E4411(1) CH NGFORD CHIN 11 BOROUGH OF CHINGFORD ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1946 BOROUGH OF CHINGFORD ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1946 ANNUAL REPORT FOR THE YEAR 1946 To the Mayor, Aldermen and Councillors of the Chingford Corporation. Mr. Mayor, Aldermen and Councillors, I have pleasure in presenting my first Annual Report upon the health and sanitary circumstances of the Borough. It is very satisfactory to note that the Birth Rate has risen steeply, the rate being 20.4 compared with 16.03 for the previous year. In addition, both the general Death Rate and the Death Rate of Infants under one year of age are lower than those for 1945, the figures being: Death Rate 7.6 (1945, 8.5) and Infant Death Rate 27.1 (1945, 29.7). There is nothing of note to mention regarding the incidence of Infectious Disease; there were no epidemics or unusual outbreaks of any illness. In conclusion, thanks are due to the Chief Sanitary Inspector, Mr. James F. Rogers, and the staff of the Health Department for their help and co-operation during the year. I am, Ladies and Gentlemen, Your obedient servant, J. H. CROSBY, Medical Officer of Health. October, 1947. 2 Section A.—STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area 2,868 acres Population—Registrar General's estimate 43,290 Number of inhabited houses and flats, end of 1946 11,820 approx. Rateable value on April 1st,, 1946 £332,615 0 0 Sum represented by a penny rate on April 1st, 1946 (gross) £1,385 17 11 Vital Statistics M. F. Live Births Total 457 427 Birth Rate per 1,000 of estimated resident population: 20.4. Legitimate 444 409 Illegitimate 13 18 M. F. Stillbirths Total 7 9 Rate per 1,000 total (live and still) births: 17.8. Legitimate 6 9 Illegitimate 1 - M. F. Crude Death Rate per 1,000 of estimated resident population: 7.6. Deaths 162 167 Deaths from Puerperal Sepsis 0 „ „ other puerperal causes 1 Death Rate of Infants under one year of age :— All infants per 1,000 live birth 27.0 Legitimate infants per 1,000 legitimate live births 23.4 Illegitimate infants per 1,000 illegitimate live births — Deaths from Cancer (all ages) 57 „ „ Measles (all ages) — „ „ Whooping Cough (all ages) 1 „ „ Diarrhoea (under 2 years of age) 1 „ ,, Scarlet Fever — 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 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 1945 37,790 606 16.03 321 8.5 18 29.7 1946 43,290 884 20.4 329 7.6 24 27 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 details of the Chingford specimens examined are again not available this year. (b) Ambulance Facilities. Two ambulances, one car and a staff of four paid drivers were maintained. The following is a summary of the work performed by the Council's Ambulance Service during 1946:— Total number of calls dealt with during year— Hire. Accidents. Maternity. Ambulance No. 1 1,087 84 199 No. 2 122 11 26 Council Car 77 2 24 1,286 97 249 Total 1,632 Total mileage covered by the Borough Ambulances during the year—22,623 miles. In addition the following calls were dealt with by transfer to other Ambulance Services on occasions when Chingford ambulances were engaged or under repair:— Hire. Accidents. Maternity. Wanstead and Woodford Borough 49 12 5 Walthamstow Borough 4 23 — Epping (private hire) 12 — 4 Loughton (private hire) 4 — 1 B.R.C. Waltham Abbey 1 — — 70 35 10 Total 115 5 The Chingford ambulances gave assistance in adjoining districts as follows:— Hire. Accidents. Maternity. Walthamstow 1 10 — Woodford 2 — 1 Epping 2 — — Waltham Abbey 1 — — Chigwell 1 1 — 7 11 1 Total 19 Assistance, by supplying drivers or attendants, was given by the St. John Ambulance Brigade members on 75 occasions. (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. (d) Clinics and Treatment Centres. See Table of Clinics on page 7. (e) Hospitals. No