LIBRARY HOR 41 BOROUGH OF HORNSEY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR ENDING 31st DECEMBER, 1949 BOROUGH OF HORNSEY With the Compliments of the MadicalOfficer of Health TOWN HAUL. THE BROADWAY, Telephone CROUCH END. N.8. Mountview 322O 2091 BOROUGH OF HORNSEY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR ENDING 31st DECEMBER, 1949 Health Committee (as at 31st December, 1949) Chairman : Councillor Miss O. R. Anderson The Mayor—Alderman G. F. N. Norman, J.P. Alderman F. H. Bailey, J.P. Alderman M. W. Burns Alderman Mrs C. M. Cave Alderman S. G. Goulding Councillor Mrs I. M. Baxter Councillor R. A. Butler Councillor W. J. M. Crosland Councillor O. J. R. de Boer Councillor R. J. Disney Councillor F. R. Dunscombe Councillor A. E. Hall Councillor P. Hardiman Councillor A. S. Kent Councillor Mrs W. L. Le Messurier Councillor A. H. Morley Councillor Miss C. E. Ross Councillor Mrs J. W. C. St. John Councillor R. F. Sutton Councillor T, E. Thursby 3 STAFF OF PUBLIC HEALTH DEPARTMENT Medical Officer of Health R. P. Garrow, m.d., d.p.h. (Retired 6.10.49). G. Hamilton Hogben, m.r.c.S., d.p.h. (Commenced 8.9.49). Deputy Medical Officer of Health Marion Lones, m.b., d.p.h., d.O.m.s. Veterinary Inspector F. G. Buxton, m.r.C.v.S. Chief Sanitary Inspector, Petro- J. H. Jesse, m.s.i.a., Cert. R. leum Inspector and Shops Inspec- San.I., Cert. Insp. of Meat and tor Foods. Senior District Sanitary Inspector J. D. Chance, m.s.i.a., Cert. R. and Shops Inspector San. I., Cert. Insp. of Meat and Foods. Sanitary Inspectors and Shops In- E. Hundy, m.s.i.a., Cert. R. San. I. spectors and S.I.E. Joint Board, Cert. Insp. of Meat and Foods, Cert. San. Science. R. Downes, m.s.i.a., Cert. R. San. I. and S.I.E. Joint Board. W. J. Wilson, d.p.a. (Lond)., m.s.i.a., Cert. R. San. I. and S.I.E. Joint Board, Cert. Insp. of Meat and Foods. S. Swinnerton, m.s.i.a., m.r.s.i., Cert. R. San. I. and S.I.E. Joint Board, Cert. Insp. of Meat and Foods. E. F. Kirby, m.s.i.a., Cert. R. San. I. and S.I.E. Joint Board, Cert. Insp. of Meat and Foods. (Appointed 10.3.49). Senior Clerk H. P. Bradford. (Appointed 19.1.49). Assistant Clerks Miss S. P. Nunn. Miss M. Chesterman. Miss M. Humphreys. Miss M. S. Arnell. Rodent Operator E. Mead. Disinfectors and Mortuary Atten- W. H. Lewis. dants P. F. Hall. P. Martin. Cleansing Station Attendant Mrs H. J. Caulfield. 4 Public Health Department, Town. Hall, Hornsey, N.8. To His Worship the Mayor, Aldermen and Councillors of the Borough of Hornsey. Mr Mayor, Ladies and Gentlemen, I have the honour to submit the Annual Report on certain aspects of the health of the Borough for the year ending the 31st December, 1949. The year saw the retirement of Dr. R. P. Garrow after twenty years distinguished service to the Borough as Medical Officer of Health and School Medical Officer. Many sincere tributes were paid to Dr. Garrow at the time he relinquished office, and he will take with him many happy memories of the people with whom he worked and was privileged to serve. Measured by vital statistics, outlined in the body of this Report, the year showed a generally satisfactory record. A disturbing feature, however, was the prevalence of polio-myelitis which kept the doctors of the district, supported by the public health department, actively cooperating in taking all possible steps to combat spread of the disease. I am indebted to my deputy—Dr. P. A. Tyser—for jointly preparing with me an outline and commentary on cases occurring in Hornsey during 1947-49, which is embodied as an appendix to this Report. I wish to acknowledge the support and encouragement accorded to me by the Chairman and Members of the Health Committee. To my colleagues in the public health department and in particular the Chief Sanitary Inspector—Mr Jesse—and to the Chief Officers of the Corporation, I offer my sincere thanks for their willing and valued co-operation. I am, Your obedient Servant, G. HAMILTON HOGBEN, Medical Officer of Health. November, 1950. 