ANNUAL (ABRIDGED) REPORT of the MEDICAL OFFICER OF HEALTH For the year 1943. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Chelsea. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit my Annual Report on the health and sanitary conditions of the Borough for 1943. As in the three preceding years, by direction of the Ministry of Health, the present Report is an abridged and interim one, and omits the figures of the population, birth rate, and death rate, for reasons of security. i The health of the population has continued to be satisfactory, notwithstanding prevailing conditions. There was no serious outbreak of infectious disease during the year under review. The number of notified cases of diphtheria continues small, and it is reasonable to regard this as mainly due to the immunisation work carried out in the past at the Chelsea Diphtheria Immunisation Clinic. None of the notified cases had completed a course of immunisation before the onset of the disease. There has been a progressive increase in Maternity and Child Welfare work, the number of attendances alone (1714), by mothers at the ante-natal clinic, constituting a notable record. Approval was given in November by the Ministry of Health for the establishment of a second war-time nursery, to accommodate 96 children, at Cheyne Hospital for children. This was opened on 15th February, 1944. The scheme for Special allowances for those who have given up work to undergo treatment for Tuberculosis became operative on July 1st. Of the forty-six cases considered, forty-two have been granted allowances, I should like to thank members of the Council for the support and sympathetic consideration which they have extended to mo and for their attention to the problems which it has been my duty to lay before them. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, W.H.L. McCarthy, M.D., D.P.H., Medical Officer of Health. Public Health Department, Town Hall, CHELSEA, S.W. 3. August, 1944. 2 AREA 660 acros. LIVE BIRTH3:- Male. Female. Total. Legitimate 205 184 389 Illegitimate 30 40 70 235 224 459 STILL BIRITHS. Male. Female. Total. 5 6 11 (Rate per 1,000 total (live and still) births = 23.4). DEATHS. Male. Female. Total. 267 287 554 DEATHS FROM PUERPERAL CAUSES;- Rate per 1,000 total Deaths. (Live and still) births. puerperal Sepsis - - Other puerperal Causes 1 2.1 INFANT MORTALITY. Male. Female. Total. 20 12 30 DEATH RATE OF INFANTS UNDER ONE YEAR OF AGE:- All infants per 1,000 live births 70 Legitimate infants per 1,000 legitimate live births 62 Illegitimate infants per 1,000 illegitimate live births 114 CLASSIFICATION OF DEATHS. The causes of deaths (554) were as follows:Scarlet Fever 1 Bronchitis 36 Tuberculosis of respiratory system. 22 Pneumonia 44 Other forms of T.B. 2 diseases 8 other respiratory Syphilitic disease 6 ulceration of Stomach influenza 12 or duodenum 11 Cancer - various sites 99 Diarrhoea (under 2) 8 Diabetes 1 Appendicitis 2 intra-cranial vascular Other digestive diseases 17 lesions 30 Nephritis 7 Heart disease 152 Maternal Causes 1 Other diseases of the Premature birth IX) circulatory system 18 Congenital malformations, birth injuries 8 Suicide 7 Road Traffic accidents 3 Other violent causes 14 All other causes 35 PROVISION OF HEALTH SERVICES IN THE BOROUGH. BACTERIOLOGICAL EXAMINATIONS. The total number carried out was lib 9 including" 0? for the "bacillus associated with Diphtheria. NURSING IN THE H3ME« The total number of visits paid by the nurses' from the Chelsea District Nursing Association was 1,305 (l6o cases). CLINICS AND_TREATMENT CENTRES« The total number of attendances at the Clinics by"cHIXdreh un3er one year of' age was 3j298, and 963 children attended between the ages of 1 and 5 years. There were 1,714 attendances by mothers at the ante-natal clinic and 18 mothers attended the post-natal clinic. CLASSIFICATION OF DEATHS. The causes of deaths (554) were as follows:- Scarlet Fever 1 Bronchitis 36 Tuberculosis of Pneumonia 44 respiratory system. 22 other respiratory Other forms of T.D. 2 diseases 8 Syphilitic disease 6 ulceration of Stomach influenza 12 or duodenum 11 Cancer - various sites 99 Diarrhoea (under 2) 8 Diabetes 1 Appendicitis 2 intra-cranial vascular Other digestive diseases 17 lesions 30 Nephritis 7 Heart disease 152 Maternal Causes 1 Other diseases of the Premature birth HO circulatory system 18 Congenital malformations, birth injuries 8 Suicide 7 Road Traffic accidents 3 other violent causes 14 All other causes 35 PROVISION OF HEALTH SERVICES IN THE BOROUGH. BACTERIOLOGICAL EXAMINATIONS• The total number carried out was 115, including 67 for the bacillus associated with Diphtheria. NURSING IN THE HOME. The total number of visits paid by the nurses from the Chelsea District Nursing Association was 1,305 (l6o cases). CLINICS AND_TREATMENT CENTRES. The total number of attendances at the Clinics by children under one year of age was 3,298, and 963 children attended between the ages of 1 and 5 years. There were 1,714 attendances by mothers at the ante-natal clinic and 18 mothers attended the post-natal clinic. INVALID CHILDREN'S AID ASSOCIATION. The number of applications referred to the Association for assistance of children under 5 years of ace was 26 (actual cases 26). HEALTH VISITORS. The total number of visits made was 5,769. the number of half-day attendances at Clinics was 600. CHILD LIFE PROTECTION. 90 visits (including 40 miscellaneous visits) were made To Foster Mothers. DENTAL TREATMENT. 