BOROUGH OF CHINGFORD ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR • 1941 E. G. Ellis & Sons (T.U.) Willow Street, Chingford BOROUGH OF CHINGFORD Committee: November, 1940—November, 1941 PUBLIC HEALTH AND HOUSING COMMITTEE Chairman:- Alderman Mrs. E. E. Stutely, J.P. (Mayor). Members:— Alderman Miss M. L. MATHIESON, C.C. „ P. S. POWELL „ R. Z. SMITH „ E. E. WAY Councillors H. E. CHINNER „ Mrs. N. HART „ F. J. KING „ Mrs. S. L. QAKES „ W. P. SOGGEE Meeting: Second Tuesday in each month, at 7 p.m. PUBLIC HEALTH OFFICERS OF THE AUTHORITY (1941). MEDLCAL OFFICER OF HEALTH: G. B. MURRAY, M.B., Ch.B., D.P.H. (To 2.7.41). WM. D. HYDE, M B., Ch.B., D.P.H. (From 19.8.41). 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. ORACKNBLL. Mrs. L. M. WAILRLIN. (From 9.12.41). A. E. CULPIN. (On Military Service). D. G. BLEACH. D. S. TAVERNIER. (From 4.3.41). F. WALTON. ('From 28.7.41). 1 ANNUAL REPORT FOR THE YEAR 1941. To the Mayor, Aldermen and Councillors of the Chingford Corporation. Mr. Mayor, Aldermen and Councillors, I have the honour to present my first Annual Report upon the health and sanitary circumstances of the district. Owing to the need for economy in time and paper the contents of this Report have been restricted to essentials, and on the grounds of national security, the undesirability of publishing comprehensive statistics has been borne in mind. The general health of the district has remained at a high level, the most encouraging feature being the low infant mortality rate of 16 per thousand live births, which is the lowest rate ever recorded for the district—a very creditable achievement under war-time conditions. Although no report of Civil Defence activities is included, the Health Department has continued to devote a considerable proportion of its time to the Casualty and other Civil Defence Services of the district. I take this opportunity of thanking the Chief Sanitary Inspector, Mr. James F. Rogers, and the staff of the Health Department, whose help and co-operation have been invaluable during this, my first year of office. I am, Ladies and Gentlemen, Your obedient servant, WM. D. HYDE Medical Officer of Health. September, 1942. 2 Section A.—STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area 2,860 acres Population—Registrar-General's estimate 35,440 Number of inhabited houses, end of 1941 11,600approx. Rateable value on April 1st, 1941 £331,256 0 0 Sum represented by a penny rate on April 1st, 1941 (gross) £1,380 4 8 Vital Statistics *Infant †Birth Mortality Rate M. F. M. F. Total 215 344 236 267 ( Birth Rate per 1,000 of Live Births Legitimate 214 234 235 257 estimated resident popuIllegitimate 1 10 1 10 lation: 14.19. *For calculating Infant and Maternal Mortality Rates, †or calculating Birth Rates M. F. M. F. Total 5 7 5 7 Rate per 1,000 total Stillbirths Legitimate 5 7 5 7 (live and still) births: Illegitimate - - - - 23.3 Crude Death Rate per M. F. 1,000 of estimated resi Deatfis 162 150 dent population: 8.8. Deaths from Puerperal Sepsis 0 „ „ other puerperal causes 1 Death Rate of Infants under one year of age:— All infants per 1,000 live births 16 Legitimate infants per 1,000 legitimate live births 16 Illegitimate infants per 1,000 illegitimate live births - Deaths from Cancer (all ages) 50 „ ,, Measles (all ages) 0 „ „ Whooping Cough (all ages) 0 ,, „ Diarrhoea (under 2 years of age) 0 „ „ Scarlet Fever 0 3 Table of Birth and Death Rates Year Population Births Rate per 1,000 population. Deaths Rate per 1,000 population. infant mortality Deaths Rate per 1,000 live births 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 1940 37,220 583 15.66 382 crude 13.13 25 45 1941 35,440 503 14.19 312 standardised 8.8 9 16 4 Section B.—GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. (a) Laboratory Facilities. No change. The number of specimens from the district examined at the Counties' Public Health Laboratories was as follows:— Diphtheria 73 Sputa 77 Typhoid 17 Ringworm Nil General 154 Milk and Ice Cream 38 Water 4 Sewage Nil Total 363 (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 Ambulance Service during 1941 : Private calls Accident calls Borough Ambulances 839* 113 Walthamstow, S.JA.B. and B.R.C. Ambulances 24 15 863 128 Total 991 *(65 of these calls were Maternity Cases.) Total Mileage by Borough Ambulances during year 13,192.2 (c) Nursing in the Home. The Chingford District Nursing Association has carried on its good work throughout the year. Maternity nursing and midwifery cases, in addition to a large number of general nursing visits, have been undertaken. 5 (d) Clinics and Treatment Centres. See table of Clinics on page 7. (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. Registered Nursing Homes. There is one registered Nursing Home in the district receiving maternity and medical patients. 6 CLINICS AND TREATMENT CENTRES Clinic or Dispensary Where held When held Diphtheria Immunisation Clinics Church Hall, The Ridgeway, North Chingford. Wednesdays 10 a.m. County Council Clinic, Marmion Avenue, South Chingford. 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 Clinjc 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 Orthopaedic 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. 7 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. During the year two samples of water were taken from the premises of a local manufacturing firm; both samples were found, on analysis, to be satisfactory. Rivers and Streams. It was necessary, in one instance, to take action as to the pollution of a watercourse in the area. Public Cleansing. The collection and disposal of house and trade refuse and salvage is carried out under the direction of the Chief Sanitary Inspector. For the first time in many years a weekly collection of refuse was not maintained; for a greater part of the year refuse and salvage were collected on alternate weeks. This system was put into operation in an endeavour more particularly to keep separate all articles having a salvage value, but the scheme was a failure, due chiefly to labour and transport difficulties. Although consent was given to the purchase of a spare refuse collecting vehicle, this was not to hand until the year 1942, and so a considerable amount of money was expended in lorry hire. The total weight of refuse disposed of at the Works was 5,089 tons, showing a further decrease of 865 tons from the amount collected during the previous year, or a decrease of 1,883 tons from the amount collected during the year ended March, 1940. The net cost per ton for the colleotion of refuse was 20s. 6¾d., as against 11s. 6½d. for the year ended March, 1941, and 8s. 5½d. for the year ended March, 1940. The net cost per ton for the disposal of refuse was 5s. 6d., as against 2s. 7¾d. for the previous year and 4s. l½d. for the year ended March, 1940. The various factors which led to the considerable increase in cost for both the colleotion and disposal of refuse are.too intimately connected with the war effort to permit all the necessary explanations in this Report. Apart from these considerations, the income from the sale of salvaged articles did not rise in proportion to the higher costs of the service. The income from the sale of salvaged articles and from other minor items was £2,580 