4413 (3) cou 27 HEALTH REPORT for 1959 for the COULSDON & PURLEY URBAN DISTRICT by the MEDICAL OFFICER OF HEALTH PRINTED BY RAYNES PARK PRESS LTD., LONDON, S.W.20. CONTENTS Page INTRODUCTION 4 Part 1. THE DISTRICT-AREA, POPULATION AND GROWTH 5 Part 2. ASSESSMENT OF THE HEALTH OF THE DISTRICT 6 Vital statistics 6 Infectious disease 12 The control of infectious disease 16 Factories Acts, 1937 to 1959 18 Part 3. PERSONAL HEALTH SERVICES 20 Addresses for reference 22 Part 4. REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR 24 APPENDICES 49 1 URBAN DISTRICT COUNCIL OF COULSDON AND PURLEY 1959 Public Health Committee. Chairman: Councillor R. N. Saunders Councillor B. E. Eastoe, a.c.a. „ Mrs. N. P. Booth „ S. E. Littlechild „ D. M. Weightman, m.a. „ Mrs. K. M. Platt Councillor H. F. Clarke „ Mrs. D. Pattison, b.a., (Vice-Chairman) „ Miss J. C. Simpson, j.p., m.a. „ S. A. Bliss „ F. Simpson, f.i.a.c. Ex-Officio: Councillor R. W. Kersey, j.p., b.sc., a.r.i.c. (Chairman of the Council) Representatives on the South Eastern Divisional Health Sub-Committee. Councillor C. J. ffield, b.sc., „ Mrs. D. Pattison, b.a. „ R. N. Saunders Councillor Mrs. K. M. Platt „ R. W. Kersey, j.p., b.sc., a.r.i.c. Public Health Department. STAFF: Medical Officer of Health: *J. B. morwood, m.b., f.r.c.s.i., d.p.h. Deputy Medical Officer of Health: *T. R. Bennett, m.r.c.s., l.r.c.p., d.p.h. Chief Public Health Inspector: W. Haworth, f.a.p.h.i. Deputy Chief Public Health Inspector'. W. Rice-Jones, m.a.p.h.i. Additional Public Health Inspectors: E. R. Rogers, m.a.p.h.i. G. H. Bourne, m.a.p.h.i. G. N. Hart Assistant to Public Health Inspectors: W. H. Sands (Retired 10/2/59) F. J. Smith (From 11/2/59) Rodent Operative: H. M. Key. Chief Clerk: *D. v. Prothero. Clerks: Mrs. L. R. Proctor. Mrs. E. Shepherd (From 2/2/59) *Mrs. M. Le Hur (From 19/1/59) ( *Part-time appointment only to this Council) 3 TO THE CHAIRMAN AND MEMBERS OF THE COULSDON AND PURLEY URBAN DISTRICT COUNCIL Mr. Chairman, Ladies and Gentlemen, I have the honour to submit my Annual Report for the year 1959 which has been prepared in accordance with Ministry of Health Circular 1/60. The health of the District remains good and the vital statistics compare favourably with those of the country as a whole. It has been an epidemic year for measles, but the cases have been mild and the use of antibiotics has greatly diminished the number of complications. There has been an unusually high incidence of dysentery of the mild Sonne type, a highly infectious disease whose incidence has been increasing throughout the country as a whole. The incidence of whooping cough has been exceptionally low, indicating the value of immunisation. The situation with regard to poliomyelitis is especially satisfactory. For the second year in succession no case has occurred in spite of a warm dry summer. A special effort was made to complete the vaccination of all the children of the District in the early part of the year and in May a poliomyelitis vaccination campaign was organised for the under 25 years age group. This campaign was most successful. In conclusion I should like to thank the Chairman and Members of the Public Health Committee for their advice and assistance and the staff of the Department for their keen co-operation. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient Servant, J. B. MORWOOD Medical Officer of Health. 4 HEALTH REPORT FOR 1959 PART 1 AREA AND POPULATION The Urban District of Coulsdon and Purley was constituted by an Order of the Local Government Board dated 1st November, 1914, and came into existence on the 7th April, 1915. It has therefore been a separate District for just over 45 years. Situated on the North Downs and for the most part in the Green Belt it is a well favoured residential area. The District has an area of 11,142 acres, these being distributed among the wards as follows:— Coulsdon East 2,812 Coulsdon West 1,253 Kenley 1,292 Purley 685 Sanderstead 2,311 Selsdon and Farleigh 1,924 Woodcote 865 At the time of the 1951 census the population was shown to be 63,770 as compared with 69,320 for the mid-year 1959. These numbers include persons resident in institutions and schools in the District, the numbers of which at the end of 1959 were as follows:— Cane Hill Hospital 2,261 Netherne Hospital 2,056 Russell Hill School 226 Reedham School 246 In December, 1959 there were 20,691 occupied houses, distributed as follows:— Coulsdon East 3,554 Coulsdon West 3,207 Purley 2,768 Woodcote 1,810 Sanderstead North 2,476 Sanderstead South 3,126 Selsdon 1,915 Kenley 1,835 This gives an average of 3.35 persons per occupied house in 1959, or 3.11 if the institutional population is excluded. 5 PART 2 STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 11,142 Registrar-General's estimate of population, mid 1959 69,320 Population, Census 1931 37,666 Population, Census 1951 63,770 Number of occupied houses, December, 1959 20,691 Number of occupied houses, 1931 9,533 Number of occupied houses, 1951 18,071 Rateable Value, December, 1959 £1,366,306 Sum represented by a penny rate £5,515 VITAL STATISTICS FOR THE YEAR 1959 Live Births 1,039 Live birth rate per 1,000 population 14.9 Corrected 16.5 Live Births-Legitimate Live Births-Illegitimate M F 499 21 506 13 Illegitimate live births per cent of total live births=3.2 Still-births 21 Still-birth rate per 1,000 live and still-births 19.8 Total live and still-births 1,060 Infant deaths 19 Still-births-Legitimate Still-births-Illegitimate 11 – 8 2 Infant deathsLegitimate 9 8 Infant deathsIllegitimate 1 1 Infant mortality rate per 1,000 live births-total 18.2 Infant mortality rate per 1,000 live births-legitimate 16.9 Infant mortality rate per 1,000 live births-illegitimate 58.8 Neo Natal Mortality rate per 1,000 live births (first four weeks) 11.5 Early Neo Natal Mortality Rate per 1,000 live births (first week) 11.5 Perinatal Mortality Rate per 1,000 live and still-births (still-births and deaths under 1 week combined) 31.1 Maternal deaths (including abortion) 1 Maternal mortality rate per 1,000 live and still-births 0.94 M F 394 533 Deaths 927 Death rate per 1,000 population 13.3 Corrected 9.9 6 VITAL STATISTICS The following table gives the average population, birth, death, maternal and other important mortality rates for the quinquennial periods 1920-1954 together with the actual figures for 1958 and TABLE I Rates per 1,000 population. 19201924. 19251929. 19301934. 19351939. 19401944. 19451949. 19501954. 1958. 1959. Birth rate 13.5 12.9 11.6 12.8 15.2 15.2 12.0 14.3 14.9 Percentage illegitimate 3.4% 3.7% 2.8% 3.4% 3.9% 3.4% 2.7% 3.2% 3.2% Stillbirth rate — — — 0.43 0.48 0.40 0.24 018 0.30 Death rate 7.4 7.0 7.4 8.3 11.4 9.7 12.1 12.8 13.3 Cancer death rate 0.96 1.15 1.35 1.19 1.70 1.75 2.02 1.80 2.04 Tuberculosis death rate (per 100,000 population) 57 36 38 35 48 36 25 11 11 Violence including Suicide 0.44 0.35 0.32 0.46 0.82 0.37 046 0.55 0.59 Maternal mortality rate per 1,000 live and still births 2.08 2.66 3.21 2.27 2.10 1.12 1.01 1.00 0.94 Infant mortality rate (per 1,000 registered births) 28 38 32 38 40 26 21 17 18 Neo-natal mortality rate – – – 26 28 19 15 12 11 Estimated population 21,351 28,950 41,616 53,084 49,880 60,610 64,466 68,580 69,320 BIRTHS During the year 1959, 1,039 births were registered as occurring in the District, of which 520 were male and 519 female, compared with 980 in 1958. It will be seen by reference to the preceding table that this is equal to an annual birth rate of 14.9 per 1,000 population, as compared with 14.3 in 1958. If this rate is corrected in accordance with the RegistrarGeneral's assessment of the atypical constitution of the population it becomes 16.5 and this is comparable with the birth rate for England and Wales which was 16.5. Illegitimacy.—In 1959, of the births registered, 34 were illegitimate (21 males and 13 females), this being 2 more than in the preceding year. Stillbirths.—The number of still-births registered during 1959 was 21 (11 males and 10 females), which is 8 more than last year. Two of the still-births were in respect of illegitimate children. The local still-birth rate was 19.8 per thousand live and still births. 7 DEATHS The number of deaths registered during 1959 as belonging to this District was 927 (394 males and 533 females), an increase of 50 compared with the previous year. Of this total 295 deaths (86 males and 209 females) occurred in the mental hospitals. The uncorrected death rate was 13.3, but the corrected death rate which allows for the high proportion of deaths occurring in the mental hospitals is 9.9 which compares with the rate of 11.6 for England and Wales. In order that a more accurate comparison can be made, the records in respect of normal residents have been kept separate from those of mental hospital patients and a full list of the causes of deaths and the ages at which they occurred is given in Tables III and IV. The principal causes of death during 1959 are shown in the following table:— TABLE II Cause. Number of Deaths General Population Mental Hospitals Heart and circulatory diseases 254 124 Pneumonia 28 57 Bronchitis 23 9 Accidents 24 17 Malignant neoplasms other than lung 89 25 Malignant neoplasm, lung 27 1 HEART AND CIRCULATORY DISEASE Among the ordinary residents the death rate from heart and circulatory disease was 3.66 compared with an average of 3.75 in the preceeding five years. Ignoring the mental hospital group, 71 per cent of residents dying from heart and circulatory disease were over 65 years of age at the time of death, compared with an average of 74 per cent in the previous five years. CANCER The cancer death rate in respect of normal residents was 2.04 in 1959 compared with an average of 1.78 in the previous five years. 