AC 4411 (1) CHINGFORD BOROUGH OF CHINGFORD CHIN 13 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1948 BOROUGH OF CHINGFORD ANNUAL REPORT MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1948 OF THE BOROUGH OF CHINGFORD Committee : November, 1)947 — November, 1948. PUBLIC HEALTH COMMITTEE Chairman: Councillor J. W. R. Nation Vice-Chairman: Councillor A. T. H. Austin Members: Alderman Mrs. S. L. Oakes Councillor Mrs. T. M. Hardy „ Miss M. L. Mathieson, C.A. ,, W. S. Higho „ T. H. Treadwell „ Mrs. J. L. L. Woods „ P. W. Wood The Mayor, Councillor A. H. Hart, J.P. (ex-officio) Meeting : Second Wednesday in each month at 7.30 p.m. PUBLIC HEALTH OFFICERS OF THE AUTHORITY (1948) Medical Officer of Health: J. H. CROSBY, M.B., Ch.B., D.P.H. Chief Sanitary Inspector: JAMES F. ROGERS, M.R.San.I., M.S.I.A. (a) (c) (d) Cleansing Superintendent. Inspector under the Shop Acts and Petroleum Acts. District Sanitary Inspectors: R. W. BASHFORD, M.S.I.A. (b) (c). K. V. SPROAT, M.S.I.A. (a) (from 9.2.48) D. G. BLEACH, (a) (from 4.5.48) Senior Clerk: Miss V. M. PETTIT. Clerks: A. E. CULPIN. Miss I. A. FOLKES D. G. BLEACH (training as Sanitary Inspector under Ministry of Health Scheme), (to 3.5.48) Miss M. E. LUCKEN. (to 7.5.48) Miss E. HOWES (from 12.5.48) (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. ANNUAL REPORT FOR THE YEAR 1948. To the Mayor, Aldermen and Councillors of the Chingford Corporation. Mr. Mayor, Aldermen and Councillors, I have pleasure in submitting my Annual Report for the year 1948 upon the health and sanitary circumstances of the Borough. Generally speaking the health of the district has been satisfactory. The incidence of infectious disease was about the level of the previous year. Notified cases of pulmonary tuberculosis show a reduction for the first time for three years, the figures being 42 cases in 1948 against 46 in 1947, 45 in 1946, and 33 in 1945. It is a pleasure to be able to record for the third year in succession that no cases of Diphtheria occurred in the Borough. The birth rate at 15.9 per 1,000 was lower than the previous year (20.3 per 1,000). The reduction in this rate is in accordance with the general reduction throughout England and Wales as a whole. The death rate was 7.3 per 1,000 compared with 8.5 per 1,000 in 1947. The death rate of infants under one year of age was 21.5 per 1,000 live births. This figure, while considerably below the rate for England and Wales, viz.: 34 per 1,000, is higher than the rate for 1947, 12.9 per 1,000. The inception of the National Health Service Act, 1946, on the 5th July, 1948, did not materially affect the administrative powers of the Borough. I desire to record my thanks to the Chief Sanitary Inspector, Mr. James F. Rogers, and to the staff of the Health Department for their hard work and assistance to me during the year. I am, Ladies and Gentlemen, Your obedient servant, J H. CROSBY, Medical Officer of Health. August, 1949. 2 Section A.—STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area 2,868 acres Population—Registrar-General's estimate 46,610 Number of inhabited houses and flats at end of 1948 12,500 Rateable value on April 1st. 1948 £357,821 Sum represented by a Denny rate on April 1st, 1948 (gross) £1,490 18 5 VITAL STATISTICS M. F. Live Births Total 399 344 Birth Rate per 1,000 of estimated reisdent papulation: 16.9 Legitimate 392 338 Illegitimate 7 6 M. F. Rate per 1,000 total (live and still) births: 22.4 Stillbirths Total 11 6 Legitimate 6 6 Illegitimate - - M. F. Deaths Crude Death Rate per 1,000 of estimated resident population: 7.3 170 170 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 21.5 Legitimate infants per 1,000 legitimate live births 20.5 Illegitimate infants per 1,000 illegitimate live births — Deaths from Cancer (all ages) 70 „ „ Measles (all ages) — „ „ Whooping Coughs (all ages) — „ Diarrhoea (under 2 years of age) — „ „ Scarlet Fever — 3 4 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 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 1948 46,610 743 15.9 340 7.3 16 21.5 Section B.—GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. (a) Laboratory Facilities. Pathological specimens from this district are examined at the Pathological Department of the St. Margaret's Hospital at Epping. The Pathologist has kindly supplied me with the following figures of specimens from Chingford examined during the year:— Number of specimens examined for the Health Department and the General Practitioners 301 Number of specimens examined for the Chingford Isolation Hospital 360 (b) Ambulance Facilities. On the 5th July, 1948, the Council's Ambulance Service was taken over by the Essex County Council, as the Local Health Authority under the National Health Service Act of 1946. The following is a summary of the work performed by the Ambulance Service during 1948:— Calls answered by the Borough Ambulance Service from 1.1.48 to 4.7.48. Hire Accident Maternity 2,850 132 184 Calls transferred to other districts 30 Total calls received 3,196 Total mileage 28,572 Calls answered by E.C.C. Ambulance Service from 5.7.48 to 31.12.48 Accidents Maternity Emergency Non-Emergency 152 152 454 2,605 Calls transfered to Ambulance Control: 145 Total Calls received 3,508 Total Mileage 31,286 Total calls received during the year 1948 6,704 Total mileage covered during the year 1948 59,858 Number of ambulances 3 Number of staff 13 (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 tables of clinics on page 7. 