BOROUGH OF CHINGFORD ANNUAL REPORT of MEDICAL OFFICER OF HEALTH Including the Report of the CHIEF PUBLIC HEALTH INSPECTOR FOR THE YEAR 1957 BOROUGH of CHINGFORD ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH including the REPORT of the CHIEF PUBLIC HEALTH INSPECTOR for the year 1957 BOROUGH OF CHINGFORD Committee: June, 1957 - May, 1958 PUBLIC HEALTH COMMITTEE Chairman: Councillor G.H. Smith Vice-Chairman: Councillor H.J, Berry Members: Councillor A.T.H. Austin „ W.J. Buckley „ J. Cooper „ Mrs. 0.Corder „ A.R. Fiddes „ V.D. Hall „ Mrs, I. Titley, J.P0 The Mayor, Councillor W.J. Bowstead, J.P. (ex officio) Meeting: Second Monday in each month at 7.30 p.m. PUBLIC HEALTH OFFICERS OF THE AUTHORITY (1. 57) Medical Officer of Health: J. H. CROSBY, M.B., Ch.B. , D.P.H. Chief Public Health Inspector: JAMES F. ROGERS, M.R.S.H. (a) (b) (c) Cleansing Superintendent, Inspector under the Shops Act and Petroleum Acts. District Public Health Inspectors: C. DAY, M.A.P.H.I. (a) (b) (d) (e) (f) E. ISMAY (a) (qualified from 1.4.57) Senior Clerk: Miss V. M. PETTIT Clerks: A. H. GILLIES Mrs. B. BENNETT Miss V. A. BROOKS (a) Certificate as Public Health Inspector (b) Certificate as Meat and Foods Inspector (c) Certificate in Advanced Knowledge of duties of Public Health Inspector (d) Certificate in Sanitary Science (e) Diploma of the Royal Institute of Public Health and Hygiene (f) Certificate as Smoke Inspector 1. ANNUAL REPORT FOR THE YEAR 19 5 7 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 1957 upon the health and sanitary circumstances of the Borough. The estimated population for the year was 46,450. Vital Statistics: In the statistics which follow, the figures in brackets refer to the previous year. The number of live births was 523 (492), the birth rate being 11.2 per thousand (10.5). The rate for England and Wales was 16.1. The infant mortality rate was 15.3 Per 1,000 live births (10.1): as indicated in a previous report this rate is subject to wide fluctuations, more especially since the numbers dealt with are small. The table of Infant Mortality on page 4 emphasizes this point. The rate for England and Wales was 23.3. There were 397 deaths (392) giving a death rate of 6.5 per thousand (8.4). The rate for England and Wales was 11.5. Causes of Death: Diseases of the heart and arteries, and cancer, were the commonest causes of death, the figures being 202 and 95 respectively: these two conditions accounted for three deaths out of every four. Infectious Disease: With the exception of measles, the incidence of infectious disease was low. There were 870 cases of measles with one death. There were no cases of diphtheria. The three cases of poliomyelitis were of the paralytic type, of whom two made a full recovery, the third having some residual weakness of one arm. The scheme for vaccination against this disease expanded considerably as more vaccine became available. The Chiropody Service for persons of pensionable age continued to attract great numbers; the scheme has been working at full pressure and there is a long waiting list. 2. Dr. F.G. Brown, Area Medical Officer, has kindly supplied the statistical natter on page 6. It is with pleasure that I record my thanks to all members of my staff for their co-operation throughout the year, and my sincere appreciation to the Chairman and Members of the Health Committee for their continued support. J. II. CROSBY Medical Officer of Health August, 1958. 3. SECTION A STATISTICS AMD SOCIAL CONDITIONS OF THE AREA Area 2,868 acres Population - Registrar-General's estimate for mid-year 1957 46,450 Number of inhabited house and flats (as at 31.12.57) 13,766 Rateable value on April 1st, 1957 £704,242 Product of a penny rate on 1.4.57 £3,219. 4. 4. VITAL STATISTICS M F. Live Births (Total 291 232 (Birth Rate per 1,000 (Legitimate 281 223 (of estimated resident (Illegitimate 10 9 (population: 11.2 Stillbirths (Total 6 3 (Rate per 1,000 total (Legitimate 5 3 ((live and still) (Illegitimate 1 - (births: 16.9 Deaths 206 191 (Crude Death Rate per (1,000 of estimated (resident population: ( 8.5 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 15.3 Legitimate infants per 1,000 legitimate live births 15.8 Illegitimate infants per 1,000 illegitimate live births - Deaths from Cancer (all ages) 95 „ „ Measles (all ages) 1 „ „ Whooping Couch (all ages) 0 4. TABLE OP BIRTH AND HEATH RATES Year Population Births Rate per 1,000 population Deaths Rate per 1,000 population Infant Mortality Deaths Rate per 1,000 live "births 1952 48,190 567 11.8 394 8.2 10 17.6 1953 47,770 603 12.6 386 8.1 8 13.3 1954 47,600 557 11.7 382 8.0 13 23.3 1955 47,310 472 9.9 343 7.2 6 12.7 1956 46,840 492 10.5 392 8.4 5 10.1 1957 46,450 523 11.2 397 8.5 8 15.3 5. SECTION 3 GENERAL PROVISION OF HEALTH SERVICES IN THE AREA (a) Laboratory Facilities Pathological specimens from this district are examined at the Pathological Departments of the St. Margaret's Hospital, Epping, the Connaught Hospital, Walthamstow, and the Whipps Cross Hospital, Leytonstone. Specimens may (by arrangement) also be left at the Town Hall, Walthamstow, on weekdays before 2.30 p.m., for collection and delivery to the Central Public Health Laboratory at Colindale. (b) Ambulance Service The Ambulance Service, maintained and controlled by the Essex County Council, has an Ambulance Station situated in Station Road, (near The Green), Chingford, which serves this area. The Station is manned continuously: the telephone number is Silverthorn6856. The general procedure for obtaining an ambulance in emergency is as follows:- Where there is a dialling system in operation in the Chingford area, dial "999." Where there is no dialling system, lift receiver and ask for an ambulance. (c) Midwifery and Home Nursing Service The Home Nursing Services are administered by the Essex County Council. Maternity nursing and midwifery cases, in addition to a large number of general nursing visits, have been undertaken. Number of Midwives or Home Nurse/Midwives - 4 * „ „ Home Nurses - 2 / (Miss D.L. Chandler, 87, Friday Hill, E.4. Silverthorn 4968 (Miss C. Lovell, 49, The Ridgeway, E.4. „ 1460 * (Mrs. P.M. Stenning, 78, Larkswood Road, E.4. „ 5414 (Miss P.M. Wilson, 33a, Woodland Road, E.4. „ 7665 (Mrs. E.V. Whiter, 79, Harold Road, .hi.4.