HOL 40 METROPOLITAN BOROUGH OF HOLBORN Abridged Report of the Medical Officer of Health for the Year 1942. POPULATION. Registrar General's estimate of population for the mid-year 1942 is not available for publication. LIVE BIRTHS Total. M. F. Birth rate per 1000 Estimated Population Legitimate 168 85 83 Illegitimate 20 11 9 11.34 STILLBIRTHS 2 2 0 Rate per 1000 total (live & still) Births 10.53 DEATHS. 250 Rate per 1000 of the estimated resident population 15.08 DEATHS FROM PUERPERAL CAUSES. There were two deaths from puerperal causes during 1942. DEATH RATE OF INFANTS UNDER ONE YEAR OF AGE. All infants per 1,000 live births 47.87 Legitimate infants per 1,000 live legitimate births 47.62 Illegitimate infants per 1,000 live illegitimate births 50.00 NOTIFICATION OF BIRTHS. The total number of notified births, including stillbirths occuring in the Borough was 41. Of this number 6 were notified by Medical Practitioners and 35 by Midwives. CLASSIFICATION OF DEATHS. The causes of deaths (250) were as follows:- Cerebro spinal fever 1 Bronchitis 12 Whooping Cough 1 Pneumonia 18 Tuberculosis of respiratory system 29 Other respiratory diseases 3 Ulceration of stomach or duodenum 4 Other forms of T.B. 1 Syphilitic disease 4 Appendioitis 2 Cancer in the male of buccal cavity & oesophagus 3 Other digestive diseases 6 Nephritis 8 - 1 - CLASSIFICATION OF DEATHS (CONTD) Cancer of the stomach & duodenum 7 Puerperal and post abortic sepsis 2 Cancer of the breast 2 Cancer of all other sites 18 Premature birth 4 Diabetes 2 Congenital malforns. Intracranial vascular disease 20 B.injury Infn.dise. 3 Heart disease 59 Suicide 2 Other diseases of the circulatory system 7 Road traffic accidents 1 Other violent causes 12 All other causes 19 INFANT MORTALITY There were 9 deaths of infants under one year of age, one of whom was illegitimate. The causes of deaths were as follows:- Pneumonia 1; Premature birth 4; Congenital malformation, birth injury, infantile disease 3; other violent causes 1. GENERAL PROVISION OF HEALTH SERVICES No changes in the health services provided in the Borough occurred during 1942. 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 1912. The number of attendances at the clinics was 560. SANITARY CIRCUMSTANCES AND ADMINISTRATION. During the year 21,338 inspections (including reinspections) were carried out by the Sanitary Inspectors. Included in this total number were 70 inspections on complaints of nuisance, and 314 with reference to infectious disease. The number of inspections of Factories, Workshops, and Workplaces was 651. Defects were found and remedied in 14 instances. 138 Intimation notices, all statutory notices under the Public Health (London) Act 1936, and 189 notices under the bylaws as to Houses-let-in-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. - 2 - DISINFECTION. During the year 109 rooms were disinfected after cases of infectious or other disease. Of these 18 were rooms which had been occupied by tuberculous persons. In addition, 159 rooms of private dwellings and 1 Tube Shelter were disinfested of vermin. At the disinfecting station 13,414 articles of bedding, clothing etc., were disinfected. CLEANSING STATION. The number of verminous persons cleansed during the year was 417 males and 2 females. HOUSING The number of house to house inspections and the number of inspections of houses after complaints or the occurrence of infectious disease was 2,088. The number of intimation notices served was 123, and the number of statutory notices 11. INSPECTION AND SUPERVISION OF FOOD. MILK. The number of milk premises on the register is 147 (19 Dairies, 37 Restaurants, 48 General shops, 5 Wholesale dealers, 1 Confectionery shop and 37 itinerant retailers), and 314 inspections and re-inspections of these premises were made. MILK (SPECIAL DESIGNATIONS) ORDER. 4 licences to sell "Pastourised" milk, 1 to sell "Tuberculin Tested" milk and 5 supplementary licences, 3 to sell "Pasteurised" milk and 2 to sell "Tuberculin Tested" milk, were granted during the year. PUBLIC HEALTH (MEAT) REGULATIONS. 