CHIN 5 BOROUGH OF CHINGFORD ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1940 E. G. Ellis & Sons (T.U.) Willow Street, Chingford BOROUGH OF CHINGFORD Committee : November, 1939—November, 1940 PUBLIC HEALTH AND HOUSING COMMITTEE Chairman:— Alderman Mrs. E. E. STUTELY, J.P. Members :— Alderman Miss M. L. MATHIESON, C.C. „ R. Z. SMITH „ E. E. WAY Councillors H. E. CHINNER „ Mrs. N. HART „ F. J. KING „ Mrs. S. L. OAKES „ W. P. SOGGEE W. F. GILLHAM, Esq., J.P. (Mayor) (ex-officio). Meeting:—Second Tuesday in each month, at 7.30 p.m. PUBLIC HEALTH OFFICERS OF THE AUTHORITY (1940) MEDICAL OFFICER OF HEALTH : G. B. MURRAY, M.B., Ch.B., D.P.H. CHIEF SANITARY INSPECTOR : JAMES F. ROGERS, M.R.San.I., M.S.I.A., Certified Inspector of Meat and Other Foods. Superintendent of Refuse Collection and Disposal. Inspector under the Shops Acts and Petroleum Acts. A.R.P.S. Instructor (Special). ADDITIONAL SANITARY INSPECTORS : J. T. S. TEMPLEMAN, A.R.San.I., M.S.I.A. (Military Service from July, 1940). P. W. EDWARDS, C.R.San.I., M.S.I.A. CLERKS. Miss V. M. PETTIT. Miss J. CRACKNELL. (From 14.5.40). A. E. CULPIN. (On Military Service). D. G. BLEACH. 2 Section A.—STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area 2,860 acres Population—Registrar-General's estimate 37,220 Number of inhabitated houses end of 1940 12,250 Rateable value on April 1st, 1940 £332,500 Sum represented by a penny rate on April 1st, 1940 (gross) £1,385 8s. 4d. Vital Statistics * Infant Mortality † Birth Rate M. F. M. F. Live Births Total 285 269 301 282 Birth Rate per 1,000 of Iestimated resident population : 15.66. Legitimate 279 264 294 277 Illegitimate 6 5 7 5 * For calculating Infant and Maternal Mortality † For calculating Birth Rates M. F. M. F. Stillbirths Total 7 7 8 7 Rate per 1,000 total (live and still) births: 25.08. Legitimate 7 7 8 7 Illegitimate — — — - Deaths M. F. Crude Death Rate per 1,000 of estimated resident population: 195 187 10.26. Corrected by comparability factor: 13.13. Deaths from Puerperal Sepsis 0 „ „ other puerperal causes 0 Death Rate of Infants under one year of age:— All infants per 1,000 live births 45 Legitimate infants per 1,000 legitimate live births 45 Illegitimate infants per 1,000 illegitimate live births Deaths from Cancer (all ages) 51 ,, „ Measles (all ages) — Deaths from Whooping Cough (all ages) 0 „ „ Diarrhoea (under 2 years of age) 1 „ „ Scarlet Fever 0 3 Table of Birth and Death Rates Year Population Births Rate per 1,000 Deaths Rate per 1,000 INFANT MORTALITY Deaths Rate per 1,000 1935 29,690 (estimated) 505 17.0 210 7.0 12 23 1936 32,850 (estimated) 563 16.3 236 7.18 21 37 1937 35,970 (estimated) 590 16.3 269 7.6 26 44 1938 37,510 (estimated) 612 16.31 269 7.17 28 45 1939 (a) 39,460 668 16.93 261 6.8 15 22 (b) 38,160 10.26 crude 13.13 standardised 25 45 1940 37,220 583 15.66 382 Section B.—GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. (a) Laboratory Facilities. The Counties' Public Health Laboratories have removed their staff to the Gidea Park College, Gidea Park, Essex, where the laboratory is now installed. The number of specimens from the district examined at the Counties' Public Health Laboratories was as follows:— Diphtheria 106 Sputa 123 Typhoid 36 Ringworm — General 149 Milk and Ice Cream 23 Water 2 Sewage - Total 439 (b) Ambulance Facilities. The ambulance facilities are adequate for the district and there was no change during the year. The following is a summary of the work performed by the Council's two ambulances during 1940 : Private calls Accident calls Council Service 876 95 St. John Ambulance Service 62 14 Total Mileage 16,324 (c) Nursing in. the Home. No change. (d) Clinics and Treatment Centres. See Table of Clinics on Page 6. (e) Hospitals. No change. (f) Midwives. Number of nurse midwives employed by Chingford District Nursing Association:—3. County Council midwife for domiciliary service:—1 (Mrs. P. M. Stenning, 237, Hall Lane, E.4. Tel. : Sil. 3263). Independent midwife : 1. During the year 2 registered Nursing Homes in the district were closed, leaving one registered Home still receiving patients. 