(part-time) „ 6194 (Mr. J. Punchon (commencing duty on 26.9.58) 6. Number of cases attended by Midwives as:- (a) Midwives - 98 (b) Maternity nurses 28 - 126 Number of visits paid by Home Nurses - 23,697 (d) Health Visiting The total number of visits paid by the Health Visitors during the year was 5,028. (e) Registered Nursing Homes There were two registered Nursing Homes in the district, one receiving maternity and medical patients, and the other receiving medical cases only. The Homes were inspected regularly and found to be conducted in a satisfactory manner. Both establishments closed during the latter part of the year, (f) Clinics and Treatment Centres See table of clinics on pages 8 and 9, Child Welfare Centres Attendances of children - under 1 year of age 8,597 „ „ „ - between 1 & 2 years 1,738 „ „ „ - 2 & 5 „ 1.216 Total 11,551 Ante-Natal Clinics Ante-natal attendances 955 Post-natal „ 15 Total 970 Women's Welfare Clinic Birth control - 1st visits 31 „ „ - revisits 227 Total 258 7. The hospitals providing general medical services for Chingford residents are chiefly the Connaught Hospital, Walthamstow, and the Wanstead Hospital, Wanstead. Persons with infectious disease, needing admission to hospital, are accommodated at the Honey Lane Hospital, Waltham Abbey, or at Isolation Hospitals in nearby districts; or, if no bed is available at these hospitals, the Emergency Bed Service arranges admission to the nearest hospital where a bed is available. (h) Day Nurseries There is one Day Nursery in the district, situated at 136/138, Chingford Mount Road. Regular medical inspection of the children attending this Nursery 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 Area Medical Officer, Municipal Offices, High Road, Woodford, E.18. (j) Chiropody Facilities A chiropody clinic for persons of pensionable age only is held on Thursday afternoons at the Essex County Health Services Clinic, Marmion Avenue, South Chingford. Appointments to attend this clinic must be made through the Area Medical Officer, Municipal Offices, High Road, Woodford, E.18. The chiropody scheme for Chingford residents of pensionable age, sponsored by the Chingford Old People's Welfare Committee and administered by the Health Department, proceeded at full pressure throughout the year. Since its inception in September 1956, 420 persons have applied for treatment, of whom 207 are actually receiving it at the present time. It must be pointed out that chiropody treatment of elderly persons is, by its very nature, of a continuous and recurring character, which, in a limited scheme of this kind, creates a long and very slow-moving waiting list. Thus there are at the present time about 97 persons awaiting their first treatment; a few of 8. these persons have been waiting for almost eighteen months. All applicants are informed of the delay that may be expected before they can be called for treatment and are advised to make private arrangements for this meanwhile. The extension of the scheme is hampered by financial considerations. In addition to the foregoing facilities, four persons, hold licences from the Essex County Council to carry on private practice as chiropodists within the borough. These premises are inspected annually. LOCAL CLINICS AND TREATMENT CENTRES. 1950 Clinic Where held When held Diphtheria Immunisation Clinics Primary Hall, Buxton Road, North Chingford. Tuesday, 2 p.m. St. Francis' Hall, Hawkwood Crescent, E.4. Wednesdays, 2 p.m. E.C.C. Health Services Clinic, Marmion Avenue, E.4. Thursdays, 11.30 a.m. E.C.C. Health Services Clinic, Hatch Lane, E.4. Wednesdays, 2 p.m. Parish Church Hall, The Ridgeway, North Chingford. Wednesdays, 10 a.m. Ante-Natal Clinics E.C.C. Health Services Clinic, Hatch Lane, E.4. Tuesdays, 2-4 P.m. E.C.C. Health Services Clinic, Marmion Avenue, E.4. Fridays, 2-4 p.m. Child Welfare Clinics E.C.C. Health Services Clinic, Hatch Lane, E.4. Wednesdays, 2-4 P.m. E.C.C. Health Services Clinic, Marmion Avenue, E.4. Tuesdays & Wednesdays, 1.45 - 3.45 p.m. Primary Hall, Buxton Road, North Chingford. Tuesdays, 2-4 p.m. St. Francis' Hall, Hawkwood Crescent, E.4. Wednesdays, 2-4 p.m. Parish Church Hall, The Ridgeway, North Chingford. Wednesdays, 9.30 - 11.45 a.m. Toddlers' Clinic E.C.C. Health Services Clinic, Marmion Avenue, E.4. Thursdays, 10.0 - ll.30 a.m. (continued:) 9. LOCAL CLINICS & TREATMENT CENTRES, 1958 (cont:) Clinic Where held When held Minor Ailment & School Clinics E.C.C. Health Services Clinic, Hatch Lane, E.4. 1st,2nd,4th Mondays, 2-4 P.m. E.C.C. Health Services Clinic, Marmion Avenue, E.4. Mondays, 10 - 12 noon Ophthalmic Clinic (as aranged by Reg. Hosp. Board) E.C.C. Health Services Clinic, Hatch Lane, E.4. Friday afternoons (by appointment only) Orthopaedic Clinics (as arranged by Reg. Hosp. Boat ) E.C.C. Health Services Clinic, Hatch Lane, E.4. Weds. & Thursdays at 2 p.m. E.C.C. Health Services Clinic, Marmion Avenue, E.4. Mondays at 2 p.m. (both by appmt. only) Dental Clinics E.C.C. Health Services Clinic, Hatch Lane, E.4. Wednesdays, 9.30 10.45 a.m.(inspections) E.C.C. Health Services Clinic, Mamion Avenue, E.4. Mondays, 9-10 a.m. (inspections) Women1 s Welfare Clinics E.C.C. Health Services Clinic, Hatch Lane, E.4. 1st Friday in every mth. 10 - 12 noon KBgn E.C.C. Health Services Clinic, Marmion Avenue, E.4. 4th Friday in every mth. at 10.15 a.m. Chest Clinic Old Monoux School, High St. Walthamstow, E.17. New cases: Adults,Weds. 10 - 12 noon New cases:Children,Fris, 10 - 12 noon Foot Clinic (Old Age Pensioners) E.C.C. Health Services Clinic, Marmion Avenue, E.4. Thursdays, 2 p.m. (by appointment only) GENERAL DEFORMATION National Assistance Board: 29, Cambridge Park, Wanstead, E.ll.