METROPOLITAN BOROUGH OF HOLBORN Abridged Report of the Medical Officer r of Henlth for the Yenr 1941» POPULATION. Registrar General's estimated population Mid-1941. 17,160 LIVE BIRTHS Total M. F. Birth rate per 1000 Estimated Population 11.13 Legitimate 163 80 83 Illegitimate 28 14 14 STILLBIRTHS 6 3 3 Rate per 1000 total(live & still) births 30.46 DEATHS 432 Rate per 1000 of the estimated resident population 25.17 DEATHS FROM FUERPERAL CAUSES. There were no deaths from puerperal causes during 1941. DEATH RATE OF INFANTS UNDER ONE YEAR OF AGE All infants per 1,000 live births 47.12 Legitimate infants per 1,000 live legitimate births 36.8l Illegitimate infants per 1,000 live illegitimate births l07.14 NOTIFICATION OF BIRTHS. The total number of notified births, including stillbirths, occurring in the Borough were 19. Of this number 3 were notified by Medical Practitioners, l6 by Midwives. CLASSIFICATION OF DEATHS. The causes of deaths (432) were as follows:- Tuberculosis of respiratory system. 20 Intracranial vascular disease 15 Other forms of T.B. 2 Heart disease 69 Syphilitic disease 6 Other diseases of the circulatory system 13 Influenza 3 Cancer in the male of buccal cavity & cesophagus 7 Bronchitis 22 Pneumonia 38 Other respiratory diseases 5 Cancer of the stomach & duodenum 7 1 Cancer of the breast 8 Ulceration of stomach or duodenum 6 Cancer of the uterus 4 Cancer of all other sites 17 Diarrhoea (under 2) 1 Diabetes 2 Appendicitis 2 Nephritis 12 Other digestive diseases 11 Premature birth 2 Congenital malforns. B. injury Infn.dis. 4 Suicide 5 Road traffic accidents 4 Other violent causes 112 All other causes 35 INFANT MORTALITY There were 9 deaths of Infante under one year of age, three of whom were illegitimate. The causes of deaths were as follows:- Syphilitic disease 1; Pneumonia 1; Diarrhoea 1; Premature birth 2; . Congenital malformation, birth injury, infantile disease 3. All.other causes 1. GENERAL PROVISION OF HEALTH SERVICES. No changes in the health services provided in the Borough occurred during 1941. Details of the services may be seen on reference to previous annual reports. HEALTH VISITORS The total number of visits made by the Health Visitors was 2948. The number of attendances at the clinics was 702. SANITARY CIRCUMSTANCES AND ADMINISTRATION. During the year 16,545 inspections (including reinspections) were carried out by the Sanitary Inspectors. Included in this total number were 124 inspections on complaints of nuisance, and 201 with, reference to infectious disease. ' - The number of inspections of Factories, Workshops and Workplaces was 397. Defects were found and remedied in 7 instance 100 Intimation Notices, 3 statutory notices under the Public Health (London) Act 1936, 294 notices under the byelaws as to Houses-let-ln-Lodgings were served during the year. No legal proceedings were necessary during the year to secure compliance with notices served under the Public Health (London) Act 1936. DISINFECTION During the year 217 rooms wore disinfected cases of 2 DISINFECTION (CONTD). infectious or other disease. Of these 10 were rooms which had been occupied by tuberculous persons. In addition 67 rooms of Private Dwellings; 7 Tube Shelters; 20 Public Shelters; 7 First Aid Posts, and 2 Rest Centres were dlsinfested of vermin. At the disinfecting station 4,793 articles of bedding, clothing etc. were disinfected. CLEANSING STATION. The number of verminous persons cleansed during the year was 174 males and 4 females. 