8 TABLE III DEATHS OCCURRING DURING THE YEAR 1959 Cause of death. Private Residents Hospital Cases Total. Under 1 year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and over. Males Females Males Females Males Females Respiratory tuberculosis 5 1 – – 5 1 – – – – – 1 3 2 Other tuberculosis — 1 — 1 — 2 – – – – – – – 2 Syphilitic disease – – – – – – – – – – – – – – Diphtheria – – – – –– – – – – – – – – – Whooping cough — — — – – – – – – – – – – – Meningococcal infections — — — — — – – – – – – – — — Poliomyelitis – – – – – – – – – – – – – – Measles — — — — — — – – – — – — — — Other infective and parasitic diseases – 1 – – – 1 – – 1 – – – – – Cancer 56 60 4 22 60 82 – – – – – 3 41 98 Leukaemia 2 3 — — 2 3 – – – – – 2 1 2 Diabetes 1 2 1 – 2 2 – – – – 1 – – 3 Vascular lesions of nervous system 29 57 5 17 34 74 – – – – – – 18 90 Coronary disease, angina 79 46 10 18 39 64 – – – – – – 48 105 Hypertension with heart disease 6 10 5 21 11 31 – – – – – 1 8 33 Other heart disease 32 50 13 34 45 84 – – – – – 1 14 114 Other circulatory disease 5 16 8 15 13 31 – – – – – – 5 39 Influenza 7 1 1 2 8 3 – – – – – — 3 8 Pneumonia 12 16 16 41 28 57 2 – – – – 1 13 69 Bronchitis 17 6 3 6 20 12 — – – – – – 10 22 Other respiratory diseases 3 2 2 1 5 3 — – 1 – – – 3 4 Ulcer of stomach and duodenum 2 3 – – 2 3 – – – – – – 1 4 Gastritis, enteritis 2 5 – 1 2 6 2 – – – – – – 6 Nephritis 1 4 — – 1 4 – – – – – – 1 4 Hyperplasia of prostate 7 — – – – – – – – – – – – 7 Pregnancy — 1 – – – 1 – – – – – 1 – – Congenital malformation 3 3 – – 3 3 4 – – – – – 2 — Other defined and illdefined diseases 28 23 11 20 39 43 11 – – 1 – 2 11 49 Motor vehicle accidents 5 2 — — 5 2 – – – 1 – – 5 1 All other accidents 4 7 4 7 8 14 — – – – 1 1 6 14 Suicide 2 4 3 3 5 7 — – – – – 5 2 5 Homicide – – – — — — 1 – – – – – – – Totals 308 324 86 209 394 533 19 — 2 2 2 18 203 681 9 TABLE IV DEATHS DUE TO CANCER DURING THE YEAR 1959 0-30. 30-40. 40-50. 50-60. 60-70. 70-80. Over 80. TOTAL. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. * P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. Skin and Tongue – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – Brain and Thyroid – – – – – – – – – – – – – – – – – – – – – – – – – – 1 – 1 – 3 1 Bone – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – 1 – Oesophagus – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – 1 2 Stomach & Duodenum – – – – – – – – – – – – – – – – – – – – 4 — 3 1 1 — — — 13 — 3 1 Intestines — — — — — — — — 1 — — — 1 — 1 1 — — 1 2 2 2 6 2 2 — — — 6 2 8 5 Liver – – – – – – – – – – – – – – 1 – – – 1 – – – 1 – – – – – – – 3 — Pancreas – – – – – – – – – – – – – – – – – – 1 – – – 1 – – – – 1 – – 2 1 Lungs – – – – – – – – – – – – 3 – 3 – 8 — — 1 7 — 2 — 3 — 1 — 21 — 6 1 Bladder – – – – – – – – – – – – 1 – – – 2 – – – 1 – – – – 1 1 2 4 1 1 2 Prostate – – – – – – – – – – – – 1 – – – – – – – 3 – – – 1 – – – 7 – – – Uterus – – – – – – – – – – 1 – – – 3 – – – 2 1 – – 1 – – – – – – – 7 1 Vagina and Ovary – – – – – – 1 – – – 1 – – – – – – – 1 2 – – 4 – – – 2 – – – 6 2 Breast – – – – – – – – – – 1 – – – 2 – – – 2 1 — — 4 2 — — 1 1 — — 10 4 Kidneys – – – – – – – – – – – – – – – – – – – – – – 1 – – – – – – – 1 — Ill-defined — — — — — — 1 – – – – 1 – 1 1 – 1 — 3 – 3 – 1 1 – – 2 – 4 1 8 2 TOTAL – – – – – – 2 — 2 — 4 1 6 1 12 1 19 — 12 8 20 2 22 8 9 1 8 4 56 4 60 22 * H=Hospital cases. P = normal residents. 10 The following table gives the causes of the 19 infant deaths which occurred during 1959, together with the age at death. TABLE V INFANT MORTALITY DURING THE YEAR 1959 Cause of Death Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total deaths under 1 year. Asphyxia neonatorum 1 — — — 1 — — — — 1 Congenital malformations 2 — — — 2 1 1 1 — 5 Prematurity 4 — — — 4 — — — — 4 Atelectasis 2 — — — 2 — — — — 2 Broncho pneumonia 1 — — — 1 1 — 1 1 4 Gastro enteritis 1 — — — 1 — — — — 1 Malignant Tumour — — — — — — — — 1 1 Obstruction 1 — — — 1 — — — — 1 TOTAL 12 — — — 12 2 1 9 2 19 11 INFECTIOUS DISEASE The following table indicates the number of cases of infectious disease notified during 1959, the number admitted to hospital and the number of deaths which occurred. TABLE VI Disease. Numbers Notified. Admitted to Hospital. Total Deaths. Scarlet fever 132 40 — Acute pneumonia 10 2 — Measles 930 2 — Whooping cough 32 1 — Erysipelas 2 — — Dysentery 141 20 — Food poisoning 17 1 — Acute poliomyelitis — — — Puerperal pyrexia 1 1 — Diphtheria — — — A further analysis of these cases by ages, wards and the months during which they occurred is given in Tables XVII and XVIII in the Appendix and the number of cases of infectious disease notified since 1929 is given in Table XIX in the Appendix. It will be seen that tuberculosis is omitted from this list of infectious diseases, as it is dealt with separately later. As in 1958, measles was the commonest disease notified. The downward trend in whooping cough noted in 1958 was continued in 1959, indicating that the immunisation scheme introduced in 1953 is proving effective. SCARLET FEVER There were 132 cases of scarlet fever, mostly of a very mild type. Forty cases were admitted to isolation hospital. Of these, thirty-two were from a residential school and although most cases were very mild indeed hospital admission was considered advisable to prevent the spread of infection. ACUTE PNEUMONIA During the year 10 cases occurred. This is the lowest number of notified cases since 1952. Two of the cases were admitted to hospital. MEASLES The number of cases of measles notified was 930 compared with 103 cases notified in 1958. Immunisation is not available 12 against this disease and it remains one of the commonest diseases of childhood. Fortunately, the use of antibiotics has greatly diminished the risk of complications. WHOOPING COUGH Thirty two cases were notified, continuing the downward trend of the incidence of this disease since immunisation was started in 1953. This is now one of the most serious diseases of infancy and immunisation of all children against it is strongly recommended. Immunisation should be commenced by at least the sixth month. ERYSIPELAS Only two cases occurred during the year. DYSENTERY During the year 141 cases of dysentery were notified, all being of the mild Sonne type. This is a highly infectious disease and its incidence has been increasing throughout the country in recent years. FOOD POISONING Seventeen cases of food poisoning occurred. There were three outbreaks, two of them family outbreaks due to salmonella typhi-murium and the third comprising nine cases, due to salmonella Thompson. There were two single cases due to salmonella typhi-murium. ACUTE POLIOMYELITIS No case was notified during 1959. This is most encouraging as the summer was warm and dry and conditions were very favourable for the spread of the disease. As in the case of whooping cough, immunisation appears to be proving effective. Details of the immunisation campaign are given in the section of this report dealing with the control of infectious disease. PUERPERAL PYREXIA One case was notified. The patient was confined in her home and was subsequently admitted to hospital. She made a complete recovery. DIPHTHERIA No case of diphtheria occurred during the year, but immunisation against this disease is as important as ever as outbreaks are still occurring elsewhere in the country and one adult case occurred in this District in 1958. SMALLPOX No case of this disease has occurred in this District since 1932. 13 TUBERCULOSIS The following table presents concisely the position with regard to tuberculosis in the District during 1959:— TABLE VII Pulmonary. Nonpulmonary. Total. M. F. M. F. M. F. Number of cases on register 266 181 18 20 284 201 Additions:— New cases notified 19 7 — 2 19 9 Cases removed into district 23 18 — 2 23 20 Restored 1 2 — — 1 2 Total Additions 43 27 — 4 43 31 Removals:— Deaths from T.B. 5 1 — 1 5 2 Other causes 2 3 — — 2 3 Removed from district 37 35 5 10 42 45 Recovered 27 11 2 1 29 12 Non T.B. 2 — — — 2 — Total Removed from Register 73 50 7 12 80 62 Number of cases on register, 1st January, 1960 236 158 11 12 247 170 The following table shows the age groups in which notifications and deaths occurred :— TABLE VIII Age Periods. New Cases. Deaths. Pulmonary Nonpulmonary. Pulmonary. Nonpulmonary. M. F. M. F. M. F. M. F. Under 1 year – – – – – – – – 1 and under 5 — — — 1 — — — — 5 and under 10 1 – – – – – – – 10 and under 15 – – – – – – – – 15 and under 20 2 1 – – – – – – 20 and under 25 3 1 – – – – – – 25 and under 35 2 1 — — 1 — — — 35 and under 45 3 4 — — 1 — — — 45 and under 55 3 — — 1 2 — — — 55 and under 65 3 – – – – – – – 65 and over 2 — — — 1 1 — 1 Totals 19 7 — 2 5 1 — 1 14 The new cases were distributed amongst the wards as follows:- TABLE IX Localisation. Coulsdon East. Coulsdon West. Kenley. Purley. Sanderstead. Selsdon. Woodcote. Pulmonary 5 7 2 6 5 — 1 Nonpulmonary — 2 — — — — — Totals 5 9 2 6 5 — 1 The following table illustrates the trend of this disease since the formation of the District. TABLE X 19151924 19251934 19351944 19451949 19501954 1958 1959 Pulmonary— New cases notified 22 29 35 49 43 31 26 *Case rate 115 82 68 81 67 45 37 Deaths 12 13 21 27 16 5 6 *Death rate 65 37 42 44 22 7 8 Non-Pulmonary— New cases notified 3 6 7 8 5 2 2 *Case rate 15 18 15 13 8 2 2 Deaths 3 3 2 2 2 3 2 *Death rate 15 8 5 3 4 4 2 * (The rates quoted are per 100,000 population). During 1959 the number of new notifications of pulmonary tuberculosis decreased to 26 compared with 31 last year and an average of 39 in the last five years. The steady improvement in the death rate from pulmonary tuberculosis is encouraging as is the decreasing prevalence of and death rate from non-pulmonary tuberculosis. The Council is responsible for rehousing, one of the most important measures in the prevention of this disease and also for disinfection, but the County Council bears the responsibility for all other preventive measures except the treatment of cases which is that of the Regional Hospital Board. 