(Wanstead 7721) Office hours: Mondays to Fridays, 9 a.m. to 5 p.m. Saturdays, 9 a.m. to 1 p.m. Registrar of Births, Deaths & Marriages: Mr. C.W. Barrett, Town Hall, Chingford, E.4. (Silverthorn 3944 and Loughton 576) Office hours: Tuesdays and Thursdays, 2.30 - 4.30 p.m. Wednesdays & Saturdays, 9-11 a.m. (continued:) 10. GENERAL INFORMATION (continued) National Health Insurance Office: 11a, The Ridgeway, Chingford, E.4. Office hours: Mondays to Fridays, 10 a.m. to 4 p.m. Saturdays, 9 a.m. to 12 noon. Duly Authorised Officers: E.C.C. Offices, West Avenue, Walthamstow, E. (Coppermill 2418) Office hours: Mondays to Fridays, 9 a.m. to 5.30 p.m. Saturdays, 9 a.m. to 12.30 p.m. Social Welfare Department: E.C.C. Offices, 35, Wanstead Place, E.ll. (Wanstead 0031) 11 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA Water Supplies. A hard, pure and constant piped water supply is provided by the Metropolitan Water Board; the supply has been satisfactory in both quality and quantity. Rivers and Streams. Forty-one visits were made during the year in connection with the pollution of water courses. Informal action secured the abatement of minor instances of pollution. Fly Nuisance. The emergence of flies from the waters of the Metropolitan Water Board Reservoirs was again experienced and for the year under review was a spring emergence in the vicinity of the William Girling Reservoir. Prompt action by the Water Board was again effective in providing at least temporary relief from the nuisance. Public Cleansing. A weekly collection of refuse and salvage was maintained and the total weight of refuse disposed of at the Works was 12,200 tons as compared with 12,044 tons for the previous year. The Registrar General's estimate of population at the mid-year 1957 indicated a further decline, being 46,450 as against the estimate for mid-year 1956 of 46,840.. The number of premises from which refuse was collected showed an increase, being 14,421 as against 14,378 for the previous year. The anlysis of income on page 15 reveals a total figure of £12,398 as against £12,164 for the previous year. Whilst the sale of waste paper made a major contribution to this figure, notable sums were also received from the sale of metals, both ferrous and non-ferrous, cullet, bottles, jars and textiles. The net cost per ton for the collection of refuse was 3l/8d. as against 30/-d. for the year ended March, 1957, and 27/1d. for the year ended March, 1956. The increase in the unit cost per ton was due to Wage Awards, no additional men being employed during the year. Five refuse collection vehicles were in daily use, with an additional vehicle, a Ford Thames 4 ton vehicle fitted with a 4cylinder diesel engine and a 15 cu. yd. "Eagle" Derby type body. 12. One replacement vehicle was also purchased during the year, and this also was fitted with a diesel engine. The net cost per ton for the disposal of refuse was 5/9d. as compared with 6/lOd. in the previous year and 4/8d. for the year ended March, 1956. The net expenditure for the collection and disposal of refuse and salvage, including loan charges, was £22,862 or 37/5d. per ton as against £22,193 or 36/lOd. per ton for the previous year. The three 24-cell Morrison Electric Trucks used in connection with street cleansing, continue to function satisfactorily. They have now been in continuous use for five years and new batteries of 238 ampere/hours capacity each were provided to each vehicle during the year. Road gullies were cleansed by contract as in the previous year, those gullies in main roads being cleansed four times per year and those in district roads twice per year. The public sanitary conveniences were maintained in good condition throughout the year, but wilful damage continued at the three conveniences which have not full-time attendants. Repairs items for the year 1957/58 show an increase due to costs involved in the repainting of the three vehicles. Item 1957/58 (Actual) 1958/59 (Estimated) Electricity £42 £45 Water and Oil 1 6 Cleaning Materials and Equipment 6 12 Repairs 27 195 Tyres 60 60 Maintenance Contract 6 30 Insurance and Licences 81 81 £223 £429 13. COLLECTION AND DISPOSAL OP HOUSE AND TRADE REFUSE COST STATEMENT 1937/58 Item Particulars Collection Disposal Totals Percentage of total gross expenditure 1 2 3 4 5 REVENUE ACCOUNT £ £ £ % 1 GROSS EXPENDITURE (i) Labour 10624 8820 19444 55 (ii) Transport 8668 - 8668 24 (iii) Plant,equipment,land and buildings 211 3286 3497 10 (iv) Other items 389 3263 3652 11 (v) Total gross expenditure 19892 15369 35261 100 2 GROSS INCOME 556 11843 12399 - 3 NET COST 19336 3526 22862 - 4 Capital expenditure met from revenue (included above) 173 329 502 UNIT COSTS s. d. s. d. s. d. 5 Gross cost per ton, labour only 17. 5. 14. 5. 31.10. 6 Gross cost per ton,transpor only t 14. 3. - 14. 3. 7 Net cost (all expenditure) per ton 31. 8. 5. 9. 37. 5. £ £ £ 8 Net cost per 1,000 population 416 76 492 9 Net cost per 1,000 premises 1341 244 1585 14. OPERATIONAL STATISTICS 10. Area (statute acres) - land and inland water 2868 acres 11. Population at 30th June, 1957 (RegistrarGeneral's Estimate) 46450 persons 12. Total refuse collected 12200 tons 13. Weight per 1,000 population per day (365 days to year) 14.4 cwts. 14. Number of premises from which refuse is collected 14421 premises 15. Premises from which collections are made at least once weekly 100% of total 16. Average haul, single journey, to final disposal point (including miles by secondary transport) 1 mile 17. Kerbside collection expressed as estimated percentage of total collection NIL % 18. Total refuse disposed of (of which Nil tons were disposed of for other local authorities) 12200 tons 19. Methods of disposal (salvage excluded) (a) Crude tipping - (b) Controlled tipping 56 % (c) Direct incineration - % (d) Separation and incineration 44 % (e) Other methods - % 100 % 20. Salvage. Analysis of income and tonnage: Income (included in item 2.) Tonnage Collected (included in item 12.) £ Tons (a) Raw Kitchen Waste 162 21 (b) Scrap Metal 3133 516 (c) Waste Paper 5913 724 (d) Other Salvage 2375 639 11583 1900 21, Trade Refuse. (a) Income £585 (b) Tonnage 760 15. ANALYSIS OF INCOME FOR THE YEAR Year ended ENDED 31st MARCH. 1958 31.3.57 £. s. d. £. s. d. £. s. d. £. s. d. Sale of Salvaged Articles: Metals 244. 