FUL 33 METR0P0LIT N BOROUGH OF FULHAM REPORT of the MEDICAL OFFICER OF HEALTH for the year 1942 JOHN ALEXANDER SCOTT, 0.8. E. ,14.D. ,M.R.C.S.,L.R.C.P. ,D.P. H., Medical Officer of Health. METROPOLITAON BOROUGHT OF FULHAM. PUBLIC HEALTH DEPARTMENT, Town Haall, Fulham, S.W.6. September, 1940 To the Mayor, Councillors Mayor Lemen, I have the honour ro submit. the Annual. Report on the health and sanitary conditions of the Borough for the year 1942. In accordance with the instructions of the Ministry of Health this report is in a summarised form and the General Statistics and the birth and death rates are not available in the usual form. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, J. A. Scott G.B.E.,M.D.,M.R.C.S.,L.R.C.P.,D.P.H., Medical Officer of Health. EXTRACTS FROM VITAL STATISTICS FOR THE YEAR. LIVE BIRTHS: Total. Males. Females. Legitimate 1,557 785 772 Illegitimate 122 66 56 851 TOTALS 1,679 828 STILLBIRTHS:- Legitimate 49 25 24 Illeg itimate 4 2 2 TOTALS 53 27 26 693 DEATHS 1,401 708 Percentage of deaths occurring in public institutions 54.03 Deaths from puerperal causes: Rate per 1,000 (Live and still) Births. Deaths From sepsis 2 1.15 From other causes 3 1.73 Death of Infants under One year of Age:- All infants per 1,000 live births 48 Legitimate infants per 1,000 legitimate births 44 Illegitimate infants per 1,000 illegitimate births 98 Deaths from:- Cancer (all ages) 242 Measles (all ages) 2 Whooping cough (all ages) 1 Diarrhoea (under two years of age) 13 CAUSES OF DEATH. These are classified in Table 1 at the end of this Report, which shows that the five commonest causes were? Heart Disease, 348 (24.84 per cent of the total deaths)', Cancer 242, (17.27), Respiratory Diseases, 196 (13.99) Intra Cranial lesions, 99 (7.07) and tuberculosis (all forms) 85 (6.07). Maternal Mortality. There were five deaths resulting from pregnancy and childbirth giving a maternal mortality rate of 2.88 per 1,000 births. Infant Mortality. The causes of death of the 81 children who died before attaining the age of one year were:- Pneumonia 19 Premature birth 18 Congenital malformations 16 Gastro-enteritis & Diarrhoea 14 Bronchitis 5 Suffocation 2 Injury at birth 2 Atelectasis 1 Tuberculosis 1 Other causes 3 Total 81 The Infant Mortality Rate was 48 per 1,000 births. Nursing in the Home. The Fulham District Nursing Association has continued to carry out this work on behalf of the Council and during the year paid 6,102 visits to 648 cases. Ultra Violet Light Clinic. This Clinic was open throughout the year and 16,797 attendances were made. Babies' Hospital. The number of cases admitted to the Hospital was 73. There was one death. Maternity and Child Welfare. The number of attendances at the Infant Welfare Centres of children under one year was 17,163 and of children aged one to five years 6,948. The number of attendances- at the Ante-natal clinics was 11,383- Health Visitors. The total number of visits paid by the Health Visitors was 23,885. Infant Life Protection. At the end of the year there were 70 children on the Register, about one half of the peace-time number. Maternity Home. During the year 535 cases were admitted for labour and 10;; for antenatal treatment. There was one maternal death, two infant deaths and 12 stillbirths. Dental Clinic. The total number of attendances to this clinic was 2,284. Wartime Day Nurseries. Three more day nurseries were opened during the year, St. James' in July, Grove house in August and St. AndreWs in October, so that by the end of the year there were, with the Bridge House Nursery re-opened in 1941, four nurseries in the Borough. The three new ones are all large houses (two of them Vicarages) adapted to Nursery use and they are all suitable for the reception of 45 children. There has never been any lack of applications for vacancies but attendances have suffered owing to the occurrences of outbreaks of disease, all of