5 (e) Hospitals. Since the inception of the National Health Service Act, 1946, on the 5th July, 1948, the Isolation Hospital, Waltham Abbey, and the Isolation Hospital, Larkshall Road, Chingford. are now administered by the North-East Metropolitan Regional Hospital Board. The change in administration has meant that cases of infectious disease in Chingford may now be admitted to the latter hospital in addition to that at Waltham Abbey. The advantage of this will be readily appreciated. (f) Midwives. Number of County Council practising midwives 5* „ „ midwives practising in the Nursing Homes 4 „ maternity nurses practising in the Nursing Homes 2 *Miss E. A. Clarke, 69, Connaught Avenue, E.4. (Telephone: Silverthorn 1801) *Mrs. G. E. M. Witter, 90, Connington Crescent, E.4. (Telephone: Silverthorn 4968) *Mrs. P. M. Stenning, 220, Hall Lane, E.4. (Telephone Silverthorn 3263) *Miss C. Lovell, 49 The Ridgeway, E.4. (Telephone: Silverthorn 1460) *Miss D. Waldie, 49, The Ridgeway, E.4. (Telephone: Silverthorn 1460) (g) Registered Nursing Homes. There are three registered Nursing Homes in the district, two receiving maternity and medical patients, and the third Home, opened in 1949, receiving medical cases only. The 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. 6 Local Clinics and Treatment Centres, 1949 Clinic Where held When held Diphtheria Immunisation Clinics Primary Hall, Buxton Rd. North Chingford Tuesdays, 2 p.m. Mission Hall, Sewardstone Road, North, E.4 2nd, 4th and 5th Wednesdays, 2 p.m. County Council Clinic, Marmion Avenue, E.4. Thursdays, 11 a.m. Friday Hill House, E.4. 16 Chingford Avenue, E.4. 1st. Wednesday, 3 p.m. Wednesdays, 9.30 a.m. Ante-Natal Cilnics Friday Hill House, E.4. Tuesday mornings Thursdays, 9.30 a.m—11.30 a.m. Marmion Avenue, E.4. Wednesdays, 9.30 a.m. County Council Clinic, 16 Chingford Avenue, E.4 2nd. Thursday 2 p.m. Fridays, 1.30p.m.— 4.30 p.m. Child Welfare Clinics Friday Hill House, E.4. Wednesdays, 1.30 p.m.—3.30 p.m. County Council Clinic, Tuesdays, 1.45 p.m.—3.45 p.m. Wednesdays, 145 p.m.—3.45 p.m. Primary Hall, Buxton Rd. Tuesdays 1.45 p.m.—3.45 p.m. Mission Hall. Sewardstone Road, North, E.4 2nd, 4th and 5th Wednesdays, 1.45 p.m.—3.45 p.m. 16, Chingford Avenue, E.4. Wednesdays, 9 a.m.—11.45 a.m. Toddlers' Clinic County Council Clinic, Marmion Avenue, E.4. Thursdays, 10.0 a.m.—11.30 a.m. Minor Ailment and School Clinics County Council Clinic, Marmion Avenue, E.4. Mondays, 9.30 a.m. Friday Hill House, E.4. 1st. 2nd and 4th. Mondays, 2 p.m. Orthopaedic Clinics County Council Clinic, Marmion Avenue, E.4. Monday afternoons, 1st, 3rd, 4th and 5th Thursdays, 2 p.m. by appointment only 16, Chingford Avenue, E.4. Thursday mornings, 2nd. Thursday afternoon, by appointment only. Dental Clinic 16, Chingford Avenue, E.4. By appointment only through Schools Eye Clinic County Council Clinic, Marmion Avenue, E.4. Friday, afternoons, by appointment only Women's Welfare Clinics County Council Clinic, 4th Friday in each month, 10.15 a.m. 16, Chingford Avenue, E.4. 1st Friday in .each month, 9.30 a.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, 5—7 p.m. Tuesdavs. 5—7 p.m. Males— Mondays, Wednesdays, Fridays, 4 p.m.—6.30 p.m. Thursdays. 10—12 noon Oldchurch County Hosp. (The Annexe), Romford Males and Females— Mondays and Tuesdays, 4 p.m.—6.30. p.m And other London Hospitals Thursdays, 12 noon—3.30 p.m. Registrar of Births, Deaths and Marriages: Mr. C. W. BARRETT, 19, Algers Road, Loughton. (Telephone: Loughton 576) Office: Town Hall, Chingford, E.4. (Telephon: Silverthorn 3944 Mondays and Thursdays, 2.30 p.m. to 4.30 p.m. Wednesdays and Saturdays, 9 a.m. to 11 a.m. Duly Authorised Officer: Mr. E. McCRAVE, 73 Dale View Crescent, Chingford, E.4. (Telephone: Silverthorn 4363) Office: Methodist Church Hall, New Road, South Chingford, E.4. (Telephone: Silverthorn 2836) Mondays to Fridays, 9 a.m. to 10 a.m. 4 p.m. to 5 p.m. Social Welfare Officer: 35, Wanstead Place, E.ll. (Telephone: Wanstead 0031) National Assistance Board: 12, Church Hill, Walthamstow, E.17. (Telephone: Larkswood 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, North Chingford, E.4. (Telephone: Silverthorn 2294) 7 Sestion 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 found necessary in two instances to take action in connection with the pollution of watercourses and the River Ching. Public Cleansing. A weekly collection of refuse and salvage was maintained and the total weight of refuse disposed of at the Works was 10,862 tons This was a considerable increase over the amount collected in the previous year, namely, 8 542 tons; the population midyear 1948 was 46,610, as compared with 45,430 for the previous year. The net cost per ton for the collection of refuse was 16s. 7d. as against 19/9id. for the year ended March. 