EAS 041 East Ham Urban District Council. PUBLIC HEALTH DEPARTMENT. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, for the Year ending 3tst December, 1898. Public Health Committee. Councillor J. SAVAGE [Chairman). T. L. KNIGHT, J.P. W. TOMLINSON. W. ANDERSON. H. MURTY. C. NORTHFIELD. H. OSBORN. EAST HAM URBAN DISTRICT COUNCIL Medical Officer of Health's ANNUAL REPORT, 1898. Public Offices, East Ham, February 1899. To the Chairman and Members of the East Ham Urban District Council. Gentlemen, I beg to present my Ninth Annual Report upon the health of the District of East Ham, and in doing so, to congratulate the District Council upon the fact that in spite of increasing population with its attendant risks, the District continues to occupy a prominent place amongst the healthier London suburbs. Infectious disease was very prevalent during the latter part of the year, the non-notifiable disease of diarrhcea being conspicuous in its fatality during the months of August and September. 4 The work of the Department in the abatement of nuisances continues to increase, and much work of a valuable and permanent character has been executed by the Inspectors during the year. General Sanitary Condition of the District. (a.) The population at the last Census (1891) was 32,710. The estimated population in January, 1898, was 70,000, this number being arrived at by counting the number of occupied houses—at the present time it is nearer 80,000. The estimated population for the four Wards is as follows:— Manor Park Ward 15,800 Plashet Ward 35,580 Central Ward 22,610 Beckton and North Woolwich Ward 5,650 79,640 (b.) The area of the District is 3,266 acres, and there are about 24 persons per acre, and 5.95 persons per inhabited house. (c.) The subsoil is sand and gravel, overlaying the London clay, much of the District being marshy. (d.) The water supply is from the East London Water Works Company, and is mostly obtained from deep wells. On the 22nd August the E. L. W. W. Co., owing to the long continued drought were forced to limit the supply to six hours daily, and on September 3rd, a further restriction to four hours took place. An immediate enquiry was made as to the storage accommodation of the lower portion of the District, and as a result I was able to report that although some inconvenience would necessarily arise, no great danger would accrue to the health of the District. 5 On 26th November, the Water Company extended the limit from four to nine hours daily, and on 12th December the supply was resumed in full. On 4th October I took samples in sterilized bottles from No. 42, Prestbury-road (at which house there had been a death from Typhoid fever), and submitted it for analysis. On examination no micro-organisms were found in it to cause Typhoid Fever. (e) The system of sewerage is by water carriage ; it is ultimately collected by two large main sewers, serving respectively the northern and southern parts of the District, and which meet and discharge at the Pumping Station, Bonny Downs. It is there 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. (f) 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, but the greater portion 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 Roding the eastern boundary of the District—both, of course, being tidal. (h) No fresh bye-laws have been adopted during the year, but increased sanitary powers have been obtained under the East Ham Improvement Act, which became law during August. 6 (i) In every new road the main sewer is laid, and the houses connected with it. (J) Great attention has been given both by the Inspector and myself to the Bakehouses and Slaughterhouses, and they are mostly in a satisfactory condition. During the year 1898 the number of deaths registered for the District was 964, excluding 32 who died in the West Ham Union 6 in the Plaistow Infectious Diseases Hospital, and 2 in the London Hospital, and, calculated on a population of 70,000, this will give a death rate of 137 per 1,000 for the year. The number of births registered for the same period was 2,614—viz., 1,338 males and 1,276 females: this gives a birth rate of 37*3 per 1,000. The following table will show the different rates of mortality in East Ham for each of the past three years, with those of England for 1898:— East Ham. England. 18 96 1897 1898 1898 Death-rate per 1,000 living 13.2 13.7 14.3 17.6 Zymotic Death-rate per 1000 living 2.4 2.6 2.7 2.22 Deaths of Infants. 42.7 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 2614 born, 428 died before reaching the age of one year. The following table will record the ages at which the deaths occurred:— 1897. 1898. Deaths under 1 year of age ... 335 428 over 1 „ and under 5 years 129 145 „ „ 5 years 15 „ 49 44 ,, ,, 15 ,, ,, 25 ,, 29 29 ,, ,, 25 ,, ,, 65 ,, ... 190 216 ,, ,, 65 ,, ... 90 102 7 The deaths of children under one year of age are still very considerable. Many samples of milk have been taken by the Inspector for analysis, which will, I hope, help to secure good milk for these infants. Zymotic Death-Rate. 192 deaths were recorded from the seven principal Zymotic Diseases, and estimated on a population of 70,000, gives a Zymotic Death-rate of 2.7 per 1,000 per annum, as compared with 2.6 per 1,000 for 1897. They were as follows:— Totals. Totals. 1897. 1898. SCARLET FEVER 4 9 under 5 years 4 10 5 over 5 ,, 6 DIPHTHERIA 20 28 under 5 ,, 12 20 8 over 5 ,, 8 CROUP 3 3 under 5 ,. 