15 THE CONTROL OF INFECTIOUS DISEASE WHOOPING COUGH Immunisation is proving increasingly effective in the control of this disease. It does give rise to the problem of the modified case, however, which can spread infection. It is important that whooping cough cases, however mild, should be excluded from school. The number of children immunised against this disease was 942 and 355 were given reinforcing injections. ACUTE POLIOMYELITIS Vaccination is proving very effective indeed in the control of acute poliomyelitis and as the great majority of children had been protected by vaccination the age group was extended to include all under 25 years of age. This older group did not respond well and it was decided to hold a Poliomyelitis Vaccination Week from the 4th May. A great deal of preparatory work was done and the week was very successful. The number of vaccinations carried out was 2,000 and the propaganda released during the campaign week continued to bear fruit for months afterwards. The photograph on the opposite page was taken during the campaign. I should like to thank the many volunteers who helped to make the campaign week such a success. The total number of persons in the South Eastern Division who have been vaccinated against poliomyelitis since the inception of the scheme with two injections is 31,188 and with three injections 28,771. DIPHTHERIA Immunisation is by far the most important preventive measure in this disease and it is very important that parents should ensure that their children are immunised before their first birthday and receive reinforcing injections when 5 and 10 years old. The number of children immunised against this disease was 945 and 1,309 were given reinforcing injections. SMALLPOX All children should be vaccinated before the age of three months. Details of the number of vaccinations carried out during the year are as follows Number of primary vaccinations 988 Number of re-vaccinations 107 16 POLIOMYELITIS VACCINATION WEEK A YOUNG PERSON BEING VACCINATED - FOOD POISONING AND DYSENTERY Immunisation is no help in the prevention of dysentery and the different forms of food poisoning and consequently hygienic measures are of the utmost importance. The food shops in the District are kept under constant supervision and strict compliance with the Food and Drugs Act, 1955 and the Food Hygiene Regulations is insisted upon. Unfortunately the preparation of food in the home cannot be so carefully supervised. Every case of food poisoning or dysentery is visited by a Public Health Inspector and a full investigation carried out. Advice is given with regard to the prevention of spread of infection and prevention of a similar infection occurring again. All cases and contacts are followed up until free from infection. TUBERCULOSIS There are several methods of control of tuberculosis and in consequence both its incidence and death rates have fallen in recent years. Mass X-ray. This has brought to light early cases which have been treated and rendered non-infectious in a short time. B.C.G. Vaccination of School Children. This protects the vulnerable under 25 years age group. Contacts. Tracing contacts and arranging for treatment of those found to be suffering have had a marked effect on the prevention of spread of the disease. Treatment. Modern treatment which includes chemotherapy and surgery is very effective and has considerably reduced the number of carriers in the population. BACTERIOLOGICAL AND CHEMICAL EXAMINATIONS Almost all the specimens requiring bacteriological examination in the interests of the public health are sent to the Public Health Laboratory, West Hill House, West Hill Road, Epsom and during 1959 reports were received on the following specimens:— Milk, ice cream and water samples 329 Food utensils 462 Nose or throat swabs 245 Faeces 1.429 Sputum 5 Animal excreta 6 Samples of milk for biological examination are sent by the Local Authority to the Public Health Laboratory Service, while samples of water requiring chemical analysis and Food and Drug samples are submitted to the Public Analyst. 17 FACTORIES ACTS 1937 and 1948 PART I OF THE ACT 1. Inspections for purposes of provisions as to health (including inspections made by Public Health Inspectors). TABLE XI Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 38 39 1 — (ii) Factories not included in (i) in which Section 7 is enforced by the local Authority 161 183 9 — (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 17 11 — Total 216 233 10 — 2. Cases in which defects were found. TABLE XII Particulars Number of cases in which defects were found No. of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l) 1 1 — — — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) 1 1 — — — Ineffective drainage of floors (S.6) — — — — — Sanitary conveniences (S.7) (a) Insufficient 5 4 1 (b) Unsuitable or defective 21 5 — — (c) Not separate for sexes — — — — Other offences against the Act (Not including offences relating to outwork) 1 — — — — Totals 29 11 — 1 — 18 PART VIII OUTWORK - (Sections 110 and 111) TABLE XIII Nature of work Section 110 Section 111 No. of Outworkers in Aug. list required by Section 110(1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwhole some premises Notices served Prosecutions Wearing apparel (Making etc. cleaning and washing) 34 — — — — — Household linen Umbrellas, etc. 1 1 — — — — Making boxes 1 — — — — — Carding, etc., of buttons, etc. 22 — — — — — Duster Dolls 4 — — — — — Cosaques, Christmas crackers, Christmas stockings, etc. 3 — — — — — Total 66 — — — — — 19 PART 3 PERSONAL HEALTH SERVICES Since 1948 the local Council has been represented on the S.E. Divisional Health Sub-Committee of the County Health Committee and the corresponding Educational Executive, which bodies have certain specified powers and responsibilities for the Personal Health Services. The Medical Officer of Health for this District and his Deputy, who hold similar positions in the Caterham and Warlingham Urban District, are the officers responsible for the Divisional Health Services which include the following :— Ante Natal Clinic An Ante Natal Clinic is held at 62, Whytecliffe Road, Purley, every Wednesday, 10 a.m. 12 noon. Home Help Service The activities of this service continue to increase, particularly as there is no comparable agency in this District. Applications for the service of a Home Help should be addressed to the Home Help Organiser, 115 Brighton Road, Purley. In case of emergency the following telephone numbers may be used: UPLands 7014 or 9277, preferably between 9.30 and 10.30 a.m. Home Helps can only be supplied for maternity cases and for other cases genuinely needing their assistance in which ill-health or old-age are involved; the capacity of the Service is limited and priority is given to those in greatest need, the degree of help varying with the physical and social circumstances of the family. Family Planning The local Family Planning Clinic is now held at the Surrey County Council Clinic, Chaldon Road, Caterham-on-the-Hill. Residents needing advice are seen only by appointment and this should be obtained by application to the Divisional Medical Officer at 115 Brighton Road, Purley. Health Visiting The Health Visitors can be contacted through the Divisional Health Visitor between 9.0 and 10 a.m. daily at 115 Brighton Road, Purley, UPLands 9277. Infant Welfare Clinics The following Infant Welfare Clinics are held regularly from 2-4 p.m. except Purley Clinic which is held from 10 a.m. - 12 noon :— Purley Clinic, 62 Whytecliffe Road, Purley Methodist Church, Brighton Road, Coulsdon Coulsdon Boys' Club, Chipstead Valley Road, Coulsdon Every Tuesday Every Thursday. Every Thursday. 20 Territorial Army Drill Hall, Marlpit Lane, Old Coulsdon Methodist Church, Sylverdale Road, Purley Baptist Church, Addington Road, Selsdon Congregational Church, Sanderstead Road, Sanderstead St. Anthony's Church, Wentworth Way, Sanderstead Church Hall, Mitchley Avenue, Purley Community Centre, Hooley Rent Office, Cherry Tree Farm Estate, Sanderstead Rent Office, Wontford Road, Purley Every Tuesday. Every Friday. Every Monday. Every Wednesday. Every Thursday. 2nd and 4th Tuesday in each month. 1st and 3rd Wednesday in each month. Every Wednesday. Every Tuesday. Mothercraft and Relaxation Classes Classes covering these subjects were commenced in Purley at the end of 1953 and the numbers attending have increased very rapidly. Expectant mothers wishing to join these classes should make application to the Divisional Health Visitor at 115 Brighton Road, Purley, who will inform them as soon as a vacancy occurs. School Health Service The basis of this service is the periodical medical and dental inspection of all the children in attendance at the local schools who, in this Division, now number over 14,000 compared with 7,490 in 1946. Some of the defects noted need to be kept under observation and others are referred for treatment by private doctors, hospitals or specialist clinics. Among the clinics organised are the dental, eye, speech, general medical, child guidance and remedial exercise clinics. Special attention is given to handicapped children, some of whom require to be admitted to special schools, e.g. those for the deaf and mentally or physically sub-normal. As is noted in other parts of this Report, the condition of the school premises and of the school meals service is kept under supervision and special steps are taken to prevent the spread of infectious diseases, including the immunisation of school children. Welfare Services The staff of the Health Department work in close cooperation with the local representatives of the County Council's Welfare, Children's and Education Departments and such voluntary bodies as the Guild of Social Service, N.S.P.C.C. and Marriage Guidance Council. The Divisional Medical Officer is responsible for co-ordinating the activities of all concerned with "Problem Families" and children neglected in their own homes. In addition to emergency meetings, all current cases are reviewed at quarterly case conferences. 