Journal Rebind Co Ltd, Una 4, Pier Wharf. GRE 56 Alertropolitan Borough of Brènboich ABRIDGED REPORT MEDICAL OFFICER OF HEALTH for 1958 68594 Owing to the difficulties in the printing trade it has been found necessary to produce this abridged version of the Annual Report for 1958. The comprehensive report will be printed as soon as possible and presented to the Council in the usual way. CON TENTS Public Health Committee 1 Staff 2 Introductory 3 General and Vital Statistics 6 Meteorological Observations 9 General Provision of Health and Welfare Services for the Area 10 Sanitary Circumstances of the Area 12 Housing 16 Inspection of Food and supervision of Food Premises 17 Prevalance of, and control over, Infectious and other Diseases 19 - 1 - PUBLIC HEALTH COMMITTEE as at 31st December 1958 THE MAYOR Councillor A.C. Chrisp, J.P., L.C.C. and 13 Members Councillor Mrs. M.L. Bennett (Chairman) Councillor Mrs. M.L. Wentworth (Vice-Chairman) ALDERMEN Mrs. L. HILLDRITH Mrs. J. GOLLOGLY P. NOBLE COUNCILLORS Mrs. C. BERRY W.S. MANNERS J.B. GILLARD H.A. READ Mrs. A.D.A. Kennedy R. RUSTON D.P. LYNCH Dr. W. SMITH - 2 - STAFF as at 31st December, 1958 MEDICAL OFFICER OF HEALTH JOHN KERR BROWN, B.Sc., M.B., Ch.B., D.P.H. PUBLIC ANALYSTS H.A.WILLIAMS, Ph.D., A.C.G.F.C., F.R.I.C. D.G.ALLEN, B.Sc., F.R.I.C. PUBLIC HEALTH INSPECTORS ac W.H.COLLINS, B.E.M. (Senior) District Inspectors abc S.A.RADFORD ab W.C.SCALES a H. D. DAWES a J.G.LYONS abefg Miss B.HATFIELD abd J.GRIMSTON a S.E.THELNER x Food Inspectors Abc G.B.ALLEN (Senior) ab C.W.SPORE CLERICAL STAFF L.A.WESTACOTT (Chief Clerk) A.H.WILCOX Mrs. V.I.STARR (Senior Clerk) (Senior S/& Typist) K.ALLUM, D.F.M. Mrs. M.G.SIMPSON A.G.LYONS C.WEYMOUTH Mrs. M.G.JANMAN F.C.SMART (Conveniences Superintendent) DISINFECTING STAFF T.SMITH (Foreman) A.MOORE H.W.C.SCARFF (Motor Driver) W.CLEMENTS A.NASH RODENT CONTROL, FLY PISINFESTATION, ETC. Team of five men a Certificated Public Health Inspector b " Meat and Other Foods c - Smoke Inspector d Certificate of Sanitary Science e Certificated Health Visitor f " State Certified Midwife g " State Registered Nurse * Commenced duties 4.12.58. - 3 - PUBLIC HEALTH DEPARTMENT, TOTOI HALL, GREENWICH, 5.E.10. July, 1959. To the Mayor, Aldermen and Councillors, Metropolitan Borough of Greenwich. Ladies and Gentlemen, I am pleased to report on the health and environmental circumstances of Greenwich for 1958, The population continues to increase each year and the birth rate is slightly raised. Deaths show a small increase but the Infantile Mortality rate at 14.98 is the second lowest in the history of the Borough. As would be expected both the neo-natal and peri-natal rates also show corresponding reductions. For the second successive year we had one maternal death which was the subject of a Coroners' Inquest. In analysing the causes of death, both cancer and heart and circulatory troubles are as usual the most common. There were 55 notifications of pulmonary tuberculosis, which is the lowest figure recorded since Greenwich became a Metropolitan Borou^i. In common with the rest of the country there has been a complete change in the pattern of disease in the last 25 years. Communicable disease is no longer of vital consequence, although periodic outbreaks of such infections as poliomyelitis, dysentery and food poisoning - which shows an increase of 22 over last year - Indicate the continued need for vigilance. This is also borne out by troublesome outbreaks of antibiotic resistant staphylococcal infection in hospitals. It is therefore important that the immunisation and preventive services should be used by the vulnerable groups in the community to the maximum extent. Antibiotic drugs should also be used with discretion and with intelligence In order that the development of resistant strains of organisms can be kept to a minimum. Preventive and palliative measures have now to be directed towards the degenerative diseases and the ailments associated with the stress of livingo Direct preventive action is impeded by an imperfect understanding of the underlying causes of ageing and the mechanisms of adaptation to stress but, as with the infectious diseases in the early days, action is being taken along sound empirical lines until more precise etiological principles have evolved. The services which are being progressively promoted for improving the conditions