them having at one time or another during the year cases of Measles, Chicken por, Scarlet Fever, Whooping Cough and'in one instance of Mumps. SANITARY CIRCUMSTANCES OF THE AREA. Sanitary Inspection of the Area. The following table gives a summary of the Inspections made by the sanitary inspectors during the years:- Cause of Inspection First inspections Reinspections Total Inspections 2255 8881 11136 In consequence of complaint " infectious disease 1565 135 1700 House to House Inspections 20 5 25 Infirm and Dirty Tenants Rent (Restriction) Acts applications 43 8 51 27 - 27 TOTALS 3910 9029 12939 As a result of these inspections 1375 Intimation Notices and 302 Statutory Notices were served. The routine visiting, of food premises, factories etc., was continued, 2899 visits being made. No legal proceedings were instituted during the year. Drainage of Buildings.. During the year 75 plans were approved by the Public Health Committee. Rent (Restrictions) Acts. In response to applications by the tenants, 18 certificates were - during the year. Aged, Infirm and Physically Incapacitated Persons. During the year 51 visits were paid by the woman sanitary inspector to aged persons. Rat Repression. During the year 1942, 2348 visits were made and poison laid in 412 sewers; 1391 rats are. known to have been destroyed. Mortuary. During the year 288 bodies were received into the Mortuary,. Shops Act. Inspections numbered 18. Factories. The inspections of factories numbered 100 and 1 notice was served. Outworkers Premises. Visits to these premi totalled 90.No notices had to be served. HOUSING Inspections of Dwelling Houses.The number of house-to-house inspections was (20 being first inspections); 5 Notices were served. The number: of inspections of houses after complaint, occurrence of infectious disease, or applications under the Rent (Restriction) Acts was 12,363 (3,847 being first inspections). The number of Intimation Notices served was 1,370 and the number of Statutory Notices 302. Disinfestation. During the year 90 families had their furniture treated by HCN process; prior to removal to a Borough Council estate. The treatment of rooms found to be infested with vermin was continued during the year, rooms being treated. INSPECTION AMD SUPERVISION OF FOOD. Milk. Samples taken numbered 504 and of these 0.4 per cent were found to be adulterated. Food and Act. During the year 1,000 samples of food and drugs were submitted to the Public Analyst and 60 or 6.0% were reported adulterated. The following are the comments of the Public. Analyst on these adulterated samples (it is regretted that it is not possible to publish his complete report). Article Total samples examined Number adulterated. Formal Informal Remarks. Butter 49 - 1 (Tinned) Tin badly blown, butter rancid. Cereals 39 - 2 Wheat flour & gum, insufficient flavour. Cereal powders 21 3 5 Improperly prepared, disintegrates on cooking. Chocolate spread 2 1 1 Cocoa not more than 7%, Wheat flour, oil free, sesame seed, trace of flavouring. Coffee Essence 6 1 1 Mouldy 13 6 - Contained (1) o.55% Citric Acid 0.056% Saccharine 0.35% other extract (2)0.003% oil of Pep. 0.49% Citric Acid, 0.051% Saccharine Cordials (3)0.72% Citric Acid 0.056% Saccharine 0.014% other extract (4)0.061% Citric Acid 0.054% Saccharine 0.11% other extract (5)97% water and O.56% Citric Acid. (6)98.7% water and 1.1% Citric Acid. 4 PREVALENCE AND OVER INFECTIOUS AND OTHER DISEASES. Notifiable Table the end of this Report gives particulars of the cases notified. The number of cases of diphtheria decreased from to 55 and of scarlet fever increased from 68 to 208. There were 845 cases of notified compared with 159 the previous year. Diphtheria Immunisation. The number of sessions held was 201 and 5103 new cases attended, a total of 18,497 attendances being made by new and old cases. By the end of the year 7,750 children had been immunised since the