HORNC 12 Hornchurch Urban District Council INTERIM REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1944 W. & W. Ltd., Romford. Hornchurch Urban District Council INTERIM REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1944 W. & W. Ltd., Romford. 2 MEMBERS OF THE COUNCIL. Councillor W. H. F. Maunder, J.P., Chairman. Councillor A. C. Salinger, Vice-Chairman. Councillor Mrs. E. M. Field. (2) ,, Mrs. A. J. E. King. ,, Mrs. R. J. Reynolds. ,, Mrs. F. Sherring. (2) ,, Mrs. C. M. Stevens. Mrs. H. S. E. Williams. (1) ,, O. P. W. Ashdown. ,, O. S. Biggs. (1) ,, W. G. Bunch. (1) and (2) E. W. J. W. Bush. (2) ,, F. J. R. Hecker. ,, A. C. Holmes. (1) ,, H. Holock. (1) ,, A. S. Hulkes. (1) ,, A. W. Pettit. (1) ., A. J. Twigger. (1) H. H. Wake, J.P. W. H. F. Webb. (3) ,, T. F. Willoughby, J.P. (1) Member of the Public Health and Ambulance Committee. (2) Member of the Romford Joint Hospital Board. (3) Chairman of the Public Health and Ambulance Committee. OFFICERS OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health: Alfred Ball, M.D., B.S. (Lond.), M.R.C.S. (Eng.), L.R.C.P. (Lond.), D.P.H. (R.C.P.S.) Lond. Deputy Medical Officer of Health: P. X. O'Dwyer, M.B., B.Ch., B.A.O., D.P.H. Sanitary Inspectors: L. Ager, San. Insp. Cert. R.S.I. Cert. Insp. of Meat and Other Foods. A. V. J. Hutchings, San. Insp. Cert. R.S.I, and S.I. Joint Board. Cert. Insp. of Meat and Other Foods. E. Ellerington, San. Insp. Cert. R.S.I, and S. I. Joint Board. Cert. Inspector of Meat and Other Foods. Clerk: *J. Blay. S. Dance (Temp.). * On War Service, 3 COUNCIL OFFICES, HORNCHURCH, 5th June, 1945. To the Chairman and Members of the Horncliurch Urban District Council. Mr. Chairman, Ladies and Gentlemen, I beg herewith to present an Interim Report on the work of the Public Health Department for the year 1944, written with reference to Ministry of Health Circular letter 49/45 dated 19th March, 1945. The report is considerably abbreviated in view of the need for economy in the use of paper, but in accordance with the suggestion of the Minister the fuller records including the statistics supplied by the Registrar General will be preserved in order that after the termination of the war the annual records may as far as practicable be continuous and complete. It is worthy of record that in this fifth year of the war the general health of the district remains satisfactory despite unavoidable anxiety and the black-out restrictions. The housing of the people will constitute the most urgent problem to be dealt with in post-war years of reconstruction. I desire to offer my thanks to the members of the Council for supporting me in my work, and to acknowledge the assistance which I have received from the Public Health staff and from my fellow Officers in all Departments. ALFRED BALL, M.D., D.P.H., Medical Officer of Health. 4 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area in acres (land and inland water)19,768 Estimate of the resident population (mid-year) 1944 84,130 Number of inhabited houses (Sept., 1944) according to Rate Books 26,332 Rateable Value (September, 1944) £672,696 Sum represented by a Penny Rate (September, 1944) £2,720 Social Conditions. Although the District is largely residential in character it still contains considerable areas of agricultural land. The riverside is the natural site for factories, but there are also important manufacturing works in the north-west and other parts. During the year there were no causes of sickness or invalidity which were especially noteworthy. There were no conditions of occupation or environment which had a prejudicial effect on the health of the public. Vital Statistics. Extracts from the Vital Statistics of the year. Number of births registered in the District (529 males, 475 females) .. 1,004 Number of deaths registered in the District:— Residents 451 Non-residents 98 Number of deaths of residents occurring outside the District. 325 Total number (adjusted for inward and outward transfers) 776 Death rate per 1,000 estimated population 9.2 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Bacteriological Laboratory. The County Laboratory established by the Essex County Council at Oldchurch Hospital has continued to serve the needs of the District and is available for any medical practitioners who desire to have a bacteriological report on the specimens which they send. Ambulance Service. There is no change in the ambulance service for the civilian population described in last year's report which includes the mutual assistance scheme with neighbouring authorities. The ambulance which is stationed at Harrow Lodge Depot is under the supervision of the Surveyor. Nursing in the Home. The three nursing associations, viz., the Hornchurch Nursing Association, the Upminster and Cranham Association and the Rainham Association have continued their beneficient work. 5 Puerperal Deaths:— (a) from sepsis 0 (b) from other causes 0 Deaths of infants under one year of age Deaths from Male. Female. Cancer 73 58 Diabetes 4 5 Diarrhoea 4 1 Influenza 2 2 Pneumonia 19 13 Measles 0 0 Whooping Cough 1 5 6 Maternity and Child Welfare. The County Council which is the Authority has maintained Clinics at the following centres:— (i) Berther Road. (ii) Hazel Close, Elm