7 68 38 11.2 25,170 1946 20.0 44 26 10.4 28,190 Page 4 Birth Rates, Civilian Death Rates, Analysis of Mortality and Case Rates for Certain Infectious Diseases in the Year 1946. (Provisional figures based on Weekly and Quarterly Returns). England and Wales 126 County Boroughs & Great towns including London 148 Smaller Towns (Resident Populations 25,000 to 50,000 at 1931 Census) London Adm. County Chigwell Rates per 1,000 population:— Still Births 0.53 0.67 0.59 0 0.60 Live Births 19.1 22.2 21.3 21.0 20.0 Deaths:- All causes 11.5 12.7 11.7 12.7 10.4 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 0.00 Scarlet Fever 0.00 0.00 0.00 0.00 0.00 Whooping Cough 0.02 0.02 0.02 0.02 0.00 Diphtheria 0.01 0.01 0.01 0.01 0.00 Influenza 0.15 0.13 0.14 0.12 0.17 Smallpox 0.00 0.00 0.00 0.00 0.00 Measles 0.00 0.01 0.00 0.01 0.00 Rates per 1,000 Live Births Deaths under 1 year of age 43 46 37 41 26 Deaths from Diarrhoea and Enteritis under 2 years of age 4.4 6.1 2.8 4.2 — Rates per 1,000 Civilian Population:— Notifications :— Typhoid Fever 0.01 0.01 0.01 0.01 0.07 Paratyphoid Fever 0.02 0.02 0.01 0.01 0.00 Cerebro Spinal Fever 0.05 0.05 0.04 0.06 0.00 Scarlet Fever 1.38 1.51 1.33 1.42 0.81 Whooping Cough 2.28 2.48 2.05 2.22 1.31 Diphtheria 0.28 0.32 0.31 0.24 0.14 Erysipelas 0.22 0.25 0.22 0.27 0.17 Smallpox 0.00 0.00 0.00 0.00 0.00 Measles 3.92 4.73 3.70 7.35 1.45 Pneumonia 0.89 1.02 0.74 0.75 0.57 Page 5 Causes of Death as Given by the Registrar General for the Year 1946. Male Female Total Tuberculosis (all forms) 9 1 10 Syphilitic disease — 1 1 Influenza 1 4 5 Acute infectious encephalitis — 1 1 Cancer (all forms) 30 28 58 Diabetes — 1 1 Intracranial vascular lesions 18 22 40 Heart disease 34 44 78 Other diseases of circulatory system 6 9 15 Bronchitis 9 4 13 Pneumonia — 9 9 Other respiratory diseases 1 3 4 Ulcer of duodenum or stomach 1 1 2 Appendicitis 1 — 1 Other digestive disease 1 5 6 Nephritis 4 3 7 Premature birth 3 2 5 Congenital malformations 5 4 9 Birth injuries Infantile diseases Suicides 1 — 1 Road traffic accidents 2 — 2 Other violent causes 3 3 6 All other causes 11 10 21 Total 140 155 295 Page 6 SECTION B General Provision of the Health Services in the District. (a) Public Health Officers of the Local Authority (sec page / ). (b) Laboratory Facilities. A Ministry of Health Laboratory operates at St. Margaret's Hospital, Epping. Milk and ice cream samples are examined at The Counties Public Health Laboratory, 66 Queen Victoria Street, London, S.W.I. (c) Ambulance Facilities. The work done during the year by the Council's Ambulance is given below. In June, 1946, a contract was entered into with Messrs. Brown's Garage, Loughton, for the conveyance of sitting cases to hospitals, maternity homes, etc. This arrangement has worked satisfactorily. Ambulance calls during 1946 were :— Accidents Medical Maternity Total number Cases Cases of Calls 113 255 13 381 Sitting Case Car. Accidents Medical Maternity Total number Cases Cases of Calls 8 275 153 436 (d) and (e) Clinics and Treatment Centres. Child Welfare Centres :— Buckhurst Hill: County Council Clinic, Buckhurst Way— Thursdays at 2.30 p.m. Chigwell: St. Winifred's Church Hall, Chigwell Row—1st and 3rd Wednesday at 2.30 p.m. Page 7 Loughton: Union Church Hall, High Road—Fridays at 2.30 p.m. Roding Road Church Hall—Tuesdays at 2.30 p.m. Goldings Hill Mission Hall—1st, 3rd and 5th Tuesdays at 2.30 p.m. Diphtheria Immunisation: Clinics are held once a month at the following Child Welfare Centres :— Buckhurst Hill: County Council Clinic, Buckhurst Way— 2nd Thursday at 2.30 p.m. Chigwell: St. Winifred's Church Hall—3rd Wednesday at 2.30 p.m. Loughton : Union Church Hall, High Road—2nd Friday at 2.30 p.m. Goldings Hill Mission Hall—3rd Tuesday at 2.30 p.m. Roding Road Church Hall—2nd Tuesday