3. 3. Iron 209. 15. 8. 226. 0. 0. Unbaled Scrap 455. 14. 4. 1150. 8. 7. Tins 148O. 10. 8. 23. 0. 0. Galvanised Tanks 26. 6. 11. 403. 2. 5. Aluminium 408. 1. 5. 241.13. 6. Copper 189. 13. 10. 44.13. 7. Lead 51. 16. 10. 13. 16. 1. Battery Lead 5. 19. 8. 39. 2. 7. Lead Type 25. 18. 10. 11. 11. 2. Pewter 16. 6. 7. 11. 8. 8. Zinc 7. 5. 10. 304. 1. 2. Brass 255. 16. 10. 3133. .7. 5. 314. 13. 5. White cullet 272. 13. 0. 46, 1. 2. Amber cullet 41. 11. 6. 921. 16. 6. Bottles & jars 903 9. 5. 1217 .13. 11. 680. 19. 0. Rags 584. 10. 9. 91. 3. 9. Carpets & Sacking 135. 18. 3. 2. 3. 9. String 2. 8. 0. 233. 6. 10. Woollens 291. 8. 7. 64. 19. 0. Flock Bedding —56. 3. 0. 1070. 8. 7. 6l66. 16. 3. Newspaper & Mixed Paper, etc. 5912. , 14. 9. 25. 18. 9. Bones 25. 4. 0. 116. 7. 0. Pig Food (Bread) 136. 9. 0. 35. 12. 1. Rubber Tyres & Tubes 42. , 2. 11. 4. 0. 0. Unsound food (disposal) 4. 0. 0. 75. 0. 0. Screenings 40. 0. 9. 6l6l. 2. 5. 11582 12. 6. 14. 0. Miscellaneous Items 11. 0. 4. 16. 7. 0. Weighbridge Fees 11. 2. 3. Rents: 200. 0. 0. Foundry 200. 0. 0. Proportion of Allotment Rents 20. 0. 0. 20 0. 0. 2. 6. Other Rents 2. 6. Refuse Collection charges: 351. 15. 1. Greengrocers and Butchers 163. 16. 5. 77. 5. 6. Others 421. 2. 10. 12164. 2. 7. 12398. 16. 4. 16. STREET AND GULLY CLEANSING COST STATEMENT 1957/58 Item Particulars Street Sweeping and Catering Street Gully Cleansing Total Percentage of total gross expenditure l 2 3 4 5 REVENUE ACCOUNT £ £ £ % 1. GROSS EXPENDITURE (i) Labour 4629 19 4648 58 (ii) Transport 2277 5 2282 29 (iii) Plant,equipment, land & buildings etc. 146 - 146 2 (iv) Other items 312 592 904 11 (v) Total gross expenditure 7364 616 7980 100 2 GROSS INC0ME(excluding reimbursements from Ministry of Transport and the County Council 80 - 80 - 3 NET COST 7284 616 7900 - 4 Capital expenditure met from revenue (included above) - - - - 5 Gross expenditure on sanding, gritting and snow clearance, not included previously. 783 - - - UNIT COSTS £ £ £ % 6 Net cost (item 3) per street mile 130 - - - 7 Net cost (item 3) per 1000 street gullies cleansed 186 - - 8 Net cost (item 3) per 1000 population 157 13 170 - 17. OPERATIONAL STATISTICS 9. Mileage of streets cleansed 56 10. Frequency of cleansing: (a) At least once daily -% (b) Three to five times weekly 5% (c) Twice weekly -% (d) Once weekly 95% (e) Less than once weekly -% 11. Percentage of street cleansing done by mechanical means Nil% 12. Number of street gullies cleansed 3301 13. Number of gully cleansings during year (Number of gullies x number of cleansings) 7780 14. Percentage of gully cleansing done by mechanical means 100% 15. Remarks: Item 1 (iv) Gully cleansing is carried out by Contractors and the figure includes labour and transport. Item 11 Sweeping carried out by manual labour and three electric trucks are used for conveyance of sweepings. 18. SANITARY INSPECTION OF THE AREA The number of complaints received at the office and recorded in the register was 793 as compared with 823 for 1956 and 600 in 1955. The total inspections made on complaint was 404 and the number of defects or nuisances revealed was 778, which are analysed in the following table. Informal notices were at once served on the owners or occupiers of the premises concerned. TABLE 1. Nuisance from noise 1 Overcrowding 3 Nuisance from smoke, odour, dust and bonfires 29 Housing defects 93 Obstructed sewers and drains 294 Defective sewers 4 Defective drains 10 Defective W.C.s. 10 Infestations of insects, flies, ants, etc. 51 Verminous persons 1 Animals kept so as to be a nuisance - Rodent Infestations (rat and mice) 171 Offensive accumulations 16 Condition of food 40 Defective and/or insufficient dustbins 3 Water supply 9 Flooding of gardens, houses, etc. 9 19. Moveable dwellings 1 Nuisance from water courses 6 Wasps Infestations 27 778 Summary of Inspections. The total number of visits paid by the Public Health Inspectors and other personnel of the Health Department staff to various premises for all purposes is summarised below, together with the number of nuisances or defects found under specific headings. The visits numbered 7300 as compared with 8646 in the previous year, and the defects dealt with numbered 1232 as compared with 1247 in 1956. TABLE 2. Visits Paid Nuisances or Defects found and dealt with. Housing Acts 1936 and 1957. Inspections 63 134 Re-inspections re Notices served 361 Certificates of Disrepair 16 Improvements Grants 18 Overcrowding 22 On Complaint 404 778 Infectious Diseases 82 Retail Pood Premises. Meat 284 12 Pish 75 1 Pried Fish 31 1 General Provisions 255 15 Other Food Shops 248 12 Restaurant and Other Food preparing premises 251 7 Ice Cream Premises 164 Itinerant Ice Cream Vendors 18 Street Food Vendors 18 Food Sampling. Ice Cream 69 Milk 23 Other Foods 85 Drugs 1 Water 13 Factories 63 2 Slaughterhouses 22 1 Bakehouses 34 2 c/f: 2620 965 20.  Visits Paid Nuisances or Defects found and dealt with. b/f: 2620 965 Dairies 18 Outworkers 221 Rent Restrictions Act 17 Public Heath Act. Visits re. Notices served 623 Other re-visits 352 Rodent Control 1329 203 Council Houses 2 Flooding 9 Reservoirs and Flies 55 Places of Entertainment 6 Schools 37 Swimming Pool 11 Shops Act. Sanitary Conditions 245 6 hours of Closing 230 3 Young Persons Employment 50 Hairdressers' Premises 14 Public & Private Conveniences 39 Pigstyes, Stables, etc. 4 Petroleum Act. 28 River Pollution 41 2 Smoke Observations 116 Smoke (special visits) 19 Noise Nuisances 8 Refuse Collection and Disposal 310 Interviews 20 Miscellaneous visits 277 Drainage 415 53 Water Act 24 Pet Animals Act 12 Street Cleansing 140 Gully Cleansing 8 7300 1232 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, Eyclaws and other Enactments. 