AC 4411(1) CHINGFORD BOROUGH OF CHINGFORD CHIN 12 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1947 BOROUGH OF CHINGFORD ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1947 BOROUGH OF CHINGFORD Committee : November, 1946—November, 1947 PUBLIC HEALTH COMMITTEE Chairman: Councillor W. S. HIGHO Vice-Chairman: Alderman Mrs. N. HART (to July, 1947) Members: Alderman H. A. FRANKLIN ,, Mrs. S. L. OAKE'S Councillor J. W. CORDER Miss M. L. MATHIESON, C.A. J. W. R. NATION T. H. TREADWELL Mrs. J. L. L. WOODS The Mayor, Councillor A. J. STRACHAN, J.P. (ex-officio) Meeting : Second Wednesday in each month at 7.30 p.m. PUBLIC HEALTH OFFICERS OF THE AUTHORITY (1947) Medical Officer of Health: WILLIAM D. HYDE, M.B., Ch.B., D.P.H. (to 6.1.47). J. >H. CROSBY, M.B., Ch.B., D.P.H. (from 1.4.47). Acting Medical Officer of Health (by arrangement with E.C.C.): J. L. MILLER WOOD, M.R.C.S., L.R.C.P., D.P.H. (from 6.1.47 to 1.4.47). Chief Sanitary Inspector: JAMES F. ROGERS, M.R.San.I., M.S.I.A. (a) (c) (d). Cleansing Superintendent. Inspector under the Shops Acts and Petroleum Acts. District Sanitary Inspectors: R. W. BASHFORD, M.S.I.A. (b) (c). C. DAY, M.S.I.A. (b) (c) (e) (f) (from 29.4.47 to 29.11.47). Senior Clerk: Miss V. M. PETTIT. Clerks: A. E. CULPIN. Miss D. M. BRADSHAW (to 6.8.47). Miss I. A. FOLKES (from 1.9.47). D. G. BLEACH (training as Sanitary Inspector under Ministry of Health Scheme). Miss M. E. LUCKEN. (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. (e) Certificate of the Royal Sanitary Institute as Smoke Inspector; (f) Certificate of the Royal Sanitary Institute in Sanitary Science. 1 ANNUAL REPORT FOR THE YEAR 1947 To the Mayor, Aldermen and Councillors of the Chingford Corporation. Mr. Mayor, Aldermen and Councillors, I have pleasure in submitting my second Annual Report upon the health and sanitary circumstances of the Borough. In the field of statistics the following points are worthy of mention:—The birth-rate has remained very high, viz.: 20.3 per 1,000, which is almost the same as the rate for 1946. The death-rate at 8.5 per 1,000 is slightly above the rate for the previous year. The rate for England and Wales was 12.0. The death-rate of infants under one year of age was 12.9, which is the lowest ever recorded, and is far below the rate for England and Wales, viz.: 41. Infectious disease notifications, with the exception of Measles, Whooping Cough and Poliomyelitis, remained much at the level of the previous year. Chingford, unfortunately, had its share of the general epidemic of Poliomyelitis throughout England and Wales in 1947. In all, there were 16 cases in the Borough, 3 of whom died. The serious pollution of the Borough's water supply in March and the measures taken to meet it, are reported in the text. I thank again the Chief Sanitary Inspector, Mr. James F. Rogers, and the staff of the Health Department, for their hard work during this strenuous year. I am, Ladies and Gentlemen, Your obedient servant, J. H. CROSBY, Medical Officer of Health. August, 1948. 2 Section A.—STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area 2,868 acres Population—Registrar General's estimate 45,430 Number of inhabited houses and flats, end of 1947 12,100 approx. Rateable value on April 1st, 1947 £339,717 Sum represented by a penny rate on April 1st, 1947 (gross) £1,439 19 5 Vital Statistics Live Births M. F. Total 484 440 Birth Rate per 1,000 of estimated resident population: 20.3. Legitimate 476 432 Illegitimate 8 8 M. F. Stillbirths Total 8 9 Rate per 1,000 total (live and still) births: 18.1 Legitimate 8 9 Illegitimate — — Deaths M. F. Crude Death Rate per 1,000 of estimated resident population: 8.5 199 189 Deaths from Puerperal Sepsis 0 „ „ other puerperal causes 0 Death Rate of Infants under one year of age:— All infants per 1,000 live births 12.9 Legitimate infants per 1,000 legitimate live births 13.3 Illegitimate infants per 1,000 illegitimate live births — Deaths from Cancer (all ages) 74 „ „ Measles (all ages) — „ „ Whooping Cough (all ages) — „ „ Diarrhoea (under 2 years of age) 2 „ „ 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 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 1947 45,430 924 20.3 388 8.5 12 12.9 4 Section B.—GENERAL PROVISION OF HEALTH SERVICES IN THE AREA (a) Laboratory Facilities. Pathological specimens from this district are 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. Three Council ambulances, plus two ambulances on hire 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 1947:— Total number of calls dealt with during year— Hire. Accidents. Maternity. Ambulance No. 1 435 15 27 ,, No. 2 1,380 110 187 „ No. 3 453 14 31 B.R.C. (hire) ,, No. 1 38 2 1 ,, No. 2 1 7 1 2,307 148 247 Total 2,702 Total mileage covered by the Borough Ambulances during the year—29,829 miles. 5 In addition the following calls were dealt with by transfer to other Ambulance Services (or private hire) on occasions when Chingford ambulances were engaged or under repair:— Hire. Accidents. Maternity. Wanstead and Woodford 33 15 10 Walthamstow 10 30 6 Epping (private hire) 3 — — Loughton (private hire) 5 — 1 Chigwell — 1 — Leyton — — 1 Chingford (private hire) 13 — — 64 46 18 Total 128 Total calls received during year: 2,830. The Chingford ambulances gave assistance in adjoining districts as follows:— Hire. Accidents. Maternity. Epping 7 — — Walthamstow — 8 1 Woodford 2 1 — Loughton 1 3 — Waltham Abbey 1 1 — 11 13 1 Total 25 Assistance, by supplying drivers or attendants, was given by the St. John Ambulance Brigade members (132 Chingford Division) on 69 occasions. 