at 2.30 p.m. Treatment of Scabies:— Buckhurst Hill: County Council Clinic, Buckhurst Way— by arrangement. Loughton : Council Depot on Tuesday and Friday afternoons. Ante-natal Clinics:— Union Church Hall, Loughton—1st, 2nd 3rd and 4th (not 5th) Thursdays at 2 p.m. County Council Clinic, Buckhurst Hill—1st and 3rd Fridays at 2.30 p.m. The Essex County Council is the authority for Maternity and Child Welfare under Part VII of the Public Health Act, 1936. Tuberculosis Dispensaries : Essex County Council. For patients in the district:— Buckhurst Hill: County Council Clinic, Buckhurst Way— 2nd and 4th Wednesdays at 2.30 p.m. Combined Treatment Centre, Regent Road, Epping—every Tuesday from 9.0 a.m. to 1 p.m. Page 8 (f) Midwives. The following are the midwives in the employment of the County Council practising in the district:— Buckhurst Hill : Miss G. D. Jones, 197, High Road, Buckhurst Hill. Chigwell: Miss F. E. R. Guise, 2, Puckeridge Cottages, Vicarage Lane, Chigwell. Loughton : Miss G. H. Quill, 36, York Hill, Loughton. Application for admission to hospital for confinement should be made to one of the Health Visitors or at an Antenatal Clinic. (g) and (h) Nursing in the Home and Home Helps: The following district nurses are employed by District Nursing Associations:— Buckhurst Hill: Miss F. Botell, 126, Queen's Road, Buckhurst Hill. Chigwell: Miss F. E. R. Guise, 2, Puckeridge Cottages, Vicarage Lane, Chigwell. Loughton : Miss J. Gardner, 60, Algers Road, Loughton. The County Council employs Home Helps, but the demand for this form of assistance far outruns the supply and no progress can be made until more suitable women are available for this work. Application should be made to one of the Health Visitors at an Ante-natal Clinic. (i) Hospitals : No change. Essex County Hospital, Wanstead. St. Margaret's Hospital, Epping Forest Hospital, Buckhurst Hill. Admission through the Social Welfare Officer. (j) Child Life Protection : The County Council is the authority under Sec. 206 of the Public Health Act, 1936. Any person who undertakes for reward the nursing or maintenance of a child under the age of nine years apart from his parents, or having no parents, must give notice to the Welfare Authority. Page 9 Application for registration as a foster parent should be made direct to the County Medical Officer, County Hall, Chelmsford or to one of the local County Health Visitors:— Buckhurst Hill: Miss Dennis, County Council Clinic, Buckhurst Way, Buckhurst Hill. Chigwell: Miss Moore, County Council Clinic, Buckhurst Way, Buckhurst Hill. Loughton : Miss Ward, Council Offices, Loughton. (k) Tuberculosis—Forest Area Tuberculosis Care Association: During the year a Care Association was set up for an area covering the Chigwell, Epping, Waltham Abbey and Ongar districts. The Association assists cases awaiting admission to sanatorium in various ways and arranges also for the admission of child contacts to convalescent homes. It concerns itself also with the after care of patients by assistance in obtaining materials for occupational therapy and whenever possible, suitable employment for those fit for work. The Association is supported by voluntary contributions and receives also a grant from the County Council. The Honorary Secretary is Mr. A. J. Edwards, 37, Woodland Road, Loughton. ESSEX COUNTY COUNCIL ACT, 1933. List of Establishments for Massage or Special Treatment. The following establishments are licensed to 31st March, 1947— Miss E. Mackern, 45, Church Hill, Loughton. "Madame Pauline," 100, High Road, Loughton. These premises have been inspected and are being conducted in a satisfactory manner. Page 10 SECTION C. Sanitary Circumstances of the Area. 1. (i) Water. The water supply for almost the whole district is derived from the Metropolitan