AC - 4309 (1) EAM 38 34/6/8 Borough of Edmonton REPORT of the MEDICAL OFFICER for the year 1953 Borough of Edmonton With the Compliments of the Medical Officer of Health. Public Health Department, Town Hall, Edmonton, N.9. Borough of Edmonton REPORT of the MEDICAL OFFICER OF HEALTH for the year 1953 Borough of Edmonton 1953 His Worship the Mayor - Alderman A. J. Hollywood, J.P. Deputy Mayor ... Alderman Mrs. F. Long, J.P. PUBLIC HEALTH COMMITTEE Chairman: Councillor J. E. Cooke. Vice-Chairman: Councillor Mrs. R. A. Smythe. Members: The Mayor (Alderman A. J. Hollywood, J.P.) (Ex Officio) The Deputy Mayor (Alderman Mrs. F. Long, J.P.) (Ex Officio) Alderman L. E. Berridge Councillor F. H. Brooks Mrs. A. M. Glover E. R. Holborn G. K. McLeod Miss D. M. Oswald 3 STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health: D. Regan, B.A., B.Sc., M.B., Ch.B., B.A.O., D.P.H.(L'pool.). Deputy Medical Officer of Health: Catherine A. Coggin, M.B., B.Ch., B.A.O., D.P.H. Senior Sanitary Inspector: abc John P. Farrar. District Sanitary Inspectors: abc f. Beilby abc H. W. Grieves abcd V. C. quin a bcd R. H. Sandford ac G. W. Alexander ac D. Harwood (Commenced 26.5.53) ac R. D. Richards (Commenced 1.6.53) Woman Sanitary Inspector: a Miss A. Hurley Senior Clerk: a F. J. Nash Clerical Staff: H. J. Weldon Miss I. Holloway A. Ballantine Mrs. E. J. Richards Mrs. I. Heard T. C. Oliver (In H.M. Forces) Miss G. Maryan (Temporary) B. English (Temporary) Shops Act and Street Trading Inspector: A. Robinson a Certificated Sanitary Inspector. b Certificate of Meat and Food Inspector. C Inspector under the Petroleum Acts. d Certificate of Smoke Inspector. 4 PREFACE Public Health Department, Town Hall, Edmonton, N.9. His Worship the Mayor, Alderman and Councillors of the Borough of Edmonton. Your Worship, Ladies and Gentlemen, I have the honour to present my Annual Report for the year 1953 on the health and sanitary circumstances of the Borough. The Report is compiled in accordance with the requirements of the Ministry of Health Circular 1/54. Death Rate.—Is approximately the same as for 1952, and has shown but little variation for a number of years. Birth Rate.—Is again reduced compared with last year, and shows a steady decline over the last few years. Infantile Mortality Rate—which reached a new low level in 1952 has, unfortunately risen this year. The rise is apparently in the Neo-Natal death rate. Maternal Mortality Rate.—Here we can congratulate ourselves in that there were no deaths. Tuberculosis.—The number of cases on the register continues to rise. We are still labouring under the lack of proper clinic accommodation in the district. The hope is being held out to us that a Chest Clinic will be developed in the precincts of the North Middlesex Hospital. This hope is of very little use when one considers the number of patients at present attending for treatment under circumstances that leave a lot to be desired. In my opinion it is a retrograde step to bring tuberculosis within the precincts of a general hospital. 5 Notwithstanding the inadequacy of the premises, the work that is being done in the Edmonton Chest Clinic is worthy of the highest praise. With regard to other clinic accommodation, there is some satisfaction that at an early date two Day Nurseries, which had given good service for the children of the district in the past, will soon be converted into clinics for mothers and children. The state of health in Edmonton continues to be satisfactory. The efforts made by your Officers in the past, as well as the present, are bearing good fruit, and as a result of these efforts the people of this district are becoming more health conscious. The old traditional methods are disappearing, and the young mothers who are coming along are more ready to accept new methods, and indeed seek after knowledge of such methods. Progress is being made in a slow but sure way, but the coordinated effort necessary for the complete success of the National Health Service Act is still lacking and will continue to be so until premises are established where the various interests of medicine can be administered under one roof. The Local Health Authority officers are to some extent hindered in their efforts because they are not free to treat their own patients except in a small and limited way. The School Health Service, the General Practitioners as well as the Hospitals still remain a divided service, although great efforts are being made to bring them together. It is not any fault of the Officers themselves, but due to carrying out their duties in premises so far apart. This is also inconvenient for the patients, referring them at one time to the General Practitioners and another time to the Hospitals. Another factor which should receive some consideration in the near future is the multiplicity of controls set up under the National Health Service Act. This is proving to be an embarrassment to Health Administration and interferes with the smooth working of the Services in the interests of those whom the Act was intended to serve. 6 If some of the Health Services were administered under one roof, overlapping could be avoided and the patient receive his or her measure of service with the least possible inconvenience. It must not be assumed, however, that all the effects of the National Health Service Act are being negatived by this overlapping; on the contrary, a great deal of good has been accomplished whilst much more remains to be done. So far as disease is concerned, quite a number of changes have occurred over the last 20 to 30 years. Scarlet Fever and Diphtheria which wrought such havoc among the younger members of the population in the past, have now become less virulent in character, whilst other diseases have assumed greater gravity—Poliomyelitis, Intestinal complaints, Allergies and some of the Chronic Nervous Disorders are becoming more prevalent. These also have a sinister effect in so far as remedies are not readily available. Patients discharged from hospitals should receive a measure of serious consideration. It is becoming more and more the policy of some hospitals to discharge patients, notably old people, to their own homes when it is apparent that nothing more can be done for them in hospital. On some occasions this has proved injurious to the relatives at home, as it sometimes happens, the aged partner at home is the only one who can give assistance to the patient. This frequently proves detrimental to both. The service which is being rendered in this district of conveying information about patients from Hospitals to General Practitioners and from Hospitals to Local Health Authorities is serving a good purpose; this liaison is very important in the interests of the patients. Housing.