1948, and 14/-d. for the year ended March, 1947. The net cost per ton for the disposal of refuse was 7/1d. as against 8/l¾d. for the previous year and 9/6¼d. for the year ended March, 1947. The net expenditure for the collection and disposal of refuse and salvage was £12 831, as against £11,926 for the previous year, and, although expenditure continued to rise unit costs per ton showed a decrease owing to the greater tonnage of refuse brought into the Works. The total income from all sources was £5,156, as compared with £4,847 for the previous year. The income from the sale of waste paper was £2,278. The Incentive Bonus Scheme which was mentioned in the report for 1947 appears to have functioned satisfactorily, and during the two years in which the Scheme has been in operation the employees have qualified for the 20 per cent. bonus which accrues when the rales exceed £3 000. The Council continued the collection of kitchen waste from communal bins in the town, and the material was transported to the approved concentration plant at Stanleford Abbots. Representation was again made to the Board of Trade for permission to deliver this material to the concentration plant at Tottenham, but once again the application of the local authority was not successful. Seventeen street orderlies were engaged in the sweeping of streets in the Borough. The Road Sweeping Machine was not delivered during the period under review. Road gullies were cleansed by contract as in previous years. The Public Sanitary Conveniences were maintained in good condition throughout the year. 8 HOUSE AND TRADE REFUSE. Table showing costs for the year ending 31st. March, 1949. 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 £10,021 9,460 7,966 7,579 17,987 17,038 B Gross Income 1,015 1,015 4,141 4441 5,156 5,1D C Net cost £9,006 8,445 3,825 3,438 12,831 11,882 Unit Costs s. d. s. d. s. d. s. d s. d. s. d D Gross expenditure per ton 18. 5. 17. 5. 14. 8. 13. 11. 33. 1. 31. 4. E Gross income per ton 1. 10. 1. 10. 7. 7. 7. 7. 9. 5. 9. 5. F Net cost per ton 16. 7. 15. 7. 7. 1. 6. 4. 23. 8. 21 11. G Net cost per 1000 population £193 181 82 74 275 255 H Net cost per 1000 houses £662 621 281 253 943 874 1. Total refuse collected (in tons) 10,862 2 Population (Mid-year) 1948 46,610 3. Weight per 1,000 population per day (in cwts.) 13 4. Number of occupied houses and premises (31.3.1949) 13,600 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, 1949. Year ended 31.3.1943 £ s. d. £ s. d. £ s. d. £ s. d. 1.—Metals: 27 16 2 Aluminium 76 5 11 35 17 4 Copper 55 19 3 57 13 6 Iron 95 2 4 43 6 7 Lead 42 14 0 24 6 1 Battery Lead 19 0 5 51 6 8 Brass 73 17 7 13 4 0 Mixed Metals 8 3 3 6 12 11 Unbaled Scrap 9 2 2 80 11 7 Tins 118 4 1 4 1.3 4 Pewter 2 13 7 501 2 7 27 16 5 Bones 43 15 9 481 16 4 Broken white glass 195 8 10 - - - Amber Cullet 4 9 3 406 13 2 Bottles and Jars 317 8 4 2 3 0 Syphons - - - 517 6 5 421 14 6 Rags 419 0 6 38 13 0 Carpets 73 5 6 492 6 0 1851 12 1 Newspapers and Mixed Waste Paper 2207 7 5 72 1 2 Board of Trade Coll. Allowance 71 9 9 2278 17 2 479 2 4 Pig Food (Kitchen Waste) 460 15 2 182 0 5 Allowance (Board of Trade) 224 0 10 684 16 0 9 3 9 Rubber 5 2 1 3 12 6 Old Gramophone Records 2 7 8 4525 14 2 - - - 2—Miscellaneous Receipts & Charges 32 18 4 66 13 6 3—Weighbridge Fees 44 10 6 4—Rents: 147 4 1 Foundry 200 0 0 20 0 0 Proportion of Allotment rents 20 0 0 9 6 6 Other rents 2 6 5—Refuse Collection Charges: 144 11 0 Greengrocers 189 11 0 137 14 6 Others 143 3 0 £4847 6 5 £5155 19 6 8,542 Tonnage 10,862 10 SANITARY INSPECTION OF THE AREA. Inspections on Complaint. The number of complaints received at the office and recorded in the register was 550, as compared with 508 in the previous year and 437 for the year 1946. The total inspections made on complaint was 649 and the number of defects or nuisances revealed was 430, 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 2 Defective roofs, spoutings and eavesgutters 19 Blocked yard and W.C. drains 20 Blocked Sewers 196 Defective sewers 4 Defective drainage 9 Defective dustbins 17 W.C.'s without proper flushing arrangements 7 Defective W.C.'s 6 Polluted water supply 1 Dampness 26 Defective stoves and fire grates 6 Defective water fittings 3 Waste pipes and sinks defective 3 Verminous premises 9 Animals kept so as to be a nuisance 14 Accumulations of offensive matter 9 Defective hot water systems 11 Lack of washing facilities 2 General housing defects 50 Overcrowding 6 Burst water pipes 5 Pollution of water courses 2 Nuisances from smoke 3 430 11 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 6,223, as compared with 5,620 in the previous year; the defects dealt with numbered 1,079, as compared with 737 in 1947. TABLE 2. Visits Paid Nuisances or Defects found Housing Act, 1936. Inspections 126 525 Ee-visits re Notices served 1004 Re Overcrowding 25 On complaint 649 430 Infectious Diseases 190 Retail Trade Premises: Meat 98 Fish 32 Fried Fish 13 General Provisions 39 Others 11 Food Preparation Premises 60 Ice Cream Premises 54 Factories 51 1 Bakehouses 36 1 Cowsheds and Dairies 6 Pigstyes 1 Re-visits re Notices Served (P.H. Act) 1365 Rodent Control 1989 120 Private Slaughtering; 3 Shop Acts (Sanitary Conditions) 2 Council Houses 7 Collection & Disposal of Refuse & Salvage 148 Kitchen Waste - Communal Bins 56 Schools 23 Hairdressers' Premises 12 Verminous Premises 22 Swimming Pool 5 Miscellaneous Visits 