Water Board, and this supply is satisfactory. There are a few houses where the supply is still obtained from wells. (ii) Drainage and Sewerage. The sewage disposal plant at Luxborough continued to work efficiently and yield a satisfactory effluent, but the sludge treatment part of the plant is working at full load due to the increase in population. This will be remedied in the scheme now in course of preparation for the approximate doubling of the whole works necessary to cope with the population increase to be expected from the L.C.C. development. The disposal plant at Millers Lane is obsolete and worn out. The quality of the effluent necessarily varies considerably as a result and the works will be entirely reconstructed as part of the major scheme now being prepared for the Luxborough Works. The four pumping plants in the district functioned efficiently throughout the year. 2. Rivers and Streams. The River Roding is the only one passing through the centre of the district dividing the wards of Chigwell on the south-east side and Buckhurst Hill and Loughton on the north-west side. There are no buildings at present liable to floods in the river area which is under the jurisdiction of the Roding Catchment Board. 3. (i) Closet Accommodation. A few closets on the conservancy system remain in Chigweil and Loughton wards. They are situated in remote cottages out of reach of sewers. (ii) Public Cleansing. House refuse was removed weekly by covered motor vans, to which paper salvage trailers are attached. During Page 11 the year the change from hired vehicles to the Council's own plant was completed, and three Fordson 10/12 cub. yd. lorries with "Eagle" bodies are now in service and working satisfactorily. Trade refuse collection on a scale of charges according to quantity was introduced during the year and many traders are availing themselves of the service. The refuse was disposed of at the contractor's tip near the district boundary by the method, with the appropriate precautions, of controlled tipping. Measures were again taken against fly nuisance during certain months and appear to have been effective. Salvage operations continued during the year throughout the district. The total salvaged material of all descriptions collected, sorted and disposed of was 380 tons, including 181 tons of paper. In addition, 145 tons of kitchen waste was collected and conveyed to a concentrator plant at Stapleford Abbotts. Road gullies (in streets under the Council's control) are emptied by a mechanical suction process. The gullies are cleared three times in each year and resealed with clean water after emptying. (iii) Sanitary Inspection of the Area. An outline of the work of the Sanitary Inspectors is given below :— Complaints received and dealt with 221 Inspections made 5,932 Nuisances abated 161 Informal Notices served 264 Informal Notices complied with 189 Statutory Notices served 52 Statutory Notices complied with 30 Legal Proceedings Nil Summary of Nuisances: Animals improperly kept 1 Cellars flooded 5 Cesspool overflows, etc. 8 Drains blocked or defective 84 Polluted ditches and streams 9 Smells from dead animals, etc. 11 Page 12 Water closets defective 25 Mosquitoes and moths 2 Moveable dwellings 1 Accumulations of refuse 4 Vermin, bed bugs 3 Well overflows, etc. 2 155 Verminous Houses: Twelve houses were found to be verminous during the year. These houses were fumigated with "Thermatox" and sprayed with "Zaldecide" with satisfactory results. Number of inspections and visits, 25. Rats and Mice Destruction Acts : There was again a rise in the number of complaints. 