CHIN 9 BOROUGH OF CHINGFORD ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1944. E. G. Ellis (£ Sons (T.U.) Willow Street, Chingford ' BOROUGH OF CHINGFORD Committee : November, 1943—November, 1944 PUBLIC HEALTH AND HOUSING COMMITTEE Chairman:— Councillor Mrs. N. HART. Vice-Chairman:— Councillor A. COLLINS. Members :— Alderman Miss M. L. MATHIESON, C.C. P. S. POWELL. R. Z. SMITH E. E. WAY. Councillor H. E. CHINNER Mrs. S. L. OAKES W. P. SOGGEE, I.P. The Mayor, Alderman S. F. BRIGG, J.P. (ex-officio). Meeting : Second Tuesday in each month at 7.30 p.m. PUBLIC HEALTH OFFICERS OF THE AUTHORITY (1944) MEDICAL OFFICER OF HEALTH : WILLIAM D. HYDE, M.B., Ch.B., D.P.H. CHIEF SANITARY INSPECTOR : JAMES F. ROGERS, M.R.San.I., M.S.I.A. (a) (c) (d), 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. (b) (c) (Military Service from July, 1940). P. W. EDWARDS, M.S.I.A. (b) (c). F. MAYHEW, M.S.I.A. (a) (c) (from 27.3.44 to 30.11.44). SENIOR CLERK : Miss V. M. PETTIT. CLERKS : Mrs. E. S. SALTER. Miss P. M. KIMBER. A. E. CULPIN (Military Service from 3.9.39). D. G. BLEACH (Military Service from 9.3.42). A. MORRIS (to 14.10.44). R. L. KING (from 2.11.44). (a) Certificate of the Royal Sanitary Institute as Sanitary Inspector ; (b) Certificate of the Royal Sanitary Institute and Sanitary Inspectors' Joint Board as Sanitary Inspector ; (c) Certificate of the Royal Sanitary Institute as Meat and Foods Inspector ; (d) Certificate of the Royal Sanitary Institute in Advanced Knowledge of duties of Sanitary Inspector. 1 ANNUAL REPORT FOR THE YEAR 1944 To the Mayor, Aldermen and Councillors of the Chingford Corporation. Mr. Mayor, Aldermen and Councillors, I have pleasure in presenting my fourth Annual Report upon the health and sanitary circumstances of the Borough. The Birth Rate has continued its upward trend, reaching 21.01, the highest rate recorded since 1922 when the figure was 21.06. The Infant Mortality Rate of 31 again compares very favourably with that of England and Wales which is 46. The incidence of infectious diseases shows a reduction over the previous two years except for Dysentery and Pneumonia. This is especially gratifying in regard to Tuberculosis and Diphtheria, but account must be taken of the fact that there was considerable evacuation of children and mothers during the summer and autumn. No report of Civil Defence activities is included, but the Health Department has continued to devote a considerable propor' tion of its time to the Casualty and other Civil Defence Services of the Borough. During the summer, 1,388 mothers and children were medically examined prior to evacuation. In conclusion, I wish again to record the continued loyal service given by the Chief Sanitary Inspector, Mr. James F. Rogers, and the staff of the Health Department. I am, Ladies and Gentlemen, Your obedient servant, WILLIAM D. HYDE, Medical Officer of Health. August, 1945. 1 Section A.—STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area 2,860 acres Population—Registrar-General's estimate 36,890 Number of inhabited houses, end of 1944 11,475 approx. Rateable value on April 1st, 1944 £331,680 0 0 Sum represented by a penny rate on April 1st, 1944 (gross) £1,382 0 0 Vital Statistics M. F. Live Births J Total 389 386 Birth Rate per 1,000 of estimated resident papulation : 21.0. Legitimate 377 375 Illegitimate 12 11 M. F. Stillbirths Total 10 19 Rate per 1,000 total (live and still) births: 36.1. Legitimate 10 17 Illegitimate — 2 Deaths M. F. Crude Death Rate per 1,000 of estimated resident population: 8.7. 