of old age and adjustment to advancing years illustrate this tentative and empirical approach. Genetical and biochemical research is also gradually revealing important contributory factors in the development of circulatory and heart disorders, and the mysteries of malignancy and of congenital defects may have a complex chemical basis within the nucleus of developing cells which may have practical preventive possibilities in the future. All this is, of course, speculative but the next great break-through in preventive medicine will almost certainly relate to the causation of malignancy in its many forms, to the basic processes of ageing, and to the underlying factors which predispose to congenital malformations arising during pregnancy. It would be surprising if future discoveries did not have practical applications on a broad community basis. - 4 - During the year the Borough continued to have considerable landings of foreign egg products, particularly Chinese. Routine extensive bacteriological testing revealed that this Chinese egg is almost invariably contaminated with food poisoning organisms. All egg products that could be submitted to a sterilising process were treated in special heat chambers to render the egg safe. This has been found to be most effective but, unfortunately, heat can only be applied to powdered or flaked albumen and not to whole egg products. This Council is disturbed about the problem and believes that stringent regulations should be made requiring all egg to be pasteurised and adequately tested prior to processing before being allowed entry into the country. Random or percentage sampling in this country can never be completely effective and it seems reasonable that the United Kingdom should demand the highest possible standards of manufacturing procedure from the country of origin. This egg question has placed an onerous burden on many riparian authorities and serious decisions regarding disposal of valuable cargoes have had to be taken. A great deal of laborious testing could be avoided if importers were required to produce adequate certificates similar to those demanded for imported meat showing effective pasteurisation and testing in the exporting country. Pasteurisation plant is available and extensive tests have proved that egg pasteurisation is both practicable and efficient and does not interfere seriously with the quality of the egg. The Rent Act has meant increased work in the Department and there seems to be no slackening in the demand for the services of the Public Health Inspector in connection with all the complicated procedures of this Act. The work on behalf of the old people has extended and has necessitated further augmentation of staff at the Bathing Station. The Council will be considering early next year the engagement of another Lady Health Inspector and already the facilities for laundry and bathing are being utilised almost to full capacity. I have included a summary of the report of the Old Peoples' Welfare Committee and it is gratifying to note the close co-operation which exists between that Committee and the Health Department. Once again we have been heavily dependent on the Geriatric Unit at St. Alfege's Hospital and it is pleasing to acknowledge the degree of willing help and co-operation that we receive from the many workers in this field. During the year one old person had to be removed to hospital for urgent care and treatment under the National Assistance Act, 1948. The detailed survey of the Council's first Smoke Control Area has progressed and early next year the Council is expected to make the necessary Smoke Control Order. Already the effortp of the Department are having practical results. Many industrial concerns have gone over to smokeless fuel or oil and analysis of our records at our two Measuring Stations shows that last year smoke pollution had decreased by almost one third over the previous year, although, as one would expect, sulphur is at about the same level. However, the problem of grit (which is not covered by the Clean Air Act) will require serious thought because despite genuine effort on the part of industrialists to minimise grit emission undoubtedly there are many processes, particularly in the north-west part of the Borough, which are associated with serious grit and dust problems and cause inconvenience and annoyance to