FEL 27 FELTHAM URBAN DISTRICT COUNCIL ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1908. C. DWIGHT MORRIS, L.R.C.P. London, M.R.C.S. England, L.S.A. London. Medical Officer of Health. "Parkside," Feltham, Middlesex. March 31st, 1909. Feltham Urban District Council. Mr. Chairman and Gentlemen, 1 beg to submit my Annual Report for the year 1908. During the year 155 Births have been registered, Boys 72, Girls 83, making a Birth Rate of 26.2 on an estimated population of 5,900. The number of Deaths registered was 75, which gives a Death Rate of 12.7 on the estimated population, but as 9 persons belonging to the district died in various institutions outside, the corrected Death Rate is 14.4 The number of illegitimate children born during the year was 4, one of which died. The number of Inquests held being 4. The Mortuary recently erected on the Council's Depot was used for the first time. The deaths in the London County Council Industrial Schools, with a population at the middle period of the year of 630, was 5. The number of Infants dying under one year of age was 20, 9 of which were registered as caused by diarrheal diseases. The Infant Mortality Rate works out at 129, and the Zymotic Death Rate at 2.7. INFECTIOUS DISEASES. The total number of infectious diseases notified during the year was 20, which was distributed over 17 centres. Diphtheria 9, Erysipelas 6, Scarlet Fever 4, Puerperal Fever 1. One of the cases of Diphtheria was not discovered until Post Diphtheritic Paralysis had set in, with fatal result. Two of the cases were connected with an outbreak in an adjoining district. Although Diphtheria Antitoxin was used in the majority of cases it was not supplied by the Council. I trust ere long that the Council may see fit to supply both Antitoxin and pay the small fees in connection with Bacteriological examinations,, so as to fall into line with other districts in the County of Middlesex. Considering our position near the Metropolis, we have a very small proportion of infectious diseases that are classed as notifiable, and in only three instances a second case being notified from an infected area ISOLATION HOSPITAL ACCOMMODATION FOR GENERAL INFECTIOUS DISEASES. The enquiry held by the Middlesex County Council, under the Isolation Hospitals Acts of 1893 and 1901, was held at the offices of the Staines Rural District Council in July 1908, and it is not until this week (the middle of March) that the draft order has come into the hands of the constituent authorities for their consideration. There should be now no reason for delay in carrying out the necessary provision for the isolation and treatment of notifiable infectious cases by the most up-to-date method possible. 4 DRAINAGE. The most important matter which you have had to consider during the year has been the proper sewering and draining of the district. You have at considerable expense employed a most eminent engineer, Mr. G. Midgley Taylor, C.E., to thoroughly examine the district, and to ascertain, by a series of trial holes, the varying water levels in various parts of the particular area to be drained, and to report to you what he considers the best method (in his opinion) of dealing with a flat and straggling parish like ours. The scheme which he has presented to you is being , discussed in all its bearings. That it must be expensive no one doubts: at the same time it is better to take a comprehensive view of future requirements, and possible extensions, than to confine ourselves to the narrow limits of the present. Many districts have made the latter mistake, to the misfortune of the ratepayers. It has taken up a considerable amount of your time, which the ratepayers should appreciate. HOUSE TO HOUSE INSPECTION. This is going on steadily and satisfactorily, and cases are very rare where owners have required pressure to be applied to make them carry out the necessary remedies ordered. HOUSING OF THE WORKING CLASSES ACTS. No action has so far been taken during the year under these Acts. The distress amongst the poorer population has been very acute during the year. This must of course rebound upon the owners of cottage property, who have not the means themselves of doing all they would had there been more prosperous times. With the great expense of drainage looming up on the horizon the situation does not lend itself to the launching out in the erection and provision of workmen's dwellings. There can be no denying the fact that too great a proportion of the working man's wages goes in actual rent, often to the detriment of the inner man. The tendency of districts so near the Metropolis like ours is to build property quite unsuitable to the working man's pocket, and whether the Town Planning Bill will help in this direction remains to be seen. NEW BUILDINGS AND DEVELOPMENT. Building is practically at a standstill, and according to the Assistant Overseer's returns only 5 houses were erected from June 1907 