159 161 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 31 Legitimate infants per 1,000 legitimate live births 30.6 Illegitimate infants per 1,000 illegitimate live births 43.5 Deaths from Cancer (all ages) 58 ,, „ Measles (all ages) 0 „ „ Whooping Cough (all ages) 2 „ „ Diarrhoea (under 2 years of age) 3 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 1939 (a) 39,460 (b) 38,160 668 16.93 261 6.8 15 22 1940 37,220 583 15.66 382 10.26 25 45 1941 35,440 503 14.19 312 8.8 9 16 1942 37,790 667 17.6 282 7.5 19 28 1943 37,860 715 18.9 313 8.3 17 23 1944 36,890 775 21.0 320 8.7 24 31 4 Section B.—GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. (a) Laboratory Facilities. Pathological specimens from this district are still examined at the E.C.C. Pathological Laboratory, St. Margaret's Hospital, Epping. Unfortunately, owing to shortage of laboratory staff, details of the Chingford specimens examined are again not available this year. (b) Ambulance Facilities. Two ambulances and a staff of three paid drivers are maintained. The following is a summary of the work performed by the Council's Ambulance Service during 1944:— Total number of calls dealt with during year— Private Hire 1,094 Accidents 88 Maternity Cases 245 Total 1,427 Total mileage covered by the Borough Ambulances during the year—23,517 miles. In addition the following calls were dealt with by the Civil Defence Ambulance Service on occasions when the Chingford ambulances were engaged or under repair :— Private Hire 20 Accidents 22 Maternity Cases 11 Total 53 Assistance, by supplying drivers or attendants, was given by the St. John Ambulance Brigade members as under— No. 85 Chingford Nursing Division—attended 34 maternity calls. No. 132 Chingford Ambulance Division—attended 280 calls. (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 6 (d) Clinics and Treatment Centres. See Table of Clinics on page 7. (e) Hospitals. No change. (f) Mid wives. Number of County Council practising midwives 2* „ „ midwives employed by Chingford District Nursing Association 3 „ „ independent domiciliary midwives 0 * Mrs. P. M. Stenning, 237, Hall Lane, E.4. (Telephone : Silverthorn 3263). * Mrs. Salter, 43, Ainslie Wood Gardens, E.4. (Telephone : Silverthorn 1345). (g) Registered Nursing Homes. There were two registered Nursing Homes in the district receiving maternity and medical patients. These Homes were inspected regularly and found to be conducted in a satisfactory manner. During the latter part of the year one Nursing Home closed down. (h) War-time Day Nurseries. There were two Nurseries in the district, one situated in converted premises at 136/138, Chingford Mount Road, and the other, of prefabricated hut construction, in Hatch Lane. Diabetes. There are two elderly ladies receiving free supplies of Insulin under Ministry of Health Circular No. 2734. CINICS AND TREATMENT CENTRES, 1945 Clinic or Dispensary Where held When held Diphtheria Immunisation Clinics The Health Dept., "Tantallon," The Ridgeway (nexttoTown Hall) County Council Clinic, Marmion Avenue, South Chingford. Wednesdays 10 a.m. Thursdays, 11.30 a.m. Maternity and Child Welfare Clinic. County Council Clinic, Marmion Av., S. Chingfd. Tuesdays 1.45 p.m.—3.45 p.m. Maternity and Child Welfare Clinic. County Council Clinic, Marmion Av., S. Chingfd. Wednesdays 1.45 p.m.—3.45 p.m. Maternity and Child Welfare Clinic. Mission Hall, Sewardstone Rd. North, Chingford. 2nd, 4th and 5th (if any) Wednesday of each month 1.45 p.m.— 3.45 p.m. Toddlers' Clinic County Council Clinic, Marmion Avenue, South Chingford Thursdays, 10 a.m.—11.30 a.m. Maternity and Child Welfare Clinic. Spicer Hall, Buxton Road, North Chingford. Thursdays 1.45 p.m.— 3.45 p.m. Ante-natal Clinic Friday Hill House. Chingford. 1st and 3rd Mondays 1.45 p.m. Maternity and Child Welfare Clinic. Friday Hill House, Chingford. 2nd, 4th & 5th Mondays, 1.45 p.m.