LON 67 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON for the year 1941. 1. STAFF. Date of Appointment. MEDICAL OFFICER OF HEALTH. White, Charles Francis, M.D., Ch.B., D.P.H., D.T.M Dec .1937. CLERICAL STAFF. Lowe, George Principal Assistant & Vaccination Officer Nov.1902. Gray, Charles M 1st Class Assistant Mar .1911. Blunt. Harold F 2nd Class Assistant May.1924. Stout, James Erl. (on Active Service) 3rd Class Assistants Jul.1930. Threadgold, Arthur W. Nov.1923. Stevens, F.W. (on Active Service) Nov .1937. Peters, E.J. (on Active Service) Unclassified Assistants Nov.1935. Wilson, J.C. (on Active Service) Jan.1936. Clements, K.N.H. (on Active Service) Nov.1936. SANITARY INSPECTORS. Robinson, Ernest S. Senior Inspectors Feb.1913. Fowler, George Henry. Oct.1920. McGrath, William Richard. Mar.1922. Harrington, George Edwin. Dec .1925. Sillett, David Ernest. Apr .1926. Neale, William G.C. Jul.1928. Thorpe, Robert C. Mar.1930. Webber, G.A.(Rat Officer) Junior Inspectora Jul .1932. Hudson, Leslie A. Apr .1934. Aldhous, H.J. Apr .1935. Holloway, A.B. (on Active Service) May .1937. Cox, C.R. (on Active Service) Oct.1938. Scott, A.E.R. Oct .1938. MEAT INSPECTION STAFF. Grace, L.B.A., M.R.C.V.S. Veterinary Officer and Chief Meat Inspector Jun.1934. Kitchener, William E. Senior Inspector Dec .1910. Matson, William S. Senior Inspectors Dec .1910. Slatter, Charles. May.1908. Murray, Samuel B. Sep.1911. Mellish, Cyril E. Jan.1912. Thompson, Frank E. Jul.1924. Perris, G.A. (killed on Active Service dec.1941) Dec.1923. Cann, S.W. J (on Active Service) Junior Inspectors May.1927. Peyton, H.R. (on Active Service) Sep.1932. Lee, W.R. J (on Active Service) Jul.1930. Bernhardt, D.R. Probationary Meat Inspectors May.1931. Seymour, K.D. (on Active Service) ) Jul.1935. WOMAN SANITARY INSPECTOR. Wilkinson, Miss Annie M. Jul,1909. TUBERCULOSIS SISTER & HEALTH VISITOR. Backhouse, Miss S.A. Jun.1931. TUBERCULOSIS NURSE & ASST. HEALTH VISITOR. Scott,Miss J.F. Apr.1938 KEEPER OF THE MORTUARY. Steggles, T. DISINFECTOR. Dec.1918. McDonnell, R.J. Apr.1903 MESSENGERS Betts, Charles (Head Messenger) Apr.1926. (on Active Service) Tierney, T.E. (Temporary)Dec.1926. LABOURERS. Hastings, T. (General Duties at Mortuary) jun.1920. Burton,John H. mar.1936. LaWRENCE, F.H may.1936. (on Active Service) Ludgate,G. (General Duties at Smithfield Market) Oct.1906. Strong;s.r. mar.1914. Prevost; A.C. feb.1923. ???ann, Ernest V. jan.1928. lawrence, Charles J. feb.1928. Graham, Mrs. (Bath Attendant and Cleaner) June.1927. "ST To the Right Honourable, The Lord Mayor, Aldermen & Commoners of the Corporation of London. Public Health Department, Guildhall, E.C.2. June, 1942. my Lord Mayor & Gentlemen, I have the honour to submit a report on the work of my Department for the year 1941. On the instructions of the Minister of Health, this report is again presented in an abridged form and briefly summarises the activities of the Department, the normal work of which has been restricted by war circumstances. Some increase, however, has been noticeable in connection with the Maternity & Child Welfare Centre, as a result of a return to the City of some of the families which were evacuated in 1940. Particular attention has been given to the rat problem and also to the supervision of food supplies. Statistical Information. Area. 661 acres (including the Temple and Tidal Water and foreshore). Population. Registrar General's estimate for 1941 - 6120. Annual Rateable Value . As at October, 1941 - £6,609,955. Annual Sum received from Penny Rate. Estimated £27.541. Births Total. M. F. Legitimate 34 17 17 Birth Rate per 1,000 estimated resident population 1941 - 6.4 Live Births Illegitimate 3 1 2 Stillbirths 2 2 - Rate Per 1,000 total (live and still) births - 51.3 Deaths under 1 year - - - Deaths 110 72 38 Death Rate per 1,000 estimated average population - 18.0 Deaths from puerperal causes (Headings 29 and 30 of the Registrar General's Short List) . Deaths. Rate per 1,000 total (live and still) births. No.29 Puerperal sepsis Nil. No.30 Other puerperal causes Nil. Total Nil. Death Rate of Infants under one year of age All Infants per 1,000 live births Nil. Legitimate Infants per 1,000 legitimate live births Nil, Illegitimate Infants per 1,000 illegitimate live births Nil. Deaths from Cancer (all ages) 14 " Measles (all ages) - " Whooping Cough (all ages) - " " Diarrhoea (under 2 years of age) - Vaccination. of the 43 births notified to the Vaccination Officer during 1940, 11 had been successfully vaccinated by the end of 1941. None had died before the age for vaccination and none was insusceptsible. Vaccination was postponed in no cases,and 22 had removed into 3. other districts. no case was