to June 1908. There were actually 6 less occupied in June 1908 than in June 1907. Great improvement has been noticed both in the roads and footpaths, and the scavenging of the same is carried out in a very satisfactory and cleanly manner. The extension of the portable dustbins to cottage property cannot have but a beneficial effect on'the occupiers by the regular removal of refuse away from the premises. WATER SUPPLY. The extension of the Company's main from Lower Feltham to Ashford Clumps which you have been recently considering is a very necessary improvement. The guarantee required would, I feel sure, soon be wiped out as the wells in this region are anything but reliable. The constituent authorities supplied by the South West Suburban Water Company, after many years of uncertainty, now know clearly where they stand with regard to rating and sale of water by meter. 5 I have made frequent analyses during the year and have found it chemically a good water. With the exception of the one Bacteriological Analysis made early in the year, and which I reported upon in my last annual report, no further Bacteriological Analysis has been made Many of the existing wells have been examined during the year, some being found of good quality, others have been condemued, and if after they are cleaned out again and the analysis proves bad the main is usually laid on without delay. FOOD SUPPLIES. Frequent visits are made to various purveyors of food. In May, owing to several families showing signs of metalic poisoning, investigation very soon proved it to proceed from tinned peaches. As there was no guide as to the date of canning I suggested that the Local Government Board should be approached with a view of getting some sort of legislation passed to more effectually deal with this most important matter, as it was generally felt most desirable that the date of canning all such tinned stuffs should be stamped on the tin. The answer of the Local Government Board was not encouraging, at the same time country districts are apparently the happy dumping ground of stale tinned goods it is impossible to sell in the more important towns. No meat was condemned during the year, but a quantity of sprats were found unsaleable and unfit for human consumption, and buried. MEDICAL INSPECTION OF SCHOOL CHILDREN. This, as far as can be ascertained, is being favourably received. This part is entirely under the control of the County Medical Officer, although we are frequently in touch with reference to infectious disease contacts, which happily are not many. Should au epidemic threaten to arise the County Medical Officer is immediately informed of the fact, and by the weekly returns sent to him. REGULATIONS re TUBERCULOSIS. As the chief Medical Officer to the Local Government Board has only just issued his Memorandum with regard to the steps a sanitary authority can take in order to control and suppress Tuberculosis (Consumption) you have so far agreed to a voluntary notification, but there are many important steps that yott can, and should take, to stamp out the White Plague. When it becomes generally known that one ninth of the total death rate of the County of Middlesex is caused by some form or other of Tuberculosis, and that a preventable disease, we ought not to be behind the times in such au excellent cause. GENERAL REMARKS. The presence of Autumn Diarrhæa, with its fatal tendency amongst very young children, is largely governed by climatic conditions, difficult of control, and during the last year has accounted for our increased infantile death rate, more than double of 1907, in which year it was practically absent. While the Birth Rate shows a slight increase the Death Rate has also gone up from last year, which includes some 15 persons dying from 65 years and upwards. I have to thank my colleagues, particularly Mr. Stewart, the Surveyor and Sanitary Inspector, for the very able manner he has carried out his work, and I attach a report from him showing the summary of work he has carried out with great tact and judgement, which his report shows. 6 My grateful thanks are also due to you all for the unfailing courtesy you have always extended to me in carrying out what at times appear stringent measures in the interest of the public health. I beg to remain, Gentlemen, Your obedient servant, C. DWIGHT MORRIS, L.R.C.P., M.R.C.S., L.S.A. Medical Officer of Health. "Parkside," Feltham. March 31st, 1909. TABLE I. Vital Statistics of Whole District during 1908. FELTHAM URBAN DISTRICT COUNCIL. Population estimated to middle of the year 5,900 Births— Number 155 *Rate 26.2 Total Deaths registered in the District— Under 1 Year of Age 20 *Rate 129 At all Ages 75 *Rate 12.7 Total Deaths in Public Institutions in the District 5 Deaths of Residents registered in Public Institutions beyond the District 9 Nett Deaths at all Ages belonging to the District 84 *Rate 14.4 * Rates are calculated per r,ooo of estimated population. Area of District in acres (exclusive of area covered by water) 1,790 acres. Total population at all ages 4,534 At Census, 1901. Number of inhabited houses 906 Average number of persons per house 5 7 TABLE III. Cases of Infectious Disease notified during the Year 1908. FELTHAM URBAN DISTRICT COUNCIL. Notifiable Diseases. Casks Notified in Whole District. At all Ages. At Ages—Years. Under 1. 