5 CLINICS AND TREATMENT CENTRES Clinic or Dispensary Where held When held Diphtheria Immunisation Clinics Church Hall, The Ridgeway, North Chingford. County Council Clinic, Marmion Avenue, South Chingford. Wednesdays 10 a.m. Mondays 11 a.m. Maternity and Child Welfare Clinic Methodist Church Hall, New Road, South Chingford. Tuesdays 1.45 p.m.—3.45 p.m. Maternity and Child Welfare Clinic Methodist Church Hall, New Road, South Chingford. Wednesdays 1.45 p.m.—3.45 p.m. Maternity and Child Welfare Clinic Mission Hall, Sewardstone Road, North Chingford. 2nd, 4th and 5th (if any) Wednesday of each month 1.45 p.m.—3.45 p.m. Toddlers' Clinic Methodist Church Hall, New Road, South Chingford. Thursdays 10 a.m.—12 noon. Maternity and Child Welfare Clinic Spicer Hall, Buxton Road, North Chingford. Thursdays 1.45 p.m.—3.45 p.m. Ante-natal Clinic 50, Friday Hill, Chingford. 1st and 3rd Mondays 1.45 p.m. Maternity and Child Welfare Clinic 50, Friday Hill, Chingford. 2nd and 4th Mondays 1.45 p.m. Ante-natal Clinic County Council Clinic, Marmion Avenue, South Chingford. Wednesdays 10 a.m. Fridays 10 a.m. (except 1st Friday in each month). Post-natal Clinic 50, Friday Hill, Chingford 1st Friday of every month at 10 a.m. Minor Ailment and School Clinic County Council Clinic, Marmion Avenue, South Chingford. Mondays 9.30 a.m.—12 noon Orthopædic Clinic County Council Clinic, Marmion Avenue, South Chingford. Masseuse in attendance, Mondays 9 a.m. Thursdays 1.30 p.m. Tuberculosis Dispensary Old Monoux School, High Street, Walthamstow, E.17. New cases— Wednesdays 10 a.m.—12 noon. Venereal Diseases London Hospitals. 6 Section C.—SANITARY CIRCUMSTANCES OF THE AREA Water Supplies. A hard, pure and constant piped water supply is provided by the Metropolitan Water Board, and the supply has been satisfactory in both quality and quantity. Work is still being continued on the second reservoir of the Metropolitan Water Board. Rivers and Streams. It was not necessary to take any action as to the pollution of water courses in the area. Public Cleansing. The collection and disposal of house and trade refuse is carried out under the direction of the Chief Sanitary Inspector. A weekly collection of refuse was maintained, using four 10 cubic yard freighters. The total weight of refuse disposed of at the Works was 5,954 tons, a decrease of 1,018 tons from the amount collected during the previous year. This decrease was due to the number of families who were evacuated. The net cost per ton for the collection of refuse was 10s. 7d. as against 8s. 5¼d. for the year ended March, 1940, and 7s. 7¾d. for the year ended March, 1939. The net cost per ton for the disposal of refuse was 2s. 7¾d., as against 4s. l¼-d. for the previous year, and 2s. ll½d. for the year ended March, 1939. It will be observed that collection and disposal costs per ton are higher than in the previous year, and this was due to the maintenance charges on the provision of a new freighter and also additional work which was incurred in the collection of salvage. Fortunately, the cost per ton on the disposal side was relieved to a considerable extent by the increased revenue from the sale of salvaged articles. The income from the sale of salvaged articles and from the minor items was £2,648, as against £1,379 in the year ended March, 1940. The increase was due chiefly, to the sale of waste paper. The system