5 Statistics for 1949 SOCIAL AND ECONOMIC STATISTICS Area (acres) 2,872 Area (square miles) 4.49 Population (census 1931) 95,524 Population—Registrar General's estimate 1949 98,670 Number of separately assessed inhabited premises according to Rate Books 26,865 Rateable value (General Rate) £1,055,021 Product of a penny rate £4,269 VITAL STATISTICS LIVE BIRTHS M F Total Legitimate 761 753 1,514 Illegitimate 39 36 75 800 789 1,589 Birth Rate ( per 1,000 population) Hornsey 16.1 England and Wales 16.7 126 County Boroughs and Great Towns including London 18.7 148 Smaller Towns 18.0 London Administrative County 18.5 STILL BIRTHS M F Total Legitimate 17 18 35 Illegitimate 2 1 3 19 19 38 Still-birth Rate (per 1,000 population) Hornsey 0.38 England and Wales 0.39 126 County Boroughs and Great Towns including London 0.47 148 Smaller Towns 0.40 London Administrative County 0.37 6 INFANT DEATHS (under i year of age) M F Total Legitimate 21 13 34 Illegitimate 4 — 4 25 13 38 INFANT DEATH RATES Hornsey All Infants 23.9 per 1,000 live births Legitimate Infants 22.5 per 1,000 legitimate births Illegitimate Infants 53.3 per 1,000 illegitimate births Comparable Infant Death Rates (per 1,000 live births) Hornsey 23.9 England and Wales 32 126 County Boroughs and Great Towns including London 37 148 Smaller Towns 30 London Administrative County 29 MATERNAL DEATHS Hornsey Nil England and Wales—Maternal Mortality (Rate per 1,000 total live and still-births) 98 DEATHS Males 519 Females 634 1,153 General Death Rate (per 1,000 population) Hornsey 11.7 England and Wales 11.7 126 County Boroughs and Great Towns including London 12.5 148 Smaller Towns 11.6 London Administrative County 12.2 PUERPERAL FEVER AND PUERPERAL PYREXIA Number of Notifications 2 Puerperal Pyrexia Rate (per 1,000 total live and still-births) Hornsey 1.2 England and Wales 6.31 126 County Boroughs and Great Towns including London 8.14 148 Smaller Towns 5.30 London Administrative County 6.82 7 8 CAUSES OF DEATH Af F Totals Cerebro-spinal fever 1 1 Tuberculosis of respiratory system 21 14 35 Other forms of tuberculosis — 3 3 Syphilitic disease i 5 6 Influenza 6 12 18 Measles I — 1 Acute poliomyelitis, polioencephalitis 4 3 7 Cancer— Uterus — 8 8 Stomach and duodenum 13 15 28 Breast 21 21 Lung and bronchus 22 8 30 All other sites 66 66 132 Diabetes 2 8 10 Intra-cranial vascular lesions 37 82 119 Heart diseases 126 186 312 Other diseases of circulatory system 18 29 47 Bronchitis 42 3i 73 Pneumonia 25 38 63 8 Other respiratory diseases 5 3 Ulcer of the duodenum and stomach 10 6 16 Diarrhoea under 2 years 1 — 1 Appendicitis — 3 3 Other digestive diseases 8 12 20 Nephritis 10 9 19 Premature birth 8 5 13 Congenital malformations, birth injuries, etc 13 6 19 Suicide 14 7 21 Road Traffic accidents 4 2 6 Other violent causes 8 19 27 All other causes 54 32 86 Totals 519 634 1,153 9 CAUSES BY AGE GROUPS AND SEXES Under 1 Day 1—6 Days 1 Week 2 Weeks 3 Weeks Total Under 1 Month 1—2 Months 3—5 Months 6—8 Months 9—11 Months T otals M F M F M F M F M F M F M F M F M F M F M F Cerebrospinal fever - - - - - - - - - - - - - - - - - - - 1 - 1 Diseases of ear and mastoid — — — — — — — — — - — — — — - — - — 2 — 2 — Pneumonia — — - — — — 1 — 1 - 3 - — 2 — 2 - - - - 3 4 Enteritis and diarrhoea - - - - - -+- - -- - - - - 1 - - - - - - - 1 — Congenital malformations 2 — — — — - - — — — 2 — 1 — 1 - — - — — 4 - Premature birth 1 7 4 - - - - - - 8 5 - - - - - - - - 8 5 Injury