10s. 2d., as against £2,648 in the year ended March, 1941. The chief item which showed a declining revenue was that derived from metals. During the year the Council embafked on the scheme for the collection of kitchen waste by the communal bin method. Throughout the district just over three hundred bins were placed 8 in the various streets, and a car with trailer attached was used for the collection of the waste food. With overhead charges amounting to £700, it was, of course, impossible for the scheme to be a financial success, but there is no doubt that the quantity of pig food sold could be justified in relation to the country's needs. The weighbridge was maintained under contract, and the fees received during the year amounted to £42 14s. 6d., representing 1,709 weighings, as against £40 19s. 0d., representing 1,638 weighings in the previous year. The sums received during the year for the removal of Trade Refuse amounted to £78, a decrease of £35 of 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. 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 £5311 4516 3981 3599 9292 8115 B Gross income 78 78 2580 2580 2658 2658 C Net cost £5233 4438 1401 1019 6634 5457 Unit Costs s. d. s. d. s. d. s. d. s. d. s. d. D Gross expenditure per ton 20 10½ 17 8½ 15 7½ 14 1½ 36 5¾ 31 10 E Gross income, per ton 3½ 3½ 10 1½ 10 1½ 10 5 10 5 F Net cost, per ton 20 6¾ 17 5 5 6 4 0 26 0¾ 21 5 G Net cost, per 1,000 population £ £ £ £ £ £ 147 125 39 28 186 153 H Net cost, per 1,000 houses or premises from which refuse is collected 451 382 120 88 571 470 1. Total refuse collected (in tons) 5,089 2. Population (Mid-Year) 35,440 3. Weight per 1,000 population per day (in cwts.) 7.9 4. Number of occupied houses and premises (end of year, 1941) 11,600 Note.—(a) "Loan charges" include interest on loans; repayment of loans; revenue contributions to capital outlay and capital receipts. 9 Year ended ANALYSIS OF INCOME FOR THE YEAR 31. 3.41 ENDED 31st MARCH, 1942 £ s. d. £ s. d. £ s. d. £ s. d. 1. Sale of Salvaged Articles: 52 15 6 Fine Ash, Clinker and Screenings Metals: 55 11 4 Aluminium 42 8 7 31 15 0 Copper 28 19 9 89 5 10 Iron 80 16 2 5 13 3 Pewter 7 5 1 23 17 3 Lead 18 16 0 Battery Lead 6 17 8 73 18 1 Brass 48 11 10 8 19 4 Mixed Metals 12 8 9 42 5 2 Unbaled Scrap 14 3 6 126 7 5 Tins 86 6 9 346 14 1 56 7 0 Bones 52 2 3 52 2 3 33 2 9 Broken White Glass 71 5 6 221 17 8 Bottles and Jars 141 8 5 52 15 3 Milk Bottles 37 15 1 — - - Paste Jars 9 17 11 260 6 11 253 19 11 Rags 288 16 6 23 7 7 Carpets 26 12 3 315 8 9 389 9 0 Newspapers 295 11 7 829 0 6 [Mixed Waste Paper 937 7 2 Magazines 5 3 2 1,238 1 11 95 16 11 Pig Food 213 19 2 1 4 0 Tyres and Tubes 2 8 0 4 16 7 Batteries (Wireless) 3 10 0 — — - Bedding 1 10 6 — — — Broken Records 5 2 0 226 9 8 2. Miscellaneous Receipts 75 7 1 and Charges 8 15 1 2,447 18 8 40 19 0 3. Weighbridge Fees 42 14 6 — — — 4. Subsidy on Sale of Scrap Iron 39 17 0 5. Rents: 30 0 0 Foundry 30 0 0 20 0 0 Proportion of Allotment Rents 20 0 0 £2648 6 5 £2,580 10 2 5,9 54 Tonnage 5,089 10 SANITARY INSPECTION OF THE AREA Inspections 011 Complaint The number of complaints received at the office and recorded in the register was 436, as compared with 260 in the previous year and 439 for the year 1939. The total inspections made on complaint was 461, and the number of defects or nuisances revealed was 358, 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 18 Defective eaves, gutters and roofs 32 Defective sink and waste pipes 8 Yard and W.C. drains blocked 137 Dampness 11 Defective drainage 18 W.C.'s without proper flushing arrangements 8 Defective dustbins 18 Defective floors 8 Defective