for the collection of kitchen waste was introduced during the year, and although a revenue of £96 was obtained, there was a loss on the first period of working due to the overhead charges such as provision of bins, provision of transport, trailer, and labour. The weighbridge was maintained under contract and the fees received during the year amounted to £40 19s. 0d., representing 1,638 weighings, as against £33 16s. 6d., representing 1,353 weighings in the previous year. The sums received during the year for the removal of Trade Refuse amounted to £113, a decrease of £33 over the amount collected in the previous year. This decrease is due to the collection of Trade Refuse free of charge in cases where this had a salvage value. 7 HOUSE AND TRADE REFUSE Table showing costs for the year ended 31st March, 1941 Item. Particulars I—Collection II—Disposal Total Including Depreciation or Loan charges Excluding Loan charges etc. Including Depreciation or Loan charges Excluding Loan charges etc. Including Depreciation or Loan charges Excluding Loan charges etc. (1) (2) (3) (4) (5) (6) (7) (8) Revenue Account (See Note a) (See Note a) (See Note a) A Gross expenditure 3543 3263 3444 2723 6987 5986 B Gross income 113 113 2651 2651 276) 2764 C Net cost 3430 3150 793 72 4223 3222 Unit Costs s. d. s. d. s. d. s. d. s. d. s. d. D Gross expenditure per ton 11 10¾ 10 11½ 11 6½ 9 2¾ 23 5¼ 20 1¼ E Gross income, per ton 4½ 4½ 8 10¾ 8 10 9 3¼ 9 3¼ F Net cost, per ton 11 6¼ 10 7 2 7¾ 0 4 14 2 10 10 G Net cost, per 1,000 population £ £ £ £ £ £ 92 84 20 2 112 86 H Net cost, per 1,000 houses or premises from which refuse is collected 280 257 65 6 344 263 1. Total refuse collected (in tons) 5,954 2. Population (Mid'Year) 37,220 3. Weight per 1,000 population per day (in cwts.) 11.2 4. Number of occupied houses and premises (end of year, 1940) 12,250 Note.—(a) "Loan charges" include interest on loans; repayment of loans; revenue contributions to capital outlay and capital receipts. 8 ANALYSIS OF INCOME FOR THE YEAR ENDED 31st MARCH, 1941 Year ended 31.3.40 £ s. d. £ s. d. £ s. d. £ s. d. 1. Sale of Salvaged Articles: 83 13 11 Fine Ash, Clinker and Screenings 52 15 6 52 15 6 Metals : 44 12 9 Aluminium 55 11 4 13 15 8 Copper 31 15 0 25 0 5 Iron 89 5 10 3 11 6 Pewter 5 13 3 5 10 0 Lead and 5 8 3 Battery Lead 23 17 3 26 7 9 Brass 73 18 1 4 16 11 Mixed Metals 8 19 4 59 11 1 Unbaled Scrap 42 5 2 25 6 6 Tins 126 7 5 — — — Zinc 2 16 3 460 8 11 29 2 7 Bones 56 7 0 56 7 0 72 7 6 Broken White Glass 33 2 9 197 18 8 Bottles and Jars 221 17 8 62 8 0 Milk Bottles 52 15 3 307 15 8 214 7 10 Rags 253 19 11 18 4 6 Carpets 23 7 7 277 7 6 226 15 8 Newspapers 389 9 0 112 7 3 Mixed Papers 829 0 6 1,218 9 6 7 4 0 Pig Food 95 16 11 2 0 3 Tyres and Tubes 1 4 0 3 13 6 Broken Records 4 4 0 0 11 6 Felt Hats 0 6 3 4 3 0 Batteries 4 16 7 - - - Tanks 2 8 6 108 16 3 2. Miscellaneous Receipts 45 17 3 and Charges 75 7 1 2,557 7 5 33 16 6 3. Weighbridge Fees 40 19 0 4. Rents : 30 0 0 Foundry 30 0 0 20 0 0 Proportion of Allotment Rents 20 0 0 £1378 12 9 £2,648 6 5 6,972 Tonnage 5,954 9 SANITARY INSPECTION OF THE AREA Inspections on Complaint The number of complaints received at the office and recorded in the register was 260, as compared with 439 in the previous year, and 448 for the year 1938. The total inspections made on complaint was 561, and the number of defects or nuisances revealed was 318, which are analysed in the following table. Informal notices were at once served on the owners or occupiers of the premises concerned. Table 1 Dirty Premises 10 Defective eaves, gutters and roofs 7 Defective sink and waste pipes 3 Yard and W.C. drains blocked 210 Accumulations of offensive matter 6 Smoke nuisances 1 Dampness 5 Defective drainage 7 