AC4341 FIN 31 THE Metropolitan Borough of Finsbury ANNUAL REPORT on the Public Health of Finsbury for the Year 1950 By— C. O. S. BLYTH BROOKE, M.B., B.S., D.P.H. Barrister-at-Law. Medical Officer of Health. Finsbury Health Centre, Pine Street, London, E.C.i. Printed by Vail & Co., Ltd. (t.u.), Finsbury, e.c. 1951 THE Metropolitan Borough of Finsbury ANNUAL REPORT on the Public Health of Finsbury for the Year 1950 By— C. O. S. BLYTH BROOKE, M.B., B.S., D.P.H. Barrister-at-Law. Medical Officer of Health. Finsbury Health Centre, Pine Street, London, E.C.i. Printed by Vail & Co., Ltd. (t.u.), Fimsbuby, e.c. 1951 2 HEALTH COMMITTEE Chairman: Alderman C. H. SIMMONS, J.P., L.C.C. Vice-Chairman: Councillor Mrs. M. BENJAFIELD Alderman Mrs. V. M. HEAPS Councillor R. A. J. BENNETT „ Mrs. E. B. BROMFIELD „ C. S. BROWN „ Miss A. T. CALLAGHAN „ J. CROSSLEY „ W. J. DAVIES „ H. DUNGER „ Mrs. C. P. FENN „ A. E. HAYNES „ S. G. A. JEFFREYS „ W. O'LEARY „ J. W. TOZER Medical Officer of Health: C. O. S. Blyth Brooke, M.B., B.S., D.P.H., Barrister-at-Law. Deputy Medical Officer of Health: G. K. Lim, M.B., B.S. (From 16.7.50) (Part-time) Public Analyst: C. Harcourt Wordsworth, B.Sc. Sanitary Inspectors: H. J. Newdick, M.S.I.A. (Senior S.I.) Miss F. Hall, M.S.I.A. (Retired 30.6.50.) R. E. Lay, M.S.I.A. R. S. Barber, M.S.I.A., Barrister-at-Law A. J. Truslove, M.S.I.A. J. Lewis, M.R.San.I. E. Ditchburn D. M. Warner, M.R.San.I. 3 Meat Inspector: T. Penman, M.B.E., M.S.I.A. (Seconded to Ministry of Food) Administrative and Clerical Staff: A. G. Holmes (Chief Clerk) Miss J. L. Faulkner Mrs. A. H. Bradford J. Lindsay R. Robertson (With H.M. Forces) A. Phillips (Temp.) Cleansing Station Nurse and Visitor to the Aged: Mrs. D. I. M. Lloyd, S.R.N. Infectious Disease Visitor: Mrs. R. Pepper, S.R.N. Resident Engineer and Health Centre Keeper: F. W. Battle 4 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Finsbury. Mr. Mayor, Ladies and Gentlemen, I have the honour to present my Annual Report for 1950 on the work of the Public Health Department. This report is prepared as in previous years in an abbreviated form in accordance with instructions given by the Ministry of Health. I am glad to be able to report that the general health of the community has remained good, and there was no incidence of infectious disease giving rise to any concern other than a small outbreak of Typhoid Fever which remained localised to one house. There was little change in the Birth and Death rates which were 17.3 and 11.7 respectively. The infant mortality continued to fall and reached the remarkably low figure of 19.4 per thousand live births. A new classification has been introduced into the causes of death. This has been necessitated by international agreement in an attempt to make statistics in the various parts of the world more readily comparable. In many ways the new method will probably be more satisfactory as it accords better with circumstances which now prevail, and is more consonant with present-day medical conceptions of diseases. It will, however, make comparisons in future years with those that have passed more difficult. The Sanitary conditions generally remained satisfactory, though many open sites remain a potential danger to health by the deposit on them of refuse. There has been some outward improvement in the appearance of property which has helped to disperse some of the cheerlessness to be found in the district. It is pleasing to record that the Council's Post-War housing programme continues to make satisfactory progress. 5 I have to thank the Chairman and Members of the Health Committee, and other Committees of the Council for their continued and generous support, and the members of my staff for their ready help and assistance at all times. I have the honour to be Your obedient Servant, C. O. S. BLYTH BROOKE, Medical Officer of Health. 6 SECTION A. Vital Statistics. Area. The area of the Borough is 587 acres. Population. The Registrar-General's mid-year estimate is: Home Population 35,810 Population Density. Number of Persons per Acre 61 Marriages Registered 293 Rateable Value. £945,914. Product of a Penny Rate £3,801. General Rate for the year 18s. 4d. in the pound. Area Comparability Factor. Births 0.97 Deaths 1.02 Live Births. The total number of live births belonging to the Borough was 619 including 37 illegitimate births and consisting of 336 males and 283 females, giving a rate of 17.3 per 1,000 civilian population. The birth rate for England and Wales was 15.8 per 1,000 total population and 17.8 per 1,000 civilian population. Stillbirths. The total number of stillbirths allocated to the Borough during the year was 10. This figure represents 1.6 per cent, of the total births. Expressed as a proportion of the population the figures are 0.28 per 1,000 civilian population for Finsbury as against 0.36 for the Administrative County of London and 0.37 for England and Wales (total population). They were distributed by sex and legitimacy as follows:— Legitimate Illegitimate Total Males 6 1 7 Females 3 — 3 9 1 10 7 Deaths. The total number of deaths belonging to the Borough registered during 1950 was 418, consisting of 231 males and 187 females, giving a general death rate of 11.7 per thousand of the civilian population. The corresponding rate in the Administrative County of London was 11.8 and of the total population of England Wales was 11.6. Comparative Statistics, 1944-1950. 1944 1945 1946 1947 1948 1949 1950 Population 26,740 27,990 33,400 35,120 35,640 36,010 35,810 Birth rate(per 1,000 population) 16.0 16.9 20.6 22.2 18.9 18.6 17.3 Death rate (do.) 19.9 17.1 15.6 14.9 11.9 13.7 11.7 Maternal mortality (per 1,000 live births) 2.4 4.2 1.5 1.3 0.0 3.0 0.0 Death rate, infants under 1 (do.) 47.0 55.0 54.0 32.0 32.6 25.3 19.4 Death rate of illegitimate infants under 1 (per 1,000 illegitimate live births) 128.0 53.6 118.0 47.6 60.0 76.9 27.02 Still-births (percentage of total births) 2.51 2.7 3.6 1.6 2.3 2.3 1.6 T.B. death rate per 1,000 inhabitants (all forms) 1.46 1.07 0.96 1.25 0.72 0.56 0.39 Illegitimate births 47 56 68 42 50 52 37 8 Causes of Death—1950. Total all Ages 0-1 1- 5- 15- 25- 45- 65- 75 Bl. Tuberculosis, respiratory 12 — — — — 4 4 4 — B2. Tuberculosis, other 2 — 1 — 1 — — — — B3. Syphilitic disease 2 — — — — — — 2 — B8. Diphtheria — — — — — — — — — B9. Whooping Cough 1 1 — — — — — — — B10. Meningococcal infections — — — — — — — — — BI2. Acute poliomyelitis — — — — — — — — — B14. Measles — — — — — — — — — B4-7, 11, 13, 15-17. Other infective and parasitic diseases — — — — — — — — — B18. Malignant neoplasm, stomach 20 — — — — — 5 11 4 Malignant neoplasm, lung, bronchus 21 — — — — — 14 3 4 Malignant neoplasm, breast 4 — — — — — 1 1 2 Malignant neoplasm, uterus 3 — — — — — 3 — — Other malignant and lymphatic neoplasms 40 — 1 1 — 2 10 10 10 Leukaemia, aleukaemia 3 — 1 — — — — 2 — B20. Diabetes 1 — — — — — 1 — — B22. Vascular lesions of nervous system 37 — — — — — 11 11 15 B26pt. Coronary disease, angina 43 — — — — — 13 19 11 B28. Hypertension with heart disease 11 — — — — 1 2 4 4 B25, 26pt., 27. Other heart disease 67 — — — 1 5 6 19 30 B29, 46pt. Other circulatory disease 23 — — — — — 2 8 13 B30. Influenza 1 — — — — — 1 — — B31. Pneumonia 27 2 — — — — 9 6 10 B32. Bronchitis 27 — — — — — 4 10 13 B46pt. Other diseases of respiratory system 4 — — — — — 1 1 2 B33. Ulcer of Stomach and duodenum 7 — — — — — 2 3 2 9  Total all Ages 0-1 1- 5- 15- 25- 45- 65- 75 B36, 43pt. Gastritis, enteritis and diarrhoea 1 1 — — — — — — — B38. Nephritis and nephrosis 5 — — — — — 2 1 2 B39. Hyperplasia of prostate 6 — — — — — 1 — 5 B40. Pregnancy, childbirth, abortion — — — — — — — — — B41. Congenital malformations 2 1 — — — — 1 — — B19, 21, 23, 24, 34, 35, 37, 42, 43pt., 44, 45, 46pt. Other defined and illdefined diseases 30 7 — 1 — 2 6 6 8 BE47. Motor vehicle accidents 3 — 1 — — 1 — 1 — BE48. All other accidents 12 — — 1 — 2 3 3 3 BE49. Suicide 3 — — — 1 — l 1 — BE50. Homicide and operations of war — — — — — — — — — Males 231 9 1 2 3 9 69 67 71 Females 187 3 3 1 0 8 34 59 79 Total all Causes 418 12 4 3 3 17 103 126 150 "B" categories refer to the Abbreviated List of 50 causes for Tabulation of Mortality contained in the Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death, Volume 1. It is not easy to make comparison of some of the details in the table with those of previous years, because of the changed form— to which reference is made in the introduction—in which the information is presented. It will be seen, however, that generally speaking the reduction in the total number of deaths has been due to a general reduction among those occurring from all causes, except cancer, and at all ages. The deaths from cancer were almost identical in number with those during 1949. Another unhappy feature which should be noted is that more deaths occurred from cerebral haemorrhage and allied causes in the age group 45-64, although there was a marked decline in those recorded above 65. 