6 (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 8. (e) Hospitals. No change. (f) Midwives. Number of County Council practising midwives 3* „ ,, midwives employed by Chingford District Nursing Association 2 ,, „ independent domiciliary midwives 0 ,, „ midwives practising in the Nursing Homes 4 ,, „ maternity nurses practising in the Nursing Homes 1 *Miss E. A. Clarke, 69, Connaught Avenue, E.4 (Telephone: Silverthorn 1801). Mrs. G. H. Salter, 81, Ainslie Wood Gardens, E.4 (Telephone: Silverthorn 1347). *Mrs. G. E. M. Witter, 90, Connington Crescent, E.4 (Telephone: Silver' thorn 4968). (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. Regular medical inspection of the children attending these Nurseries was carried out during the year. (i) Home and Domestic Help Scheme. There is a Home and Domestic Help Scheme in the Chingford district under the auspices of the Essex County Council. Application for these facilities should be made to the Health Visitors in the district. 7 LOCAL CLINICS AND TREATMENT CENTRES. 1948 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, E.4 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 Tuesdays, 2 p.m., 2nd and 4th Thursdays, 9.30 a.m.—11.30 a.m Wednesdays, 9.30 a.m. Second Thursday, 2 p.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., Mission Hall, Sewardstone Road North, E.4. 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. 2nd, 4th and 5th Wednesdays, 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, Monday afternoons, 1st, 3rd, 4th and 5th Thursdays, 2 p.m., by appointment only. Thursday mornings, 2nd Thursday afternoon, 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 Clinics County Council Clinic, Marmion Avenue, E.4 16, Chingford Avenue, 4th Friday every month, 10.15 a.m. 1st Friday in each month, 2 p.m. Tuberculosis Dispensary Old Monoux School, High Street, Walthamstow, E.17 New cases: Adults— Wednesdays, 10 a.m.—12 noon New cases: Children— Fridays, 10 a.m.—12 noon. Venereal Disease Clinics Prince of Wales Hospital, Tottenham 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. Oldchurch County Hosp. (The Annexe), Romford And other London hospitals. Registrar of Births, Deaths and Marriages : Mr. C. W. BARRETT, 19 Algers Road, Loughton. (Telephone: Loughton 576). Office : Town Hall, Chingford, E.4. Mondays and Thursdays, 2.30 p.m. to 4.30 p.m. Wednesdays and Saturdays, 9 a.m. to 11 a.m Social Welfare Office: 35 Wanstead Place, Wanstead, E.ll. (Telephone : Wanstead 0031). National Assistance Board: 12 Church Hill, Walthamstow, E.17. (Telephone: Larks' wood 3347). Office Hours: Mondays to Fridays, 9 a.m. to 5 p.m. Saturdays, 9 a.m. to 1 p.m. Ministry of National Insurance: 11a The Ridgeway, Chingford, E.4. 8 Section C.—SANITARY CIRCUMSTANCES OF THE AREA Water Supplies. For the first time in the history of the Borough it is necessary to record that the water supplied by the Metropolitan Water Board was not satisfactory throughout the year, due to the flooding of the Lea Bridge Pumping Station on the 15th March, 1947. For about two months prior to this date there had been constant falls of snow and the general temperatures had been so low as to retard thawing. Consequently, when the thaw did set in on the 14th/l 5th March, flood water flowed over the flood banks into the aqueduct at the Lea Bridge Pumping Station and thence into the Works which became completely swamped at about 5.30 a.m. to depths varying from 1 to 3 feet; thus the whole of the Lea Bridge Works were put out of action depriving approximately l¼ million people of their normal water supply. The problem, therefore, facing the Metropolitan Water Board and the local authorities concerned was a major one. To cope with this emergency the Metropolitan Water Board immediately set up the distribution of water from mobile tanks and at one time 55 lorries fitted with tanks were operating in the Borough. After some hesitancy, only natural to the inauguration of such a scheme, the emergency water supply of the Borough was carried out in an exemplary manner. Having regard to the general position in respect to the precautions necessary, the Medical Officer of Health prepared a leaflet for distribution throughout the district, such leaflet stressing the need for the use of water with the utmost economy, and also recommending that water used for drinking or cooking purposes should be boiled, and giving other suggestions as to sanitation generally. A conference also took place between Medical Officers of Health of adjoining districts when it was decided that schools should remain open, and the Divisional School Medical Officer arranged for the supply of containers to each school in the Borough. At the commencement of the period of emergency the Chairman of the Public Health Committee and the Chief Sanitary Inspector visited the District Water Engineer, whose headquarters were at the Chingford Pumping Station, and in addition to dealing with the general arrangements to be made for the emergency siipply of water, also detailed priority supplies to the Hospital and Nursing Homes in the Borough, doctors' surgeries, dispensing