HES 28 Borough of Heston and Isleworth 1941 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE Borough of Heston and Isleworth Public Health Department, 92 Bath Road, HOUNSLOW. To the Mayor, Aldermen and Councillors of the Borough of Heston and Isleworth. Lady and Gentlemen, I beg to submit my Annual Report for the year 1941. The report is presented largely in the form of a tabulated summary with the corresponding details for 1940 shown for purposes of comparison. The various items have been selected to show broadly the work carried out by the Department and as pointers to the general health of the inhabitants of the Borough. The various sections of the Department have continued to function and every effort has been made to maintain the services. The figures show that apart from the Sanitary Inspectors' section the services have not been curtailed. The call on the Sanitary Inspectors for other work in connection with certain aspects of Civil Defence has reduced the time available for their routine duties and this is reflected in the statistics dealing with their work. Shortage of materials and labour have necessitated the reduction to a minimum of the work asked for in connection with housing defects and nuisances but it is hoped that more attention can be given soon to the inspection and supervision of food. The outstanding feature in regard to infectious disease was a small outbreak of paratyphoid fever. The first case was notified at the end of April and was followed by 16 in May, 6 in June, 1 in July, 3 in August, 1 in September and 2 in October. Of the 30 cases, 16 were diagnosed in West Middlesex County Hospital and 5 May cases, 4 June cases, 1 July case, 1 August case and the 1 September and 2 October cases were not residents of the Borough. The 16 Borough cases varied in age from 3 to 66 years and 10 were females. All cases were admitted to South Middlesex Infectious Diseases Hospital and none died. One case discharged from hospital after 92 days remains a carrier and is being kept under observation. Despite the expenditure of much time and toil the source of infection was not traced conclusively. The investigations suggested artificial cream as the likeliest source of infection. It is certain that a carrier of paratyphoid bacilli engaged in the handling of food was not exercising due care in cleansing of hands after use of the water closet. The need for the provision of adequate washing facilities for staff and insistence on the use of such facilities by the staff are not realised in all premises where food is handled. Scarlet fever, whooping cough and tuberculosis were more prevalent than in 1940. The increase in the notifications of tuberculosis was general throughout the country and is in some way associated with war conditions. Diphtheria cases and deaths are still too frequent. The attendance at diphtheria immunisation clinics was the largest since the scheme started in 1930 but unless a larger number of parents take and continue to take an active interest in protecting their children diphtheria will take toll of young life. The birth rate is the lowest recorded for the Borough during the present century. The death rate is lower than in 1940 largely due to the absence of deaths by enemy action. The percentage of deaths occurring at age 65 or over was 51 as compared with 48 in 1940, 45 in 1938 and 32 in 1908-15. Deaths from tuberculosis digestive diseases and nephritis all showed increases as compared ' with 1940. The increase in infant deaths and still—births gives some cause for anxiety. Investigations have failed to reveal any special contributory causes but the increase serves to emphasize the need for vigilance and perseverance In efforts to safeguard the welfare of expectant mothers and young babies. The records of the ante-natal clinics fail to reveal any general deterioration in the health of expectant mothers and the percentage of cases where midwives have sought medical aid has not increased. Of the infant deaths 63 per cent. occurred before the child reached the age of one month. No significant change occurred in the maternal mortality rate. Mothers and children continue to take advantage of the facilities for obtaining milk or dried milk free or at reduced cost under the National Milk Scheme, This has not lessened the extent of use of the facilities provided by the Council in regard to dried milk and vitamin preparations. In addition to this vitamin preparations supplied by the Government have been distributed at Infant Welfare Centres. A further step in the work of safeguarding