change. (f) Midwives. Number of County Council practising midwives 2* ,, ,, midwives employed by Chingford District Nursing Association 3 ,, „ independent domiciliary midwives 0 „ ,, midwives practising in the Nursing Homes 4 ,, ,, maternity nurses practising in the Nursing Homes 1 *Mrs. P. M. Stenning, 237, Hall Lane, E.4 (Telephone: Silverthorn 3263). (not now practising) ^Mrs. G. H. Salter, 81, Ainslie Wood Gardens, E.4 (Telephone: Silverthorn 1347). (g) Registered Nursing Homes. There are two registered Nursing Homes in the district, one receiving maternity and medical patients and the other receiving only maternity patients. These Homes were inspected regularly and found to be conducted in a satisfactory manner. (h) Day Nurseries. There are 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. 6 LOCAL CLINICS AND TREATMENT CENTRES, 1947. Clinic Where held When held Diphtheria Immunisation Clinics Spicer Hall, Buxton Rd., North Chingford Mission Hall, Sewardstone Road North, E.4 County Council Clinic, Marmion Avenue, South Chingford Friday Hill House, E.4 Thursdays, 2 p.m. 2nd, 4th and 5th Wednesdays, 2 p.m. Thursdays, 11 a.m. 1st Wednesday, 3 p.m. Ante'Natal Clinics. Friday Hill House, E.4 County Council Clinic, Marmion Avenue, E.4 16, Chingford Avenue, E.4 Thursdays, 9.30 a.m.—11.30 a.m. Wednesdays, 9.30 a.m. Fridays, 9.30 a.m. Child Welfare Clinics Friday Hill House, E.4 County Council Clinic, Marmion Avenue, E.4 Spicer Hall, Buxton Rd., North Chingford Wednesdays, 1.30 p.m.—3.30 p.m. Tuesdays, 1.45 p.m.—3.45 p.m. Wednesdays, 1.45 p.m.—3.45 p.m. Thursdays, 1.45 p.m.—3.45 p.m. Toddlers Clinic County Council Clinic, Marmion Avenue, E.4 Thursdays, 10 a.m.—11.30 a.m. Minor Ailment and School Clinics County Council Clinic, Marmion Avenue, E.4 Whitehall Road School, E.4 Mondays, 9.30 a.m. 2nd and 4th Mondays, 2 p.m. Orthopaedic Clinics County Council Clinic, Marmion Avenue, E.4 16, Chingford Avenue, E.4 Monday afternoons, 1st, 3rd and 5th Thursdays by appointment only Thursday mornings, 2nd and 4th Thursday afternoons by appointment only Dental Clinic 16, Chingford Avenue, E.4 Monday—Friday, 9 a.m.—9.30 a.m. Inspection only Eye Clinic County Council Clinic, Marmion Avenue, E.4 Friday afternoons. By appointment only Women's Welfare Clinic County Council Clinic, Marmion Avenue, E.4 16, Chingford Avenue, E.4 4th Friday every month. By appointment only 2nd Friday every month, 12 noon—1 p.m. Tuberculosis Dispensary Old Monoux School, High Street, Walthamstow, E.17 New cases:Adults— Wednesdays, 10 a.m.—12 noon New cases:Children— Fridavs, 10 a.m.—12 noon. Venereal Disease Clinics Prince of Wales Hospital, Tottenham Oldchurch County Hosp. (The Annexe), Romford And other London hospitals. Females— Thursdays, 10—12 noon, Thursdays, 5—7 p.m., Tuesdays, 5—7 p.m. Males— Mondays, Wednesdays, Fridays, 4 p.m.—6.30 p.m., Thursdays, 10—12 noon Males and Females— Mondays and Tuesdays, 4 p.m.—6.30 p.m., Thursdays, 12 noon—3.30 p.m. District Welfare Officer: Mr. E. McCRAVE, 73, Dale View Crescent, Chingford, E.4. (Telephone No.: Silverthorn 4363.) Welfare Office: Methodist Church Hall, New Road, South Chingford. (Telephone No.: Silverthorn 2836). Office hours: 9 a.m. to 10 a.m. and 4 p.m. to 5 p.m. Saturdays 9 a.m. to 1 p.m. for urgent cases only. (Urgent applications may be made at the residence of the District Welfare Officer: 73, Dale View Crescent, 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 Park, 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. During the year the weekly collection of refuse was reinstituted, not without difficulties, but with beneficial results gener ally. The total weight of refuse disposed of at the Works was 7,771 tons, an increase of 1,828 tons over the previous year. This considerable increase of the quantity of refuse was due principally to the rise in the population