BOROUGH OF HORNSEY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEATH FOR THE YEAR ENDING 31st DECEMBER, 194 R. P GARROW, M.D., D.P.H. Medical Officer of Health BOROUGH OF HORNSEY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR ENDING 31st DECEMBER, 1947 R. P. GARROW, M.D., D P H Medical Officer of Health Health Committee (as at 31st December, 1947) Chairman: Councillor Miss Anderson The Mayor—Alderman Mrs Cave, J.P. Alderman Bailey Alderman Goulding Alderman Grimshaw, J.P. Alderman Mrs Hill Alderman Miss McCullough Alderman Rowlands, J.P. Alderman Shipp Alderman Wall Councillor Burns Councillor Crosland Councillor Milne Councillor Muldoon Councillor Pallett Councillor Mrs St. John Councillor Thursby Councillor Webb 3 STAFF OF PUBLIC HEALTH DEPARTMENT (as at 31st December, 1947) Medical Officer of Health and School Medical Officer Deputy Medical Officer of Health and Assistant School Medical Officer Assistant Medical Officer of Health and Assistant School Medical Officer Assistant Medical Officer of Health and Assistant School Medical Officer Veterinary Inspector Senior Sanitary Inspector, Petroleum Inspector, Shops Acts Inspector Sanitary Inspectors and Shops Acts Inspectors Chief Clerk ... Assistant Clerks Rodent Operator Disinfectors and Mortuary attendants Medical Services Motor Driver R. P. Garrow, m.d., d.p.h. Marian Lones, b.sc., m.b., b.S., m.r.C.S., l.r.c.p., d.p.h., d.o.m.S. Margaret Robinson, m.b., ch.b., d.t.m., & h. J. A. Montgomery, m.d. F. G. Buxton, m.r.c.v.s. J. H. Jesse, m.s.i.a., Cert. R. San. I., Cert. Insp. of Meat and Foods J. D. Chance, m.s.i.a., Cert. R. San. I., Cert. Insp. of Meat and Foods. E. Hundy, m.s.i.a., Cert. R. San. I., Cert. Insp. of Meat and Foods, Cert. San. Science. R. Downes, m.s.i.a., Cert. R. San. I. J. Calderbank, m.s.i.a., M.R. San. I., Cert. R. San. I. & S.I.E. Joint Board, Cert. Insp. of Meat and Foods W. J. Wilson, m.s.i.a., Cert. R. San. I., Cert. Insp. of Meat and Foods. N. Smith, m.s.i.a,, Cert. R. San. I., Cert. Insp. of Meat and Foods (resigned 30.6.47). E. Cheesman (resigned 16.8.47). W. A. Simons (acting 18.8.47). T. Hadley. Miss E. A. Smith. Miss S. P. Nunn. Miss M. Chesterman. Miss D. M. Sellman. Miss M. Humphreys. Miss M. S. Arnell. E. Mead. W. H. Lewis. P. F. Hall. P. Martin. 4 To the Mayor, Aldermen and Councillors of the Borough of Hornsey. Mr Mayor, Ladies and Gentlemen, I have the honour to submit my Annual Report on the Public Health of the Borough for the year ending 31st December, 1947. Local Government Changes on the "Appointed Day" (5th July, 1948) On the 5th July, 1948—the "Appointed Day" under the National Health Service Act, 1946—considerable changes took place in the structure of public health and in the relations between the authorities. The general effect was that the "major" authorities (Counties and County Boroughs) became more major and the "minor" authorities (Municipal Boroughs and Urban Districts) became more minor. In this process the municipal Borough of Hornsey suffered disruption of its public health duties and functions, the larger part of these passing to the Middlesex County Council and the Regional Hospital Board. Public Health or Preventive Medicine is generally recognised as embracing two main branches— (a) Environmental Hygiene (b) Personal Health Services (a) Environmental Hygiene Environmental Hygiene is sometimes appropriately called "nineteenth century public health." It may be said to have commenced in 1848 and expanded during the nineteenth century as the chief responsibility of the Local Authorities. It concerns itself with everything which contributes to clean healthy surroundings free from disease and infection. It is many-sided. It involves the Borough Engineer & Surveyor's Department in sewage disposal, collection and disposal of house refuse, street cleansing and lighting, the care and upkeep of parks and open spaces. It is a pleasure to record that in Hornsey during 1947 and 1948, this work took on a more positive aspect with the title of the "Amenity Scheme" under which the planting of trees in streets and provision of flower beds in various sites throughout this beautiful Borough has made Hornsey still more beautiful and contributed to the mental health and happiness of its citizens. Environmental hygiene is also the function of the Housing Department in the difficult task of providing adequate and suitable accommodation for the rapidly increasing number of growing young families. Overcrowding and the sharing of cooking and washing facilitiess and sanitary accommodation constitute the chief threat to the public health to-day. Although this does not show itself in the vital statistics which reflect physical health, the housing shortage is a cause of worry, anxiety, annoyance, bad temper and frustration which contribute to the commonest of 5 all illnesses to-day, namely, neurosis. Environmental public health also involves the Medical Officer of Health's department—chiefly through the Sanitary Inspectors—in the important functions of house repairs, abatement of nuisances, cleanliness of foods, disinfection of premises, disinfestation of persons and premises, destruction of rats and mice, prevention of atmospheric pollution, purity of water supply—everything indeed in the immediate surroundings of the individual or family or group which contributes to health comfort and happiness. (b) The Personal Health Services These have grown up during the twentieth century. They include :— (a) all services for the care of expectant and nursing mothers and children up to the age of five years provided by the Maternity and Child Welfare Committee of the Council, and (b) the School Medical Service administered by the Education Committee. On the 5th July the personal health services passed to the new Health Authority under the 1946 Act—Middlesex County Council—and will be administered as Area No. 3 of the County Council's Scheme which comprises the Boroughs of Hornsey and Tottenham. The Borough Council, through its Health, Housing and Highways Committees, remains responsible for the environmental hygiene of the Town. In the work of this many-sided and vast domain of public health involving directly or indirectly practically every Committee of the Council, there is the closest co-operation and understanding between the Departments, and my Department is constantly indebted to the Town Clerk, Borough Engineer & Surveyor, Housing Manager and other Officers for their help. Reports for 1947 have already been submitted to the Education Committee and to the Council with a survey of the personal health services from their inception in 1907 (School Medical) and 1915 (Maternity and Child Welfare). It remains only to report to the Health Committee on the Vital Statistics of the Borough, the incidence of infectious disease, the destruction of rats and mice, disinfection, disinfestation, food inspection and other measures which are the responsibility of the Public Health Committee. Vital Statistics The Vital Statistics of the Borough in 1947 were the best in its history and there is no reason to believe that during 1948 to date there has been any deterioration. The infant mortality figure of 26.43the lowest recorded, and the infant mortality rate is generally regarded as the most delicate index of social, economic and cultural conditions in a community. It is just one quarter of what it was at the beginning of the century. 