firegrates 10 Defective wall and ceiling plaster 25 Defective W.C.'s 10 Defective woodwork of windows and doors 22 Yard and passage surfaces defective 2 Animals kept so as to be a nuisance 2 Water fittings defective 12 Insufficient water supply 9 Defective chimney stacks 2 Defective 'Wash boilers 2 Insufficient lighting and ventilation 1 Re Overcrowding 1 Accumulation of stagnant water 1 Rat infestation 1 358 11 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 2,355, as compared with 2,301 in the previous year; the defects dealt with numbered 536, as compared with 370 in 1940. Table 2 Visits Paid Nuisances or Defects found Housing Act, 1936: Inspections 7 48 Re-visits 25 Re Overcrowding 2 Re "Permitted Numbers" 48 On complaint 461 358 Miscellaneous 53 Infectious Diseases 145 Slaughterhouses 2 Meat and Food Shops 124 1 Factories 9 Bakehouses 6 Cowsheds 10 Dairies and Milkshops 13 Pigsties 13 1 Re New Drainage 12 Reinspections re Notices Served 456 Infestation by Rats or Mice 49 Shops Acts 2 Visits re Milk Samples 27 Visits re Water Samples 6 Collection & Disposal of Refuse & Salvage 75 Inspections of Council Houses 135 Inspections re Tenants of Council Houses 2 Re Pollution of Watercourse 5 Drains tested 12 Petroleum Acts 3 Requisitioned Houses 641 128 Public Shelters 10 Cats’ Meat Shops 2 2,355 536 12 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 38 Defective eaves, gutters and roofs 48 Defective sinks and waste pipes 11 Yard and W.'C. drains blocked 181 Dampness 14 Defective drainage 26 W.C.'s without proper flushing arrangements 12 Defective dustbins 23 Defeotive floors 10 Defective firegrates 17 Defective wall and ceiling plaster 34 Defective W.C.'s 19 Defective woodwork of windows and doors 29 Yard and passage surfaces defective 2 Animals kept so as to be a nuisance 4 Water fittings defective 20 Insufficient water supply 10 Defective chimney stacks 3 Defective wash boilers 2 Insufficient lighting and ventilation 5 Insufficient drainage 1 Defective yard paving 2 Defective brickwork and pointing 2 Defective stoves 1 Defective door and window fasteners 11 Breach of Byelaws 1 Defective shop fittings 1 Accumulations of rubbish 3 Defective road gully 1 Defective hot-water pipes 1 Pollution of watercourse 1 Re Overcrowding 1 Accumulation of stagnant water 1 Rat infestation 1 536 13 Table 4 Letters sent out and notices served in connection with Sanitary Matters Letters 554 Public Health Acts: Preliminary Notices 157 Secondary Notices 7 Statutory Notices 1 Housing Acts: Preliminary Notices 7 Secondary Notices — Statutory Notices — Letters sent out by the Chief Sanitary Inspector on all matters (including letters and notices listed above) 2,361 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 by the Bacteriologist to be satisfactory and suitable for swimming bath purposes. Chlorine and alkalinity readings are forwarded weekly to the Public Health Department by the Pool 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 0. Disinfested 0. Infested 4. Disinfested 4. (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. 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. Factories and Workshop Acts. Nine 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. 14 Section D.