W.C.s' without proper flushing arrangements 5 Defective dustbins 17 Defective floors 1 Defective firegrates 3 Verminous premises 5 Defective wall and ceiling plaster 10 Defective W.C.'s 6 Defective woodwork of windows and doors 2 Miscellaneous 1 Yard and passage surfaces defective 4 Animals kept so as to be a nuisance 1 Overcrowding 1 Water fittings defective 8 Insufficient water supply 3 Dangerous chimney stacks 2 318 10 Summary of Inspections The total number of visits paid by the Sanitary Inspectors to various premises for all purposes is summarised below, together with the number of defects found under specific headings. The visits numbered 2,344, as compared with 4,154 in the previous year; the defects dealt with numbered 371, as compared with 624 in 1939. Table 2 Visits Paid Nuisances or Defects found Housing Act 7 46 Re-visits—Re-Housing Act 127 On complaint 561 318 Miscellaneous 64 3 Infectious Diseases 165 Slaughterhouses 42 Meat and Food Shops 250 2 Factories 5 1 Outworkers 8 Bakehouses 12 Cowsheds 3 Dairies and Milk Shops 4 Pigsties 1 Drainage 24 Smoke Observations 5 Re-Inspections re Notices Served 628 Rats and Mice Destruction Order 60 Private Slaughtering 2 Visits to Picture Houses, etc. 1 Shops Acts 2 Housing Act (Overcrowding) 9 Refuse Collection and Disposal 5 Council Houses 125 Milk samples 16 Water samples 2 Re-Housing-Homeless persons 17 Refuse Disposal Works 83 Cleansing visits 40 Inspections prior to entering Council Houses 2 Inspections for Council house tenants 5 Refugees 18 Food sampling 4 Visits re permitted Nos. 3 Domestic servants' register 1 1 2,301 371 11 Nuisances and Defects In the following table is summarised the nuisances and defects dealt with or in connection with which action was commenced during the year under the Housing Acts, Public Health Acts, Byelaws and other Enactments : Table 3 Dirty Premises 34 Defective roofs and eaves gutters 32 Blocked Yard and W.C. Drains 159 Defective Yard paving 1 Defective Sinks and Waste Pipes 10 Accumulations of Offensive Matters 4 Defective walls and ceiling plaster 8 W.C.'s without proper flushing arrangements 6 Defective dustbins 62 Defective water-fittings 2 Insufficient W.C. accommodation 1 Dampness 4 Insufficient water supply 6 Defective drainage 10 Defective external brickwork 1 Defective floors 2 Defective firegrates 4 Defective woodwork of windows and doors 4 Insufficient flushing to W.C.'s 1 Defective water-closets 5 Defective lighting and ventilation 6 Defective wash-boilers 4 Verminous premises 5 371 12 Table 4 Letters sent out and notices served in connection with Sanitary Matters. Letters 1079 Public Health Acts: Preliminary Notices 145 Secondary Notices 19 Statutory Notices 2 Housing Acts : Preliminary Notices 9 Secondary Notices — Statutory Notices 2 Shops Act. It was not necessary to take action, during the year, with regard to the public health provisions of the Shops Acts. Smoke Abatement. Owing to the continuance of war conditions no action was taken in respect of smoke abatement. Swimming Baths and Pools. Samples of water from the Larkswood Swimming Pool were taken during the bathing season and all these were found to be satisfactory and suitable for swimming bath purposes by the bacteriologist. Chlorine and alkalinity readings are forwarded weekly to the Public Health Department by the Depot Superintendent. Eradication of Bed Bugs (1) The following table gives information on the action taken for the eradication of bed bugs: Council Houses Other Houses Infested 1. Disinfested 1. Infested 4. Disinfested 4. 