78 Places of Entertainment 2 Public Conveniences 34 Petroleum Acts 5 Outworkers 20 Smoke Observations 23 Pollution of Rivers and Watercourses 28 2 Street Food Vendors 7 Movable Dwellings 9 6233 1079 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 58 Defective roofs, spoutings and eavesgutters 125 Blocked yard and W.C. drains 23 Blocked sewers 266 Defective sewers 32 Defective drainage 30 Wall and ceiling plaster defective 110 Ashbins defective 25 W.C.'s without proper flushing arrangements 22 Insufficient water supply 2 Water Closets defective 24 Dampness 54 Defective stoves and firegrates 44 Defective floors 46 Water fittings defective 16 Defective external brickwork 9 Stairs and rails defective 4 Defective woodwork of windows and doors 87 Sinks and waste pipes defective 11 Yard paving defective 12 Defective wash coppers 6 Defective sash cords, glazing etc. 22 Rat infestation 120 Animals kept so as to be a nuisance 2 Accumulations of offensive matter 2 Defective hot water systems l Walls defective 21 Absence of proper foodstores 2 Pollution of rivers and watercourses 2 Lack of intervening ventilated space 1 1079 TABLE 4. Letters sent out and notices served in connection with sanitary matters Letters 2020 Public Health Acts: Preliminary Notices 112 Secondary Notices 6 Statutory Notices 8 Statutory Notices (re Maintennace of Sewers) 15 Housing Acts: Preliminary Notices 62 Secondary Notices 25 Statutory Notices 9 13 Shops Acts. It was not found necessary to take action during the year under the provisons of the Shops Acts. Smoke Abatement. During the period under review complaints were received as to the emission of smoke and grit from a chimney stack of a factory in the town. Investigations proved that the alleged nuisance was caused by the emission of grit rather than smoke. Glass slides, coated with clear varnish, were set up in various roads in the vicinity of the factory in order to gauge the fall of grit, and subsequently a report was submitted to the Public Health Committee. The problem was a complex one, and the Council decided to ask for the co-operation of the Ministry of Fuel and Power. This was readily granted, and a meeting was arranged between a sub-committee of the Council, the proprietor of the factory, and an engineer from the Ministry. Arising out of this conference the factory proprietor agreed to investigate the possibilities of grit arrestors, or, if these were not practicable, to consider the use of a different grade of fuel. Swimming Baths and Pools. Summaries of the daily chlorine and akalinity 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 are reported on under the heading "Bacteriological Examinations." 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 4. Disinfested 4. (2) Methods. Spraying with an insecticide is the general rule, following the removal of architraves, skirtings and picture rails. Papered rooms are stripped. (3) Inspectional 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. 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. Informal action was necessary in one instance to secure necessary cleansing and limewashing of a bakehouse. Factories Act, 1937. Eighty-seven visits were paid to Factories, and in one instance action was taken regarding the provision of an intervening ventilated space in connection with 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 be enforced by Local Authority. 5 11 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority. 43 70 1 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding Outworkers' Premises) 4 6 - - Total 52 87 1 - 15 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.l) — — — — — Overcrowding (s.2) — — — — — Unreasonable temperature (s.3) — — —. — — Inadequate ventilation (s.4) — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences s.7) (a) Insufficient — — — — — (b) Unsuitable or defective 1 1 — — — (c) Not separate for sexes — — — — — Other offences against the Act 'not including offences relating to Outwork) — — — — — Total 1 1 — — — 16 Number and Trades of Outworkers notified during 1948. Wearing Apparel 102 Footwear 5 Brush-making 1 Handbags 3 Paper Bags 4 Box Making 3 Leather Goods 3 Fancy Goods 4 Outworkers were notified in the following Areas: Croydon 1 Stepney 1 St. Pancras 2 Stoke Newington 2 Leyton 35 Islington 3 Holborn 3 Woodford 4 St. Marylebone 9 Hornchurch 1 Westminster 12 London Corporation 12 Walthamstow 2 Bethnal Green 9 Hackney 33 Shoreditch 6 Tottenham 7 Finsbury 15 Chigwell 1 Hampstead 1 Rats and Mice (Destruction) Act, 1919. The Council continues to employ a full-time Rodent Operative under the Scheme inaugurated by the Ministry of Agriculture and Fisheries. Whilst there was no evidenceof major infestations in the town, the Rodent Operative paid many calls to deal with 120 minor infestations at private and business premises in the town. The initial treatment of sewers was carried out during the year, and thereafter the first maintenance treatment. Prior to the initial treatment all sewer manhole covers were loosened and greased, and where necessary sludge deposits were removed from benching and floors of the manholes. The total number of manholes in Part 1 of the initial treatment was 798, and of this number 429 showed complete or partial takes. Part 2 of the initial treatment, which was undertaken four weeks after the commencement of Part 1, consisted of the re-treatment of all manholes which had shown takes. Of the 429 manholes re-treated in Part 2 only 145 showed takes. Generally there was ample evidence of the effectiveness of the treatment in the number of dead rats which were found at the Sewage Disposal Works. The first maintenance treatment was carried out in February, 1949, and of 499 manholes treated 15 per cent, showed complete or partial takes. Secton D.