3 3 0 over 5 ,, 0 TYPHOID FEVER 1 8 under 5 „ 1 10 7 over 5 ,, 9 MEASLES 20 26 under 5 „ 32 33 6 over 5 ,, 1 DIARRHCEA 65 71 under 5 ,, 80 83 6 over 5 ,, 3 WHOOPING COUGH 14 14 under 5 „ 33 33 SMALL POX nil — nil Total from the 7 principal Zymotic Diseases 159 192 The following figures show the increase, or otherwise, of deaths from Zymotic Diseases:— 1896 1897 1898 SCARLET FEVER 9 9 10 DIPHTHERIA 25 28 20 CROUP 2 3 3 TYPHOID FEVER 8 8 10 SMALL POX — — — MEASLES 28 26 33 DIARRHœA 37 71 83 WHOOPING COUGH 23 14 33 Totals 132 159 192 8 Under the Infectious Disease (Notification) Act, there were 950 cases reported:— Totals. SCARLET FEVER under 5 years 168 593 over 5 „ 425 DIPHTHERIA under 5 ,, 81 212 over 5 „ 131 CROUP under 5 „ 6 7 over 5 „ 1 TYPHOID FEVER under 5 ,, 6 79 over 5 „ 73 ERYSIPELAS under 5 ,, 8 54 over 5 ,, 46 PUERPERAL FEVER 4 4 SMALL POX over 5 „ 1 1 Total 950 The total number of cases notified for each Ward was as follows:— Manor Park Ward 242 Plashet Ward 370 Central Ward 273 Beckton and North Woolwich Ward 65 Table shewing comparison of the number of Infectious Diseases notified for three years 1896, 1897, and 1898 1896. 1897. 1898. January 58 41 49 February 43 38 61 March 44 46 60 April 36 24 63 May 27 45 56 June 55 60 46 July 38 55 61 August 46 59 51 September 37 70 83 October 47 121 168 November 54 98 149 December 57 72 03 Totals 542 729 950 9 Table shewing the comparison of each Infectious Disease for two years, 1897-98. Scarlet Fever. Diph.theria. Croup. Typhoid Fever. Erysipelas. Puerperal Fever. Small Pox. Totals. 1897 1898 1897 1898 1897 1898 1897 1898 1897 1898 1897 1898 1897 1898 1897 1898 January 16 30 12 10 ... ... 7 2 6 7 ... ... ... ... 41 49 February 21 41 14 11 ... 2 2 2 1 4 ... ... ... 1 38 61 March 24 37 9 12 ... ... 6 4 6 7 1 ... ... ... 46 60 April 15 43 3 12 ... ... 1 3 3 5 1 ... ... ... 24 60 May 26 36 9 11 ... ... 4 4 5 5 1 ... ... ... 45 56 June 38 33 11 8 ... ... 4 2 7 3 ... ... ... ... 60 46 July 32 43 15 11 ... 1 1 3 4 2 2 1 ... ... 55 61 August 28 35 25 6 ... ... 2 6 4 3 ... 1 ... ... 59 51 September 41 39 19 30 ... 2 6 8 4 4 ... ... ... ... 70 83 October 90 112 17 38 ... 1 9 12 5 4 ... 1 ... ... 121 168 November 60 76 17 33 ... ... 4 29 14 10 2 1 ... ... 98 149 December 43 68 21 30 ... 1 4 4 3 1 ... ... ... 72 103 Totals 434 593 172 212 3 7 50 79 62 54 8 4 ... 1 729 950 NOTIFICATION RATE Whole District 13 5 per 1,000 Manor Park Ward 20'1 ,, Plashet Ward 115 Central Ward 131 „ Beckton and N. Woolwich Ward 10 8 ,, Houses fumigated 711 SCARLATINA. • Manor Park Ward Plashet Ward. Central Ward Beckton & North Woolw'h Ward Totals. 1897 1898 1897 1898 1897 1898 1897 1898 1897 1898 January 3 10 6 12 4 6 3 2 16 30 February 3 14 11 16 6 6 1 5 21 41 March 2 11 7 16 9 6 6 4 24 37 April 3 11 7 15 3 13 2 4 15 43 May 1 14 15 13 10 6 — 3 26 36 June 6 8 13 17 19 6 — 2 38 33 July 1 14 11 9 20 18 — 2 32 43 August 1 17 6 7 21 8 — 3 28 35 September. 5 16 11 9 23 12 2 2 41 39 October 50 46 19 37 20 23 1 6 90 112 November 19 21 16 29 24 26 1 — 60 76 December 13 8 19 24 11 33 — 3 43 68 Total 107 190 141 204 170 163 16 36 434 593 10 The total number of cases notified from Scarlet Fever was 593, which resulted in 10 deaths, as against 434 reported cases and 9 deaths for 1897. In order to meet the increasing wants of the District, it became necessary to provide further accommodation for this disease. The District Council, at their meeting held on 15th November, sanctioned the use of a large building, known as Rancliffe House, as a home to which the patients from the Fever Hospital at Bonny Downs might be drafted upon convalescence. Accommodation being provided for twenty-four patients. I secured the services of a Matron and staff of three Nurses, and am pleased to report that the addition has been of the greatest benefit to the District. I have visited the Schools during the year on several occasions, and examined the children separately, and any child found desquamating was sent home, with any others living in the same house, and isolated. DIPHTHERIA. Manor Park Ward. Plashet Ward Central Ward. Beckton & North Woolw'h Ward. Totals. 1897 1898 1897 1898 1897 1898 1897 1898 1897 1898 January - - 10 6 1 4 1 - 12 10 February 1 1 8 7 3 2 2 1 14 11 March — 1 6 6 2 3 1 2 9 12 April — 1 2 8 1 3 — — 3 12 May 1 2 4 3 4 2 — 4 9 11 June — 2 3 2 8 1 — 3 11 8 July 4 1 3 5 5 1 3 4 15 11 August 1 - 19 4 5 - - 2 25 6 September. 8 1 10 16 - 0 1 7 19 30 October 1 9 12 18 4 10 — 1 17 38 November 3 4 13 18 1 11 - - 17 33 December — - 12 19 6 11 3 — 21 30 Total 19 22 102 112 40 54 11 24 172 212 11 There were 219 cases of Diphtheria (including 7 cases of Croup) notified, resulting in 23 deaths. Fifteen of these deaths were under 5 years of age, and 8 over 5 years, as against 175 cases recorded for 1897, which resulted in 31 deaths. The arrangement is still continued with the West Ham Corporation by which we are enabled to send cases of Diphtheria to the Plaistow Infectious Diseases Hospital; 25 cases were admitted, and 6 deaths occurred there. Deaths occurred at the following places, and the added particulars will show the condition of premises, drains, &c., at the time of the visits of the Inspector of Nuisances. 1 st January.—St. Bernards Road; aged 2 years; drain tested—no defects;, premises in fair condition. Died 7th January. 4th January.—Temple Road; aged 5 years; drain tested— no defects ; premises in fair condition. Died 5th January. 21 st January—Strone Road; aged 6 years; drain defective; no cover to cistern. Died 26th January. 24th January—York Road; aged 4 years; drain being reconstructed; premises in fair condition. Died 31st January. 15th February—Abbotts Park Road (Croup); aged 11 months; drain tested—no defects; premises in good condition. Died 15 th February. 9th March—Park Terrace, North Woolwich; aged 4 years; soil pan foul and broken; rooms in filthy condition; drain tested— no defects. Died 9th March. 12 28th March—Ratcliffe Road; aged 9 months; drain tested— no defects ; no water to w.c.; soil pan broken ; no cover to cistern. Died 28th March. 16th April—Herbert Road; aged 5 years; drain tested—trap defective; rain water pipe too short; dilapidated seat, floor and walls of w.c.; dilapidated wash-house walls and floor; no proper sill to back door. Died 29th April. 