21. TABLE 3. Nuisance from Animals 1 Offensive Accumulations, Odours, Dust, etc. 37 Cleansing of Walls and Ceilings - Roofs, Spoutings and Eaves gutters repaired or renewed 110 External Walls repaired 70 Wall and ceiling plaster repaired 36 Floors repaired 20 Sub-floor ventilation 12 Stairs 16 Yard surface repaired 24 Woodwork of doors and sashcords, glazing and cills repaired 153 Flues and chimney stacks repaired or rebuilt 21 Dampness remedied 55 Drains cleansed 31 Drains repaired 26 Drains - new inspection chambers 1 New sinks provided 4 Water Closets repaired or reconstructed 5 Water Closet pedestals fixed 5 Water Closet flushing cisterns repaired or renewed 7 Water storage tanks and piping repaired or renewed 12 Hot Water Systems repaired 4 Dustbins provided 7 Rat Infestations 203 Sewers cleansed 294 Sewers repaired 27 Food Premises Limewashed and cleansed 4 Improvements 27 Additional Sanitary accommodation — Washing facilities provided 20 Lighting and heating improved - 1232 22. Housing Act: Preliminary Notices 5 Statutory Notices 7 Inspections of Factories and Other Premises Inspections for purposes of provisions as to health (including inspections made by Public Health Inspectors) Premises No. on Register Inspections No. of written notices. Occupiers Prosecuted 1 2 3 4 5 (i) Factories in which sections 1,2,3,4 and 6 are to be enforced. - - - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority. ♦ 71 61 - - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding Outworkers premises) 3 2 - - Total: 74 63 - - Shops Act, 1950. A total of 1279 visits were paid to shops and generally conditions were found to be satisfactory. Swimming Pool. Summaries of the total chlorine and alkalinity readings are forwarded weekly to the Health Department by the Borough Engineer, The Pool was opened on the 11th May and closed on the 8th September, 1957. The total attendance throughout the season was 160,429, the highest attendance being on the 30th June, 1957, when 11,862 persons were present. Samples of water were taken from the Pool on seven occasions during the period May to September and the results in five cases 23. indicated that the water was of a high standard of bacterial purity; in two cases, owing to very high bathing loads and exceptionally hot weather, the quality of the water deteriorated slightly, although the bacteriologist certified it to be suitable for bathing purposes. Schoolso The general condition and supply of water to schools has been satisfactory during the year. Co-operation continued with the School Medical Officer and reports were forwarded to that Officer following quarterly visits paid to the canteens attached to all Schools. During the year continued progress was made in the execution of works of repair and maintenance. Offensive Trades. Within the meaning of the Public Health Act there are no offensive trade premises in the district but there are eight fish fryers. The number of visits made to fish shops was 71. Bakehouses. Thirty-three visits were paid to the eight bakehouses in the district and generally they were maintained in a satisfactory condition. Prevention of Damage by Pests Act. 1949. A full time Rodent Operative is employed for rodent infestation work and whilst there was no evidence of major infestations in the town,1234 visits were paid to deal with minor infestations at private and business premises and in connection with sewer maintenance. The seventeenth and eighteenth maintenance treatments were carried out in April and October respectively. In April 122 manholes were baited and of these 87 showed complete or partial takes; 240 manholes were baited in October, 44 of which showed complete or partial takes. 24. NUMBER AND TRADE OF OUTWORKERS NOTIFIED DURING 1957 Wearing Apparel 179 Knitwear 93 Quilts 2 Upholstery 2 Footwear 12 Paper Bags 1 Toys. 18 Novelties 1 Button Carding 3 Recaning 1 Art Needlework 2 Paint Boxes 9 Handbags 3 Artificial 5 Flowers Brushes 34 Boxes & Stationery 15 OUTWORKERS WERE NOTIFIED FROM THE FOLLOWING AREAS:- Bradford 4 Leyton 90 Bethnal Green 5 London 15 Chingford 15 St. Marylebone 5 Edmonton 41 St. Pancras 3 Enfield 6 Shoreditch 20 Finsbury 25 Stepney 8 Hackney 97 Stoke Newington 5 Hornsey 1 Tottenham 18 Islington 10 Walthamstow 2 Kensington 8 Wanstead & Woodford 2 Lambeth 4 West Ham 1 Wood Green 1 25. SECTION D. KENT ACT. 1957. Certificates of Disrepair. The following table gives information as to the applications which were received for Certificates of Disrepair from the coming into operation of the Rent Act 1957 in July up to the 31st December 1957. It will be seen that the number of applications was small and that in all cases but one the appropriate Undertakings were given by the landlords. Number of applications for certificates 16 Number of decisions not to issue certificates 0 Number of decisions to issue certificates (a) in respect of some but not all defects 7 (b) in respect of all defects 9 Number of undertakings given by landlords under para. 5 of the First Schedule 15 Number of undertakings refused by Local Authority under proviso to para. 5 of the First Schedule 0 Number of Certificates issued 1 Improvement Grants. Six applications for Improvement Grants were received and three were granted. Sub-Standard Properties. A considerable amount of work was carried out on substandard properties in the northern part of the Borough as a result of informal notices served on the owners. Although the property was brought up to an excellent standard of fitness, improvements such as bathrooms and hot water systems were not incorporated. Five-Year Programme. Three further properties were demolished during the year, leaving a residue of five houses to be dealt with out of the fifteen which were originally submitted within the five-year programme. In the three cases mentioned, alternative accommodation was provided by the Corporation. 26. HOUSING STATISTICS FOR THE YEAR 1957. 1. Number of Houses erected during the year:- (1) By the L.A. (permanent) Traditional (including flats) 152 (2) By private enterprise (including flats) 47 199 2. Inspection of dwellinghouses during the year:- (1) (a) Total number of dwellinghouses inspected for housing defects (under Public Health or Housing Acts). 