6 The Maternal Mortality rate which remained in the region of four deaths per thousand births for the greater part of the same period and appeared to resist all efforts at improvement has, only in the last decade, fallen to less than one per thousand. The General Death rate of 12.36 per thousand of population in Hornsey as against 12.0 for the Country as a whole is due to the higher proportion of persons of advanced age in the Borough. Indeed the care of aged and infirm has become one of the chief problems of the Health Authority (County Council of Middlesex). The Prevalence of Poliomyelitis The only blot on an otherwise very clean bill of health for 1947 was the epidemic of infantile paralysis (Poliomyelitis). The notifications of this disease numbered 31 of which 14 occurred in September and 22 in the months July, August, September and the first week in October. It is essentially a summer disease and tends to be epidemic in warm, dry seasons. Twenty-three cases were admitted to the Isolation Hospital, Muswell Hill, 5 were admitted to other Hospitals and 3 were nursed at home. Of the total cases notified (31), 10 turned out to be other conditions not obviously connected with poliomyelitis, 7 cases were so mild that no paralysis developed, but examination of their cerebro-spinal fluids showed the increase in lymphocytic cells which is also a feature of paralytic poliomyelitis. They were therefore believed to be the same infection as infantile paralysis. They are called "benign lymphocytic meningitis" from which recovery was complete in all cases. Eleven cases developed some paralysis in some part of the body and 3 other cases were of such overwhelming severity or affected such vital centres in the brain that death supervened early in the illness. One Year Later The eleven cases which developed paralysis have been visited in October, 1948—a year or more after their illness—when it was found that nine had made a complete or almost complete recovery. A girl aged 4 years is at Heatherwood Orthopaedic Hospital, Ascot, with some weakness of the left foot which gives her a slight limp. A boy aged 6 years has paralysis of the left leg and is wearing a caliper. He has recently left the district with his parents. We are singularly fortunate in a recovery rate which leaves us without a case so crippled as to be "handicapped" in the sense of requiring special education or special occupation. 7 The Pandemic Nature of the Outbreak The outbreak was not confined to Hornsey. It prevailed in towns and rural areas all over the Country, that is to say, it was "pandemic" in England and Wales. Although this strange disease has been notifiable in this country for 35 years (since 1912) and has been studied intensively from the clinical and epidemiological points of view as well as in the laboratory in Britain and more especially in America, where vast sums have been spent in the process, it has to be admitted that very little progress has been made in preventing or controlling outbreaks or in mitigating the permanently disabling consequences of a severe paralytic attack. Outbreaks in all parts of the world appear to be associated with spells of hot dry summer weather. In 1946 small groups of cases in Hertfordshire and Middlesex gave warning of a possible epidemic in that year, but a cold wet summer probably saved the situation. The summer of 1947, on the contrary, was dry and warm and apparently furnished the conditions in which the virus of the disease flourished. When the infection has become established in an area, there is a tendency for the summer prevalence to be repeated in the years following an epidemic. Here again it is probable that the cold wet summer of 1948 has contributed to the fact that only two cases have been notified this year. It is a sad commentary on our inability to cope with epidemic infantile paralysis that we are dependent on a poor summer for its control. I have the honour to be, Mr Mayor, Ladies and Gentlemen, Your obedient Servant, R. P. GARROW, Medical Officer of Health. 