—Some Clearance Areas have already been dealt with, and it is to be hoped that this work will be expedited to the fullest extent of the resources of the Council as some of the people of Edmonton have lived long enough under circumstances that are extremely undesirable. 7 It is to be regretted that our Sanitary Inspector Staff has been considerably depleted by a number of Inspectors obtaining appointments elsewhere, consequently it has been impossible for the remaining members to maintain the continuity of their work so essential for the efficient execution of their duties and responsibilities. Once again I wish to record my thanks to the members of my Staff for their continued loyal support and assistance throughout the year. In conclusion, I would express my appreciation of the help I have received from the Public Health Committee and the Council during the past year. I have the honour to be, Your Worship, Ladies and Gentlemen, D. REGAN, Medical Officer of Health. 8 STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 3,896 Population— Census of 1921 66,809 Census of 1931 77,652 Census of 1951 104,270 Estimated by the Registrar-General for mid-year 1953 101,400 Number of inhabited houses and separate dwellings at the end of 1953 28,662 Number of inhabited houses and separate dwellings at the end of 1952 28,652 Rateable value, April, 1953 £753,528 Estimated product of Id. in the £ for the year ending March 31st, 1954 £3,035 Rates in the £ for the year ending March 31st, 1954 23s. 4d. VITAL STATISTICS. Live Births. M. F. Total Grand Total Legitimate 678 555 1,233 Illegitimate Birth-rate per 1.000 of population 22 18 40 1,273 12.55 Stillbirths. Legitimate 18 12 30 Illegitimate - - - 30 Total of live and stillbirths ... ... ... 1,303 Rate per 1,000 total births ... ... ... 23.02 Deaths. Number 516 464 980 Rate per 1.000 population ... ... ... 9.66 Maternal Mortality. Rate per 1.000 tota Deaths Rate per 1,000 live and stillbirths total Toxaemias of Pregnancy — — Complication of Pregnancy and Delivery — — Death rate of Infants under one year of age. M. F. Total Number 20 12 32 All infants per 1.000 live births 25.13 Legitimate infants per 1,000 legitimate live births 25.14 Illegitimate infants per 1.000 illegitimate live births 25.00 Deaths from Cancer (all ages) 166 Measles (all ages) — „ „Whooping Cough (all ages) — „ „ Diarrhoea (under 2 years of age) — 9 The following causes of death are supplied by the Registrar General and refer to deaths which were registered during the calendar year:— Cause of Death M. F. Total Tuberculosis, respiratory 15 8 23 Tuberculosis, other 3 1 4 Syphilitic disease 1 2 3 Diphtheria ... ... ... Whooping Cough ... ... ... Meningococcal infections 1 ... 1 Acute Poliomyelitis ... ... ... Measles ... ... Other infective and parasitic diseases 2 ... 2 Malignant neoplasm, stomach 12 8 20 Malignant neoplasm, lung, bronchus 32 4 36 Malignant neoplasm, breast ... 15 15 Malignant neoplasm, uterus 6 6 Other malignant and lymphatic neoplasms 47 42 89 Leuksemia, aleukaemia 2 3 5 Diabetes 1 2 3 Vascular lesions of nervous system 35 59 94 Coronary disease, angina 101 52 153 Hypertension with heart disease 14 10 24 Other heart disease 31 84 115 Other circulatory disease 25 27 52 Influenza 12 6 18 Pneumonia 29 23 52 Bronchitis 60 35 95 Other diseases of the respiratory system 3 3 6 Ulcer of stomach and duodenum 8 1 9 Gastritis, Enteritis and Diarrhoea ... 4 4 Nephritis, and Nephrosis 8 1 9 Hyperplasia of Prostate 5 ... 5 Pregnancy, childbirth, abortion ... Congenital malformations 6 6 12 Other defined and ill-defined diseases 43 41 84 Motor Vehicle Accidents 9 4 13 All other accidents 8 9 17 Suicide 2 8 10 Homicide and operations of war 1 ... 1 TOTALS 516 464 980 10 The two following tables give the deaths of those registered during the 52 weeks ended 2nd Jannuary, 1954. The slight difference between the following tables in respect of the causes of death and the one supplied by the Registrar General is that the Registrar General is in possession of additional information on the matter. MALES Causes of Death ALL AGES to 1 1 to 2 2 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 and over Tuberculosis, respiratory 16 ...... ... ... ... ... 4 3 2 4 3 ... Tuberculosis, other 4 ... ... ... ... ... 1 ... 1 1 1 ... Syphilitic disease 1 ... ... ... ... ... ... ... ... 1 ... ... Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal infections 1 ... ... ... 1 ... ... ... ... ... ... ... Acute Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ••• Other infective and parasitic diseases 2 ... ... ... ... ... ... ... 1 1 ... ... Malignant neoplasm, stomach 12 ... ... ... ... ... ... 2 3 6 1 1 Malignant neoplasm, lung, bronchus 31 ... ... ... ... ... ... 1 7 12 6 5 Malignant neoplasm, breast ... ... ... ... ... ... ... ... ... ... ... ... Malignant neoplasm, uterus ... ... ... ... ... ... ... ... ... ... ... ... Other malignant and lymphatic neoplasms 44 ... ... ... 1 ... 1 1 7 10 10 14 Leukaemia, aleukæmia 2 ... ... ... ... ... ... 1 1 ... ... ... Diabetes 1 ... ... ... ... ... ... ... ... ... 1 ... Vascular, lesions of nervous system 37 ... ... ... ... ... 1 ... 4 5 13 14 Coronary disease, angina 100 ... ... ... ... ... ... 1 14 27 38 20 Hvoertension with heart disease 14 ... ... ... ... ... ... ... ... 6 3 6 Other heart diseases 31 ... ... ... ... ... ... 2 3 3 5 IS Other circulatory disease 23 ... ... ... ... ... ... ... 1 5 10 7 Influenza 12 ... ... ... ... ... ... ... 2 5 3 2 Pneumonia 29 8 ... ... ... ... ... ... 2 3 5 11 Bronchitis 60 ... ... ... ... ... ... ... 8 10 25 17 Other disease of respiratory system 3 ... ... ... ... ... ... ... 1 ... ... 2 Ulcer of stomach and duodenum 8 ... ... ... ... ... ... ... 2 ... 4 2 Gastritis, Enteritis and Diarrhoea ... ... ... ... ... ... ... ... ... ... ... ... Nephritis and nephrosis 8 ... ... ... 1 ... 1 1 ... 2 2 1 Hyperplasia of prostate 5 ... ... ... ... ... ... ... ... ... 1 4 Pregnancy, childbirth, abortion ... ... ... ... ... ... ... ... ... ... ... ... Congenital malformations 6 3 1 ... ... 1 ... ... 1 ... ... ... Other defined and ill-defined diseases 42 9 ... ... ... 1 ... 2 2 6 12 10 Motor Vehicle Accidents 9 ... ... ... ... 3 2 ... 1 1 2 All other accidents 8 ... ... ... 1 ... ... ... 1 3 3 Suicide 2 ... ... ... ... ... ... ... ... 2 ... ... Homicide and operations of war 1 ... ... ... ... 1 1 ... ... ... ... ... TOTALS 512 20 1 ... 4 5 11 14 64 109 148 |136 11 FEMALES Causes of Death ALL AGES to 1 1 to 2 2 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 and over Tuberculosis, respiratory 10 ... ... 1 1 ... 3 1 1 2 1 ... Tuberculosis, other 1 ... ... ... 1 ... ... ... ... ... ... ... Syphilitic disease 1 ... ... ... ... ... ... ... ... ... ... 1 Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal infections ... ... ... ... ... ... ... ... ... ... ... ... Acute Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... Other infective and parasitic diseases ... ... ... ... ... ... ... ... ... ... ... ... Malignant neoplasm, stomach 8 ... ... ... ... ... ... ... 