13 (2) Methods. Spraying with a contact insecticide is the general rule, following the removal of architraves, skirtings and picture rails. Papered rooms are stripped. (3) Inspectional Methods. Before any tenant moves into a Council house, the prospective tenant's house and belongings are thoroughly inspected by a Sanitary Inspector, as is also the Council house into which the family is to move. (4) Disinfestation. Fumigation with Hydrogen Cyanide is always carried out by a contractor; other disinfestations are carried out by the Local Authority. Schools The sanitary condition and water supply of Schools has been satisfactory during the year. All cases of infectious disease amongst school children are notified to the head teachers, as are also contacts. It was not necessary during the year to close any school on account of infectious disease. PREMISES AND OCCUPATIONS WHICH CAN BE CONTROLLED BY BYELAWS OR REGULATIONS Offensive Trade Premises The offensive trade premises on the register number 9, being one fat extractor and eight fish fryers. The licences in connection with four of the latter-mentioned trades are subject annual renewal. Offensive - trades are controlled by Byelaws adopted by the Council. Bakehouses There are 8 of these premises within the district and they have been maintained in a satisfactory condition during the year. The visits paid to these premises during the year was 12. Factories and Workshop Acts. Seventeen visits were paid to Factories, this number is small, due to pressure of work in other directions. No case of infectious disease occurred at outworkers' premises during the year ; 8 visits were paid to these premises. 14 INSPECTION OF FACTORIES AND OTHER PREMISES 1.—INSPECTIONS FOR PURPOSES OF PROVISIONS AS TO HEALTH Including Inspections made by Sanitary Inspector Premises (1) Number of Inspections Written Notices Occupiers Prosecuted (2) (3) (4) Factories with mechanical power 17 2 — Factories without mechanical power — — — † other Premises under the Act (including works of building and engineering contruction hut not including outworkers' premises) - - - † Electrical Stations should be reckoned as factories. Total 17 2 — 2.—DEFECTS FOUND Particulars Number of Defects No. of defects in respect of which Prosecutions were instituted Found Remedied Referred to H.M. Inspector (1) (2) (3) (4) (5) Want of cleanliness (S. 1) 1 1 - - Overcrowding (S. 2) Unreasonable temperature (S. 3) Inadequate ventilation (S. 4) Ineffective drainage of floors (S. 6) Sanitary Conveniences (S. 7) insufficient unsuitable or defective 1 1 - - not separate for sexes Other offences (Not including offences relating to Home Work or offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921, and re-enacted in the Third Schedule to the Factories Act, 1937.) Total 2 2 - - 15 Section D.-HOUSING STATISTICS FOR THE YEAR 1940 1. Number of New Houses erected during the Year : (1) By the L.A. (2) By other L.A's 385 (3) Other bodies 201 586 2. Inspection of Dwelling-Houses during the Year : (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 922 (b) Number of Inspections made for the purpose 1,677 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 7 (b) Number of Inspections made for the purpose 134 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation — (4) Number of dwelling-houses (exclusive of those referred to under the preceding subhead found not to be in all respects reasonably fit for human habitation 55* Note—This figure includes all houses where defects were found, including those which were inspected and recorded under the Housing Act, 1936. 3. 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 89 4. Action under Statutory Powers during the Year : A. Proceedings under sections 9, 10 and 16 of the Housing Act, 1936 : (1) Number of dwelling-houses in respect of which notices were served requiring repairs 2 16 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) by owners 1 (b) by Local Authority in default of owners 1 B. Proceedings under Public Health Acts : (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 2 (2) Number of dwelling-houses in which defects were remedied after service of formal notices : (a) by owners 2 (b) by Local Authority in default of owners — Section E.