21 NATIONAL ASSISTANCE ACT, 1948, SECTION 47 The powers given under this Section for securing the removal of aged persons living in insanitary conditions were not utilised during 1959. Periodically border-line cases occur in which the Welfare Officers seek advice, but every endeavour is made to find a satisfactory solution without resorting to compulsory powers. NATIONAL ASSISTANCE ACT, 1948, SECTION 50 Under the above section, as from 5th July, 1948, the Council became responsible for the disposal of the remains of any person who dies in the District if suitable arrangements would not otherwise be made. During the year the Council dealt financially with one case of this type. HEALTH PROPAGANDA Constant attention is given to the opportunities for health propaganda at the Clinics and Centres in the area and during the visits made by the Health Visitors and Public Health Inspectors. In addition each year a number of talks are given by the Officers to various organisations and schools. The material supplied by the Central Council for Health Education and other bodies is extremely useful. Addresses for Reference Public Health Inspectors' Office, 73 Brighton Road Purley Telephone : UPLands 6981 UPLands 9644 Ambulances Ambulance Station, 115a Brighton Road, Purley. Sanderstead Fire and Ambulance Station, Limpsfield Road, Sanderstead. Requests should be made to MITcham 2084,, or in cases of emergency dial 999. Authorised Officer for Mental Health Services Mr. D. E. Twivey, 44, Reigate Hill, Reigate Telephone : Reigate 3357 Blind Welfare Worker Miss C. M. Barnard, County Health Dept., County Hall, Kingston-on-Thames Telephone : KINgston 1050 Children's Officer for the District Mrs. Docherty, Children's Department, County Hall, Kingston-upon-Thames Telephone : KINgston 1050 Divisional Health and School Health Services Immunisation and Family Planning Divisional Medical Officer, 115, Brighton Road, Purley. Telephone : UPLands 9277 Divisional Education Executive 38, Grovelands Road, Purley Telephone : UPLands 7601 22 Emergency Units ('Flying Squads') Redhill County Hospital, Earlswood Common, Redhill St. Helier Hospital, Wrythe Lane, Carshalton Mayday Hospital, Mayday Road, Croydon Telephone : Redhill 3581 FAirlands 6622 THOrnton Heath 6999 Hospital Groups Croydon General Hospital, London Road, Croydon Redhill County Hospital, Earlswood Common, Redhill Telephone : CROydon 7755 Redhill 3581 School Clinics S.C.C. Clinic, 62, Whytecliffe Road, Purley Baptist Church, Addington Road, Selsdon Territorial Army Drill Hall, Old Coulsdon Mondays 9—11 a.m. Mondays 1.30—2.0 p.m. Tuesdays 1.45—2.0 p.m. School Dental Clinics S.C.C. Clinic, 62, Whytecliffe Road, Purley Monday, 9.45 a.m. or by appointment. Welfare Officers 115a, Brighton Road, Purley Mr. E. G. Griffiths (Principal Divisional Welfare Officer) Mrs. J. M. Parker, (Divisional Welfare Officer) Telephone: UPLands 0776 WALington 9237 Caterham 4713 Welfare Homes "Chipstead Lodge", Hazelwood Lane, Chipstead "Santa Tecla", Stanstead Road, Caterham Telephone: Downland 4811 Caterham 2641 Road Safety Committee (Coulsdon and Purley) Organiser: Mr. P. E. Arthur, 71, Brighton Road, Purley Telephone : UPLands 4844 Caterham 4018 Voluntary Bodies Moral Welfare Miss Scoones, 1 Sunnyrise, Caterham Telephone : Caterham 3728 National Society for the Prevention of Cruelty to Children Inspector A. J. G. Budge, 37, Hartley Road, Croydon THOrnton Heath 4250 Coulsdon and Purley Guild of Social Service Secretary: Miss Honeyman, 105, Brighton Road, Purley UPLands 6800 Coulsdon and Purley Old People's Welfare Association Secretary: Miss D. M. Barnett, 51a, Brighton Road, Purley. Coulsdon and Purley Marriage Guidance Council Secretary: Mrs. H. W. Pritchard, 38, Russell Hill, Purley UPLands 9029 Home Safety Council (Coulsdon and Purley) Secretary: Mrs. D. Pope, 34, Grasmere Road, Purley UPLands 8047 23 PART 4 REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR 1959 TO THE CHAIRMAN AND MEMBERS OF THE COULSDON AND PURLEY URBAN DISTRICT COUNCIL Mr. Chairman, Ladies and Gentlemen, I have the pleasure to submit herewith a report on the work of the Public Health Inspectors for the year 1959. Nothing spectacular was achieved but much good work was done of a routine character. During the early months of the year considerable time and effort were expended in the investigation of cases of Sonne Dysentery and in carrying out the necessary preventive measures. This important duty requires the utmost patience, tact and perseverance if it is to achieve its purpose of identifying and segregating as necessary the affected persons and contacts. Of the many hundreds of visits made in this connection it is very satisfactory to report the absence of any complaint. The exceptionally fine summer coincided with a record number of complaints of wasps nests and although it is no part of the duty of a Public Health Authority to deal with these pests the department has been prepared to afford relief to residents where possible and on payment of a fee. In recent years one has noted an increasing tendency on the part of the general public to avail themselves of advice and assistance from the Department on the many facets of environmental health and the number of calls recorded during the year is an indication of the use made of the service. In conclusion I should like to express my appreciation of the co-operation and happy relationship that has developed with Dr. Morwood the Medical Officer of Health, and thank all my colleagues in the Department for their ready assistance during the year. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient Servant, W. HA WORTH, Chief Public Health Inspector. 24 HOUSING The following is a summary of work carried out in respect of the sanitary condition of dwelling houses during the year. 1. Inspection of Dwelling Houses during the year 1959 (i) Total number of houses inspected for housing defects (under Public Health or Housing Acts) 337 (ii) Number of dwelling houses [included under subhead (i) above] which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 30 (iii) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 13 (iv) Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 279 2. 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 226 3. Action under Statutory Powers during the year (a) Proceedings under Sections 9, 10 and 12 of the Housing Act, 1957 — (i) Number of dwelling houses in respect of which notices were served requiring repairs 1 (ii) Number of dwelling houses which were rendered fit after service of formal notices (a) By owners Nil (b) By Local Authority in default of Owners Nil (b) Proceedings under the Public Health Acts — (i) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 26 (ii) Number of dwelling houses in which defects were remedied after service of formal notices — (a) By owners 7 (b) By Local Authority in default of Owners 14 25 (c) Proceedings under Sections 17 and 23 of the Housing Act, 1957 — (i) Number of dwelling houses in respect of which Demolition Orders were made Nil (ii) Number of dwelling houses demolished in pursuance of Demolition Orders Nil (d) Proceedings under Section 18 of the Housing Act, 1957 — (i) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (ii) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil 4. Housing Act, 1957 — Part IV — Overcrowding (a) (i) Number of dwellings overcrowded at the end of the year 1 (ii) Number of families dwelling therein 1 (iii) Number of persons dwelling therein 10 (b) Number of new cases of overcrowding reported during the year 3 (c) (i) Number of cases of overcrowding relieved during the year 2 (ii) Number of persons concerned in such cases 9 (d) Particulars of any case in which dwelling houses in respect of which the Local Authority have taken steps for the abatement of overcrowding have again become overcrowded Nil Number of New Houses erected during the year By the Local Authority 36 By other persons 373 During the year eight houses were demolished as part of the Council's Clearance programme and the sites are being utilised by the Council for the erection of flats. A further eighteen houses were included in Clearance Areas. Action was taken under the provisions of Sections 16 and 18 of the Housing Act, 1957 in respect of three dwellings and undertakings not to relet were accepted from the owners. Three applications for Certificates of Disrepair were received and in two cases the landlords gave undertakings to carry out the 26 necessary repair works. In the remaining case the repairs were carried out on receipt of the notice of intention to issue the Certificate of Disrepair. Cancellation certificates were issued in respect of three properties. Housing repair work has followed the pattern of recent years and the efforts of the department have been fairly successful. There is, however, a fairly large number of houses in the district upon which the effects of the Rent Act, 1957 or the opportunities for improvement by way of grant aid appear to make little impression. Reference has been made in previous years to this type of house occupied in the main by tenants of long standing and forming a range of substandard housing accommodation in respect of which it would appear only time will provide a remedy. Although not "unfit" these houses fall far short of what is now recognised as the standard acceptable to the modern housewife. The owners appear to have little interest except to sell with vacant possession at the first opportunity and it is becoming clear therefore that the period is drawing to a close when the private landlord will own and let cottage property for investment purposes. In the meantime unless housing standards are improved legally or other forms of redevelopment are initiated, this class of property will lag behind in satisfying the demand for better housing. During the year Discretionary Improvement Grants were made in respect of four houses where improvement works were carried out to the total value of £1,801. In all cases 50% grants were made and a high standard of improvement was achieved. WATER SUPPLY The water supply of the district is provided by The Sutton District Water Company and The East Surrey Water Company from deep wells or borings in the chalk. The water is softened and chlorinated and all houses in the District are provided with a direct supply. There are no private wells in the District with the exception of one at Cane Hill Hospital which is used to supplement the public supply. Routine samples of the treated water in public supply were submitted quarterly for bacteriological and chemical examination. In all 16 samples were taken for bacteriological examination and 8 samples for chemical examination with satisfactory results in each case. In addition, both