70 cases attended the Dental Clinic at the Violet Melchett Infant Centre for the provision of preventive dental treatment for children under 5 years of age. Arrangements were also made for 64 expectant mothers to receive dental treatment at St, Stephen's Hospital, Of these, 8 mothers were provided with dentures, HOME HELPS, One case was attended by a Home Help - the nett cost to the Council being £4:0:0. DISTRIBUTION OF VITAMINS TO EXPECTANT MOTHERS AND CHILDREN. By arrangement with the local office of the Ministry of Food these preparations were distributed from the Welfare Centre by a member of the Public Health Staff. SANTARY CIRCUMSTANCES AND ADMINISTRATION. 12,825 inspections (including re-inspections) Were carried out by the Sanitary Inspectors. Included in this total number were 3,376 inspections on complaint of nuisance, 463 with reference to Infectious Disease and 173 as to conditions in Factories, 442 Intimation Notices and 86 Nuisance Notices under the Public Health (London) Act, 1936 were served during the year. Legal proceedings under the Public Health (London) Act, 1936, in respect of sanitary conditions were undertaken in 17 instances, DISINFECTION OR DISINFESTATION. The routine disinfection of rooms after the occurrence of infectious disease was continued, and also disinfestation for vermin. At the Disinfecting Station 23,721 articles were disinfected or disinfested and 239 articles were destroyed in the incinerator, SCABIES. Scabies was made notifiable this year, and 217 Adults and 158 children were treated at the cleansing Station, The total number of treatments was 848, as compared with 1,356 in 1942. Disinfection of the patients personal clothing was carried out whilst the patients were being treated. The Woman sanitary Inspector visited homes, and arranged for examination of contacts. VERMINOUS PERSONS. 24 Adults and 251 children (including children attending elementary schools) were cleansed at the Disinfecting Station, HEAD LICE. To give effect to the recommendations contained in the Ministry of Health's Circular regarding infestation by head lice, special attention and advice is given by the Health visitors at the Welfare Centre and when visiting homes. suitable combs are made available whenever necessary. INSPECTION AND SUPERVISION OF FOOD. The Inspectors made 980 inspections of premises where food is prepared, stored or sold. Unsound food was surrendered and either destroyed or disposed of for purposes other than human consumption. 3 4 Analyst for analysis during the year. of these 200 were taken as "formal" and 200 as "informal". Seventeen samples were returned as adulterated. In eo„ch of these cases a warning letter was sent to the Vendor concerned. All other samples were returned as genuine. INFECTIOUS AND OTHER DISEASES. NOTIFICATIONS. The total number of notifications received during the year was 753 as follows:- Diphtheria 18 Acute primary Pneumonia 18 Erysipelas 10 Acute Influenzal pneumonia 6 Scarlet Fever 96 Measles 297 Enteric Fever 2 Whooping Cough 42 puerperal pyrexia 6 Scabies 62 Cerebro-Spinal fever 4 Food Poisoning 30 Ophthalmia Neonatorum 1 Pulmonary Tuberculosis 72 Dysentry 85 Non-pulmonary Tuberculosis 4 DIPHTHERIA. 18 cases were notified, of which one proved not to be suffering from this disease. There were no deaths. DIPHTHERIA IMMUNISATION CLINIC. 348 new cases attended. SCARLET FEVER. 96 cases were notified, of which two proved not to be suffering from this disease. There was one death - female 4 years. OPHTHALMIA NEONATORUM. One case was notified - the child made a complete recovery. SMALLPOX AND VACCINATION. No case of Smallpox was notified. Of the 179 births registered in Chelsea during 1942, 114 were, successfully vaccinated - a percentage of 63.7. (Figures for 1943 are not yet available). TUBERCULOSIS. 72 new cases of pulmonary and 4 cases of nonpulmonary tuberculosis were notified. In addition, 20 now cases came to the knowledge of the Medical Officer of Health from other sources. The total number was therefore 96, (pulmonary - Males 44, Females 45; Non-pulmonary - Males 2, Females 5). The total number of deaths from all forms of Tuberculosis was 24, (pulmonary 22, Non-pulmonary 2). PUBLIC HEALTH (TUBERCUL0SIS) REGULATIONS, 1930. The total number of cases of Tuberculosis in the Borough on the 31st December, 1943, was 222, (Pulmonary - Males 108, Females 83; Non-pulmonary - Males 15, Females 16). The Tuberculosis Visitor paid 79 visits to nondispensary cases, DISPENSARY AND SPECIAL CASES. New cases examined l85. Of these, 24 were found to be definitely tuberculous. 117 contacts also examined. The number of attendances (including contacts) was 1,156, and 2,679 visits were made by the nurse to homes of patients. The Tuberculosis Officer visited 17 patients at their homes, and 94 patients wore referred to him at the Dispensary by Medical practitioners, 152 specimens of sputum examined, and 552 X-Ray examinations were made in connection with the work. The total number of cases on the Dispensary Register on the 31st December, 1943 was l5l. CHELSEA TUBERCULOSIS CARE COMMITTEE. the Committee met 4 times and 118 cases were considered. Social services in co-operation with voluntary societies were continued. During the year 35 patients received artificial pneumo-thorax treatment, 31 patients were in receipt of extra nourishment provided by the Council, and one patient received dental treatment under the Borough Council scheme.