12th September.—Malvern Road; aged 4 years; drain tested—no defects; premises in good condition. Died 22nd September. 26th September.—Kensington Terrace, White Post Lane (Croup); aged 4 years; drain tested—no defects; premises in fair condition. Died 24th September. 30th September—Third Avenue (Croup); aged 1 year; drain tested—no defects ; no cover to cistern ; surface-gully choked. Died 29th September. 11 th October—Monega Road; aged 7 years; drain tested— no defects ; premises in fair condition. Died 14th October. 24th October—Frairs Road; (2 deaths) aged 7 years and 5 years ; drain tested—no defects; premises in fair condition. Died 25th and 29th October. 31st October—Rutland Road; aged 10 years; drain tested—no defects; premises in fair condition. Died 12th November. 16th November—Shelley Avenue; Aged 4 years; drain tested—no defects; premises in fair condition. Died 15th November. 13 16th November—Norman Terrace, High Street South; aged 3 years; premises new and in good condition. Died i8th November. 29th November—Thorpe Road; aged 3 years; drain tested—no defects; premises in good condition. Died 28th November. 12th December—Sherrard Road; aged 3 weeks; drain tested—no defects; premises in fair condition. Died nth December. 14th December—Park Avenue; aged 7 years; drain tested —no defects; premises in fair condition. Died 26th December. 19th December—Strone Road; aged 1 year; drain tested—no defects; premises in fair condition. Died 22nd December. 20th December—York Road; aged 4 years; drain tested— no defects; no cover to cistern; no dust bin. Died 23rd December. TYPHOID FEVER. M an or Park Ward. Plashet Ward. Central Ward. Beckton & North Woolw'h Ward. Total. 1897 1898 1897 1898 1897 1898 1897 1898 1897 1898 January 1 - 3 2 2 - 1 - 7 2 February - - 1 - 1 2 — - 2 2 March — 1 1 1 2 2 3 — 6 4 April — 1 1 1 — 1 — — 1 3 May — 1 2 1 2 2 — — 4 4 June — — 2 2 2 — — — 4 2 July — — — 2 1 1 — — 1 3 August — 1 2 1 — 3 — 1 2 6 September 1 — 3 5 1 3 1 — 6 8 October — 5 3 5 6 2 — — 9 12 November — 9 3 9 1 9 — 2 4 29 December 1 1 3 — — 3 — — 4 4 Totals 3 19 24 29 18 27 5 3 50 79 14 There were 79 cases of Typhoid Fever reported, which resulted in 10 fatal cases, as against 50 reported cases and 8 deaths for 1897. The majority of the cases were of a mild type; hence the small number of deaths (10) in proportion to the number of cases (79): 21 cases were removed to hospital. 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, and the water supply used for domestic purposes, and also that used for flushing the w.c. Enquiries were also made as to the food supply. Deaths occurred at the following places, and the added particulars will show the condition of premises, drains, &c , at the time of the visits of the Inspector of Nuisances:— 19th March.—Arragon Road; aged 18 years; new house in fair condition ; no dust bin. Died 22nd March. 10th May—Outram Road; aged 41 years; drain tested— no defects; yard paving dilapidated; no dust bin. Died 9th May. 15th August.—St. Bernards Road; aged 33 years; drain tested—no defects; premises in good condition. Died 18th August. 8th September.—High Street, North; aged 22 years; drain tested—no defects; premises in fair condition. Died 30th September (at London Hospital). 3rd October—Manor Park Road; aged 39 years; drain tested—no defects; no yard paving; no dust bin; no underfloor ventilation; front room walls damp; no fore-court paving Died (at London Hospital) 20th October. 15 28th October.—St. Stephens Road; aged 42 years; drain tested — no defects; premises in fair condition. Died 29th October. 3rd November—Skeffington Road; aged 25 years; defective drain ventilator. Died 14th November. 8th November.—York Villas. Southboro Road; aged 23 years ; drain tested—no defects; no cover to cistern; no dust bin. Died 9th November. 9th November.—New Winifred Road; aged 34 years; drain choked; roof defective. Died 9th November. 16th November.—Claremont Street, North Woolwich; aged 25 years; drain tested—no defects; premises in fair condition. Died 16th November. 17th November.—Rosebery Avenue; aged 27 years; drain tested—no defects; premises in fair condition. Died 19th November. 4th December,—Arthur Street; aged 33 years drain tested —no defects; piemises in fair condition. Died 3rd December Diarrhœa. Eighty-three deaths were attributed to Diarrhœa; 80 of these cases were under the age of five years, and 3 over, and all the deaths occurred during August and September. I submitted a Report in November, of which the following is a copy. 16 Report of the Medical Officer of Health on the prevalence of Diarrhcea. This disease is included in the seven principal Zymotic diseases, and as a rule causes a greater mortality than any other. It is not infectious in the ordinary sense of the term, and therefore not notifiable. The Death-rate is said to decrease in districts where the water supplies and drainage are improved, so that it can in a great measure be controlled by an efficient sanitary administration. In this district a hot, dry summer, with a continuous high temperature, seems to me to be the most potent cause; this, together with improper feeding and maternal neglect, is accountable for the high mortality. Diarrhcea generally commences in June, increases during July and August, again falling rapidly throughout September and October, and the increase or decrease fluctuates in different years according to the temperatures. Thus the summer of 1893 was characterised by early, long-continued heat, and that of 1894 was an exceptionally cold and uncongenial one. The heat of the summer of 1897, until after the first week of August, was abnormal, and was the immediate cause of the excessive diarrhceal mortality which prevailed throughout August. In 1893 there were 36 cases during July, August, and September. In 1894 there were 19 cases during July, August, and September, out of a population of 45,500. In 1897 there were 63 cases during July, August, and September, out of a population of 60,000. 