8 Statistics for 1947 SOCIAL AND ECONOMIC STATISTICS Area (acres) 2,872 Area (square miles) 4.49 Population (Census 1931) 95,524 Population—Registrar-General's estimate 1947 97,510 Number of separately assessed inhabited premises (end of 1947) according to Rate Books 23,376 Rateable value (General Rate) at 31st December, 1947 £1,076,316 Product of a penny rate £4,300 LIVE BIRTHS M F Total. Legitimate 987 963 1,950 Illegitimate 49 44 93 1,036 1,007 2,043 Comparable Live Birth Rates (per 1,000 population) Hornsey — 20.95 England and Wales 20.5 126 County Boroughs and Great Towns including London 23.3 148 Smaller Towns 22.2 London Administrative County 22.7 STILL-BIRTHS M F Total Legitimate 30 20 50 Illegitimate — — — 30 20 50 Comparable Still-birth Rates (per 1,000 population) Hornsey — 5.1 England and Wales 50 126 County Boroughs and Great Towns including London 62 148 Smaller Towns 54 London Administrative County 49 9 DEATHS Males 593 Females 612 1,205 Comparable Death Rates (per 1,000 population) Hornsey — 12.36 England and Wales 12.0 126 County Boroughs and Great Towns including London 13.0 148 Smaller Towns 11.9 London Administrative County 12.8 INFANT DEATHS (under one year of age) M F Total Legitimate 27 22 49 Illegitimate 4 1 5 31 23 54 INFANT MORTALITY RATES Hornsey All Infants 26.43 Per 1,ooo live births Legitimate Infants 25.13 per 1,000 legitimate live births Illegitimate Infants 53,76 per 1,000 illegitimate live births Comparable Infant Mortality Rates (per 1,000 related births) England and Wales 41 126 County Boroughs and Great Towns including London 47 148 Smaller Towns 36 London Administrative County 37 MATERNAL DEATHS Puerperal and Post-Abortive Sepsis NIL Other Maternal Causes 2 TOTAL 2 Maternal Mortality Rates (per 1,000 total live and still-births) Hornsey — .95 England and Wales 1.17 10 PUERPERAL FEVER AND PUERPERAL PYREXIA Number of Notifications 9 Puerperal Pyrexia Rates (per 1,000 total live and still births) Hornsey — 4.3 England and Wales 7.16 126 County Boroughs and Great Towns including London 8.99 148 Smaller Towns 6.27 London Administrative County 6.94 PUBLIC HEALTH ACT, 1936 (Section 203) Notification of Births All live births and still births of seven months and over must be notified to the Medical Officer of Health within 36 hours, in addition to being registered within a period of six weeks after birth. SUMMARY OF BIRTHS NOTIFIED, 1947 M F Total Live births 1,148 1,130 2,278 Still births 32 18 50 1,180 1,148 2,328 The births were notified:— By Doctors 16 „ Borough Midwives 511 „ Alexandra Maternity Home 591 „ Other Midwives 29 „ Hospitals 756 „ Others 381 2,284 Not notified (information extracted from Registrar's Returns):— Live births 39 Still births 5 44 — 2,328 Of this number there were:— Live births Still births Occurring in the Borough and transferred to other districts 277 2 Belonging to Hornsey and occuring in Hospitals, etc., outside the district 742 17 11 The 2,049 nett number of notified births belonging to Hornsey were divided among the districts of the Welfare Centres as follows:— Live births Still births Total Town Hall Centre 811 21 832 Burgoyne Road Centre 518 9 527 Church Road Centre 285 7 292 Fortis Green Centre 337 10 347 Campsbourne Centre 33 1 34 Stroud Green Centre 17 — 17 2,001 48 2,049 Births attended by Borough Midwives:— Miss Andrews 110 Miss Mathews 110 Miss Jones 137 Mrs Hall 60 Miss Smith 87 Relief Midwives 7 511 PREMATURE BIRTHS The total number