551 (b) Number of inspections made for the purpose 1535 (2) (a) Number of dwellinghouses (included under sub-head (l) above) which were inspected and recorded under the Housing Regulations 63 (b) Number of inspections made for the purpose 237 (3) Number of dwellinghouses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 0 (4) Number of dwellinghouses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 65 :X: :X: Note: This figure includes all houses where defects were found, including those which were inspected and recorded under the Housing Acts, 1936 and 1957. 3. Remedy of Defects during the year without service of Formal Notices. Number of defective dwellinghouses rendered fit in consequence of informal action by the Local Authority or their officers 31 4. Action under Statutory Powers during the year: A. Proceedings under the Housing Acts, 1936 and 1957. (1) Number of dwellinghouses in respect of which notices were served requiring repairs 5 (2) Number of dwellinghouses which were rendered fit after service of formal notices 3 27. B. Proceedings under Section 17 of the Housing Act 1957. (1) Number of Demolition Orders served 2 (2) Number of Closing Orders served 0 C. Proceedings tinder Public Health Acts: (1) Number of dwellinghouses in respect of which notices were served requiring defects to be remedied 22 (2) Number of dwellinghouses in which defects were remedied after service of formal notices 22 28. SECTION E. INSPECTION AND SUPERVISION OF FOOD. Milk Supply. The milk supply is from several large firms with dairy premises outside the Borough boundaries and mainly pasteurised. Sixteen samples of milk were analysed during the year and all were certified to he genuine. Milk (Special Designations) Regulations, 1949. 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:- 5 dealers' licences to sell milk as Pasteurised. 12 " " " " " " Sterilised. 3 supplementary licences to sell milk as Pasteurised. 4 " " " " " " Sterilised. 5 dealers' licences to sell milk as Tuberculin Tested. 1 supplementary licence to sell milk as Tuberculin Tested. 1 " " " " " " " "(Pasteurised) Food and Drugs Act, 1955. Food and Drugs Authority. The Council is the Food and Drugs Authority for the district and during the year samples approximating in number to two per thousand of the population were taken and submitted to the joint Public Analysts. Public Analyst. Mr. George Taylor, F.R.I.C., 20 Eastcheap, London, E.C.3. and Dr. J. H. Hamence, F.R.I.C., 20 Eastcheap, London, E.C.3. continued as Joint Public Analysts for the area. Samples submitted for Analysis. 103 samples of food and drugs were submitted for analysis, 92 formal and 11 informal and it will be seen by the following table that a reasonably wide field was covered. The table shows that no samples were reported upon adversely. 29. The Public Analysts drew attention to the need for a revision of the standard laid down by the Ministry of Agriculture, Fisheries and Food in relation to orange drink. The analysis of one sample showed that the drink contained a little less fruit than is normally in drinks of this nature, but nevertheless the Analysts felt it had in all probability been prepared in accordance with the Ministry's specification. One sample which created interest was that of a tinned fish and meat Preparation which was primarily sold for feeding cats. The reason for submitting this sample for examination was that it had come to the notice of the Department that this preparation was being consumed by immigrants, and the question naturally arose as to whether or not the product was fit for human consumption. An exhaustive examination, both bacteriologically and chemically showed that the preparation was sterile and free from any harmful contamination. 30. Samples taken during the year 1957. Article Number Examined Total Result of Analysis Formal Informal Genuine Non-genuine Milk 15 1 16 16 - Cream 1 1 2 2 - Butter 1 - 1 1 - Margarine with 10% butter 1 - 1 1 - Sausages - Beef 7 - 7 7 - Pork 4 - 4 4 — Steak and Kidney Pie 1 - 1 1 - " " " Pudding 2 - 2 2 — Meat Paste 2 - 2 2 - Minced Pork 1 - 1 1 - Fish & Meat Food (Kit-e-Kat) 1 1 1 - Soups (Meat & Vegetable) 4 - 4 4 - Tomato Ketchup - 1 1 1 — Potato in Powder Form 1 - 1 1 - Beef Suet - 1 1 1 - Mint Sauce 1 1 1 - Christmas Pudding 1 - 1 1 - Icing Sugar flavoured 3 - 3 3 - Cheese Spread with Ham 1 - 1 1 - Horseradish Sauce 1 - 1 1 - Dried Mint 1 - 1 1 - Corn Flour 2 - 2 2 - Ground Almonds 2 2 2 - Liquid Apples 1 - 1 1 - Barbados Sugar 1 - 1 - Fishcakes 1 - 1 1 - Cockles — 1 1 1 Salmon Spread - 1 1 1 - Smoked Cod Roe - 1 1 1 - Malt Vinegar 3 - 3 3 - Ice Lollies 1 - 1 1 - Ice Cream 4 - 4 4 - Colouring 2 - 2 2 - Rum Flavouring 1 - 1 1 - Canned Beer 1 - 1 1 - Rum 1 - 1 1 - Jam - Diabetic 1 - 1 1 - Ordinary standards 3 - 3 3 - Coconut 1 - 1 1 - Table Jelly 1 - 1 1 - Lemon Curd 1 - 1 1 Glucose Powder with Vitamin B„ - 1 1 1 - c/f: 74 10 84 84 - 31. Article Number Examined Total . Result of Analysis Formal Informal Genuine Non-genuine b/f: 74 10 84 84 - Glucose Sweets 1 — 1 1 - Diabetic Chocolate l - 1 1 - Condensed Milk 1 - 1 1 - Apple Drink 1 - 1 1 - Lemon Juice, Unsweetened 1 - 1 1 - Orange Drink 3 - 3 3 - Grapefruit Juice 1 - l 1 - Lemonade Powder 1 - 1 1 - Plain Flour 3 - 3 3 - Baking Powder 1 - 1 1 - Yeast Extract 1 - l 1 - Parrishes Pood B.P. 1 1 1 1 - Stone Milled Ginger 1 - 1 1 ~ Tea 2 - 2 2 - 92 11 103 103 - Three cases were taken before the Magistrates under the Act in relation to the following offences:- Offence Section Result Screw in Bread Roll 2 Fine £40. Yoghourt - Mould Contamination 2 Fine £3. Contaminated Food Beverage 2 Case dismissed 32. Handling, wrapping and delivery of food. Progress has continued in the maintenance of hygienic conditions in food premises in relation to these Byelaws. 1344 visits were paid to food premises, including restaurants and other food preparing premises. Set out hereafter is general information with regard to food premises and other aspects of food hygiene:- 1. The number of food premises in the area by type of business is as follows:- Fishmongers 16 Butchers 29 Provisions 47 Greengrocers 22 Bakers 14 Confectionery 43 Off Licences 7 Chemists 11 Public Houses 13 Restaurants 2+2 244 2. The number of registered food premises is as follows:- (a) the number registered under Section 16 of the Food and Drugs Act, 1955 97 (b) the number registered under the Essex County Council Act, 1933 74 (c) the number of dairies registered 8 3. The number of inspections of registered food premises during the year:- 215 4. Condemned food is disposed of by incineration at the Refuse Disposal Works. 