pending. There were 10 cases of conscientious objection. .The Public Vaccinator performed 2 revaccinations during the year, and in addition to the successful vaccinations referred to above, 3 adult persons were vaccinated for the first time. MATERNITY & CHILD WELFARE. No of City Births notified (including stillbirths) 18 Total Visits by Health Visitors 407 Under one year 107 Over one year and under 5 years 236 Ante Natal 63 Ophthalmia - Still Births 1 Infant Life Protection - Home Helps - Scabies 2 Visits to Shelters for Homeless People 37 Milk supplied to Expectant and Nursing Mothers and young children liquid 0 gln dried milk 62 lbs INFANT WELFARE CENTRE. No. of Sessions (including sessions for Diphtheria Immunisation and Schick Testing) 151 Attendances Under one year 261 Over 1 year and under 5 years 305) 646 Mothers 80 Dentures provided 1 Home Helps provided - No. of children immunised against Diphtheria 43 No. of injections 125 INFECTIOUS DISEASE. Notifications received:- These consisted of the following:- Total cases notified. Cases admitted to Hospital. Erysipelas 1 - Measles 3 3 Paratyphoid C. 1 1 Scarlet Fever 5 5 Tuberculosis 9 7 Typhoid Fever 1 1 Whooping Cough 1 1 PROVISION OF HEALTH SERVICES. Tuberoulosis Dispensary. No.of Sessions held 204 No. of Patients attending:- Residents 78) 295 Non-Residents 217 No.of New Patients 193 No.of Patients admitted to Sanatoria, Hospices, etc 42 No.of Artificial Pneumothorax Refills given 182 No.of Visits made to Homes 71 No.of Contacts kept under observation 33 No.of Patients supplied with milk - average 1 to 2 per month 34 glns 4. Genereal Diseases. Sessions held daily except Sunday M. F. Total. - - 23,243 New Patients 693 65 758 Bacteriological Examinations. The following specimens were examined during the year. Specimen. Disease suspected. Result. Positive. Negative. Sputum Tuberculosis - 1 Throat Swabbing Diphtheria - 1 Diphtheria Anti-Toxin. Quantity provided to private practitioners Nil. MEAT INSPECTION. amount of meat delivered at Smithfield Market:- 41,921 tons. amount of meat seized by Meat Inspectors at Smithfield Market:- 125 tons. 0 cwts. 2 qrs. amount of meat seized by Meat Inspectors at Cold Stores, Leadenhall Market & City shops:- 53 tons. 1 cwts. 1 qrs. 16 lbs. no.of Prosecutions instituted:- Nil no.of Demonstrations and Instructions in Meat Inspection:- Nil. no.of Naval Officers receiving instruction in Meat Inspection:- Nil. PUBLIC HEALTH ( MEAT ) REGULATIONS,1924. The improvement in carriage of meat noted in past reports has been maintained,although of course the quantities carried are very much less. PREMISES WHERE FOOD IS PREPARED AND OFFERED FOR SALE. All these premises are subject to regular inspection. Inspections have been made and without exception all criticisms have received immediate attention. ITINERANT FOOD VENDORS. Constant inspections of barrows and of itinerant food vendors have been made and the issue of cautionary letters has resulted in a marked improvement in the general condition of this class of trade. RIVERSIDE WHARVES. The food delivered at riverside wharves has consisted of the customary varieties and lias been the subject of constant inspection and 341 tons 9 cwts 1 qrs 1 lbs. have been condemned as unfit for human consumption, 297 tons 15 cwts 0 qrs 8 lbs. of which it has been possible to utilize for animal feeding, fertilizers or manufacturing purposes. FOOD AND DRUGS ACTS. 578 samples have been submitted to the Public Analyst for examination. 40 of these were formal samples and 538 were informal samples. 26 samples were reported against. The percentage of adulterated samples was 4.4 Legal proceedings were necessary in 6 cases. 5. 2 applications were received for registration as purveyors of milk, both of which were granted. No samples of Condensed Milk were purchased for analysis. 3 licenses were issued under the Milk (Special Designations) Order. SANITARY CIRCUMSTANCES. The general sanitary supervision has been maintained and in this connection 3,721 inspections have been made. As a consequence of these Inspections it was necessary to serve 3 Statutory Orders and 16 Intimation notices. No legal proceedings were necessary. Tenement Houses were inspected and the only common lodging house in the City was kept under regular supervision. HOUSING. The total number of dwelling houses inspected for housing defects as 31 and 19 were found not to be in all respects reasonably fit for human habitation. 