17 In 1898 there were 77 cases during July, August, and September, out of a population of 70,000. To prevent the recurrence of this great mortality among infants, I should advise the frequent flushing of sewers, and the ventilation of them; the earth beneath the house should be covered by an impervious stratum of cement, so as to prevent any gases rising into the house. Strict supervision should be given to the food supply, especially milk, and frequent samples taken for analysis. (Signed) A. W. BEAUMONT, Medical Officer of Health Measles. Thirty-three deaths were registered from Measles, as against 26 for the year 1897. Influenza Still continues amongst us. Small Fox. One case was notified of a mild type. Extra precautions were taken, and the remainder of the family were re-vaccinated. Puerperal Fever. Four cases were reported, resulting in one death as against eight cases of last year and four deaths. The houses and drains were inspected, and every precaution taken by isolation and disinfection to prevent recurring cases, and the nurses cautioned not to take lying-in cases for a certain time. 18 Notification Returns. I have made Returns each month to the Essex County Council, and weekly to the Local Government Board, of the number of fresh cases notified in the District. Offensive Smells. Several complaints of this description came before us, for which Notices were served to remedy, and the nuisances abated ; and there have also been complaints referring to the smells arising from surface ventilators, so that I would advise that more up-cast ventilating shafts should be erected. Buildings. A large amount of building is still going on. Plans for 2,565 houses being deposited and approved by the Council during the past year. New roads are constantly being made, and a long time elapses before they are taken over, and being used for traffic so quickly get into a bad insanitary state by the water, rubbish, &c., remaining on the surface; and I believe that this accounts for a great many cases of Diphtheria. Bakehouses. Together with Mr. Banks, the Chief Inspector, I visited the Bakehouses in the District, and, so far as known, we have 32 Bakehouses, 17 on ground-floor, and 15 under-ground. With a few exceptions they are generally kept in a satisfactory condition; but there are several who require frequent visits to see that the provisions of the several Factory and Workshop Acts are carried out. Isolation Hospital. Our Isolation Hospital is of corrugated iron and contains three wards with 30 beds. 19 A Lodge has been erected in the grounds where visitors may seek shelter during inclement weather. Telephonic communication has been established with the Fire Station. Two hundred-and-six cases of Scarlet Fever were treated in this Hospital during the year, and six deaths occurred. Sanitary 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. Summary of Statistics. Birth-rate 37.3 per 1,000. Death-rate 14.3 „ Zymotic Death-rate 2.7 „ (Signed), A. W. BEAUMONT, B.A., M.D., Medical Officer of Health. 20 Inspector of Nuisances Annual Report. To the Chairman and Members of the East Ham District Council. Gentlemen, I herewith beg to place before you my Fourth Annual Report of the work accomplished by the Sanitary Inspectors during the year ending 31st December, 1898. Inspection of the District and Removal of Nuisances. In compliance with complaints lodged, notifications of Infectious Diseases received, house-to-house inspections, &c., 3,751 primary inspections were made in the District, as compared with 2,349 for the year ending 31st December, 1897. The increase of 1,402 is caused by the appointment in January, 1898, of an additional Assistant Inspector. Of the 3,751 inspections: 755 were made in the Manor Park Ward. 942 „ „ Plashet Ward. 1,469 „ „ Central Ward. 585 „ „ Beckton and North Woolwich Ward. Details and particulars of the above inspections are entered in the Inspector's Journal. 21 At 72 per cent. of the premises inspected, various works of sanitary amendment were required to be executed, to put the houses into a sanitary condition. There have been 5,090 nuisances discovered in the course of the inspections made, the nature of which manifest the need of the house-to-house inspections which have been systematically carried out in many parts of the District. Two thousand one hundred and fifty written Preliminary Notices were served, and in cases where the provisions were not complied with, the serving of 62 Statutory Notices was necessary. In three cases legal proceedings were instituted and Magistrates' Orders obtained; but this course is seldom found necessary, as the persons on whom Notices are served know, (some of them from experience) that it is to their advantage to comply with the provisions therein contained. It will be noticed that the nuisances discovered are in excess of the Notices served; this is owing to the fact that one Notice will call for the abatement of several nuisances, and in many instances personal interviews were obtained and the required works executed by the respective persons liable. 