adjacent residents,, ■="5 - I would like to acknowledge with thanks the figures regarding the personal health services which I have included in the report and which were very kindly given by Dr. F.R.Waldron the Divisional Medical Officer. I am also grateful to Dr. J.M.Morgan, Director of the Mass Miniature Radiography and to Dr. Joyce Brown the Chest Physician for informative and important contributions. The work of the Department has been hampered byshortage of Public Health Inspectors and unfortunately there is no indication that the position is improving. This Is a serious problem having regard to the Council's heavy commitments in environmental hygiene. It Is, therefore, with particular pleasure that I thank the staff, both administrative and technical, for their work during the year and to the Chairman and Vice-Chairman I express my gratitude for the help and support which I receive at all times. In conclusion I would like to thank my brother Chief Officers for their friendship and willing co-operation. I have the honour to be, Your obedient Servant, J. KERR BROWN MEDICAL OFFICER OF HEALTH. GENERAL STATISTICS ELEVATION:- Varies from below high-water mark up to 249 feet above sea level AREA OF THE BOROUGH AND DISTRICTS:- East Greenwich 1,300 acres West Greenwich 453 St. Nicholas, Deptford 115 " Charlton and Kidbrooke 1,990 " 3,858 acres POPULATION:- At Census, 1951 ... ... ... .. 89,846 Estimated, 1958 (mid-year) 89,180 DENSITY OF POPULATION (persons per acre) 23.1 NUMBER OF INHABITED DWELLINGS - end 1958 24,101 (according to Rate Books) Structurally separate dwellings at Census, 1951 ... 21,348 NUMBER OF UNINHABITED DWELLINGS:- At Census, 1951 364 At end 1958 187 NUMBER OF FAMILIES OR SEPARATE OCCUPIERS: - At Census, 1951 ... 26,397 RATEABLE VALUE, 1958 £1,433,902 SUM REPRESENTED BY A Id RATE, 1958 ... £5,764 - 7 - EXTRACTS FROM VITAL STATISTICS OF THE YEAR LIVE BIRTHS Actual number of Live Births Males Females TOTAL 1,259 Legitimate 632 627 Illegitimate 38 76 38 670 665 1,335 TOTALS Birth Rate (per 1,000 population) 15.02 Crude Adjusted 14.11 STILLBIRTHS Males Females TOTAL 13 26 Legitimate Illegitimate 13 1 2 3 TOTALS 15 29 14 Stillbirth Rate (per 1,000 total births) 21.26 DEATHS Actual number of Deaths Males Females TOTAL 478 441 919 Death Rate (per 1,000 population) Crude 10.34 Death Rate (per 1,000 population) Adjusted 11.78 MATERNAL DEATHS One maternal death was recorded during the year, the cause being attributed to "renal failure following septic 'abbrtion caused by an instrument", the Verdict at-the Coroner's inquest being given as manslaughter against some person or persons unknown" Maternal Mortality Rate 0.73 DEATHS OF INFANTS UNDER ONE YEAR Legitimate 20 Illegitimate - TOTAL 20 Infantile Mortality Rate (per 1,000 live births) 14.98 Legitimate Rate (per 1,000 legitimate births) 15.88 Illegitimate Rate (per 1,000 illegitimate births) Neo-Natal Mortality Rate (infants under 1 month) 11.23 Tcomprising 75% of all infant deaths) Perl-Natal Mortality 30.79 Stillbirths 42 Infants under 1 week 13) — 23 DEATH RATES - Special Causes No. Rate Maternal Causes (per 1,000 total births) 1 0.73 Tuberculosis (all forms)(per 1,000 population) 7 0.07 Tuberculosis, Pulmonary (per 1,000 population) 5 0.05 Cancer (per 1,000 population) 179 2.01 Heart (per 1,000 population) 310 3.48 Common Infectious Diseases (per 1,000 population) 1 0.01 Influenza (per 1,000 population) 2 0.02 MARRIAGES Mr. J. Abercrombie, the Superintendent Registrar of the Greenwich Registration District, has kindly furnished me with particulars relating to the number of marriages solemnised or registered in the Borough of Greenwich during 1958. The total of 673 gives a marriage rate of 15.14, a decrease of 0.25 from that of the previous year. The following table shows these particulars giving the number of marriages in the Borough for each year since 1938:- Churches of England Superintendent- Registrar's Office Chapels and Roman Catholic Churches Greenwich Charlton and ) Kidbrooke ) St. Nicholas ) Approximate Population YEAR TOTAL 1938 309 185 31 101 268 894 95,770 94,790 74,280 57,070 60,530 62,870 61,800 63,800 76,840 82,230 84,410 87,680 89,570 89,390 90,880 90,440 90,600 89,490 88,780 88,910 89,180 395 218 31 128 397 1,169 1939 451 243 33 126 345 1,198 1940 277 7* 241 790 1941 174 91 1942 257 192 3 79 198 729 1943 209 166 2 73 171 621 1944 