33. Inspection of Meat and Other Foods. Public Health (Meat) Regulations 1924-32. There is one private licensed slaughterhouse in the Borough and twenty-six butchers, and the following table shows the number of animals slaughtered and inspected up to the 31st December, 1957. Cattle Calves Sheep Pigs Number killed - - 73 44 Number inspected - - 73 44 iA11 diseases except Tuberculosis & Cysticerci. - - - - Whole carcases condemned - - - - Carcases of which some part or organ was condemned - - - 6 Percentage of the number inspected affected with disease - - 5.5% 13.6% Tuberculosis only. - - - - Whole carcases condemned - - - - Carcases of which some part or organ was condemned - - - - Cysticercosis. - - - - Carcases of which some part or organ was condemned - - - - Carcases submitted to treatment by refrigeration. - - • - Generalised and totally condemned - - - - 34. CONDEMNED POOD TINNED AND BOTTLED Article Quantity Meat 157 tins Fish 41 " Fruit and Vegetables 342 " Orange Juice 6 bottles Jam & Marmalade 9 jars Soup 12 tins Milk 77 tins Ham 14 tins Cream 3 tins Bacon 1 tin Liver 12 tins Sausages 2 tins Tongue 59 tins OTHER FOODS Dried Fruit 41 packets Blancmange 4 x 7 lb. packets. Coconut 13 lbs. Rice 28 lbs. Fish 31 stone 4½ lbs. Condemnation certificates were issued in respect of the undermentioned home-killed and imported meat and offal. Beef 277¼ lbs. Lamb 132 lbs. Pork 27¼ lbs. Minced Beef 30 lbs. Liver 27¾ lbs. BACTERIOLOGICAL EXAMINATIONS The Counties Public Health Laboratories, 66 Victoria Street, London, S.W.l., undertake bacteriological examinations for the Council through the Essex County Council Bacteriological Laboratory Service. During the year, thirty-seven samples of ice-cream, as shown overleaf, seven samples of water from the swimming pool and four samples of milk were submitted to the Laboratory. 35. Ice Cream. Grade I. 33 Grade II. 1 Grade III. 1 Grade IV. 2 No. Type Colonies per ml, on Agar @ 37°C in 48 hours Coliform Test 3 tubes Bact. Coli 3 tubes Ministry Grade 1. Chocolate Bar 400 0/3 0/3 I 2. Brickette 1100 0/3 0/3 I 3. Pola Maid 500 0/3 0/3 I 4. Brickette 300 0/3 0/3 I 5. Chocolate Bar 500 0/3 0/3 I 6. Brickette 400 0/3 0/3 I 7. Brickette 200 0/3 0/3 I 8. Chocolate Bar 200 0/3 0/3 I 9. Brickette less than 100 0/3 0/3 I 10. Chocolate Bar 200 0/3 0/3 I 11. Brickette 300 0/3 0/3 I 12. Brickette 300 0/3 0/3 I 13. Brickette 600 0/3 0/3 I 14. Loose from bulk 300 0/3 0/3 I 15. Brickette 400 0/3 0/3 I 16. Brickette 100 0/3 0/3 I 17. Brickette 200 0/3 0/3 I 18. Pola Maid 500 0/3 0/3 I 19. Brickette 240000 1/3 3/3 IV 20. Brickette less than 100 0/3 0/3 I 21. Brickette 500 0/3 0/3 I 22. Brickette less than 100 0/3 0/3 I 23. Brickette 3000 0/3 0/3 I 24. Brickette 300 0/3 0/3 I 25. Brickette 180000 0/3 3/3 III 26. Brickette 240000 0/3 3/3 IV 27. Loose from bulk 100 0/3 0/3 I 28. Brickette 9300 0/3 0/3 I 29. Chocolate Bar 300 0/3 0/3 I 30. Chocolate Bar 300 0/3 0/3 I 31. Pola Maid 400 0/3 0/3 I 32. Brickette 100 0/3 0/3 I 33. Loose from bulk 400 0/3 0/3 I 34. Brickette 100 0/3 0/3 I 35. Brickette 200 0/3 0/3 I 36. Canada Bar 30000 0/3 1/3 II 37. Brickette 300 0/3 0/3 1 36. SECTION F PREVENTION AND CONTROL OF INFECTIOUS AND OTHER DISEASES Diphtheria This has been the seventh successive year in which no case of diphtheria was notified to the health department. Primary and secondary immunisation against this disease was carried out to the following extent in children under 15 years of age:- Primary immunisations - under 5 years - 520 " " - 5 to 15 years - 30 Total - 550 Number receiving secondary or reinforcing injections - 229 Scarlet Fever This disease was of a mild character in all the 54 cases that occurred in the Borough. The following table indicates the cases notified during the past five years and the percentage of cases removed to hospital 1953 1954 1955 1956 1957 Confirmed cases 168 64 33 65 54 Percentage removed to hospital 37 17 27 26 9 Measles Measles was the most prevalent of the infectious conditions with a total of 870 cases, the highest number since 1952. Six of the cases only were admitted to hospital; there was, unfortunately, one death. Whooping Cough The incidence of this condition was very low - 52 cases only being notified. The number of children who received a full course of immunisation against this disease during 1957 was 26l. 57 Acute Poliomyelitis There were three cases during the year, all being paralytic poliomyelitis. Pull recovery took place in two of the patients, the third, a child of three years, having some residual paralysis of one arm. Vaccination against poliomyelitis, which commenced in 1956, expanded appreciably during 1957 when a total of 1,249 children were vaccinated. Tuberculosis Thirty-two new cases of pulmonary tuberculosis and 3 new cases of tuberculosis of other organs were recorded in 1957. In addition, 11 established cases of pulmonary tuberculosis originally acquired in other areas, took up residence in the Borough. There were five deaths from this disease. B.C.G. vaccination of school children in their fourteenth year was offered to all those children who were eligible; 365 children were thus vaccinated after parental consent had been obtained. This represents only 65% of those who were offered vaccination. Vaccination with B.C.G. vaccine is a measure of proved value and many more parents are urged to consent to their children being vaccinated. The Walthamstow and Chingford Association of Tuberculosis Care Helpers gave material assistance in the way of milk, groceries, clothing, etc. to the families of tuberculous persons who were in need of such support. The Chingford Borough Council makes an annual contribution to the funds of this Association. Mass Radiography