EAS 040 East Ham Urban District Council. PUBLIC HEALTH DEPARTMENT, ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, for the year ending 31st December, 1897. EAST HAM URBAN DISTRICT COUNCIL. Medical Officer of Health's ANNUAL REPORT, 1897. Public Offices, East Ham, February, 1898. To the Chairman and Members of the East Ham Urban District Council. Gentlemen, I have the honour to submit my Eighth Annual Report relating to the Health and General Sanitary conditions of this District, for the year 1897. General Sanitary Condition of the District. (a) The estimated population in March, 1897, was 60,000, this number being arrived at by counting the number of occupied bouses, although we have made a recent count (January, 1898), from which we find there are no less than 12,387 houses in the District: 11,508 of these are occupied, 139 empty, and 740 in course of construction. 4 The number of occupied houses and estimated population for the four Wards are as follows: Occupied bouses. Empty houses. Houses in course of construction Estimated population. Manor Park Ward 1,983 28 179 11,798 Plashet „ 5,297 80 354 31,517 Central „ 3,285 26 207 19,545 Beckton and North Woolwich Ward 943 5 — 5,610 Totals 11,508 139 740 68,470 It seems to have been a remarkable year for building operations, for some 1,386 new houses have been constructed in the District. It will be seen that the population has increased since March, 1897, from 60,000 to the present estimated number of 68,470 : this is an increase for the year of over 10,000. The population at the last Census (1891), was 32,710. These figures speak for themselves, and it is scarcely necessary for me to further comment on the phenomenal growth of the District. (6.) The area of the District is 3,266 acres, and there are about 20.8 persons per acre, and 59 persons per inhabited house. (c.) The subsoil is sand and gravel, overlying the London clay, much of the District being marshy. (d.) The water supply is from the East London Water Works Company, and is obtained mostly from deep wells; it is generally ample and of good quality, and the amount used is about twenty gallons per head per day, On the 15th October, I took samples from No. 13, Bonny Downs Road (at which house there had been several cases of 5 Typhoid Fever), and submitted them to Thomas A. Pooley Esq., B.Sc., &c., Public Analyst for the County of Essex whose Analysis was as follows:— General appearance Fairly bright, a small quantity of reddish brown sediment deposited. Colour in 2 ft. tube Slight greenish tinge. Total solids dried at 230''F 21 grains per gallon. Loss on ignition of same 3.5 „ Chlorine 1.66 „ Equal to Chloride of Sodium 2 73 „ Nitrogen as Nitrates 0.103 „ Equal to Nitric Acid 0.463 „ Saline Ammonia 0.0014 „ Albuminoid Ammonia 00066 „ Oxygen absorbed from Permanganite acting for 15 minutes 0.040 „ Ditto, 4 hours 0.0355 „ Hardness before boiling 17½ Hardness after boiling 4½ Microscopical examination Sediment mainly composed of mineral matters with a few fibres and some vegetable debris. Observations. The analysis shows that this water has a composition indentical with that of the public supply of the District in which it was taken. I detected no unusual amount of organic impurities, and I am of opinion it is of fair quality for dietetic purposes. (Signed), THOMAS A. POOLEY, B.Sc., F.C.S., F.I.C. (e.) The system of sewerage is by water carriage, where the sewage is chemically treated and precipitated in tanks, the effluent passing through filters and thence into Barking Creek, the sludge being put on the land, where there is ample space, 6 (£.) The principal industries are the Beckton Gas Works and the products in connection therewith, there are also a large number of men in the South of the District who work at the Royal Albert Docks; the Building Trades employ a great number, and the Urban District Council about 200; while the greater part of the workmen travel to London, as will be seen by the overcrowded condition of the trains both night and morning. The inhabitants appear healthy, and do not suffer from any special disease. (g.) The Thames forms the Southern Boundary, and the Boding the Eastern Boundary of the District, both of course being tidal. (h.) No fresh Bye-Laws have been adopted during the year. (i.) In every new road the main sewer is laid, and the houses connected with it. (j.) Several cases of Overcrowding have occurred, and have been dealt with satisfactorily. (k.) Great attention has been given both by the Inspector and myself to the Bakehouses and Slaughterhouses, and they are mostly in a satisfactory condition. (I.) Systematic Inspections of premises, etc., have been carried out, both by the Inspector and myself, for the abatement of Nuisances, and in the majority of cases Notices were sufficient, in others Legal Proceedings were taken. During the year 1897, the number of deaths registered for the District was 822, excluding 22 who died in the West Ham Union and 3 in the Plaistow Isolation Hospital, and, calculated on a population of 60,000, will give a Death-rate of 13 7 per 1000 for the year. 7 The number of births registered for the same period was 2,209, viz.: 1,150 males, and 1,059 females: this gives a Birth Rate of 36.7 per 1,000. The following table will show some of the different rates of mortality in East Ham for each of the past three years, with those of England for 1897 :— East Ham England. 1895. 1896. 1897. 1897. Death-rate per 1,000 living 15.5 13.2 18.7 17.4 Zymotic Death-rate per 1,000 living 2.2 2.4 2.6 2.15 Deaths of Infants. 40 7 per cent. of the total number of deaths from all diseases were those of children under one year of age, for out of a total of 2,209 born, 335 died before reaching the age of one year. The following table will record the ages at which the deaths occurred throughout the whole District. 1896. 