211 136 74 171 592 — 1945 228 211 2 87 233 761 1946 258 196 1 86 235 776 1947 192 160 13 93 318 776 202 152 8 104 345 811 1948 129 10 90 272 1949 184 685 206 121 6 245 652 1950 74 210 3 60 264 670 1951 133 1952 191 144 4 102 279 720 1953 221 136 4 113 305 779 325 1954 200 155 5 86 771 116 1955 197 5 106 290 714 6 1956 194 169 133 221 723 1957 177 159 2 118 226 682 189 142 10 93 239 1958 673 Ж St. Peter's, Creek Road, Closed ǿ Holy Trinity, Blackheath Hill - 9 - MSTEOROLOGICAL OBSgRVATIONS - 1958 I am indebted to the Director of the National Maritime Museum and, in particular, to "Eng. Commander H.O.Hill, R.N., for the following meteorological data for the year ended December, 1958;- Temperature Highest screen temperature was 82° F. on 9th July. Lowest screen temperature was 23° F. on 23rd January. Maximum temperature for:- January .... 57 F. February .. .. 58° F. November .. .. 57° F. December .. .. 56° F. Sunshine Total hours for 1958, 1,237.5 hours. Sunniest day, 14.0 hours, 24th May. Number of days with no sunshine, 86:- January .... 16 days February .... 10 days March 6 days April 3 days May 1 day June ....... 4 days July 2 days August ...... 2 days September ... 2 days October 5 days November .... 16 days December .... 19 days Rainfall Total amount for year, 30.06 inches. Higiest fall in 24 hours, 1.45 inches on 5th September. Driest month, March, 1.37 inches. Wettest month, September, 4.31 inches. -10- GENERAL PROVISION OF HEALTH AND WELFARE SERVICES fOR THE AREA Since July, 1948, the Personal Health Services available to residents of the Borough have been under the control of the London County Council and Dr. Waldron, the Divisional Medical Officer has kindly supplied me with information and statistics relating to Health Visitors' records, attendances at Infant Welfare Centres, Prophylaxis figures, etc. for 1958. HEALTH VISITING The following is a brief summary of the work carried out by the Health Visitors during the year:- No. of Visits Expectant Mothers 1,271 Premature Babies 32 Stillbirths 22 Infants under 1 year 7,235 Children 1-5 years 13,111 School Children 396 Old People 349 Others in need of care 208 Miscellaneous 1,154 Unsuccessful 2,126 INFANT WELFARE CENTRES Total Attendances Infant Welfare Clinics Babies 0-1 year 19,683 Children 1-2 years 4,642 Children 2-5 years 3,057 Ante and Post Natal Clinics Ante Natal 5,150 Post Natal 140 Toddlers' Clinics 569 Relaxation and Educational Sessions Relaxation 1,250 Educational 1,600 Artificial Sunlight and Chlldrens' Exercise Classes Artificial Sunlight 2,614 Exercise 377 Chiropody Treatment 18,502 -11- HOME HELP SERVICE Number of Cases Attended 866 Number of Visits made by Organising Staff 2,733 PROPHYLAXIS Immunisation and Vaccination (completed cases) Diptheria immunisation 665 Whooping cough immunisation 650 Vaccinations 493 B.C.G. Vaccination No. of Children 13 years old 2,464 No. for whom parental consent was obtained 1,947 No. of negative reactors vaccinated 1,541 No. of positive reactors x-rayed 160 Poliomyelitis Innoculation No. of Resident children and those attending Greenwich Schools 8,195 No. of young adults (16-25 years) living or working in Greenwich and Expectant Mothers 1,519 DISTRICT NURSING The staff of the Queens District Nursing Association for Charlton and Blackheath made 29,179 visits during the year. Visits carried out by the Ranyard nurses and the Nursing Sisters of St. John the Divine were additional to those quoted above. SCHOOL HEALTH SERVICE Attendances Vision 793 Special Investigation 400 Minor Ailments Clinics 57,403 - 12 - SANITARY CIRCUMSTANCES OF THE AREA The following brief summary serves to show the work carried out by the Department during the year:- Work Performed by the Public Health Inspectors during 1958. Inspections Houses Inspected (House to House) 82 (Complaints, nuisances) 1,290 (Infectious Disease) 216 (Overcrowding) 68 Re-inspections, calls made, etc. 9,239 Inspections of Factories 423 " " Shops 24 " " Hairdressers or Barbers 50 " " Licensed Victuallers 10 " " Pet Shops 8 " " Stables and yards 10 " "Urinals 57 " " Houses let In Lodgings 16 " " Outworkers premises 53 Under Clean Air Act 993 Miscellaneous 1,183 Inspection of Premises (Pharmacy and Poisons Act, 1933) 21 " " " (Rent Acts) 194 Investigations (Rats and Mice) 544 On notice from Builder 628 15,109 Drains Drains tested - by smoke 162 " " - by