—HOUSING STATISTICS FOR THE YEAR, 1918. 1. Number of Houses Erected during the Year. (1) By the L.A. (permanent) traditional (including flats) 206 (2) By the L.C.C. (permanent) traditional 337 (3) Cost of works re-buildings by local builders 143 (4) Cost of works re-buildings by Council 11 (5) By private enterprise 5 707 17 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) 965 (b) Number of inspections made for the'purpose 3334 (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 126 (b) Numbsr of inspections made for the purpose 1155 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 4 (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 284 Note. This figure includes all houses where defects were found, including these 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 217 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 7 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By owners 2 (b) By Local Authority in default of owners 1 18 B. Proceedings under Section 11 and 13 of the Housing Act, 1936: (1) Number of Demolition Orders served 7 (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 17 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By Owners 4 (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 6. 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. Extraneous Matters in Foodstuffs. During the year a series of complaints occurred which resulted in the Corporation instituting proceedings in no less than 11 instances on account of extraneous matters found in food. In the majority of instances the places of 19 manufacture were outside the area of the Borough, and in these cases notification was forwarded to the authorities concerned. In a further three instances letters of warning were sent in connection with foreign substances in food where evidence was judged to be insufficient to warrant legal proceedings. The cases are summarised below :— No. Offence Result 1. Particles of steel in bread Fine — £5 0 0 Costs — 15 0 2. Metal in bread Fine — £2 10 o — Costs — 7 6 3. Cigarette end in fruit Fine — £2 10 0 ~ cake Costs — 7 6 4. Shredded tobacco in loaf Fine — £2 10 0 Costs — 7 6 5. Cigarette end in chocolate Fine — £5 0 0 sponge cake Costs — 2 6 6. Glass in bread Fine — £2 10 0 Costs — 7 6 7. Glass in bread Fine — £2 10 0 Costs — 7 6 8. Cigarette end in bread Fine — £5 0 0 Costs — 2 6" 9. Particles of steel in Fine — £25 0 0 bread Costs — 12 6 10. Nail in rock cake Fine — £2 0 0 11. Pin in scone Fine — £2 10 0 Costs — 12 6 (Note—Cases taken under Section 9 of the Food and Drug Act, 1938). Meat and Other Foods. There is one licensed slaughterhouse and twenty-five butchers' shops in the area; the visits paid to these and other retail trade premises numbered 307. 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 :— 20 TINNED FOODS. Article. No. of Tins Bacon 3 Corned Beef 243 Minced Beef 2 Beef Loaf 2 Minced Loaf 2 Veal Loaf 1 Jellied Veal 2 Meat Lunch 9 Corned Mutton 33 Stewed Steak 6 Pork Meat 4 Pork Ham 1 Spam 2 "Prem" Meat 1 Lambs Tongues 1 Beasts Tongues 50 Anchovy Fillets 1 Dressed Crab 1 Cod Roes 10 Whiting 2 Hake 1 Cod Liver Roe 7 Pilchards 9 Salmon 12 Frisco Sild 10 Roe Spread 1 Sardines 8 Herring Tidbits 1 Herrings 3 Cod Liver and Roe 3 Mussels 31 Fish Spread 1 Rock Cod 10 Paste 21 Lobster and Tomato 1 Soup 30 Sausage 1 Cod Roe Paste 2 Spaghetti 6 Betox 1 Piccalilli 1 Horse Radish 1 Pickle 2 Tomato 11 Tomato Sauce 11 Tomato Juice 10 Parsnips 1 Peas 49 Dried Carrots 5 Beetroot 5 Spinach 1 Mixed Vegetables 4 Carrots 3 Pototoes 2 Gherkins 16 Golden Berries 2 Fruit Salad 13 Gooseberries 3 21 TINNED FOODS—Continued Article. No. of Tins Apricots 8 Plums 9 Peaches 3 Grapefruit 10 Pears 3 Apples 3 Pineapples 9 Prunes 1 Oranges 3 Grapes 1 Orange Juice 14 Fruit Juice 1 Jam 26 Marmalade 16 Golden Syrup 2 Milk 133 Full Cream 2 Sandwich Spread 2 Ka-fat 1 OTHER FOODS. Article. Quantity. Beasts Livers 52½ lbs. Beef 172 lbs Skate Wings 11 stone Witches 5 stone Whiting 6 stone Cat Fish 8½ stone Herrings 3 stone Herring Roes 6 stone Bacon 10 lbs. 3½ozs. Meat Pies 6 lbs. Sausage Meat 24 lbs. Savoury Sausage Meat 120 lbs. Pheasant One Flour 27 lbs. Sugar 70 lbs. Cheese 25$ lbs. Currants 106 lbs. Dates 2 cases Skimmed Milk 4 cwts. Dried Egg 3 pkts. Rabbits 58 lbs. 22 BACTERIOLOGICAL AND CHEMICAL EXAMINATION OF FOOD. Bacteriological Examinations. The Counties Public Health Laboratories, 66, Victoria Street, London, S.W.I, undertake bacteriological examinations for the Councii, through the Essex County Council Bacteriological Laboratory Service. During the year 39 samples were forwarded to the Laboratories for bacteriological examination, 35 being samples of