HOL 42 THE METROPOLITAN BOROUGH OF HOLBORN Abridged Report of the Medical Officer of Health for the year 1944. RESIDENT POPULATION. Estimated to middle of 1944 (as supplied by the Registrar General) for birth and death rates 18020. LIVE BIRTHS Total M F. Birth rate per 1000 estimated population 11.49. Legitimate 171 84 87 Illegitimate 36 21 15 STILLBIRTHS. 8 3 5 Rate per 1000 (Live and still births) 37.21. DEATHS 302 163 139 Death rate per 1000 estimated population 16.76. DEATHS FROM PUERPERAL CAUSES. There were no deaths from puerperal causes during 1944. DEATH RATE OF INFANTS UNDER ONE YEAR OF AGE. All Infants per 1,000 live births 53.14 Legitimate Infants per 1,000 live legitimate births 46.78 Illegitimate Infants per 1,000 live Illegitimate births 83.33 NOTIFICATIONS OF BIRTHS The total number of births, Including stillbirths, notified as occurring in the Borough was 31. Of this number, 1 was notified by a Medical Practitioner, 27 by Midwives and 3 by other persons. CLASSIFICATION OF DEATHS. The causes of deaths (302) were as follows:- Tuberculosis of the respiratory system 12 Bronchitis 20 Pneumonia 21 Other forms of T.B. 3 Ulceration of stomach or duodenum 4 Syphilitic disease 9 Cancer of buccal cavity & oesophagus 3 Diarrhoea 3 Appendicitis 1 -1- INFANT MORTALITY There were eleven deaths of Infants under one year of age, three qf whom were Illegitimate. The causes of deaths were as follows:- Pneumonia 4, Diarrhoea 3, Congenital malformation, birth injury, infantile disease 2. All other causes 2. GENERAL PROVISION OF HEALTH SERVICES.' No major changes in the health services provided In the Borough occurred during 1944. Details of the services may be seen on reference to previous annual reports. MATERNITY AND CHILD WELFARE. WORK The total number of visits made by the Health Visitors was 2,774. The number of attendancesof children at the Infant Welfare Centres was 4,519. The number of attendances at the Ante-natal clinics was 464. DAY NURSERIES. . There are two day nurseries in the Borough, one of which was taken over by the Council as a War-time Nursery on 1st June, 1943, This latter provides places for 45 children. The other one Is still continuing as a voluntary nursery for 50 children. SANITARY CIRCUMSTANCES AND ADMINISTRATION. During the year 20,599 Inspections (including reinspections) were carried out by the Sanitary Inspectors. Included in this total number were 50 Inspections on complaints of nuisance, and 321 with reference to Infectious disease. The number of Inspections of factories, workshops and workplaces was 369. Defects were found and remedied In 23 Instances. _ 2 _ CLASSIFICATION OF DEATHS (CONTD) Cancer of uterus 3 Other digestive diseases 10 Cancer of stomach & duodenum 5 Nephritis 10 Congenital malforms. Birth injury, Infn. diseases 3 Cancer of breast 7 Cancer of all other sites 32 Diabetes 3 Suicide 5 Intra-cranial Vascular disease 18 Other violent causes 24 All other causes 21 Heart disease 75 Other diseases of the circulatory system 10 SANITARY CIRCUMSTANCES AND ADMINISTRATION (CONTD). 116 Intimation Notices, 5 Statutory Notices under the Public Health (London) Aot 1936, and 183 notices under the Bylaws 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 317 rooms were disinfected after cases of infectious or other disease. Of these, 8 were rooms which had been occupied by tuberculous persons. In addition, 249 rooms of private dwellings were dlsinfested of vermin. At the Disinfecting Station 5,525 articles of bedding, clothing, etc., 209 books and 15 toys were dlsinfested. CLEANSING STATION. The number of verminous persons resident in Holborn cleansed during the year was 106 men and 14 women. HOUSING The number of house-to-house inspections and the number Of Inspections of houses after complaints or the occurence of infectious disease was 1,698. The.number of Intimation Notices served was 77, and the number of Statutory Notices 5. In one case an undertaking to close one house was accepted by the Council from the owners until it has been rendered fit for human habitation under Section 11 of the Housing Act 1936. INSPECTION AND SUPERVISION OF FOOD. MILK - The number of milk premises .on the register is 67 lib dairies; 14 restaurants; 30 general shops; 5 wholesale dealers). These premises were all Inspected as occasion required during the year. In addition, 35 retailers were registered for Itinerant sale of milk from premises in the areas of other Local Authorities. MILK (SPECIAL DESIGNATIONS) ORDER. 4 licences to sell "Pasteurised" milk, and 6 supplementary licences, 3 sell "Pasteurised" milk and 3 to sell "Tuberculin Tested" milk, were granted during the year. - 3 - PUBLIC HEALTH (MEAT) REGULATIONS.