Park. (iii) Malvern Road. (iv) Athelstan Road, Harold Wood. (v) Rainham First-Aid Post. (vi) Waldegrave Gardens, Upminster. Hospital Services. During the year 132 persons notified to be suffering from infectious diseases and 16 observation cases needing hospital treatment were admitted to the Joint Isolation Hospital at Rush Green. The average weekly number of patients from this District in the Isolation Hospital was 13. Supply of Insulin for Diabetics. Reference was made in last year's report to Circular 2734 dated 4th January, 1943, in which the Minister of Health drew the attention of local authorities to the desirability of providing insulin for certain classes of persons for whom a public provision is necessary. These include old age pensioners, women engaged in household duties, and other dependants who are not eligible for medical benefit under the national health insurance acts. In compliance with this letter the Council have exercised the power given to them by consent or approval of the Ministry under section 177 of the Public Health Act, 1936, to supply insulin for persons suffering from diabetes among the poorer inhabitants of the District. During the year 28 women and 1 youth under insurable age were supplied with this remedy, and of these 24 received free supplies and 5 at reduced cost in accordance with the Council's scale. The majority of these persons were elderly women, 12 being widows or married women in receipt of old age pensions. Every person applying for a grant was required to furnish a medical prescription stating the variety and amount of insulin to be used. During the year a total of 214,600 units of insulin was supplied under the Council scheme, this being made up of 47,000 Soluble, 62,400 Zinc Protamine, and 105,200 units of Globin Insulin. Water. The water supply of the area and of its several parts has been satisfactory both in quality and in quantity. 7 A piped supply of water is laid on to almost the whole of the houses in the District, though private wells are still in use as domestic supplies in some of the outlying areas. In response to my enquiry the Engineer of the South Essex Waterworks Company has kindly supplied the following information:— "The water supply to the District has been sufficient at all times. In all, over 3,000 examinations for chemical bacteriological and biological purposes have been made of the various waters supplied by the Company. Daily analyses are made of the water supplied from our Stour sources after treatment, weekly samples are analysed in respect to the water supplied from the wells situated in our District of supply after treatment, and bacteriological samples of the raw water at each of our wells are analysed periodically. All samples analysed of the waters leaving our various pumping stations are reported as being pure and wholesome. The water is not plumbo-solvent. Standpipes are not in use." Rats and Mice (Destruction) Act, 1919. Infestation Order, 1943. The Council is the Local Authority for the purposes of this Act, the powers having been delegated by the County Council. The Infestation Order, 1943, lays an obligation on the Local Authority to take the necessary action to cause the destruction of rats and mice in the District. Under the Rats and Mice Destruction Act it is the duty of occupiers of land to take steps to destroy these pests. After a survey of the District no major infestation was found but minor infestations have been dealt with. All complaints by the public of the occurrence of rats are enquired into by the Sanitary Inspectors, who after investigation on the site give advice to the occupiers of the land or premises on the appropriate methods to be used to eradicate the rodents. 8 SECTION C. Sanitary Officers Regulations. The Sanitary Inspectors have carried out their ordinary duties as far as possible, but in addition undertook work of a similar character for which they are qualified by reason of their training. This work includes visiting public and private air-raid shelters: civil defence depots : inspecting foodstuffs damaged in air-raids. One Sanitary Inspector also carries out inspections of the carcases of animals slaughtered for food at the Regional Slaughterhouse in Romford. SECTION D. HOUSING. During the year 89 houses were completed by private builders and housing certificates were issued. No houses were built by the Council. SECTION E. controlled trades. Milk Production. There are 17 dairy farms in the District, which include 10 farms licensed by the County Council for the production of Accredited Milk and 1 farm for the production of Tuberculin Tested Milk. Inspections of these farms are carried out by the Sanitary Inspectors, and suitable advice given on the production of clean milk and the general hygiene of the premises. Meat. There are 4 slaughterhouses in the district licensed under Section 57 of the Food and Drugs Act, but none is in regular use for slaughtering animals, this being prohibited during the war, by the Livestock (Restriction on Slaughtering) Order, 1940. 