of premature babies notified during 1947 who were born:— At home 18 In hospital or nursing home 10 The number of those born at home:— who were nursed entirely at home 15 who died during the first 24 hours — who survived at the end of one month 17 The number of those born in hospital or nursing home:— who died during the first 24 hours 1 who survived at the end of one month 9 DEATHS FROM SPECIAL CAUSES Deaths from Cancer (all ages) 216 Deaths from Measles (all ages) — Deaths from Whooping Cough (all ages) 2 Deaths from Diarrhoea (under 2 years of age) 6 12 DEATHS STATISTICS Cerebro-spinal Fever 2 Whooping Cough 2 Tuberculosis of respiratory system 35 Other forms of tuberculosis 5 Syphilitic disease 9 Influenza 17 Polio-myelitis and Polio-encephalitis 2 Cancer 216 Diabetes 8 Intra-cranial vascular lesions 143 Heart disease 322 Other diseases of circulatory system 54 Bronchitis 71 Pneumonia 71 Other respiratory diseases 15 Ulcer of stomach or duodenum 5 Diarrhoea under 2 years 6 Appendicitis 4 Other digestive diseases 27 Nephritis 21 Maternal causes 2 Premature birth Congenital malformations, birth injuries, etc. 25 Suicide 15 Road traffic accidents 3 Other violent causes 20 All other causes 98 1,205 13 SANITARY CIRCUMSTANCES OF THE AREA WATER SUPPLY The water supply for Hornsey is provided by the Metropolitan Water Board. The supply has been satisfactory both in quantity and quality during the year 1947. Hornsey is supplied from two sources:— (a) Water from the New River, treated at the Board's filtration works at Stoke Newington, and (b) River Thames water stored in Littleton reservoir and treated at the Board's filtration works at Kempton Park. Water is pumped from these works into service reservoirs at Crouch Hill. Samples of water are collected on five days in every week at each stage of the purification process and tests include physical, chemical and microbiological examination. The water supplied to this area is not plumbo-solvent. All new and repaired mains are chlorinated before being restored to use and samples of water from them are tested bacteriologically to ensure efficient disinfection. Bacteriological Results No. of Samples Agar Colney count Bact. coli Test Neg. Bact. coli per 100 ml. Bact. coli per 100 ml. Hornsey 258 19.8 97.7% 0.058 Stoke Newington 387 33.1 95.9% 1.232 Kempton Park 911 40.9 99.1% 0.093 SANITARY INSPECTIONS The following statement of the work of the Sanitary Inspectors has been prepared by Mr J. H. Jesse, Chief Sanitary Inspector:— Complaints 3,103 Re-inspections 6,612 Information from Builder 496 Other reasons 474 Drainage 377 Water Tests applied (new drains) 57 Smoke and Chemical Tests (old drains) 94 Carried forward 11,213 14 Sanitary Inspections -continued Brought forward 11,213 Tests applied on payment of a prescribed fee 1 Verminous conditions 81 Overcrowding conditions 29 Overcrowding re-inspections 5 Surveys (Permitted Number) 5 Re-surveys (Permitted Number) 22 Memorandum from Borough Enginner and Surveyor 14 Memorandum from Town Clerk 3 Notifiable Infectious Diseases 297 Scabies 7 Smallpox Contacts 29 Public Health (Aircraft) Regulations, 1938 15 Shops Acts Inspections 28 Shops Acts Re-inspections 9 Sunday Trading Inspections 308 Butchers' Shops 23 Slaughterhouses 1 Milkshops 6 Grocers' Shops 38 Bakehouses 18 Fish Shops 21 Restaurant Kitchens 30 Greengrocers' Shops 8 Ice Cream Premises 120 Other Food Shops 1 Food Inspections 458 Food and Drugs Act 2 Milk Surveys 2 Factories 38 Young Persons Act 1 Offices 1 Music and Dancing Licences 29 Piggeries 1 Housing Inspections 3 Petroleum Stores 122 Registration of Hawkers 31 Building Licences 6,964 Certificate of Essential Repairs 1,527 Landlord and Tenant (War Damage) Amendment Act, 1941 3 