beginning of the campaign in' 1954. Cancer. The percentage of deaths from this cause was 17.27 and the death, rate 2.56, The age of distribution at death is shown in Table 1 at the : end of this Report. Tuberculosis. The death rate from this cause was 0.89 (pulmonary 0.77 and non-pulmonary : 0.12), The following is the information Required by the Ministry of Health. CASES NOTIFIED AND DEATHS. Age periods years New Cases Respiratory Non-respiratory Deaths. Respiratory Non-respiratory M F M F M F M F 0 - 1 - - - - 1 - - - 1 - 5 1 2 1 3 1 - 1 - 5 - 15 9 7 5 3 - 1 1 - 15 -- 25 33 32 7 5 3 9 2 3 25 - 35 28 29 2 1 7 8 - 1 35 - 45 22 3 2 3 11 2 - - 45 - 55 13 4 1 1 8 3 2 - 55 - 65 12 3 2 - 11 3 1 1 65 upwards 5 - - - 5 - - - TOTALS 123 80 20 16 47 26 7 5 Dispensary. A total of 3546 attendances were made including 691 patients who attended for the. first time during the year; 15.6 patients were recommended for residential treatment. Vaccination, The annual return : furnished to the Ministry of Health showed that 54.32 per cent of the children.born in 1941 had been successfully vaccine,ted' by 31st January 1943. Disinfection, The routine disinfection of rooms after the occurrence of infectious diseases was continued and 25,997 articles were treated at the Disinfecting station. TABLE 1 - Causes of and at Death during year 1942 All Ages 0- 1- 2- 5 - 15- 25- 35- 45- 55- 65- 75 Cause of Death Typhoid & Paratyphoid fevers - I I i i I I I Cerebro-spinal fever - i i i I I i i Scarlet Fever - I I .. I Whooping Cough 1 1 J J i i Diphtheria 3 I I 1 1 i i • 1 Tuberculosis of respiratory system 73 1 1 t i 1 12 15 15 11 14 5 i ! i Other forms of Tuberculosis 12 I I I 1 1 5 1 2 2 l #• ! I i , I Syphilitic diseases 20 t I I I 2 4 2 6 6 Influenza 8 I I I I ! ! 1 I 2 ! 3 1 1 Measles 2 1 1 I I • i ! Acute Poliomyelitis - f ! Acute Poliomyelitis - Cancer of buccal cavity & oesophagus (M) 14 1 6 4 3 Cancer of uterus (F) 17 I 1 I I 3 8 2 3 Cancer of stomach & duodenum 27 1 1 7 13 5 Cancer of Breast 29 2 7 10 6 4 Cancer of all other sites 155 1 9 20 42 59 24 Diabetes 12 3 6 3 Intra-cranial vascular lesions 99 i 2 12 15 36 34 Heart Disease 348 1 3 11 26 54 90 163 Other diseases of circulatory system 49 . 1 2 11 17 18 Bronchitis 86 6 1 2 1 14 23 39 Pneumonia 93 18 4 1 1 2 2 7 12 23 23 Other respiratory diseases 17 2 1 3 1 4 4 2 Ulcer of stomach or duodenum 26 I 1 4 10 7 4 Diarrhoea under 2 years 13 13 I I I Appendicitis 7 I 2 2 2 1 Other digestive disorders 42 3 1 1 4 4 6 9 14 Nephritis 40 1 1 6 9 5 8 10 Puerperal & post abortion sepsis 2 I 2 Other maternal causes 3 J 2 1 ; Premature birth 18 18 Congenital malformations, birth injuries &c., 18 17 1 Suicide 10 ! 1 3 2 2 2 Road traffic accidents 12 1 1 1 2 2 - 2 3 Other violent causes 31 3 3 2 2 2 4 2 3 10 All other causes 113 2 2 1 3 2 10 9 5 12 18 49 TOTALS 1401 81 8 9 13 30 42 80 129 246 345 418 Cases Certified 1064; Inquests 61; Coroner without inquests 276. (7) TABLE 2. INFECTIOUS DISEASES NOTIFIED DURING 1942 Notifiable Diseases Number of cases notified 1 Total case s removed to Hospital Deaths At Ages - Years 3 At all ages 0- 1- 2- 3- 4- 5- 10- 15- 20- 35- 45- 65 - Smallpox Cholera, Plague - 55 1 2 8 5 4 17 8 4 5 . 1 J 55 3 Diphtheria Erysipelas 24 2 2 3 1 9 7 13 Scarlet Fever 208 3 11 13 14 19 71 20 42 13 2 201 Typhus Fever - Enteric Fever - Relapsing and Continued Fever - 6 6 6 1 Puerperal Fever Puerperal Pyrexia 19 19 19 Cerebro-Spinal Meningitis 8 2 1 2 1 1 1 8 Poliomyelitis 2 1 1 2 Ophthalmia Neonatorum 8 8 3 Tuberculosis of Respiratory System 209 1 3 8 8 26 98 25 33 7 - 73 Non-Pulmonary Tuberculosis 38 4 3 5 7 10 5 4 12 Measles 845 25 56 76 99 79 479 21 4 4 1 1 69 2 Encephalitis Lethargica - Pneumonia 58 4 4 3 3 10 6 16 12 4 93 Diarrhoea 16 6 5 1 2 - 2 t t 10 13 Malaria - I I I I I ! I I i I I I I I I I 1 I I I Trench Fever Whooping Gough 132 19 20 13 25 17 36 1 1 19 Totals 1642 69 105 114 146 122 622 69 89 174 38 67 27 421 198