water 276 Opened, cleansed and repaired 285 Reconstructions and additions 217 Inspection chambers constructed 132 New covers to manholes 62 Soil and vent shafts repaired or renewed 114 Traps (gully) 207 Drains sealed off, etc. 76 Yards and forecourts drained 36 Waterclosets and Urinals Closets erected 116 W.C's repaired 196 Sanitary conveniences or improvements effected to Factories and Workplaces 13 W. C. pedestals installed 264 Urinals cleansed or repaired 23 Dustbins Provided 148 Pavings Yards and Forecourts 57 General Water Supply Water fittings amended 287 Extra water supply to tenement houses - Water supply certificates granted (Sect. 95) 393 - 13 - Other Improvements Houses generally repaired 90 Rooms cleansed and repaired 570 Rooms and staircases lighted and ventilated 13 Verminous rooms cleansed 99 Roofs, gutters and rainwater pipes repaired 565 Dampness abated 500 Sinks, baths and lavatory basins 233 Sink, lavatory and bath waste pipes trapped or amended 207 Stoves and fireplaces 106 Washing coppers repaired or provided 9 Floors repaired 255 Provision for storage of food 24 Miscellaneous repairs 940 Other Nuisances Abated Illegal use of Underground rooms discontinued 1 Overcrowding abated 51 Animals kept in unfit places discontinued or removed 1 Dung receptacles provided - Accumulation of manure and other obnoxious matter removed 44 Rat infestation abated 195 Smoke Nuisances Observations 597 Statutory Notices served (Sects. 147 and 148) - Notices, Etc. Intimations served under Public Health (London) Act, 1936 838 Statutory Notices served 183 Houses rendered fit by informal action 106 LEGAL PROCEEDINGS Offence Result of Proceedings Premises Summons withdrawn on payment of 3/- costs. 236 Creek Rd. Non-compliance with Statutory Notice " " 270 Creek Rd. Summons withdrawn on payment of 5/- costs. 22 Elverson Rd. " Summons withdrawn on payment of 3/- costs " 61 Eversley Rd. " " 34 Fingal St. " " 2 Humber Rd. Order for work to be executed within 28 days. £2/2/- costs 690 Woolwich Rd. " -14- Summary of the work carried out by the Lady Public Health Inspectors during 1958 Dirty premises inspected 31 Verminous premises inspected 22 Dirty rooms cleansed 50 Verminous rooms cleansed 62 Verminous persons visited 24 Verminous persons treated:- Heads 203 Other 103 Visits to scabios cases 16 Visits for Cleansing Sarvica:- First 55 Subsequent 95 Articles cleansed 15,398 Inspections of factories:- 58 (a) with mechanical powor 58 (b) without mechanical power - (c) other premises 3 Inspections of Hairdressers' premises 42 Inspections Of Outworkers premises 53 Inspections of Houses Let-in-Lodgings 6 Inspections Of Women's Conveniences 18 Bathing Centre Sessions 104 Baths:- At home 224 At centre 151 Visits to Infirm Persons 1,313 Visits to Rest Homes, Hospitals, etc. 40 Visits re: housing 25 Visits to Food premises re: Meals for O.A.P's 30 Miscellaneous visits 214 calls made, etc 174 Interviews for Holidays 260 Interviews at offices 117 Complaints received 54 Intimation Notices served Nil. RENT ACT, 1957 Applications for Certificates of Disrepair Applications for certificates 107 Decisions not to issue certificates 2Җ Decisions to issue certificates 105 (a) in respect of some but not all defects 86 (b) in respect of all defects 19 Undertakings given by landlords under paragraph 5 of the First Schedule 57 Undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule nil Certificates issued 48 Applications for Cancellation of Certificates Applications by landlords to Local Authority for cancellation of certificates 28 Objections by tenants to cancellation of certificates 12 Decisions by Local Authority to cancel in spite of tenants' objection nil Certificates cancelled by Local Authority 16 Җ(this figure includes 1 application withdrawn) - 15 - Rodent Control Summary of the work carried out in respect of rat repression during the current year:- Complaints received 551 Premises found to be infested 473 Premises inspected 3,811 Premises re-visited 56 With regard to rodent control, special attention is given to the baiting and inspection of the Council's sewers by the Borough Engineer's Department. Verminous Conditions Treatment for all cases is carried out at the Tunnel Avenue Cleansing Station and the following Return summarises the work carried out during the year:- Attendances Vermin Scabies Adults 261 26 Children under school