—3.45 p.m. Ante-natal Clinic County Council Clinic, 16, The Ave., Chingford Wednesdays, 9.30 a.m., Fridays, 9.30 a.m., 3rd Friday in each month, 1.45 p.m. Women's Welfare Clinic County Council Clinic, 16, The Ave., Chingford 4th Friday of every month at 2 p.m. Minor Ailment and School Clinic County Council Clinic, 16, The Ave., Chingford Mondays 9.30 a.m.—12 noon Orthopædic Clinic County Council Clinic, 16, The Ave., Chingford Masseuse in attendance, Mondays, 2 p.m., Thursdays, 1.30 p.m. Tuberculosis Dispensary Old Monoux School, High Street Walthamstow, E.17. New Cases—Adults: Weds., 10 a.m.-12 noon. Children : Fris., 10 a.m.—12 noon. Venereal Diseases Prince of Wales Hospital, Tottenham. Mondays to Fridays, 8 a.m.—6 p.m. Saturdays 8 a.m.-12noon Tuesdays, 4.30 p.m.—7.30 p.m. Thursdays, 12.30 p.m.—3.30 p.m. Oldchurch County Hosp. (The Annexe) Romford. And other London Hospitals. Acting Relieving Officer: Mr. E. McCRAVE, 40, Long Deacon Road, Chingford, E.4. (Telephone No. : Silverthorn 4363.) Relief Office : Methodist Church Hall, New Road, South Chingford. (Telephone No. : Silverthorn 2836). Office hours : 9 a.m. to 10 a.m. (Urgent applications may be made at the residence of the Acting Relieving Officer : 40, Long Deacon Road, Chingford, E.4) Vaccination Officer : Mr. C. W. BARRETT, 19, Algers Road, Loughton. (Telephone No. : Loughton 576.) Registrar of Births and Deaths : Mr. F. JACKSON, "Cromer," Summerhill Grove, Bush Hill Parle, Enfield. (Telephone No. : Laburnum 4104.) Attends at the Methodist Church Hall, New Road, South Chingford, E.4. on Mondays and Thursdays, 2.30 p.m. to 4.30 p.m. ; and Wednesdays and Saturdays, 9 a.m. to 11 a.m. 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; the supply has been satisfactory in both quality and quantity, Rivers and Streams. It was not found necessary to take action in connection with the pollution of watercourses. Public Cleansing. The collection and disposal of house and trade refuse and salvage is carried out under the direction of the Chief Sanitary Inspector. The fortnightly collection of refuse was maintained but with difficulty. The total weight of refuse disposed of at the Works was 4,876 tons, an increase of 358 tons over the previous year. The net cost per ton for the collection of refuse was 20s. 2d. as against 21s. 5d. for the year ended March, 1944, and 17s. 6½d. for the year ended March, 1943. The net cost per ton for the disposal of refuse was 10s. 5¾d. as against 5s. 6d. for the previous year and nil for the year ended March, 1943. An examination of the analysis of income for the year shows that of the total of £2,771, no less 'han £1,233 was received for the sale of waste paper. During the year the Council continued to take all kitchen waste collected to an approved Concentration Plant and the income from this part of the Council's salvage scheme was £516. The weighbridge was maintained under contract and the fees during the year amounted to £35 15s. 0d., representing 1,420 weighings as against £25 6s. 6d., or 1,013 weighings in the previous year. The income derived from the collection of trade refuse was £61, which was less than normal, due to the remission of charges in cases where the material collected had a salvage value. 8 HOUSE AND TRADE REFUSE Table showing costs for the year ended 31st March, 1945 Item. 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 £4987 4987 5322 5115 10309 10102 B Gross income 61 61 2771 2771 2832 2832 C Net cost £4926 4926 2551 2344 7477 7270 Unit Costs s. d. s. d. s. d. s. d. s. d. s. d. D Gross expenditure per ton 20 5 20 5 21 10 20 11¾ 42 3 41 4¾ E Gross income, per ton. 3 3 11 4¼ 11 4¼ 11 7¼ 11 7¼ F Net cost, per ton 20 2 20 2 10 5¼ 9 7½ 30 7¾ 29 9½ G Net cost, per 1,000 population £ 133 £ 133 £ 69 £ 60 £ 202 £ 193 H Net cost, per 1,000 houses 428 428 222 204 650 632 1. Total refuse collected (in tons) 4,876 2. Population ('Mid-Year) 36,890 3. Weight per 1,000 population per day (in cwts.) 7.2 4. Number of occupied houses and premises (end of year, 1944) 11,475 Note.