—INSPECTION AND SUPERVISION OF FOOD Milk Supply. There are still only two cowsheds on the register for the Chingford district ; the number of retail purveyors of milk is 30 and one wholesale purveyor. The number of visits paid to cowsheds, dairies and milkshops was 7. Milk (Special Designations) Order, 1936. Graded Milks. The following table shows the licences granted during the year for the sale of milk under the special designations, as provided by the above Order : 5 dealers' licences to sell milk as Pasteurised. 3 supplementary licences to sell milk as Pasteurised. 3 dealers' licences to sell milk as Tuberculin Tested. 2 supplementary licences to sell milk as Tuberculin Tested. 1 supplementary licence to sell milk as Accredited. 1 dealers' licence to pasteurise and bottle milk. 1 dealers' licence to bottle and sell milk as Tuberculin Tested. 17 Ice Cream—Registration of Manufacturers and Vendors. There was one application for registration for the manufacture of ice cream under section 14 of the Food and Drugs Act, 1938. The number of persons registered at the end of the year was as follows : For the manufacture, storage and sale 19 For the storage and sale only 28 Registration of Premises under Section 14—Food and Drugs Act. There were four applications during the year for registration of premises at which Sausages are manufactured of food potted, pickled, pressed or preserved. No application was refused during the year. Meat and Other Foods There is one licensed slaughter-house and twenty-two butchers' shops in the area ; the visits paid to these premises number 292. The undermentioned table sets forth the carcases inspected and the instances in which parts of carcases were condemned: CARCASES INSPECTED AND CONDEMNED Cattle excluding cows Cows Calves Sheep and Lambs Pigs Number Inspected (at slaughterhouses and Butchers' shops) 10 — — 8 152 All diseases Except Tuberculosis. Whole carcases condemned — — — 1 — Carcases of which some part or organ was condemned ... 2 — —• — 7 Percentage of the number inspected affected with disease other than tuberculosis 20.0 - - 12.5 4.6 Tuberculosis only. Whole carcases condemned — - — - - Carcases of which some part or organ was condemned 3 - — 1 5 Percentage of the number inspected affected with tuberculosis 30.0 - - 12.5 3.3 18 The following list gives details of the diseased or unsound meat, included in the above table, which was voluntarily surrendered and destroyed: Article Condition Weight 1 bullock's head and tongue Tuberculosis 34 lbs. 2 bullock's lungs „ 20 lbs. 2 bullock's mesenteries „ 8 lbs. 1 bullock's thick flank, thin flank and portion of rump 25 lbs. 5 pig's heads „ 40 lbs. 1 pig's pluck „ 3 lbs. 3 bullock's livers Flukes 40 lbs. 3½ pig's livers Cirrhosis 10 lbs. 1 pig's leg and chump Hemorrhægic Spots 12 lbs. 2 legs of pork Abscess 18 lbs. 1 pig's kidneys Cystic and Nephretic ½ lb. 8 calves' heads Decomposition 40 lbs. 32 calves' feet „ 24 lbs. 1 sheep's carcase Dropsy and Emaciation 41 lbs. 4 sheep's plucks Decomposition 12 lbs. 1 sheep's liver Parasitic 2 lbs. 15 legs of lamb Damage by glass 8 shoulders, aitch bone joint splinters 103 lbs. Other articles found unfit for human consumption, and which were voluntarily surrendered and destroyed are as follows : Skate wings Decomposition 56 lbs. 3 Boxes of kippers Unsound 42 lbs. Yellow fillets „ 7 lbs. 7 Tins of spiced ham „ 42 lbs. Potatoes „ 1456 lbs. Bacon Slime and Bone Taint... 