10 Deaths from coronary disease which have attracted considerable attention are now set out separately for the first time; previously they were included among other Heart diseases. Maternal Mortality. There were no maternal deaths during the year. Inquests. Inquests were held on 24 residents during the year. The causes of death found were:— Natural causes 5 Road Accidents: (Males 72, 25 and 13 years, and Female 3 years) 4 Misadventure: (Males 61, 53 and 53 years, and Female 73 years) 4 Accidental Falls: (Males 70, 69 and 42 years, and Females 85, 84 and 81 years) 6 Asphyxia due to inhalation of vomit: (Male 44 years) 1 During operation whilst under anaesthesia: (Male 51 years) 1 Suicide: (Males 67, 58 and 21 years) 3 24 Infant Mortality. There were 12 deaths amongst infants under one year of age and the Infant Mortality rate based on 1,000 live births was 19.4. Of these deaths 7 occurred in the neonatal period; 1 occurred in an illegitimate child also in the neonatal period. The neonatal mortality rate was 11.3. The comparative infant mortality rates for London and England and Wales were 26.3 and 29.8 respectively. 11 Infant Mortality, 1950—Causes of Death. Cause of Death 0-1 wk. 1-2 wks. 2-3 wks. 3-4 wks. Total under 4wks. 1-3 mths. 3-6 mths. 6-9 mths. 9-12 mths. Total under 1 yr. Measles - - - - - - - - - - Whooping Cough - - - - - - - 1 - 1 Diphtheria - - - - - - - - - - Pneumonia - - - - - 2 - - - 2 Diarrhoea and Enteritis - - - - - - 1 - - 1 Congenital malformation 2 - - - 2 - - 1 - 3 Birth Injury and other diseases of early infancy 2 - - - 2 - - - - 2 Premature Birth 2 - - - 2 - - - - 2 Other defined causes 1 - - - 1 - - - - 1 7 - - - 7 2 1 2 - 12 12 SECTION B General Provision of Health Services Health Centre. The Council continued to maintain the Health Centre for the administration of the Public Health Services, and arrangements continued in force for the use by the Regional Hospital Board and by the London County Council of those portions of the building which were occupied by services transferred to those bodies under the National Health Service Act, 1946. The Council also continued to act as an agent for the Regional Hospital Board in respect of certain services controlled by them. Laboratory. The Laboratory serves the needs of the Public Health Department in the control of Infectious Disease and the bacterial cleanliness of foodstuffs. The work was carried out by the laboratory technician who was transferred to the Regional Hospital Board, and has operated in close association with the Public Health Laboratory service Laboratories in Colindale. It has also undertaken work on behalf of the Regional Hospital Board. The arrangements continued to operate whereby in some cases special examination may be carried out by the Archway Group Laboratories, but no use was made of this service in 1950. Work of the Public Health Department Number positive Total Number Examined Total 1949 1950 1949 1950 1950 (1949) Throat and Nose Swabs for Diphtheria — — 302 616 Sputums for Tubercle Bacilli 83 97 466 455 Post nasal swabs and/or cough Plates for H. Pertussis — 38 1 75 White Cell counts — — — 48 Faeces and Rectal Swabs for Salmonella, etc. 6 111 67 732 Urine Examination for Typhoid — 2 - 71 1,997 (836) 13 Number Total UnsatisNumber Number Total factory Poor Examined 1949 1950 1949 1950 1949 1950 1950 (1949) Milk— Pasteurised 1 I 5 2 — 305 173 Tuberculin Tested Pasteurised — — 1 —25 35 Sterilised — — — —44 55 Ice-Cream 9 26 13 590 111 374 (464) Other foods — — — —34 28 Water— Wells — — — —9 — Tanks — — — — 4 41 Swimming Baths — — — —5 16 Various — — — —46 10 95 (98) Totals 2,466 (1,398) Work of the Regional Hospital Board For General Practitioners For Various Clinics Totals 1949 1950 1949 1950 1949 1950 Blood Counts 39 61 61 148 100 209 Blood Sedimentation Rate estimations — 1 18 11 18 12 Urine Examinations 14 10 13 47 27 57 Various 1 11 27 6 28 17 Total 173 295 It will be seen from the comparative figures given in the above tables that there has been a very great increase in the amount of work performed in the laboratory during the past year. Blood Transfusion. The Council continued to co-operate with the North London Blood Supply Depot of the National Blood Transfusion Service, by arranging Blood Donation Sessions at the Health Centre. Four sessions were held during the year at which 317 donors gave blood, as against two sessions held in 1949. 14 International Certificates of Vaccination and Inoculation. Arrangements continued during the year for the authentication by the Medical Officer of Health of Certificates of Vaccination and Inoculation in the International form. These certificates are required by passengers proceeding abroad from this country and the purpose of the authentication is to provide proof to health authorities abroad that the signature of the person issuing the certificate is that of a registered medical practitioner. Burial or Cremation of the Dead. It is provided under the provisions of Section 50 of the National Assistance Act, 1948, that the Local Authority shall arrange burial or cremation in the case of any person who has died or been found dead in the Borough, in any case where it appears to the authority that no suitable funeral arrangements have been or are being made. During the year three persons were buried or cremated under these provisions. Health Education. Health Education was continued during the year by the exhibition of Public Posters and by the distribution of literature from suitable centres. The Health Propaganda undertaken was, however, on a comparatively small scale, and as a consequence, the existing programme was reviewed towards the end of the year with a view to its extension in 1951. It was suggested to the Council that increased use should be made of Posters and Literature, and that consideration should be given to the following methods of increasing the efficiency of the Health Propaganda service:— Lectures to the Public; Discussion Groups with talks ; Showing of film strips and pathological demonstrations; Film Shows at the Health Centre and at a local cinema. The adoption of these suggestions was, however, deferred by the Council pending further consideration of the financial provision to be made for such an extension in the estimates for 1951/2. 15 Preliminary arrangements were also made to arrange a joint meeting with headmasters, education officers and the school medical officers to further health propaganda in the schools in the borough. It may also be said that the character of the Health Centre building which houses the Public Health Department was designed to inspire the conception of Health among the many members of the Public who use it for one purpose or another. Aged Persons. The Council continued its very active interest in the Health and Welfare of that section of the community comprised of men over 65 and women over 60. Those known to the department were visited regularly according as their needs were known and every effort was made to give them help and encouragement in looking after themselves. Arrangements remained in force for providing nursing services through the Metropolitan District Nursing Association where these are certified on behalf of the Council as being required. 7,395 visits were paid in this connection during the year. The number of visits paid for 1949 being 1,487. Difficulties frequently arose owing to the shortage of hospital accommodation in securing admission to an institution when proper care was not obtainable at home. This caused many distressing circumstances to arise as many old persons live alone and have no one to care for them in the event of illness. There is an urgent need for the provision of sick bays where such persons may stay for short periods to receive attention during minor illnesses as well as for further hospital provision for more serious cases. Were this available I believe many persons would be saved from permanent sickness which results partly from failure to have proper care in the early stages of diseases such as Acute Bronchitis and Influenza. It was not found necessary to make any application under the National Assistance Act for compulsory removal during the year. The Council encouraged all Voluntary Organisations in the Borough to extend the services for meals and recreation. Grants 16 were made on the basis of reports made to the Council on the work of each society and amounted in all to £550 0s. 0d. between twelve organisations. Facilities for Mid-day Dinners were provided by the Red Cross Society, W.V.S., Alexandra Trust and St. Mary's Mission (service commenced 12th December, 1950). The meals being purchased in three instances from the L.C.C. Catering Department and sold to the Aged at a cost of 8d. per meal. The L.C.C. making