—HOUSING STATISTICS FOR THE YEAR 1941 1. Number of New Houses erected during the Year: (1) By the LA. — (2) By other L.A.'s — (3) Other bodies — 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) 1,441 (b) Number of Inspections made for the purpose 1,922 (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 (h) Number of Inspections made for the purpose 25 (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 176* *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 154 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) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By owners — (b) By Local Authority in default of owners — 15 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— Proceedings under Sections 11 and 13 of the Housing Act, 1936: Demolition orders made — Houses demolished — Proceedings under Section 12 of Housing Act 1936 : Closing orders — Closing orders determined — Section E.—INSPECTION AND SUPERVISION OF FOOD Milk Supply. There is only one cowshed 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 23. Milk (Special Designations) Order, 1936. Graded Mil\s. 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. Ice Cream—Registration of Manufacturers and Vendors. There were no applications 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 16 Registration of Premises under Section 14—Food and Drugs Act. No applications were received during the year for the registration of premises at which Sausages are manufactured or food potted, pickled, pressed or preserved. Meat and Odier Foods There is one licensed slaughter-house and twenty-two butchers' shops in. the area ; the visits paid to these premises numbered 126. There were seven pigs' carcases inspected at registered slaughter-houses and six pigs' carcases inspected at private houses. The following list gives details of the diseased or unsound meat and other articles found unfit for human consumption, which were voluntarily surrendered and destroyed:— Article Condition Weight 1 Ox liver Flukes 14 lbs. 2 sheep's carcases Brine damage 108 lbs. 8 tins beans Damaged by enemy action 6 tins peas „ „ „ „ Butter Rancid 3¾ lbs. Mixed confectionery Damaged by enemy action 2½ cwts. 5 boxes sprouts „ „ „ „ „ 6 bags cabbages „ „ „ 10 bags parsnips „ „ „ „ 10 bags carrots „ „ „ „ 10 bags turnips „ „ „ „ 10 bags swedes „ „ „ „ 17 tins corned beef „ „ „ „ 24 tins corned beef „ „ „ „ 29 tins corned beef „ „ „ „ 19 tins evaporated milk Unsound Cheese trimmings Mould 4 lbs. Fish fillets Unsound 4 stone Onions „ 65 lbs. 15 tins tomatoes „ Dog fish „ 7 stone 1 tin condensed milk „ 1 tin pilchards „ 1 tin salmon „ 6 tins herrings „ Streaky bacon „ 13 lbs. Fore end „ 18 lbs. 1 tin Victoria gallantine „ 1 ox head „ 30 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: Cows Sheep Pigs 2 129 32 17 Chemical and Bacteriological Examination of Food. The Counties' Public Health Laboratories, Gidea Park College, Gidea Park, Essex, undertake bacteriological examinations for the Council. Dr. Bernard Dyer and Partners, Peek House, 20, Eastcheap, E.C.3, carry out the chemical analysis of food and drugs. The following were forwarded for bacteriological examination during the year: No. Designation Result 184 Ordinary Unsatisfactory 185 Pasteurised Satisfactory 186 Ordinary Unsatisfactory 187 Pasteurised Satisfactory 188 Tuberculin Tested „ 189 „ „ „ 190 Ordinary „ 191 1 Pt. Bottle Efficiently cleansed and sterilised 192 Tuberculin Tested Unsatisfactory 193 Ordinary „ 194 Tuberculin Tested „ 195 1 Pt. Bottle Efficiently sterilised 196 1 Pt. Bottle Efficiently cleansed and sterilised 197 Tuberculin Tested Unsatisfactory 198 „ „ 199 Ordinary „ 200 Bottle Efficiently sterilised 201 Ordinary (Ungraded) Unsatisfactory 202 Tuberculin Tested „ 203 „ „ „ 204 „ „ Satisfactory 205 „ „ „ „ 206 „ „ „ 207 „ „ „ 208 Accredited „ 209 Ordinary „ 210 Tuberculin Tested „ 211 ½ Pt. Bottle Efficiently sterilised 212 Ordinary Satisfactory 213 „ „ 214 „ „ 215 Tuberculin Tested „ 216 „ „ „ 217 „ „ „ 218 „ „ „ 219 Ordinary (Ungraded) „ 220 Corned Beef Suitability for human consumption doubtful 221 Sardine and Tomato Paste Genuine 222 Crab and Lobster Paste „ 223 Cakes „ 224 Savoury Roll „ 225 Specimen of Meat Suitable for human consumption The unsatisfactory samples of milk were brought to the notice of the producers concerned, and the necessary action was taken. 