576 visits were made and energetic action has been taken to exterminate the rodents by means of gassing with "Cymag" gas, baiting with Red Squill and trapping. There is no serious infestation, but the presence of rats is still being reported from all over the district particularly where houses are situated near open spaces, such as farm and forest land. SECTION D. Housing Statistics for the Year 1946. Number of new houses erected and occupied during the year:— Permanent 44 Pre-fabricated 101 145 Page 13 Inspection of Dwelling Houses During the Year: 1. (a) Total number of dwelling-houses inspected for housing defects (under Public Health and Housing Acts) 403 (b) Number of inspections made for the purpose 1,146 2. (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 Nil (b) Number of inspections made for the purposes Nil 3. Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil 4. Number of dwelling-houses clusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 51 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 180 Action Under Statutory Powers During the Year: (a) Proceedings under Section 9, 10 and 16 of the Housing Act, 1936. (1) Number of dwelling-houses in respect of which notices were served requiring repairs 50 Page 14 (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) by Owners 26 (b) by Local Authority in default of Owners 2 (b) Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 1 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) by Owners 1 (b) by Local Authority in default of Owners Nil (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 Nil (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil Housing Act, 1936—Part IV—Overcrowding No formal action owing to the general housing shortage. Eleven inspections and visits have been made and action taken where possible, but as there is still an acute shortage of houses there is great difficulty in alleviating overcrowding. The issue of certificates showing permitted numbers to the end of the year is as follows:— Buckhurst Hill 350 Chigwell 169 Loughton 397 916 ' Page 15 Summary of Defects. Defective roofs 120 gutters and rain water pipes Ill external walls 68 „ yard paving 37 drains and vent pipes 50 W.C.s 34 flush tanks 20 sinks and waste pipes 31 „ water fittings 28 internal walls (plaster) 76 floors, doors, etc. 149 sash cords 71 „ stoves 46 Dampness 81 Under floor ventilation, lack of 10 Dustbins, inefficient, etc. 31 Verminous rooms 12 Dirty walls and ceilings 119 Miscellaneous 27 SECTION E. Inspection and Supervision of Food. (a) Milk Supply. There are 12 cowkeepers on the register for the district; 2 produce and retail and 10 produce and sell wholesale. The number of farms producing graded and ungraded milk is: Tuberculin Tested 2; Accredited 8; Ordinary 3; total 13. The cowsheds have been kept in a satisfactory condition during the year and 172 visits have been made. The following premises have ceased to produce milk during the year:— Address. Type of Milk. Date. Loughton Hall Farm, Loughtcn. Ordinary. March, 1946. The Old House, Loughton. „ August, 1946. Debden Farm, Loughton. Tuberculin October, 1946. Tested. Page 16 5 samples of milk were taken for bacteriological examination by the County Council Public Health Department and all were reported upon as satisfactory. 36 samples of milk were taken by the Weights and Measures Department of the County Council during the year and all were reported upon as genuine. There are seven dairies and milkshops registered. 71 visits to these premises were made. There are 10 retail purveyors of milk registered. (b) Meat and Other Foods. There are 7 slaughterhouses in the district all licensed under the Food and Drugs Act, 1938. During the year 12 pigs were slaughtered under licence, also 4 young goats. 44 visits were made to slaughterhouses. There are 22 butchers' shops in the district and 285 visits were made to these premises. 