chemists, bakehouses, restaurants and other essential services. The co-operation which existed between the local officials of the Metropolitan Water Board and the Corporation was of a very high order, and throughout the whole of the emergency the problem was tackled with the utmost efficiency and courtesy. The Council 9 expressed thanks to the Women's Voluntary Services who, through their leader, Mrs. E. M. Clarke, established a canteen for the use of men engaged in the distribution of water. A main piped supply of water was generally available throughout the district on the 25th March, 1947, and, apart from some general instructions issued to the residents as to the treatment of storage cisterns and the inspection of domestic boilers and water heaters, the period of emergency was at an end. Rivers and Streams. It was not found necessary to take action in connection with the pollution of watercourses. Public Cleansing. As from the 1st April, 1947, the Council resolved that the cleansing of highways should be under the jurisdiction of the Public Health Committee and that the street orderlies, convenience attendants and other staff engaged upon Cleansing Services be brought under the control of the Chief Sanitary Inspector. The collection and disposal of house, trade refuse and salvage was carried out, as in previous years, under the direction of that officer. A weekly collection of refuse and salvage was maintained and this fact, coupled with regularity of visits to houses each week, has resulted generally in an improved service. The total weight of refuse disposed alt the Works showed an increase over the amount collected in the previous year, namely 8,542 tons as against 7,771 tons. The population mid-year 1947 was estimated to be 45,430 as compared with 44,098 for the previous year. The Council pursued a progressive policy in the replacement of Refuse Collection Freighters and, keeping in mind the extensive delivery periods, orders were judiciously placed with various manufacturers which gave the delivery of five new vehicles within a period of just over eighteen months. New vehicles consisted of one S. & D. Freighter, two Fordson vehicles with Eagle bodies, and two Karrier C.K.3. Refuse Collecting vehicles, all these of ten-cubic yard capacity. The net cost per ton for the collection of refuse was 19/9½d. as against 14/0d. for the year ended March, 1947, and 16/5½d. for the year 1946. The net cost per ton for the disposal of refuse was 8/1¾d. as against 9/6¼d. for the previous year and 6/9¼d. for the year ended March, 1946. Salvage continued to play an important part in the Corporation's activities, the total income from all sources being £4,847 as compared with £3,780 for the year ended 31st March, 1947. The sale of waste paper continued to provide the major item of income and a Waste Paper Drive, held on conventional lines in the early part of the year, did much to stimulate public interest. 10 As from the 1st April, 1947, the Council instituted an incentive bonus scheme, which superseded the normal bonus scheme which had been in operation for many years. A copy of the new scheme is detailed below, but as the Disposal Works were partially closed for repairs for nearly the whole of the period under review, it would not be wise to comment on the efficiency or otherwise of the scheme. "Incentive Bonus Scheme. Irrespective of cash value received, a bonus of 10% be paid on the annual cash value of salvage sold, subject to the substitution of the following scale of payments where appropriate: (a) Basis of Bonus Payment. Annual Cash Value of Salvage Sold. Total Percentage Bonus payable by Council to the Staff as a Whole. Exceeding £2,000, but not exceeding £2,250 10 per cent. of total income. Exceeding .£2,250, but not exceeding £2,500 12½ ,, ,, ,, ,, Exceeding £2,500. but not exceeding £2,750 15 ,, ,, ,, ,, Exceeding £2,750, but not exceeding £3,000 17½ ,, ,, ,, ,, Exceeding £3,000 20 (b) Staff Eligible for Receipt of Bonus. All permanent and temporary staff employed at the Refuse Disposal Works to be eligible for the receipt of bonus, subject to the minimum period of employment of one week, and that absence from duty owing to sickness or holidays be also included as time worked for purposes of calculation of bonus. (c) Calculation of Bonus. Bonus to be distributed on the basis of the number of weeks that each man has been employed on the collection and disposal of salvage throughout the year, subject to a minimum period of employment of one week." In January, 1947, the works were commenced in connection with which the Council had entered into a contract the previous year. The original contract was for £4,963 and comprised the dismantling of the then existing 30 ins. elevating belt conveyor and the receiving hopper, and the provision of a reinforced concrete pit, together with a steel plate refuse receiving hopper 30 ft. long by 9 ft. wide and 6 ft. deep, fitted with an overlapping belt plate feed conveyor 5 ft. wide and one 30ins. elevating belt conveyor 11 of about 71 ft. centres, arranged so as to discharge crude refuse into the existing rotary screen. The contract was in the hands of Messrs. Heenan & Froude, Ltd., Engineers. Unfortunately, a long period of unfavourable weather ensued after the commencement of the work, and this fact, coupled with the extensive delivery periods