1897. Deaths under 1 year of age 299 335 464 under 5 years. „ over 1 „ and under 5 years 116 129 „ „ 5 years „ 15 „ 46 49 358 over 5 years. „ „ 15 „ „ 25 „ 25 29 „ „ 25 „ „ 65 „ 147 190 „ „ 65 „ 74 90 707 822 Zymotic Death-Rate. One hundred and fifty-nine deaths were recorded from the seven principal Zymotic Diseases, and estimated on a population of 60,000, gives a Zymotic Death-Rate of 2.6 per 1,000 per annum for the year 1897, as compared with 2.4 per 1,000 per annum for 1896. They were as follows :— 8 Zymotic Death-Rate.—(continued). Totals. 1896. Totals. 1897. SCARLET FEVER 4 9 under 5 years 4 9 5 over 5 „ 5 DIPHTHERIA (including Croup) 15 27 under 5 „ 23 31 12 over 5 „ 8 TYPHOID FEVER 1 8 under 5 „ 1 8 7 over 5 „ 7 MEASLES 25 28 under 5 „ 20 26 3 over 5 „ 6 DIARRHŒA 35 37 under 5 „ 65 1 2 over 5 „ 6 WHOOPING COUGH nil 23 under 5 „ 14 4 SMALL POX — nil Total from the 7 principal Zymotic Diseases 132 159 The following figures show the increase, or otherwise, of deaths from Zymotic Diseases :— 1895 1896 1897 SCARLET FEVER 8 9 9 DIPHTHERIA (including Croup) 48 27 31 TYPHOID FEVER 7 8 8 SMALL POX nil nil nil MEASLES 5 28 26 DIABRHCEA 44 37 71 WHOOPING COUG 1 23 14 Totals 113 132 159 Under the Infectious Diseases (Notification) Act, there were 729 cases reported :— Totals. SCARLET FEVER over 5 years 290 434 „ under 5 „ 144 DIPHTHERIA over 5 „ 106 172 „ under 5 „ 66 TYPHOID FEVER over 5 „ 45 50 „ under 5 „ 5- ERYSIPELAS over 5 „ 52 62 „ under 5 „ 10 PUERPERAL FEVER 8 8 CROUP over 5 „ 1 3 under 5 „ Total 729 9 The total number of eases notified for each Ward were as follows:— Manor Park Ward 131 Plashet Ward 306 Central Ward 256 Beckton and North Woolwioh Ward 36 Total 729 Table showing comparison of the number of Infectious Diseases notified for three years 1895, 1896, and 1897:— 1895. 1896. 1897. January 35 58 41 February 14 43 38 March 14 44 46 April 20 36 24 May 20 27 45 June 43 55 60 July 81 38 55 August 45 46 59 September 77 37 70 October 84 47 121 November 94 54 98 December 43 57 72 Totals 570 542 729 TABLE shewing the comparison of each Infectious Disease for two years, 1896-97. Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Puerperal Fever. Croup. Small Fox. Totals 1896 1897 1896 1897 1896 1897 1896 1897 1896 1897 1896 1897 1896 1897 1896 1897[/ ] January 31 16 14 12 4 7 3 6 1 .. .. .. 5 .. 58 11 February 25 21 50 10 6 2 2 1 .. .. .. .. .. .. 43 38 March 14 24 22 9 3 6 4 6 .. 44 46 April 11 15 18 3 2 1 5 3 .. 1 .. 1 .. .. 36 24 May 16 26 8 9 1 4 1 0 .. 1 1 .. .. .. 27 45 June 34 38 14 11 4 4 6 1 .. 1 .. .. .. 55 60 July 23 32 8 15 0 1 4 4 1 2 .. ..1 .. .. 38 55 August 28 28 8 20 5 2 4 4 1 .. .. .. .. .. 46 59 September 17 41 12 19 5 6 2 4 1 .. .. .. .. .. 37 70 October 21 90 12 17 10 9 2 5 2 .. .. .. .. .. 47 121 November 20 60 24 17 9 4 .. 11 1 2 .. ..1 .. .. 54 98 December 27 43 22 21 5 4 1 3 1 1 1 .. 57 72 Totals 267 434 172 172 56 50 29 62 9 8 4 3 5 .. 542 729 10 The Notification Rate for the whole District for 1897 was 12.15 per 1,000. Manor Park Ward 11.9 per 1,000 Plashet Ward 11.3 „ „ Central Ward 16 „ „ Beckton & North Woolwich Ward 6 „ „ Zymotic Death Rate 2 6 „ „ per annum. Houses fumigated 546 SCARLATINA. It will be observed by the following table that the total number of cases notified during the year 1897 were 434, as compared with 267 for the previous year. compared with 267 for the previous year. This shows an increase of 167 cases. Manor Park Ward. Plashet Ward. Central Ward. Beckton & North Woolw'h Ward. Totals. 1896 1897 1896 1897 1896 1897 1896 1897 1896 1897 January 5 3 15 6 11 4 3 31 16 February 4 3 9 11 9 6 3 1 25 21 March 2 2 7 11 9 1 6 14 24 April i 3 3 7 4 3 3 2 11 15 May 2 1 8 15 4 10 2 , . 16 26 June 6 6 14 13 11 19 3 , , 34 38 July 7 1 9 11 2 20 5 . . 23 32 August 12 1 12 6 4 21 . . . . 28 28 September 3 5 10 11 2 23 2 2 17 41 October 5 50 12 19 2 20 2 1 21 90 November 2 19 6 16 6 24 6 1 20 60 December 6 13 13 19 8 11 5 27 43 Total .. 53 107 113 141 69 170 3, 16 267 434 This increase occurs chiefly in the Manor Park and Central Wards. In the Beckton and North Woolwich Ward the decrease is very remarkable, and it will be noticed that during the summer months of May, June, July, and August no cases were reported. 11 The number of deaths occurring in the District for 1897 was nine, exactly the same as for the previous year. The character of the disease has been of a very mild form as will be seen by the small percentage of deaths. The number of cases occurring in the Manor Park Ward from January to September was 25, the highest in any of those months being six, in June. In September the number of cases was five, but in October it rose to 50. On the 22nd October I wrote to the Clerk to the East St Ham School Board informing him that since the 1st October 23 cases had occurred at houses from which children had been attending Manor Park Board School, and informing him that it was my intention to visit the school and invited him to be present. I visited the school on the 25th, and examined all the children in attendance, and found 14 who, in my opinion, were suffering from Scarlet Fever desquamation. I subsequently informed the Clerk to the Board of the result of my investigation, advising the immediate closing of the school for a period of 14 days, during which time the school could be disinfected. My advice was acted upon by the Board, and the school closed. I personally supervised the disinfecting of the school, which was first fumigated with Sulphur di-Oxide, followed by all the woodwork, &c., being washed with Perchloride of Mercury, and finally scrubbed with Creosote. The school was re-opened on the 10th November. From the 1st October till the closing of the school on the 27th, 40 cases occurred at houses from which children had been attending this school. I find that since the re-opening on 10th November till 31st December only 12 cases were reported. I am more than convinced that the closing and disinfecting of the school was the best method of arresting the epidemic. 