—(a) "Loan charges" include interest on loans ; repayment of loans ; revenue contributions to capital outlay and capital receipts. 9 10 Year ended v ANALYSIS OF INCOME FOR THE YEAR ENDED 31st MARCH, 1945 £ s. d. £ 6. d. £ s. d. £ s. d. 1. Sale of Salvaged Articles : Fine Ash, Clinker and Screenings Metals : 19 10 10 Aluminium 17 6 10 7 10 8 Copper 7 17 8 43 4 3 Iron 25 0 6 6 13 9 Lead 7 12 4 4 11 0 Battery Lead 2 8 11 13 2 7 Brass 9 14 0 , 37 12 2 Mixed Metals 3 4 9 20 2 7 Unbaled Scrap 4 6 0 92 15 11 Tins 62 9 7 - — — Pewter 1 19 10 142 0 5 35 14 6 Bones 31 6 7 31 6 7 151 10 10 Broken White Glass 89 5 8 250 7 9 Bottles and Jars 219 16 8 309 2 4 434 4 3 Rags 260 2 . 2 11 4 3 Carpets 22 7 0 282 9 2 51 9 0 Newspapers 104 5 2 1644 15 9 Mixed Waste Paper 1,129 0 2 129 1 6 Magazines — — — 1,233 5 4 492 11 9 Pig Food 516 10 10 516 10 10 37 11 6 Rubber 25 12 6 25 12 6 39 5 6 2. Miscellaneous Receipts and Charges 145 17 9 1,686 4 11 25 6 6 3. Weighbridge Fees 35 10 0 251 1 3 4. Subsidy on Sale of Scrap Iron — — — 5. Rents : 30 0 0 Foundry 30 0 0 20 0 0 Proportion of Allotment Rents 2 0 0 0 £3849 8 1 £2,271 14 11 4,518 Tonnage 4,876 SANITARY INSPECTION OF THE AREA Inspections on Complaint The number of complaints received at the office and recorded in the register was 192, as compared with 224 in the previous year and 331 for the year 1943. The total inspections made on complaint was 133 and the number of defects or nuisances revealed was 183, 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 4 Defective roofs, spoutings and eavesgutters 5 Blocked yard and W.C. drains 2 Blocked sewers 118 Defective drainage 26 Defective wall plaster 2 Ashbins defective 6 W.C.'s without proper flushing arrangements 5 Water closets defective 4 Insufficient water supply 3 Dampness 1 Defective stoves 2 Defective floors 3 Water fittings defective 2 183 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 2,345, as compared with 3,247 in the previous year ; 'tihe defects dealt with numbered 398, as compared with 812 in 1943. Table 2 Visits Paid Nuisances or Defects found Housing Act, 1936 : Inspections 34 190 Revisits re Notices served 532 Re Overcrowding 4 On Complaint 133 183 Miscellaneous 34 Infectious Disease 260 Meat and Food Shops 115 Factories 14 Bakehouses 12 Cowsheds 8 Dairies and Milkshops 7 Pigstyes 16 Drains tested 5 2 Revisits re Notices served (Public Health Act) 642 Infestation by Rats and Mice 102 23 Private Slaughterhouses 3 Shops Acts 9 Council Houses and re tenancies 8 Collection and Disposal of Refuse and Salvage 205 Re Crickets 6 Restaurants and Canteens 14 Swimming Pool 4 Re Certificates of Essentiality 14 Re Building Licences 21 Schools 2 Re Kitchen Waste Collection 64 Cinemas 2 Outworkers' Premises 4 Civil Defence: Depots 45 Food Decontamination Centre 6 Repair Garage 9 Rest Centres 11 2,345 398 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 24 Defective roofs, spoutings and eavesgutters 26 Blocked yard and W.C. drains 2 Blocked sewers 118 Defective drainage 30 Defective wall and ceiling plaster 34 Ashbins defective 10 W.C.'s without proper flushing arrangements 17 Insufficient water supply 7 Water closets defective 6 Dampness 14 Defective stoves and firegrates 17 Defective floors 14 Water fittings defective 5 Insufficient lighting and ventilation 5 Defective external brickwork 17 Defective stairs and rails 1 Defective