243 inspections of butchers' shops and market stalls were made during the year. DAY NURSERIES. There are two voluntary day nurseries in the Borough, one of which receives a grant as a war-time nursery from the Ministry of Health. INSPECTION OF OTHER PREMISES WHERE FOOD IS PREPARED OR OFFERED FOR SALE. Under this head are included the following premises:- Bakehouses; kitchens of hotels, restaurants and eating houses; INSPECTION OF OTHER PREMISES ETC. (CONTD) tripe, offal and other meat shops; fried fish, eel and other fish shops; premises where ice cream is made; and other places where food is prepared for sale. 2,450 inspections were made of these premises during the year. 30 notices under the Food Bylaws were served requiring remedy of defects. UNSOUND FOOD. 4 tons 11 cwt. 2 qrs. 3 lbs. of Tinned Meat, Fish and other foods were surrendered and destroyed or otherwise disposed of. FOOD AND DRUGS ACT 1938. During the year 600 formal samples were submitted to the Borough Analyst for analysis; of these 12 were adulterated, 8 milks, 1 sausages and 3 cordials. Legal proceedings were taken in 11 instances, as follows:- 6 milks containing added water, 17.2%: 16.0%: 17.8%: 13.4%: 12.9%: and 12.9%: the vendor of these 6 samples was convicted and fined £20 on each summons and ordered to pay a total of £15. 15s. 0d. costs. 1 milk contained 9.2% added water; the vendor was convicted and fined £5 and ordered to pay £5. 5s. 0d. costs. 1 milk 9.2% added water and 19.3% deficient in fat; the summons in respect of this sample was dismissed under the Probation of Offenders Act and the vendor ordered to pay £.5.5s.0d. costs. 3 cordials, viz: Orange Flavour Cordial 98.31% of water, 1.61% Citric Acid and trace of saccharin; Lime Flavour Cordial 98.12% water, 1.6l% Citric Acid and trace of saccharin: Lime Juice Flavour Cordial 97.71% water, 1.89% Citric Acid and trace of saccharin; summonses in respect of these three samples stand adjourned at the date of the preparation of this report. With regard to the sample of sausages, which contained 0.0137% Sulphite preservative, a letter of warning was sent to the vendor. INFECTIOUS DISEASE AND OTHER DISEASES. The total number of notifications received during the year was 242 as follows:- Diphtheria 17 Ophthalmia Neonatorum 5 Scarlet Fever 23 Enteric Fever 1 Cerebro-Spinal Fever 1 Whooping Cough 48 Puerperal Fever 2 Measles 58 INFECTIOUS AND OTHER DISEASES (CONTD). Puerperal Pyrexia 7 Pulmonary Tuberculosis 45 Pneumonia 20 Non-pulmonary Tuberculosis 8 Erysipelas 7 DIPHTHERIA IMMUNISATION CLINIC 190 new cases attended the Clinic during the year. It is estimated that at the end of the year, of the child population of the Borough, 50.28% of children under 5 years of age and 66.0% of children between the ages of 5 and 15 were immunised. WHOOPING COUGH IMMUNISATION CLINIC The Council established in October 1939 a Clinic for active immunisation against whooping cough, at the Maternity and Child Welfare Centre No. 10 John Street. The Clinic is held on Wednesday afternoons of each week. The outstanding feature of our experience is the absence of reaction in nearly every case. 96 children attended the Clinic during the year. SCABIES 280 cases (95 men, 74 women and 111 children) attended for treatment during the year. Arrangements were made with the Middlesex Hospital to treat cases of scabies occuring among residents of the Borough. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. The total number of cases of tuberculosis in the Borough on 31st December 1942, was 276(pulmonary-males 154, females 58; non-pulmonary-males 34, females 30). TUBERCULOSIS DISPENSARY The number of new cases examined was 107; 48 of these were definitely tuberculous (38 pulmonary and 10 nonpulmonary) 56 non-tuberculous and 3 doubtful. 34 contacts were also examined, 10 were definitely tuberculous (7 pulmonary and 3 non-pulmonary)22 non-tuberculous and 2 doubtful. The number of attendances was 481 and 682 visits to the homes of patients were made by the Dispensary Visitor. The total number of cases on the register on the 31st December was 264. - 5 - Artificial Pneumothorax treatment. 5 patients received treatment. The total cost (£31. 9s. 0d.) was borne by the Council. Extra Nourishment 20 cases received extra nourishment. The total cost (£83. 15s. 0d.) was borne by the Council. Dental treatment. 1 patient was supplied with dentures. The cost borne by the Council was £3. 15s. 0d. STAFF CHANGES Of the three Health Visitors, one retired during the year, the work now being carried on by the remaining two Health Visitors. J. A. STRUTHERS, M.D., MR.C.P., DP.H., Medical Officer of Health.