for essential parts, meant that the works were partially closed for about 14 months. Certain quantities of refuse were disposed of by arrangement to Disposal Works of adjoining authorities, namely: Edmonton, Tottenham and Walthamstow. The Council continued to collect kitchen waste from communal bins in the town, and transported this material to the approved concentration plant at Stapleford Abbots. Representations were made to the Board of Trade on two occasions to be allowed to take kitchen waste to the nearby plant at Tottenham, thus releasing available time for a more intensive collection. The representations of the local authority, unfortunately, however, met with no success, and so a scheme for the carrying out of this work by direct labour was abandoned. In the report for the year ended March, 1947, mention was made of the fact that the Council had under consideration the provision of circular concrete bases fitted with upright supports to each of the communal kitchen waste-bins in the town. The scheme was approved by the Council, and during the year under review the majority of the 200 kitchen waste-bins were fitted with these stands. They have proved a success in limiting the misuse of the bins. The Chief Sanitary Inspector submitted a scheme for the utilization of a street sweeping-collecting machine and two trials took place in the Borough of a machine made by Lewin Road Sweepers, Ltd. The performance of the vehicle was so satis' factory as to find favour with the Council, and consequently an order was placed for the delivery of a vehicle at the earliest possible date, namely, 1949. The Public Sanitary Conveniences were maintained in good condition through the year, and at the underground convenience, Albert Crescent, washing facilities were restored. These facilities have not yet been used to their full capacity, but this may be due to the lapse of time since they were previously available. Road gullies were cleansed by contract as in previous years. County road gullies were cleansed 4 times per year and district road gullies twice. 12 Item I—Collection II—Disposal Total HOUSE AND TRADE REFUSE Table showing costs for the year ended 31st March, 1948 Including Depreciation or Loan charges Excluding Loan charges, etc. Including Depreciation or Loan charges Excluding Loan charges, etc. Including Deprc ciation 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) £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. A Gross expenditure 9397. 3. 5 9191. 16. 11 7376. 17. 3 6989. 7. 7 16774. 0. 8 16181. 4 6 B Gross income 943. 8. 3 943. 8. 3 3903. 18. 2 3903. 18. 2 4847. 6. 5 4847. 6 5 C Net cost 8453. 15. 2 8248. 8. 8 3472 19. 1 3085. 9. 5 11926. 14. 3 11333. 18 1 Unit Costs s. d. s. d. s. d. s. d. s. d. s. d. D Gross expenditure perton 22 0 21 6¼ 17 3¼ 16 4¼ 39 3¼ 37 10½ E Gross income per ton 2 2½ 2 2½ 9 1½ 9 1½ 11 4 11 4 F Net cost per ton 19 9½ 19 3¾ 8 1¾ 7 2¾ 27 11¼ 26 6½ £ s. d. £ s. d. £ s. d. £ S. d. £ s. d. £ s. d. G Net cost, per 1,000 population 185 16 0 181 5 0 76 6 0 67 16 0 262 2 0 249 1 0 H Net cost, per 1,000 houses 676 0 0 659 0 0 278 0 0 247 0 0 954 0 0 906 0 0 1. Total refuse collected (in tons) 8,542 2. Population (Mid-Year) 45,430 3. Weight per 1,000 population per day (in cwts.) 10.2 4. Number of occupied houses and premises (iMarch, 1948) 12,500 13 ANALYSIS OF INCOME FOR THE YEAR ENDED 31st MARCH, 1948 Year ended 31.3.47 £ s. d. £ 6. d. £ s. d. £ s. d. 1.—Metals: 30 11 9 Aluminium 27 16 2 32 9 10 Copper 35 17 4 61 18 2 Iron 57 13 6 36 8 2 Lead 43 6 7 10 18 8 Battery Lead 24 6 1 47 9 8 Brass 51 6 8 16 2 2 Mixed Metals 13 4 0 17 14 0 Unbaled Scrap 6 12 11 91 17 4 Tins 80 11 7 2 6 3 Pewter 4 13 4 345 8 2 35 19 3 Bones 27 16 5 115 16 3 Broken White Glass 481 16 4 655 6 8 Bottles and Jars 406 13 2 15 9 Syphons 2 3 0 890 12 6 257 13 9 Rags 4,21 14 6 24 1 0 Carpets 38 13 0 460 7 6 1182 6 4 Newspapers and Mixed Waste Paper Board of Trade Coll. Allowance 1851 12 1 30 6 7 72 1 2 1923 13 3 595 12 1 Pig Food (Kitchen Waste) 479 2 4 172 7 0 Allowance (Board of Trade) 182 0 5 661 2 9 16 6 Rubber 9 3 9 4 0 0 Old Gramophone Records 3 12 6 4321 16 10 25 19 0 2. — Miscellaneous Receipts Charges 48 19 6 3.—Weighbridge Fees 66 13 6 — 4.—Rents — 30 0 0 Foundry 147 4 1 16 111 5 Proportion of Allotment Rents 20 0 0 — Other Rents 9 6 6 — Refuse Collection Charges 235 10 3 Greengrocers 144 HI U Others 137 14 6 £3779 17 4 £4847 6 5 7,771 Tonnage 8,542 14 SANITARY INSPECTION OF THE AREA Inspections on Complaint The number of complaints received at the office and recorded in the register was 508 as compared with 437 in the previous year and 212 for the year 1945. The total inspections made on complaint was 873 and the number of defects or nuisances revealed was 289, 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 2 Blocked yard and W.C. drains 6 Blocked sewers 155 Defective sewers 8 Defective drainage 13 Defective dustbins 13 W.C.'s without proper flushing arrangements 18 Defective W.C. s 7 Insufficient water supply 1 Dampness 3 Defective stoves and fire grates 5 Defective water fittings 8 Waste pipes and sinks defective 6 Verminous premises 13 Animals kept so as to be a nuisance 9 Accumulations of offensive matter 15 Defective hot water systems 3 Lack of W.C. accommodation 1 Lack of washing facilities 2 289 15 Summary of Inspections The total number of visits paid by