woodwork of doors, windows, etc. 18 Defective sinks and waste pipes 3 Yard paving defective 4 Dangerous buildings 3 Rat infestation 23 398 Table 4 Letters sent out and notices served in connection with sanitary matters. Letters 691 Public Health Acts: Preliminary Notices 61 Secondary Notices 2 Statutory Notices (re maintenance of Sewers) 36 Housing Acts : Preliminary Notices 51 Secondary Notices 8 Statutory Notices 16 13 Shops Acts. It was not found necessary to take action during the year under the 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. Summaries of the daily chlorine and alkalinity readings are forwarded weekly to the 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 —■ Disinfested — 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) Disinfection. 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 notifiable 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 schools on account of infectious disease. 14 PREMISES AND OCCUPATIONS WHICH CAN BE CONTROLLED BY BYELAWS OR REGULATIONS Offensive Trade Premises The offensive trade premises on the register number 8, all being 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 Act, 1937. Twenlty-six visits were paid to Factories. No case of infectious disease occurred at outworkers' premises during the year. Numbers and Trades of Outworkers notified during 1944. Wearing Apparel 42 Artificial Flowers 2 Paper Bag-making 1 Flag-day Emblems 2 Box Making 1 Furriers 1 Small Munitions 1 Gas Detector Sleeve 1 Outworkers were notified from the following Areas : Bethnal Green 3 Islington 1 Ohigwell 1 Leyton 10 Corporation of London 5 St. Marylebone 5 Edmonton 1 Shoreditch 3 Finsbury 5 Walthamstow 1 Hackney 15 Wanstead & Woodford 1 15 Section D.—HOUSING STATISTICS FOR THE YEAR 1944 1. Number of New Houses erected during the Year : (1) By the L.A. — (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) 439 (b) Number of Inspections made for the purpose 1,613 (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 34 (b) Number of Inspections made for the purpose 532 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 3 (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 49* —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 45 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 16 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By owners 37 (b) By Local Authority in default of owners — 16 B. Proceedings under Public Health Acts : (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied — (2) Number of dwelling-houses in which defects were remedied after service of formal notices : (a) by owners — (b) by Local Authority in default of owners— Proceedings under Sections 11 and 13 of the Housing Act, 1936: Undertakings accepted 3 Section E.—INSPECTION AND SUPERVISION OF FOOD Milk Supply. There is only one cowshed on the register for the Chingford district; Ifche number of retail purveyors of milk is 4. The number of visits paid to cowsheds, dairies and milkshops was 15. Milk (Special Designations) Orders, 1936 and 1938. 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 : 2 dealers' licences to sell milk as Pasteurised. 2 supplementary licences to sell milk as Pasteurised. 2 dealers' licences to sell milk as Tuberculin Tested. 2 supplementary licences to sell milk as Tuberculin Tested. Meat and Other Foods There is one licensed slaughterhouse and twenty-two butchers' shops in the area ; the visits paid to these premises numbered 115. 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 or used for animal feeding purposes:— 17 18 TINNED GOODS. No. of Tins. Article. 73 Pilchards. 9 Herrings. 9 (jars) Herrings. 18 Salmon. 10 Crawfish. 7 Sardines. 4 Shrimps. 1 Mackerel. 