nutrition has been the provision by the Council of two municipal restaurants. It may be said that there has been little if any deterioration in the general health of the population though some of the matters referred to above will require close attention and observation. Much work preliminary to the provision of day nurseries was carried out during the year. The burden of work falling to the Department is steadily increasing and it is due to the loyal cooperation of the permanent and temporary staff that the load continues to be carried. I desire to express my thanks to the Chairmen and Members of the Committees for their support and consideration and to my colleagues in other departments for their ready co-operation. I remain, Your obedient servant, A. ANDERSON. Medical Officer of Health. GENERAL STATISTICS. 1941. 1940. Population (Registrar-General's estimate). 93,990 97,530 Number of inhabited houses (rate-books). 26,850 (estimated) 27,219 Number of houses erected during year. — — Rateable value of Borough. £941,043 £911,969 Sum represented by a penny rate. £3,792 (estimated) £3,716 Live Births - legitimate - male. 586 641 - female. 579 653 - illegitimate - male. 28 17 - female. 24 23 Birth Rate per 1,000 population. 12.95 13.68 Birth Rate per 1,000 population (England and Wales). 14.2 14.6 Still Births - legitimate - male. 23 16 - female. 18 15 - illegitimate- male. 1 1 - female. 2 2 Still Birth Rate per 1,000 (live and still) births. 34.89 24.85 Deaths - male. 476 608 - female. 492 592 Death Rate per 1,000 population. 10.3 12.3 Death Rate per 1,000 population (England and Wales). 12.9 14.3 Infant Mortality Rate. 60.5 58.07 Infant Mortality Rate (England and Wales). 59 55 Maternal Mortality Rate. 2.43 2.26 Maternal Mortality Rate (England and Wales). 2.23 2.16 Out-relief disbursed to Heston and Isleworth residents. £17,644 £22,303 5. GENERAL PROVISION OP HEALTH SERVICES. No change in the general provision of health services was made during 1941. 1941. 1940. Laboratory facilities - specimens examined. 702 1,054 District Nursing - visits paid. 30,832 29,727 Infant Welfare Centres - no. of sessions. 561 547 - attendances, (a) under 1 year. 15,046 14,003 (b) 1-5 years. 11,252 10,579 (c) all ages. 26,298 24,582 Ante-natal and Post-natal Clinics. Routine clinics - sessions. 229 200 - attendances. 3,965 3,018 Consultant clinics - sessions. 51 56 - attendances. 874 797 Total attendances. 4,839 3,815 Artificial Sunlight Clinic - children treated. 46 30 Orthopaedic Treatment - children treated. 8 5 Refraction Clinic - children examined. 56 54 Minor Ailments Clinic - children treated. 58 76 Midwives - number notifying intention to practice. 50 29 - cases attended as midwife. 495 551 - cases attended as maternity nurse. 206 210 - percentage of cases where medical aid summoned. 37 36 - fees paid to medical practitioners. £248 £241 Municipal Domiciliary Midwifery Service. No. of municipal midwives. 8 8 No. of cases booked - as midwife. 571 532 - as maternity nurse. 97 59 No. of cases completed - as midwife. 463 496 - as maternity nurse. 68 57 No. of visits - ante-natal. 3,365 3,057 - post-natal. 9,479 10,011 6.  1941. 1940. Home Helps - no. of cases where home help provided. 54 63 Convalescent Homes - no. of mothers sent. 1 — - no. of children sent. 3 5 Health Visitors - no. employed. 12 12 - attendances at M & C.W. clinics, etc. 1,547 1,313 - visits to mothers and children. 13,846 12,761 Child Life Protection. No. of foster children on register. 71 53 No. of visits by Health Visitors. 499 489 Dental Treatment of Mothers and Children. Total attendances of mothers and children. 2,895 3,359 No. of extractions - mothers. 1,633 1,714 - children. 882 424 No. of fillings - mothers. 335 424 - children. 215 230 No. of dentures supplied to mothers. 208 247 Milk and Other Poods Supplied Free or at Reduced Cost. Pasteurized milk (gallons). — 7,988 Dried milk (lbs.). 799 2,448 National dried milk (lbs.). 5,554 944 Virol (lbs.). 39 59 Groats (tins) 90 — Cod liver oil (4 oz.). 204 269 Cod liver oil emulsion (8 oz.). 348 202 Cod liver oil and malt lbs.). 131 400 Lactagol (tins). 265 122 Bemax (tins). 165 73 Adexolin (½ oz.). 414 184 Cod liver oil & malt with Parrish's (lbs.). 328 — Kalzana (tablets). 1,630 5,320 Celin (pkts, containing 34 tablets). 80 — Value of sales at cost price. £1,865 £1,576 7.  1941. 1946. Vitamin preparations distributed under Ministry of Food Scheme. Black currant puree (tins). 2,670 — Black currant juice (bottles). 475 — Cod liver oil (bottles). 1,231 — Municipal Restaurants. 2 — Meals supplied at British Restaurants. 