438¾ lbs. Assistance was given to the Waltham Abbey Urban District Council during the year in the inspection of carcases at the Ministry of Food slaughterhouse situate in that area. The following table shows the number of carcases examined, and details of diseased or unsound meat will be found in the report of the Medical Officer of that district : Bovine Cows Calves • Sheep Pigs 72 29 22 288 582 19 The following samples were procured for bacteriological examination during the year: No. Designation Result 169 Ordinary Unsatisfactory 170 Tuberculin Tested Satisfactory 171 Pasteurised „ 172 „ „ 173 Tuberculin Tested „ 174 „ „ „ 175 „ „ „ 176 „ „ „ 177 1 Pt. Bottle Efficiently cleansed 178 Pasteurised Under 2.3 Blue Units 179 „ Satisfactory 180 „ „ 181 „ „ 182 „ Unsatisfactory 183 „ Under 2.3 Blue Units The unsatisfactory samples were brought to the notice of the dealers concerned and the necessary action taken. Food and Drugs (Adulteration) Act, 1938. The following articles were submitted during the year in supplementation of the Essex County Council's Food and Drugs service : No. Sample Result 254 Salmon Tin Satisfactory Steak & Kidney Pie „ Pineapple Tin „ 255 Pasteurised Milk „ 256 Cre-mar Substitute Cream 257 Substitute Cream „ 258 Salmon Sandwiches „ 259 Tin of Salmon „ 260 Sample of Vomit „ 260a Stewed Prunes „ Bread Pudding and Custard „ Stewed Steak and Veg. „ Corned Beef „ 20 PREVENTION AND CONTROL OF INFECTIOUS AND OTHER DISEASES Scarlet Fever The following table shows the total number of cases notified during the year, and the percentage of cases removed to hospital The figures for the previous four years are also included. 1936 1937 1938 1939 1940 Cases notified 52 61 66 144 47 Percentage removed to hospital 59 58 72 66 72 Diphtheria Immunisation. Number of children immunised during the year : Under 5 years 151 Between 5 and 15 years 113 Total 264 During the year, 264 children were immunised against Diphtheria. The material used in most instances was Diphtheria Alum Precipitated Toxoid, the dosage being .lcc and .3cc at an interval of 4 weeks. Of the total of 264 children, 151 were under the age of 5 years, and 113 were between the ages of 5 years and 15 years. In accordance with Ministry of Health's Circular No. 2230 dated 17th December, 1940, special effort was made to encourage parents to have their children immunised, and the number of children brought for immunisation rapidly increased towards the end of the year. Tuberculosis There were 61 cases of all forms of Tuberculosis notified during 1940, a decrease of 9 on the previous year, and of these 31 or 50.9 per cent. were transfers from other districts. Deaths There were 19 deaths from Tuberculosis during the year, of which 4 had not been previously notified. Particulars of these 4 cases are given below : Pulmonary Tuberculosis 3 cases. Non'Pulmonary Tuberculosis 1 case. Ratio of non-notified tuberculosis deaths to total tuberculosis deaths=l to 4.7. 21 Age periods. NEW CASES DEATHS Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F 0 to 1 year — - - - - - - - 1 to 4 years — — — — — — — — 5 to 14 years 2 - 1 1 — — - — 15 to 24 years 6 9 — 1 2 1 1 —- 25 to 34 years 5 14 — 1 — 4 - — 35 to 44 years 5 5 1 - 1 2 — — 45 to 54 years 5 2 — — 1 1 - — 55 to 64 years 1 1 — — 4 — 1 — 65 and upwards — 1 — — 1 — — - Totals 24 32 2 3 9 8 2 — Cancer. DEATHS FROM CANCER. Site 0-25 25-35 35-45 45-55 55- Totals M. F. M. F. M. F. M. F. M. F. M. F. Gastro-Intestinal Tract — — — — 2 2 4 2 12 10 18 14 32 Lungs and Mediastinum — — — — — — 1 — 2 — 3 — 3 Genito-urinary organs - - - - - - - 2 2 2. 2 4 6 Breast — — — — — 1 — 1 2 — 4 4 Other sites — — — — 2 2 — 1 1 3 3 6 Totals - - — — 4 5 5 5 17 15 26 25 51 Death rate =1.37 per 1,000 (as compared with 1.20 per 1,000 in previous year). 