During September, the Mass Radiography Unit visited the town and held a total of eleven sessions at three convenient centres. The analysis of this survey is as follows:- Males Females Total Number examined 1316 2181 3497 Cases of pulmonary tuberculosis discovered:- Presumed healed 5 Cases needing occasional clinic supervision, 9 Cases needing close clinic supervision 2 Cases needing immediate treatment 7 Other conditions discovered:- Heart and arterial diseases 7 Other abnormalities 16 38. Dysentery No cases were notified during the year. The need, however, for hygienic practices to prevent this disease and the enteric group of diseases cannot be too strongly emphasised: careful handwashing after every visit to the toilet and also before preparing and eating food is the key to the successful elimination of them. Much can and is being done at school to train children in hygienic ways, but it is in the home that a solid foundation in healthy habits can be established; the good example of parents and older children is invaluable in this respect. Young children, in particular, need constant supervision and training in this matter. Food Poisoning There were seven cases of food poisoning all of which were investigated. In five of them it was possible to identify the causal agent. Three of the seven cases arose from an outbreak at a school in a neighbouring area. Food Hygiene The Health Inspectors maintained close liaison with all food premises in the Borough. Vaccination 875 persons received primary vaccination and 499 were revaccinated during the year. These figures are a great increase on those for 1956, viz: 309 and 178 respectively, and there is no doubt in my mind that this sudden increase was due to the occurrence of a case of smallpox in an adjoining authority and a suspected case in another one. How the public flock to the vaccination centres when smallpox is near at hand, only to neglect it when the risk has passed! The tragic thing about this is that flocking to the vaccination centres may be too late to avert the disease in every case. Vaccination should be carried out in early infancy and revaccination every three years. National Assistance Act. 1948 (a) Section 47: Care of Aged and Chronic Sick. There were no cases needing statutory action under this section. Hospital accommodation, or accommodation in hostels for the aged, was arranged for several aged and infirm persons. In a few other instances the provision of a home help obviated the need for hospital care. 39. (b) Section 50: No burials needed to be arranged by the Council under Section 50. Medical Examinations During the year 112 examinations were carried out by me in respect of Chingford Council staff and 56 in respect of staff of the Essex County Council, CAUSES OF DEATH AS GIVEN BY THE REGISTRAR-GENERAL FOR THE YEAR 1957 Causes of death Males Females Total Tuberculosis, respiratory 3 2 5 Syphilitic disease 1 - 1 Measles 1 - 1 Malignant neoplasm, stomach 6 - 6 Malignant neoplasm, lung, bronchus. 23 5 28 Malignant neoplasm, breast 1 12 13 Malignant neoplasm, uterus - 2 2 Other malignant & lymphatic neoplasms 22 24 46 Leukaemia, aleukaemia - 1 1 Diabetes - 1 1 Vascular lesions of nervous system. 18 30 48 Coronary disease, angina 4 6 16 62 Hypertension with heart disease 1 2 3 Other heart disease 23 38 61 Other circulatory disease 12 16 28 Influenza - 1 1 Pneumonia 5 9 14 Bronchitis 20 6 Other diseases of respiratory system. 3 3 6 Ulcer of stomach and duodenum 3 1 4 Gastritis, enteritis & diarrhoea - 2 2 Nephritis and nephrosis 1 - 1 Hyperplasia of prostate 1 - 1 Congenital malformations 1 2 3 Other defined & ill-defined diseases. 12 17 29 All other accidents 2 - 2 Suicide 1 1 2 Totals - all causes 206 191 397 Totals - year 1956 214 178 392 40. DEATHS FROM CANCER There were 95 deaths from cancer, of which 93 occurred in persons over the age of 45 years. The following chart tabulates the sites, age and sex groups. Site 0-44 years 45 years and over Total M. F. M. F. M. F. Gastro-intestinal tract. 1 - 6 10 7 10 Lungs and Mediastinum. - - 23 5 23 5 Genito-urinary organs. - 1 10 4 10 5 Breast . - 1 12 1 12 Other sites - - 11 11 11 11 Totals 1 1 51 42 52 43 Death rate = 2.04 per 1,000 (as compared with 1.66 per 1,000 in 1956) 41. TUBERCULOSIS NEW CASES TRANSFERS DEATHS Respiratory Non Respiratory Respiratory NonResp iratory Respiratory NonResp iratory M F. M. F. M. F. M. F. M. F. F. 0 to 1 year - - - - - - - - - - - - 1 to 4 years - - - - - - - - - - - - 5 to 14 years 1 2 - 1 - - - - - - - - 15 to 24 years 5 4 1 - 1 1 - - - - - - 25 to 34 years 1 1 1 - 2 1 - - - - - - 35 to 44 years 5 1 - - 3 1 - - 1 ж - - - 45 to 54 years 5 - - - - - - 1 - - - 55 to 64 years 4 1 - - 1 . - - 1 - - - 65 and upwards 2 - - - - 1 - - 1 - - - TOTALS 23 — 9 2 1 7 4 - - 4 - - - Add - deaths of un-notified cases - 1 - - 4 1 - - ж note a tuberculous death 42. NOTIFIABLE DISEASES (after correction) Year Scarlet Fever Erysipelas Measles Whooping Cough Tuberculosis Dysentery Puerperal Pyrexia Pneumonia Meningococcal Infection Acute Poliomyelitis Acute Infective Encephalitis Typhoid or Paratyphoid Fever Food Poisoning Malaria Pulmonary Other forms 1952 181 6 893 66 30 4 10 1 24 1 4 - 1 4 - 1953 168 9 380 181 39 5 22 - 34 1 6 1 - 5 - 1954 64 5 195 138 30 2 17 2 17 - 4 - - 3 1 1955 33 5 492 14 20 2 7 1 18 1 12 - - 9 - 1956 65 5 5* 249 20 2 23 1 17 1 1 - 1 * 4 1 1957 54 5 870 52 32 3 - - 26 - 3 ~ - 7 - 43. NOTIFIABLE DISEASES TABULATED ACCORDING TO AGE (after correction) Diseases Under 1 year 1 2 3 4 5-9 10-14 15 - 19 2 0 -34 35-44 45-64 65 & over Totals Scarlet Fever - 1 1 4 - 33 7 2 - - - - 54 Erysipelas. - - - - - - - - 1 2 1 1 5 Measles 15 47 83 104 100 511 8 — 2 - — - 870 Whooping Cough 4 2 4 6 5 27 2 - 1 - - 1 52 Pneumonia - 1 - - - 5 1 - 4 2 6 7 26 Food Poisoning - - - - - 2 - 1 - 1 3 ~ 7 Acute Poliomyelitis - - 1 1 - - " 1 " " - 3 ANALYSIS OF NOTIFIABLE DISEASES (after correction) Diseases Total cases Total admitted to hospital Scarlet Fever 54 5 Erysipelas 5 1 Measles 870 6 Whooping Cough 52 3 Pneumonia 26 5 Food Poisoning 7 2 Acute Poliomyelitis 3 3