Rats and Mice (Destruction) Act, 1919 195 Street Trading 1 Smoke Observations 2 Rent Restrictions Acts 15 Moselle Pollution 12 21,739 15 NOTICES The Notices served during the year are as follows:— Verbal Preliminary Statutory Public Health and Housing Acts 292 1,930 260 Housing Byelaws — 35 — Statutory Byelaws — — 1 Factory Act — 2 2 292 1,967 263 SUMMARY OF SANITARY IMPROVEMENTS CARRIED OUT DRAINAGE Number of houses and premises redrained 19 Repairs or amendments to existing drains 86 Drains or gullies unstopped or cleansed 103 Manholes provided 36 Manholes repaired 42 Intercepting traps fixed 10 New gulley traps fixed 80 New soil pipes and ventilating shafts fixed 39 Soil pipes and ventilating shafts repaired 57 WATER-CLOSETS AND SANITARY FITTINGS New water-closet buildings 3 New water-closet pans fixed 115 Water-closets unstopped, cleansed or repaired 129 New sinks provided 14 New lavatory basins provided 23 Waste-pipes trapped, repaired or unstopped 107 Waste-pipes diverted into proper drain 16 Baths provided or made usable 3 Urinals cleansed 2 MISCELLANEOUS Roofs repaired 610 Eaves guttering renewed, cleansed or repaired 275 Rain-water pipes provided, repaired 174 Damp walls remedied 288 16 Miscellaneous—continued Damp-proof courses inserted 40 Paving of yards repaired 71 Rooms cleansed, distempered or papered 437 Premises disinfested of vermin 24 Drinking-water cisterns repaired, cleansed and covered 81 Water supply pipes repaired 64 Water supply (additional) provided 8 Windows and skylights provided or made usable 202 Sub-floor ventilation 70 Floors repaired 221 Walls and ceilings repaired 603 Windowsills repaired 114 Sashcords and fittings repaired 146 Sanitary dustbins provided 69 Accumulations of manure and refuse removed 6 Stoves, ranges and coppers repaired or renewed 187 Food stores provided 9 Sundry items 183 BYELAWS relating to houses intended or used for occupation by the working classes and let in lodgings or occupied by members of more than one family Three houses have been dealt with under these Byelaws during the year and the following work carried out:— Byelaws 4 (d) Food stores 1 5 (g) Staircase repairs 1 8 Stairs lighted 1 SHOPS ACTS The following are the particulars of action taken during the year under the provisions of the Shops Act, 1934, relating to the heating of shops:— Notices Complied with Heating provided 1 1 17 HOUSING STATISTICS The housing statistics of the year as required by the Ministry of Health are set out below:— 1.—Inspection of Dwelling-houses during the Year:— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 2,470 (b) Number of inspections made for the purpose 7,082 (2) (a) Number of dwelling-houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 — (b) Number of inspections made for the purpose- (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 1 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 2,108 2.—Remedy of Defects during the Year without service of formal notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 886 3.—Action under Statutory Powers during the Year:— (a) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which notices were served requiring repairs 5 (2) Number of dwelling-houses which were rendered fit after service of formal notices (a) by owners – (b) by Local Authority in default of owners – (b) Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 255 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) by owners 122 (b) by Local Authority in default of owners – 18 (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which Demolition Orders were made 1 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 1 (d) Proceedings under Section 12 of the Housing Act, 1936:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made – (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit – 4.