at birth 1 2 2 — — — 1 — — — 4 2 - -- - - - - - - 4 2 Other diseases peculiar to first year of life 1 — 1 1 - - - - - - 2 1 - - - - - - - - 2 1 Other causes - - - - - - - - - - - - - - - - 1 - - - 1 — TOTALS 5 3 11 5 — — 2 — 1 — 19 8 2 2 1 2 1 - 2 1 25 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 1949. Hornsey is supplied from two sources :— (a) Water from the New River, treated at the Board's filtration works at Hornsey, 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 supply 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 Bact. coli Test No. of Agar Colony Neg. Bact. coli Bact. coli Samples Count per 100 ml. per 100 ml. Stoke Newington 256 8.7 100.0% Nil Kempton Park 1,175 29.5 99-9% -°02 SANITARY INSPECTIONS The following work of the Sanitary Inspectors has been prepared by Mr. J. H. Jesse, Chief Sanitary Inspector :— The number and nature of the inspections made during the year are as follows:— Complaints 2,240 Re-inspections 8,638 Other reasons 555 Drainage 512 Water Tests applied 87 Smoke and Chemical Tests 115 10 Sanitary Inspections—continued Surveys (Permitted number) 19 Overcrowding conditions 83 House to House Inspections 12 Building Licences 125 W.B.A. Certificates 1 Notifiable Infectious Diseases 253 Smallpox contacts 37 Verminous conditions 67 Cinemas, Halls, etc., Renewal of Music and Dancing Licences 27 Petroleum Stores 131 Street Trading 5 Rats and Mice (Destruction) Act, 1919 135 Smoke Observations 20 Rent Restrictions Acts 7 Moselle Pollution 73 Stables and Urinals 21 Registration of Hawkers 12 Campsbourne Area Census 268 Review of Housing Waiting List 290 13,733 NOTICES The Notices served during the year are as follows :— Verbal Preliminary Statutory Public Health and Housing Acts 182 1,218 251 Housing Byelaws 34 3 Shops Acts 8 1 — Food and Drugs Act 6 — Factories Act 1 — 190 1,260 254 11 SUMMARY OF SANITARY IMPROVEMENTS CARRIED OUT DRAINAGE Number of houses and premises redrained 27 Repairs or amendments to existing drains 111 Drains or gullies unstopped or cleansed 201 Manholes provided or repaired 93 Intercepting traps fixed 24 Soil and Vents repaired or renewed 133 WATER-CLOSET AND SANITARY FITTINGS Water-closet buildings provided or repaired 65 Water-closet pans provided or renewed 164 Water-closets unstopped, cleansed or repaired 98 Flushing cisterns provided or repaired 103 New sinks provided 64 New lavatory basins provided 75 Waste pipe trapped, repaired or unstopped 174 Baths provided or made useable 41 Urinals cleansed 5 MISCELLANEOUS Roofs repaired 765 Rain-water gutters, renewed or repaired 459 Rain-water pipes provided or repaired 365 Dampness remedied 357 Damp-proof courses provided 102 Yard paving provided or repaired 119 Rooms cleansed 1,208 Rooms disinfested of vermin 27 Walls and ceilings repaired 2,553 Floors repaired 403 Sub-floor ventilation provided 95 Windows, doors, skylights, sashcords and fittings repaired 1,090 Window-sills repaired 171 12 Summary of Sanitary Improvements—continued Water cisterns repaired, cleansed or covered 70 Water supply pipes repaired 57 Stoves, Ranges, Coppers renewed or repaired 265 Flues and Chimneys repaired 164 Accumulation of Refuse removed 58 Dustbins provided 21 Miscellaneous items 316 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. Thirty-three houses have been dealt with under these Byelaws during the year and the following work carried out:— 4 (b) Water supply 18 4 (c) Washing accommodation 1 4 (d) Food stores 2 5 (b) Means of carrying off waste water 21 5 (h) Handrails provided 4 8 Cleansing and painting 3 Stairs lighted 2 Stairs ventilated 5 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) M94 (b) Number of inspections made for the purpose 1,698 (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 2 13 Housing Statistics—continued (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 habitation 1,018 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 1,195 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 — (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 251 (2) Number of dwelling-houses in which defects were remedied after service of formal notices (a) by owners 229 (b) by Local Authority in default of owners — (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 4 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 2 (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 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenements or rooms having been rendered fit — CAMPSBOURNE AREA During the latter part of 1948 and the early part of 1949, a detailed survey of the working class houses forming part of the Campsbourne Area was carried out by this department. The area comprised Brook Place, parts of Brook Road and Eastfield Road, and the basement houses of Boyton, Campsbourne and Myddelton Roads, a total of 109 houses. The report and the official representation was subsequently considered by the Health and Housing Committees, who recommended that a copy of the report be forwarded to the Minister of Health for his observations, with a request to the Minister to arrange an interview with representatives of the Council to discuss the matter. The meeting took place in March, and it was indicated that the Minister would agree to a start being made on the first part of the scheme (Brook Road Area) providing that the Council could rehouse, on the site, as many or more families than were housed there at present. The scheme to proceed stage by stage, and provision be made for rehousing the families in the Brook Road Area prior to demolition. The Council ultimately resolved that the area be defined on maps in pursuance of Section 25 of the Housing Act, 1936 as :— The Campsbourne No. 1 Clearance Area. The Campsbourne No. 2 Clearance Area. The Campsbourne No. 3 Clearance Area. comprising buildings No's 2—54 Brook Road, Brook Place, several garages, and work-shops, and two plots of land and a Compulsory Purchase Order known as "The Hornsey (Compulsory Clearance Area) Compulsory Purchase Order No. 1 1949" be made and submitted to the Minister of Health for confirmation. Meanwhile the Borough Engineer and Surveyor was instructed to prepare a "Master Plan" of the whole of the Campsbourne Area and proposals be submitted for the redevelopment of the area during the next five years. The Minister has now confirmed the Order, and it is anticipated that the year 1950 will see the commencement of the first stage of the redevelopment, with the disappearance of the unsightly and worn out houses in the Brook Road Area, to make way for a block of modern flats. 15 l6 FACTORIES ACT, 1937 The following tables show the work carried out by the Sanitary Inspector under this Act:— 1. Inspections of Factories Premises Number of Inspections Written Notices Prosecutions Factories with Mechanical Power 127 5 NIL Factories without Mechanical Power ... — — TOTALS 127 5 NIL 2. Defects Found Particulars No. of defects Referred to H.M. Inspector Number of defects in respect of which Prosecutions were instituted. Found Remedied Want of Cleanliness - - Overcrowding — — Unreasonable Temperature — — Inadequate ventilation 1 1 Ineffective drainage of floors — — NIL NIL Sanitary Conveniences (a) insufficient 1 1 (b) unsuitable or defective 5 5 (c) Not separate for sexes - - Other offences — — TOTALS 7 7 NIL NIL OUTWORKERS There are 619 Outworkers on the register engaged in the following occupations:— Wearing apparel 369 Hair