ice cream and four samples of Swimming Pool water. Ice Cream. The results of the ice cream are summarised below, and it will be noted that the presence of bacteria coli was detected in one sample only. The classification of the samples in relation to the Ministry's Provisional Grading is as follows:— Grade I. Grade II. Grade III. Grade IV 2 12 9 10 One sample not graded owing to colouring. One sample fruit lolly not graded. The samples in the following table which were adversely reported on by the Bacteriologist gave rise to further investigations by the Department, and letters were forwarded to dealers and manufacturers. Where the source of manufacture was outside the area of the Borough due notice of the defaulting sample was forwarded to the authority controlling the manufacture. No. Type Colonies per ml. on Agar @ 37°c in 48 hrs. Coliform test (3 tubes). Bact. coli. test (3 tubes). Ministry Grade. Hours Grade 293 Hot Mix. 86,000 3/3 0/3 O/IV. 294 Hot Mix. 220 0/3 0/3 3½ / II 295 57,000 3/3 0/3 O/IV. 296 Cold Mix. 14 Neg.10 ml (Fruit Lolly) 297 Hot Mix. 1,900 0/3 0/3 4/11 (Choc. Ice) 298 Hot Mix. 22,000 0/3 0/3 4/11 (Choc. Ice) 299 Hot Mix. 17,000 0/3 0/3 24/11 300 Hot Mix. 18,000 0/3 0/3 O/IV. 302 Hot Mix. 1.30,000 3/3 0/3 ½/III 303 Hot Mix. 3,000 0/3 0/3 3½/11 (Choc. Ice) 304 Hot Mix. 50,000 3/3 0/3 O/IV. 305 Hot Mix. 30,000 3/3 0/3 ½/III 23 No. Type Colonies per ml. on Agar @ 37°c in 48 hrs. Coliform test (3 tubes). Bact. coli. test (3 tubes). Ministry Grade Hours/ Grade. 307 Hot Mix. 150,000 3/3 0/3 O/IV. 308 Hot Mix. 20,000 3/3 0/3 /III 309 Hot Mix. 10,000 3/3 0/3 1½/III 310 Hot Mix. 60,000 3/3 0/3 O/IV. 311 67,000 3/3 0/3 O/IV. 312 8,200 0/3 0/3 3/II 313 1,900 0/3 0/3 + 4½/I 315 Hot Mix. 9,000 3/3 0/3 3/II 316 Hot Mix. 90,000 2/3 0/3 Coloured 317 Mix. 60,000 2/3 0/3 2 / III 318 Hot Mix. 1,200 1/3 0/3 4½/I 320 Hot Mix. 20,000 3/3 0/3 O/IV. 321 Hot Mix 250,000 3/3 3/3 ½/III 322 Hot Mix 120,000 3/3 n/3 ½/III 323 Hot Mix 600 0/3 0/3 4/11 324 Hot Mix 120,000 0/3 0/3 8/II 325 Hot Mix 250,000 3/3 0/3 O/IV. 326 Cold Mix. 2,500 0/3 0/3 4/II 327 Hot Mix 100,000 3/3 0/3 O/IV. 328 21,000 3/3 0/3 l/III 329 Hot Mix 18,000 3/3 0/3 3/II 330 Hot Mix 3,200 2/3 0/3 4/II 331 Hot Mix 25,000 3/3 0/3 l/III Swimming Pool Water. Four samples of water were taken from the Swimming Pool during the season. Three were reported on satisfactorily by the Bacteriologist, but one sample was stated to be not of the standard desirable. This was due to the inefficiency of the soda injector, and new apparatus was installed later in the year. Chemical Examinations. Dr Bernard Dyer and Partners Ltd., Peek House, 20, Eastcheap, E.C.3, are the Public Analysts for the district. The following table gives a list of articles submitted for chemical examination during the year, in supplementation of the Essex County Council's Food and Drugs Service. In connection with samples Nos. 292 and 295 representations were made to the Ministry of Food which carried out investigations. Samples Nos. 300 to 311 were samples of School milk, and it is pleasing to note that the supply to Schools was of a good quality. 24 No. Sample Result. 292 Strawberry Jam Contained 0.18% fine quartz sand, free from harmful arsenical or metallic contamination Strawberries used in manufacture had been insufficiently cleansed from earthy matters. 293 Condensed Milk Prolonged storage had resulted in a precipitation of fat and casein by crystalization of the sugar; a brownish colour being due to caramelization. 294 Milk Powder No traces of arsenic and objectionable metallic contamination. Brownish sediment due to becoming slightly scorched or burnt in processing; suitable for cooking purposes. 295 Milk Powder Contained 45 parts per million of lead Unsuitable for human consumption. 298 Ginger Beer Satisfactorily free from traces of arsenic and objectionable metallic contamination. 299 Milk Powder Free from harmful traces of arsenic and objectionable metallic contamination. 300 Pasteurised Milk 301 " " " 302 " " " 303 " " " 304 " " " 305 " " " 306 " " " 307 " " " SOB " " " 309 " " " 310 " " " 311 " " " Above required standard for fat content. Certified as genuine milks. Section F.—PREVENTION AND CONTROL OF INFECTIOUS AND OTHER DISEASES. Diphtheria. It is very gratifying to be able to report that, for the third year in succession, no cases of Diphtheria occurred in the 25 Borough. This is directly attributable to the great success of the immunisation campaign during the last fourteen years. A great deal of propaganda with regard to Diphtheria immunisation has been carried out during the year through schools and clinics in the Borough ; the local press and cinemas have also assisted in this effort. As a result of this campaign, everyone, but especially parents and those in charge of young children, must now be familiar with the facilities in this district for this very valuable protection against this deadly disease. The clinic facilities are listed on page 7 of this report. In addition arrangements are made for school children to be immunised at school. The prophylactics used are Diphtheria Alum Precipitated Toxoid and Toxoid Antitoxin Floccules. Diphtheria Immunisation. Primary immunisations—number of children immunised during