22 I append tabulated particulars of work done in the District:— Wards. Manor Park. Plashet. Central. Beckton and North Woolwich Totals Primary Inspections made 755 942 1469 585 3751 Notifications of Infectious Diseases 242 370 273 65 950 House-to-House Inspections 129 91 528 342 1090 Houses found in a sanitary condition 210 384 298 166 1058 Walls and Ceilings requiring repair 70 95 197 193 561 Yards and Forecourts insufficiently and not paved 197 153 447 116 913 Drains and Connections requiring amendment 49 20 46 22 137 Defective W.C. traps 23 20 9 8 60 Defective sink waste pipes 7 5 23 37 72 Rainwater pipes directly connected to drains 15 20 34 15 84 Defective flushing apparatus, or no water to W.C. 30 44 77 34 185 W.C. flushed direct from drinking water Cisterns 4 1 1 7 13 Foul and broken soil pans 45 53 133 84 315 Defective rainwater pipes and eaves gutters 20 14 29 25 94 Roofs not watertight 32 20 48 89 189 Water cut off (E.L.W.W.Co.) 21 23 10 ... 54 Drinking Water cisterns without covers 114 67 62 50 293 Dampness 13 16 15 12 56 Inundations 1 3 2 ... 6 Offensive accumulations 66 58 59 20 203 No under-floor ventilation 93 42 94 107 336 Breaches of Council's Bye-laws 10 18 28 3 59 No dust-bins 79 53 76 23 231 Overcrowding 1 ... 7 ... 8 Defective drain ventilating shafts 7 15 12 2 36 Dilapidated floors 20 10 52 63 145 Animals improperly kept 5 6 1 ... 12 Choked drains 72 94 202 59 427 Other nuisances 184 121 229 67 601 Preliminary Notices served ... ... ... ... 2150 Statutory Notices served ... ... ... ... 62 Summonses ... ... ... ... 3 Nuisances abated 1035 941 1763 992 4731 23 Dairies and Cowsheds. There are 11 Registered Cowsheds and 80 Dairies in the District. During the year, 23 dairymen and purveyors of milk have been added to the Register: 178 inspections were made, and particulars entered in the "Dairies and Cowsheds Register." The general condition of the dairies and cowsheds are satisfactory but to keep them so they require constant attention. Slaughter-houses. There are 15 Licensed Slaughter-houses in the District which have been periodically inspected and kept under regular supervision, and I am glad to report that the owners have always been willing to adopt any suggestions made by myself for keeping these places in a sanitary condition. No applications have been received during the year for premises to be licensed. Offensive Trades. Complaint was made of the establishment of a Fellmonger in the Manor Park Ward. Steps were at once taken by the Public Health Committee, and the business abolished. In September it was discovered that two different persons had established and were carrying on the business cf Fish-Skin Scraping at Wall End. Proceedings were instituted against them, fines inflicted, and Orders made by the Magistrate prohibiting the business. The presence of the defendants in Court (said the Chairman of the Bench, after he had ordered the windows to be opened) was sufficient evidence to convince him that the trade was an offensive one Factories and Workshops Acts. The premises (including Laundries) under the regulations of the above Acts have been visited, and as a rule were found in a fair condition. In one or two instances a word of warning has had to be given. Application was made early in the year to use the premises No. 1, Roman Road, which are partly underground, for the 24 purpose of a Bakehouse. The Public Health Committee, after inspecting the premises, declined to grant the request. Drain-testing. During the year, 797 drains were tested by chemicals and smoke, and in 197 cases defects were discovered to exist, principally in the traps. In each case steps were immediately taken to procure the amendment of such defects. Much good work has been done in this direction, and some of the old properties in the District can now boast of new drains. Complaints. Four hundred and fifty-two complaints have been received— 266 written and 186 verbal; many of them proved, on examination to be frivolous, and others beyond the jurisdiction of the Sanitary Authority, others had been made from sheer vindictiveness, whilst many were perfectly justifiable. There are many persons with confused ideas as to what are the functions of a Sanitary Inspector applications being frequently made for the ejectment of an undesirable lodger or neighbour, &c. A large number of anonymous letters containing various complaints have been received, and in a few instances neither the name nor the number of any street was given, in consequence of which they could not be traced. The rule of the Department is to investigate every complaint made, and personally I think that it is preferable that a few anonymous, frivolous complaints should be investigated, than run the risk of neglecting one that may turn out to be of a serious character. Unsound Food. The Market Places and Stalls have been under the observation of the Sanitary Inspectors daily, and especially on Saturday nights. On six occasions unsound food has been discovered and destroyed by the owner in the presence of the Inspector. In one instance a box of 400 eggs was seized, and condemned by a Magistrate ; the owner having decamped, no prosecution followed. 25 Several trunks of fish and barrels of crabs have been destroyed at owners' requests. Trade Refuse. Much trouble is caused and time taken up by Shopkeepers considering the Public Highway to be a suitable place to deposit their Trade Refuse. Caution Notices are served on each offender. Infectious Disease. Nine hundred and fifty notifications of Infectious Diseases were received during the year, and particulars entered in the Infectious Disease Register. Each house has been visited immediately on 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 were proved to exist a Notice has been served on the responsible person and the work carried out under the supervision of the Department. Two hundred and ninety-six infectious cases have been safely removed to Hospitals 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 at which Scholars reside who are attending their respective Schools; they are further informed when the house has been fumigated and when the children may resume School. Schools. The Elementary Schools in the District are periodically visited and examinations made of the Sanitary appliances. In some cases it has been necessary to call the attention of the School Managers to irregularities. 