1 3 2 2 Malignant neoplasm, lung, bronchus 4 ... ... ... ... ... ... ... 1 2 1 Malignant neoplasm, breast 15 ... ... ... ... ... ... 2 3 2 6 3 Malignant neoplasm, uterus 6 ... ... ... ... ... ... ... 2 1 3 ... Other malignant and lymphatic neoplasms 43 ... ... ... ... 1 ... ... 7 10 11 14 Leukaemia, aleukaemia 3 ... ... ... ... ... ... ... ... 1 1 1 Diabetes 2 ... ... ... ... ... ... ... ... ... 1 1 Vascular, lesions of nervous system 61 ... ... ... ... ... 1 1 4 7 17 31 Coronary disease, angina 52 ... ... ... ... ... ... ... 3 6 24 19 Hypertension with heart disease 10 ... ... ... ... ... ... ... ... 3 3 4 Other heart diseases 84 ... ... ... ... ... ... 3 2 6 13 60 Other circulatory disease 22 ... ... ... ... ... ... ... 2 2 3 15 Influenza 6 ... ... ... ... ... ... 1 ... ... ... 5 Pneumonia 24 3 ... ... 1 ... ... ... ... 5 2 13 Bronchitis 32 ... ... ... ... ... 1 4 4 6 17 Other disease of respiratory system 3 ... ... ... ... ... ... ... ... ... 1 2 Ulcer of stomach and duodenum ... ... ... ... ... ... ... ... ... ... ... ... Gastritis, Enteritis and Diarrhoea 3 ... ... ... ... ... ... 1 ... ... 1 1 Nephritis and nephrosis 3 ... ... ... ... ... ... ... ... ... 1 2 Hyperplasia of prostate ... ... ... ... ... ... ... ... ... ... ... ... Pregnancy, childbirth, abortion ... ... ... ... ... ... ... ... ... ... ... ... Congenital malformations 6 3 ... ... 1 ... 2 ... ... ... ... ... Other defined and ill-defined diseases 38 6 ... ... ... ... ... ... 1 3 11 17 Motor Vehicle Accidents 4 ... ... 1 ... ... ... ... ... ... 1 9 All other accidents 9 ... ... ... ... ... ... ... ... 1 2 6 Suicide 8 ... ... ... ... ... 1 1 1 3 1 1 Homicide and operations of war ... ... ... ... ... ... ... ... ... ... ... ... TOTALS 458 12 - 3 3 1 8 10 32 59 112 218 12 INFANTILE MORTALITY. The deaths of infants under one year of age were as follows :— M. F. Total Legitimate 20 11 31 Illegitimate — 1 1 20 12 32 The death rate of all infants per 1,000 live births was 25.13. The death rate of all infants under one month of age per 1,000 live births was 14.13. A detailed sub-division of the causes, etc., of these DEATHS is as follows:— MALES. Causes of Death One week Second Week Third Week Fourth Week Total under 1 month 1—3 months 3—6 months 6—9 months 9—12 months Total under 1 year Pneumonia ... ... ... ... ... 1 4 2 1 8 Premature Birth 2 ... ... ... 2 ... ... ... ... 2 Atelectasis 5 ... ... ... 5 ... ... ... ... 5 Other Causes 2 ... ... ... 2 ... ... ... ... 2 Congenital Malformations ... ... 1 ... 1 ... 1 1 ... 3 Totals 9 - 1 - 10 1 5 3 1 20 FEMALES. Causes of Death One week Second week Third week Fourth week Total under 1 month 1—3 months 3—6 months 6—9 months 9—12 months Total under 1 year Pneumonia 1 ... ... ... 1 ... 1 ... 1 3 Premature Birth 2 ... ... ... 2 ... ... ... ... 2 Congenital Malformations 1 ... ... 1 1 ... 1 ... 3 Other Causes 1 ... ... ... 1 ... ... ... ... 1 Injury at Birth 1 ... ... ... 1 ... ... ... ... 1 Atelectasis 2 ... ... ... 2 ... ... ... ... 2 Totals 7 l — — 8 1 1 1 1 12 13 COMPARATIVE STATISTICS The Registrar-General has forwarded provisional figures relating to the country as a whole and to London, enabling comparisons to be made as follows:— Birth-rate per 1,000 population Death-rate per 1,000 births. From diarrhoea, etc., under 2 years Total deaths under 1 year Live Still England and Wales 15.5 0.35 1.1 26.8 London 17.5 0.38 1.1 24.8 Edmonton 12.55 0.29 0.0 25. 13 Annual Death Rate per 1,000 of Population. All Causes Whooping Cough Diphtheria Influenza England and Wales 11.4 0.01 0.00 0.16 London 12 5 0.00 - 0.15 Edmonton 9.66 0.00 0.00 0.17 The following table gives the number of births and deaths (registered) sub-divided into the four Wards of the Borough. It should be remembered that births are only those which occurred in Edmonton of residents; these are registered in Edmonton. Births which take place outside the Borough are not included; this fact accounts for the differen ce between these figures and those supplied bv the Registrar-General. The deaths include those taken place outside the Borough, the information being given quarterly by the Registrar-General. Ward Births Deaths Infant Deaths M. F. M. F. M. F. Bury Street 141 99 141 117 4 4 Church Street 67 35 102 14S 5 2 Angel Road 78 75 124 89 5 Silver Street 115 106 145 104 6 6 Vagrants ... 401 315 512 458 20 12 14 LABORATORY SERVICE The following specimens submitted from the Edmonton area were examined by the Medical Research Council Laboratory (Edmonton), during the year as follows:— Nature of Examination Positive Negative Total Blood Counts - - 50 Blood—Haemoglobin Estimation - — 281 Blood—Kahn Reaction - — 199 Blood—Rhesus Factor - — 200 Blood—Grouping - — 199 Blood—Sedimentation Rate - — - Eye swabs for organisms 1 7 8 Faeces for the presence of organisms 669 3,583 4,252 Per-nasal Swabs for H. Pertussis — 2 2 Swabs for presence of C. Diphtherias: (a) From Suspect Cases — 18 18 (b) From Contacts — 24 24 (c) From Carriers and old cases, etc. — - - Swabs for presence of Haemolytic Streptococci 411 1,697 2,108 Swabs for presence of Vincent's Angina — 11 11 Urines — - 256 Vaginal swabs for presence of organisms — - - „ „ „ „ „ Trich. Vag. 7 71 78 Nose swabs — 7 7 Ear swabs - 2 2 Swab from Pus - - 1 „ „ Stye - - 1 Discharge from Sinus - - 1 Pus from wound of hand — - 1 Discharge from Sinus for Tubercle Bacilli — 1 1 Well water — - 1 Bath tap water — — 1 Swabs from Boils — - Faeces from dog — 1 1 Fish Paste for organisms — — 1 Chicken—heart, liver, kidney and intestines for S. Para-typhi B - 4 4 Pig faeces for S. Para-typhi B — 2 2 Pig trough scrapings for S. Para-typhi B. — 2 2 Total 7,716 15 MILK (SPECIAL DESIGNATION) REGULATIONS, 1949. 131 samples of Designated Milks were examined during 1953. Results were as follows:— Pasteurised Milk. 49 Samples were examined. 28 Samples satisfied both the prescribed tests. 19 Samples failed to pass the Methylene Blue test. (18 of these results may be disregarded in view of the rise in temperature to above 65° F.) 2 Samples failed to pass Phosphatase test. Tuberculin Tested (Pasteurised) Milk. 40 Samples were examined. 23 Samples satisfied both the prescribed tests. 17 Samples failed the Methylene Blue test. (16 of these results may be disregarded in view of the rise in temperature to above 65° F.) Sterilised Milk. 42 Samples were examined and all passed the Turbidity test. SANITARY CIRCUMSTANCES OF THE AREA. The water supply of the Borough has at all times been satisfactory both in quality and quantity. The Metropolitan Water Board is responsible for the supply which is piped direct to every dwelling-house throughout the Borough, and serves the entire population. The co-operation of the Board has at all times been of the fullest. SANITARY INSPECTION IN THE AREA. Seven District Sanitary Inspectors and one woman Sanitary Inspector are engaged in the sanitary supervision of the Borough, working under the supervision of the Senior Sanitary Inspector. The Senior Sanitary Inspector supervises the work of the Borough. 