a grant of 4d. per meal. The Council also made arrangements whereby meals could be obtained by the Aged from the Alexandra Trust, a Charitable Organisation, at a charge of 10d. per meal. 11,750 (approximately) mid-day dinners were served during 1950. Dinners were available as under:— Two days a week Two Centres Five days a week One Centre Daily One Centre. The Council also have an arrangement with the Invalid Kitchens of London, whereby upon the recommendation of the Medical Officer of Health a mid-day meal will be provided to the Aged in their own homes. The Council agreed in principle to the establishment during 1951 of a Laundry Service for the Chronic Sick and a Cleaning Service for those Aged Persons who are unable, by reason of ill health, senility, etc., to keep their abode in a state of cleanliness required to ensure a healthy environment. The Council continued and extended a new service designed to preserve the health of the elderly by allowing those sufficiently strong to benefit from a stay of 2 weeks in the country or at the seaside. Applications were invited by public announcement and through variously interested clubs and societies, and these were made to the Department. Each applicant was required to contribute a small amount towards the cost, normally 10s. 0d., but varied slightly in some cases. Arrangements were then made for the holiday at one or other of the six following holiday homes:— 17 Eastwood Lodge, Rayleigh, Essex. Fairlawn, Herne Bay. Singholm, Walton-on-the-Naze. Whitechapel Mission Holiday Home, Southend. Bell Memorial Home, Lancing, Sussex. Convalescent and Holiday Home, 83, Beaconsfield Villas, Brighton. A grant was made to each of these homes to cover the cost including the railway fare and their necessary travelling expenses, less that amount which the individual was required to contribute. Arrangements were made with the co-operation of the Red Cross Society and W.V.S. for those Aged Persons who so desired, to save, through the medium of Savings Stamps, the amount or part of the amount they would be required to contribute towards the cost of the holiday. Stamps were on sale at the Health Centre, Red Cross and W.V.S. Centres, and in all £88 was saved in this way by Aged Persons. In this way a holiday was provided for 212 persons comprising 15 married couples, 54 men and 128 women, at a total cost to the Council of £1,092. The Scheme proved an unqualified success as was evidenced by the large number of appreciative letters received, and in other ways. It is felt, as a point of interest, that the existence of the Council's Scheme has in some cases inspired relatives of the Aged Persons to send them for a holiday privately. I am more than satisfied that a holiday at the seaside or country benefits considerably the permanent health of the individual by building up the body for the winter months, and is of considerable value sociologically. All this apart from the pleasure and enjoyment given to the individual at the time. 18 SECTION C. Sanitary Circumstances. Water. The Borough is freely supplied with water by the Metropolitan Water Board. As this supply is under continuous control no examinations were made of this water. In addition there are 3 wells in use in the Borough. Samples of water from these wells have been regularly examined and have been found consistently satisfactory. There are also certain other wells but these are not normally used. Swimming Baths. There are 4 indoor swimming baths in the Borough, 3 of which belong to the Council all of which maintain regular chlorination of the water. Bacteriological examination has shown an almost complete freedom from contamination. Sanitary Conditions. The Sanitary conditions of the Borough were subject to routine inspection and investigations were made into the circumstances of all complaints made. The work undertaken apart from that detailed elsewhere in this report is summarized in the following table:— Sanitary Conditions. The following is a summary of work undertaken by the Sanitary Inspectors during 1950. Houses, damp, dirty or dilapidated, remedied 1,053 Doors, windows, floors, walls, ceilings, sashcords repaired 1,240 Water closet defects remedied 276 Water closets erected 440 Urinal defects remedied 16 Urinals erected 29 Soil pipe and ventilating shaft defects remedied 69 19 Sanitary Conditions—continued Soil pipe and ventilating shafts erected 187 Yard defects remedied 47 Waste pipe defects remedied 97 Waste pipes erected 117 Water cistern defects remedied 104 Accumulations of rubbish or manure removed 124 Dung or dust receptacles repaired or renewed 48 Drains relaid, amended or sealed 257 Drains cleared or tested 147 Rain water pipes cleared, repaired or renewed 65 Water supply to houses reinstated 9 Roofs and gutters repaired 605 Area defects remedied 42 Wash-house defects remedied 65 Animal nuisances abated 4 Stables cleansed or repaired 1 Water supply laid on to upper storeys of house 9 Miscellaneous nuisances abated 150 Public Conveniences—Inspections 10 First visits (complaints, casual visits) 6,824 Re-visits 7,146 Intimation Notices served 1,116 Nuisance Notices served 90 House inspections 2,155 Complaints received 2,303 Nuisance Notices were served in all instances where necessary, but in most cases co-operation with owners by informal approach and the service of Intimation Notices, secured the abatement of nuisances and in addition on many occasions other improvements in living conditions. In a number of cases time, additional to that provided for in notices, had to be allowed owing to such circumstances as shortage of material and of labour. It was frequently found that landlords were willing to comply with requirements but experienced delay in securing builders to execute the necessary works. 20 Legal proceedings instituted under the Public Health (London) Act, 1936, for non-compliance with Nuisance Notices only occurred in the cases set out in the following table:— Date Premises Offence Result 27.9.50 16, Cynthia Street Failing to abate nuisances. Costs £2 2s. Order to do the work within 21 days. 27.9.50 19, Cynthia Street Failing to abate nuisances. Costs £2 2s. Order to do the work within 21 days. 27.9.50 22, Cynthia Street Failing to abate nuisances. Costs £2 2s. Order to do the work within 21 days. 29.11.50 18, Calshot Street Failing to abate nuisances. Fined £1. Costs £1 Is. Order to do the work within 14 days. 11.12.50 23, Shene Street Failing to abate nuisances. Costs £2 2s. Order to do the work within 7 days. 29.12.50 23, Shene Street. Summons to abate a nuisance. Fined £5. Costs £2 2s. Much of the property remains in a dilapidated and outworn condition. A considerable improvement was, however, effected during the year although this may not be very apparent from the outside. An attempt was made to improve the cleanliness and hygienic condition of the courtyards and areas of one large block of tenement buildings where the tenants had been guilty of throwing rubbish out of the windows, and other careless and untidy habits, by circulating a personal appeal to each one. It was felt that the result was to some extent successful. The dreary and desolate character of many parts of the Borough was enhanced by the frequent deposit of rubble and rubbish on vacant sites which was difficult to control. The presence of harmless rubbish on vacant ground apart from being unsightly leads to the dumping thereon of vegetable and other refuse which may well constitute a danger to health, especially for children who play there. When such deposits were recognised as likely to be injurious to health they were removed by the Council. 21 Common Lodging Houses. The only common Lodging House is that situated at 88, Old Street, which is licensed for 348 beds. Twenty-seven visits of inspection were made. Canal Boats. Canal boats do not normally halt during their passage along the short stretch of canal in the Borough. Shops. The number of inspections made under the Shops Act, 1934, during 1950 was 193, and 6 Notices were served for contraventions. Rag and Bone Dealers. There are 7 premises within the Borough in which this type of business is conducted. Eleven visits were made to these premises. Rag Flock. Two samples were taken during the year, both of which proved satisfactory. Offensive Trades. The following premises were licensed for the purpose of carryng on offensive trades:— (a) Messrs. Henson, 187, Whitecross Street, E.C.I. (b) Messrs. F. & W. Warman, Ltd., 5, Eagle Court, E.C.I. (c) Messrs. T. Kendon 8c Sons, Charterhouse Mews, E.C.I. All were regularly visited. Factories. A register of Factories is maintained which indicates which are designated " Power " and which " Non-Power " Factories. Power : Number added to the Register during 1950 61 Number removed from the Register during 1950 54 Number on Register at end of 1950 1,412 Number Employed—13,274 men, 14,383 women—27,657 Persons. 