33 Luncheon Meat. 16 Casserole Steak. 14 Chopped Ham. 12 Master Mix. 5 Spam. 4 Prem. 3 Sausage Meat. 3 Minced Beef Loaf. 2 Sheep's Tongue. 2 Steak and Vegetables. 1 Beef Loaf Cereal. 1 Lamb Tongue. 1 Brisket. 1 Brisket Beef. 1 Cam. 1 Brunch. 27 Jam. 23 Marmalade. 1 Golden Syrup. 2 Vegetables. 2 Carrots. 1 Beetroot. 8 Peas. 40 Beans. 14 Plums. 1 Pineapple. 32 Soups. 109 Milk. 4 (bottles) Pickles. 1 (jar) Beetox. OTHER FOODS. Article. Weight. Flour 51 lbs. Batter Flour 6 lbs. Oat Flour 4 lbs. Scone Meal 3 lbs. Scone Mixture 6 packets. Yorkshire Pudding Mixture 1 packet. Butter 33 lbs. Margarine 3¼ lbs. Lard 1 lb. Sausages 188 lbs. Spam 1¼ lbs. Brawn ¾ lb. Bacon 33 lbs. Gammon 2 lbs. Cheese 87½ lbs. Cheese Trimmings 7 lbs. Oranges 37 lbs. Prunes 14½ lbs. Raisins 7 lbs. Spaghetti 25 lbs. Macaroni 3 lbs. Breakfast Food 17 packets. Puffed Wheat 1 packet. Vita Wheat 1 packet. Sage and Onion Stuffing 2 packets, Beef Aspic Jelly 2 oz. Jar. Beef Extract 2 os. bottle. Eggs (Hens) 16. Eggs (Ducks) 79. Sugar 117 lbs. Sweets 5¾ lbs. Junket 32 pint packets. Sauce 4 bottles. Vinegar 3¼ pints. Rolled Oats 5¼ lbs. Dried Peas 6½ lbs. Rice 1 lb. Tea 1 lb. Bread 6 large loaves. Marmalade (War Damage) 10 lbs. Jam (War Damage) 2 lbs. 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. Sample. Result. 239 Pasteurised Milk Satisfactory and sufficiently heat treated. 240 Do. Do. 19 Food and Drugs Act, 1938. The following articles were submitted for chemical examination during the year in supplemention of the Essex County Council's Food and Drugs service: No. Sample. Result. 271 Liver Sausage Contained not more than 42% of meat instead of 45%. 272 Fish Roll Clean and laquered interior of tin not attacked. Unpalatable until cooked. PREVENTION AND CONTROL OF INFECTIOUS AND OTHER DISEASES Scarlet Fever The following table shows the total number of cases notified during the year, the percentage of cases removed to hospital and the corresponding figures for the previous four years : 1940 1941 1942 1943 1944 Cases notified 47 32 186 376 82 Percentage removed to hospital 72 91 82 72 64 During the year the number of notifications of Scarlet Fever fell to a comparatively low figure, the percentage of cases removed to hospital reaching a lower figure, indicating the mild type of the infection and the realisation that in many cases where home nursing and isolation are possible, it is medically sound to have home isolation rather than treatment in Hospital wards. Diphtheria. During the year only two cases of Diphtheria occurred, the patients being a girl aged years and a boy aged 9 years, neither of whom had been immunised. Diphtheria Immunisation. Number of children immunised during the year:— Under 5 years 404 Between 5 and 15 years 58 Total 462 The total number of children immunised during the year was considerably lower than the preceding years, especially with refer' ence to school children. Nevertheless, it is estimated that in Chingford 62'% of children under 5 years and 76% of children aged between 5 and 15 years had been immunised as at 31st December, 1944. 20 Efforts during the year were again concentrated on securing the immunisation of children as soon as possible after their first birthday. The material used in all instances was Diphtheria Alum Precipitated Toxoid, the dosage being 0.2 c.c. and 0.4 c.c. or 0.5 c.c. ?.t an interval of four weeks. Measles. There was a further marked decrease in the number of cases of Measles, only two patients requiring admission to hospital. Scabies. Number of cases treated at Church Hall First Aid Post during the year: Pre-school age 7 School age 11 Adults 7 (Only 16 out of the Total 25 total of 25 returned for second treatment.) No regular clinic for