16 Sanitary Conveniences. As previously reported in 1952, consideration was given to the question of the free use of w.c.s in the Council's Public Conveniences. Following the satisfactory result of the experiments carried out, the Council decided that free use of w.c.s at women's conveniences be granted, except in cases where there is no attendant. Rodent Control. Under this heading your Senior Sanitary Inspector, as Officer-in-Charge, Rodent Control, reported as follows: — The Council have an Assistant Rodent Officer, two Rodent Operators, the part-time services of a Clerk and appointed the District Sanitary Inspectors as Rodent Officers. During the year the treatment of business premises by " Warfarin " was continued and has proved very successful. The new method of rodent control has the advantage that the materials are undetectable by rats and mice, therefore poison shyness does not occur, and the rodents continue to feed until all are dead. Further, no prebaiting is necessary and the baiting is continuous. "Warfarin" destroys the ability of the blood to clot and the rats become weaker and die painlessly from internal haemorrhage. The District Sanitary Inspectors in cases where there was a possibility of the infestation being due to defective drainage visited the premises and tested the drainage and any defects discovered were dealt with through the usual channels. In 80 per cent, of the cases defects were discovered and as one can quite appreciate entailed quite a large amount of work. The following table gives details of the work carried out during the year. 1. Prevalence of Rats and Mice. Type of Property Local Authority Dwellinghouses Agricultural All other (including Business and Industrial) Total I. Number of Properties inspected by the Local Authority during 1953 as a result (a) of notification or (b) otherwise. (a) 6 511 • • 33 550 (b) 2 1,224 •• 16 1,242 2. Number of Properties (under 1) found to be infested by rats. Major 3 6 .. 15 24 Minor 1 394 .. 3 398 3. Number of Properties (under 1) found to be seriously infested by mice 1 94 •• 9 104 4. Number of Infested Properties (under 2 and 3) treated by the Local Authority. 5 491 .. 23 519 5. Number of Notices served under Section 4 (1) Treatment .. .. .. .. .. (2) Structural Works (i.e. Proofing) •• .. •• .. .. 17 2. Measures of Control. Type of Property. Properties Inspected. No. of Inspections Notices Served. Treatment Completed. Block Treatments Hats. Mice. Local Authority's Premises 8 174 .. 3 1 .. Dwelling Houses 1,735 4,828 .. 415 87 .. Business Premises 49 268 •• 13 10 •• Total 1,792 5,270 •• 431 98 •• During the year maintenance treatments of the sewers took place by the Borough Engineer's Department, and I am indebted to the Borough Engineer for the following report: — Rat Destruction in Sewers, The 12th Maintenance treatment was completed on 23rd January, 1953, and the 13th Maintenance treatment was carried out from 20th April to 7th July. The 14th Maintenance treatment commenced on 9th November and will be completed early in 1954. The results of the last four treatments can be summarised as follows: — No. of Treatment No. of M.H.s Baited Prebait Takes (Total) Prebait Takes (Complete) Poison Takes (Total) Bodies seen Poison used 10 1,040 481 244 461 81 Zinc Phosphide 11 1,096 495 210 467 23 Arsenious Oxide 12 1,122 547 266 533 46 Zinc Phosphide 13 1,132 559 249 423 28 Arsenious Oxide These results—which extend over two years, appear to be fairly uniform and seem to show that the rat population in the sewers is being held at a stationary level, that is, neither increasing or decreasing. This is in accordance with observations made by Ministry Officials with regard to returns made throughout the country. I would advise the continuance of treatment of the whole system of foul water sewers, as the untreated areas may encourage infestation by migration. Middlesex County Council Act, 1950, Section II. Section II of this Act, which relates to Hawkers of Food and their Premises, came into operation on the 1st of April. 1951. No persons or premises were registered during the year, and no persons were registered to trade in the Borough where storage premises are located in other districts. There were 125 hawkers on the Register at the end of 1953. Rent and Mortgage Interest (Restrictions) Acts 1920-1933. During the year no certificates under the above Acts were issued. 18 Disinfection and Disinfestation. The following table gives some idea of the work carried out: — Number of journeys to collect bedding 304 „ „ return bedding 306 Rooms disinfected after infectious disease 243 „ „ „ phthisis 72 „ „ „ other cases 45 „ „ „ vermin 220 Bedding, clothing, etc., disinfected after infectious disease 2,530 articles „ .. .. phthisis 374 „ „ „ „ other cases 2,378 ,, vermin 109 The Council distribute a disinfecting powder and fluid to residents who apply for same at the Town Hall Yard. During the year, the applicants numbered 6,534. One hour daily is allowed for such distribution with the exception of Fridays and Saturdays. A Formalin Chamber is used for the disinfection of books, leather goods, etc., articles that would be damaged by steam. The number of books and other articles thus disinfected was 1,156. Nine Council properties and 91 other houses were found to be infested; the total number of rooms disinfested was 220. The whole of the work is carried out by the Department, the materials used being insecticides containing D.D.T. as a base. Petroleum (Regulations) Acts, 1928 and 1936. During the year 7 new licences and 103 renewals were granted by the Council. The following is a list of particulars of quantities, etc., affected by these licences: — Petroleum spirit Petroleum mixtures (cellulose) Rubber solution 426,424 galls. 10,948 galls. 