- 390 inspections or butchers' shops and market stalls were made during the year. INSPECTION OF OTHER PREMISES WHERE FOOD IS PREPARED OR OFFERED FOR SALETI Under this head are included the following premises:- Bakehouses; kitchens of hotels, restaurants and other eating houses; butchers1 shops; tripe, offal and other meat shops; fried' fish, eel and other flsh 6hops. 826 inspections were made of these premises during the year.- 23 Notices under the Food and Drugs Act 1938, were served requiring defectes to be remedied. UNSOUND FOOD. 4 tons 13 cwt. 2 qtrs. of tinned meat, fish and other foods were surrendered and destroyed, or disposed of otherwise. FOOD AND DRUGS SAMPLING. During the year 600 formal samples were submitted to the Borough Analyst for analysis; of these one was adulterated, viz:- Milk 4.0% added water. Legal proceedings were taken in this instance. The summons was dismissed under the Probation of Offenders Act, and the defendant was ordered to pay £5. 58. Od. costs. WATER. 1. The water supply in this area has been satisfactory both In quantity and quality. There have been no complaints received. 2.There is a piped supply, and-bacteriological examinations of the raw water are made by the Metropolitan Water Board, who also perform -chemical analyses. 3.The water is not known to have any plumbo-solvent action. 4. No action has been necessary in respect of contamination. -4- WATER (CONTD). 5. All dwelling houses are supplied direct from the mains, and stand-pipes are normally used only In cases of emergency such as repair of mains. There was* no case during 1944 in which the use of stand-pipes was necessary owing to bomb damage. INFECTIOUS AND OTHER DISEASES. The total number of notifications received during the year was 280 as follows:- Diphtheria 5 Ophthalmia Neonatorum 4 Scarlet Fever 20 Enteric Fever 1 Puerperal Fever 2 Whooping Cough 30 Puerperal Pyrexia 1 Measles 33 Pneumonia 14 Pulmonary Tuberculosis 41 Dysentery l3 Non-Pulmonary Tuberculosis 9 Erysipelas 8 Scabies 99 DIPHTHERIA IMMUNISATION CLINIC 94 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, 65% of children under 5 years of age and 60% 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 afternoon of each week. The outstanding feature of our experience Is the absence of reaction in nearly every case. 84 children attended the Clinic during the year. SCABIES During the year 99 cases were notified by medical practitioners. Arrangements were made with the Middlesex Hospital for the treatment of scabies In October 1942. During the year 1944, 403 attendances were made by Holborn residents at the Hospital Clinic. In addition 30 children were treated at the London County Council School Clinics, held at this Council's Cleansing Station. * Disinfection of patients clothing was carried out during treatment. Homes were visited by the Health Visitor who arranged for disinfection - 5 - SCABIES (CONTD) of bedding etc. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS 1930. The total number of notified cases of tuberculosis In the Borough on the Notification' Register on 31st December 1944, was 328 (pulmonary - males 171. females 87; non-pulmonary males 30, females 40)• TUBERCULOSIS DISPENSARY. The number of new cases examined was 107; 31 of these were definitely tuberculous (27 pulmonary and 12 non-pulmonary) 60 non-tuberculous and 8 doubtful. 20 contacts were also examined, 4 were suffering from tuberculosis (2 pulmonary and 2 non-pulmonary), 15 were non-tuberculous and 1 doubtful. The number of attendances was 596; and 403 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 310. In view of the war-time movoment of the population, a revision of the Register Is being undertaken. Allowances for Tuberculous Patients' undergoing treatment. During the year 1944, forty-two patients received allowances. Thirty-four new applications were reclved, twenty-four of which were granted. Twenty-three patients have now removed or resumed work, or have died. The allowances were made up as follows:- Maintenance allowances 32 Special allowances 14 Discretionary allowances 12 The amount disbursed during the year was £1,260. 6s. 8d. Artificial Pneumothorax Treatment. 19 patients received treatment. The total cost, £70, was borne by the Council. Extra Nourishment 19 cases received extra nourishment. The total cost, £85, was borne by the Council. Dentures. 2 patients were supplied with dentures during the year, and the total cost of £7. 5s• Od. was brne by the Council. (Sgd) J. A. STRUTHERS, M.D. ,M.R.C Medical Officer of Health. D.P.K