figure, namely 44,098 mid-year, 1946, as against 37,790 mid-year, 1945. The net cost per ton for the collection of refuse was 14s. Od. as against 16s. 5½d. for the year ended March, 1946, and 20s. 2d. for the year ended March, 1945. The net cost per ton for the disposal of refuse was 9s. 6¼d. as against 6s. 9¼d. for the previous year and 10s. 5 3/4d. for the year ended March, 1945. An examination of the analysis of income for the year shows that of the total of £3,779, no less than £1,212 was received for the sale of waste paper. The total income for the year is one of the highest ever recorded, and the income for this part of the Council's Salvage Scheme, including the allowance from the Board of Trade, was £768. During the latter part of the year the Council had under consideration the provision of circular concrete bases fitted with two upright supports to each of the communal kitchen waste bins in the town. The object of these bases was to prevent the bins being overturned, and the Council decided to purchase 100 of these bases. The weighbridge was maintained under contract and the fees during the year amounted to £48 19s. 6d., representing 1,959 weighings as against £40 5s. Od. or 1,610 weighings in the previous year. The income derived from the collection of trade refuse was £235. 8 HOUSE AND TRADE REFUSE Table showing costs for the year ended 31st March, 1947 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 £6443 6346 64 63 6272 12906 12618 B Gross income 1004 1004 2759 2759 3763 3763 C Net cost £5439 5342 3704 3513 9143 8855 Unit Costs s. d. s. d. s. d. s. d. s. d. s. d. D Gross expenditure per ton 16 7 16 4 16 7¼ 16 1 3/4 33 2½ 32 5 3/4 E Gross income, per ton 2 7 2 7 7 1¼ 7 1¼ 9 8¼ 9 8¼ F Net cost, per ton 14 0 13 9 9 6¼ 9 0½ 23 6¼ 22 9½ G Net cost, per 1,000 population £ s. d. £ s. d. £ s. d £ s. d. £ s. d. £ s d. 123 2 3 121 8 2 84 3 8 79 17 8 3/4 207 15 11 201 5 0 H Net cost, per 1,000 houses 436 2 4 3/4 427 7 2½ 296 6 4 3/4 28 0 9½ 731 8 10½ 708 8 0 1. Total refuse collected (in tons) 7,771 2. Population (Mid-Year) 44,098 3. Weight per 1,000 population per day (in cwts.) 9.6 4. Number of occupied houses and premises (March, 1947) 12,676 Note.—(a) "Loan charges "include interest on loans; repayment of loans revenue contributions to capital outlay and capital receipts. 9 ANALYSIS OF INCOME FOR THE YEAR ENDED 31st MARCH, 1947 Year ended 31.3.46 £ s. d. £ s. d. £ s. d. £ s. d. 1.—Metals: 14 0 0 Aluminium 30 11 9 11 13 6 Copper 32 9 10 38 18 0 Iron 61 18 2 12 12 7 Lead 36 8 2 Battery Lead 10 18 8 14 9 1 Brass 47 9 8 31 15 5 Mixed Metals 16 2 2 7 5 6 Unbaled Scrap 17 14 0 86 0 2 Tins 91 17 4 1 17 3 Pewter 2 6 3 347 16 0 22 14 11 Bones 35 19 3 35 19 3 102 18 1 Broken White Glass 115 16 3 402 4 8 Bottles and Jars 655 6 8 — Syphons 15 9 771 18 8 230 0 3 Rags 257 13 9 31 8 6 Carpets 24 1 0 281 14 9 63 18 3 Newspapers and 1182 6 4 1036 7 9 Mixed Waste Paper 12 9 9 Ministry of Supply Coll. Allowance 30 6 7 1212 12 11 520 12 3 Pig Food (Kitchen Waste) 595 12 1 — Pig Food (Supple mentary. Allen. (Board of Trade) 172 7 0 767 19 1 — Rubber 16 6 16 6 — Old Gramophone Records 4 0 0 4 0 0 3422 17 2 196 6 7 2. — Miscellaneous Receipts & Charges 25 19 0 40 5 0 3.—Weighbridge Fees 48 19 6 4.—Rents 30 0 0 Foundry 30 0 0 20 2 6 Proportion of Allotment Rents 16 11 5 2928 0 0 3544 7 1 170 0 0 Refuse Collection Charges 235 10 3 £3098 0 0 £3779 17. 