the Water Companies and Local Authorities sharing these public supplies provided the Department with copies of reports on the samples taken by them. 27 During the summer the East Surrey Water Company reported that a sample of water taken from the Kenley Pumping Station had a slightly musty taste and odour. Although this abnormality gave no chemical or bacteriological reaction, the two bore holes in question were taken out of supply until appropriate treatment could be brought into action. Investigations were carried out by the Company with a view to ascertaining the source of the trouble without success, and the abnormality cleared naturally later in the year. Three other complaints were investigated by the Department without any satisfactory explanation forthcoming. Forty-nine samples were taken from the supplies of the two Companies and examined for hardness by the department, all of which were satisfactory in that adequate softening had been carried out as required. The private supply at Cane Hill Hospital is kept under supervision and sampled regularly by the Public Health Department of the London County Council. Copies of reports on the samples taken are submitted to the Department for information. Rainfall The rainfall registered by the automatic rain gauge installed at Alderstead Heath, was 25-21 inches in 1959 this being a decrease of 12-05 inches compared with the previous year and the lowest since 1949 when 24-86 inches was recorded. The monthly totals throughout the year were as follows :— inches January 3.28 February 0.14 March 2.41 April 2.59 May 0.88 June 1.65 July 1.02 August 1.04 September 0.20 October 3.03 November 3.55 December 5.42 DRAINAGE AND SEWERAGE There was no extension of the sewerage system during the year but the Council agreed to extend the public sewer in Highland Road for a distance of 78 feet in order to enable the owner of a private property in Cullesden Road to connect thereto and thus eliminate cesspool drainage at the property. 28 At the end of the year there were 95 cesspools and 6 pail closets in the District. By agreement sewage from the District drains into the sewerage systems of The Croydon Borough Council and The West Kent Main Sewerage Board for treatment. The sewerage problem at Purley Corner is the subject of a report by an Engineer appointed jointly by all the Authorities concerned, to prepare a scheme and report upon the remedial measures required. A Public Inquiry in connection with this matter is to be held by an Inspector of the Ministry of Housing & Local Government in due course. PUBLIC CLEANSING This service is administered under the direction of the Engineer and Surveyor - Mr. H. M. Collins. A weekly collection of house refuse is in operation and trade refuse is collected concurrently as part of the daily routine in the five collection areas. The Engineer and Surveyor has reported that the revised arrangements which came into operation in May, 1958 have proved successful. There were no alterations in the methods of cesspool emptying or the disposal of refuse during the year under consideration. House refuse is disposed of partly by incineration at Kenley Works and partly by means of controlled tipping. Cesspool contents are emptied into the sewer. Charges are made for the removal of trade refuse and for cesspool emptying. The charges for cesspool emptying at private properties were reviewed during the year and although it was agreed to make no change in the present charges for emptying existing cesspools in the district, the charge for emptying cesspools constructed on or after 1st April, 1959 at newly erected properties was increased to £1. 5s. Od. per load. The scale of charges for the service is now as follows :— (a) Existing cesspools at private properties erected before 1st April, 1958 — 10/- per load for the first 12 loads in any year and thereafter 15/- per load for all additional loads in the same year. (b) Cesspools constructed on or after 1st April, 1958 and before 31st March, 1959 at newly erected properties •— a standard charge of 15/- per load. (c) Cesspools constructed on or after 1st April, 1959 at newly erected properties *— a standard charge of 25/- per load. (d) Cesspools at commercial premises — 25/- per load. 29 RIVERS AND STREAMS The only water courses in the District are those provided by the intermittent Bourne flows. These present no difficulties apart from occasional rat infestation along the banks. INSPECTION OF THE DISTRICT It is the statutory duty of a Public Health Inspector to inspect and have a thorough knowledge of the sanitary circumstances of the district in order that action can be taken if necessary to abate conditions that give rise to nuisance or are prejudicial to health. Under the following headings comment is made on particular aspects of this work, concluding with a summary of the complaints received, visits made, notices served, works carried out and defects remedied during the year. Camping Sites In view of the rural character of much of the Council's district, a close watch has to be maintained for unauthorised siting of movable dwellings. Control is exercised mainly through planning powers although prohibition orders obtained in 1951 in respect of two areas in the district under the provisions of the Surrey County Council Act have continued to prove effective in preventing nuisance arising from itinerant gypsy encampments. No serious difficulties have been experienced during the year. The permanent Boy Scouts' Camp at Featherbed Lane continues to be used in a very satisfactory manner and the residential caravan camp established on land at Dean Lane, Merstham, still operates although the permission granted by the Ministry of Housing & Local Government for the continued use of the land as a camp site for a period of three years has now expired. A further application for planning permission to continue its use has been refused and notice has been given by the owners of intention to appeal against the decision. During the year a report by Sir Arton Wilson on his investigations into the use of caravans as homes was submitted to the Minister. This report read in conjunction with the Social Survey carried out on behalf of Sir Arton Wilson by the Central Office of Information, provides valuable and up-to-date information on the problem presented by this mode of living. It is recognised in the report that the powers of control should be strengthened and as a result "The Caravan Sites and Control of Development Bill" has been presented to Parliament with that object in view. 30 Clean Air At the beginning of the year the Minister of Housing & Local Government issued a circular No. 5/59 on the formation of Smoke Control Areas and requested councils in "Black Areas" to prepare a programme for the establishment of Smoke Control areas over the next five years. As it was not clear whether this Council's area was within the "Black Areas" around London, an enquiry was addressed to the Ministry who indicated that the Council need not regard their district as being in one of these areas for the purpose of making a report under the above circular. Having at the same time considered a comprehensive report on the subject, setting out the action being taken or proposed by neighbouring authorities and the position regarding the supply of solid smokeless fuels the Council decided in the circumstances to take no action in the matter for the time being. Later in the year on the recommendation of the Planning New Streets and Buildings Committee, the Council agreed to make a Building Byelaw to provide for the installation in new buildings of appliances for heating or cooking which are suitably designed for burning smokeless fuels. In the absence of direct control, householders can still make a valuable contribution to the cause of Clean Air by the use of approved appliances and smokeless fuel. Although there may be shortages from time to time of the more reactive smokeless solid fuels, supplies of open fire coke complying with the British Standard Specification and more reactive than some ordinary cokes are becoming more readily available. It is important, however, that with this latter type of fuel only improved grates, preferably with gas ignition, should be used and with spacing of the bars of the bottom grate. During the year a number of complaints of smoke nuisance was received and investigated. Most were of a minor character only and were remedied following representation to the persons concerned. There is little or no industrial smoke in the district. Hairdressing Establishments Byelaws are now in force in the district which provide for securing the cleanliness of premises and the instruments, towels, equipment and materials used in the premises. Heating Appliances (Fireguards) Act, 1952 Inspections are carried out, as necessary, to ensure that domestic heating appliances offered or exposed for sale are fitted with proper guards complying with standards prescribed in regulations made under the Act. 31 Any contraventions noted are usually confined to secondhand articles and during the year four such appliances were altered or withdrawn from sale as a result of representations made by the Department. Mines & Quarries Act, 1954 This Act requires compliance with provisions designed to prevent accidents arising through lack of proper fencing or too easy access. Routine visits are made to quarries in the district and in one instance the repair of fencing was required. Schools In co-operation with the Divisional Medical Officer and in the course of milk sampling, schools are visited from time to time. In December a survey of all the school kitchens in the district was commenced with a view to reporting to the Divisional Education Officer on matters requiring attention. Shops Act As far as possible inspections have been made in respect of the provision and maintenance of sanitary accommodation, washing facilities, heating, lighting and ventilation in shops. By arrangement with the Engineer & Surveyor, the Department is given an opportunity of examining all plans submitted for the construction of new shops or alteration of existing premises, with a view to obtaining proper compliance with the requirements of the Act. This is generally appreciated by shop developers who are usually very willing to co-operate. The Council is also the Authority responsible for enforcement of the Shops Hours of Closing and Sunday Trading provisions of the Act. Routine surveys and inspections are carried out for this purpose but no serious difficulty has been experienced during the year. Swimming Baths There are two swimming baths in the District used by the public; one an open-air pool at Selsdon is owned privately and although operating primarily in conjunction with a large hotel, is made available to the general public at a charge. The second is a covered bath situate at Reedham Orphanage which is used extensively by the Divisional Education Authority for school children. Both baths are provided with the necessary plant for chlorination and filtration. During the year 21 samples of the water in these baths were submitted for chemical and bacteriological examination and all were found to be satisfactory. 