12 In pursuance with the General Order of the Local Government Board, Sections 15 and 16, I forwarded them and the Medical Officer of Health of the Essex County Council the following reports:— Public Offices, East Ham, E 16tli November, 1897. Sir,—I beg to inform you that owing to an outbreak of Scarlet Fever at Manor Park, within the Urban District of East Ham, I deemed it advisable to suggest the closing of the Manor Park Board School for 14 days. The suggestion was acted upon by the School Board authorities, and the school accordingly closed. The reason for my advising this action was the sudden increase in the number of cases. I attach statement of cases attending this school for the current year, from which you will observe the sudden rise during October. I visited the school on the 25th October, and discovered 14 children in school desquamating from Scarlet Fever. I accordingly suggested the closing of the schools to permit of their disinfection, which has been done under my personal supervision. I am, Sir, Yours obediently, A. W. BEAUMONT, Mcdical Officer of Health. 13 Scarlatina. Infectious cases which occurred among the scholars of Manor Park Board School, 1897. January 2 February 1 March nil April nil May 1 June 2 July 5 August nil September 7 October to 27th inclusive 40 To the Secretary Local Government Board. On the 4th November I was informed by the Head Teacher (Infants' Department) of the High Street School that two children had been suspected by their teacher to be desquamating from Scarlet Fever, and had been taken to a doctor, who confirmed the teacher's suspicions and notified one of the cases. On receiving this information I personally called cn the Clerk to the East Ham School Board, but did not succeed in seeing him, but I left the information that it was my intention to visit the High Street Schools that day for the purpose of detecting any children who, in my opinion, were in an infectious condition. I visited the schools accordingly, and sent several children home, where I subsequently visited and examined them, and found two suffering from Scarlet Fever desquamation. The school was closed for half a day on the Friday afternoon, when our Sanitary Staff commenced the work of disinfecting, which was done with Formic Aldehyde sprayed through a Defries Equifex Sprayer, a method in which I have every confidence. The work was finished, and the school opened on Monday morning. In compliance with the instructions given at the Council Meeting, held 2nd November, to visit the whole of the schools 14 in the District, with a view of ascertaining if any infected children were in attendance, I officially informed the Clerk to the School Board of my intention, suggesting dates and schools when such visits should be made. I regret having to report that the School Board deemed it necessary to raise objections and impede me in the work of detecting infected children whilst attending school. I received a letter from the Clerk to the School Board enclosing a resolution passed at a specially-convened Meeting of the School Management Committee, informing me " That the Board had issued instructions to their Head Teachers not to permit the personal examination of any scholars to take place in the schools or on any part of the premises adjoining the schools, pending a reply from the Local Government Board, to whom they had appealed for information relating to the powers of the Medical Officer of Health to the Urban District Council to carry out this work." In pursuance with the Council's instructions I visited the Shaftesbury Boad and Shrewsbury Road Schools on 10th November, and Plashet Lane School on the 11th November, and made a personal application to the Head Teachers to suspend lessons and assist me in the work of examining the children. To this application they declined. I reported the circumstances to the Council, who instructed the Clerk to send full particulars to the Local Government Board, applying for their ruling. On 24th December the East Ham School Board received a communication from the Local Government Board, the substance of which was, that as the Local Government Board were advised, a Medical Officer of Health had no right, either with or without an order from a Sanitary Authority, to insist, 15 in virtue of his office on admission to a school without permission from its managers, but in similar instances that had come under the Local Government Board's notice, managers of schools tad, as a rule, been found quite willing to avail themselves of the help and advice of a Medical Officer of Health to prevent the spread of infectious disease among children, and also that it was to the interest of the East Ham School Board that all children who were in an infectious state should be so recognised and excluded from school—as otherwise the spread of disease among the scholars might cause a larger diminution of attendance, and might also render the closing of the schools necessary. It will be gathered from this communication that while the School Board are under no legal obligation to permit me carrying into effect your instructions it is to their interest, the children's good, and the District's welfare, that we should work amicably together in this important undertaking of detecting, preventing and stamping out Infectious Disease. Diarrhcea. Seventy-one deaths were attributed to Diarrhcea, 65 of these cases were under the age of five years and six over. It will be also interesting to state that out of this 65 there were 55 under the age of one year, and all of these infants died during July, August, and September. It appears to me that the higher the temperature and the longer it lasts, the greater the mortality amongst infants from this complaint. I still consider that the milk supply should be thoroughly investigated, especially during the summer months, as this is the main food of these infants. In this group I have given only those cases of simple Diarrhcea. 