4 5,943 Tonnage 7,771 10 SANITARY INSPECTION OF THE AREA Inspections on Complaint The number of complaints received at the office and recorded in the register was 437, as compared with 212 in the previous year and 192 for the year 1944. The total inspections made on complaint was 1,174 and the number of defects or nuisances revealed was 247, 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 1 Defective roofs, spoutings and eavesgutters 3 Blocked yard and W.C. drains 15 Blocked sewers 131 Defective sewers 16 Defective drainage 18 Defective dustbins 19 W.C.s without proper flushing arrangements 3 Defective W.C.'s 5 Insufficient water supply 2 Dampness 4 Defective stoves and fire grates 10 Defective water fittings 4 Waste pipes and sinks defective 5 Verminous premises 3 Animals kept so as to be a nuisance 3 Accumulations of offensive matter 4 Defective hot water systems 1 247 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 4,126, as compared with 3,038 in the previous year; the defects dealt with numbered 614, as compared with 620 in 1945. Table 2 Visits Paid Nuisances or Defects found Housing Act, 1936: Inspections 76 364 Re-visits re Notices served 468 Re Overcrowding 15 On complaint 1174 247 Re Licence Applications and Essential Materials 193 Infectious Disease 439 Retail Trade Premises: Meat 82 Fish 11 Fried Fish 17 General Provisions 73 Others 7 Food Preparation Premises 27 Factories 19 1 Bakehouses 12 1 Cowsheds and Dairies 5 Pigstyes 2 Revisits re Notices served (P.H. Acts) 1308 Infestation by Rats and Mice 6 Private Slaughtering 2 Shops Acts (Sanitary Conditions) 3 1 Council Houses 8 Collection and Disposal of Refuse and Salvage 147 Schools 7 Verminous Premises 2 De-requisitioned Premises 9 Hairdressers' Premises 10 Swimming Pool 4 4,126 614 12 Nuisances and Defects In the following table are 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 2 Defective roofs, spoutings and eavesgutters 31 Blocked yard and W.C. drains 28 Blocked sewers 131 Defective sewers 21 Defective drainage 33 Wall and ceiling plaster defective 57 Ashbins defective 51 W.C.'s without proper flushing arrangements 9 Insufficient water supply 4 Water closets defective 14 Dampness 31 Defective stoves and firegrates 17 Defective floors 32 Water fittings defective 16 Insufficient lighting and ventilation 12 Defective external brickwork 20 Stairs and rails defective 3 Defective woodwork of windows and doors 27 Sinks and waste pipes defective 16 Yard paving defective 4 Defective wash coppers 1 Defective sash cords, glazing, etc. 24 Rat infestation 4 Animals kept so as to be a nuisance 3 Accumulations of offensive matter 4 Lack of sanitary accommodation 1 Defective hot water systems 5 Walls defective 6 Cleansing, limewashing and decoration required 7 614 Table 4 Letters sent out and notices served in connection with sanitary matters. Letters 1775 Public Health Acts: Preliminary Notices 106 Secondary Notices 7 Statutory Notices (re maintenance of Sewers) 9 Housing Acts: Preliminary Notices 73 Secondary Notices 6 Statutory Notices 14 13 Shops Acts. It was found necessary in one instance to take action during the year under the provision of the Shops Acts. Smoke Abatement. 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. Samples of the water at the Pool were taken during the year, and these were considered to be of a satisfactory standard of bacterial purity and the water suitable for swimming bath purposes. 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, 13. Disinfested, 13. (2) Methods. Spraying with an insecticide is the general rule, following the removal of architraves, skirtings and picture rails. Papered rooms are stripped. (3) Inspectorial Methods. In certain cases 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 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 Bye-laws 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. Thirty-one visits were paid to Factories, and in one instance action was taken regarding the provision of sanitary accommodation. Number and Trades of Outworkers notified during 1946. Wearing Apparel 28 Brush Making 3 Box Making 2 Handbags 1 Footwear 2 Outwbrkers were notified from the following Areas: Bethnal Green 3 Penge 1 Finsbury 10 Stepney 1 Hackney 5 Wanstead & Woodford 4 Holborn 1 West Ham 1 Leyton 8 Westminster 