the Sanitary Inspectors and other personnel of the Public Health Department staff to various premises for all purposes is summarised below, together with the number of defects found under specific headings. The visits numbered 5,620 as compared with 4,126 in the previous year; the defects dealt with numbered 737 as compared with 614 in 1946. Table 2 Visits Paid Nuisances or Defects found Housing Act, 1936: Inspections 73 297 Revisits re Notices served 604 Re Overcrowding 40 On complaint 873 289 Re Licence Applications and Essential Materials 87 Infectious Diseases 281 Retail Trade Premises: Meat 97 Fish 21 Fried Fish 10 General Provisions 69 Others 22 Food Preparation Premises 36 Ice Cream Premises 81 Factories 19 1 Bakehouses 19 1 Cowsheds and Dairies 5 Pigstyes 4 Revisits re Notices Served (P.H. Act) 1619 Rodent Control 1237 149 Private Slaughtering 3 Shops Acts (Sanitary Conditions) 9 Council Houses 6 Collection and Disposal of Refuse and Salvage 156 Kitchen Waste—Communal Bins 90 Schools 12 Hairdressers' Premises 16 Verminous Premises 15 Swimming Pool 9 Miscellaneous Visits 40 Places of Entertainment 5 Public Conveniences 23 Petroleum Acts 9 Outworkers 26 Smoke Observations 4 5620 737 16 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 1 Defective roofs, spoutings and eavesgutters 64 Blocked yard and W.C. drains 13 Blocked sewers 155 Defective sewers 8 Defective drainage 13 Wall and ceiling plaster defective 34 Ashbins defective 19 W.C.'s without proper flushing arrangements 26 Insufficient water supply 1 Water closets defective 14 Dampness 21 Defective stoves and firegrates 31 Defective floors 25 Water fittings defective 20 Defective external brickwork 10 Stairs and rails defective 4 Defective woodwork of windows and doors 35 Sinks and waste pipes defective 10 Yard paving defective 4 Defective wash coppers 1 Defective sash cords, glazing, etc. 15 Rat Infestation 149 Animals kept so as to be a nuisance 9 Accumulations of offensive matter 15 Lack of sanitary accommodation 1 Defective hot water systems 11 Walls defective 12 Defective water storage tanks 1 No washing facilities 1 Defective window sills 1 Verminous premises 13 737 Table 4 Letters sent out and notices served in connection with sanitary matters. Letters 2071 Public Health Acts: Preliminary Notices 120 Secondary Notices 6 Statutory Notices 9 Statutory Notices (re Maintenance of Sewers) 13 Housing Acts: Preliminary Notices 71 Secondary Notices 3 Statutory Notices 4 17 Shops Acts. It was not found necessary to take any action during the year under the provision of the Shops Acts. Smoke Abatement. In two instances informal action was taken regarding the emission of smoke and grit. 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 Properties Other Houses Infested, —. Disinfested, —. Infested, 10. Disinfested, 10. (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 with the exception of the period when the piped supply was not available owing to the flooding of the Lea Bridge Water Works. During this period a reasonable supply of water was available by the provision of water containers. 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. 18 PREMISES AND OCCUPATIONS WHICH CAN BE CONTROLLED BY BYELAWS OR REGULATIONS Offensive Trade Premises. Within the meaning of the Public Health Act there are no offensive trade premises in the district, but there are 8 fish fryers. 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-eight visits were paid to Factories, and in one instance action was taken regarding the provision of sanitary accommodation. Inspection of Factories and Other Premises. 1.—Inspections for Purposes of Provisions as to Health. Including Inspections made by Sanitary Inspectors. Premises. Number on Register. Number of Inspections. Written Notices. Occupiers Prosecuted (1) (2) (3) (4) (5) (i) Factories in which Sections 1, 2, 3, 4 and 6 are to been forced by Local Authorities 5 7 1 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 41 29 1 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding Outworkers' Premises) 4 2 — - Total 50 38 2 - 19 2.—Cases in which Defects were Found. Particulars Number of cases in which defects found No. of cases in which prosecutions were instituted. Found Remedied Referred To h.m. Inspector. Referred By h.m. Inspector. (1) (2) (3) (4) (5) (6) Want of cleanliness (S.1) 1 1 - - - Overcrowding (s.2) - - - - - Unreasonable temperature (S.3) Inadequate ventilation (s.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7): (a) Insufficient 1 1 - 1 - (b) Unsuitable or defective - - - - - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to Outwork) - - - - - Total 2 2 - 1 - Number and Trades of Outworkers notified during 1947 Wearing Apparel 2 Down Quilts Footwear Stationery Brush-making Toys Handbags Paper Bags Outworkers were notified from the following Areas: Bethnal Green Leyton Finsbury 3 Stoke Newington Islington 8 St. Marylebone Hackney 30 Finchley 1 Tottenham 6 Stratford 1 Holborn 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 Agriculture and Fisheries. Whilst there was no evidence of major infestations in the town, the Rodent Operative paid many calls to deal with 149 minor infestations at private and business premises in the town. A 10% test-baiting of sewer manholes was carried out and the final result showed that 44% of the manholes tested gave complete takes. Under these circumstances the local authority made arrangements for the initial treatment of sewers to be carried out in the financial year 1948/49. 