18 Food and Drugs (Adulteration) Act, 1938. The following articles were submitted, for chemical examination, during the year in supplementation of the Essex County Council's Food and Drugs service. No. Sample Result 261 Table Jelly Genuine 262 Coffee and Chicory Essence Suitable for human consumption 263 Baked Beans in Tomato Sauce Suitable for human consumption 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. 1937 1938 1939 1940 1941 Cases notified 61 66 144 47 32 Percentage removed to hospital 58 72 66 72 91 Diphtheria. During the year four cases of Diphtheria were notified and removed to hospital. These patients were aged 3 ½ years, 7 years, 7 years, and 24 years. This is the lowest number of notified cases of Diphtheria in the district within recent years. Diphtheria Immunisation. Number of children immunised during the year : Under 5 years 632 Between 5 and 15 years 597 Total 1,229 During the year 1,229 children were immunised against Diphtheria. The material used in most instances was Diphtheria Alum Precipitated Toxoid, the dosage being 0.1cc. and 0.3cc. at an interval of four weeks. Of the total of 1,229 children, 632 were under the age of 5 years, and 597 were between the ages of 5 years and 15 years. 19 In accordance with Ministry of Health Circular No. 2230, dated 17th December, 1940, a special effort was made to encourage parents to have their children immunised, and the number of children brought for immunisation throughout the year showed a satisfactory increase, it being estimated that 60 per cent. of the children in the Borough had been immunised within recent years. This percentage, while encouraging, is still far short of ideal, and further efforts must be made to increase the number of children whose parents take advantage of the facilities afforded them for this successful method of prevention of Diphtheria. Measles. There was a minor epidemic of Measles during the spring and summer months, but fortunately few of the cases were of a serious nature, only 10 requiring admission to hospital. Prophylactic use of Adult Measles Serum was made by many of the doctors with satisfactory results, the material being supplied through the Health Department from the stock held in the Centra! Emergency Pathological Laboratory from the pool organised by the Medical Research Council. Scabies. Towards the end of the year the incidence of Scabies increased considerably, but the timely issue pf the Scabies Order, 1941, proved valuable in combatting the epidemic. Tuberculosis There were 48 cases of all forms of tuberculosis notified during 1941 (a decrease of 13 on the previous year), and of these 16 cases (33 per cent.) were transfers from other districts. There were 25 deaths from tuberculosis during the year ; 10 of these had not been previously notified as suffering from Tuberculosis. Particulars of these 10 cases are given below:— Pulmonary Tuberculosis 7 cases. Non-Pulmonary Tuberculosis 3 cases. Ratio of non-notified tuberculosis deaths to total tuberculosis deaths= 1 to 2.5. 