2 Rats and Mice (Destruction) Act, 1919. The Council continues to employ a full-time Rodent Operative under the Scheme inaugurated with the Ministry of Food. Whilst there was no evidence of major infestation in the town the Rodent Operative paid many calls to various properties to deal with minor infestations. The Council had under consideration the initial treatment of sewers, but owing to the high costs involved and the lack of firm evidence of rat infestation in sewers in the town, it was decided to carry out a 10 per cent. test baiting of manholes. This work was not carried out until the year 1947. 15 Section D.—HOUSING STATISTICS FOR THE YEAR 1946 1. Number of Houses erected during the Year: (1) By the L.A. (permanent houses) Nil (2) By the L.A. (temporary houses) 120 (3) By the L.C.C. (permanent houses) traditional 134 (4) By the Ministry of Works (permanent prefabs.) 58 (5) Cost of works re buildings by local builders 2 (6) By private enterprise 1 315 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) 1,693 (b) Number of Inspections made for the purpose 3,469 (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 76 (b) Number of Inspections made for the purpose 544 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 5 (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 *505 *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 423 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 14 (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 — 16 B. Proceedings under Sections 11 and 13 of the Housing Act, 1936: (1) Number of Demolition Orders served — (2) Number of Undertakings accepted 4 (3) Number of Undertakings completed 2 C. Proceedings under Public Health Acts: (1) Number of dwelling'houses in respect of which notices were served requiring defects to be remedied 9 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) by owners 11 (b) by Local Authority 1 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 4. The number of visits paid to cowsheds and dairies was 5. Milk (Special Designations) Regulations, 1936-1946. 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 Regulations : 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 217. 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, or returned to the Ministry of Food for processing purposes:— 17 TINNED FOODS. Article. No of Tins. Crab 5 Pilchards 50 Herrings 1 Salmon 58 Crayfish 3 Sardines 26 Brisling 2 Luncheon Meat 16 Spam 1 Corned Beef 60 Corned Mutton 3 Steak and Kidney 4 Stewed Steak 105 Sausage Meat 2 Sausages 5 Meat and Vegetables 21 Lamb Tongue 2 Ox Tongue 8 Brisket Beef 1 Mixed Vegetables 12 Carrots 5 Beetroot 9 Peas 83 Tomatoes 10 Baked Beans 82 Soups 57 Hors d'Oeuvres 4 Pate de Foie 2 Milk 359 Apricots 10 Plums 27 Fruit Pudding 31 Jam 3 Marmalade 2 Golden Syrup 6 Treacle 1 Macaroni 2 OTHER FOODS. Article Quantity. Flour 13 20½ lbs. Batter Flour 38 ,, Cake Flour 66 pkts. Yorkshire Pudding Mixture 4 „ Bread 386 3/4 lbs. Butter 5 ozs. Margarine 23½ lbs. Lard 1 lb. 10 ozs. Suet 18 lbs. 14 ozs. Sausages 5 lbs. Pork Brawn 48 „ Minced Beef 56 3/4 ,, Bacon 48 lbs. 6 ozs. Fish 38 3/4 stones Paste 4 jars Cheese 38 lbs. Cheese Trimmings 8 „ Prunes 62 „ 18 OTHER FOODS (Contd.) Article Quantity. Dates 70½ lbs. Figs 64 Raisins 51 „ Macaroni 90 „ Semolina 23 ,, Spaghetti 88 ,, Pearl Barley 100 „ Barley Flakes 50 pkts. Wheat Flakes 1 pkt. Breakfast Cereal 17 ,, Rolled Oats 26 lbs. Sage and Onion Stuffing 20 pkts. Oxo Cubes 12 Jardox 4 ozs. Soup Powder 24 pkts. Mixed Herbs 48 „ Bicarbonate of Soda 11 tins Curry Powder 31 „ Eggs 180 Dried Egg 1 Pkt. Jelly 48 pkts. Gelatine 30½ lbs. Sugar 3cwts. 62lbs Chocolate 6½ lbs. Chocolate Spread 7 pkts. Nestle's Food 6 tins Soya Cream 1„ Chocolate Biscuits 19 lbs. Biscuits 107 „ Ryvita 2 pkts. Tea 20¾ lbs. Coffee 38 „ Mustard 14 „ Pepper 7 „ Peas 110 „ Tomatoes 78 „ Marmalade 3 „ Jam 18 „ Pickles 13 jars Sauce 18 bottles Cake Decorations 3 Essences 55 bottles Cordial 18 „ 19 CHEMICAL AND BACTERIOLOGICAL EXAMINATION OF FOOD The Counties Public Health Laboratories, 66, Victoria Street, London, S.W.I, undertake bacteriological examinations for the Council. The following were forwarded for bacteriological examination during the year:— No. Sample. Result. 