101,804 — Nursing Homes. No. registered at end of year, - nursing homes. 1 2 - maternity homes. 1 1 - nursing and maternity homes. 1 1 Superannuation Acts. No. of employees examined. 18 15 8. SANITARY CIRCUMSTANCES OF THE AREA. There was no significant change in the sanitary circumstances of the area as compared with 1940. A summary of the work of the inspectors in regard to general sanitation is given below:- 1941. 1940. Visits re complaint or remedy of nuisances. 4,143 4,080 Inspections of piggeries. 1 24 Inspections of stables. — 71 Inspections of urinals. 10 2 Visits re infectious disease. 415 472 Smoke observations. 25 158 Inspections re offensive trades. 17 47 Inspections of tents, vans and sheds. 4 54 Inspections of common lodging houses. 8 8 Inspections of shops re sanitary arrangements. — 1 Inspections of factories, workplaces, etc. 166 367 Houses disinfested. 19 14 Inspections of canal boats. 4 32 HOUSING. 1941. 1940. No. of new houses erected - by private enterprise. — — - by local authority. — — No. of houses inspected for housing defects. 256 260 No. of houses found unfit for human habitation. — 2 No. of houses rendered fit by informal action. 246 184 No. of houses rendered fit by formal action. 29 35 No. of houses demolished in pursuance of Demolition Orders. 4 12 No. of houses rendered fit in pursuance of undertaking. 1 1 No. of houses where undertaking not to re-let accepted. — 19 No. of underground rooms closed. — — No. of houses known to be overcrowded at end of year. 64 69 No. of new cases of overcrowding found during year. 1 — No. of cases of overcrowding relieved during year. 6 — No. of houses demolished voluntarily. 1 4 INSPECTION AND SUPERVISION OF FOOD. 1941. 1940. Inspections of dairies, etc. 48 178 Inspections of ice cream premises. 12 93 Inspections of bakehouses. 2 62 Inspections of slaughterhouses. 11 9 Inspections of premises where food is sold or manufactured, - meat. 175 427 - fish. 52 105 - provisions. 126 199 - greengrocery and fruit. 73 148 - hawkers. 2 27 - food preparation. 30 194 - other foods. 161 304 Unsound food seized or surrendered (lbs.) 7,127 4,613 Unsound tinned food surrendered (tins). 1,164 9. PREVALENCE OF INFECTIOUS AND OTHER DISEASES. 1941 1940 Cases Notified, Deaths. Cases Notified. Deaths. Smallpox. — — — — Scarlet fever. 117 — 96 — Diphtheria. 37 3 73 5 Erysipelas. 20 — 35 — Pneumonia. 124 41 200 57 Cerebro-spinal fever. 34 2 43 6 Epidemic encephalitis. 1 1 1 2 Poliomyelitis and polioencephalitis. 1 — 1 — Typhoid fever. 2 — 4 — Paratyphoid fever. 30 — Dysentery. — — — — Tuberculosis. 172 78 141 59 Ophthalmia Neonatorum, 5 — 2 — Puerperal pyrexia. 22 1 42 2 Measles. 580 — 1,109 2 Whooping cough. 286 1 123 3 Non-notifiable Infectious Diseases. 1941. 1940. German Measles. 8 1,127 Chicken pox. 460 450 Mumps. 352 98 Disinfection - no. of rooms disinfected. 192 286 Hospital Treatment of Infectious Diseases. Total cases treated in hospitals. 370 453 Diphtheria Immunisation. No. of attendances at clinics. 12,846 8,204 No. given certificates after immunising. 1,989 755 No. submitted to primary Schick test. 3,094 1,676 - Sohick positive. 2,916 1,534 - Schick negative. 178 142 No, of cases of diphtheria in immunised persons. 3 1 No. of deaths from diphtheria in immunised persons. — — 10. TABLE OP CAUSES OF DEATHS DURING 1941. Causes of Death. Civil Residents all ages. Male. Female. All causes 476 492 1 Typhoid and paratyphoid fever — — 2 Cerebro-spinal fever 2 — 3 Scarlet Fever — — 4 Whooping cough 1 — 5 Diphtheria 2 1 6 Tuberculosis of respiratory system 47 23 7 Other forms of tuberculosis 4 4 8 Syphilitic diseases 2 3 9 Influenza 5 4 10 measles — — 11 Acute polio-myelitis and polio-encephalitis — — 12 Acute infectious encephalitis — 1 13m Cancer of buccal cavity and oesophagus 3 — 15f Cancer of uterus — 8 14 Cancer of stomach and duodenum 14 13 15 Cancer of breast 1 15 16 Cancer of all other sites 41 47 17 Diabetes 4 4 18 Intro-cranial vascular lesions 29 40 19 Heart disease 101 130 20 Other diseases of circulatory system 16 14 21 Bronchitis 27 22 22 Pneumonia 21 20 23 Other respiratory diseases 12 3 24 Ulceration of stomach or duodenum 12 — 25 Diarrhoea under 2 years 6 6 26 Appendicitis 4 1 27 Other digestive diseases 14 19 28 Nephritis 17 17 29 Puerperal and post-abortive sepsis — 1 30 Other maternal causes — 2 31 Premature birth 10 10 32 Cong. malformations, birth injury, etc. 11 12 33 Suicide 4 8 34 Road Traffic Accidents 13 5 35 Other violent causes 13 12 36 All other causes 40 47 According to figures furnished by the Registrar-General, 11.