the treatment of Scabies has been inaugurated, but by special arrangement, in certain cases, baths and treatment 'have been provided with the 'help of Civil Defence First Aid Post personnel. From information and notifications received in the Health Department, it does not appear that the incidence of Scabies was unusually high during the year. Dysentery. During the year there was an increase in the number of cases of Dysentery. In all cases where specimens were examined bacteriologically the type of infection was found to be Sonne, and in most cases the illness was of short duration and mild upset. Infection appeared to be from contact with patients and no source of infection relative to general milk or food supplies could be traced. Tuberculosis. There were 57 cases of all forms of Tuberculosis notified during 1944 (a decrease of 5 on the previous year) and of these, 12 cases (21%) were transfers from other districts. There were 15 deaths from Tuberculosis during 'the year; 3 of these had not been previously notified as suffering from Tuberculosis. The ratio of non-notified tuberculous deaths to total tuberculous deaths is 1 to 5.0. 21 Vaccination. The Vaccination Officer for the area has furnished the following return for 1944:— Births registered 352 Successfully vaccinated 112 Percentage vaccinated 31.4 Insusceptible 1 Exemptions 126 Died before vaccination 8 Postponed 10 Removed—new address unknown 5 Removed—address known and V.O. notified 15 Outstanding 75 Medical Examinations. During the year nine examinations were carried out by the Medical Officer of Health in respect of the Superannuation and Sick Pay Scheme. CAUSES OF DEATH AS GIVEN BY THE REGISTRAR-GENERAL FOR THE YEAR 1944 Causes of Death. Males. Females. Total. Whooping Cough 2 - 2 Tuberculosis of respiratory system 8 5 13 Other forms of tuberculosis 2 2 Syphilitic diseases 1 - 1 Influenza 1 - 1 Acute infectious encephalitis 1 1 Cancer of buccal cavity and oesophagus (M) uterus (F) 2 - 2 Cancer of stomach and duodenum 7 1 8 Cancer of breast - 13 13 Cancer of all other sites 19 16 35 Diabetes 4 - 4 Intra-cranial vascular lesions 15 15 30 Heart disease 29 30 59 Other diseases of circulatory system 6 7 13 Bronchitis 8 9 17 Pneumonia 6 8 14 Other respiratory diseases 4 1 5 Ulcer of stomach or duodenum 3 2 5 Diarrhoea under 2 years 1 2 3 Appendicitis 1 - 1 Other digestive diseases 6 10 16 Nephritis 5 10 15 Maternal causes (excluding puerperal sepsis) 1 1 Premature birth 4 1 5 Congenital malformation, birth injury, infantile disease 7 5 12 Suicide 2 3 5 Road traffic accidents 2 3 5 Other violent causes 3 7 10 All other causes 11 9 20 Totals—all causes 158 160 318 Totals—year 1943 154 160 314 22 Tuberculosis. Age periods. NEW CASES TRANSFERS DEATHS Respiratory Non Respiratory Respiratory Non Respiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. M. F. M. F. 0 to 1 year - - - - - - - - - - - - 1 to 4 years — 3 — — — — — — — — — — 5 to 14 years 2 5 — — — — — 1 — — — — 15 to 24 years 7 5 — 2 2 — 1 — — — 1 1 25 to 34 years 2 4 1 — 2 1 — — 1 — — — 35 to 44 years 1 3 — — 3 1 — — 1 2 — — 45 to 54 years 5 4 - - - - - - 3 1 — — 55 to 64 years — 1 — — — 1 — — 1 — — — 65 and upwards - - - - - - - - - 1 — — Totals 17 25 1 2 7 3 1 1 6 4 1 1 Add—Deaths of un-notified cases 1 2 — — 7 6 1 1 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-testinal Tract — — — — 2 — 3 1 8 8 13 9 22 Lungs and Mediastinum - - - - - - 1 — 3 1 4 1 5 Genito-urinary organs - - - - - - - 2 5 3 5 5 10 Breast — — — 1 — 2 — 2 — 7 — 12 12 Other sites — — — 1 1 — — — 6 — 7 1 8 Totals - - - 2 3 2 4 5 22 19 29 28 57 Death rate =1.54 per 1,000 (as compared with 1.58 per 1,000 in previous year). 