100 lb. & 850 galls. Mortuary. During the first three months of the year no bodies were deposited in the Mortuary. The use of the Council's Mortuary for the reception of bodies was discontinued after 31st March, 1953, and by arrangement with the North East Metropolitan Regional Hospital Board, on and after 1st April, 1953, all bodies which would normally have been received at the Council's Mortuary will be received at the Prince of Wales's Hospital, Tottenham. Mortuary. Inspections. The following tabular statement gives the number and the nature of the inspections made during the year: — Complaints 1.809 Infectious Diseases 658 Food Poisoning 19 House-to-house 98 Factories with mechanical power 430 Factories without mechanical power 13 19 Factories (other) — Outworkers 12 Schools 13 Offensive trades 18 Shops and Stalls 109 Shops Act 3 Rag Flock premises 12 Pet Shops 31 Sanitary conveniences and urinals 221 Smoke observations 394 Rat infestation 419 Petroleum 193 General inspections 553 Sundry visits 1,976 Cinemas and Halls 43 Stables and Piggeries 65 Moveable Dwellings 70 Sampling Rag Flock 12 Sampling Water 7 Sampling Ice Cream 92 Sampling Milk 125 Re-inspections ,090 Inspection of Places where Food is Prepared. Butchers 152 Fish shops 69 Cafes 393 Dairies and milkshops 102 Slaughterhouses 17 Bakehouses (Factory) 29 Bakehouses (Workshops) 1 Ice cream shops 278 Canteens 133 Other food premises 179 Number of Notices Served. Preliminary or Informal Notices 558 Statutory Notices 418 Defects Remedied. Roofs repaired 620 Gutters and rainwater pipes repaired 338 Brickwork or Pointing Repaired 213 Chimney Stacks, etc., repaired or rebuilt 50 Yards or forecourts repaved or repaired 46 Drains examined, tested or exposed 496 Drains cleared, trapped or repaired 396 Drains reconstructed 129 Chambers inserted or built up to ground level 40 20 Soil and vent pipes, new fixed or repaired 88 W.C.s repaired or improved 207 Flushing cisterns repaired or new fixed 85 Sink waste pipes repaired or new fixed 63 New sinks fixed 34 Drinking water cisterns covered, cleansed, repaired 5 Water fittings repaired 21 Water taken off main or restored 2 Internal walls 647 Ceilings repaired, cleansed, etc 522 Floors repaired 167 Floors ventilated 55 Dampness remedied 234 Window frames or sashes repaired or renewed 660 Fireplaces, stoves repaired 163 Coppers repaired 2 New dustbins supplied 25 Premises rat-proofed 35 Improper keeping of animals discontinued 2 Foul accumulations removed 10 Other nuisances abated 247 Moveable dwellings removed 61 Places of Public Entertainment. Forty-three inspections of cinemas and other places of entertainment were made in accordance with the Circular of the Ministry of Health of 1920. Conditions were found to be generally satisfactory. FACTORIES ACTS, 1937 & 1948 The following work has been carried out under the above Act: — 1. Inspections for the Purpose of Provisions as to Health. Premises Number in Register Inspections Written Notices Occupiers Prosecuted Factories with mechanical power 223 430 Factories without mechanical power 13 19 – – Other premises under the Act (including works of building and engineering and construction but not including outworkers' premises) – – – – Totals 236 449 — — 21 22 2. Defects Found. Particulars Number of defects No. of defects in respect of which prosecutions were instituted Found Remedied Referred tD H M Inspector by H.M. Inspector Want of cleanliness _ – _ – Overcrowding – — Unreasonable temperature – — Inadequate ventilation – — Ineffective drainage of floors __ Sanitary Conveniences : – – – – – Insufficient __ Unsuitable or defective 68 57 10 Not separate for sexes — — Other offences (Not including offences relating to outwork) – – – – – Totals 68 57 — 10 — 3. Outwork—Sections 110 & 111 Nature of Work Section no Section hi No. of Outworkers in August list No of cases of default in sending lists to the Council No of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Noti es served Prosecutions Wearing apparel, making, etc. 385 1 – – Artificial flowers 15 – – Locks, latches and keys 1 – The making of boxes or other receptacles or parts thereof made wholly or partially of paper 30 – – Brush making 80 — — — Stuffed toys 11 — – Cosaques, Christmas crackers, Christmas stockings, etc. 19 – – – – – Lampshades 3 — — — — Brass and Brass articles 17 — — — Carding, etc., of Buttons, etc. 5 — — — Curtains and Furniture Hangings 4 _ – – Chocolates and Sweetmeats 1 — — — Household Linen 2 — — — – Paper Bags 3 — — — — Furniture & Upholstery 5 — — — — — Feather Sortings 4 — — — — — Totals 3,585 1 — — — — Rag Flock and Other Filling Materials Act, 1951. This Act came into force on the 1st November, 1951. Number on Register at end of year: — Premises where filling materials used 13 Licences granted for storage of rag flock 2 Twelve samples of rag flock and other filling materials were examined during the year; all proved satisfactory. HOUSING. 1. Re-development Areas. Following representations by the Medical Officer of Health, the Council on the 23rd November, 1952, made Clearance Area Compulsory Purchase Orders under Part 3 of the Housing Act, 1936, comprising the following premises :— (a) Langhedge Lane (No. 1) Clearance Area, 1952 42 to 46 and 52 to 96 (even numbers inclusive) and 9. 11. 15 and 17 Langhedge Lane. 1 to 31 (odd numbers inclusive) and 2 to 26 (even numbers inclusive) Milton Road. 1 to 25 (odd numbers inclusive) and 6 to 26 (even numbers inclusive) Shakespeare Road. 1 to 11 (odd numbers inclusive) and 2 to 8 (even numbers inclusive) Short Street. (b) Langhedge Lane (No. 2) Clearance Area, 1952 12 to 26 (even numbers inclusive), Langhedge Lane. (c) Bridport Road,Clearance Area, 1952 1 to 29 (odd numbers inclusive), 37 to 49 (odd numbers inclusive) and 2 to 102 (even numbers inclusive) Bridport Road. 1 to 19 (odd numbers inclusive) and 2 to 18 (even numbers inclusive) Gilpin Crescent. 1, 2 and 3 Linton Broadway. 1 to 8 (consecutive), 13 to 44 (consecutive), 44a and 45 Linton Road. 87 to 97 (odd numbers inclusive) Fore Street. (d) Northumberland Place Clearance Area, 1952 5 to 9 (consecutive) Northumberland Place. making a total of 254 houses involving 965 persons. 23 The Public Inquiry was held in May, 1953, and the Minister of Housing and Local Government subsequently confirmed the Orders. Following representations by the Medical Officer of Health, the Council on the 24th February, 1953, made Clearance Area Compulsory Purchase Orders under Part 3of the Housing Act, 1936, comprising the following premises :— (e) Montagu Road, Edmonton. Clearance Area, 1953 147 and 149 Montagu Road. Two houses involving 10 persons. The Order was subsequently confirmed by the Minister of Housing and Local Government. Following representations by the Medical Officer of Health, the Council on the 28th April. 1953, made Clearance Area Compulsory Purchase Orders under Part 3 of the Housing Act, 1936, comprising the following premises:— (f) Beaconsfield Road, Edmonton. Clearance Area, 1953 60 to 98 (even numbers inclusive) and 25 to 51 (odd numbers inclusive) Beaconsfield Road. 2 to 20 (even numbers inclusive) Plevna Road. Making a total of 44 houses involving 129 persons. A Public Inquiry was held in October, 1953. (g) Claremont Street, Edmonton, Clearance Area, 1953 1 to 77 (odd numbers inclusive) and 44 to 50 (even numbers inclusive) Claremont Street. Making a total of 43 houses involving 120 persons. The Orders were subsequently confirmed by the Minister of Housing and Local Government. Following representations by the Medical Officer of Health, the Council on the 22nd September, 1953, made Clearance Area Compulsory Purchase Orders under Part 3 of the Housing Act, 1936, comprising the following premises :— (h) The Broadway. Edmonton, Clearance Area, 1953 31 to 45 (consecutive inclusive) The Broadway. Making a total of 15 houses involving 38 persons. A Public Inquiry will be held in February, 1954. 