20 Section D.—HOUSING STATISTICS FOR THE YEAR 1947 1. Number of Houses Erected during the Year: (1) By the L.A. (permanent) traditional 26 (2) By the L.C.C. (permanent) traditional 286 (3) By the Ministry of Works (permanent prefabs.) 53 (4) Cost of works re-buildings by local builders 48 (5) By private enterprise 3 416 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) 1288 (b) Number of inspections made for the purpose 2895 (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 73 (b) Number of inspections made for the purpose 588 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 11 (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 *357 *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 301 4. Action under Statutory Powers during the Year: A. Proceedings under Section 9, 10 and 16 of the Housing Act, 1936: (1) Number of dwelling-houses in respect of which notices were served requiring repairs 4 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By Owners 6 (b) By Local Authority in default of owners — 21 B. Proceedings under Section 11 and 13 of the Housing Act, 1936: (1) Number of Demolition Orders served 2 (2) Number of Undertakings accepted - (3) Number of Undertakings completed 3 C. Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 23 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By Owners 7 (b) By Local Authority — 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 Miks. 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 and other retail trade premises numbered 240. 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:— 22 TINNED FOODS. Article. No of Tins. Corned Mutton 40 Corned Beef 209 Pork Sausage 28 Stewed Steak 32 Steak and Kidney 1 Brisket 1 Luncheon Meat 12 Chopped Ham 1 Irish Stew 12 M. & V. 22 Ox Tongue 1 Bacon Rashers 4 Meat Roll 4 Luncheon Galantine 1 York Meat Lunch 4 Corn Beef Hash 2 Roast Beef 2 Pork Loaf 6 Braised Beef 1 Calf's Head 1 Mixed Loaf 1 Minced Loaf 3 Salmon 54 Pilchards 12 Crawfish 3 Sardines 1 Mackerel 2 Herrings 44 Fish Roll 3 Crab 1 Snoek 1 Hake 7 Crayfish 1 Whiting 9 Clams 1 Anchovies 2 Anchovy Fillets 2 Cod Liver Roe 2 Baked Beans 78 Peas 57 Tomatoes 9 Vegetables in gravy 59 Carrots 3 Potatoes 10 Beetroot 5 Gherkins 3 Spinach 3 Mixed Vegetables 4 Tomato Juice 1 Celery 1 Carrots and Peas 1 Macaroni 3 Soup 56 Peaches 9 Plums 15 Apples 1 Apricots 7 Grape Fruit 5 Fruit Salad 2 23 TINNED FOODS—Continued. Article. No. of Tins Pears 1 Milk 535 Jam 9 Bournvita 1 Full Cream 1 Orange Juice 1 Golden Syrup 4 Spaghetti 2 Scotch Broth 6 Strained Foods 2 Macaroni and Cheese 1 Dried Egg 1 Sultana Puddings 2 Marmalade 3 Heinz Tidbits 24 OTHER FOODS. Article Quantity. Bacon Rashers 10 lbs. Liver 137½ lbs. Pork 8 lbs. Forequarter Beef Trimmings 57 lbs. Forequarter Beef 127½ lbs. Brisling 1 jar Hake 70 lbs. Cod 70 lbs. Kippers 2 boxes Witches 6 stone Skate 24 stone Haddock 5 stone Fish 42 stone 10 lbs. Fish Paste 3 jars Potted Meat 2 jars Cooking Fats 1½ lbs. Butter 3½\ lbs. Margarine 67½ lbs. Sugar 45 lbs. Bread 382 lbs. Flour 6 lbs. Suet 1 pkt. Tea 12 lbs. 6 ozs. Eggs 5 doz. Prunes 10 lbs. Potatoes 5 ½ cwts. Pearl Barley 1½ cwts. Marmalade 2 lbs. Currants 8 ozs. Wheat 2 pkts. Dates 156 lbs. Soyghetti 28 lbs. Cornflakes 1 pkt. Cheese 48 lbs. 10 ozs. Pickles 4 jars Sauce 1 jar Horseradish Cream 1 jar Horseradish and Beetroot Sauce 4 jars Sweets 23 lbs. 24 CHEMICAL AND BACTERIOLOGICAL EXAMINATION OF FOOD The Counties Public Health Laboratories, 66 Victoria St., London, S.W.l, undertake bacteriological examinations for the Council. During the year 41 samples were forwarded to the Laboratories for bacteriological examination, 25 being samples of ice-cream, 10 of other foods and 6 samples of water from the Swimming Pool. Owing to the greater importance which was given to ice-cream, a much larger number of samples was taken than in previous years. In two instances the Bacteriologist reported that the samples were unsatisfactory in that they contained excessive numbers of bacteria which included organisms of excremental origin. In one instance a letter of warning was sent to the Manufacturer and an ice-cream of improved quality was produced. In the other case the Local Authority decided to institute proceedings under the Food and Drugs Act, 1938, and, whilst the decision of the magistrates was against the Local Authority, it was felt that the publicity which was given to the case was helpful in bringing to the notice of dealers and manufacturers of ice-cream in the district the importance of the utmost cleanliness in the handling of this product. Dr. Bernard Dyer & Partners, Ltd., Peek House, 20 Eastcheap, E.C.3, are the Public Analysts for the district. 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. 280 Cheese Genuine cheese—nothing abnormal. 281 Saccharin Tablets In substantial accord with minimum requirements of Sacc. (Co. M.P.) Order. 282 Sherbert Powder Unsweetened effervescent powder of a normal character. 283 Bread Slightly fermented, objectionable but not harmful. 284 Cut Celery No harmful amounts of tin, lead, copper or zinc. 28b Beans in Tomato Sauce Unsuitable for human consumption, 2.9 grains of tin per pound. 