—Overcrowding:— Ten new cases of overcrowding have been reported during the year, involving fourteen families and fifty-two persons. Fourteen inspections were also made at the request of other Local Authorities in connection with re-housing. INSPECTION AND SUPERVISION OF FOOD lbs. ozs. lbs. ozs Tinned Vegetables 740 3 Margarine 65 8 Tinned Fruit 285 12 Tea — 8 Tinned Meat 1,798 8 Sugar 1 8 Tinned Fish 220 10 Flour 126 8 Tinned Milk 998 8 Cereals 140 4 Tinned Soup 66 0 Dried Vegetables 487 3 Tinned Marmalade 68 8 Dried Fruit 351 4 Tinned Jam 266 12 Bottled Fruit 1 9 Meat 765 8 Mincemeat 1 0 Fish 6,692 6 Golden Syrup 2 0 Poultry 56 0 Biscuits 14 0 Bacon 47 0 Pickles 33 12 Rabbits 115 0 Fruit 322 8 Cheese 30 12 Sweets 77 9 Butter 6 4 Eggs 304 TOTAL Food Condemned—13,882 lbs. 12 ozs. and 304 eggs. 19 RODENT CONTROL During the twelve months ending 31st December, 1947, the following work was carried out under the Rats and Mice (Destruction) Act, 1919:— Visits by the Sanitary Inspectors 195 Visits by the Rodent Operator 2,945 Premises disinfested for Rats 160 Premises disinfested for Mice 54 No evidence of infestation – Disinfestation in hand—Rats 94 Disinfestation in hand—Mice 87 DISEASES OF ANIMALS ACTS Mr F. G. Buxton, the Veterinary Inspector, has kindly supplied me with details of his work in the Borough under the Diseases of Animals Acts and Orders during 1947 as follows:— Total number of Licences issued under the Contagious Diseases of Animals Acts 0 Inspections made under the Contagious Diseases of Animals Acts (on fowls) 5 Number of fowls inspected 32 No action was necessary under the Tuberculosis Order, 1925. CLEANSING STATIONS Persons Treated Hornsey Other verminous Other Districts Other verminous Scabies conditions Scabies conditions Total Women and Children:— Pear Tree Cottage, rear of Town Hall 105 44 55 10 214 Men and Youths:— Central Depot, High Street, N.8. 27 – 13 – 40 20 INFECTIOUS DISEASES Corrected Notifications during 1947 (By age and Sex) AGE Scarlet Fever Whooping Cough Ac. Poliomyelitis Ac. Polioencephalitis Measles Diphtheria M F M F M F M F M F M F 0-1 1 20 9 — — — 14 11 — 1-3 6 4 36 33 — — — — 70 64 2 — 3-5 21 14 24 28 — 1 — — 65 73 1 — 5-10 34 32 40 30 2 1 — — 115 95 1 — 10-15 9 31 2 — 1 — — — 7 5 — — 15-25 1 8 — 1 3 1 — 1 6 6 — 1 25— 3 4 1 3 2 2 — — 2 6 — 1 Age unknown — — — — — — — — — 3 — — TOTALS 74 94 123 104 8 5 — 1 279 263 4 2 168 227 13 I 542 6 AGE Ac. Pneumonia Dysentery Paratyphoid Fevers Erysipelas Cerebro Spinal Fever Puerperal Pyrexia Opthalmia Neonatorum Malaria (contracted abroad) M F M F M F M F M F M F M F M F 0-5 6 3 3 2 3 1 2 5-15 3 2 — 1 — — — — 2 1 — — — — — — 15-45 10 5 — — — 1 2 6 3 2 — 9 — — 2 — 45-65 5 7 1 — — — 3 7 — — — — — — — — 65— 3 5 — — — — 2 2 — — — — — — — — Age unknown — — — — — — — — — — — — — — — — 27 22 4 1 — 1 7 15 7 6 — 9 1 2 2 — 49 5 1 22 13 9 3 2 21 INFECTIOUS DISEASES NURSING OF CASES Removed to 1sol. Hosp. Removed to Other Hosps. Nursed at home TOTAL Scarlet Fever 111 1 56 168 Whooping Cough 38 0 189 227 Poliomyelitis 5 5 3 13 Polioencephalitis 0 0 1 1 Measles 22 2 518 542 Diphtheria 6 0 0 6 Pneumonia 1 1 47 49 Dysentery 3 1 1 5 Paratyphoid Fever 0 0 1 1 Erysipelas 6 1 15 22 Cerebro Spinal Fever 9 1 3 13 Puerperal Pyrexia 1 3 5 9 Opthalmia Neonatorum 0 3 0 3 Malaria (cont. abroad) 0 2 0 2 TOTALS 202 20 839 1,061 CORRECTED NOTIFICATIONS DURING 1947 (Bv Wards) DISEASE Highgate Muswell Hill Crouch End Central Hornsey North Harringay South Harringay Stroud Green Finsbury Park Scarlet Fever 8 28 6 39 21 30 28 8 Whooping Cough 13 25 9 40 26 23 58 33 Poliomyelitis – 5 1 1 1 2 3 – Polioencephalitis – – 1 – – – – 1 Measles 52 48 38 60 80 73 133 58 Diphtheria – – – 2 1 – 1 2 Pneumonia 6 7 4 9 5 11 5 2 Dysentery 2 1 – – – – 1 1 Paratyphoid Fever – – – 1 – – – – Erysipelas 3 7 2 4 – – 6 – Cerebro Spinal Fever 2 1 1 6 – 1 2 — Puerperal Pyrexia 1 4 – – – 1 1 – Opthalmia Neonatorum — 2 — 1 — — – — Malaria (cont. abroad) — — — 1 1 — — — TOTALS.. 