Stylists 2 Curtains and furniture hang- Bundling thongings 1 ings 1 Leather goods 3 Furniture and Upholstery 4 Handbags 4 Umbrellas, etc 1 Stationery 6 Artificial flowers 21 Embroidery 8 Boxes, etc. 130 Printers and Publishers 3 Feather sorting and mounting 5 Shoe trimmings 2 Art jewellery repairs 2 Millinery 8 Carding, etc. of buttons, etc. 3 Brace manufacturers 1 Toys and games 30 Electrical apparatus 2 Basket making 3 Haberdashery 1 Christmas crackers, etc. 4 Fancy goods 5 131 visits were paid to outworkers' premises during the year. INSPECTION AND SUPERVISION OF FOOD The subject of food hygiene has been prominently before the public during the last two or three years. Conditions in the food trades have been criticised, much publicity has been given to outbreaks of food poisoning, and questions on food hygiene have frequently been asked in Parliament. Whilst the importance of this subject cannot be over-estimated it should be kept in its proper perspective. On the question of food poisoning the Minister of Health said in the House of Commons, on the 10th November, in reply to a question, "The apparent increase in the number of outbreaks (from 156 in 1938 to 964 in 1948) is probably largely due to increased information and investigation." There is no doubt that during the war years and for some time afterwards, the methods of handling and preparation of food left much to be desired. Shortages of equipment, indifferent staff, restrictions on building repairs and improvements, and food shortages all contributed to this state of affairs. The easing of building licensing restrictions and improvement in the supply of equipment has enabled long overdue repairs and replacements to be put in hand, particularly in the case of the larger food shops and restaurants. The smaller cafes, especially of the "pull up for carmen" type and those catering for workmen, are still a problem owing to their restricted space, but frequent inspection and supervision is gradually effecting an improvement. The proper maintenance and cleanliness of all food premises is an essential principle of food hygiene. There is little chance of practising clean methods of handling in premises which are dirty. A total of 927 food premises were inspected during the year. Apart from the statutory requirements of the Food and Drugs Act, special attention has been paid to the cleansing of utensils used in the preparation and serving of food and drink, particularly in cafes and restaurants. The use of insufficient water for washing-up purposes, failure to change it frequently and the absence or improper use of detergents and the practice of leaving equipment for long periods after use before cleansing are matters in which there is room for improvement. In ice-cream establishments information has been given as to the proper cleansing of ice-cream and wafer servers, and the use of Quaternary Ammonium Compounds in this connection. Existing legislation provides for the registration by the local authorities of ice-cream premises, premises used for the preparation or manufacture of certain preserved foods and sausages, dairies and distributors of milk. Whilst realising the difficulties, I submit that the registration of all premises where food is prepared, manufactured, stored or sold is desirable. No outbreak of food poisoning has been reported during the year. i8 Inspection and Supervision of Food—continued Inspections of food premises have been made during the year as follows :— Butchers' Shops 147 Restaurants, Cafes, etc. 178 Grocers' Shops 201 Bakehouses 93 Fish Shops 87 Milkshops 29 Greengrocers' Shops 20 Other Food Premises 12 Cooked Meat Shops 6 Ice Cream Premises 154 Total Inspection Made-927 The following is a list of food condemned as unfit for human consumption. Wherever possible this was disposed of as salvage:— lbs. ozs. lbs. ozs. Canned Vegetables 940 11 Honey 1 0 Canned Fruit 429 0 Chocolate Spread 14 8 Canned Fruit Juice 41 8 Tomato Paste 10 0 Canned Meat 1,067 7 Date Paste 110 0 Canned Fish 109 12 Dates 2 0 Canned Milk 986 1 Figs . 