HAMPTON URBAN DISTRICT COUNCIL. Medical Officer's Report. HAMPTON, February 3rd, 1898. Gentlemen, I herewith present my Annual Report for the year ended December 31st, 1897. The number of deaths registered is 80, made up as follows :— Under 5 years of age. Whooping cough 4 Diarrhoea 13 Bronchitis 2 Other Diseases 8 Total 27 Five years and upwards. Typhoid Fever 1 Puerperal Fever 1 Rheumatic Fever 1 Phthisis (Consumption) 7 Bronchitis, or Pneumonia 4 Heart Disease 8 Injuries 4 Other Diseases 27 Total 53 As to Ages. Under 1 year 26 1, and under 5 years 1 5, „ 15 „ 2 15, 25 „ 6 ." 25, ,, 65 ,, 32 65, and upwards 13 Total 80 We therefore get the rate of deaths per 1,000 as 13.3, a rise as compared with last year, which was 11.16. The number of births registered was 163, last year it was 157; an increase of 6. This year the death rate per 1000 of Infants under one year is 159, an increase of about 50 per cent, as compared with last year, which was 108. This was caused by Diarrhoea, which prevailed to a great extent during the months of August and September. At that time the temperature was continuously high, reaching sometimes to 90 or 91 in the shade. It will be noticed that 13 deaths took place from this disease in the year, all under 2 one year of age. This shows that there must have been many cases. In my report (1895-6) I drew attention to the care required in feeding and preparing food of Infants (and during hot seasons of the year this is still more important) to observe the greatest cleanliness as to washing feeding bottles, and milk jugs being scalded; also the milk itself being raised to a temperature of 180 before use. I am aware it entails a certain amount of trouble, but really not much. I am sure good will result, so, therefore, again give this advice to all it may concern; also the feeding of Infants in the early months with artificial foods is unwise. In mentioning 180 degrees, I may say that it means heating just short of boiling point. The Birth rate per 1000 is 27.16. Whooping Cough prevailed very much this year: Measles also so much so that I advised the schools to be closed for a time, which had a good result. No death took place from Measles, but 4, as previously stated, from Whooping Cough. The cases coming to my knowledge under the Notification Act are as follows:— Under 5 years. Scarlet Fever 2 cases. Over 5 years. Scarlet Fever 3 „ Diphtheria 1 „ Erysipelas 6 „ Measles 10 „ Typhoid Fever 4 „ Puerperal Fever 1 „ Total 27 Last year the total was 97. I think we must be well satisfied with the record. Three of the Scarlet Fever cases were removed to the Hospital, the other two were treated at their own houses, and in no instance did it spread beyond the one case in each house. The case of Diptheria was very mild in type and did well. Four cases of Typhoid Fever occurred, and one proved fatal; two were removed to Hospital; defects of drains were found on investigation, which probably were the cause. I have examined the water from 17 wells, and found 9 unfit for use. Water has been, or is about to be, laid on in all the premises where I found it unfit for domestic use. The Sewerage scheme for the District is nearly complete, and I trust, after all the expense and difficulty in carrying out this matter, the result will prove a boon so far as health is concerned; also the dreadful business of emptying cesspools will be done away with, together with its attendant evils. I am satisfied with the condition of the Slaughter-houses, Bake-houses, and Dairies, and certain alterations have been carried out upon recommendation during the year in Slaughter-houses and Bake-houses, thereby improving their Sanitary condition. I have also inspected a Dairy Farm, and found the cowsheds were in a condition requiring a good deal of improvement. I am glad to say that alterations have been carried out, and that I have no fault to find now. On the subject of cowsheds and the proper attention to cows, it is most important to owners to carefully study the sanitary surroundings in order 3 to ensure the good health of the beasts. It only requires a thought to grasp the fact how easily disease may spread by such an article of food as milk, if any carelessness exists as to drainage, ventilation, warmth, and water supply, in the keeping of milk cows. The Water supply has been good, and the Grand Junction Water Co. has re-laid the service mains in the District to a depth sufficient to guard against frost, so we may trust not to have again the great discomfort experienced two years ago by a short supply, burst pipes, &c. It has been necessary to advise the closing of some houses as being unfit for habitation. This has been done by the owners in every case. There is a certain amount of overcrowding existing, due to a temporary excess of workmen employed upon public works. This is beingwatched and guarded, so that it does not reach dangerous proportions. The Sanitary work done has been heavy. The details are furnished on a separate form which I enclose. The work includes— Premises periodically inspected. House to house inspection. Cisterns inspected and cleansed. Drains examined and tested. Cesspools examined and tested. Rooms fumigated, stripped, &c. Dust-bins provided. Roofs and gutterings seen to. Ventilation of flooring. Contageous Diseases of Animals. The roads have been very much disturbed by reason of the public works proceeded with, viz., by Water Works, Gas Works and Sewage Works. I