22 Non-Power: Number added to the Register during 1950 9 Number removed from the Register during 1950 11 Number on Register at end of 1950 822 Number Employed—1,450 men, 768 women, Persons. 2,218 Total Number on Register at end of 1950 2,234 Total Number Employed—14,724 men, 15,151 women—29,875 Persons. These factories were visited and inspected when first registered as regards those matters which arc the responsibility of the Borough Council. They have been further inspected on receipt of complaints and as far as possible at regular intervals. It has not been possible to visit each factory every year. The general standard of Hygiene and compliance with legal requirements was found to be very good and only occasionally were defects, as set out below, discovered. In such cases notices were served. Number of Inspections—Power Factories 471 —Non-Power Factories 91 —Total 562 Number of complaints received from II.M. Inspector of Factories 18 Number of complaints received from others Number of Defects discovered :— Want of cleanliness 4 Unreasonable temperature In relation to Sanitary Conveniences 52 Various 10 Total 66 Number of Notices served 22 No prosecutions were instituted during the year. Number of notices sent to H.M. Inspector of Factories 11 23 (The information given here is exclusive of Bakeries and certain other premises which arc referred to elsewhere in this report.) Outworkers. Number of firms in the Borough who employ outworkers 238 Number of notifications received of:- 1. Finsbury outworkers employed by Finsbury Firms 488 2. Outworkers in other districts employed by Finsbury Firms 4,857 3. Finsbury outworkers employed by Firms in other districts 87 Total number of notifications received in respect of:— 1. Finsbury outworkers employed by: (a) Finsbury Firms 578 (b) Firms outside Finsbury 170 748 2. Outworkers employed by Finsbury Firms 5,435 Outworkers who are sub-contractors arc normally occupiers of Premises registered as Factories and inspected as such. Domestic outworkers are visited in their homes to ensure that work is not carried out in unsuitable surroundings. Number of visits to Domestic outworkers 77 Number of notices served in respect of unsatisfactory conditions 12 Smoke Abatement. Ten complaints were received and 138 observations made during the year in regard to smoke emission. No notices were served. Generally speaking I am of opinion that there has been some diminution of atmospheric pollution in recent years. Verminous Premises and Articles. During the year 451 premises were found to be verminous, and disinfestation measures were carried out. Similar measures have been carried out on certain other occasions on request. In all Disinfestation measures were carried out in 525 premises. 24 The measures adopted have been the spraying of the room thoroughly with a D.D.T. Solution on one occasion, and the steam disinfection of the bedding in most cases and whenever considered necessary. As a routine measure for the control of vermin, disinfestation is carried out in the case of tenants moving into the Council's Housing Estates (other than Post-War Estates), or requisitioned property. This was carried out on 384 occasions during the year. The normal routine is for old accommodation of the prospective tenant to be sprayed with a D.D.T. Solution some days before the removal, and at the same time for the proposed new accommodation to be treated in the same way. On the day of removal bedding is collected from the old address, steam disinfected in the Council's ovens, and then removed to the new premises. In the case of Post-War Estates the Council has entered into arrangements for the furniture and effects to be treated with hydrogen cyanide gas before removal to the Estate. Verminous Persons. The Borough Council continued the operation of the Cleansing Station in the Health Centre for the treatment of verminous conditions, including Scabies, and the arrangements whereby school children were treated on behalf of the London County Council under the supervision of a nurse appointed by them. At other times the work was carried out under the supervision of the nurse appointed by the Borough, who also undertook the Home Visiting. Arrangements were also continued during the year by which cases were treated on behalf of the Shoreditch Borough Council. The Service has worked very satisfactorily, but owing to the very small incidence of these conditions, the total numbers have, therefore, been small. Total number of treatments given to Finsbury cases (other than school children) 86 Total number of treatments given to Shoreditch cases (other than school children) 72 Total number of treatments given to School children 1,168 Total number of Home Visits paid 21 25 Rodent Control. This service was continued under the supervision of the Senior Sanitary Inspector who is designated Rodent Officer. A foreman and 4 rodent operatives have been employed. There is undoubtedly considerable infestation in the Borough and in the sewers, but this is certainly much less than it was some years ago. Without continued attention it would grow very rapidly into a serious menace once again. Number of complaints and requests for treatment received 748 Number of additional premises found infested 356 Number of houses treated 1933 Number of other premises treated 999 Number of visits made to houses 11,655 Number of visits made to other premises 5,870 Number of treatments of sewers carried out 2 Reception House. The portion of the Health Centre which had in the past been maintained by the Council as a Reception House (for persons who could not remain in their own rooms whilst these were being cleansed after infectious disease, or who had no alternative accommodation in which to reside during housing repairs) was by agreement with the North East Metropolitan Regional Hospital Board taken over by the Board for the purpose of accommodating the administrative side of the Mass Radiography Unit. The Islington Borough Council kindly agreed to provide accommodation for Finsbury residents at their Reception House as and when the occasion should arise. The necessity to take advantage of this arrangement did subsequently arise early in the year, when, as the result of an outbreak of Typhoid Fever in the Borough, the remaining members of the family concerned (6 adults and 4 children) who were immediate contacts of the patients had to be isolated for a period of approximately one month. Disinfection. Disinfection is carried out in all cases after infectious disease has occurred when this is considered necessary, and in other cases 26 on request generally after advice has been given that it would be advisable for it to be carried out. During the year it was carried out in the following instances for the reasons set out:— Suspected Diphtheria 4 Suspected Scarlet Fever 49 Suspected Measles 40 Suspected Whooping Cough 36 Tuberculosis 31 Scabies 5 On behalf of St. Marks and other Hospitals 15 Miscellaneous 311 Bedding and clothing were brought to the Disinfecting Station in the Health Centre in these cases, and disinfected with steam. In all, including the cases where this was carried out for the control of vermin, 14,151 articles were treated. Goods, mostly clothing, were also disinfected on behalf of certain export firms as follows:— Number of articles 1,34,55 Number of times disinfecting plant charged 1,233 Mortuary. The mortuary attached to the Health Centre remained available for the reception of bodies throughout the year, but one body only was received—in April. This mortuary is primarily intended for the isolation of the bodies of those dying from infectious disease and the early removal from overcrowded rooms of the bodies of those dying from other conditions when this cannot otherwise be effected. At the present time other facilities are usually made available by undertakers and there have been no deaths from any serious infectious disease. It is, however, of great value to have this provision for use in an emergency. 27 SECTION D. Housing. General. It is estimated that there are 9,890 houses in the Borough. Unfortunately a very considerable proportion are dilapidated and outworn, and incapable at a reasonable expense of being reconditioned to comply with modern standards. Deterioration is proceeding almost as rapidly as temporary improvements can be effected. Nevertheless it can be accepted that there was some betterment during the year. Again much of the property was built many years ago and is unsuitable for conversion into the type of accommodation that it is desired to provide at the present time. Until such time as demolition and rebuilding can be carried out on an extensive scale, it is clear that every effort must be exercised to preserve houses wherever possible and prevent the falling off of even those amenities that are available to residents Most of the work to secure this has been undertaken under the Public Health Act by informal action. Proceedings under the Housing Act. No representations were made and no notices served under Section 9 and 10 of the Housing Act, 1936 requiring notices to be served. 