age 20 11 School children 163 9 Home Visits by Lady Public Health Inspector 40 Home Re-visits by Lady Public Health Inspector 82 Disinfestation Under the direction of the Senior Public Health Inspector the following treatments were carried out during 1958:- Rooms sprayed for bugs and other vermin 1,649 Rooms sprayed for dirty conditions 410 Rooms treated after storm flooding 115 Dust Chutes treated 5,325 E.W.S. tanks treated 14 On request, 19 wasp's nests were also destroyed by the disinfestation staff. National Assistance Act, 1948 Under Section 47, as amended by the National Assistance Amendments Act, 1951, action was necessary in respect of the compulsory removal of one aged and infirm lady of 80 years of age who was unable adequately to care for herself. Scavenging and Refuse Disposal The collection of refuse in the Borough is under the control of the Borough Engineer, who has kindly supplied me with the following information:- Scavenging Street gullies cleansed ..„ 4,451 Street sweepings collected (tons) 1,364 Refuse Collection The total refuse collected was 22,532 tons from 26,727 premises in the Borough, giving an average of 13.9 cwts. per 1,000 population per day. -16- Refuse Disposal Of the total of 22,532 tons of refuse collected in the Borough, 21,690 tons was disposed of into barges for transportation to a controlled tip near the mouth of the river. The residue of 842 tons of refuse collected was sold, realising a sum of £7,172. Aged and Infirm Persons Extracts from the Greenwich Old People's Welfare Association's sth Annual Report are given below:- Meals on Wheels The following is a statement of the number of meals served during the year ended 31st March, 1959:- British Red Cross Society's Van Old People's Welfare Association Van Women's Voluntary Services Van 8,152 7,644 6,020 21,816 Holidays Total number of persons for whom holidays were arranged during the year under review was 252. Christmas Food Parcels During the Christmas period, 350 food parcels were distributed to home-bound elderly persons. HOUSING Housing Act, 1957 - Section 18 Part of building unfit for human habitation, i.e. a room, the surface of the floor of vrtiich is more than 3 feet below adjoining ground level and defective in matters listed in Section 4 of the above Act:- 135 Greenwich High Road 22 Woodland Walk Re-Housing G. B. C. L.C.C. Others Families housed and re-housed (including transfers, casual voids, etc.) 393 356 24 Overcrowding Complaints received 58 Cases found to be overcrowded 18 Cases of overcrowding abated 51 Certified cases of overcrowding remaining 104 New Housing Accommodation Type of Dwelling G.B.C. L.C.C. Private Total Houses 31 23 16 70 Flats 166 100 55 321 71 Total No.of Dwellings 197 123 391 - 17 - INSPECTION OF FOOD AND SUPERVISION OF FOOD PREMISES Supervision of Food Premises To ensure the highest available standard of hygiene, the food inspectors made 3,659 visits to shops, stores and factories where food is processed or otherwise handled and as a result of these visits 87 premises were improved. M I L K Milk and Dairies Regulations c 1949/54. The number of Distributors registered at the end of the year was 120, which total includes 6 dairy premises. The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949-1953 and The Milk (Special Designation; (Raw Milk) Regulations,, 1949/54. The following licenses, operative from the Ist January and issued in accordance with the above regulations had been granted and were In force on the 31st December, 1958. Licenses Issued In Operation 31. 12. 58 Principal Licences Distribution of Sterilised Milk 96 94 Distribution of Pasteurised Milk Distribution of Tuberculin 48 46 Tested Milk 38 37 Supplementary Licences Distribution of Sterilised Milk 21 21 Distribution of Pasteurised Milk Distribution of Tuberculin 19 19 Tested Milk 19 19 Sampling Under provisions of the Third Schedule to the first of the above mentioned Regulations, 61 samples of milk, consisting of 49 Pasteurised, 4 Sterilised, 7 T.T. Pasteurised and 1 T.T.Raw milks were examined, all of which proved to be satisfactory. Analytical Examination A total of 39 samples, 24 formal and 5 informal, were submitted for chemical analysis and all proved to be genuine. Four samples of cream were also submitted and found to be satisfactory. Preserved Food and Ice Cream Premises Number of Preserved Food premises registered at the end of the year ... ... ... 