have great hopes in my next report that this great nuisance will have ceased to exist. It has been necessary to give warnings to the Water Companies to abate the smoke from their shafts. This, really at times is a serious nuisance, by causing people to keep windows closed when they ought to be open, thereby stopping the proper and necessary ventilation of houses. There is also the damage done to paintwork. Another trouble arose this year by an accumulation of sand taken from the filter beds during the dry weather and allowed to become extremely offensive. I trust the Water Co. will, in future, not allow this to recur for obvious reasons. On other matters appertaining to the health of the District, I quietly keep my " eye open," and am most efficiently assisted by our Inspector of Nuisances, Mr. Shail, to whom I tender my thanks for his zeal and willing assistance to any matters concerning the health and welfare of this District committed to our care and supervision. I am, Gentlemen, Your obedient Servant, WENTWOKTH TYNDALE. To the Hampton Urban District Council. Urban District Council of Hampton. min ANNUAL REPORT OF THE Medical Officer of Health, FOR THE VEAR ENDED 31 st December, 1897. MAKEPEACE, PRINTER, HAMPTON HILL. Annual Report on the Sanitary Condition of the Urban District of Hampton Wick for the year 1897. THE URBAN DISTRICT COUNCIL OF HAMPTON WICK. Gentlemen, I have the honour to present to you my Annual Report on the Mortality, Health, and Sanitary Condition of your District for the year 1897. The total number of deaths which occurred and were registered was 33, and included— 3 from diphtheria, 2 from measles, 2 from phthisis, 2 from bronchitis and pneumonia, 5 from diseases of the heart, 3 from cancer, 3 from accidents, 2 from premature birth and debility from birth, 2 from old age, and 9 from various causes. 33 Eleven were males and 22 females. Two were under 1 year of age, and 14 above 65. Two persons were found drowned in the river, and they had no connection with the district; this reduces the number of deaths to 31. The population of Hampton Wick was, according to the census of 1891,. 2,378, and it was in 1897 probably approximately the same. Taking this figure as correct, the mortality from all causes is at the average annual rate of 13*03 for every 1,000 persons living. This death-rate is somewhat higher than the average of the previous 10 years (11 *7), and this is owing to the great mortality of old people, nearly 50 per cent, being persons over 65 years of age. The number of births was 44. Twenty-eight were males and 16 females. The birth-rate was IS'45, and the infant mortality 45 per 1,000 births. Infectious Diseases. I.— Not notifiable. Influenza. — Several cases of epidemic influenza occurred in the middle of December, and the disease became very prevalent in the beginning of 1898. The cases, with few exceptions, were not of a very severe type, and no fatal case was reported in 1897. Measles.—Towards the end of February several cases of measles came under notice, and the number increased steadily in the beginning of March. Strict orders were given to masters and mistresses of the schools not to admit any child from houses where a member of the family was attacked. In spite of those measures the epidemic spread rapidly, and in order to check it, I served notices (15th March) on the Managers of the Public Elementary Schorrs to (116) 2 close them, and not to open them till after the Easter holidays. By that time the epidemic bad nearly disappeared. Before the schools were reopened the schoolrooms were thoroughly disinfected. Although some cases were of a severe type, only 2 cases proved fatal, and those were weak children under 2 years of age. Whooping Cough.—Only some isolated cases came under notice, and no death was reported. Diarrhoea.-—No death occurred, although the disease was very prevalent in July and beginning of August. II.—Notifiable. Thirteen notifications were received —5 of scarlatina, 4 of diphtheria, and 4 of erysipelas. There was no case of small-pox, typhoid fever, membranous croup, or puerperal fever. Scarlatina.—The 5 cases occurred in the beginning of January, 3 belonged to one family, where strict isolation could not be enforced, the house containing only two rooms. The other 2 cases were strictly isolated. The premises were in all cases disinfected, and no other case was notified during the year. There has been no mortality, and the type of the disease has been a mild one. Diphtheria.—Of the 4 cases 3 proved fatal. All were notified between 11th and 20th August. The first occurred in Upper Teddington Road, and the child died on the fifth day. No cause of the outbreak could be traced. Two cases were notified on 16th August, from the same house, in Old Bridge Street, one child died on the fourth day and the other on the sixteenth. Those two children never came into contact with the first case, the milk was supplied from different sources, and no insanitary condition could be found in the house. The fourth occurred on 20th August in the adjoining house in Old Bridge Street, and the child became infected by having come into contact with the two other children in the yard behind the houses. This child recovered rapidly under early use of anti-diphtheritic serum, which was not adopted in the 3 fatal cases. Ail the rooms occupied by the diphtheritic children were thoroughly disinfected, and no farther spread of the infection took place. Erysipelas.