1 to 5 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Diphtheria 9 - 2 7 - - - Erysipelas 0 — 1 1 — 3 1 Scarlet Fever 4 — 1 — 3 — — Puerperal Fever 1 — — — — 1 — Totals 20 - 4 8 3 4 1 Isolation Hospital—Under consideration. TABLE IV. Causes of, and Ages at, Death during Year 1908. FELTHAM URBAN DISTRICT COUNCIL. Causes of Death. Deaths in or belonging to Whole district at subjoined Ages. All Ages. Under 1 year. 1 and under 5. 5 and under 15 15 and under 25 25 and under 65 65 and upwards. Measles 4 4 - — - Diphtheria 1 — 1 — — — — Croup 1 — 1 — — — - Diarrhoea 9 8 1 — — — — Enteritis 1 1 — — — — - Puerperal Fever 1 — — — — 1 - Phthisis (Pulmonary Tuberculosis) 7 — — — — 5 2 Other tuberculous diseases 6 2 ] 2 — 1 —| Cancer, malignant disease 7 — — — — 2 5 Bronchitis 2 1 — — — — 1 Pneumonia 4 — 2 — — 2 — Pleurisy 1 — — — — 1 — Alcoholism, Cirrhosis of liver 1 — — — — I — Premature birth 1 1 — — — — — Diseases & accidents of parturition 1 — — — — 1 — Heart diseases 6 — — — — 4 2 Accidents 2 — — 2 — — — Suicides 1 — — — — 1 — All other causes 28 - 1 4 2 5 9 All causes 84 20 11 8 2 24 19 8 TABLE V. Infant Mortality during the Year 1908. Deaths from stated Causes in Weeks and Months under One Year of Age. FELTHAM URBAN DISTRICT COUNCIL. Cause of Death. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months, 7-8 Months. 8-9 Months. 10-11 Months. 11-12 Months. Total Deaths under 1 Year. Diarrhœa, all form 1 - 1 1 1 - 2 1 1 8 Enteritis — — — — — 1 — 1 Premature Birth 1 — 1 — - - — 1 Congenital Defects — 1 - - 1 - - - - - - - - - 1 Atrophy, Debility, Marasmus - - 1 1 2 1 — 4 Tuberculous Meningitis — - - - - - - - - 1 — 1 Other Tuberculous Diseases - - - - - - - - - - - - - 1 Bronchitis — — 1 1 — — 1 Other Causes 1 — — — 1 1 — — — — - — - 2 Totals 2 1 1 1 5 4 1 1 1 2 1 3 1 1 20 Population (estimated to middle of 1908) 5,900. Births in the year, legitimate 151, illegitimate 4. Deaths in the year of legitimate infants 19, illegitimate infants 1. Factories, Workshops, Laundries, Workplaces and Homework. 1—INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices Prosecutions. Factories (including Factiory Laundries) 12 Workshops (including Workshop Laundries) 5 — — Workplaces — — Total 17 - - 4 —REGISTERED WORKSHOPS. Bakehouses 3 9 FELTHAM URBAN DISTRICT COUNCIL. SANITARY WORK, 1908. FORM C I. Particulars as to Staff employed in Sanitary Department— R. T. Stewart, Fellow of the Institute of Sanitary Engineers, and Associate of Royal Sanitary Institute, Inspector of Nuisances and Surveyor. 1 Foreman and 2 men engaged on cesspool cleansing work. 1 man on house refuse collection. INSPECTIONS— Number of Premises Inspected on Complaint 12 Number of Premises Inspected in connection with Infectious Diseases 17 Number of Premises under Periodical Inspection 520 Houses Inspected from House-to-House 235 Total Number of Inspections and Re-inspections made 247 NOTICES— Cautionary or Intimation Notices Given 100 Statutory Orders Issued 46 DWELLING HOUSES— Houses, Premises, &c., Cleansed, Repaired, &c. 8 FORM C II. BAKEHOUSES— Number in District 3 SLAUGHTER HOUSES— Number on Register 3 Number of Inspections made 4 DAIRIES AND MILKSHOPS- Number 011 Register 2 Number of Inspections made 4 UNSOUND FOOD— Condemned by Magistrate 1 Articles or Parcels surrendered 1 WATER SUPPLY AND WATER SERVICE— Wells—Cleansed, Repaired, &c. 2 Closed as Polluted 1 Percentage of Houses supplied from Public Water Service 80% Percentage of Houses supplied on Constant System 80% Number of Samples obtained for Analysis—From Local Wells 50 From Public Supply 6 10 SANITARY WORK, 1908. — Continued. FORM C III. drainage & sewerage op existing buildings-- Water Closets—Number of Water Closets substituted for Dry Receptacles 3 Percentage of Houses provided with Water Closets 80% Drains—Examined, Tested, Exposed, &c. 32 Unstopped, Repaired, Trapped, &c. 27 Waste Pipes, Rain Water Pipes Disconnected, Repaired, &c. 7 Reconstructed 12 Cesspools—Rendered Impervious, Emptied, Cleansed, &c. 800 disinfection- Rooms Disinfected—Ordinary infectious diseases 11 Phthisis 5 Rooms Stripped and Cleansed 11 Articles Disinfected or Destroyed—All in the Rooms 16 dust— New Bins Provided 93 How frequently is dust removed from each house Once per week Number of Complaints of Non-Removal received 1 Method of Disposal Tipping in Depot sundry nuisances abated— Overcrowding 4 Smoke 1 Accumulations of Refuse 6 Foul Ditches, Ponds, &c , and Stagnant Water 3 Dampness 2 Yards repaved or repaired 1 Other Nuisances 7 Geo. W. Lancett, Printer, Feltham.