22 Deaths from all causes at various Ages Age No. of Deaths Under 1 Year 25 1 and under 2 4 2 and under 5 2 5 and under 15 9 15 and under 25 18 25 and under 35 14 35 and under 45 25 45 and under 55 50 55 and under 65 64 65 and under 75 74 75 and upwards 97 Total deaths 382 ATTENDANCES AT LOCAL CLINICS DURING 1940 Ante-Natal Clinics : Friday Hill Sessions 18 Attendances 158 South Chingford „ 86 „ 1,342 Infants' and Toddlers' Welfare Clinics : Friday Hill Sessions 20 Attendances (Infants and Toddlers) (New Infants, 60). 379 Sewardstone Road Sessions 47 Attendances (Infants and Toddlers) 1,067 North Chingford „ 45 Attendances : Infants 1,223 Toddlers 806 New Infants 74 23 24 NOTIFIABLE DISEASES Year Scarlet Fever Diphtheria Erysipelas Measles Whooping Cough Tuberculosis Dysentery Encephalitis Lethargica Puerperal Fever Puerperal Pyrexia Ophthalmia Neonatorum Pneumonia Cerebro-Spinal Fever Enteric Fever Acute Poliomyelitis Pulmonary Other Forms 1935 59 18 4 - — 34 7 1 — 2 3 1 4 1 2 — 1936 53 12 7 — — 40 7 3 — 2 11 1 17 - 4 — 1937 61 21 10 — — 51 6 4 - — 7 1 34 1 11 3 1938 66 7 7 — — 38 5 11 — — 10 2 23 2 2 - 1939 144 26 10 3 — 53 17 1 - — 8 - 28 1 — - 1940 47 6 14 30 1 56 5 1 — — 5 1 44 4 2 — NOTIFIABLE DISEASES TABULATED ACCORDING TO AGE. Under 1 year 1 2 3 4 5-9 10-14 15-19 20-34 35-44 45-64 65 and over Totals Scarlet Fever 2 9 — 5 4 16 6 3 7 1 I 47 Diphtheria — — 1 1 1 1 — 1 — ] — — 6 Erysipelas — 1 — — - — 1 — 2 3 5 2 14 Measles — 6 2 7 - 8 2 4 1 — — — 30 Whooping Cough - - - - - - - - - - - - 1 Dysentery — — — - — — — — 1 — — — 1 Puerperal Pyrexia — — — - — — — — 3 2 — — 5 Ophthalmia Neonatorum 1 - - - - - - - - - - - 1 Pneumonia 1 3 2 2 — 2 — 1 4 4 14 11 44 Cerebro-Spinal Fever — 1 — — 1 — 1 — 1 — — — 4 Enteric Fever - - - - - - - - - 1 1 — 2 ANALYSIS OF NOTIFIABLE DISEASES AND DEATHS. Diseases Total cases notified Cases admitted to hospital Total Deaths Scarlet Fever 47 34 - Diphtheria 6 6 — Erysipelas 14 2 — Measles 30 2 — Whooping Cough 1 1 — Dysentery 1 — — Puerperal Pyrexia 5 4 — Ophthalmia Neonatorum 1 1 - Pneumonia 44 15 — Cerehro-Spinal Fever 4 4 1 Enteric Fever 2 2 1 25 26 Birth-rates, Death-rates, Analysis of Mortality, Maternal Mortality and Case-notes for certain Infectious Diseases in the Year 1940. (Provisional figures based on Weekly and Quarterly Returns) England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns Resident Pop.: 25,000—50,000 (1931 Census) London Administrative County Chingford England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns Resident Pop.: 25,000—50,000 (1931 Census) London Administrative County Chingford Births : Rates per 1,000 Population Deaths under 1 year of age Rates per 1,000 Live Births Live 14.6 16.0 15.7 13.7 15.66 55.0 61.0 54.0 50.0 45 Still 0.55 0.64 0.55 0.44 0.38 Deaths: Deaths from Diarrhoea and Enteritis under 2 years of age 4.6 5.9 4.4 5.8 1.8 All Causes 14.3 15.8 12.8 17.8 13.13 Typhoid and Paratyphoid 0.03 Scarlet Fever — —. — — — Rates per 1,000 Total Births (Live and Still Whooping Cough 0.02 0.02 0.02 — — Diphtheria 0.06 0.07 0.05 0.01 - Influenza 0.32 0.29 0.30 0.18 0.16 Maternal Mortality: (Excluding Abortion) Puerperal Infection (No. 147) 0.52 Not available Smallpox — — — — Measles 0.02 0.02 0.02 0.01 — Notifications : Others 1.64 — Enteric 0.07 0.06 0.10 0.06 0.05 Total 2.16 Cerebro-Spinal Fever 0.32 0.33 0.29 0.28 0.11 Scarlet Fever 1.63 1.53 1.57 0.82 1.26 Notifications: Whooping Cough.. 1.34 1.29 1.35 0.22 0.03 Puerperal Fever 11.96 13.90 9.73 3.34 8.36 Diphtheria 1.16 1.29 1.21 0.61 0.16 „ Pyrexia 13.30 IncludingPuer peral Fever Erysipelas 0.33 0.36 0.30 0.35 0.38 Smallpox —- - — — — Measles 10.24 9.23 9.99 1.78 0.81 Pneumonia 1.20 1.37 1.00 0.87 1.18