286 Tomatoes Unsuitable for human consumption, 2.3 grains of tin per pound. 287 Mireen Green Pea Soup No harmful amounts of tin, lead, copper or zinc. 288 Margarine Presence of rancidity. Unfit for human consumption. 279a Fish Omelette No harmful amounts of tin, lead, copper or zinc. 280a Breakfast Roll 281a Vegetables in Gravy 282a Fish Roll 283 a Herrings in Tomato Sauce 289 Beef Sausages Free from preservatives. 290 Jam Tart Jam tart unfit for human consumption. Foreign matter found to be finely shredded tobacco leaf. In connection with Sample No. 290, a letter of warning was sent to the firm. 25 Section F—PREVENTION AND CONTROL OF INFECTIOUS AND OTHER DISEASES Diphtheria. For the second year in succession I am glad to be able to report that no cases of Diphtheria occurred in the Borough. I feel that this is due in no small measure to the increasing number of children who have been immunised during the year, details of which are given below. It is estimated that about 80% of Chingford children are now fully immunised, but there is still room for improvement and so I would urge parents to make full use of the facilities available for this purpose. Children should be immunised a/t nine months of age or as soon as possible thereafter and should receive reinforcing immunisation at ages 5, 8 and 11 years. Facilities exist at all County Council Clinics in the Borough and, in addition, arrangements are made for schoolchildren to be immunised at school. The prophylactics used are Diphtheria Alum Precipitated Toxoid and Toxoid Antitoxin Floccules. Diphtheria Immunisation. Number of children immunised during the year:— Under 5 years 742 Between 5 and 15 years 126 Total 868 Number receiving secondary or reinforcing injections during the year 449 These figures are an increase of 77% over those for 1946, a very creditable response on the part of parents to the immunisation campaign in the Borough. Scarlet Fever. The number of Scarlet Fever notifications was 69, a reduction of 5 on the previous year. All were of the mild type of fever that has been prevalent in recent years. There was again a decrease on the number admitted to hospital. 1943 1944 1945 1946 1947 Cases notified 376 82 62 74 69 Percentage removed to hospital 12 64 77 64 61 26 Measles. 290 notifications were received in regard to Measles, showing an increase of 78 on the previous year. Only 3 cases needed admission to hospital. Adult Measles serum was available to practitioners through the Health Department for the treatment of cases and protection of contacts. Whooping Cough. There was quite a considerable increase in the number of Whooping Cough cases notified, viz.: 202, compared with 88 in 1946. Of these, only 2 needed admission to hospital. Poliomyelitis. 16 persons were confirmed as suffering from Poliomyelitis, 3 of whom died. The remainder, with one or two exceptions, have made a complete recovery from their paralysis. Dysentery. Again there has been a big reduction in the notifications of dysentery, only 2 cases being confirmed, against 13 the previous year. It was not possible to trace the source of infection. Both patients made an uneventful recovery. Tuberculosis. There were 87 cases of all forms of Tuberculosis notified during 1947 (an increase of 8 on the previous year), and of these, 34 cases (39%) were transfers from other districts. There were 30 deaths from Tuberculosis during the year; 9 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 3.3. Food Poisoning. No confirmed cases of food poisoning occurred during 1947. Scabies. Four persons, all adults, received treatment during the year at the Scabies Treatment Centre. Diabetes. There were two elderly ladies receiving free supplies of Insulin under Ministry of Health Circular No. 2734. 27 Vaccination. The Vaccination Officer for the area has furnished the following return for 1947:— Births registered 717 Successfully vaccinated 292 Percentage vaccinated 40.725 Insusceptible 2 Exemptions 193 Died before vaccination 7 Postponed 21 Removed—new address unknown 14 Removed—address known and V.O. notified 52 Outstanding 136 Medical Examinations. During the year 41 examinations were carried out by the Medical Officer of Health in respect of the Superannuation and Sick Pay Scheme of the Chingford Corporation. In addition, 11 re-examinations were carried out on Council staff and 14 medical examinations in respect of Essex County Council staff. CAUSES OF DEATH AS GIVEN BY THE REGISTRAR-GENERAL FOR THE YEAR 1947 Causes of Death. Males. Females. Total. Cerebrospinal fever - 1 1 Tuberculosis of respiratory system 10 15 25 Other forms of tuberculosis 2 2 4 Syphilitic diseases 2 - 2 Influenza 5 - 5 Acute poliomyelitis and polio-encephalitis 2 1 3 Acute infantile encephalitis 1 1 2 Cancer of buccal cavity and œsophagus (M) uterus (F) 2 - 2 Cancer of stomach and duodenum 12 4 16 Cancer of breast - 5 5 Cancer of all other sites 26 25 51 Diabetes - 5 5 Intra-cranial vascular lesions 12 31 43 Heart diseases 47 39 86 Other diseases of circulatory system 11 6 17 Bronchitis 14 9 23 Pneumonia 6 12 18 Other respiratory diseases 4 1 5 Ulcer of stomach or duodenum 4 1 5 Diarrhœa (under 2 years) 2 - 2 Appendicitis 3 1 4 Other digestive diseases 6 2 8 Nephritis 3 5 8 Premature birth 1 - 1 Congenital malformation, birth injury, infantile disease 4 4 8 Suicide 1 3 4 Road traffic accidents 2 - 2 Other violent causes 4 4 8 