17 8 Canned Soup 63 3 Oranges 40 0 Canned Marmalade 95 8 Pepper 21 0 Canned Jam 74 1 Soup Powder 7 0 Dried Milk 30 0 Custard Powder 8 Dried Egg 14 5 Slab Cake 101 9 Cheese 80 4 Fat Expender 7 0 Fats 284 8 Pudding Mixture 4 0 Tea 6 0 Flour 370 0 Sugar 323 0 Bread Improver 56 0 Cereals 132 0 Flavouring Powder 98 0 Golden Syrup 32 0 Colouring Essence 13 0 Meat 2,255 6 Decorative Nibs 14 0 Fish 4,142 0 Jellies 55 2 Poultry 40 11 Salt 16 0 Rabbits 372 0 Olive Oil 3 gallons Bacon 189 4 Lemon Squash 2 gallons Pickles 18 14 Eggs 80 Salad Cream 62 10 TOTAL Food Condemned—12,748 lbs. 40zs., 5 gallons of Liquid and 80 Eggs. 259 visits were made of food premises in connection with condemnation. Slaughterhouses.—The Live Stock (Restriction of Slaughtering) Order, 1940, continued in force and no slaughtering was carried out during the year. 19 The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949. The Milk (Special Designation) (Raw Milk) Regulations, 1949. These Regulations came into force on the 1st October, 1949, and re-enact with amendments the Milk (Special Designations) Orders, 1936/1946. Annual licences for the sale of special designated milk were granted as follows : Dealers' Licences— Supplementary Licences— Pasteurised 45 Pasteurised 9 Tuberculin Tested 29 Tuberculin Tested 9 Accredited 1 Sterilised 8 Sterilised 39 34 samples of milk were taken for examination in course of delivery or from shops. These were Pasteurised 19, Heat treated 2, Tuberculin Tested 7, Sterilised 6. All the samples satisfied the Methylene Blue, Phosphatase and Turbidity tests. ICE CREAM There are 120 premises registered for the sale, manufacture or storage of ice cream. Section 14 of the Food and Drugs Act, 1938, requires that premises used for the sale, manufacture or storage of ice cream shall be registered. This does not apply to premises used primarily as a theatre, cinema, music hall, concert hall, hotel, inn, club, or restaurant but if ice cream is manufactured at a theatre, cinema, music hall, concert hall, then these premises must be registered. The enforcement of the provisions of the Act as to registration and the general hygienic requirements of both the Food and Drugs Act, 1938, and the Ice Cream (Heat Treatment) Regulations, 1947, have called for regular and frequent supervision of plant and premises by the Sanitary Inspectors. During the year 154 inspections of registered premises were carried out. Thirty-two samples of ice cream were taken during the year and submitted for bacteriological examination. The results were as follows:— Grade 1 Grade 2 Grade 3 Grade 4 14 9 3 6 These grades are provisional and cannot be said to give conclusive results but they do give an indication of bacterial cleanliness. All unsatisfactory samples are followed up and observations kept on methods of manufacturing and handling in order to obtain improvement. 