20 Age periods. NEW CASES TRANSFERS DEATHS Respiratory NonRespiratory Respiratory NonRespiratory Respiratory NonRespiratory M. F, M. F. M. F. M. F. M. F. M. F. 0 to 1 year - - - - - - - - - - - - 1 to 4 years — — - — — — — 1 — — — — 5 to 14 years - — — 1 1 — 2 — — 1 — — 15 to 24 years 8 2 — — — 1 — 1 1 3 — 1 25 to 34 years 3 5 — 1 4 — — — 3 1 — — 35 to 44 years 5 2 — — — 2 — — — 3 — — 45 to 54 years 3 2 — — 1 1 - 1 1 1 — — 55 to 64 years — - - - 1 - - - - - - - 65 and upwards - - - - - - - - - - - - Totals 19 11 — 2 7 4 2 3 5 9 — 1 Add—Non-notified Cases 4 3 3 — 9 12 3 1 Cancer. DEATHS FROM CANCER. 1941. 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 - - - - - — 1 1 16 10 17 11 28 Lungs and Mediastinum - - - - - - - - - 2 - 2 2 Genito-urinary organs — — — — — — — 1 4 3 4 4 8 Breast - - - - - - - 1 — 9 — 10 10 Other sites - - - - - - - - - - 2 — 2 Totals — — — — — — 1 3 22 24 23 27 50 Death rate — 1.41 per 1,000 (as compared with 1.37 per 1,000 in previous year). 21 Deaths from all causes at various Ages Age No. of Deaths Under 1 Year 9 1 and under 2 3 2 and under 5 5 5 and under 15 8 15 and under 25 9 25 and under 35 20 35 and under 45 29 45 and under 55 34 55 and under 65 53 65 and under 75 68 75 and upwards 74 Total deaths 312 ATTENDANCES AT LOCAL CLINICS DURING 1941 Ante-Natal Clinics: Friday Hill Sessions 22 Attendances 215 South Chingford „ 88 1,433 Infants' and Toddlers' Welfare Clinics: Friday Hill Sessions 25 Attendances 572 (Infants and Toddlers), (including 49 new infants) Sewardstone Road Sessions 29 Attendances 661 (Infants and Toddlers). North Chingford „ 51 Attendances: Infants (including 96 new infants) 1,284 Toddlers 930 South Chingford „ (April/Dec., 1941, only) Infants 68 Attendances (including 237 new infants) 2,876 Toddlers 34 Attendances 606 22 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 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 — 1941 32 4 4 311 197 46 8 - — — 1 — 54 7 — — 23 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 - 1 3 1 3 18 1 2 3 - - - 32 Diphtheria — — — 1 — 2 — - 1 — - — 4 Erysipelas — — — — — — — - - 1 3 — 4 Measles 12 22 25 27 27 184 10 - 4 — — — 311 WhoopingCough 9 9 23 30 33 83 3 1 4 1 - 1 197 Puerperal Pyrexia - - - - - - - - 1 - - - 1 Pneumonia 3 1 5 6 2 4 4 2 4 3 6 14 54 CerebrcSpinal Meningitis — — 2 — 1 1 — — 3 - — — 7 ANALYSIS OF NOTIFIABLE DISEASES AND DEATHS. Diseases Total cases notified Total admitted to hospital Total Deaths Scarlet Fever 32 29 - Diphtheria 4 4 — Erysipelas 4 — — Puerperal Pyrexia 1 — — Pneumonia 54 12 1 Cerebro-Spinal Meningitis 7 7 1 Measles 311 11 - Whooping Cough 197 - - 24 Birth-rates, Death-rates, Analysis of Mortality, Maternal Mortality and Case-notes for certain Infectious Diseases in the Year 1941. (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 59.0 Rates per 1,000 Live Births 16 Live 14.2 14.7 16.4 8.9 14.9 71.0 56.0 68.0 Still 0.51 0.58 0.60 0.33 0.34 Deaths: Deaths from Diarrhœa and Enteritis under 2 years of age 5.1 7.5 4.6 6.8 - All Causes 12.9 14.9 13.0 16.3 8.8 Typhoid and Paratyphoid 0.00 0.00 0.00 0.1 - Scarlet Fever 0.00 0.00 0.01 0.00 — Rates per 1,000 Total Births (Live and Still) Whooping Cough 0.06 0.07 0.06 0.04 0.02 Diphtheria 0.07 0.08 0.06 0.03 — Influenza 0.19 0.17 0.20 0.15 0.02 Smallpox — — — — — Maternal Mortality: (Excluding Abortion) Measles 0.03 0.03 0.03 0.02 — Notifications: Puerperal Infection (No. 147) 0.48 Not available - Typhoid Fever 0.03 0.02 0.03 0.04 - Paratyphoid Fever 0.09 0.12 0.09 0.05 - Others 1.75 1.75 Cerebro Spinal Fever 0.25 0.31 0.20 0.30 0.19 Total 2.23 1.75 Scarlet Fever 1.47 1.49 1.51 1.01 0.90 Notifications: Whooping Cough.. 4.39 4.3'7 4.50 3.50 5.55 Puerperal Fever 11.91 15.64 9.43 2.29 1.94 Diphtheria 1.25 1.53 1.19 0 93 0.11 Erysipelas 0.30 0.36 0.27 0.50 0.11 „ Pyrexia 19.3 Smallpox - — - - —. IncludingPuer peral Fever Measles 10.33 8.27 10.47 4.77 8.77 Pneumonia 1.25 1.53 1.04 1.07 1.52 25