27 House to House inspections were carried out. No representations were made during the year under Section 11 that premises were unfit for habitation and could not at a reasonable expense be made fit. The position at the end of 1950 with regard to the two representations made under Section 11 in 1949 was as follows: 1.—In respect of a tenement house. The representation was agreed by the Council, proposals by the owners not having been accepted, and a Demolition Order was made. The matter was given further consideration during the year, but the house had not been demolished by the end of the year. 28 2.—In respect of buildings comprising 60 tenements. This representation was agreed by the Council and a Demolition Order was made but the premises had not been demolished by the end of the year. Three new representations were made in respect of Closing Orders during the year:— (1) Flat in a Block of Buildings. (2) Tenement over stables. (3) Basement Room. In the first instance the matter was subsequently referred to the District Surveyor for his action, the other two representations were still under consideration at the end of the year. Tabular Statement prepared in accordance with the Housing Consolidated Regulations, 1932. Number of Houses considered on inspection to be unfit for human habitation Nil. Number of Houses wherein defects were remedied by informal action Nil. Number of Representations made with a view to: (a) serving notices requiring the execution of works Nil. (b) making demolition or closing orders 3 Number of Notices served requiring the execution of repairs Nil Number of Houses rendered fit after service of notices Nil. Number of demolition or closing orders made Nil. Number of Houses in respect of which undertakings were accepted Nil. Number of Houses Demolished Nil 29 Houses let in Lodgings. The register constructed in 1935 was maintained and at the end of the year contained entries in relation to 456 houses. No action was taken during the year under the Byelaws applicable to them. Housing. Below is a list of the new properties which have been complete:! since the war :— Finsbury Borough Council Number of Flats Completed Spa Green Estate :— Wells House 48 12. 2.49 Sadler House 33 23. 6.49 Tunbridge House 48 13.12.49 Priory Green Estate :— Kendal House 85 4.9.50 (First lettings) Killick Street Estate :— Stuart Mill House 24 11.12.50 London County Council Percival Street Estate :— Tompion House 80 12. 5.48 Earnshaw House 10 3-49 Private Enterprise Cable House, Lloyd Street 16 13.10.48 Great Percy Street Scheme 20 Proposals in regard to the erection of further accommodation include:— Busaco Street Scheme 276 by Finsbury Borough Council. Holford Square Scheme 134 „ Wilmington Square Scheme 8 „ Farringdon Road Scheme 8 „ 1/9, Percival Street Scheme 24 „ Myddelton Passage Scheme 30 by Private Enterprise. 30 The Borough Council Housing Estates consisted at the end of the year of the flats set out in the following table:— Lloyd Baker Street 119 Margery Street 144 Cyrus House 40 Mandeville Houses 118 Grimaldi House 15 Royley House 12 Spa Green Estate 129 Killick Street Estate 24 Priory Green Estate 85 686 These flats contained the number of rooms as under:— 1 Room—12 Flats 3 Rooms—341 Flats 5 Rooms—15 Flats 2 Rooms—40 Flats 4 Rooms—278 Flats 537 premises having been requisitioned remained in use for housing purposes at the end of the year. In addition the Borough Council remained in possession of “Corporation Buildings” consisting of 183 Flats. This is old property acquired before the War as a site for rebuilding. The County Council Housing Estates consisted at the end of the year of the flats as set out in the following table:— Coster Buildings 56 Wenlake Buildings 86 Chadworth Buildings 136 Mallory Buildings 33 Amias House 29 Tompion House 80 Earnshaw House 10 Total 430 Slum Clearance. The tentative proposals submitted to the Council and approved and forwarded by it to the London County Council were still under consideration by the County Council at the end of the year. 31 Rehousing. Applications for rehousing by the Borough Council are made to the Housing Department and these are assessed according to their need according to a points scheme. When accompanied by medical certificates to support the application on medical grounds these are referred to the Medical Officer of Health. Enquiries are then made by the Nurse/Visitor into the detailed nature of the family health and the apparent bearing of the accommodation in use on this, and when desirable, an inspection is carried out by the Sanitary Inspector. These reports are then correlated with the medical certificates, and a degree of medical priority is then allotted according to the scheme. A large number of applications were dealt with in this manner. Applications for rehousing by the London County Council are made to that body. Reports are then frequently asked for and supplied in regard to existing overcrowding and sanitary defects. If accompanied by medical certificates, further information is given, on request, to the Medical Officer of Health to the London County Council, who is responsible for allocating priorities on medical grounds. During the year 514 families consisting of 1,999 persons were rehoused as follows :— Families Persons Rehoused in Council Flats 89 363 Transfers in Council Flats 62 247 Rehoused in requisitioned property 90 288 Transfers in requisitioned property 48 2I7 Transfers from requisitioned property to Council flats 33 140 Transfers from Council flats to requisi- tioned property 2 8 Rehoused by London County Council "3 488 Rehoused by owners and agents 36 114 Found own accommodation 41 134 514 1.999 Rent and Mortgage Restriction Act. No certificates of unfitness were issued during the year. Three old certificates were still in operation at the end of the year. 32 SECTION E. Food Food Hygiene. While the formation of a clean Food Guild remains in abeyance, informal talks and advice were given by the Inspector during his visits to the various food premises. Co-operation with the Food Office has been maintained and no new licences for restaurants and snack bars were issued by the Food Office until the premises were considered satisfactory by this department. Adulteration of Food. 750 samples of Food and Drugs were submitted to the Public Analyst, who reported only 7 as being "not genuine." The practice of taking most samples informally has been continued, those adversely reported upon being sampled formally. The following is a summary of the samples taken:— Samples Taken Number Adulterated Milk (See also under Milk). 159 0 Ice-Cream (See also under Ice-Cream). 38 0 Meat Products (See below). 109 3 Other Foods: Samples Taken Number Adulterated Butter 17 4 Margarine, Cooking Fat, etc. 30 Jams, etc. 22 Cheese 9 Flours, etc. 5 Cereals 7 Coffee, Tea, Extracts, etc. 25 Sauces, Vinegar, etc. 30 Herbs, Spices, Condiments 55 Powders—Baking, etc. 29 Canned Vegetables, etc. 33 Non alcoholic Drinks 18 Various 63 Total 343 4 33 Drugs: Samples Taken Number Adulterated Simple Medicines 42 Nil. Powders 15 Tablets 28 Saccharines 1 Ointments 15 Total 101 Nil. Adulterated samples were: 1. Two samples of sausages were deficient in meat, one by 30 per cent. the other by 42 per cent. 2. One sample of sausages contained preservatives which were not disclosed as required by the Preservative Regulations. This was a very temporary lapse as when the formal sample was procured a proper notice was found displayed. It was not considered necessary to take proceedings in these instances. 3. Three samples purchased as vinegar, were reported by the Public Analyst as being "not malt vinegar." The vendor of two of the samples (one informal and one formal) was prosecuted at Clerkenwell Magistrates' Court, and fined 10s. on each of 2 summonses plus 10s. costs. It was not possible to obtain a formal sample in the other case as the vendor changed his description of the commodity to comply with the legal ruling. 4. Following a complaint by a member of the public a formal sample of a "Pastry Mix" was obtained. The Public Analyst reported this as being rancid and at the court proceedings instituted on the Committee's instructions, the case against the vendor was proved but was dismissed on payment of 20s. costs. Milk. The change over in the methods of the milk trade referred to in last year's report continues and at the end of the year only 3 traders in the borough were bottling milk, and only 9 others were handling loose milk. The register of dairies has been adjusted accordingly. During the year the largest dairy in the borough at 116/120, Goswell Road discontinued pasteurising and bottling milk, but remains as a wholesale distributing depot, handling some 8,000 gallons of milk daily. 