24 2. Action taken under the Housing and Public Health Acts. Part A. Clearance Areas (Housing Act, 1936) Number of dwelling-houses demolished in the period Number of persons Unfit houses Other houses displaced (1) Land coloured " pink " (2) Land coloured "grey" 31 8 64 19 Part B. Houses not included in Clearance Areas Number of Houses aced Persons Demolition and Closing Orders (1) Housing Act, 1936 (a) Houses demolished as a result of formal or informal procedure under Section 11 3 12 (b) Houses closed in pursuance of an undertaking given by the owners under Section 11, and still in force ... ... (c) Parts of buildings closed (Section 12) ... ... ... (2) Housing Act, 1949 (a) Closing Orders made under Section 3 (1) (b) Demolition Orders determined and Closing Orders substituted under Section 3 (2) ... ... (3) Local Government (Misc. Provisions) Act, 1953 Closing Orders made under Section 10(1) 1 2 25 Number of Houses Repairs Informal Action (4) Number of unfit or defective houses rendered fit during the period as a result of informal action by the local authority under the Public Health or Housing Acts 558 Action under Statutory Powers (5) Public Health Acts Number of houses in which defects were remedied after service of formal notices: — (a) by owners 340 (b) by local authority in default of owners 12 (6) Housing Act, 1936 Number of houses made fit after service of formal notices (Sections 9, 10 and 16): — (a) by owners 62 (b) by local authority in default of owners 4 SLAUGHTERHOUSES. Seventeen visits were paid and the carcases and organs of 39 pigs killed were inspected during or shortly after slaughter. None was found to be affected with tuberculosis. 23 carcases of which some part or organ was condemned showed a percentage of the number inspected affected with disease, other than tuberculosis, of 58.97. The following organs were surrendered: — 19 sets of lungs, 4 plucks, 2 kidneys. INSPECTION AND SUPERVISION OF FOOD. Milk Supply. Various licences were granted as under:— Pasteurised Tuberculin tested Sterilised Primary 48 25 105 178 Supplementary 19 16 18 53 Suplementary licences are granted to retailers who live outside the Borough but who sell milk in the Borough ; the primary licence is granted by the Authority in which the premises are situate. The number of Dairies registered at 31st December, 1953, was 10. 26 Food and Drug Act, 1938 — Section 14. During the year 21 premises were registered for the Sale and Storage of Ice Cream. Number on Register at end of year: — Manufacturers and Vendors 8 Vendors only 205 95 samples of ice cream were submitted to the Methylene Blue test and graded as follows:— Grade 1 73 „ 2 13 3 5 „ 4 4 During the year no premises were registered for the Preparation or Manufacture of Preserved Food, etc. Number on Register at end of year 39 Unsound Food. The following is a list of the food surrendered for examination and retained as unfit for human consumption:— Meat 1,203 tins Dates 2 pkts. Milk 1,349 „ Veal 49 lb. Fish 192 „ Beef . 3,906 „ Jams, etc. 205 „ Lamb . 649 „ Soups 294 Pork . 202 „ Beans 258 „ Offal . 877i „ Beetroot 9 „ Rabbits . 290 „ Carrots 9 „ and 1 case Mixed Veg. 6 „ Chickens 26J lb. Peas 494 „ and 3 birds Prunes 16 „ Ham . 824 lb. Apples 44 „ Cod 16i stone Apricots 40 „ Dog Fish 7* .. Blackcurrants 48 „ Haddock 32i „ Cherries 978 „ Herrings 3* „ Damsons 559 „ Skate 18 „ Gooseberries 149 „ Bovril 11 botts. Grapefruit 11 „ Oxo 301 cubes Grapes 20 „ Tea 52 lb. Greengages . 6 „ Baby Food 69 tins Oranges 77 „ Cakes . 103 Peaches 72 „ Cereals . 200 lb. Pears 64 „ and 157 pkts. Pineapple 107 „ Cheeses . 12,260 Plums 2,018 „ Chocolate Spread 1 tin Raspberries 32 „ Fish Paste 173 tins Rhubarb 21 „ Macaroni 41 „ Strawberries 24 „ Meat Paste 8 jars Tomatoes 109 „ Sausages 26i lb. Tomato Juice 11 „ Pickle 103 jars Fruit Juices 18 „ Puddings . 217 27 Sauce 244 botts. Whiting 17 stone Spaghetti 44 tins Kippers 1 „ Chocolates 7½ lb. Coffee 40 botts. Coconut 185 tins Turkeys 8 Sandwich Spread 44 tins Biscuits 82} lb. Cocoa 98 pkts. and 212 Suet 10 „ Eggs 20 doz. Flour ... 126 lb. The food examined and condemned by the Officers of the Public Health Department is disposed of either at the Council's Refuse Disposal Incinerating Plant or the Council's Refuse Disposal Pit. CLEAN FOOD CAMPAIGN. The survey of food premises commenced in 1952 was continued during 1953. The statement set out below shows the nature and number of the inspections made and the work carried out during the year: — Inspections Visits to Cafes, etc 328 „ Industrial Canteens 98 „ Other Food Premises 50 „ Fish Shops 14 „ Ice Cream Shops 75 Work Done Roofs repaired 4 Walls cleansed and redecorated 41 Ceilings cleansed and redecorated 43 Windows repaired 30 Floors repaired or cleansed 20 Equipment and/or fittings cleansed 41 renewed 30 New sinks provided 31 Defective sinks replaced 9 Drains repaired or cleansed 4 Defective refuse bins replaced 28 Washing-up methods improved 54 Sanitary accommodation improved 8 Ventilation improved 30 Indicating notices re hand-washing provided 125 Personal washing facilities provided 10 Provision of food display cabinets 23 Summary of Food Premises registered under Section 14 of the Food and Drugs Act, 1938. Manufacture and Sale of Ice Cream 8 Sale only of Ice Cream 205 Manufacture of Sausages 24 28 Manufacture of Sausages and Sale of Pressed, Pickled. Preserved, Potted Meats and other foods 13 Manufacture of Cooked Meat 1 Manufacture of Preserved Foods 1 Summary of Food Premises. Butchers 60 Fish Shops 35 Bakers and Confectioners 23 Fruiterers and Greengrocers 73 Cafes 108 Grocers & Provision Dealers 188 Dairies 10 Retail Purveyors of Milk ... 