26 Gipsies and Tent Dwellers. During the year great difficulty has been experienced in keeping the land clear of Squatters and Tent-dwellers. Our District being in such close proximity to London, suits their convenience and pleasure, and in consequence we are frequently called upon to use compulsory measures to remove them, a work both dangerous and unpleasant. It often happens that we remove them by force from the Northern portion of the District, only to find that they wander a short distance away, and return at night to the South of the District, and vice versa. Urinals. The Public Urinals in East Ham are daily cleansed by a man specially appointed for that duty, and during the past year have been kept in a satisfactory condition. The Private Urinals are a great nuisance, and much trouble has been experienced in compelling the owners to keep them clean. Removal of Dust and House Refuse. For the purpose of this work, the District is divided into six sub-Districts. Two carts and three men work the district near the Shoot, and three carts and four men in the districts that have to cart the dust the greater distance. It is so arranged that whilst one cart is filling, the others are travelling to the Shoots, and by this method very little time is lost. We have 14 carts and 20 men at this work, and a responsible Dust Foreman who reports to me. During the past year very few complaints were received, and the work has proceeded satisfactorily, and, taking into consideration the phenomenal growth of the District and the great tax put upon this department of the work, it has been creditably dealt with. The weekly pail system continues to give satisfaction. 27 I am hoping in the near future to see properly constructed tipcovered vans at work collecting the dust, as this would greatly facilitate the collection in those districts farthest from the shoot. I have to again mention that there are a large number of householders who refuse to place their dust outside their doors ready for the dustmen to collect, necessitating the going through the houses, which causes much loss of time and delay in the collection. During the year, 231 Notices have been served on owners to supply portable iron dust-bins. In 140 cases they were complied with, but in 91 instances the District Council did the work of providing them, and recovered the costs from the owners. Number of Loads removed from Manor Park Ward. Plashet Ward. Central Ward. Beckton & North Woolw'h Ward. Total Lds. collected per Month. 1897 1898 1897 1898 1897 1898 1897 1898 1897 1898 January 133 138 278 374 163 193 89 73 663 778 February 120 128 265 339 162 167 73 62 620 696 March 130 138 297 374 175 199 86 76 688 787 April 130 120 285 374 165 202 79 64 659 760 May 132 118 272 362 162 186 78 79 644 745 June 115 122 254 364 160 191 79 70 608 747 July 115 124 272 365 182 195 79 78 648 762 August 96 127 244 335 152 191 98 77 590 730 September 99 128 269 331 168 190 84 66 620 715 October 116 142 285 342 236 211 62 70 699 765 November 127 142 352 370 189 236 78 75 746 823 December 143 157 375 429 201 224 71 70 790 880 Totals 1456 1584 3448 4359 2115 2385 956 860 7975 9188 1897. Loads. 1898 Loads. Deposited at the Sewage Works 3,590 6,430½ „ „ Hockley Brick and Tile Co.'s. Works — 1,781½ „ „ Manor Way 632 352 „ „ Brickfield, Ley Street, Ilford — 323 „ „ Little Ilford Shoot 3,753 301 28 Housing of the Working Classes Act. During the year five houses in Howards Road, and six in Plevna Street, were dealt with under this Act as unfit for human habitation; they were thoroughly renovated and put in a sanitary condition. Sale of Food and Drugs Act. In May last the Public Health Committee, feeling that the provisions of the Sale of Food and Drugs Acts were not being carried out in the District with that amount of energy which such important work demanded, instructed me to procure samples of Food and Drugs and submit the same for analysis. From that date until 31st December, 36 samples were taken and forwarded to the Public Analyst, who certified to eight of them being adulterated. On 7th August a sample of Milk was taken in transit from a van of the Dairy Supply Company, at the place of delivery, and which proved upon analysis to be adulterated with 15 per cent. of added water A Summons was duly issued and the case heard at the Stratford Petty Sessions; a warranty from the farmer who had supplied the Milk was produced in Court. The Summons was dismissed, the Dairy Supply Company agreeing to pay all costs incurred. The Warranty and Time Limit Clauses are great hindrances to the effectual working of this Act. The defendant is under no obligation to give notice that he holds a warranty, and the first intimation received is when it is produced in Court; the limitation of time having expired (28 days from the date when the sample was taken) proceedings cannot be instituted against the Warrantor. It is satisfactory to know that provision is made in the Bill now before Parliament to somewhat amend this serious defect when it becomes law. It is provided, that the Warranty defence shall 29 not be available unless within seven days from the service of the Summons, the defendant shall give notice to the purchaser, together with the name and address of the person from whom he received the warranty. But it frequently happens that 18 or 20 days elapse before the result of the analysis is made known. The Summons must be served 14 days before it is heard, and the defendant is only called upon to give seven days notice to the purchaser that he possesses a warranty. It will be seen that the 28 days' limit will often have a disastrous effect upon the prosecution. One would like to see, in cases where the warranty defence is to be available, the 28 days' limit suspended or extended. A good feature in the new Bill is that the minimum fine for second offences is £5, and for subsequent offences the Court may commit to prison. The Number and Nature of Samples of Food taken during the year. Article of Food. Total number of Samples taken. Result of Analysis. Genuine. Adulterated. Milk 24 17 7 Butter 10 9 1 Pepper 1 1 — Mustard 1 1 — 36 28 8 (Signed) JOSEPH BANKS, Assoc. San. Inst., Inspector of Nuisances. 