34 1. Dairies : At the end of the year the number of premises on the register was 13 2. Distributors : Number registered on 1st January 108 Number of Transfers approved 2 Number of new applications received and approved 3 The only cancellations were those resulting from transfers; and one due to business ceasing to operate. 3. Designated Milks : Number of licences issued :— Pasteurisers 1 Dealers in T.T. Milk 41 supplementary 17 Dealers in Pasteurised Milk 68 supplementary 18 Dealers in Sterilised Milk .. 74 supplementary 19 4. Quality : Number of samples submitted to Public Analyst 159 Number of these reported as adulterated Nil The average fat content of the milk samples was 3.5 per cent, and of non-fatty solids 8.87 per cent. 5. Cleanliness : Number of samples submitted for bacteriological examination 230 Number of samples below required standard 5 Investigations were made in every case where the results did not conform to the standard required. 6. The total number of visits to milk premises was 315 Ice Cream. The number of premises registered for manufacture 25 The number of premises registered for storage and sale 82 35 Whilst there is still no legal standard for the composition of ice-cream, the arrangement between the Ministry of Food and the traders whereby the trade agreed to provide not less than 2.5 per cent. fat in ice-cream continued throughout the year. Number of samples submitted to Public Analyst 38 Number of samples below 2.5 per cent, fat Nil The fat content ranged from 3.3 per cent, to 17.5 per cent. fat, the average being approximately 7 per cent. Samples were submitted to the pathological laboratory for examination regarding the bacteriological condition of ice-cream with the following results:— Total number of samples submitted 110 Number of samples satisfactory 74 Number of samples poor 12 Number of samples unsatisfactory 24 Many of the samples returned as poor and unsatisfactory were repeated samples from a manufacturer. For a time the cause was inexplicable, but the trouble was eventually traced and overcome satisfactorily. Total number of visits to Ice-Cream premises 172 Meat Inspection. Meat inspection continued to be carried out in the Borough including the area in the vicinity of the Smithfield Meat Market. Regular inspections were made of meat and offal consigned to the various wholesale butchers and offal shops. Inspections were also made of the Public Cold Air Stores, bacon factories, wholesale bacon and provision warehouses. The increased amount of meat and other foodstuffs condemned during the year was due to the fact that larger quantities of supplies arrived at the market, and to the re-opening of many food premises which were closed during the war. A special examination of 25,462 carcases of frozen Argentine mutton was carried out by the Meat Inspector for caseous lymphadenitis and of this number 7.9 per cent, were affected with the 36 disease. Approximately 7,000 carcases remain to be examined in the Cold Air Store at the end of the year. A systematic examination of imported carcases of mutton and lamb was carried out at the Cold Air Stores for caseous lymphadenitis, and 216 carcases were found to be diseased. Sixty-seven certificates for the export of meat extracts were issued during the year mostly for U.S.A., Australia, South America, Egypt and the Phillipine Islands. A total of 2,751 visits were made to the retail butchers shops and stalls in the Borough. Bakehouses. There were 21 bakehouses in use at the end of the year, and of these 16 were basement premises. Machinery is used in all of them. 71 inspections were made during the year. Underground Bakehouses. It was suggested to the Health Committee in the early part of the year that although consideration of the certificates in relation to underground bakehouses would not fall due until 1954, it would only be fair to give some indication in the interim to the Owners of a possible or probable revocation. The Owners obviously being unwilling to spend large sums of money in reconditioning and improving premises without a reasonable guarantee that the certificates would not be revoked. In accordance with the authority of the Health Committee, I personally inspected all the underground bakehouses in the Borough and reported as follows:— In 14 instances without making any formal statement which would bind the Council, I gave reasonable assurance that I would recommend that the certificates in relation to the underground bakehouse be not revoked when it falls to be again considered in 1954 and that in these circumstances I urge and require that improvements be effected from time to time and that every possible effort be made to maintain the best hygienic conditions possible in the bakehouse, 37 In two instances I have informed the owners that it is unlikely that I should be able to advise the Council not to revoke the certificate when it falls to be again considered in 1954, and cannot therefore advise that they become involved in heavy expense without at least prior consultation. Registered Food Premises. The number of premises registered for the preparation or manufacture of sausages, potted, pressed, pickled or preserved food at the end of 1950 was 57. Of these 12 were in respect of Fried Fish Shops. The number of premises registered for carrying on the business of a wholesale dealer in Margarine was 14. Apart from premises whose formal registration is required there are a very large number of places where food is handled and many persons are employed in one way or another in the handling of food. It is estimated that there are in the Borough 159 Restaurants and Cafes, and 180 Canteens (exclusive of Public Houses). All food premises remained under supervision as far as was possible and 1,157 visits of inspection were made. Street Markets. Much food is handled in the Street markets and licences were issued for 268 stalls during the year. In each case any storage accommodation used for foodstuffs was inspected throughout the year. Licensed Premises and Public Houses. There were 136 licensed premises in the Borough, 126 of which were Public Houses. 144 inspections were carried out. Unsound Food. No food was seized and formally condemned during the year. On the other hand considerable quantities of unsound food were voluntarily surrendered, either on the initiative of the trader or on its discovery by an inspector, and were then disposed of for animal food or industrial use. The following table gives a summary of the quantity of foodstuffs confiscated or surrendered:— 38 Meat Diseased 25,102 lbs. Total 69,409 lbs. Meat Unsound 10,301 lbs. Bacon 34,006 lbs. Offals Diseased and unsound 26,925 „ Poultry 5,548 „ Game 4,185 „ Rabbits 6,565 „ Cereals 150 „ Cheese 310 „ Fish 364 „ Fats 7,259 „ Dried Fruit 551 „ Tins 123,936 „ Other Foodstuffs 52,242 „ Total 297,444 „ 132.78 Tons. It is found now that it is not often that any effort is made by traders to dispose of unsound food to the public. In many cases they themselves call attention to the condition of the food and surrender it voluntarily in order, on the evidence of the certificate, to make a claim on their suppliers for financial re-imbursement and/or for replacement of controlled commodities. At times there is even a desire to surrender food which though perhaps unsaleable is not unfit for human consumption. The headquarters of certain multiple stores are in this Borough and often unfit food from many of the branches is returned before official attention is called to its condition. For this reason the amount of canned goods surrendered is greater than it would otherwise be. Several complaints were received from customers that food purchased was unwholesome. In most cases the complaint was not regarded as serious or did not evidence any carelessness or negligence by the vendor, and was dealt with by the issue of a warning letter. 39 The collection of unsound food from the Smithfield Meat Market continues to be carried out by the Council's contractor, The Smithfield Animal Products, Ltd., Court Farm, Stanwell, Middlesex. Listed Sellers of Poisons. Forty-six applicants were approved by the Council in accordance with the Pharmacy and Poisons Act, 1933, each of whom were visited. Food Poisoning. Five cases of Food Poisoning were notified during the year. There were no deaths. There were no outbreaks of Food Poisoning due to identified causes during the year. One outbreak due to an unidentified cause occurred as under:— 1. Domestic (June)—4 cases—1 notified—Suspected cause: Beef—partly cooked and allowed to stand in gravy. Apart from the outbreak detailed above, the following individual cases were investigated:— 1. A case notified in November.