13 were rendered fit as a result of informal action by the inspectors and 2 notices were served requesting defects to be remedied. No case of overcrowding in the City of London was reported. FACTORY ACT, 1937. Factory premises have been under such supervision as has been possble having regard to their needs. There-are 3 above-ground bakehouses and 4 underground bakehouses. The provisions of the Act relating to outworkers have been carried out as heretofore. No case of infectious disease was reported in connection with outforkers premises in the City. SHOPS ACT, 1934. 260 shops and warehouses have been inspected and where necessary re-insnected. Any defects have been remedied without recourse to legal proceedings. In cases where satisfactory alternative sanitary accommodation was available, and it was not practicable to make provision on the premises, exemption certificates were granted. PHARMACY AND POISONS ACT, 1933. 60 persons were registered under this Act, 56 of which were reregistrations . FERTILIZERS AND FEEDING STUFFS ACT, 1926. The provisions of the above Act were carried out without recourse to legal proceedings or especial difficulty. MERCHANDISE Marks ACT, 1908. Agricultural Produce (Grading & Marking) Act, 1928 - 1931. No difficulty was experienced during the year in regard to the administration of the above Act. CREMATIONS. 478 cremations were carried out at the City of London Crematorium at Ilford. 6 RAT REPRESSION. Inspections continue to be made of City premises in an endeavour to assist occupiers of property to comply with their liabilities under the Rats & Mice (Destruction) Act, 1919. The devastation caused by enemy action in the City area has undoubtedly reduced the rat population. The Cripplegate area was, in pre-air aid times, a very badly infested area, and hundreds of rats must have: been destroyed by the fires there. At the same time, there is still in other areas, severe infestation. Where there has been complete destruction of a large area the problem has gone. Where destruction is only partial it appears that the rat has been helped. Thus it is found that premises, previously rat free or only subject to occasional visits by ???arauding rats, now suffer constant infestation. Buildings which have suffered damage by fire or blast on upper floors can be included in this category. Ratproofing in such cases is practically impossible. The hundreds of sandbag blast walls erected throughout the area, particularly those encased in wood and not ratproofed, provided safe and undisturbed harbourage for rats, of which the vermin has been quick to take advantage, and many such walls have now been replaced by brick structure, often as a means of overcoming rat infestation. Whenever similar substitution is possible, it is certainly advisable. Fresh harbourage in lofts, introduced by the sandbagging of the floors, is speedily utilised by the pest. The advent of fire-watching has played its part in increasing the rat problem, There is, because of this, far more indiscriminate feeding in City buildings to-day, Again the need for leaving doors open throughout buildings to facilitate firewatchers access to rooms also assists the rat. There is, too, the fact that more water is available to the rat, although experience has shown that this attraction was always easily obtainable in most City premises before the war. To summarise the position it can be said that in some previously severely infested areas the problem no longer exists, that in others the nuisance is intensified, and that, in the time of war, when not only our foodstuffs but also our refuse and waste has a high value, the presence of this vermin still presents a grave problem in the City area. The Ship Rat continues to provide the chief nuisance. It is possible that sewer rat infestation has slightly increased, due to damaged drainage systems resulting from bombing, but no particular manifestation of this aspect of the situation can so far be reported. It is to be hoped that when structural reconstruction is considered legislation will be introduced to ensure that adequate steps are taken to construct ratproof buildings, in order that those areas, many of which previous to destruction, were veritable 'rat-holes', may not again become center of infestation. ■# CITY MORTUARY. Bodies received 173 Inquest on bodies 52 " " fires 1 ■ 7. DISINFECTION AND CLEANSING OF VERMINOUS PERSONS. Export of Clothing. No.of articles disinfected117,144 fees received £242. general Disinfection. Infectious Diseases, etc. Articles of clothing and bedding disinfected 8,349 Horse-hair and bristles (cases) 15 Cleansing of persons. No.of verminous persons bathed 146 No.of articles disinfected 1,782 Cleansing of School Children. No.of children cleansed 1,444 No.of articles disinfected 1,595 Destructions. Pigeons - by staff Nil by contractors 15 I have the honour to be, Gentlemen, Your obedient Servant, CHAS. F. WHITE. Medical Officer of Health, City of London.