105 Factory Canteens 73 Pet Animals Act, 1951. This Act, which came into operation on 1st April, 1952, regulates the sale of pet animals, and provides that no person shall keep a pet shop except under the authority of a licence granted by the Borough Council. During the year three new licences were granted. Number on Register at end of year was 11. Game Dealers' Licences. Four licences to sell Game were renewed during the year. SHOPS ACT AND STREET TRADING. The Department administers three local Orders under the Act: The Edmonton Hairdressers and Barbers (Late Day) Order, 1947, made under the Shops (Hours of Closing) Act, 1928; The Shops Act. 1912, Edmonton Weekly Half-holiday Order, Section 4(2) and (6) (Butchers); The Shops Act, 1912, Edmonton Weekly Half-holiday Order, Section 4(2), all the Orders stand amended by the Shops Act, 1950. There are approximately 1.305 shops and places other than shops in the Borough which are liable to inspection. The Shops Acts and Street Trading Inspector submits a monthly report to the Public Health Committee, and the following is a short summary of the work carried out during the year. Visits to Shops, Licensed Street Traders, etc 1,297 Washing facilities, sink water heaters installed 10 Contraventions were in the main of a minor character, mostly concerned with the exhibition of notices. Shops Act, 1950—Part I, Section 1(2). Edmonton Weekly Half-holiday Order — Letters of Warning were sent to the occupiers of two shops where the above Order was being contravened in that the shops were not closed for the serving of customers on a Thursday afternoon. 29 Shops Act, 19S0—Part I, Section 2—General Closing Hours. A letter of warning was sent respecting a shop found to be not closed for the serving of customers at the normal evening closing hour. Shops Act, 1950, Part II, Section 17(1)—Conditions of Employment. Provisions as to assistants' half-holiday. Letters of warning were sent to the occupiers of 3 shops where assistants were found working during the occasion of their weekly half-holiday. Legal proceedings were taken in one instance where the occupier of a shop had been previously warned. A fine of £1 0s. 0d., together with £2 2s. Od. costs was imposed. Shops Act, 1950, Part IV—Sunday Trading. Thirty-three shops were visited in addition to supervisory operations and observations. Two contraventions were discovered; a letter of warning was sent in each case. Registers required to be kept under this Act were inspected periodically. Young Persons (Employment) Act, 1938. Cinemas and Boot and Shoe Repairing are the only occupations where young persons are being employed under the above Act. The Registers kept at these premises were perodically inspected. Middlesex County Council Act, 1944-1950—Street Trading. Under these provisions one Street Trading Licence was revoked on account of subletting, and two licences were surrendered voluntarily. Four letters of warning were sent concerning contraventions of the Act and Byelaws: two to licensed street traders and two to unlicensed street traders. The inspection of shops, stalls and other traders' premises coming within the scope of the Acts has been carried out throughout the year, including Sundays and evenings. Heating Appliances (Fireguards) Act, 1952. The above-named Act came into operation on the 23rd March, 1953. Regulations made thereunder which came into operation on 1st October, 1953, require fireguards to be fitted to gas fires, electric fires and oil heaters. Standards of construction and fitting for guards and the tests to be employed are set out in the Schedule and the necessary apparatus for testing the guards has been obtained. Under Regulations 5. heating appliances, other than imported appliances, manufactured before the date of the coming into operation of the Regulations and not fitted with the requisite guard may be sold or let until the end of September, 1954. The Shops Act Inspector has been appointed the Authorised Officer under the Act. 30 PREVALENCE OF INFECTIOUS DISEASE. Measles and Whooping Cough. These diseases were made compulsorily notifiable in October, 1939. 1,207 cases of Measles and 204 cases of Whooping Cough were notified during the year. There were no deaths from these diseases. Diphtheria. One case was notified during the year. The patient was a 12-year-old boy who had not been previously immunised. No cases were notified in 1952. Scarlet Fever. Continued to occur throughout the year in a mild form. There were 220 cases compared with 318 in 1952; there were no deaths. " Return" cases numbered two, allowing for an interval of 28 days between a patient returning home from the Isolation Hospital and the onset of the disease in another inmate of the house. Smallpox. No cases of smallpox were notified during the year. Enteric Fever. Five cases of Paratyphoid " B " and two cases of Typhoid Fever were notified during the year. In one case of Paratyphoid " B " the onset commenced whilst the patient was on holiday in the Channel Islands. Investigations of the remaining cases failed to reveal the source of infection. The two cases of Typhoid Fever occurred in one family (mother and son). The source of infection was suspected to be shellfish eaten whilst the patients were on holiday on the East Coast. The mother was eventually discharged from hospital as a " persistent carrier." She has been advised as to the necessary precautions to be taken to avoid the spread of infection, and is being kept under close observation. Faeces specimens are submitted at regular intervals for examination. Dysentery. During the year 426 cases of Dysentery were notified—331 Sonne, 56 Giardia, 29 Salmonella Typhi-murium, 2 Salmonella Enteritidis and 8 unspecified. This figure shows a considerable increase compared with 1952, when 176 cases of dysentery were notified. The disease persisted throughout the year in a mild form, but of a total of 426 cases, 331 occurred during the first five months of 1953. The control measures, detailed in my Report for 1950. were maintained, and again I wish to record my appreciation of the co-operation and assistance 31 I received from the General Practitioners. Dr. M. Thomas and Staff of the Public Health Laboratory Service (Edmonton), Education Department and Teachers, and the Staff of the Health Department. Meningoccal Infection. Four cases were notified during the year. In addition, a boy aged 11 years died from Waterhouse Friederichsen Syndrome. Ophthalmia Neonatorum. Nineteen cases were notified during the year (17 in North Middlesex Hospital, 1 at home and 1 in Other Institution). Of this total 7 were Edmonton cases. Puerperal Pyrexia. The Puerperal Pyrexia Regulations 1951 which came into operation on 1st August, 1951, replaces Regulations previously in force, and modify the definition of Puerperal Pyrexia. 184 cases were notified during the year (4 at home and 180 in North Middlesex Hospital). Of this total 59 were Edmonton cases. During 1952 111 cases were notified. Food Poisoning. Seventeen cases (non-fatal) were notified during the year, as follows:— Case No. Sex Age Suspected Cause of Illness Organism Responsible 1 M 31 Home-made Pigs' Head Brawn Salmonella Typhi-murium 2 F 27 „ „ „ „ „ 3 F 5 „ „ „ „ „ 4 M 57 Home-made Sandwiches „ „ „ 5 F 20 Home-cooked cold beef Staphylococcal Toxin 6 M 48 99 99 „ „ 7 M 38 ? Pork Luncheon Meat Unknown 8 M 1 99 99 „ 9 M 4 99 99 „ 10 F 40 Home-cooked brisket of beef „ 11 M 41 ? Corned Beef „ 12 F 36 99 99 „ 13 M 6 Unknown „ 14 M 4 „ „ 15 F 26 „ „ 16 F 66 „ „ 17 M 29 „ Shigella Sonnei and Bact. Coli Type E.893 32 Pneumonia. 