243 Cooked beef No pathogenic organisms isolated 244 Cooked ham 245 Margarine 246 Custard powder 247 Self'raising flour Dr. Bernard Dyer and Partners, Ltd., Peek House, 20, Eastcheap, E.C.3, are the Public Analysts for the district. The following articles were submitted for chemical examina' tion during the year in supplementation of the Essex County Council's Food and Drugs service:— No. Sample. Result. 276 Pasteurised Milk Satisfactory. 277 Medicated Lozenges Not regarded as properly des' cribed as "Med. Loz." 278 Butter Genuine butter. No evidence of margarine. 279 Meat—? horseflesh Not able to say sample was not beef. 20 Section F— PREVENTION AND CONTROL OF INFECTIOUS AND OTHER DISEASES Diphtheria. It is gratifying to note that no cases of Diphtheria occurred during the year under review. It would be futile, however, to regard this as a direct result of the immunisation of children carried out during 1946 and previous years, as the number of children presenting themselves for immunisation is still far too few. However, the number immunised during 1946 shows an increase of 129 over those for 1945, viz.: 744 against 615 for 1945, an increase of 21%. In Chingford it is estimated that ony 72% of children under 15 years of age are immunised. It is considered that unless and until about 95% of all children under the age of 15 years are immunised, Diphtheria cannot be regarded as an entirely preventable disease. It cannot be too strongly urged on parents to have their children immunised as soon after the age of nine months as possible, and to have reinforcing immunisation carried out at the age of 5 years and again at the age of 8 years and 11 years. Facilities for immunisation exist at all County Council clinics in the Borough and arrangements are made, as occasion arises, for school children to be immunised at school. The prophylactics used are Diphtheria A.P.T. and T.A.F. Diphtheria Immunisation. Number of children immunised during the year:— Under 5 years 576 Between 5 and 15 years 131 Total 707 Number receiving secondary or reinforcing injections during the year 37 The number of children immunised during the year showed an increase over the previous year, but the numbers accepting this service are not sufficiently high to warrant any sense of security. Scarlet Fever. Cases of Scarlet Fever during 1946 show a slight increase over those for 1945. The figures for the years 1942'46 are shown in the following table, together with the percentage removed to hospital:— 1942 1943 1944 1945 1946 Cases notified 186 376 82 62 74 Percentage removed to hospital 82 72 64 77 64 All the cases of Scarlet Fever were of the usual mild type, presenting few if any complications. The percentage of cases removed to hospital decreased. 21 Measles. There was a slight increase in the number of cases of Measles, but only one case was admitted to hospital. Adequate supplies of Measles serum were made available for the use of practitioners in the prophylaxis and treatment of cases. Dysentery. The number of cases of Dysentery decreased considerably, viz.: 13 cases against 38 in 1945. Only in seven of these cases could the causal organism be identified bacteriologically, and no case was considered to have been caused by any infected food or drink. Tuberculosis. There were 79 cases of all forms of Tuberculosis notified during 1946 (an increase of 29 on the previous year) and of these, 29 cases (37%) were transfers from other districts. There