30 TABLE shewing the Localities in which certain Diseases of a Zymotic character occurred during the year 1898. Locality. Number of Houses. Small Pox. Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Puerperal Fever. Croup. Albany Road 45 ... 4 ... ... ... ... 1 Ashley Road 24 ... 2 1 ... ... ... ... Arragon Road 81 ... 6 ... 1 1 ... ... Abbotts Park Road 66 ... ... ... 1 ... ... ... Arthur Street 11 ... ... ... 1 ... ... ... Albert Road 153 ... 11 9 ... ... ... ... Aintree Avenue ... ... ... ... ... ... ... ... Bessborough Road 96 ... 4 ... ... ... ... ... Browning Road 119 ... 1 1 1 ... ... ... Bristol Road 133 ... 1 4 1 ... ... ... Bath Road 6 ... ... 1 ... ... ... ... Balmoral Road 1 ... ... ... ... ... ... ... Byron Avenue, East 134 ... 1 3 1 3 ... ... Byron Avenue, West 46 ... l 2 ... ... ... ... Berkeley Road 27 ... l ... ... ... ... ... Boundary Road 31 ... ... ... ... ... ... Benson Avenue 70 ... l 1 1 ... ... ... Barking Road 160 ... 7 1 ... ... ... ... Boleyn Road 88 ... 5 ... 2 1 ... ... Bendish Road 49 ... ... 1 1 ... ... Burges Road 14 ... 1 ... ... ... ... ... Bonny Downs Road 57 ... 1 3 ... ... ... ... Beaconsfied Street 18 ... ... ... ... ... ... ... Brighton Road ... ... ... ... ... ... ... Carlton Road 48 ... 1 ...... ... ... ... ... Clarence Road 29 ... 2 ... ... ... ... Cumberland Road 16 ... 4 2 ... ... ... ... Capel Road 69 ... 5 ... ... ... ... ... Carlyle Road 118 ... 6 ... 1 ... ... ... Colchester Avenue 26 ... ... ... ... ... ... ... Church Road 31 ... 1 ... 1 ... ... ... Crescent Road 46 ... ... ... ... ... ... ... Cowper Avenue 25 ... 1 ... ... ... ... ... Cromwell Road 63 ... 4 ... ... 1 ... ... Colston Road 43 ... ... ... ... ... ... ... Clifton Road 34 ... 1 1 ... ... ... ... Chester Road 63 ... 3 ... ... ... ... ... Claremont Road 64 ... 4 1 ... ... ... ... Coleridge Avenue 67 ... 8 ... ... ... ... ... Compton Avenue 50 ... 1 ... ... ... ... ... Castle Street 38 ... ... ... ... 3 ... ... Cleves Road 87 ... 2 1 1 1 ... ... Colvin Road 51 ... 2 1 ... ... ... ... Clements Read 29 ... 3 ... ... ... ... ... Caledon Road 40 ... 2 1 ... ... ... ... 31 Locality. Number of Houses. Small Pox. Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. peral Fever. Croup. Caulfield Road 12 ... ... 1 ... ... ... ... Charlemont Road 9 ... ... 1 ... ... 1 ... Cyprus Place 41 ... 1 3 ... ... ... ... Cameron Street 20 ... ... ... ... ... ... ... Church Street 6 ... ... ... 1 ... ... ... Claremont Street 60 ... 2 ... 1 ... ... ... Central Park Road 75 ... 2 ... ... ... ... ... Creighton Avenue 11 ... ... ... ... ... ... ... Chesterford Road 4 ... ... ... ... ... ... ... Cook Road 2 ... ... ... ... ... ... ... City of London Cemetery 3 ... ... ... ... ... ... ... Durham Road 99 ... 3 1 ... ... ... 1 Dorset Road 68 ... 1 ... ... ... ... ... Dickens Road 3 ... ... ... ... ... ... ... Dersingham Avenue 6 ... ... ... ... ... ... ... Drew Road 4 ... ... ... ... ... ... ... Eighth Avenue 23 ... 1 ... ... ... ... ... Elizabeth Road 116 ... 4 ... ... 1 ... 1 Edith Road 30 ... 1 1 ... ... ... ... Essex Road 88 ... 1 ... ... ... ... ... Eversleigh Road 67 ... ... ... 2 2 ... ... Elizabeth Street 110 ... 5 1 ... ... ... ... Elsenham Road ... ... ... ... ... ... ... ... Forest Drive 32 ... ... ... ... ... ... ... Forest View Road 26 ... 1 ... ... ... ... ... First Avenue 83 ... 10 ... ... ... ... ... Fourth Avenue 69 ... 7 1 ... ... ... ... Fifth Avenue 13 ... 3 ... ... 1 ... ... Fry Road 15 ... 2 ... ... ... ... ... Finden Road 13 ... ... ... ... ... ... ... Florence Road 34 ... 4 1 ... ... ... ... Friars Road 88 ... 2 5 ... 1 ... ... Fabian Street 20 ... 3 ... ... ... ... ... Ferndale Street 10 ... ... ... ... ... ... ... Francis Street 22 ... ... ... ... ... ... ... Factory Road 1 ... ... ... ... ... ... ... Gordon Road 10 ... ... ... ... ... ... ... Gladding Road 12 ... 20 2 ... ... ... ... Gloucester Road 49 ... 6 ... ... ... ... ... Greenhill Grove 99 ... 10 1 1 1 ... ... Green Street 67 ... 2 ... 1 ... ... ... Gipsey Lane 123 ... ... 5 1 ... ... ... Goldsmith Avenue 76 ... 5 ... 1 1 ... ... Greenleaf Lane 4 ... ... ... ... ... ... ... Grosvenor Road 28 ... ... ... ... ... ... ... Glenister Street 34 ... ... ... ... ... ... ... 32 Locality. Number of Houses Small Pox. Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Puerperal Fever. Croup. Herbert Road 142 ... 11 3 ... 2 ... ... Harcourt Avenue 94 ... 8 ... ... ... ... ... Halley Road 198 ... 1 3 ... ... ... ... Henderson Road 88 ... 2 5 ... ... ... ... Hilda Road 28 ... ... ... ... ... ... ... Hampton Road 32 ... ... ... ... ... ... ... High Street North 125 ... 6 1 3 ... ... ... Heigham Road 125 ... 8 1 1 ... ... ... Harrow Road 40 ... 3 2 ... ... ... ... Holme Road 49 ... 1 2 ... ... ... ... Howard Road 5 ... ... ... ... ... ... ... Holloway Road 7 ... 1 1 ... ... ... ... High Street South 89 ... 8 3 1 ... ... ... High Street, N.Woolwich 49 ... 2 ... 1 ... ... ... Hartley Avenue ... ... ... ... ... ... ... ... Jephson Road 50 ... 4 2 1 ... ... ... Jews Farm Lane 2 ... ... ... ... ... ... ... Katherine Road 164 ... 2 2 2 3 ... ... Kings Road 41 ... 2 ... ... ... ... ... Kempton Road - ... ... ... ... ... ... ... Kelly Road 42 ... 7 ... ... ... ... ... Kensington Avenue 21 ... ... ... ... ... ... ... Little Ilford Lane 19 ... 2 2 ... ... ... ... Lansdowne Road 62 ... 