32 visits have been made to restaurants and cafes. Other foodshops to which 375 visits have been made have been well conducted. The following foodstuffs have been submitted for inspection and found unsound or unfit for human consumption. Some items have been returned to suppliers for re-processing, others have been disposed of for animal food, or for manufacturing purposes and the remainder destroyed :— Fish Pilchards: tins 44 Salmon: tins 24 Sardines: tins 12 Crawfish: tins 1 Bristling: tins 1 Sild: tins 2 Fish paste: pots 1 Kippers: stone \\ Fruit Oranges: lbs. 150 Apples: lbs. 48 Sultanas: lbs. 15 Grapefruit: lbs. 40 Figs: lbs. 4 Dates: lbs. 7 Fruit cocktail: tins 1 Plums: tins 3 Pears: tins 1 Damsons: tins 1 Apricots: tins 5 Page 17 Meat Bacon: lbs. 50 Stewed steak: tins 9 Ham: tins 1 Pork and beans: tins 11 Steak and kidney: tins 2 Corned beef: 6-lb. tins 16; 12-oz. tins 6; 1 -lb. tins 3 Corned mutton: 1 -lb. tins 2; 12-oz. tins 1. Meat and vegetables: tins 19 Sheeps' tongues: tins 1 Sausage meat: tins 8 Luncheon meat: tins 8 Prem: tins 1 Vegetables Split peas: lbs. 90 Potatoes: lbs. 32; tins 1 Peas: tins 40 Carrots: tins 5 Dried peas: lbs. 11 Beetroot: tins 28 Beans: tins 47 Mixed vegetables: tins 6 Other Items Chocolate: 1 lb. 2 ozs. Milk: tins 292 Tea: lbs. 6 Table dessert: tins 20 Vegetables and gravey: tins 20 Party loaf: tins 1 Lemon curd: lbs. 3 Porridge oats: lbs. 18 Cheese Camambert: boxes 13 Wheat flakes: packets 2 Ovaltine rusks: packets 3 Macaroni cheese: tins 1 Chocolate pudding: packets 3 Sweets: lbs. 8 Jam: lbs. 6; tins 15 Sugar: lbs. 39¼. Marmalade: tins 6 Prepared meals: tins 1 Eggs: 76 Soup: tins 8 Cheese: lbs. 18 Macaroni: tins 4 Biscuits: lbs. 9 Corn flakes: packets 1 Tomato ketchup: galls. 2 All the tinned goods were either blown or punctured. Some items were rendered unfit by fouling by vermin. In the district there are 11 bakehouses. 136 visits have been made to these premises. (c) Factories. 78 visits have been made. (d) Outworkers. 18 visits have been made during the year. Page 18 (e) Shops Acts. 163 visits have been made as compared with 34 last year. (f) Adulteration. This is dealt with by the County Council. (g) Chemical and Bacteriological Examination of Food. This is dealt with by the County Council. A few samples of milk have, however, been submitted for examination. (h) Nutrition. No action. (i) Ice Cream. 125 visits have been made during the year. There are 6 manufacturers and 48 vendors on the register. Of the former, only one manufactures in a large way and on 3 occasions during the year, samples taken were reported upon as unsatisfactory. These premises have been visited regularly and advice and help given, resulting in various improvements to the factory and plant. 31 samples have been taken and submitted for examination with the following result:— Satisfactory Unsatisfactory Manufactured in district 23 3 Manufactured outside district 5 0 Summary of Sanitary Inspector's Visits During the Year Ended 31st December, 1946. General Sanitation. Nature of visit or inspection Total number of visits. Water supply 20 Drainage 705 Stables and piggeries 6 Fried fish shops 20 Tents, vans and sheds 5 Factories 78 Workshops 50 884 Page 19 C/F 884 Outworkers 18 Bakehouses 136 Public conveniences 2 Refuse collection 48 Refuse disposal 15 Rats and mice 576 Shops 163 Schools 4 Knackers' yard 23 Petrol 42 Miscellaneous sanitary visits 672 2,583. Housing. Under Public Health Acts. Number of houses inspected 198 Visits paid to above houses 463 Under Housing Acts. Number of houses inspected 205 Visits paid to above houses 683 Overcrowding. Number of houses inspected 5 Visits paid to above houses 6 Verminous Premises. Number of houses inspected 12 Visits paid to above houses 13 Miscellaneous housing visits 661 2,246 Infectious Disease. Inquiries in cases of Infectious