—The individual concerned had severe abdominal pains, diarrhoea, and feeling of nausea. Probable cause, a tin of stewed steak purchased in the morning and prepared at home for the mid-day meal. There were no remains of the meal which could be submitted to pathological examination in the laboratory. 2. A case notified in November.—The individual concerned had diarrhoea and vomiting. Probable cause thought to be a meal consumed at a canteen. The Canteen was visited but enquiries failed to reveal any other case of illness. 3. A case notified in November.—The child concerned suffered from severe diarrhoea for two days, but had no abdominal pains or vomiting. The probable cause considered to be either an egg or fish. 4. A case notified in December.—The individual had abdominal pains, but no diarrhoea or vomiting. No other persons in the family complained of any illness, the probable cause considered to be a meal taken away from home. 40 SECTION F. Infectious Diseases. General. Apart from a small but serious outbreak of Typhoid Fever which was confined to the residents of one house, there has been no incidence of infectious disease to give rise to any serious concern. All cases notified were visited by the Infectious Diseases Nurse/Visitor and energetic measures taken wherever indicated to ensure adequate treatment for the patient and the minimization of the danger of infection to others. Number of visits by Infectious Disease Visitor 2,188 The following table shows the cases of notifiable diseases of which information by notification or otherwise was received in the several age periods set out:— All Ages Under 1 year 14 yrs. 514 yrs. 1524 yrs. 2544 yrs. 4564 yrs. 65+ Cases treated in Hosp. Acute Influenzal Pneumonia 2 - - - - - 1 1 1 Acute Primary Pneumonia 41 3 8 5 4 6 13 2 27 Diphtheria 1 — — — — — 1 — 1 Dysentery 29 2 18 4 — 2 2 1 19 Erysipelas 8 — — — 2 4 2 — 2 Food Poisoning 5 — 1 — — 1 3 — — Gastro enteritis (under 2 yrs.) 15 9 6 - - - - - 15 Measles 298 12 171 114 — 1 - — 45 Meningococcal infection 1 1 — — — — — — 1 Ophthalmia Neonatorum 1 1 - - - - - - 1 Puerperal Pyrexia 6 — — — 2 4 — — 6 Poliomyelitis (Paralytic) 5 - 5 - - - - - 5 Scabies 32 1 5 18 — 4 1 3 — Scarlet Fever 48 — 27 18 1 2 - — 35 Tuberculosis (Pulmonary) 81 — 6 6 23 32 11 3 — Tuberculosis (Other forms) 5 — 1 — — 4 - — — Paratyphoid 1 — 1 — — — — — 1 Typhoid 11 1 1 3 4 1 1 — 11 Whooping Cough 188 22 118 48 — — — — 47 778 52 368 216 36 61 35 10 217 41 Incidence Rates. The rates per thousand of the population are set out below, together with the corresponding rates for England and Wales, the larger towns, the smaller towns, and London as a whole for comparison:— (Notification Rates (Comparative Table) per 1,000 population.) Finsbury England and Wales 126 C.B's. and great towns including London 148 smaller towns, Res. population 25,000 to 50,000 at 1931 census London Adm. County Typhoid Fever 0.30 0.00 0.00 0.00 0.01 Paratyphoid Fever 0.03 0.01 0.01 0.01 0.01 Meningococcal infection 0.03 0.03 0.03 0.02 0.03 Scarlet Fever 1.34 1.50 1.56 1.61 1.23 Whooping Cough 5.25 3.60 3.97 3.15 3.21 Diphtheria 0.03 0.02 0.03 0.02 0.03 Erysipelas 0.22 0.17 0.19 0.16 0.17 Smallpox — 0.00 0.00 — — Measles 8.32 8.39 8.76 8.36 6.57 Pneumonia 1.20 0.70 0.77 0.61 0.50 Acute poliomyelitis (including polioencephalitis)— Paralytic 0.14 0.13 0.12 0.11 0.08 Non-paralytic — 0.05 0.05 0.06 0.05 Food Poisoning 0.14 0.17 0.16 0.14 0.25 Diphtheria. Again it may be recorded that there has been no true case of Diphtheria arising in the Borough. One case (a man of 62) who had already been under treatment in Bethnal Green Hospital for Bronchitis for 18 days developed the disease, but it is most unlikely that he was already suffering from Diphtheria when admitted. In February information was received that a female aged 22, employed by a firm in the Borough but resident elsewhere, had been admitted to hospital with Diphtheria and the diagnosis confirmed. Swabs were taken of all employees who had been in contact with the patient, and also of the maintenance staff. In one instance only was a positive result obtained (a nasal swab) and the persons was excluded from work until three negative results had been obtained. No other case of diphtheria occurred on the premises. 42 Smallpox. No cases occurred in the Borough. A few contacts arriving here of cases which originated abroad were supervised during the period of possible incubation. Erysipelas. Eight cases were notified during the year, and all were mild and recovered. Scarlet Fever. There were 48 cases during the year, almost all of them were young children and as in recent years, very mild. In only one case was there any complication, this was a child of 4 who developed an ear discharge which lasted for about a month. It is interesting to note that only in 5 cases was a source of infection in the family or at school even suspected. Influenzal Pneumonia. Two cases were notified during the last quarter of the year. In both instances the illness was severe and death occurred in one case. Acute Primary Pneumonia. Forty-one cases were notified and these were distributed throughout the year with but little preponderance in the winter months. Thirty-one cases were severe and there were 2 deaths. In these 2 cases (one a male of 58, and one a female of 64) the home conditions were noted as particularly poor; both, however, were treated in hospital. Ophthalmia Neonatorum. One case was notified but there was no probability of the infection having been venereal in character, and there was full recovery. This case occurred in hospital. Puerperal Pyrexia. Six cases were notified. Four cases were in hospitals and 2 had deliveries (in one case an abortion) at home, but were later admitted to hospital. All cases were mild and recovered except for one which arose in hospital and pyrexia was discovered to be due to Tuberculosis. 43 Poliomyelitis. Five cases of paralytic disease occurred during the year, two in the winter, one in June, August and September respectively. All were young infants below school age and the paralyses were distributed as follows:— Left leg 3 Right arm 1 Left side of face 1 The cases were mild on the whole and made satisfactory progress. No relationship to any other cases was discovered in spite of very intensive enquiries. No cases of Non-Paralytic disease were reported or discovered among contacts. Meningococcal Infections. There was one case in a baby aged 2 months. Complete recovery followed. Typhoid. In the early part of the year a localised outbreak of Typhoid Fever occurred in one house which involved eventually 10 persons. At the end of February information was received from a general practitioner that 2 persons living in an overcrowded tenement house were probably suffering from Typhoid Fever. Both persons were found to be suffering from Typhoid in about the second week of the disease and to be seriously ill, and were removed to the Park Hospital immediately, where they were found to be almost moribund. They responded, however, to treatment with Chloromycetin and recovered dramatically. The next day all the other residents in the house were examined and two were thought to be suffering from Typhoid and were admitted to hospital (one, a baby, was later discharged it being thought that he had in fact not suffered). The remainder were transferred to the Islington Reception House which was kindly put at the disposal of the Department. They were kept under strict supervision and systematic blood and stool examinations were made. In the course of the following ten days six were found to have either clinical symptoms of Typhoid or to have positive bacteriological or serological findings and were admitted to hospital. Two of these 44 became seriously ill but recovered. One other child who did not seem well was also admitted for observation but was found not to be suffering from Typhoid. In the meantime the house was completely disinfected and closed for about a month, when it became clear that the only three remaining persons were not incubating the disease and were allowed to return. As soon as the first cases were removed enquiries were made regarding a baby who had been in hospital for a month with gastro enteritis, and further pathological investigations showed that it was in fact suffering from Typhoid Fever. The source and early progress of the infection within the families which were inter-related, were never firmly established. The Phage type of the infecting organism was the same as that involved in the Croydon epidemic, but intensive enquiries failed to elicit any connection between this outbreak and those known to have infected in the Croydon and other outbreaks of the same Phage Type. In the early autumn a child was notified also as suffering from Typhoid. She had clearly been infected during a holiday in Italy. She was treated in hospital and made a full recovery. There were thus in all 11 cases of Typhoid Fever during the year. Paratyphoid. There was one case of Paratyphoid B during the year. This was in a child aged 2½ who was treated in hospital and made a full recovery. No source of the infection was traced. Contacts of Typhoid and Paratyphoid. In addition to the known contacts of the cases recorded above, members of a party of schoolchildren, one of whom developed Paratyphoid on return from a holiday, were kept under strict supervision until the risk of the disease was over. Gastro Enteritis. Fifteen cases under 2 years were notified during the year—all were treated in hospital, and there was one death. In all these cases full investigations were carried out and later in the year these were extended to include stool examinations wherever possible of the contacts. 