—Four cases were notified, 3 of which were complicated with other diseases. Inspections, Nuisances, Condition of Roads. In the month of December I made a systematic inspection of the district in company with the Inspector of Nuisances. Not many insanitary conditions were discovered, and such as existed were abated either by verbal advice or by notices. Much good is done by impressing upon the inhabitants the advantages of cleanliness, and by getting them to understand that it is for their own benefit as well as for that of the district that the Council insists upon their premises being kept clean. Directions were constantly given to the occupiers of cottages to clean out their cisterns periodically. Special inspection of certain localities were made in connection with infectious diseases. May's Cottages were several times inspected on account of defective water supply to closets, stopped drains, and insanitary condition of the yard; the wash-house standing in the yard, which was a dangerous structure, has been pulled down, but the wooden w.c.'s are still standing, and the whole should be cleared away as being insanitary. I reported last year about the dangerous and insanitary condition of the Hampton Court Road. The defective water-main has now been repaired. The double traffic which was carried on on the half width of the road has so ploughed up the roadway that it has been impracticable for the appliances of the parish to scavenge it, and the fact of the falling leaves decaying and mixing with the mud, coupled with the wet and mild winter, has made this part of the district very insanitary as well as dangerous. The water company have lately patched 3 up portions of the road and taken away quantities of dirt, and it is further hoped that they will immediately place the whole length of the road in proper repair. The asphalted footpath in Church Grove is in a very defective state ; it is perfectly worn out, and the holes constitute a danger to passengers, especially in the night. Some of the cul-de-sac roadways are also in an insanitary condition, especially that of the back of the Terrace leading into Church Grove and the yard round May's Cottages. Whilst on this point, I beg to call your attention to the landing-stage and the land adjoining west of Kingston Bridge. It is a quagmire, and the horses have great difficulty to get along with their heavy loads. This portion of the roadway is also in a very insanitary condition. Nuisances. The Inspector of Nuisances reports that— 27 complaints were received. 125 houses inspected. 36 statutory orders reissued. 9 houses provided with Company's water. 9 flush cisterns supplied to w.c.'s. 12 drains unstopped and repaired. 3 drains reconstructed. 7 drains new laid. 3 cesspools abolished. 8 rooms fumigated. 9 new dust-bins provided. Nuisances abated. 10 from accumulation of refuse. 2 from foul pigs. 4 from various causes. Dust and House Refuse. Seventeen complaints of non-removal of house-refuse were received, and they were promptly attended to. The refuse of this and other districts is being carted into the Home Park, for the purpose of filling up depressions near the entrance. It is to be hoped the work will be completed before the summer, and the adjoining ditch piped. It is anticipated the authorities of Hampton Court will cover the refuse from time to time with mould, and so prevent as far as possible an evil which might become a source of danger to health. Water Supply. The supply of the Grand Junction Water Company was very satisfactory during the year. Slaughter Houses. They have been from time to time inspected, and found in a good condition. Dairies, Cowsheds, and Bakehouses. All have been periodically inspected, and have been found in a satisfactory condition. Drainage and Sewerage. A number of new houses have, during the year, been connected with the main sewers, and in all cases manholes have been inserted adjoining the respective roadways, and the drains tested with water. Several old houses 4 have also been re-drained, and others, particularly on the Terrace, need re-draining and the same test applied. The flushing of drains was continued as last year, and, in addition, disinfectants were mixed with the water during the outbreak of diphtheria. Mortuary. The newly-erected mortuary has given great satisfaction, and the Coroner for West Middlesex pronounced it as one of the best in his district. Isolation Hospital. I have again to draw the Council's attention that no provision is made for the isolation of infectious diseases in the district. 1 remain, Gentlemen, Your obedient Servant, TH. GUNTHER, M.D., Medical Officer of Health. Hampton Wick, 30th January 1898. Area and Population of the District. Area in acres 1,315 Population (1891) 2,378 „ (estimated to middle of 1897) Same Death f General, 13*03 per 1,000 population, estimate! to middle of rates 1896 Infant (under one year of age), 45 per 1,000 births registered. Hampton Wick District.—Mortality of the last ten years, 1888-97. Year 1888. 1889. 1890. 1891. 1892. 1893. 1894. 1895. 1896. 1897. Number of deaths 24 35 27 25 29 36 27 28 24 31 Annual death-rate 11.10 16.18 12.27 10.51 12.19 13.03 9.25 11.77 8.41 13.03 Average annual death-rate for the last 10 years, 11.7. The calculation of the annual death-rate is made on the census, and on the estimated population in various years; cases which have no connection with the district being omitted. Th. Gunther, M.D.