16 DIPHTHERIA. Manor Park Ward Plashet Ward. Central Ward. Beckton & North Woolw'h Ward. Totals. 1896 1897 1896 1897 1896 1897 1896 1897 1896 1897 January 7 .. 3 10 2 1 2 1 14 12 February 1 1 2 8 6 3 1 2 10 14 March 3 .. 11 6 8 2 .. 1 22 9 April 3 .. 4 2 6 1 5 .. 18 3 May .. 1 6 4 2 4 .. .. 8 9 June 1 .. 2 3 10 8 1 .. 14 11 July .. 4 2 3 6 6 .. 3 8 15 August 1 1 3 19 3 5 1 .. 8 25 September 3 8 3 10 5 .. 1 1 12 19 October 1 1 6 12 4 4 1 .. 12 17 November 1 3 10 13 4 1 9 .. 24 17 December .. .. 22 12 .. 6 .. 3 22 21 Totals 21 19 74 102 56 40 21 11 172 172 There were 175 cases of Diphtheria (including three cases of Croup) recorded in 1897, resulting in 31 deaths. Twentythree of these deaths were under five years of age and eight over five years, as against 176 recorded for the year 1896, which resulted in 28 deaths. It always occurs in its greatest severity among children during the first five years of life. In a great many instances, when one case occurs in a family, several, and often all, the members in the household are attacked respectively. I still consider that milk, water and food, in many cases, have not been wrongly suspected as the cause of contagion, although in some instances defective drainage has been contributory to the spread of Diphtheria. An arrangement was made in September with the West Ham Corporation to admit cases of Diphtheria into the 17 Plaistow Infectious Diseases Hospital, and since that date to 31st December, 17 cases have been sent in which resulted in three deaths. See pages 19, 20, and 21 for addresses. TYPHOID FEVER. Manor Park Ward. Plasliet Ward. Central Ward. Beckton & North Woolw'h Ward. Total. 1896 1897 1896 1897 1896 1897 1896 1897 1896  January 2 1 1 3 1 2 .. 1 4 7 February 1 .. 2 1 3 1 .. .. 6 2 March .. .. 2 1 1 2 .. 3 3 6 April 1 .. .. 1 1 .. .. 2 1 May .. .. .. 2 1 2 .. .. 1 4 June .. .. 2 2 1 2 .. .... 4 4 July .. .. 2 1 .. .. 2 1 August 2 .. 2 3 .. .. 5 2 September 2 .. 2 3 1 1 .. 1 5 6 October 1 .. 4 3 5 6 .. 10 9 November .. 1 8 5 1 3 .. 9 4 December 1 1 1 3 3 .. .. .. 5 4 Totals 10 3 17 24 25 18 4 5 56 50 There were 50 cases of Typhoid Fever reported, which resulted in eight fatal cases, as against 56 reported cases and eight deaths for 1896. In every case the residence of the patient was examined as to the sanitary condition of the external drainage, as also the drains inside the house, including the water supply used for domestic purposes, in addition to that used for flushing the w.c., and also food supply as far as possible. The majority of the cases were of a mild type, hence the small number of deaths (8) in proportion to the number of cases (50). 18 The following particulars will show the condition of premises, drains, etc., at the time of the visits of the Inspector of Nuisances :— 12th January.—Cyprus Place; aged 15 years; shed in front of back room window impeding light and ventilation; drain tested—no defects. Died 15th January. 25th January.—Clarence Road; aged 51 years; improper gulley; drain tested—no defects. Died 31st January. 22nd May.—Katherine Road; aged 4£ years; drain tested—no defects; premises in good condition. Died 24th May. 22nd May.—Bendish Road; aged 28 years; drain tested —no defects; premises in good condition. Died 29th May. 18th June.—Prestbury Road; aged 43 years; defective drain; defective flushing apparatus; no cover to drinkingwater cistern. Died 17th June. 6th September.—Park Terrace, North Woolwich; aged 6 years; premises in fair condition. Died 6th September. 29th September.—Elizabeth Road; aged 24 years; drain tested—no defects; premises in fair condition. Died 26th October. 4th December.—St. Stephen's Road; aged 33 years; rain-water pipe directly connected to drain, front and back gmttering defective, drain tested—no defects. Died 16th December. Diphtheria (including Croup). The following particulars will show the condition of premises, drains, etc , at the time of the visits of the Inspector of Nuisances :— 19 24th December, 1896.—Halley Road; aged 3 years; drain tested—no defects, no cover to drinking-water cistern, yard PaviDefender defective, no dust bin. Died 1st January, 1897. 18th January .—Beaconsfield Street; premises in fair condition. Died 18th January. 9th February.—Sherrard Road; aged 8 years; w.c. flushed direct from drinking-water cistern, no cover to drinking-water cii-tern; back room, ground floor, walls, and ceiling dirty; yard not paved; drain tested—no defects. Died 9th February. 10th February.—Cleves Road; aged 3 years; drain tested—no defects; premises in good condition. Died 12th. February. 22nd February. -Red Post Lane; aged 5 years; defective drain; no cover to drinking-water cistern; back room, first floor, walls and ceiling dirty. Died 28th February. 26th March.—Claremont Street; aged 18 years; yard not properly paved, no dust bin, roof defective, walls damp. Died 24th March. 26th March.—27, Dorset Road (Group); drain tested— no defects; premises in good condition. Died 28th March. 6th April.—Outram Road (Croup); aged 1 year; drain tested—no defects; no cover to drinking-water cistern. Died 6th April. 4th May.—Stamford Road; aged 3£ years; w.c. choked; no proper dust bin. Died 19th May. 3rd June.—Heigham Road (two deaths); aged 4 years and 2 years; drain tested—no defects; vent pipe joints slightly defective. Died 3rd and 6th June respectively. 20 19th July.—Heigham Road; aged 3 years; drain tested —no defects; premises in good condition. Died 19th July, 19th July.—Fabian Street; aged 5 years; drain tested— no defects; premises in fair condition. Died 25th July. 31st July.—Friars Road (Croup); aged 4 years; drain tested—no defects; premises in good condition. Died 31st July. 6th August.