20 SHOPS ACTS, 1912/1938 The Sanitary Inspectors are appointed as Shops Inspectors and during the year 277 inspections were made. Contraventions in the main were of a minor character, mostly concerned with the non-provision of the necessary notices. Regular observations are kept on the shopping areas during evenings and days of the weekly half holiday to ensure that the provisions of the Acts are complied with. The following are particulars of action taken during the year under the provisions of the Shops Act, 1934, relating to the health and comfort of shop workers:— Lighting provided 1 Heating provided 1 Sanitary Accommodation provided 2 Washing facilities provided 2 No. of shops cleansed 4 SHOPS (SUNDAY TRADING RESTRICTION) ACT, 1936 By virtue of Section 1 every shop is required, except as otherwise provided by the Act, to be closed for the serving of customers on Sundays. The excepted transactions are those set out in the first schedule. The majority of the shops open on Sundays in the Borough are newsagents, confectioners and tobacconists. Many of these are "mixed" shops and if open on Sundays have to exhibit the prescribed notices. There are also certain provisions as to the employment of assistants on Sundays and compensatory holidays in lieu. 437 visits have been made for this purpose. RODENT CONTROL During the twelve months ending 31st December, 1949, the following work was carried out under the Rats and Mice (Destruction) Act, 1919:— Visits by the Sanitary Inspectors 135 Visits by the Rodent Operator 2,951 Premises disinfested for Rats 199 Premises disinfested for Mice 42 No evidence of infestation 4 Disinfestation in hand—Rats 129 Disinfestation in hand—Mice 75 Regular sewer maintenance treatments were carried out during the year. 21 LEGAL PROCEEDINGS Legal proceedings were taken in 16 instances. Date of Hearing Premises Act or Byelaws Result of Proceedings 18/5/49 43 Middle Lane, N.8. P.H.A. 1936 Court Order for execution of work within 28 days. 18/5/49 23 New Road, N.8. P.H.A. 1936 Court Order for execution of work within 42 days. 18/5/49 28 Claremont Road, N.6. P.H.A. 1936 Adjourned for 28 days as work was in progress. 18/5/49 100 Barrington Rd., N.8. P.H.A. 1936 Adjourned for 28 days as owner appeared and undertook to arrange for work to be done. 18/5/49 28 Harvey Rd., N.8. P.H.A. 1936 Court Order for execution of work within 28 days. 20/7/49 11 Eastfield Road, N.8. P.H.A. 1936 Court Order for execution of work within 28 days. 27/7/49 13 Hillfield Park, N.10. P.H.A. 1936 Adjourned sine die as owner agreed to commence the work within 14 days. 27/7/49 32 Woodstock Rd., N.4. P.H.A. 1936 Court Order for execution of work within 28 days. 3/8/49 3, 9, 11, Hanbury Rd., N.8. P.H.A. 1936 Court Order for execution of work within 14 days. 17/8/49 74 Westfield Road, N.8. P.H.A. 1936 Court Order for execution of work within 2 months. 19/10/49 7 Lightfoot Road, N.8. P.H.A. 1936 Court Order for execution of work within 28 days. 19/10/49 6 Northwood Road, N.6. P.H.A. 1936 Court Order for execution of work within 6 weeks. 16/11/49 31 Northwood Rd., N.6. P.H.A. 1936 Court Order for execution of work within 8 weeks. 7/12/49 5 & 7 Hanbury Road, N.8. P.H.A. 1936 Court Orders for execution of work within 14 days and £2:2:0 costs. 7/12/49 20 Myddelton Road, N.8. P.H.A. .1936 Court Order for execution of work within 6 weeks. £1:1:0 costs. 14/12/49 77 Lausanne Road, N.8. P.H.A. 1936 Court Order for execution of work within 3 weeks. £1 : 1 :0 costs. 22 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 1949, as follows:— Total number of Licences issued under the Contagious Diseases of Animals Acts 0 Inspections made under the Contagious Diseases of Animals Acts 0 Inspections made under the Riding Establishment Act, 1939 3 No action was necessary under the Tuberculosis Order, 1925. CLEANSING STATIONS Persons Treated Hornsey Other Districts Totals Scabies Other verminous conditions Scabies Other verminous conditions Women and Children:— Pear Tree Cottage, rear of Town Hall 34 56 5 - 95 Men and Youths:— Central Depot, High Street, N.8 7 1 - 1 9 23 NOTIFICATION OF INFECTIOUS DISEASE 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 - - 4 6 - - - — 13 18 — — 