32 In addition, at the Reedham Bath, regular tests are carried out by an Inspector to check the chlorine content and the Ph value of the water. During the early part of the year representations were made to the Divisional Education Authority and to the Headmistress as to the desirability of providing adequate purification plant in connection with a proposed 'Teaching Swimming' pool at Keston County Primary School. The plans are now well advanced and the necessary filtration and chlorination plant has been installed. The Fabrics (Misdescription) Act, 1913 The Fabrics (Misdescription) Regulations 1959 The above mentioned Regulations which came into force on the 11th May, 1959 prescribe new standards of non-inflammability for textile fabrics to which is attributed the quality of noninflammability or safety from fire or any degree of that quality. During the year 17 shops were visited in pursuance of the Regulations and in no case were goods stocked to which the Regulations apply. Radioactivity During the year the Minister of Housing and Local Government issued a Memorandum setting out the various measures being taken by the different government departments and agencies to assess the extent, and control so far as possible the sources of radioactivity. Much of the work being done is of direct interest to local authorities but it would appear that apart from seeking advice of the particular department concerned in the event of a local problem arising, no further action need be taken by individual authorities at the present time. In the meantime the training of local authority officers in radiation matters is receiving attention. Disinfection and Disinfestation Disinfection is carried out when considered necessary following cases of infectious disease and otherwise on request and on payment of a small charge. Bedding and other clothing if possible is disinfected by arrangement with the Wandle Valley Hospital in a steam disinfector at the hospital. Sick rooms and other articles are disinfected by means of formaldehyde gas or spray, and library books are treated in a disinfecting chamber at the offices at 73, Brighton Road, Purley. 33 During 1959 the following disinfections were carried out:— Free of cost Upon Payment Total Loads of bedding, etc. 12 — 12 Houses disinfected 15 — 15 Parcels of clothing — 3 3 Library books 463 — 463 Disinfestation work is now largely confined to the more common domestic pests such as flies, ants, cockroaches and wasps. No case of bug infestation was recorded during the year. School canteens are sprayed annually with a liquid insecticide to prevent fly infestation. The use of proprietary insecticides principally of the liquid variety and having a residual effect, is proving very effective in dealing with all types of insect pests. During the year 177 cases of infestation were dealt with by the department. COMPLAINTS RECEIVED General disrepair and insanitary conditions 30 Dampness 15 Defective drainage systems 19 Blocked drainage systems 223 Defective drainage fittings 11 Defective W.C. pans and flushing apparatus 4 Defective service water pipes 2 Absence of, or defective dustbins 1 Accumulation of refuse, etc. 20 Rats and mice 342 Keeping of animals 1 Insect pests, etc. 76 Wasps nests 260 Smoke nuisance 16 Contaminated food 33 Unsound food 28 Insanitary pig waste bins 1 Miscellaneous 79 Total 1,161 VISITS CARRIED OUT AND INTERVIEWS Number of houses visited in respect of improvement and repair 344 Number of reinspections made to above houses in respect of improvement and repair 2,856 Verminous premises 7 Insect pests 440 Water supply 32 Tents, vans and sheds 42 34 Schools 50 Places of entertainment 2 Licensed premises 60 Storage of refuse 37 Accumulation 166 Piggeries, fowls and other animals 96 Stables 4 Rodent control 4,693 Drainage inspected 1,514 Drainage tested 357 Pail closets 1 Cesspools 81 Urinals 2 Sewers and street gullies 124 Dairies and milkshops 34 Ice cream premises 19 Meat shops 117 Food preparing premises 378 Other food shops 546 Bakehouses - Power 44 -Other — Slaughterhouses 12 Food inspection - meat 15 Food inspection - other food 67 Factories - Power 139 - Other 11 Workplaces 39 Outworkers 13 Heating Appliances (Fireguards) Act 5 Rag Flock etc. Act 2 Pet Animals Act 2 Shops Act 755 Mines and Quarries Act 11 Clean Air Act 41 Hairdressing Establishments 25 Infectious disease enquiries 1,645 Infectious disease contacts 40 Food poisoning enquiries 84 Disinfection 53 Disinfestation 41 Swimming baths 71 Sampling - Food and Drugs Act, 1955 146 - Ice Cream 112 - Milk (Bacteriological) 158 - Water 53 Interviews 2,706 Number of incoming telephone enquiries and personal callers received at the office 2,687 Miscellaneous visits 1,134 NOTICES SERVED Preliminary Notices 633 Statutory Notices 54 35 WORK CARRIED OUT AND DEFECTS REMEDIED Drainage and Sanitary Fittings :— Drains repaired or reconstructed 84 Blocked drains cleared 199 Disused drains sealed off 21 Soil and vent pipes repaired/renewed 8 Inspection chambers provided or repaired 97 Fresh air inlets repaired or renewed 12 Stoppers to interceptors renewed 17 New W.C. pans fixed 36 W.C. cisterns repaired or renewed 27 Cesspools abolished and filled in 2 Cesspools provided 2 Cesspools cleansed 4 Eaves gutters and rainwater pipes renewed/repaired 44 Lavatory basins renewed or provided 10 Baths renewed or provided 3 Sinks renewed or provided 7 Waste pipes renewed or repaired 18 Sink gully curbs and dishings renewed 31 Soakaways reconstructed or provided 18 Miscellaneous 11 General Housing Repairs:— Defective roofs repaired 48 Chimney stacks repaired or rebuilt 27 External walls repaired 31 Yards paved or paving repaired 12 Steps repaired or renewed 5 External paintwork renewed 17 Boundary fences and gates repaired or renewed 20 Coalsheds repaired or renewed 5 Dampness in walls remedied 32 Damp-proof courses provided 9 Walls and ceilings repaired 85 New ceilings provided 10 Walls of rooms cleansed or redecorated 40 Ceilings of rooms cleansed or redecorated 49 Floors repaired or renewed 39 Internal woodwork cleansed or redecorated 28 Staircases repaired or renewed 5 Additional light/vent provided to W.C. Compartment 2 Accumulations removed 27 Additional subfloor vent provided 1 Windows repaired or renewed 79 Doors repaired or renewed 28 Firegrates repaired or renewed 20 Domestic hot water systems repaired or renewed 6 Water storage tanks repaired or renewed 1 Water service pipes repaired or renewed 7 Walls and ceilings of W.C. compartments repaired 9 36 Walls and ceilings of W.C. compartments cleansed 7 Floors to W.C. compartments repaired or renewed 4 Portable dustbins provided 8 Miscellaneous 22 Food Premises:— Premises reconstructed 1 Premises altered and improved structurally 8 Floors repaired/renewed/recovered 26 Walls and ceilings of rooms repaired 28 Walls of rooms cleansed or redecorated 75 Ceilings of rooms cleansed or redecorated 63 Windows repaired or renewed 3 Doors repaired or renewed 2 Woodwork cleansed or redecorated 30 Roofs repaired 3 Rainwater pipes and gutters repaired or renewed 2 External walls repaired 2 Yards paved or paving repaired 8 Food stores provided 9 Sinks renewed or new sinks provided 24 Draining boards provided 12 Hot water supply provided for personal ablution purposes 25 Hot water supply provided for cleansing purposes 10 Waste pipes repaired or renewed 1 Towels, soap, nailbrushes supplied 12 First-aid equipment supplied 26 Lockers for clothing provided 12 Equipment cleansed 14 Equipment renewed or repaired 23 New equipment provided 14 Additional lighting provided 3 Additional ventilation provided 7 Sanitary accommodation provided for staff 3 Sanitary accommodation repaired 19 Sanitary accommodation cleansed 30 Staff Rooms provided 1 Lavatory basins provided 24 Miscellaneous 60 Ratproofing:— Work carried out by occupiers of premises after completion of treatment 10 Heating Appliances (Fireguards) Act, 1952 :— Fires altered or withdrawn from sale 4 Shops Act :— Additional sanitary accommodation provided 1 Sanitary accommodation redecorated 1 Washing facilities provided 3 Heating provided 3 Notices provided 2 Ventilation improved 4 37 PREVENTION OF DAMAGE BY PESTS ACT, 1949 RODENT CONTROL The Council employ the services of a rodent operator assisted as necessary by another officer in the department for work under this heading. Compared with 1958 there was an appreciable increase in the number of complaints received and premises found to be infested by rats and mice and during the year the Department agreed to carry out on a contract basis certain disinfestation work at agricultural premises formerly carried out by the Ministry of Agriculture, Fisheries & Food. The Department does not, of course, rely solely on the receipt of complaints as an indication of infestation and routine inspections of dwelling houses, business premises including agricultural holdings, council owned properties and land are carried out from time to time and in conjunction with treatment on adjoining premises. On the 31st March, 1959 the grant payable