—Shaftesbury Road; aged 4 years; drain tested—trap defective; water wasting; no dust bin. Died 19th September. 9th August.—Friars Road; aged 5 years; drain tested— no defects; premises in good condition. Died 24th August. 11th August.—Cleves Road; aged 2£ years; drain tested —no defects; premises in good condition. Died 11th August. 24th August.— Castle Street; aged 6£ years; drain tested —no defects; premises in good condition. Died 5th September. 25th August.—"Woodstock Road; aged 5 years; drain tested—no defects; premises in good condition. Died 4th September. 26th August.—Castle Street; aged 31 years; drain tested—no defects; premises in good condition. Died 28th August. 7th September.—Claremont Road; aged 3 years; ground floor w.c., defective connection between trap and drain; first floor w.c., defective connection between trap and soil pipe; soil pan defective form; defective joints to drain vent pipe—upper parts too small, with acute angles; stack-pipe directly connected to drain, and defective; yard gulley too large, with defective connection to drain. Died 7th September. 21 20th September.—Greenbill Grove; aged 8 years; drain tested—no defects, vent pipe joints defective. Died 24th September. 16th October.—Greenhill Grove; aged 5 years; back and front rooms, first floor, walls and ceilings dirty; defective joint to soil pan. Died 15th October. 16th October.—Greenhill Grove; aged 4 years; back and front rooms, first floor, walls and ceilings dirty, defective joint to soil pan. Died 15th November. 21st October.— Strone Road; aged 4 years; drain tested —no defects; premises in good condition. Died 30th October. 27th November.—Whitta Road; aged 2 years; drain tested —no defects; premises in fair condition. Died 28th November. 3rd December.—Grosvenor Road; aged 10 years; drain tested—no defects; premises in good condition. Died 11th December. 20th December.—Park Road; aged 8 years; defective w.c. connection, no dust bin. Died 31st December. 29th December.—Claremont Street (2 deaths); aged 2 years and 11 months; drain tested—no defects; premises in fair condition. Died 28th December. Measles. Twenty-six deaths were registered from Measles, as against 28 for the year 1896, shewing a decrease in the number of deaths of two. There was a great prevalence of tbe disease during the last three months of the year; and, in consequence, I visited the schools in the affected districts, and concluded from information obtained that the best means to arrest the epidemic was to close the Infants' Schools (including Sunday Schools) for a season. 22 The following is a special report made to the Local Government Board and Essex County Council: Public Offices, East Ham, 24th January, 1898. Sir,—I beg to inform you that, in consequence of the great prevalence of Measles in the District, I have deemed it advisable to close the Infants' Departments of the High Street, New Beckton, and Stamford Eoad Schools. The epidemic made its first appearance in the Beckton Ward. I visited the New Beckton School on the 29th November, 1897, and found that, in the Infants' Department, the percentage of attendance had fallen from 85.0 to 48.0. The head teacher prepared a statement, from which I learned that 71 children were away suffering from Measles. The number of infants on the books was 220; the number in school at the time of visit, 61. I suggested the closing of the New Beckton School (infants' department) for twenty- one days. The School Board complied with my suggestion. On the same day I visited the Stamford Road ("temporary school), and found 168 scholars on the books, and 87 in school. The percentage of attendance had fallen off from 78.5 to 51-0. The head teacher prepared me a list of 24 scholars reported to be suffering from Measles, and, on the 30th November, sent me a further list of sixteen more scholars so suffering, bringing the number up to forty. I suggested the immediate closing of the school for twenty-one days, and this suggestion was acted upon by the School Board. The closing of the schools at Beckton had the desired effect, and the epidemic abated in that District. From information received, I discovered great prevalence of the disease in theBonney Downs district, and in the vicinity 23 of the High Street School, which, at the time, was closed for the Christmas holidays. I suggested that the school should be kept closed for fourteen days from the 7th January. This suggestion was acted upon by the School Board. The epidemic has been of the mild type, and, during the month of December, eight deaths occurred. Yours obediently, A. W. BEAUMONT Medical Officer of Health. Influenza Still continues amongst us. Small Pox. No cases of Small Pox were notified during 1897. PuEBPEEAL FeVEB. Eight cases of Puerperal Fever were reported, resulting in four deaths, as against nine cases of last year, and no deaths. The houses and drains were inspected, and every precaution taken, by isolation and disinfection, to prevent recurring cases. Directions are given to the nurse not to attend any lyingin cases for a period of three months. Offensive Smells. Several complaints of this description came before us, for which Notices were served, and the nuisance abated; and there have also been complaints referring to the smells arising from surface ventilators, so that I would advise that more upcast ventilating shafts should be erected. Buildings. A large amount of building is still going on (about 1,000 houses per year), as will be shewn by the increase of population. 