3 ... ... ... ... ... Lancaster Road 81 ... 2 2 ... ... ... ... Lawrence Road 72 ... 5 ... 2 ... ... ... Lathom Road 19 ... 1 ... ... ... ... ... Lloyd Road 25 ... 3 ... ... 1 ... ... Langdon Road 3 ... ... ... ... ... ... ... Livingstone Street 19 ... — ... ... ... ... ... Lawrence Avenue 26 ... ... ... ... ... ... ... Little Ilford Avenue — ... ... ... ... ... ... ... Manor Park Road 53 ... 1 ... 1 1 ... ... Michigan Avenue 13 ... 1 1 ... ... ... ... Morris Avenue 42 ... 1 ... ... ... ... ... Meanley Road 86 ... 1 ... ... ... ... ... Milton Avenue 160 ... 8 1 ... ... ... ... Marlborough Road 54 ... 5 1 ... ... ... ... Monega Road 204 ... 6 5 ... ... ... ... Macaulay Road 40 ... ... ... ... ... ... ... Malvern Road 58 ... 2 ... ... ... ... ... Myrtle Road 4 ... ... ... ... ... ... ... Melbourne Road 49 ... 7 2 ... ... ... ... Market Street 41 ... 3 ... ... ... ... ... Mountfield Road 78 ... 2 ... ... 1 ... ... 33 Locality. Number of Houses. Small Pox. Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Puerperal Fever. Croup. Manor Way 16 ... ... ... ... ... ... ... Muir Street 18 ... ... ... ... ... ... ... Manor Road 48 ... ... ... ... ... ... ... Manor Avenue 16 ... ... ... ... ... ... ... Napier Road 60 ... 7 2 ... ... ... ... Norman Road 22 ... 1 ... ... ... ... ... Nelson Street 8 ... ... 1 ... ... ... ... Newland Street 6 ... ... ... ... ... ... ... Nigel Road 6 ... ... ... ... ... ... ... Oregon Avenue 6 ... ... ... ... ... ... ... Osborne Road 39 ... 1 2 ... ... ... ... Outram Road 68 ... 2 ... 1 2 ... ... Oakfield Road 79 ... 6 ... 1 ... ... ... Parkhurst Road 24 ... ... ... 3 ... ... ... Park Road 63 ... ... ... 1 2 ... ... Plashet Lane 133 1 3 2 1 1 ... ... Plashet Grove 171 ... 6 3 1 ... ... ... Prestbury Road 73 ... 1 ... 1 2 ... ... Priory Road 44 ... ... ... 1 ... ... ... Parr Road 58 ... 1 ... 1 ... ... ... Park Avenue 12 ... 1 2 1 ... ... ... Plevna Street 10 ... ... ... 1 ... ... ... Poulett Road 8 ... ... ... 1 ... ... ... Romford Road 371 ... 14 2 2 ... ... ... Rabbits Road 7 ... ... ... ... 1 ... ... Rothsay Road 53 ... ... ... ... ... ... ... Ratcliffe Road 51 ... ... 2 ... ... ... ... Red Post Lane 219 ... 9 1 ... 1 ... ... Rulland Road 73 ... 10 6 ... ... ... ... Rosebery Avenue 81 ... 2 ... 1 1 1 ... Ruskin Avenue 122 ... 4 ... ... 1 ... ... Rixsen Road 31 ... 7 1 ... ... ... ... Redcliffe Road 46 ... 2 ... ... ... ... ... Ranelagh Road 58 ... 3 4 ... ... ... ... Roman Road 123 ... 6 9 ... ... ... ... Robert Street 33 ... ... ... ... ... ... ... Rectory Road 2 ... ... ... ... ... ... ... Salisbury Road 65 ... 1 ... 1 ... ... ... Station Road 45 ... 1 ... 2 ... ... ... Southborough Road 84 ... ... ... 2 ... ... ... Second Avenue 110 ... 13 1 ... ... ... ... Sixth Avenue 91 ... 2 1 ... ... ... ... Seventh Avenue 65 ... ... 1 ... ... ... ... St. Stephens Road 124 ... 6 ... ... ... ... ... Shaftesbury Road 47 ... ... 1 ... ... ... ... 34 Locality. Number of Houses. Small Pox. Scarlet Fever. Diphtheria. Typhoid Fever. sipelas. Puerperal Fever. Croup. South Esk Road 188 ... 7 6 7 ... ... ... Strone Road 213 ... 5 1 1 ... ... ... Sherrard Road 359 ... 15 24 1 ... ... ... St. Dunstans Road 24 ... ... 1 ... ... ... ... Sandringham Road 30 ... ... 1 ... ... ... ... Stafford Road 97 ... ... 1 ... ... ... ... Shrewsbury Road 149 ... 5 6 ... ... ... ... Sibley Grove 103 ... 12 ... ... ... 1 ... Shelley Avenue 137 ... 2 2 ... ... ... ... Stanley Road 38 ... 6 ... ... ... ... ... Swinbourne Avenue 19 ... 1 ... ... ... ... ... Shakespeare Crescent 39 ... ... ... ... ... ... ... St. Martins Avenue 49 ... 1 ... ... ... ... ... Seymour Road 72 ... 2 1 1 2 ... ... St. Bernards Road 91 ... ... 1 l 2 ... ... Spencer Road 33 ... ... ... ... 1 ... ... Stamford Road 98 ... 1 ... 1 1 ... ... Skeffington Road 22 ... l ... l ... ... ... St. Johns Road 18 ... ... ... ... ... 1 ... Storey Street 46 ... 1 ... ... 1 ... ... Staveley Street 6 ... ... ... ... ... ... ... Stanley Street 20 ... ... ... ... ... ... ... Sussex Road 1 ... ... ... ... ... ... ... Sebert Road 1 ... ... ... ... ... ... ... Sherringham Avenue 15 ... ... ... ... ... ... ... School Road 22 ... 1 ... ... ... ... ... Toronto Avenue 6 ... ... ... ... ... ... ... Third Avenue 113 ... 16 3 2 ... ... 1 Tennyson Avenue 46 ... ... ... ... ... ... ... Thackeray Road 14 ... ... ... ... 1 ... ... Tudor Road 59 ... 1 ... ... ... ... ... Temple Road 13 ... l 1 ... ... ... ... Thorpe Road 41 ... 2 2 ... ... ... ... Talbot Road 94 ... l 1 ... ... ... ... Telham Road 67 ... 10 10 ... ... ... ... The Chase 3 ... ... ... ... ... ... ... The Warren 28 ... 11 ... 1 1 ... ... Victoria Avenue 80 ... 2 2 ... ... ... ... Vicarage Lane 15 ... ... ... ... ... ... ... Vernon Avenue 7 ... ... ... ... ... ... ... White Post Lane 167 ... 6 ... 3 l ... 1 Wentworth Road 33 ... 3 ... ... ... ... ... Whitta Road 45 ... 1 ... ... l ... ... Washington Avenue 27 ... 2 ... ... ... ... ... Worcester Road 50 ... 3 ... ... ... ... ... Washington Road 10 ... ... ... ... ... ... ... Waterloo Road 21 ... ... ... l ... ... 35 Locality. Number of Houses. Small Pox. Scarlet Fever. Diphtheria. phoid Fever. sipelas. Puerperal Fever. Croup. Walpole Road 34 ... 1 1 1 ... ... ... Whitfield Road 46 ... 3 2 ... ... ... ... Whittaker Road 42 ... 1 ... ... ... ... ... Wyndham Road 40 ... 2 ... ... ... ... ... Wortley Road 24 ... 2 ... ... ... ... ... Woodstock Road 61 ... 11 1 1 ... ... ... Windsor Road 68 ... 1 1 ... ... ... ... Woodhouse Grove 43 ... 2 ... ... ... ... ... Wordsworth Avenue 51 ... 2 ... ... ... ... ... Winifred Road 88 ... 3 ... 2 ... ... ... Wilson Road 20 ... ... ... ... 1 ... ... Wakefield Street 115 ... 11 2 ... ... ... ... Wellington Road 65 ... 3 1 ... ... ... ... Wellstead Road 38 ... 3 ... ... ... ... ... Winsor Terrace 110 ... 4 ... ... 1 ... ... York Road 93 ... 3 4 ... ... ... ...