87 128 62 166 135 141 238 104 DIPHTHERIA IMMUNISATION Regular sessions for this purpose are held at the Welfare Centres and the parents of children attending the Day Nurseries are also encouraged to allow their children to be immunised. I.—Immunisation during 1947:— Number of Children who had completed a full course of Immunisation at any time up to 31st December, 1947. Age at 31/12/47 i.e. born in year Under 1 1947 1 1946 2 1945 3 1944 4 1943 5-9 1938-1942 10-14 1933-1937 Total under 15 Number immunised 29 995 942 1,202 1,627 6,201 3,311 14,307 Estimated mid-year child population 1947 Children under five Children 5-14 8,030 9,410 17,440 2.—Diphtheria Notifications and Deaths in relation to Immunisation: NOTIFICATIONS DEATHS Age at date of Notification No. of cases notified. Number of cases included in preceding column in which the child had completed a full course of immunisation Under 1 0 0 1 1 1 2 1 1 3 0 0 NIL 4 1 1 5-9 1 1 10-14 0 0 TOTALS 4 4 VACCINATION The Public Vaccinators inform me that they performed vaccination of persons in the Borough during 1947 as follows:— Doctor E. Buckler 415 Doctor A. Dickie 568 Doctor E. Barry-Smith 284 OPHTHALMIA NEONATORUM Domiciliary confinements Institutional confinements Cases notified 1 2 Cases removed to hospital 1 Cases in which vision was unimpaired 3 23 TUBERCULOSIS The total number of cases on the Tuberculosis Register at the end of 1947 was 1,289, viz., pulmonary 1,033, non-pulmonary 256, an increase of 55 on the total for last year. Accommodation for Tuberculosis cases in the County of Middlesex as at 31st December as follows:— Institution Adults Children Type of Case M F Harefield County 194 176 66 Pulmonary—sanatorium Hospital 4 4 10 „ —observation Clare Hall County 282 216 34 „ —sanatorium Hospital 14 14 „ —hospital Danesbury Manor, Welwyn — 55 — „ —convalescent Grim's Dyke, Harrow Weald 50 — — „ —rehabilitation White House, Milford 30 — — „ —chronic Ashford County Hospital 28 28 — „ —hospital Central Middlesex County Hospital 28 30 ,, – ,, Chase Farm Hospital 17 17 — ,, – ,, North Middlesex County Hospital 8 8 — ,, – ,, Redhill County Hospital 34 36 — ,, – ,, West Middlesex County Hospital 45 43 ,, – ,, Of the beds shown above, the following were not available for use, owing to shortage of nursing and domestic staff:— Harefield County Hospital 53 male 32 female 26 children Clare Hall County Hospital 97 ,, 36 „ 20 „ Redhill County Hospital 10 „ 10 „ — West Middx. County Hospital 25 ,, — — 24 LABORATORY SERVICES Pathological specimens are forwarded for examination to the Central Public Health Laboratory at Hendon which was established by the Medical Research Council on behalf of the Ministry of Health. The assistance of the technical staff attached to the Laboratory is also available in connection with outbreaks of infectious diseases at Day Nurseries and Schools and this assistance is of extreme value in controlling the spread of infection. Details of specimens examined at the Central Public Health Laboratory are as follows:— Throat and Nose Swabs Diphtheria bacilli 5 Haemolytic streptococci 262 Vincents angina 11 Negative 610 886 Faeces Shigella Salmonella 1 Protoza — Negative 34 35 Sputum Tuberculosis smear 10 Other organisms 25 Negative 81 116 Pertussis Cough plates — Postnasal swabs — Negative 53 53 Milk Pasteurized 3 Water — 3 Miscellaneous 55 55 1,148 25 PRINTED By ROBERTS & NEWTON L.™ London. N.S