were 17 deaths from Tuberculosis during the year ; 2 of these had not been previously notified as suffering from Tubercu' losis. The ratio of non^notified tuberculous deaths to total tubercu' lous deaths is 1 to 8.5. Food Poisoning. Two outbreaks of food poisoning involving about 100 people on each occasion, occurred in a factory canteen towards the end of the year. It was considered that both outbreaks were due to meat pies which had become infected during preparation. All those involved made a rapid recovery. In addition, an isolated case of food poisoning was also reported, recovery being uneventful. Scabies. The number of cases treated during the year at the Scabies Treatment Centre, The Green, E.4, is as follows :— Pre'school age 1 School age 6 Adults 9 Total 16 Diabetes. There are two elderly ladies receiving free supplies of Insulin under Ministry of Health Circular No. 2734. 22 Vaccination. The Vaccination Officer for the area has furnished the following return for 1946:— Births registered 598 Successfully vaccinated 184 Percentage vaccinated 30.76 Insusceptible — Exemptions 177 Died before vaccination 8 Postponed 18 Removed— new address unknown 6 Removed—address known and V.O. notified 76 Outstanding 129 Medical Examinations. During the year 42 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 1946 Causes of Death. Males. Females. Total. Whooping Cough - 1 1 Tuberculosis of respiratory system 11 5 16 Other forms of tuberculosis 1 - 1 Syphilitic diseases 3 — 3 Influenza — 1 1 Cancer of buccal cavity and oesophagus (M) uterus (F) 2 - 2 Cancer of stomach and duodenum 7 7 14 Cancer of breast — 12 12 Cancer of all other sites 16 13 29 Diabetes — 1 1 Intracranial vascular lesions 19 23 42 Heart disease 40 48 88 Other diseases of circulatory system 5 7 12 Bronchitis 8 4 12 Pneumonia 4 5 9 Other respiratory diseases 2 5 7 Ulcer of stomach or duodenum 6 — 6 Diarrhoea under 2 years - 1 1 Appendicitis — 1 1 Other digestive diseases 4 5 9 Nephritis 5 3 8 1 Maternal causes (excluding puerperal and postabortive sepsis) - 1 Premature birth 1 4 5 Congenital malformation, birth injury, infantile disease 6 8 1 4 Road traffic accidents 2 - 2 Other violent causes 6 2 8 All other causes 14 10 24 Totals—all causes 162 167 329 Totals—year 1945 158 163 321 23 Tuberculosis. Age periods. NEW CASES TRANSFERS DEATHS Respiratory NonRespiratory Respiratory NonRespiratory Respiratory Non- Respiratory M. F. M. F. M. F. M. F. M. F. M. F. 0 to 1 year 1 - - - - - - - 1 - - - 1 to 4 years - - - - - - - - - - - - 5 to 14 years — 1 1 1 - - 1 2 - - - - 15 to 24 years 7 8 1 — 1 - - 1 3 - - 25 to 34 years 10 1 o — 4 - - - - 1 — — 35 to 44 years 6 1 — — 5 4 - - 2 1 — — 45 to 54 years 3 1 — — 1 1 - - 3 1 - - 55 to 64 years 3 - - - 2 - - - 2 — — — 65 and upwards 3 - - - - - - - - - - - Totals 33 12 4 1 13 12 1 3 12 3 - - Add—Deaths of unnotified cases - 2 — — 12 5 — — Deaths from Cancer. The following table showing deaths from Cancer, persons over 45 years of age. Site 0—44 years 45 years & over Totals M. F. M. F. M. F. Gastrointestinal Tract 1 1 6 13 7 14 Lungs and Mediastinum - - 7 1 7 1 Genitourinary organs — 1 1 2 1 3 Breast — - - 6 - 6 Other sites 2 2 7 6 9 8 Totals 3 4 21 28 24 32 Death rate=1.29 per 1,000 (as compared with 1.34 per '1,000 in previous year). 