9 SECTION F. PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASE. During the year there was a considerable decrease in the notifications of infectious disease this being especially marked in the case of Scarlet Fever and Measles. The Scarlet Fever notifications numbered 194 as compared with 373 in the previous year and the Measles notifications dropped from 600 to 154. On the other hand Whooping Cough notifications increased from 130 to 229. There were no cases of Smallpox, Typhoid Fever, Ophthalmia Neonatorum or Poliomyelitis. In the following table are shown the number of notifications received and the number of cases removed to hospital. Disease. Notified. Total Number of Cases Admitted to Hospital. Smallpox 0 0 Scarlet Fever 194 65 Diphtheria 7 7 Cerebro-spinal Fever 3 3 Puerperal Pyrexia 9 7 Erysipelas 23 3 Pneumonia 61 28 Measles 154 1 Whooping Cough 229 11 Dysentery 3 1 Encephalitis 1 1 Diphtheria Immunisation. Immunisation against Diphtheria was carried on during the year. The Ministry of Health, by advertisements in the national and local press, by their display of advertisements, by the distribution of literature through the schools and child welfare centres, and by cinema notices, continued to bring to the notice of the public the importance of having their children immunised, especially at the age of one year. Mothers were also advised b.y the Health Visitors and Sanitary Inspectors of the facilities provided by the Council for this to be done. 10 Appointments were sent to those parents who signified their wish for their children to be immunised and special sessions were held at five centres in the District for this purpose. During the year 915 children completed the course which consists of two injections of A.P.T. with an interval of four weeks. The immunising substance used is supplied free by the Ministry of Health through the laboratory at Epping. The value of this work is shown by the continued low incidence of Diphtheria of which 7 cases were notified. No death from Diphtheria occurred in this District during the year, but one death of a child belonging to the District who contracted the disease and died in another part of the country is included in the final returns. Infective Hepatitis. During the war, there has been an increase in the number of cases of the disease previously known as Catarrhal Jaundice, but which is now included in the designation Infective Hepatitis. The Minister of Health has arranged for this disease to be investigated by a group of workers in collaboration with the Medical Research Council, and in order to ascertain its prevalence over a wide area has required it to be compulsorily notifiable in the Eastern Region. The Jaundice Regulations by which power is taken to require notification came into operation in Hornchurch on the 22nd January, 1944. The total number of notifications of Infective Hepatitis received during the year was 81, referring to 79 civilians and 2 persons in the armed forces. The following are details of the 79 civilians. The months in which notified, the sexes, and age groups are shown in tabular form. It will be observed that the largest number of cases occurred in February, March and May. Months. Total Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Male 44 1 13 8 3 6 1 4 3 2 1 1 1 Female 35 2 9 6 3 5 1 1 3 1 1 2 1 11 Age Groups. Years. Males. Females 1-2 1 3-4 4 5-9 7 8 10-14 7 9 15-24 11 3 25-34 2 7 35 - 44 3 1 45-54 2 1 55 - 64 2 3 65 and upwards . 6 2 Totals 44 35 As a result of enquiry it was found that in 56 of the 79 cases there was no known contact with a previous case; in 16 cases of which 13 were in the patient's home and 3 outside the home a history of contact with a previous case was ascertained, in 5 cases no information as to previous contact was available and in 2 cases the jaundice was a complication of another disease. In one case it was stated that the patient had suffered from a previous attack some months previously. Of the 13 cases in which a history of contact with a previous case in the home was given the inteival between contact and onset was approximately a month in 7 cases; about 12 months in 3 cases; about a week in 1 case and in 2 cases the interval was not known. In the 59 instances in which there was no contact with a previous case in the home the number of other persons in the house in which the patient was nursed and who were therefore exposed to infection varied from 1 to 8 as follows:- One person 6, two persons 16, three persons 27, four persons 6, five persons 2, seven persons 1, eight persons 1. None of these contacts developed the disease and infection of other members of the family by the patient appears to be relatively infrequent, 12 Tuberculosis. The new cases of Tuberculosis added to the register during the year consisted of 94 pulmonary and 23 non-pulmonary, and of these 67 were males and 50 females. This is 10 fewer than last year. There were 41 deaths, viz., 20 males and 21 females, of which 18 of each sex were pulmonary cases. This is 14 fewer deaths than in the year 1943. Infectious Diseases occurring in Schoolchildren. An extensive outbreak of Rubella amongst schoolchildren in Elm Park and Upminster was reported by Headteachers principally during the first half of the year, 381 children being affected. Next in frequency were Whooping Cough 128 cases: and Chicken Pox 126 cases. In addition 18 cases of Mumps, 18 cases of Scabies and 9 cases of Impetigo were reported.