under the Prevention of Damage by Pests Act 1949 on expenditure incurred by the Council on rodent control ceased as a result of the Local Government Act, 1958. The Ministry of Agriculture, Fisheries & Food will, however through its regional and divisional pests staff, give an improved technical advisory and instructional service on rodent control to local authorities. Meetings of the No. 10 London Workable Area Committee of which this Authority is a member, are held from time to time to discuss with the Minister's officers, problems and new developments in connection with rodent control. It is the legal responsibility of the occupier of premises to keep the premises free from infestation by rats and mice, and in view of this the Council has maintained the principle that a small charge should be made in respect of destruction work carried out by the Council at private dwellings. A nominal charge of 5/- is made therefore for this service which is generally appreciated and in respect of which no serious difficulty has been experienced since it was first put into practice in 1951. Work carried out at business premises including agricultural holdings is charged at the full cost which, during 1959, was increased to 11/3d. per hour plus cost of materials. In view of the comparative freedom from rat infestation of the Council's sewerage system it was agreed with the Infestation Division of the Ministry that only a modified testing and treatment of part of the system was necessary during the year. A total of 85 manholes were test baited and in only one manhole was there any evidence of infestation. 38 In the latter part of the year 11 manholes were test baited during a "vertical block control" treatment. For a number of years the department has relied principally on the use of Warfarin as a convenient and very effective poison for surface treatment, but on the advice of the Ministry its use has now been extended to sewer treatment by the addition of a preservative which inhibits mould growth in the poison. The Council has continued to undertake rodent control at local schools for The Surrey County Council on a contract basis. 39 40 RODENT CONTROL The following table is a tabular statement indicating the action taken in 1959. TABLE XIV Type of property Number of properties inspected by the Local Authority as a result of: Number of properties found to be infested by Number of treatments carried out by the Department by arrangement with occupier Number of Notices served under Section 4 Number of inspections made Notifica tion Otherwise Total Rats Mice Rats Mice Treatment Structural works, i.e. proofing Primary and reinspec tions Sewer treatment Total Local Authority 4 5 9 7 1 7 1 — — Dwelling Houses 282 25 307 207 27 197 27 — — Business Premises 39 40 79 20 12 20 12 — — 4,115 578 4,693 Agricultural 5 32 37 7 — 7 — — — Total 330 102 432 241 40 231 40 — — INSPECTION AND SUPERVISION OF FOOD THE FOOD AND DRUGS ACT, 1955 The Food Hygiene Regulations, 1955 The enforcement of these regulations has resulted in better standards of food hygiene both of premises and amongst food handlers, but the maintenance of this improvement requires in some cases constant supervision and exhortation both official and otherwise. The alteration of premises and provision of new improved equipment is not sufficient of itself if staff are not sufficiently interested or are in such short supply that proper care is not taken. The demand for labour and the shortage of the right type of staff, particularly perhaps in the catering industry, result in lack of continuity and training which are essential requirements of the good food handler. However, food hygiene has become a selling point with the far sighted trader and the modernisation of shops and erection of new self-service stores is adding fresh stimulus to the demand for higher standards. With this changing outlook has come the development in food presentation. Frozen foods of all kinds are now displayed and the rapid expansion in the broiler fowl industry has been a feature of the past few years. Food vending machines are becoming a familiar sight and there are press reports of plans to market complete meals in packets. This enterprise and change in the food industry behoves the health officer to keep abreast of developments and condition his approach to the public health aspect accordingly. During the year a change of emphasis has been made in the number and kind of food samples submitted for bacteriological examination. Less milk and ice cream samples have been taken in view of the consistently good results in recent years with a corresponding increase in the number of miscellaneous foods sampled such as fresh and frozen veal, synthetic cream, egg albumin, frozen and dried egg, cream cakes, minced beef, sausages and sausage meat, frozen steakettes, etc., totalling 134 samples. The reports on these samples have been reassuring and it is intended to continue these investigations, Advisory work continues to be carried out by the Inspectors as and when considered necessary. During the year 77 swabs were taken from 385 items of washed crockery and submitted for bacteriological examination. 41 There is evidence to indicate that this method of checking the standard of washing up is producing improved results. Further details of food samples are recorded elsewhere in this report. The register of premises coming within the scope of the Food Hygiene Regulations at present includes the following : - Confectioners 58 Butchers 32 Fishmongers (wet and dry) 13 Fishmongers (fried) 5 Bakers 23 Greengrocers and Fruiterers 46 Cafes and Restaurants 41 Grocers 75 Chemists 18 Licensed premises 31 Hospitals, Nursing Homes, Guest Houses Hotels 14 Canteens, Clubs, Halls, etc 46 Schools 46 Eight grocers' shops and one baker's premises are registered for the preparation of preserved meat, etc., and all the fish friers' premises are similarly registered in respect of fish frying. Milk. Milk & Dairies Regulations, 1949-1954 The handling and retail distribution of milk in urban areas has become a concentrated and well organised industry. Apart from small quantities bottled on the farms, milk is collected in the distant producing areas and transported in bulk to large processing plants situate in the consuming centres where it is pasteurised or sterilised and bottled for sale by a comparatively few large dairy companies. Residents in this district rely in the main on these sources of supply, there being only one registered dairy now operating in the Council's area. General control by the Department is exercised under the above regulations and only pasteurised, tuberculin tested or sterilised milk can be sold in the district as a result of a Special Designations Order made in 1951. The entries in the register, which has to be kept, were as follows:— Distributors of Milk in the District 18 Premises registered as Dairies 1 Under the Milk (Special Designation) Regulations, 1949-1954, the following licences to sell milk were issued during the year :— Dealers: Tuberculin Tested 19 Pasteurised 22 Sterilised 17 Pasteurisers's 1 Supplementary : Tuberculin Tested 8 Pasteurised 8 Sterilised 6 42 A total of 184 samples of milk was submitted for bacteriological examination, with the results set out in the following table :— TESTS REQUIRED BY THE MILK (SPECIAL DESIGNATION) REGULATIONS, 1949-1954 TABLE XV Designation Number Methylene Blue Phosphatase T urbidity Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Pasteurised 143 143 — 143 — — — T.T. (Raw) 20 18 2 — — — — T.T. (Pasteurised) 10 10 — 10 — — — Sterilised 11 — — — — 11 — Total 184 171 2 153 — 11 — It will be seen that of these samples only two raw milks failed to pass the methylene blue (keeping quality) test and the efficiency of modern pasteurisation is reflected in the results of the phosphatase testing of the samples. A total of 65 washed milk bottles was submitted for bacteriological examination with satisfactory results. Ice Cream The Ice Cream (Heat Treatment etc.) Regulations, 1947 to 1952 Ice cream which is now an important and popular item of food, has been the subject of special legislation and more strict control in post war years with the result that its manufacture is mainly undertaken by the large companies who produce an article of uniform quality, pre-packed in a variety of ways for sale by local retailers, from modern refrigerated units. One hundred and thirteen premises are registered for the sale of ice cream within the district and although two premises are also registered for the manufacture of this product, no manufacturing has been carried out for some years. A total of 100 samples of ice cream was examined for bacterial quality by submission to the methylene blue reduction test, and placed in the following provisional grades :— Grade I 99 Grade II — Grade III 1 Grade IV — These results can be considered very satisfactory. 43 Meat Slaughterhouses Act, 1958 Slaughter of Animals Act, 1958 Public Health (Meat) Regulations 1924-1955 There are no slaughterhouses in the District apart from the one at Netherne Hospital which is used for the slaughter of surplus animals from the Hospital farm to provide meat for consumption by hospital inmates. The arrangement to carry out post mortem inspection of all animals slaughtered at this slaughterhouse continued, and during the year the carcases and offals of ten cattle and 1 calf were inspected for evidence of disease. The carcase and offal of 1 cow were condemned as unfit for food. Retailers obtain supplies of fresh and imported meat from the Croydon Abattoir and Meat Market and the Smithfteld Market, and in addition small quantities of fresh meat direct from Scotland. During the year consideration was given to the information required by the Minister of Agriculture, Fisheries and Food on the existing and probable future requirements of the district for slaughterhouse facilities in accordance with the Slaughterhouses Act, 1958. In preparation of the necessary report the following persons or organisations were consulted :— (a) All retail meat traders in the district. (b) London Retail Meat Traders' Association Inc. (Division X). (c) Union of Shops, Distributive and Allied Workers (London Division). (d) The Chief Public Health Inspector of Croydon. From the replies received it appeared that no difficulties are being experienced at the present time in obtaining supplies of fresh meat from existing sources and that the Croydon Corporation are planning to reconstruct their existing Abattoir or alternatively erect new premises on a new site. In view of this information it was anticipated that the Council would submit a nil report. One slaughterman's licence was issued under the Slaughter of Animals Act for the purpose of slaughtering at Netherne Hospital. There are 32 butchers' shops in the District, all registered for the preparation or manufacture of sausages or potted, pressed, pickled or preserved meat under the provisions of Section 16 of the Food and Drugs Act, 1955. Unsound Food The following is a list of foodstuffs which after inspection were classified as unfit for human consumption. 