24 Deaths from all causes at various Ages Age No. in district DEATHS Outward Transfers Inward Transfers No. of deaths which apply to district Under 1 year 17 7 14 24 1 and under 2 2 2 — — 2 and under 5 2 1 1 2 5 and under 15 7 6 1 2 15 and under 25 7 6 7 8 25 and under 35 6 2 5 9 35 and under 45 5 1 19 23 45 and under 55 17 - 21 38 55 and under 65 33 — 22 55 65 'and under 75 47 2 27 72 75 and upwards 72 7 31 96 Totals 215 34 148 329 ATTENDANCES AT LOCAL CLINICS DURING 1946 Ante-Natal Clinics : Friday Hill sessions 24 Attendances 447 16, Chingford Ave. sessions 107 Attendances 2,435 Infants' 8C Toddlers' Welfare Clinics: Friday Hill sessions 21 Attendances 43 3 (including Infants 6? Toddlers) (including 54 new infants). Sewardstone Road sessions 28 Attendances 692 (including Infants & Toddlers) (including 60 new infants). North Chingford sessions 51 Attendances 2,915 (including Infants & Toddlers) (including 116 new infants). Marmion Avenue sessions: Infants 102 Attendances 5,254 (including 432 new infants). Toddlers 48 Attendances 541 Specialist Obstetric Clinic : 16, Chingford Ave. sessions 10 Attendances 60 Women's Welfare Clinic : 16, Chingford Ave. sessions 84 Attendances 153 Minor Ailment 8C Schco! Clinics: 16, Chingford Ave. sessions 46 Attendances 836 Whitehall Road School sessions 36 Attendances 754 Orthopaedic Clinic: 16, Chingford Ave. sessions 94 Patients treated 167 25 NOTIFIABLE DISEASES (after correction) Year Scarlet Fever Diphtheria Erysipelas Measles Whooping Cough Tuberculosis Dysentery Encephalitis Lethargica Puerperal Pyrexia Ophthalmia Neonatorum Pneumonia Cerebrospinal Fever Pulmonary Other Forms 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 1945 62 4 9 210 94 41 9 38 - 3 1 88 2 1946 74 — 9 212 88 70 9 13 - 2 2 103 3 26 NOTIFIABLE DISEASES TABULATED ACCORDING TO AGE. (after correction). 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 2 9 7 35 11 4 2 2 - - 74 Erysipelas - - - - - - - - 1 2 5 1 9 Measles 15 22 45 26 25 64 7 3 2 3 — — 212 WhoopingCough 9 8 24 18 3 26 - - - - - - 88 Puerperal Pyrexia - - - - - - - - - - - - 2 Pneumonia 5 2 7 10 2 9 3 — 11 13 20 21 103 Cerebro'Spinal Fever - - - - - 1 1 1 - - - - 3 Dysentery — — 1 1 — 4 1 1 1 2 2 — 13 Ophthalmia Neonatorum 2 - - - - - - - - - - - 2 ANALYSIS OF NOTIFIABLE DISEASES (after correction). Diseases. Total cases Total admitted to hospital Scarlet Fever 74 47 Erysipelas 9 3 Puerperal Pyrexia 2 2 Pneumonia 103 10 Cerebrospinal Fever 3 3 Measles 212 1 Whooping Cough 88 2 Dysentery 13 2 Ophthalmia Neonatorum 2 2 Non'riotifiable cases admitted to Isolation Hospital during the year :— Infective Hepatitis 2 Gastro-Enteritis 1 Chickenpox 1 Pemphigus 1 (mother also admitted) 27 Birth-rates, Civilian Death-rates, Analysis of Mortality, Maternal Mortality and Case rates for certain Infectious Diseases in the Year 1946. (Provisional figures based on Weekly and Quarterly Returns). England and Wales 126 County Boroughs 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 Populati on :— Deaths under 1 year of age Rates per 1,000 Live Births :— Live 19.1 22.2 21.3 21 20.4 43 46 i I 37 | 41 27 Still 0.53 0.67 0.59 0 0.4 Deaths : Deaths from Diarrhoea and Enteritis under 2 years of age 4.4 1 | 6.1 2.8 4.2 1.1 All Causes 11.5 12.7 11.7 12.7 7.6 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 - Scarlet Fever 0.00 0.00 0.00 0.00 - Rates per 1,000 Total Births (Live and Still) Whooping Cough 0.02 0.02 0.02 0.02 0.02 Diphtheria 0.01 0.01 0.01 0.01 ■— (a) Notifications : i : Influenza 0.15 0.13 0.14 0.12 0.02 Smallpox 0.00 0.00 0.00 — — Puerperal Fever.. 8.50 10.35 7.63 1.62 I 9.68* 2.2 Measles 0.00 0.01 0.00 0.01 — Notifications: Pyrexia Typhoid Fever 0.01 0.01 0.01 0.01 (b) Maternal Mortality in England and Wales : Paratyphoid Fiver. Cerebro-Spinal Fever 0.02 0.05 0.02 0.05 0.01 0.04 0.01 0.06 0.06 No. 140 Abortion with Sepsis No. 141 Abortion 1 without Sepsis | No. 147 Puerperal Infections Nos. 142-6 148-150 1 Other maternal causes Scarlet Fever 1.38 1.51 1.33 1.42 1.7 0.13 1 0.06 | 0.18 1 1.06 Chingford Whooping Cough 2.28 2.48 2.05 2.22 2.03 1.1 Diphtheria 0.28 0.32 0.31 0.24 — Abortion—Mortality per million women aged 15-45 in England nnrl Walps • Erysipelas 0.22 0.25 0.22 0.27 0.02 Smallpox 0.00 0.00 0.00 0.00 — No. 140 with Sepsis 11 No. 141 . | without Sepsis 1 5 " Measles 3.92 4.73 3.70 7.35 4.89 Pneumonia 0.89 1.02 0.74 0.75 2.37 * including Puerperal Fever. 28