163 cases were notified during the year. Diarrhoea and Enteritis under 2 years of age. The death rate for 1,000 live births for London was 1.1, whilst that for Edmonton was 0.0 as compared with 0.7 and 0.74 respectively last year. Poliomyelitis. During the year six confirmed cases of Poliomyelitis (5 Paralytic, 1 NonParalytic) occurred in the Borough. Notifications were received in January (1), June (1), July (1), August (1) and September (2). There were no deaths from this disease. 16 cases were notified in 1952. The following table gives the age, incidence, etc., of those suffering from notifiable diseases, excluding Tuberculosis which is dealt with separately. It must be noted that the figures in the second column "No. removed to hospital" includes those already under treatment at a hospital, for instance, the North Middlesex Hospital. This remark applies more particularly to the infections associated with parturition and includes puerperal pyrexia and ophthalmia neonatorum. The number of deaths from Pneumonia includes all forms of this disease. Disease Total No. of Cases No. Removed to Hospital Deaths to 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 20 20 to 35 35 to 45 45 to 65 65 and over Scarlet Fever 220 137 ... ... 2 13 13 22 136 28 3 1 1 1 ... Measles 1207 29 ... 35 105 168 158 213 492 23 6 6 1 1 ... WhoopingCougb 204 12 ... 16 20 14 26 37 86 2 I 2 ... ... ... Pneumonia 163 13 52 2 4 6 4 5 16 11 2 19 30 43 22 Puerp. Pyrexia 184 180 ... ... ... ... ... ... ... ... 13 133 37 1 ... Erysipelas 23 1 ... ... ... ... ... ... ... 2 1 5 4 10 1 Food Poisoning 17 3 ... ... 1 ... ... 2 2 ... ... 5 4 2 1 Poliomyelitis 6 5 ... ... ... 2 ... ... 1 2 ... ... 1 ... ... Ophth- ... ... ... ... ... ... ... ... ... ... ... ... ... ... Neonatorum 19 18 ... 19 ... ... ... Dysentery 426 5 ... 13 21 28 20 16 143 45 15 59 35 23 8 Meningococcal ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... Infection 4 4 1 ... 1 ... ... 1 ... ... ... 1 ... Diphtheria 1 1 ... ... ... ... ... ... i ... 1 ... ... ... Paratyphoid 'B' 5 5 ... ... ... ... ... ... 3 ... ... 1 ... ... Typhoid Fever 2 o ... ... ... ... ... ... 1 ... ... 1 ... ... ... Malaria 1 1 ... ... ... ... ... ... ... ... 1 ... ... ... 33 The following table indicates the Wards from which the various cases were notified: — Disease Bury Street Ward Church Street Ward Angel Road Ward Silver Street Ward N. Middx. Hosp. Other Instns. Total Scarlet Fever 96 33 38 53 ... ... 220 Measles 460 214 247 286 ... ... 1,207 Whooping Cough 74 64 30 36 ... ... 204 Pneumonia 94 24 11 34 ... ... 163 Puerperal Pyrexia 1 •t ... 1 180 ... 184 Erysipelas 16 2 3 2 ... ... 23 Food Poisoning 9 3 4 1 ... ... 17 Poliomyelitis 1 4 1 ... ... ... 6 Ophth-N eonatorum 1 ... ... ... 17 1 19 Dysentery 81 54 180 109 2 ... 426 Meningococcal Infec. 2 ... ... 2 ... ... 4 Diphtheria ... ... 1 ... ... ... 1 Paratyphoid 'B' ... 4 ... ... 1 ••• ... 5 Typhoid Fever 2 ... ... ... ... ... 2 Malaria ... 1 ... ... ... ... 1 IMMUNISATION. As and from 5th July, 1948, immunisation against Diphtheria and Whooping Cough became the responsibility of the Middlesex County Council. Diphtheria. During the year, 1,224 appointments were made—1,170 children completed treatment; of these, 1,139 were under 5 years of age. In October, 1950, combined Diphtheria and Whooping Cough immunisation was introduced; 699 children completed this treatment. Of the 1.139 children referred to above. 695 received the combined treatment. No children were Schick tested. In addition, 1,276 children received a re-inforcing injection. Whooping Cough. During the year, 29 appointments were made for this treatment—26 children completed treatment. In addition, 699 children completed combined Diphtheria and Whooping Cough treatment. 3 children were given reinforcing injection. CANCER. The incidence of Cancer relative to the various organs of the body is given as under: — Males Females Breast — 15 Uterus — 6 Lung, Bronchus 31 4 Stomach 12 8 All other sites 44 43 87 76 34 NATIONAL ASSISTANCE ACT, 1948. Section 47—Removal to suitable premises of persons in need of care and attention. No action was necessary during the year under this Section. Several cases were dealt with by the Public Health Department, and admission to suitable premises was obtained without recourse of legal action. MIDDLESEX COUNTY COUNCIL ACT, 1944. Establishments for Massage or Special Treatment. One new licence was granted and six existing licences renewed during the year. TUBERCULOSIS. In addition, 19 cases of pulmonary tuberculosis and 3 cases of nonpulmonary tuberculosis previously notified in other areas, moved into Edmonton. The total number of names added to the Register for the first time during the year, excluding of course, non-notified deaths was: — Males Females New cases (respiratory) 80 73 (non-respiratory) 3 5 Transferred cases (respiratory) 10 9 (non-respiratory 1 2 94 There were no non-notified deaths. 35 89 The table below gives details of the ages and sex of new cases of Tuberculosis, also deaths from the disease ; this latter figure includes the deaths of non-notified cases. Age Periods New Cases Deaths Respiratory N on-respiratory Respiratory Non-respiratory M. F. M. F. M. F. M. F. Under 1 year 1 1 ... ... ... ... ... ... 1— 5 years 3 ... ... ... 1 ... ... 5—15 „ 3 5 ... ... ... 1 ... 1 15—25 „ 22 28 ... 2 ... ... ... ... 25—35 „ 15 19 1 1 4 3 1 ... 35—45 ,, 8 12 2 3 1 ... 45—55 ,, 11 5 ... ... 2 1 1 ... 55—65 ,, 14 3 ... 2 4 2 1 ... 65 years upwards 3 ... ...+ ... 3 16 1 1 ... 80 73 3 5 10 4 1 The non-respiratory forms of tuberculosis notified were:— Males Females Pericardium 1 — Other bones and joints 1 — Glands — 2 Spine — 1 Genito-Urinary System 1 1 Skin — 1 The corresponding figures at the end of 1952 were:— Males Females Total Pulmonary forms 563 469 1,032 Non-pulmonary forms 72 98 170 635 567 1,202 Corresponding figures for previous years were: — Males Females Total 1951 570 536 1.106 1950 519 498 1,017 1949 509 468 977 1948 500 452 952 1947 442 405 847 1946 417 375 792 1945 389 332 721 1944 370 319 689 1943 411 355 766 1942 348 304 652 1941 355 293 648 1940 349 313 662 1939 357 301 658 1938 363 297 660 1937 336 260 596 1936 315 252 567 1935 330 265 595 COUNCIL'S EMPLOYEES. During 1953 the Medical Officer of Health paid a total of 268 visits to those employees who had been on the sick list for longer than a fortnight and when necessary, at fortnightly intervals. Of these, 29 were " not at home " and 11 had already resumed duty. Also, during the year, 68 persons were examined prior to appointment to permanent posts. 36 The number of cases of tuberculosis on the Register at the end of 1953 was:— Males Females Total Pulmonary forms 597 505 1.102 Non-pulmonary forms 71 93 164 668 598 1,266 ioWy the Printer Ltd. T.U. Fore Street, Edmonton