24 New roads are constantly being made, and a long time elapses before the road is taken over. The new roads are soon used for traffic before being taken over by the Council, and quickly get into a bad, insanitary state, by the water, rubbish, &c., remaining on the surface ; and, I believe, this accounts for a great many cases of Diphtheria, for many of our first cases are reported from houses in these new roads. Bakehouses. Together with Mr. Banks, the Chief Inspector, I visited the Bakehouses in the District, and, so far as known, we have now 32 Bakehouses, 17 on ground floor, and 15 underground. Three new Bakehouses have been opened during the year. In inspecting the Bakehouses throughout tho District, I caDnot say that the general condition is as perfect as might be expected. Empty sacks, boxes, &c., find their way into the Bakehouse, which, in many instances, becomes a lumber store: Air space and ventilation, to the Baker, are his very last thoughts, while fresh air is regarded as his enemy, because, he says, that it prevents his bread from rising. In many of our Bakehouses, although means for ventilation is provided, it is totally disregarded. Isolation Hospital. Our Isolation Hospital is of corrugated iron, and contains three wards, with thirty beds. Increased accommodation for the staff has been provided during the year. 142 cases of Scarlatina were taken and treated in this Hospital during the year, and four deaths occurred. 25 Sanitaey Department. Our Sanitary Staff consists of a Medical Officer of Health, Chief Inspector, and two Assistant Inspectors of Nuisances, Sanitary Clerk, Dust Inspector and Disinfecting Man. The routine work of the Department is carried on in a very efficient and methodical manner, and a great deal of work has been done during the year. Summary of Statistics. Birth-rate 36.7 per 1,000. Death-rate 13.7 „ Zymotic Death-rate 2.6 ,, (Signed), A. W. BEAUMONT, Medical Officer of Healt 26 Inspector of Nuisances Annual Report. I have the honour of submitting to you my Third Annual Report of the work done in this District during the year ending 31st December, 1897. Inspection of the District and Removal of Nuisances. With a view of ascertaining what nuisances exist calling for abatement, 2,349 Primary Inspections have been made; this is an increase of 381 on the number of Inspections made in 1896. Of the 2,349 Inspections: 401 were made in the Manor Park Ward, 765 „ ,, Plashet „ 921 ,, ,, Central ,, 262 ,, ,, Beckton and North Woolwich Ward. Details and particulars of the above Inspections are entered in the Inspector's Journal kept for that purpose. At 73 per cent, of the houses inspected, various works of sanitary amendment were required to be executed to put the premises in a sanitary condition. In a large number of cases the required works were executed by the respective persons liable, on the servioe of the usual written Preliminary Notice -which in all cases precedes the service of the Statutory Notice, but in four cases it was found necessary to resort to Legal Proceedings. In one case the work was done on the service of the Summons, in the other three cases the Magistrates made Orders for the necessary work to be done for the abatement of the nuisance, and in one instance a fine of Forty Shillings and Costs was inflicted for non-compliance with the Notice and a re-curring penalty of Ten Shillings per day after the expiration of the Order. 27 The above Inspections have necessitated the service of 896 Preliminary Notices and 112 Statutory Notices, besides a large number of courtesy letters intimating the institution of legal proceedings in default of the work being done. Daisies and Cowsheds. There are 10 licensed Cowsheds and 71 Dairies in the District, and during the year 103 Inspections have been made. Particulars and idsults of such Inspections have been entered in the Register kept for that purpose. The general condition of the Dairies is satisfactory, but the Cowsheds require frequent attention. Slaughter Houses. There are 15 Slaughter Houses in the District, which have been periodically inspected, and to carry into effect the Council's Bye-Laws they require my constant attention. During the year, two applications have been made for Licenses for Slaughtering. The Public Health Committee, after careful consideration and visiting the premises, recommended the Council to decline to grant the applications. Factories and Workshops. By the provision of the various Factory and Workshop Acts, it is the duty of the Sanitary Authority to see that in all Workshops (including Laundries) there is no overcrowding, an efficient means of ventilation, a sufficient water supply and sanitary appliances, a sufficient means of escape in the event of fire, and that the Workshops generally are cleansed and kept in a sanitary condition. Much time has been given to this work. Infectious Diseases. Seven hundred and twenty-nine Notifications of Infectious Diseases have been received during the year, and particulars entered in the Infectious Disease Journal kept for that 28 purpose. Each house has been visited immediately on the receipt of the Notification; a printed form of precautions has been handed to the householder, and directions given as to isolation, &c.; and disinfectants have been supplied gratis. The premises have been inspected and drains tested in all cases, and where defects have been proved to exist, a Notice has been served, and the work carried out under the supervision of the Department. One hundred and eighty-six infectious cases have been safely conveyed to Hospital during the year. The Head Teachers of the Day Schools and the Superintendents of the Sunday Schools are advised of all cases of Infectious Disease occurring at the houses in which scholars reside who are attending their respective schools ; they are further informed when the house is free from infection and the children can resume school with safety. Removal of Dust and House Eefuse. The weekly pail system of collecting the Dust and House Eefuse continues to give general satisfaction. We have at present ten carts and fifteen men collecting throughout the District. The phenomenal growth of the District during the past year greatly taxes the weekly collection, but in the near future we hope to see the new Motor Dust Van successfully working, which I feel confident will facilitate the maintenance of the weekly collection. It is with regret that I have to again mention that there are still a large number of Occupiers who refuse to place their dust out ready for the Dustmen to collect, necessitating the going through the house and picking up the dust, causing great loss of time and delay in the collection. During the year, 196 houses have been supplied with portable Sanitary Dust Bins, either by the Owners or by the Council, who will recover from the Owners. 