the year : — Under 5 years 737 Between 5 and 15 years 150 Total 887 Number receiving secondary or reinforcing injections during the year 709 These figures represent an increase of 21 per cent, over those for 1947. Scarlet Fever. The number of notified cases of Scarlet Fever at 78 is an increase of 9 on the figures for 1947. The disease was the usual mild type of recent years. There has been an increasing tendency for cases of this disease to be nursed at home, as is indicated in the figures given below. Mild uncomplicated cases and those where adequate facilities exist for isolation at home need seldom be sent tio hospital, thus effecting a great saving in hospital beds, nursing staff, etc. 1944 1945 1946 1947 1948 Cases notified 82 62 74 69 78 Percentage removed to hospital 64 77 64 61 52 Measles. The figures of notified measles cases for 1948 are an increase of 65 on 1947, viz.: 355 against 290. It is noteworthy that only 7 of tihese patients needed admission to hospital. A supply of adult measles serum was again available to practitioners through the Health Department for treatment of cases and protection of contacts. Whooping Cough. A decrease in the incidence of Whooping Cough occurred during the year, the notifications being 190 as against 202 in 1947. Only 4 were ill enough to need admission to hospital. 26 Poliomyelitis. The number of persons confirmed as suffering from acute poliomyelitis during the year was four. All have made a good recovery from their paralysis. Some advance has been made in the knowledge of the method of spread of the virus of poliomyelitis and the precautions to be taken in the event of infection. It is known that the virus is harboured in the nose, throat and intestines after infection. It remains in these situations for several weeks. The virus is spread mainly by person to person contact. Much can be done to diminish the risk of infection by scrupulous attention to personal hygiene—the use of a handkerchief in coughing and sneezing, washing of the hands after using the toilet and before eating or preparing food. Early and complete rest in bed in suspicious cases has been shown to diminish the danger of paralysis. The risk of any person being permanently paralysed from poliomyelitis is extremely slight. The great majority of confirmed cases make a good, if not complete, recovery from their illness. I feel that the publication of these details may allay considerably public anxiety in regard to this disease. Dysentery. Only one case of Dysentery occurred during 1948. Enquiries failed to elicit the source of infection. Recovery was rapid. Tuberculosis. The number of new cases of tuberculosis, both pulmonary and non-pulmonary, notified for 1948 was 49, a reduction of four cases on the figures for 1947. In addition, 57 previously notified cases of tuberculosis, pulmonary and non-pulmonary, moved into the district during the year. A detailed analysis for the year is given in the table on page 29. There were 23 deaths from tuberculosis, during the year) five 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 4.6. Food Poisoning: No confirmed cases of food poisoning occurred during 1948. Scabies. No persons were in need of treatment during the year at the Scabies Treatment Centre. 27 Vaccination. Since tihe 5th July, 1948, when the National Health Service Act, 1946, came into force, the Vaccination Acts have been completely repealed, vaccination being now an entirely voluntary procedure. No. of births registered in 1948 525 No. of vaccinations 106 Percentage of vaccinations to registered births 20.1 Medical Examinations. During the year 34 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, 30 medical examinations were carried out in respect of Essex County Council staff. CAUSES OF DEATH AS GIVEN BY THE REGISTRAR GENERAL FOR THE YEAR 1948. Causes of Death Males Females Total Tuberculosis of respiratory system 6 10 16 Other forms of tuberculosis 3 2 5 Syphilitic diseases — 1 1 Cancer of buccal cavity and oesophagus (M) uterus (F) 2 4 6 Cancer of stomach and duodenum 4 4 8 Cancer of breast — 11 11 Cancer of all other sites 28 17 45 Diabetes — 1 1 Intra-cranial vascular lesions 11 25 36 Heart diseases 43 46 89 Other diseases of circulatory system 8 6 14 Bronchitis 13 2 15 Pneumonia 11 5 16 Other respiratory diseases 4 2 6 Ulcer of stomach and duodenum 4 — 4 Other digestive diseases 4 6 10 Nephritis 3 7 10 Premature birth 1 1 2 Congenital malformation, birth injury, infantile disease 8 4 12 Suicide 3 1 4 Foad traffic accidents 3 1 4 Other violent causes — 4 4 All other causes 13 10 23 Totals—all causes 172 170 342 Totals—year 1947 199 189 388 28 Tuberculosis. NEW CASES TRANSFERS DEATHS Age periods Respiratory NonRespiratory Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. M. F. M. F. 0 to 1 year 1 — — — — — — — — — — — 1 to 4 years 1 1 — — 1 1 — — — — — — 5 to 14 years 3 1 2 2 2 5 4 1 — — — — 15 to 24 years 2 12 1 1 2 3 1 1 — 4 — 1 25 to 34 years 3 3 — — 10 8 — — — 1 — — 35 to 44 years 5 1 — — 7 4 — — 3 2 — — 45 to 54 years 2 1 — — 6 1 — — 3 1 — — 55 to 64 years 3 — — — — — — — 1 1 — — 65 and upwards 2 1 —' 1 — — — — — 1 — — Totals 22 20 3 4 28 22 5 2 7 10 — 1 Add—Deaths of un-notified cases 2 1 1 1 Deaths from Cancer. 