Disease 69 Visits re disinfection 7 Miscellaneous Infectious Disease visits 48 124 Meat and Food Inspection. Visits to slaughterhouses 12 „ other premises 1 Total meat and food inspection visits 31 Page 20 Visits to butchers 285 „ fishmongers and poulterers 44 „ „ grocers 47 „ greengrocers and fruiterers 12 „ „ cowsheds 172 „ dairies and milkshops 71 „ „ ice-cream premises 125 „ restaurants 32 „ „ market stalls 5 Miscellaneous food visits 142 979 5,932 House refuse is collected under the supervision of Mr. G. Holbourn, A.M.Inst.C.E., Engineer and Surveyor. (Signed) W. H. DIGWEED, A.R.San.I., M.S.I.A., Senior Sanitary Inspector. SECTION F. Prevalence of, and Control Over, Infectious and Other DiseasesDiphtheria Immunisation. On 1st January, 1946, the County Council became the authority responsible for immunisation, but the arrangements as to clinics remained unchanged. There was a slight decrease in the number of children treated compared with the previous year. It is estimated that 61 per cent. of the children under 5 have now been immunised. Number of children immunised during the last 5 years :— 1942 1943 1944 1945 1946 762 408 401 445 371* *Note.—266 treated at clinics 105 by private practitioners. Number of children given third or re-inforcing injection, 199. Four cases of diphtheria were notified during the year; in one, the diagnosis was not confirmed. The remaining three were members of one family—a child not previously immunised and two adults. Page 21 Scarlet Fever. There was a decrease in the number of notifications, the disease continued to be mild in type and nearly half the cases were nursed at home. Measles. As was to be expected after the epidemics in 1945/46, the incidence was low in the district. Scabies. There was a gratifying fall in the number of notifications, 78 as compared with 103 in the previous year and it is hoped that with gradual improvement in housing conditions the disease will continue to become less prevalent. The arrangements for treatment at Buckhurst Hill and Loughton were unaltered and worked satisfactorily. Summary of treatment at clinics :— Male Female under 15. over 15 under 15. over 15. Total. Notified cases 12 23 11 32 78 Contacts ... 2 30 35 49 116 194 Summary of Cases of Infectious Disease Notified, Showing Number of Cases, Admissions to Hospital and Deaths. Total Cases notified Civilian Cases only). Admissions to Hospital. Deaths. Scarlet Fever 23 13 — Erysipelas 5 — — Acute Primary Pneumonia 16 - - Diphtheria 5* 5 — Pueperal Pyrexia 1 — — Dysentery 2 — — Measles 41 — — Whooping Cough 37 1 — Scabies 78 — — Typhoid 2 2 — 210 21 - * Diagnosis subsequently not confirmed in one case. Page 22 Tuberculosis. NEW CASES DEATHS Respiratory NonRespiratory Respiratory NonRespiratory Age Period. M. F. M. F. M. F. M. F. Under 1 year - - - - - - - - 1 and under 5 - - - - - - - - 5 „ „ 15 1 1 1 1 — — — — 15 „ „ 25 — 3 — 3 — — — — 25 „ „ 35 4 4 — — 2 1 — — 35 „ „ 45 8 3 — — — — — - 45 „ „ 55 5 3 — 1 4 — — — 55 „ „ 65 2 — — — 2 — — — 65 and upwards 1 — — — 1 — — — 21 14 1 5 9 1 — - Note.—35 new cases of pulmonary tuberculosis and 6 non-pulmonary were notified as compared with 31 and 5 in 1945. There were 10 deaths compared with 7 in 1945. APPENDIX. Rainfall in Inches by Months for 1946. Metropolitan High Beech Water Board Buckhurst Hill Luxborough S.D. Works C.U.D.C. Loughton Depot January 1.87 1.69 1.18 1.27 February 2.90 2.82 2.39 2.66 March 1.56 1.25 1.19 1.01 April 1.77 1.55 1.24 1.41 May 2.64 2.92 3.48 2.56 June 2.83 2.95 3.10 3.02 July 3.16 2.25 1.72 2.34 August 4.06 4.65 3.58 3.47 September 3.10 3.16 2.77 3.13 October 1.87 1.55 1.10 1.90 November 4.36 4.02 3.03 3.76 December 2.10 2.06 1.80 2.01 Totals 32.22 30.87 26.58 28.54 The highest point in the District is 372 O.D., and the lowest 44 O.D. Page 23