29  Number of Loads removed from Manor Park Ward. Plashet Ward. Central Ward. Beckton & North Woolw'h Ward. Total Lds. collected per Month 1896 1897 1896 1897 1896 1897 1896 1897 1896 1887 January 123 133 284 278 144 163 101 89 652 663 February 109 120 249 265 120 162 86 73 564 620 March 111 130 264 297 137 175 84 86 596 688 April 131 130 249 285 144 165 78 79 602 659 May 122 132 226 272 135 162 76 78 559 644 June 116 115 247 254 146 160 86 79 595 608 July 120 115 236 272 150 182 82 79 588 648 August 95 96 202 244 135 152 70 98 502 590 September 106 99 226 269 139 168 75 84 546 620 October 121 116 252 285 151 236 77 62 601 699 November 110 127 260 352 155 189 72 78 597 746 December 122 143 265 375 148 201 87 71 622 790 Total 1386 1456 2960 3448 1704 2115 974 956 7024 7975 1896. 1897. Loads. Loads. Deposited at Little Ilford Shoot 3,534 3,753 „ „ the Sewerage Works 3,009 3,590 „ „ Beckton Road 481 – „ „ Manor Way – 632 Tbade Refuse. Much trouble has been experienced during the year with the shopkeepers depositing Trade Refuse upon the Highway, and a Caution Notice has been served on each of the offenders. Makket Places. The Market places and stalls have been regularly inspected, and on nine occasions unsound food has been discovered on the premises, and in all cases, the Owner, in the presence o^ the Inspector, has destroyed the same. In no instance was the food exposed for sale at the time of the Inspector's visits in such a conditioa as to justify seizure. 30 I append tabulated particulars of work done in the District. Wards. Manor Park. Plashet Central Beckton and North Woolwich Totals. Primary Inspections made 401 765 921 262 2349 Notifications of Infectious Diseases 131 306 256 36 729 House-to-House Inspections 6 34 134 77 251 Houses found in a sanitary condition 118 292 164 53 627 Walls and Ceilings requiring repairing 38 66 257 68 429 Yards insufficiently and not paved 34 53 165 51 303 Drains and Connections requiring amendment 17 63 64 3 147 Defective W.C. traps 3 23 24 2 52 Defective sink waste pipes 3 8 8 4 23 Rainwater pipes directly connected to drain 9 13 42 7 71 Defective flushing apparatus or no water to W C. 20 32 60 17 129 W.C. flashed direct from drinking water cisterns 5 2 2 6 15 Broken soil pans 14 18 55 10 97 Defective rainwater pipes and eaves gutters 11 22 103 17 153 Roofs not water-tight 10 16 139 43 208 Water cut off (E.L.W.W.Co.) 27 30 10 1 68 Drinking water cisterns without covers 29 65 79 5 178 Dampness 9 16 73 11 109 Inundations 4 10 5 5 24 Offensive accumulations 37 54 27 13 131 No underfloor ventilation 6 14 90 10 120 Breaches of Council's Bye-laws 2 2 9 2 15 No dust bins 16 27 72 7 122 Overcrowding .. 2 3 1 6 Defective drain ventilating shafts 6 23 15 .. 44 Dilapidated Floors 5 8 34 16 63 Animals improperly kept 6 4 10 2 22 Other Nuisances 109 162 255 59 585 Preliminary Notices served .. .. .. .. 896 Statutory Notices served .. .. .. .. 112 Summonses .. .. .. .. 4 Nuisances abated 403 659 1427 336 2825 31 TABLE showing the Localities In which certain Diseases of a Zymotic character occurred during the year 1897. Locality. Number of Houses Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Puerperal Fever. Croup. Albany Road 45 .. .. .. .. .. .. Ashley Road 24 1 1 .. .. .. .. Arragon Road 68 1 .. .. 1 .. .. Abbotts Park Road 45 .. 1 .. .. .. .. Arthur Street 11 .. .. .. .. .. .. Albert Road 115 .. 1 1 .. .. .. Bessborough Road 9 .. .. .. .. .. .. Browning Road 26 .. .. .. .. .. .. Bristol Road 134 1 10 .. 2 .. .. Bath Road 6 .. .. .. .. .. .. Balmoral Road 1 .. .. .. .. .. .. Byron Avenue 46 4 1 .. 1 .. .. Berkeley Road 24 .. .. .. .. .. .. Boundary Road 31 .. .. .. .. .. .. Benson Avenue 70 2 .. .. 1 .. .. Barking Road 156 6 3 .. .. .. .. Bcleyn Road 88 4 1 .. .. .. .. Bendish Road 49 .. 2 1 .. .. .. Burges Road 14 6 .. .. .. .. .. Bonny Downs Road 45 6 .. 4 .. .. .. Beaconsfield Street 18 .. .. .. .. .. .. Carlton Road 48 3 .. .. 1 .. .. Clarence Road 29 3 .. 1 .. .. .. Cumberland Road 16 6 .. .. .. .. .. Capel Road 66 9 2 .. .. .. .. Carlyle Road 105 5 .. .. .. .. .. Colchester Avenue 10 .. .. .. .. .. .. Church Road 29 .. .. .. .. .. .. Crescent Road 47 .. .. .. .. .. .. Cowper Avenue 21 .. .. .. .. .. .. Cromwell Road 50 2 4 .. 2 .. .. Colston Road 48 1 .. .. .. .. .. Clifton Road 22 .. .. .. .. .. .. Chester Road 63 3 .. .. .. .. .. Claremont Road 61 1 2 .. .. .. .. Coleridge Avenue 67 1 1 2 .. .. .. Compton Avenue 16 3 .. .. .. .. .. Castle Street 38 1 3 .. .. .. .. Cleves Road 87 7 3 .. .. .. .. Colvin Road 45 1 .. .. .. .. .. Clements Road 10 .. .. .. .. .. .. Caledon Road 40 .. .. 1 1 .. .. Caulfield Road 12 1 .. .. .. .. .. Charlemont Road 8 2 .. .. .. .. .. Cyprus Place 41 1 .. 2 .. .. .. 32 Locality, Number of Houses Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas Puerperal Fever. Croup. Cameron Street 20 .. .. .. 1 .. .. Church Street 6 .. .. .. .. .. .. Claremont Street 60 1 .. .. .. .. .. Creek Terrace 38 1 .. .. .. .. .. Durham Road 97 13 .. .. .. .. .. Dorset Road 61 3 4 .. .. .. .. Dickens Road .. .. .. .. .. .. .. Eighth Avenue 24 .. .. .. .. .. .. East Road 14 .. .. .. .. .. .. Elizabeth Road 116 2 2 1 1 .. .. Edith Road 30 .. .. .. 1 .. .. Essex Road 12 .. .. 