23 Deaths from all causes at various Ages Age No. of Deaths Under 1 year 24 1 and under 2 3 2 and under 5 — 5 and under 15 1 15 and under 25 6 25 and under 35 13 35 and under 45 26 45 and under 55 36 55 and under 65 49 65 and under 75 81 75 and upwards 81 Total deaths 320 ATTENDANCES AT LOCAL CLINICS DURING 1944 Ante-Natal Clinics: Friday Hill Sessions 23 16, The Avenue Sessions 134 Infants' & Toddlers' Welfare Clinics: Friday Hill Sessions 23 (including Infants & Toddlers) Sewardstone Road Sessions 30 (including Infants & Toddlers) North Chingford Sessions 48 (including Infants & Toddlers) 16, The Avenue Sessions: Infants 103 Toddlers 49 Specialist Obstetric Clinic: 16, The Avenue Sessions 10 Women's Welfare Clinic: 16, The Avenue Sessions 12 Minor Ailment & School Clinic: 16, The Avenue Sessions 50 Whitehall Road School Sessions 16 Orthopaedic Clinic: 16, The Avenue Sessions 80 Attendances 306 Attendances 2,377 Attendances 439 (including 34 new infants). Attendances 604 (including 40 new infants). Attendances 2,522 (including 125 new infants). Attendances 4,194 (including 495 new infants). Attendances 451 Attendances 54 Attendances 79 Attendances 930 Attendances 287 Patients Treated 160 24 25 NOTIFIABLE DISEASES Year Scarlet Fever Diphtheria Erysipelas Measles Whooping Cough Tuberculosis Dysentery Encephalitis Lethargica Puerperal Pyrexia Ophthalmia Neonatorum Pneumonia Cerebro-Spinal Fever Enteric Fever Pulmonary Other Forms 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 41 7 — — 1 — 54 7 — 1942 186 4 8 504 75 56 14 1 1 3 — 64 3 — 1943 376 13 16 189 83 55 7 2 — 2 1 88 3 — 1944 82 2 5 61 72 52 5 20 — 2 1 73 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 — 1 2 2 8 38 16 3 6 5 1 - 82 Diphtheria — — — — 1 1 — — — - - - 2 Erysipelas — — — — — 1 — — 1 — 2 1 5 Measles 5 4 5 7 5 28 3 2 1 1 - - 01 WhoopingCough 5 9 9 10 7 28 — — 2 1 1 - 72 Puerperal Pyrexia - - - - - - - - - - - - 2 Pneumonia 2 1 1 4 3 6 1 4 8 9 23 11 73 Cerebro-spinal Fever 1 - - - - - - - - - - - 2 Dysentery — 2 2 1 — 5 3 — 3 1 3 - 20 Ophthalmia Neonatorum 1 - - - - - - - - - - - 1 ANALYSIS OF NOTIFIABLE DISEASES AND DEATHS. Diseases Total cases notified Total admitted to hospital Total Deaths Scarlet Fever 82 53 - Diphtheria 2 2 - Erysipelas 5 3 — Puerperal Pyrexia 2 2 — Pneumonia 73 20 14 Cerebro-Spinal Fever 2 2 - Measles 61 2 - Whooping Cough 72 5 2 Dysentery 20 2 - Ophthalmia Neonatorum 1 1 — 26 27 Birth-rates, Civilian Death-rates, Analysis of Mortality, Maternal Mortality and Case rates for certain Infectious Diseases in the Year 1944. (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 Civilian Population :— Deaths under 1 Rates per 1,000 Live Births:— Live 17.6 20.3 20.9 15.0 21.0 year of age 46 52 44 61 31 Still 0.50 0.64 0.61 0.42 0.79 Deaths: All Causes 11.6 13.7 12.4 15.7 8.7 Deaths from Diarrhœ and Enteritis under 2 years of age 4.8 7.3 4.4 10.1 3.9 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 - Scarlet Fever 0.00 0.00 0.00 0.00 - Whooping Cough 0.03 0.03 0.02 0.04 0.05 Rates per 1,000 Total Births (Live and Still) Diphtheria 0.02 0.03 0.03 0.01 — Influenza 0.12 0.10 0.11 0.08 0.03 Smallpox Measles 0.00 — — — — 0.01 0.01 0.01 0.00 — Notifications: Notifications: Typhoid Fever 0.01 0.01 0.01 0.01 — Puerperal Fever 10.3 4 13.13 9.25 3.61 Paratyphoid Fever 0.01 0.00 0.01 0.01 — Cerebro-Spinal Fever 0.05 0.06 0.04 0.06 0.05 „ Pyrexia 14.14 2.49 Scarlet Fever 2.40 2.41 2.67 1.57 2.22 Maternal Mortality: Whooping Cough 2.49 2.49 2.29 2.90 1.95 Diphtheria 0-58 0.67 0.69 0.31 0.05 Maternal causes 1.25 Not available. 1.24 Erysipelas 0.29 0.32 0.28 0.37 0.14 Smallpox 0.00 0.00 0.00 0.00 - (excluding Abortion and Puerperal Infections) Measles 4.16 4.51 3.94 2.98 1.65 Pneumonia 0-97 1.13 0.82 0.93 1.98 ,