All other causes 13 12 25 Totals—all causes 199 189 388 Totals—year 1946 162 167 329 28 Tuberculosis. Age periods. NEW CASES TRANSFERS DEATHS Respiratory NonRespiratory 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 1 1 — — — 1 — — 1 — — — 5 to 14 years 2 4 — 1 2 2 1 — — — — — 15 to 24 years 3 5 — 1 1 4 1 — 1 3 — — 25 to 34 years 5 3 2 1 5 6 — — — 4 — — 35 to 44 years 6 5 — — 5 3 1 — 4 1 — — 45 to 54 years 4 1 — 2 1 — — — 3 1 — — 55 to 64 years 2 1 - — — 1 — — — — — — 65 and upwards 1 2 - - - - - - — 3 — — Totals 24 22 2 5 14 17 3 — 9 12 — — Add—Deaths of unnotified cases 2 4 1 2 11 16 1 2 Deaths from Cancer. The following table of deaths from Cancer shows that out of a total of 74 deaths from this disease, 69 of them occurred in persons over the age of 45 years. Site 0—44 vears 45 years 6? over Totals M. F. M. F. M. F. Gastrointestinal Tract 1 — 16 21 17 21 Lungs and Mediastinum 2 — 10 — 12 — Genito-urinary organs — — 4 2 4 2 Breast - — 5 — 5 Other sites 2 1 7 3 9 4 Totals 5 1 37 31 42 32 Death rate=1.62 per 1,000 (as compared with 1.29 per 1,000 in 1946) 29 Deaths from all causes at various Ages Age DEATHS No. of deaths which apply to district No. in district Outward Transfers Inward Transfers Under 1 year 11 6 8 13 1 and under 2 1 1 — — 2 and under 5 3 3 3 3 5 and under 15 2 1 1 2 15 and under 25 2 1 8 9 25 and under 35 8 2 9 15 35 and under 45 17 5 19 31 45 and under 55 9 — 24 33 55 and under 65 31 2 34 63 65 and under 75 62 7 41 96 75 and upwards 82 6 47 123 Totals 228 34 194 388 ATTENDANCES AT LOCAL CLINICS DURING 1947 Ante-Natal Clinics: Friday Hill sessions 40 Attendances 622 16, Chingford Ave. sessions 51 Attendances 856 Marmion Avenue sessions 23 Attendances 513 Infants' & Toddlers' Welfare Clinics: Friday Hill sessions (including Infants & Toddlers 39 Attendances (including 72 new infants). 1,125 Sewardstone Road sessions (including Infants & Toddlers 29 Attendances (including 67 new infants). 937 North Chingford sessions (including Infants & Toddlers 51 Attendances (including 185 new infants). 2,319 Marmion Avenue session: Infants 104 Attendances (including 275 new infants). 3,645 Toddlers 50 Attendances 1,269 Specialist Obstetric Clinic: 16, Chingford Ave. sessions 7 Attendances 32 Women's Welfare Clinic: 16, Chingford Ave. sessions 2 Attendances 9 Marmion Avenue sessions 12 Attendances 84 Minor Ailment & School Clinics: Marmion Avenue sessions 45 Attendances 678 Whitehall Road School sessions 45 Attendances 586 Orthopædic Clinic: 16, Chingford Ave. sessions 76 Patients treated 129 Marmion Avenue sessions 35 Patients treated 157 30 31 NOTIFIABLE DISEASES (after correction) Year Scarlet Fever Diphtheria Erysipelas Measles Whooping Cough Tuberculosis Dysentery Encephalitis Lethargica Puerperal Pyrexia Ophthalmia Neonatorum Pneumonia Cerebrospinal Fever Acute Poliomyelitis Acute Polio' Encephalitis Pulmonary Other Forms 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 — — 1947 69 — 10 290 202 77 10 2 - 5 — 114 1 14 2 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 — 4 4 7 7 29 9 6 — 2 1 — 69 Erysipelas - - - - - - 1 - - 1 7 1 10 Measles 18 29 35 26 46 121 6 8 — 1 — — 290 Whooping Cough 18 22 33 25 31 66 5 1 — — 1 — 202 Puerperal Pyrexia — — — — — — — — 2 3 — — 5 Pneumonia 8 3 10 2 2 16 4 1 6 17 20 25 114 Cerebro-Spinal Fever - - - - 1 - - - - - - - 1 Dysentery — — — — — — — — 2 — — — 2 Acute Poliomyelitis - 2 1 - 1 3 2 1 3 1 - - 14 Acute PolioEncephalitis - - - - - 1 1 - - - - - 2 ANALYSIS OF NOTIFIABLE DISEASES (after correction). Diseases. Total cases Total admitted to hospital Scarlet Fever 69 42 Erysipelas 10 8 Puerperal Pyrexia 5 5 Pneumonia 114 17 Cerebro-Spinal Fever 1 1 Measles 290 3 Whooping Cough 202 2 Dysentery 2 2 Acute Poliomyelitis 14 13 Acute Polio-Encephalitis 2 2 32 33 Birth-rates, Civilian Death-rates, Analysis of Mortality, Maternal Mortality and Case rates for certain Infectious Diseases in the Year 1947 (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: Rates per 1,000 Live Births:— Live Births 20.5† 23.3 22.2 22.7 20.3 All causes under 1 year of age 41 47 36 37 12.9 Still Births 0.50† 0.62 0.54 0.49 0.37 Deaths: Enteritis and Diarrhœa under 2 years of age 5.8 8.0 3.7 4.8 2.2 All Causes 12. 0† 13.0 11.9 12.8 8.5 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 Scarlet Fever 0.00 0.00 0.00 0.00 — Notifications: Rates per 1,000 Total Births (Live and Still): Whooping Cough 0.02 0.03 0.02 0.02 — Diphtheria 0.01 0.01 0.01 0.01 — Influenza 0.09 0.09 0.08 0.08 0.11 Smallpox 0.00 0.00 0.00 — — Puer. Fever 7.16 8.99 6.27 1.21 5.3 Measles 0.01 0.02 0.02 0.01 — Puer. Pyrexia *6.94 Notifications: Typhoid Fever 0.01 0.01 0.00 0.01l - Paratyphoid Fever 0.01 0.01 0.01 0.01 - Maternal Mortality in England and Wales: Cerebrospinal Fever 0.05 0.06 0.05 0.05 0.02 Rate per 1,000 Total (Live and Still) Births Rates per Million Women aged 15-44 Chingford Rate per 1,000 Total (Live and Still) Births Scarlet Fever 1.37 1.54 1.37 1.31 1.5 Whooping Cough 2.22 2.41 2.02 2.80 4.4 Diphtheria 0.13 0.15 0.14 0.14 - 140 Abortion with sepsis 0.10 9 Erysipelas 0.19 0.21 0.18 0.22 0.22 141 Abortion without sepsis 0.06 5 Smallpox 0.00 0.00 0.01 0.00 - 147 Puerperal Infections 0.16 Measles 9.41 9.13 9.58 5.29 6.38 142-146 0.85 0.00 Pneumonia 0.79 0.89 0.68 0.64 2.5 148-150 Other maternal causes †Rates per 1,000 total population. *including Puerperal Fever.