44 The majority of the foodstuffs were destroyed at the Council's refuse destructor at Kenley. cwts. lbs. ozs. Sugar, jams, etc. — 12 — Canned Fruit 1 42 13 Canned Milk — 6 4 Meat, Poultry and Bacon 5 57 5 Fresh Fish — — 3¼ Tinned Meat 2 46 12 Tinned Fish — 10 8¼ Tinned Vegetables 3 71 l½ Frozen Foods — 88 14¼ Tinned Soup — 29 12 Food & Drug Samples During the year a total of 151 samples of food and drugs, including 28 milk samples were purchased for the purpose of analysis by the Public Analyst. Again, for similar reasons as previously mentioned, the number of milk samples has been decreased with an increase in the number of other foods. The milk samples were all of good quality and only four adverse reports were received on the remaining samples. Particulars of the unsatisfactory samples are as follows :— Rice, Vitafied with Essential B Although claims were made on the label for the presence of Vitamin B in this article of food, the minimum quantity of this Vitamin was not specified in the manner prescribed by the Labelling of Food Order, 1953. Investigation revealed that the importers of this product had already taken action to amend the labels on all future supplies of these goods. Fat Free Milk The Public Analyst reported that the statement specifying the ingredients of this article was not in accordance with the requirements of the Labelling Food Order, 1953, in that generic and not specific descriptions were used, namely — refined unhydrogenated vegetable oil and emulsifying agents. After considerable correspondence a form of label was devised that proved satisfactory. Cambridge Steaks (2 samples) These two samples were of the same product, the second being obtained in an unopened tin in order to facilitate a more accurate assessment of the contents. 45 The Public Analyst reported that these were samples of a minced meat and cereal product containing onion and other flavouring and seasoning, together with added gravy and that the total meat content of the whole article amounted to 60% and 51% respectively. In his opinion, as judged by the low overall meat content, and the presence of added gravy, this article was not entitled to the description Cambridge Steaks without qualification. The Public Analyst suggested that at least "with gravy" should be added to the description and representations were made to the Manufacturers accordingly with satisfactory results. 46 LIST OF SAMPLES TABLE XVI Article Analysed Non-Genuine Formal Informal Total Formal Informal Total Ale - mild 1 — 1 — — — Alfona fat free milk ... — 1 1 — 1 1 Anchovies (fillets) 1 — 1 — — — Apricots (dried) ... l — 1 — — — Asparagus Spears (tinned) l — 1 — — — Baked Beans — 1 1 — — — Bannocks, Cream l — 1 — — — Beef and Kidney Pie 1 — 1 — — — Brandy 1 — 1 — — — Bread - Danish ... 1 — 1 — — — Bread - White — 2 2 — — — Breakfast Sausage 1 — 1 — — — Biscuits ... 2 — 2 — — — Butter 1 — 1 — — — Cake - Trifle 1 — 1 — — — Cambridge Steaks 2 — 2 2 — 2 Cascara Safrada Tabs. ... 1 — 1 — — — Castor Oil B.P — 1 1 — — — Catarrh Syrup l — 1 — — — Cheeses - Assorted 1 — 1 — — — Cherries - Glace ... 1 — 1 — — — Chicken - Curry ... l — 1 — — — Chicken - Minced — 1 1 — — — Coconut - Dessicated ... 2 — 2 — — — Coffee 1 — 1 — — — Coffee and Chicory 2 1 3 — — — Condensed Milk ... 2 — 2 — — — Confectionery 5 — 5 — — — Cooking Oil — 1 1 — — — Cooking Fat 1 — 1 — — — Cordial, Ginger ... — 1 1 — — — Corn Flour 1 — 1 — — — Cora Oil ... 1 — 1 — — — Cough Mixture ... — 1 1 — — — Crab dressed 1 — 1 — — — Crab Meat 1 — 1 — — — Cranberries — 1 1 — — — Cream - English (tinned) 1 — 1 — — — Cream Pure 1 — 1 — — — Cheese - grated 1 — 1 — — — Dates 1 — 1 — — — Flour Wholemeal S.R. ... 1 — 1 — — — Fruitarian Sandwich — 1 1 — — — Fruitcadian Sandwich — 1 1 — — — Gelatine 1 — 1 — — — Gin 2 — 2 — — — Gravy Browning 2 — 2 — — — Ground Nut Oil ... — 1 1 — — — Hand Cream — 1 1 — — — Influenza and Cold Tabs. 1 — 1 — — — Jam (Damson) 1 — 1 — — — Jelly 2 — 2 — — — Junket Tablets 1 — 1 — — — Kosher Margarine 1 — 1 — — — Lard 1 — 1 — — — Total C/fwd. 54 15 69 2 1 3 47 Article Analysed Non-Genuine Formal Informal Total Formal Informal Total Total B/fwd. 54 15 69 2 1 3 Orange Drink 1 — 1 — — — Margarine 2 — 2 — — — Marzipan 2 — 2 — — — Milk Shake Powder 1 — 1 — — — Milk 28 — 28 — — — Mincemeat 1 — 1 — — — Mixed Cut Peel 2 — 2 — — — Mushrooms (button tinned) 1 — 1 — — — Pate 1 — 1 — — — Peas, Dried 1 — 1 — — — Pectin (liquid fruit) 1 — 1 — — — Peel (Cutdrained) 1 — 1 — — — Pickle, Sweet 1 — 1 — — — Rice, Vitafied 1 — 1 1 — 1 Rivella 1 — 1 — — — Rose Hip Syrup — 1 1 — — — Rum 1 — 1 — — — Sausages, Pork 3 — 3 — — — Sausages, Beef 5 — 5 — — — Sausages, Skinless (tinned) 1 — 1 — — — Saccharin Tablets 1 — 1 — — — Sago 1 — 1 — — — Salmon & Anchovy Paste 1 — 1 — — — Salmon Potted 1 — 1 — — — Scone Mix 1 — 1 — — — Sherry 1 — 1 — — — Shortbread 1 — 1 — — — Soup 2 — — — — — Spaghetti Bolo 1 — 1 — — — Sponge Mix 1 — 1 — — — Steak and Kidney Pie 1 1 — — — — Steak Pie 1 1 — — — — Suet Shredded Beef 1 — 1 — — — Suet 1 — 1 — — — Sugar Icing 1 — 1 — — Sugar Soft Brown 1 — 1 — — — Tea 1 — 1 — — Vegetable Rissole 1 — 1 — — — Vinegar, Malt with caramel — 1 1 — — Vinegar, Pure Malt 2 — 2 — — — Whisky 2 — 2 — — — Totals 132 19 151 3 1 4 48 49 TABLE XVII CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1959 Disease. At all ages. Number of cases notified. At Ages—Years. Total cases notified in each Ward. Under 1 year. 1 and under 2. 2 and under 3. 3 and under 4. 4 and under 5. 5 and under 10. 10 and under 15. 15 and under 20. 20 and under 35. 35 and under 45. 45 and tinder 65. 65 and over. Coulsdon East. Coulsdon West. Purley. Kenley. Sanderstead. Selsdon and Farleigh. Woodcote. Diphtheria — — — — — — — — — — — — — — — — — — — — Scarlet fever 132 — 3 3 3 1? 77 30 4 — — — — 10 6 74 5 27 9 1 Pneumonia 10 — — — — — — 2 1 1 2 4 3 — 4 1 2 — — Measles 930 8 43 88 106 124 520 33 3 2 1 2 — 98 115 225 87 281 116 8 Whooping cough 32 1 6 3 3 — 10 7 1 1 — — — 8 3 6 1 12 2 — Erysipelas 2 — — — — — — — — — — 1 1 — 1 — — — — — Dysentery 141 — 6 12 6 8 70 11 2 2 12 2 10 38 35 40 19 5 4 — Poliomyelitis (paralytic) — — — — — — — — — — — — — — — — — — — Poliomyelitis (non para) — — — — — — — — — — — — — — — — — — — — Meningococcal infection — — — — — — — — — — — — — — — — — — — — Puerperal pyrexia 1 — — — — — — — — — 1 — — — — — — — — — Encephalitis — — — — — — — — — — — — — — — — — — — — Food poisoning 17 1 1 — 1 — 3 1 — 2 — 8 — — 3 2 1 9 2 — Totals 1,265 10 59 106 119 144 680 84 10 8 15 15 15 157 163 351 115 336 134 9 50 TABLE XVIII THE MONTHLY INCIDENCE OF INFECTIOUS DISEASE, 1959 Disease. Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total Diphtheria — — — — — — — — — — — — — Scarlet fever 3 20 17 12 4 7 2 1 1 10 15 40 132 Pneumonia 2 4 2 1 — — — — — 1 — — 10 Measles 134 78 71 139 154 264 71 16 1 — — 2 930 Whooping cough 4 1 3 2 2 — 5 6 1 1 6 1 32 Erysipelas — — 1 — 1 — — — — — — — 2 Dysentery 13 23 44 21 7 18 9 4 1 — — 1 141 Poliomyelitis — — — — — — — — — — — — — Meningococcal infection — — — — — — — — — — — — — Puerperal pyrexia — — — 1 — — — — — — — — 1 Encephalitis — — — — — — — — — — — — — Food poisoning 1 — — — 2 — 10 2 — — — 2 17 Totals 157 126 138 176 170 289 97 29 4 12 21 46 1,265 51 TABLE XIX INFECTIOUS DISEASE NOTIFIED EACH YEAR SINCE 1929 Disease 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 Smallpox 2 2 3 4 — — — — — — — — — — — — — — — — — — — — — — — — — — — Scarlet fever 125 69 45 29 69 119 124 117 62 71 65 61 39 45 184 88 67 93 78 62 138 149 90 80 118 68 46 41 47 49 132 Diphtheria 26 17 8 21 16 24 52 35 8 10 10 25 7 9 7 19 15 8 — — — — — — — — — — — 1 — Erysipelas 3 11 8 11 23 17 11 12 14 13 10 17 27 22 5 9 4 8 5 8 4 4 3 — 3 4 4 8 1 4 2 Typhoid and paratyphoid fever 6 4 4 7 5 5 1 3 26 5 1 53 12 3 1 6 4 4 2 2 2 1 11 1 1 3 3 — — — Meningococcal infection 1 — — — — — 1 1 — — 4 8 6 1 4 2 1 3 1 1 — — — 1 — — — — — 1 — Puerperal fever 1 — 1 1 — 1 1 1 5 — — — — — — — — — — — — — — — — — — — — — — Puerperal pyrexia 1 1 3 5 1 2 1 — 2 5 3 2 — 2 3 1 2 2 1 2 2 2 3 2 3 — 3 2 4 1 1 Poliomyelitis — 1 — 2 — 1 1 — 3 1 1 1 2 3 — — 2 1 11 2 9 10 — 8 9 1 17 7 13 — — Polio-encephalitis — — — — — — — — 2 — — — — — — — — 1 — — — — — — — — — — — — — Acute encaphalitis — — — — — — — — — — — — — — — — — — — — — — — — — — — 1 1 1 — Ophthalmia neonatorum — 1 1 2 — 1 — 1 1 1 — 1 1 — 1 — 1 — — — — 1 — — — — — — — — — Pneumonia 38 11 14 29 28 20 32 13 30 12 52 19 32 38 27 9 17 16 20 13 5 23 51 21 44 20 31 36 26 22 10 Malaria — — — — — — — — — — — — — — — — — — — — — 1 — — — — — 2 — — — Measles 2 11 214 479 275 52 705 41 218 567 600 477 810 170 1319 9 1012 82 1184 103 930 Dysentery 5 — — — — — 6 — 1 2 10 85 224 121 21 42 172 82 43 71 14 28 22 48 13 12 98 81 2 35 141 Whooping cough 6 1 136 36 55 51 100 31 115 201 42 242 204 196 66 131 64 93 58 41 32 Food poisoning 2 6 2 5 2 74 5 8 3 1 17 Tuberculosis :— Pulmonary 22 38 44 36 44 28 30 27 36 32 31 31 32 43 39 51 44 38 59 48 57 47 60 42 37 31 47 41 45 31 26 Other forms 2 7 4 6 10 17 5 3 7 10 12 8 11 7 9 7 3 7 11 13 5 7 4 4 3 7 3 3 2 1 2 Totals 232 162 135 154 196 235 265 213 197 162 207 323 743 809 632 337 1137 335 564 990 880 998 1260 579 1617 359 1333 408 1386 291 1,293