9 11 1 2 The following table of deaths from cancer shows that out of a total of 69 deaths from this disease, 66 of them occurred in persons over the age of 45 years. SITE 0—44 M. years F. 45 years & over M. F. Totals M. F. Gastro-Intestinal Tract 1 16 13 17 13 Lungs and Mediastinum — 1 7 1 7 2 Genito-urinary organs — — 6 7 6 7 Breast — 1 — 10 — 11 Other sites — — 2 4 2 4 Totals 1 2 31 35 32 37 Death rate = 1.48 per 1,000 (as compared with 1.62 per 1,000 in 1947) 29 DEATHS FROM ALL CAUSES AT VARIOUS AGES DURING 1948. Age DEATHS No. of deaths which apply to district No. in district Outward Transfers Inward Transfers Under 1 year 10 6 11 15 1 and under 2 5 3 2 4 2 and under 5 1 1 — — 5 and under 15 — — 1 1 16 and under 25 5 2 4 7 25 and under 35 3 1 10 12 35 and under 45 8 3 9 14 45 and under 55 13 1 21 33 55 and under 65 40 3 34 71 65 and under 75 46 4 29 71 75 and upwards 79 7 40 112 Totals 210 31 161 340 ATTENDANCES AT LOCAL CLINICS DURING 1948. Ante-Natal Clinics: Friday Hill sessions 52 16, Chingford Ave. sessions 52 Marmion Avenue sessions 57 Infants' & Toddlers' Clinics: Friday Hill sessions 52 (including infants & toddlers) Sewardstone Road N. sessions 27 (including infants & toddlers) Buxton Road sessions 52 (including infants & toddlers) 16, Chingford Avenue sessions 47 (including infants & toddlers) Marmion Avenue sessions: Infants 104 Toddlers 52 Specialist Obstetric Clinic: 16, Chingford Avenue sessions 4 Women's Welfare Clinics : 16, Chingford Avenue sessions 12 Marmion Avenue sessions 11 Minor Ailment & School Clinics: Marmion Avenue sessions 45 Friday Hill House sessions 48 Orthopcedic Clinics: 16, Chingford Avenue sessions 57 Marmion Avenue sessions 77 Eye Clinic: Marmion Avenue sessions 44 Dental Clinic: '16, Chingford Ave. sessions 395 Attendances 574 Attendances 975 Attendances 1,028 Attendances . . 2,301 (including 92 new infants). Attendances 942 (including 49 new infants). Attendances 3,093 (including 185 new infants). Attendances 960 (including 45 new infants). Attendances 5,066 ^including 332 new infants). Attendances 1,122 Attendances 20 Attendances 87 Attendances 144 Attendances 734 Attendances 878 Attendances 469 Attendances 945 Attendances 753 Attendances 2,849 30 NOTIFIABLE DISEASES (after correction) Year Scarlet Fever Diphtheria Erysipelas Measles Whooping Cough Tuberculosis Puerperal Pyrexia Ophthalmia Neonatorum Pneumonia Cerebro-Spinal Fever Acute Poliomyelitis Acute PolioEncephalitis Pulmonary Other Forms Dysentery 1943 376 13 16 189 83 49 7 2 2 1 88 3 — — 1944 82 2 5 61 72 42 3 20 2 1 73 2 — — 1945 62 4 9 210 94 33 9 38 3 1 88 2 — — 1946 74 — 9 212 88 45 5 13 2 2 103 3 — — 1947 69 — 10 290 202 46 7 2 5 - 114 1 14 2 1948 78 — 13 355 190 42 7 1 1 1 78 3 4 - 31 NOTIFIABLE DISEASES TABULATED ACCORDING TO AGE (after correction). Underl year 1 2 3 4 5-9 10-14 ] 15-19 20-34 35-44 45-64 65 and over Totals Scarlet Fever .. — 3 5 7 7 43 8 2 3 — — — 78 Erysipelas — — — — — — — — 1 1 9 2 13 Measles 9 39 33 39 71 160 2 1 1 — — —- 355 Whooping Cough 18 39 25 29 26 46 — — 3 3 1 — 190 Puerperal Pyrexia — — — — — — — — 1 — — — 1 Pneumonia 3 1 1 4 2 14 4 — 7 8 22 12 78 Cerebro-Spinal Fever 1 1 — — — — — — 1 — — — 3 Dysentery — — — — — 1 — — — — — — 1 Acute Poliomyelitis — — — — — 1 1 — 2 — — — 4 Ophthalmia Neonatorum 1 -— — — — — — — — — — — 1 ANALYSIS OF NOTIFIABLE DISEASES (after correction). Diseases Total cases Total admitted to hospital Scarlet Fever 78 41 Erysipelas 13 6 Puerperal Pyrexia 1 1 Pneumonia 78 24 Cerebro-Spinal Fever 3 3 Measles 355 7 Whooping Cough 190 4 Dysentery 1 — Acute Poliomyelitis 4 3 Ophthalmia Neonatorum 1 1 32 Birth-rates, Civilian Death-rates, Analysis of Mortality, Maternal Mortality and Case-rates for certain Infectious Diseases in the year 1948. (Provisional figures based on 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 PoDulation : — Deaths : Rates per 1.000 Live Births : — Live Births 17.9 (a) 20.0 19.2 20.1 15.9 All causes under 1 year of age 34(b) 39 32 31 21.5 Still Births 0.42(a) 0.52 0.43 0.39 0.36 Deaths: All Causes 10.8(a) 11.6 10.7 11.6 7.3 Enteritis and Diarrhoea Typhoid and Paratyphoid. . 0.00 0.00 0.00 0.00 under 2 years age 3.3 4.5 2.1 2.4 Whooping Cough 0.02 0.0,2 0.02 0.01 — Diphtheria 0.00 0.00 0.00 0.01 — Tuberculosis 0.51 0,59 0.46 0.63 0.45 Influenza 0.03 0.03 0.04 0.02 — Rates per 1,000 Total (Live and Still) Births. Smallpox — — — — — Acute Poliomyelitis and Polioencephalitis 0.01 0.01 0.01 0.00 Notifications: (Corrected) Pneumonia Notifications (Corrected) 0.41 0.38 0.36 0.54 0.34 Puerperal Fever and Pyrexia . . 6.89 8.90 4.71 7.34(c) 1.31 Typhoid Fever . . 0.01 0.00 0.01 0.00 — Paratyphoid Fever 0.01 0.01 0.01 0.01 — Cerebro-spinal Fever 0.03 0.03 0.02 0.03 0.06 Maternal Mortality in England and Wales : Scarlet Fever .. 1.73 1.90 1.82 1.37 1.-67 Whooping Cough 3.42 3.51 3.31 3.13 4.07 Rates per 1,000 Total (Live and still)Births Rates per million women aged 15-44 Diphtheria 0.08 0.10 0.09 0.10 — Erysipelas 0.21 0.23 0.21 0.22 0.27 Smallpox — — — — — Measles 9.34 9.75 8.84 9.17 7.61 Pneumonia 1 0.73 0.84 0.60 0.57 1.67 140 Abortion with Sepsis 0.11 9 Acute 141 Abortion without Sepsis 0.05 4 Poliomyelitis 0.04 0.05 0.04 0.04 0.08 147 Puerperal infections 0.13 Chingform 33