45 Dysentery. The total number of cases of dysentery (Sonne type) in the Borough during 1950 was 29 (including 4 adults). Of these 6 were connected with outbreaks in a Day Nursery (vide below) and 4 were connected with an outbreak in a Day Nursery in a neighbouring Borough. The remaining 19 cases occurred sporadically throughout the year, one was probably infected in the home by a brother who suffered in a Nursery outbreak, and in one instance 4 members of the same family were involved. In no other case was there any evidence discovered either of a source of infection or of a spread of the disease. Pathological examinations were made as far as possible of all home contacts and it has been remarkable, the friendly co-operation that was shown by the families concerned and the extent to which they came to rely on the Health Department for advice. Eight of the patients were severely ill but the remainder were mild cases. Nineteen cases were admitted to hospital. Two outbreaks of Dysentery (Sonne type) occurred in a Nursery for 90 children attached to an industrial concern in the Borough in February and November respectively. In all, 53 children were involved. Nearly all of these showed mild symptoms of the disease and only one was really ill. The majority of the cases were residents of neighbouring boroughs. Neither was easily controlled and in spite of repeated examinations and immediate exclusion of all infectious cases discovered in that way among either staff or children, and regular disinfection of the premises, further cases developed over a considerable period, and the second outbreak lasted right on to the end of the year. Whooping Cough. There was a considerable incidence of Whooping Cough throughout 1950 with a tendency to increase in the last few months of the year, and I regret to have to report one death in a baby aged 5 months. In all there were 188 cases (including 5 unnotified), no adults, and of these 60 were regarded as mild, 81 as moderate, and 47 as 46 severe. Apart from the death no complications were reported. Forty-seven cases were admitted to hospital. During the year facilities were arranged in the laboratory for the taking of cough plates and their examination for establishing at an early period the diagnosis, and the use of this service gradually extended and was useful in the control. Measles. During the early part of the year there was a low incidence, but in the autumn it became apparent that a major epidemic was beginning. Thus, in the first three quarters there were 68 cases, and in the last quarter 230 cases, making a total for the year of 298. Most of the cases in the last quarter were in the North of the Borough. Five of the cases developed in hospitals whilst under treatment for other conditions. Only one of the cases occurred among adults. By far the majority occurred in Schools and Nurseries. One hundred and eighty-seven cases were recorded as mild, 68 as moderate, and 43 as severe. The number admitted to hospital was 40. Six cases of the complication of Acute Bronchitis or Bronchopneumonia were reported. There were no deaths. Tuberculosis. The total number of new cases entered into the register during the year was 86. The distribution by sex and age, and according as to whether the case was of Pulmonary or Non-Pulmonary Tuberculosis, was:— 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65 + Total Males Pulmonary 0 2 1 2 7 6 10 9 6 4 2 49 Females Pulmonary 0 4 3 0 2 8 10 3 0 1 1 32 Males Non-pulmonary 0 0 0 0 0 0 1 1 0 0 0 1 Females Non-pulmonary 0 1 0 0 0 0 1 1 0 0 0 3 Total 0 7 4 2 9 14 22 14 6 5 3 86 Miliary Tuberculosis and Meningitis has been classified as Non-Pulmonary in accordance with the International Classification of diseases. The Non-Pulmonary cases include:— 47 1, Left Hip Joint; 1, Meningitis; 1, Lymphatic Glands of the Neck; 1, Fallopian Tubes and Endometrium; and 1, Spine and Kidneys. The numbers are slightly lower than last year (when there were 99 notifications) and are equivalent to a notification rate of 24.0 per 10,000. Too much significance must not, however, be attached to this figure as it varies from year to year according to the clinical standards accepted for diagnosis. The average figure in Finsbury from 1931 to 1938 was 18.5, and in London for 1948 was 17.9. The distribution as shown in the table is somewhat similar to that in recent years. The total number of cases remaining on the register after adjustments for deaths and transfers was on the 31st December, 1950, as follows:— Males Females Total Pulmonary 163 120 283 Non-Pulmonary 14 14 28 Total 177 J34 311 The full details of each case obtained by the Tuberculosis Visitor were by kind co-operation of the London County Council made available to, and any preventive measures possible co-ordinated with those of the Borough Council. Each case was visited with a view to tracing the source of infection, the conditions which may have influenced its development, the actual spread which may already have taken place, and the means that could be adopted or advised to prevent further danger of spread as well as to give help and advice. Disinfection was carried out whenever thought advisable and on request. Eleven deaths occurred from Pulmonary Tuberculosis as set out:— 0- 15- 45- 65 + All ages Male 0 l 4 3 8 Female 0 0 0 1 3 Total 0 3 _ 4 4 11 48 There were two deaths from Non-Pulmonary Tuberculosis, a female aged 4 years, and male aged 21 years. The Tuberculosis Death-rate from all forms was 0.39 per thousand. In only two cases did death take place where the cases had not previously been notified, and most cases had been notified several years before. Mass Radiography Unit 6D. (Information kindly provided by Dr. W. D. R. Thompson, Medical Director). A Mass Radiography Unit of the North East Metropolitan Regional Hospital Board, which commenced operations in May, 1950, has its headquarters at the Finsbury Health Centre. The Unit was originally responsible for the City of London, and the Metropolitan Boroughs of Bethnal Green, Finsbury, Hackney, Poplar, Shoreditch, Stepney and Stoke Newington, but sebsequentlv, Bethnal Green, Poplar and Stepney were transferred to another Unit. During 1950, the Unit has visited a number of firms in these Boroughs. Details of the firms in the Borough of Finsbury examined up to the end of December, 1950, are given hereunder:— No. of Persons Examined Large Films Referred for further observation Males Females Total Messrs. Blades. East & Blades, Ltd., Leonard Street, E.C.2 (including St. Luke's Printing Works, and firms in the vicinity of Messrs. Blades, East & Blades). 669 671 1,340 107 13 The Smithfield College of Food Technology, Eagle Court, St. John'sLane, E.C.I. (This Survey included staff of Finsbury Borough Council, Nurses and Nursing staff of Health Divisions 3, 4 and 5, and firms in the neighbourhood). 375 233 608 37 4 Messrs. Lilley & Skinner, Ltd., Pentonville Road, N.I. 285 166 451 35 8 49 On the 1st November, 1950, the Unit commenced operations at the Mass Radiography Centre, 20, Golden Lane, London, E.C.1, which although in the City of London is conveniently situated for firms, etc., in the Borough of Finsbury. The Unit will remain at the Centre for several months each year. Mass Radiography enables large groups of people to have their chests X-rayed with a minimum amount of inconvenience. The purpose is to discover Tuberculosis and other chest ailments in their early stages—when they can be more easily cured. The Service, which is part of the National Health Service, is reliable, speedy, painless and confidential. A notification of the result is sent to examinees who are asked to bring a stamped, addressed envelope for the purpose. Firms and individuals who wish either to avail themselves of this Chest X-ray Service or to obtain further information, should communicate with Mr. E. G. Crowsley, Organising Secretary, Mass Radiography Unit, Finsbury Health Centre, Pine Street, London, E.C.i. (Telephone Numbers—Terminus 2121, Ext. 92, or Terminus 6184).