100 persons (88 males, 10 females and 2 children) were cleansed for scabies. Under the scheme arranged with the London County Council 506 attendances were made by children from elementary schools at the cleansing station. HOUSING The number of house to house inspections and the number of inspections of houses after complaints or the occurrence of infectious disease was 1,293. The number of intimation notices served was 73 and the number of statutory notices 3. INSPECTION AND SUPERVISION OF FOOD. MILK. The number of milk premises on the register is 147 (l9 Dairies, 37 Restaurants, 48 General shops, 5 Wholesale dealers, 1 Confectionery shop and 37 itinerant retailers), and l6l inspections and re-inspections of these premises were made. MILK (SPECIAL DESIGNATIONS) ORDER. 5 licences to sell "Pasteurised" milk 1 to sell "Tuberculin Tested" milk and 5 supplmentary licences, 3 to sell "Pasteurised, " milk and 2 to sell "Tuberculin Tested" milk, were granted during the year. PUBLIC HEALTH (MEAT)REGULATIONS 255 inspections of butchers' shops and market stalls were made during the year, INSPECTION OF OTHER PREMISES WHERE FOOD IS PREPARED OR OFFERED FOR SALE. Under this head are included the following premises;Bakohouses; kitchens of hotels; restaurants and eating nouses; 3 INSPECTION OF OTHER PREMISES ETC. (CONTD) tripe, offal and other meat shops; fried fieh eel and other fieh shops; premises where ice cream is made; and other places where food is prepared for sale. 1,482 inspections were made of these premises during the year. 2 notices under the Food Bye-Laws were served requiring remedy of defects. UNSOUND FOOD. 4,449 tins Tinned Foods; , 8l tins Evaporated Milk; 30½ lbs. Fruit; 5 lbs. belted potatoes; 201 lbs. flour; 72 lbs. sugar; l½ lbs. cheese cuttings; 1 lb. Marmalade; 2 lbs. Jam; 22 lbs. Butter; 3 lbs. .Bacon; 15½ lbs. Meat; 12 lbs. Sausages; 21 x 6 lbs. Tins Corned Beef; 254-2¼ lb. tins salmon and anchovy roll; 6 stone Fish, and 27 Pigeons. FOOD AND DRUGS ACT 1938. During the year 595 samples were submitted to the Borough Analyst for analysis; of these 274 were taken as "formal" and 321 "Informal". Of this total 7 proved to be adulterated, all having been purchased informally. In each case a further sample was taken and found to be genuine. No legal proceedings were taken. INFECTIOUS DISEASE AND OTHER DISEASES. The total number of,notifications received during the year was 194 as follows:- Diphtheria 14 Enteric Fever 3 Scarlet Fever 16 Whooping Cough 42 Cerebro-Spinal Fever 7 Measles Pulmonary 34 Puer Puerperal Fever 1 Puerperal pyrexia 2 Tuberculosis 47 Pneumonia 18 Non-pulmonary Tuberculosis 6 Erysipelas 3 Ophthalmic Neonatorum 1 DIPHTHERIA IMMUNISATION CLINIC 269 new cases attended the Clinic during the year. WHOOPING COUGH IMMUNISATION CLINIC The Council established in October 1939 a Clinic for active immunisation against whooping cough, at the Maternity and Child Welfare Clinic, 10 John Street. The Clinic is held on Wednessay afternoons of each week. 4 WHOOPING COUGH IMMUNISATION CLINIC (CONTD) The outstanding feature of our experience is the absence of reaction in nearly every case. 58 children attended the clinic during the year. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS 1930. The total number of cases of tuberculosis in the Borough on 31st December 1941 was 330 (pulmonary - males 176, females 80; non-pulmonary - males 38; females 36)• TUBERCULOSIS DISPENSARY The number of new cases examined was 59; 26 of these were definitely tuberculous (23 pulmonary and 3 non-pulmonary) and 1 doubtful. 56 contacts were also examined 8 were definitely tuberculous (7 pulmonary and 1 non-pulmonary) and 1 doubtful. The number of attendances was 409 and 721 visits to the homes of patients were made by the Dispensary Visitor. The total number of cases on the register on the 31st Deeenber was 269. Artificial Pneumotherax treatment. 12 patients received treatment. The total cost (£75- 16s- 0d.) was borne by the Council. Extra Nourishment 16 cases received extra nourishment. The total cost (£110. 14s. 9d.) was borne by the Council. Dental Treatment. There were no patients recommended for dental treatment during the year. J. A. STRUTHERS, M.D., M.R.C.B., D.P.H., Medical Officer of Health.