1 l .. .. Eversleigh Road 67 1 1 .. .. .. .. Elizabeth Street 110 1 l .. .. .. .. Forest Drive 28 5 .. .. .. .. .. Forest View 25 1 .. .. .. .. .. First Avenue 63 .. .. .. .. .. .. Fourth Avenue 21 1 .. .. .. .. .. Fifth Avenue 23 1 .. .. .. .. .. Fry Road 13 .. .. .. .. .. .. Finden Road 14 1 .. .. .. .. .. Florence Road 34 .. 1 .. 1 .. .. Friars Road 89 5 l 1 .. .. 2 Fabian Street 20 4 l .. .. .. .. Ferndale Street 10 .. .. 2 .. .. .. Fraacis Street 22 .. .. .. .. .. .. Gordon Road 10 .. l .. .. .. .. Gladding Road 9 4 .. .. .. .. .. Gloucester Road 49 .. .. .. .. .. .. Greenhill Grove 97 4 5 .. .. .. .. Green Street 75 1 .. .. 1 .. .. Gipsey Lane 123 3 4 .. .. .. .. Goldsmith Avenue 53 1 .. 1 .. .. .. Greenleaf Lane 4 .. .. .. .. .. .. Grosvenor Road 28 2 1 .. .. .. .. Glenister Street 34 2 .. .. .. .. .. Herbert Road 141 7 .. .. .. .. .. Harcourt Avenue 2 .. .. .. .. .. .. Halley Road 198 5 4 1 .. 1 .. Henderson Road 63 1 2 .. .. .. .. Hilda Road 28 .. .. .. .. .. .. Hampton Road 29 1 .. .. .. .. .. High Street, North 111 3 .. .. .. .. .. Heigham Road 123 9 4 .. 3 1 .. 33 Locality. Number of Houses Scarlet Fever. Diphtheria Typhoid Fever. Erysipelas. Puerperal Fever. Croup. Harrow Road 40 .. .. .. .. .. .. Holme Road 33 5 .. .. .. .. .. Howard Road 5 .. .. .. .. .. .. Holloway Road 7 .. .. .. .. .. .. High Street, South 95 2 1 .. .. .. .. High Street, North Woolwich 49 .. .. .. .. .. .. Jephson Road 44 .. 2 .. 1 .. .. Jews' Farm Lane 19 .. .. .. 1 .. .. Katherine Road 151 6 .. 1 .. 1 .. Kings Road 41 .. 2 .. 1 .. .. Kempton Road .. .. .. .. .. .. .. Kelly Road 42 2 .. .. .. .. .. Little Ilford Lane 19 .. .. .. .. .. .. Lansdowne Road 68 .. 1 .. .. .. .. Lancaster Road 50 .. .. 1 .. .. .. Lawrence Road 64 5 3 .. .. .. .. Lathom Road 19 1 .. .. .. 1 .. Lloyd Road 25 1 .. .. .. .. .. Langdon Road 3 .. .. .. .. .. .. Livingstone Street 19 .. .. .. .. .. .. Manor Park Road 54 2 .. .. .. .. .. Michigan Avenue 13 .. .. .. .. .. .. Morris Avenue 25 1 .. .. .. .. .. Meanley Road 69 4 1 .. .. .. .. Milton Avenue 159 4 3 .. 2 1 .. M arlborough Road 41 3 .. .. .. .. .. Monega Road 202 6 5 .. 1 .. .. Macaulay Road .. .. .. .. .. .. .. Malvern Road 48 2 .. .. .. .. .. Myrtle Road 4 .. .. .. .. .. .. Melbourne Road 48 .. .. .. .. .. .. Market Street 36 1 .. .. .. .. .. Mountfield Road 78 1 .. 1 1 .. .. Manor Way 31 .. .. .. 1 .. .. Muir Street 18 .. .. .. .. .. .. Napier Road 59 5 .. .. .. .. .. Norman Road 8 1 .. .. .. .. .. Nelson Street 4 1 .. .. .. .. .. North Woolwich Road 1 .. .. .. .. .. .. Newland Street 6 .. .. .. .. .. .. Oregon Avenue 5 .. .. .. .. .. .. Osborne Road 39 .. .. .. .. .. .. 34 Locality. Number of Houses Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Puerperal Fever. Croup. Outram Road 68 5 2 .. 1 .. 1 Oakfield Road 75 10 .. .. 3 .. .. Parkhurst Road 5 .. .. .. .. .. .. Park Road 51 1 4 .. .. .. .. Plashet Lane 138 3 1 .. 2 .. .. Plasliet Grove 175 4 1 .. .. .. .. Prestbury Road 73 1 1 1 .. .. .. Priory Road 44 5 .. .. .. .. .. Parr Road 36 3 .. .. .. .. .. Park Avenue 12 .. .. .. .. .. .. Plevna Street 10 .. .. .. .. .. .. Romford Road 364 11 2 1 1 .. .. Rabbits Road 7 .. .. .. .. .. .. Rothsay Road 52 4 2 .. .. .. .. Ratcliff Road 50 .. 1 .. .. .. .. Red Post Lane 197 2 1 1 3 .. .. Rutland Road 62 .. 2 1 .. .. .. Rosebery Avenue 40 1 .. .. .. .. .. Ruskin Avenue 51 2 .. 1 .. .. .. Rixsen Road 31 2 .. .. .. .. .. ltedcliffe Road 42 .. 1 .. .. .. .. Ranelagh Road 38 1 1 .. 1 .. .. Roman Road 120 l .. .. l .. .. Robert Street 33 .. .. .. .. .. .. Salisbury Road 33 .. .. .. .. .. .. Station Road 45 6 .. .. .. .. .. Southboro' Road 17 1 .. .. .. .. .. Second Avenue 110 2 1 .. .. .. .. Sixth Avenue 23 1 .. 1 .. .. .. Seventh Avenue 33 1 .. .. .. .. .. St. Stephen's Road 124 3 2 .. 1 .. .. Shaftesbury Road 47 3 1 .. l .. .. South Esk Road 191 2 6 3 2 .. .. Strone Road 210 11 4 .. .. .. .. Sherrard Road 278 5 4 1 3 .. .. St. Dunstans Road 24 .. 2 .. .. .. .. Sandringham Road 30 2 .. .. 1 .. .. Stafford Road 98 2 1 .. 2 .. .. Shrewsbury Road 213 7 1 .. 4 .. .. Sibley Grove 63 2 1 1 .. .. .. Shelley Avenue 117 10 1 .. .. .. .. Stanley Road 42 1 3 .. .. .. .. Swinbourne Avenue 3 .. .. .. .. .. .. Shakespeare Crescent .. .. .. .. .. .. .. St. Martin's Avenue 26 .. .. .. .. .. .. Seymour Road 59 11 .. .. .. .. .. 35 Locality. Number of Houses Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Puerperal Fever. Croup. St. Bernards Road 80 14 3 .. .. .. .. Spencer Road 33 .. .. 1 .. .. .. Stamford Road 93 4 2 .. 1 .. .. Skeffington Road 7 .. .. .. .. .. .. St Johns Road 14 .. 1 .. .. .. .. Storey Street 46 2 2 .. 1 .. .. Staveley Street 6 .. .. .. .. .. .. Stanley Street 20 .. 1 .. .. .. .. Toronto Avenue 6 .. l .. .. .. .. Third Avenue 104 1 .. .. .. .. .. Tennyson Avenue 47 2 .. .. .. .. .. Thackeray Road .. .. .. .. .. .. .. Tudor Road 46 6 .. 1 .. .. .. Temple Road 6 2 .. .. 1 .. .. Thorpe Road 25 .. .. .. 1 .. .. Talbot Road 62 2 .. 2 1 1 .. Telham Road 54 3 .. .. 1 .. .. Victoria Avenue 80 1 3 1 .. .. .. Vicarage Lane 15 .. .. .. .. .. .. White Post Lane 168 11 2 1 .. .. .. Wentworth Road 33 .. .. .. .. .. .. Whitta Road 42 8 4 .. .. .. .. Warren Road 28 .. .. .. .. .. .. Washington Avenue 24 .. .. .. .. .. .. Worcester Road 50 .. .. .. .. .. .. Washington Road 10 .. 1 .. .. .. .. Waterloo Road 21 1 3 1 .. .. .. Walpole Road 36 .. 1 .. .. .. .. Whitfield Road 46 4 .. 1 1 1 .. Whittaker Road 42 .. 1 .. 1 .. .. Wyndham Rr ad 40 1 l .. .. .. .. Wortley Road 22 1 3 .. .. .. .. Woodstock Road 59 1 2 1 .. .. .. Windsor Road 68 3 .. l .. .. .. Woodhouse Grove 41 1 1 .. .. .. .. Wordsworth Avenue 51 3 3 .. .. .. .. Winifred Road 88 2 .. l .. .. .. White Horse Lane 45 .. .. l .. .. .. Wilson Road 20 1 .. .. .. .. .. Wakefield Street 114 8 1 3 .. .. .. Wellington Road 58 3 .. .. .. .. .. Wellstead Road 26 .. .. .. 2 .. .. Windsor Terrace 110 3 2 .. .. .. .. York Road 89 3 .. .. .. .. ..