91 Number of Ice Cream premises registered at the end of the years ...197 Visits to these premises were made on 155 occasions and 8 improvements were effected. - 18 - Manufacture and Sale of Ice Cream As in previous years, ice cream has been liberally sampled and factories in the area which produce "Ice Lollies" or "Lolly" syrup are regularly and carefully supervised. Sampling Bacteriological. Fifty samples, 41 of ice cream and 9 ice lollies were submitted for examination and grading according to the Ministry's Grading Scheme. All were reported upon as being satisfactory and recourse to administrative action was unnecessary. Quantitative Analysis. In the normal course of food sampling, 7 Ice creams and 1 ice lolly were submitted for analysis, all of which were considered to be of satisfactory standard. Food Rejected (Public Health (London) Act, 1936) From shops, stalls, etc: - Meat 292 3\4 lbs. Other foods 15,543 1\4 lbs. Public Health (Imported Food) Regulatlons, 1937 and 1948 Food rejected: - Meat 1,096 1\2 lbs. Other foods 3,943 3\4 lbs. Caseous Lymphadenitis Australian and Now Zealand Sheep:- 89,262 Landed Examined 916 Rejected Nil Imported Food Samples Egg Products Control Samples Positive Dried Egg Albumen 154 17 Frozen Whole Egg 195 23 Dried Whole Egg 469 5 Other Commodities Number of Chemical Analyses carried out 104 Number of Bacteriological Investigations 20 Catering Establishments As a result of 334 visits of inspection to catering establishments, insanitary conditions were remedied and improvements effected on 136 occasions. Food and Drug Act, 1955 Number of samples examined 522 Number of Samples adulterated 32 Appropriate action was taken with regard to the nongenuine samples but in no instance was it necessary to institute legal proceedings. Pharmacy and Medicines Act, 1941 Five samples wore taken for analysis, all of which complied with the provisions of the Act. - 19 - PREVALENCE OF AMD CONTROL OVER INFECTIOUS AND OTHER DISEASES The total number of infectious diseases notified under Section 144 of the Public Health Act, 1936; Section 192 of the Public Health (London) Act, 1936: Section 26 of the Food and Drugs Act, 1955 and associated Orders and Regulations was 588. Under the Public Health (Tuberculosis) Regulations, 1952 there were 60 notifications giving a consolidated total of 648 cases notified during the year. In two of these cases the diagnoses were not confirmed, thus giving a corrected figure of 646. The following table shows the cases notified for the various diseases:- Measles 306 Whooping Cough 55 Pneumonia - (Acute Primary and Influenzal) 42 Paratyphoid Fever 1 Scarlet Fever 106 Erysipelas 3 Zymotic Enteritis or Epidemic Diarrhoea - (Children under 5 years) 9 Sonne Dysentery 20 Scabies 1 Puerperal Pyrexia 1 Ophthalmia Neonatorum 1 Poliomyelitis 1 Malaria 1 Tuberculosis - Pulmonary 55 - Non-pulmonary 5 Food Poisoning 39 Tuberculosis The number of notified cases remaining on the Register at 31st December, 1958 was:- Men Women Boys Girls TOTAL 575 496 23 20 1,114 Pulmonary 23 13 7 88 Non-pulmonary 45 Mass Radiography The responsibility for this service rests with the South "East Metropolitan Hospital Board and the following is a summary of surveys carried out in the Borough during 1958:- Men Women TOTAL Number x-rayed 3,483 2,032 5,515 Number abnormal on Large film 92 26 118 32 Cases considered tuberculous 10 42 Verminous Conditions Treatment for all cases is carried out at the Tunnel Avenue Cleansing Station and the following table summarises work carried out during the year:- Attendances Vermin Scabies Adults Children under school age School children 261 26 20 11 163 9 -20- Disinfection Total number of rooms disinfected 310 Total number of articles disinfected 2,670 Total number of articles destroyed 3,120 Total number of Library books disinfected 66 CHEST CLINIC I am indebted to Dr. J.L.Brown, Chest Physician at the Greenwich Chest Clinic for the following statistics:- Number of new out-patients 1,775 Number of out-patient attendances (excluding refills) 5,958 Attendances for pneumoperitoneum refills 825 Number of Radiological examinations 6,461 Visits by Chest Physician to patients in their houses 12 Number of B.C.G. vaccinations 140 Number of home visits by Health Visitors 3,221 Number of contacts examined for the first time 301