1—3 3 — 13 18 1 — — — 87 100 — — 3—5 12 10 13 15 3 7 1 — 105 98 — — 5—10 25 38 14 10 5 5 — — 133 121 — — 10—15 8 4 1 2 — — — — 5 6 1 — 15—25 3 2 — — 2 3 — — 2 2 1 — 25— 4 — — 2 3 3 1 — 2 4 — — Age unknown — — — — — — — — 1 — — TOTALS 55 54 45 53 14 18 2 — 347 350 2 109 98 32 2 697 2 AGE Ac. Pneumonia Dysentery Ac. Encephalitis Lethargica Enteric or Typhoid Fever Paratyphoid Fevers Erysipelas Food Poisoning Puerperal Pyrexia Ophthalmia Neonatorum Cerebrospinal Meningitis M F M F M F M F M F M F M F M F M F M F 0—5 1 3 - 2 - - - - - - - - - - - - 1 - - - 5—15 2 6 1 1 — — — — — — — 2 — — — — 15—45 10 10 1 1 - - 1 - - - 3 3 1 1 - - - - - 1 45—65 8 10 - - — — 1 1 1 3 - - - - - - - - - 65— 6 10 — 1 — — — — — 4 — — — — — — — — TOTALS 27 39 1 5 1 - 2 1 1 - 6 8 2 1 — 2 1 — — 1 66 6 1 3 1 14 3 2 1 1 24 INFECTIOUS DISEASES—NURSING OF CASES Removed to Hospital Locally Removed to Hospital outside this district Nursed at home TOTALS Scarlet Fever 66 4 39 109 Whooping Cough 4 2 92 98 Ac. Poliomyelitis 22 7 3 32 Ac. Polioencephalitis 1 1 — 2 Measles 17 5 675 697 Diphtheria 2 — — 2 Ac. Pneumonia 2 18 46 66 Dysentery 1 1 4 6 Ac. Encephalitis Lethargica — 1 — 1 Enteric or Typl oid Fever 1 2 — 3 Paratyphoid Feveis — — 1 1 Erysipelas 1 1 12 14 Food Poisoning — 1 2 3 Puerperal Pyrexia — 1 1 2 Ophthalmia Neonatorum — 1 - 1 Cerebro-Spinal Meningitis ... 1 — — 1 TOTALS 118 45 875 1,038 NOTIFICATION OF INFECTIOUS DISEASE BY WARDS Highgate Muswell Hill Crouch End Central Hornsey North Haringey South Haringey Stroud Green Finsbury Park Scarlet Fever 17 24 8 19 7 9 20 5 Whooping Cough 9 6 2 5 28 21 18 9 Ac Poliomyelitis 12 11 — 2 1 2 2 2 Ac. Polioencephalitis 1 — 1 - - - - - Measles 148 124 45 59 68 78 101 74 Diphtheria — — — — 1 1 — — Ac. Pneumonia 9 8 3 12 9 6 14 5 Dysentery 1 1 1 1 1 — — 1 Ac. Encephalitis Lethargica 1 — — — — — — — Enteric or Typhoid Fever — 3 — — — — — — Paratyphoid Fevers — 1 — — — — — — Erysipelas 2 2 2 2 3 — 3 — Food Poisoning — - 1 — — 1 — 1 Puerperal Pyrexia — — 1 — — — — 1 Ophthalmia Neonatorum — — — 1 — — — — Cerebro-Spinal Meningitis — — 1 - - - - TOTALS 200 180 65 101 118 118 158 98 25 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. 1.—Immunisation in relation to child population:— Number of children at 31st December, 1949, who had completed a course of immunisation at any time before that date (i.e. at any time since 1st January, 1935). Age at 31/12/49 i.e. Born in year Under 1 1949 1 2 1948 1947 3 1946 4 1945 5 to 9 1940-1944 10 to 14 1935-1939 Total under 15 Number Immunised 73 1,073 | 1,293 1,291 1,040 1,052 165 5,987 Estimated mid-year child population 1949 Children under five 8,198 Children 5—14 9,899 18,097 2.—Diphtheria Notifications and Deaths in relation to Immunisation during the year 1949 :— Age at date °f Notification No. of cases notified Number of cases included in preceding column in which the child had completed a full course of immunisation Deaths Under 1 1 — — 2 — — 3 — — NIL 4 — — 5-9 — — 10-14 1 1 TOTALS 1 1 NIL OPHTHALMIA NEONATORUM Domiciliary confinements tutional confinements Cases notified 1 — Cases removed to hospital 1 — Cases in which vision was unimpaired 1 92 TUBERCULOSIS The total number of cases on the Tuberculosis Register at the end of 1949 was 797, viz., pulmonary 696, non-pulmonary 101. TUBERCULOSIS REGISTER, 1949 Pulmonary Non-Pulmonary Total Male Female Male Female Male Female (a) Number of Cases on Register at commencement of 1949 363 290 49 49 412 339 (b) Number of Cases notified for first time during year under Regulations 59 36 6 5 65 41 (c) Cases restored to Register during 1949 1 1 — — 1 1 (d) Cases added to Register otherwise than by notification under Regulations (1) Transferred from other Districts 13 18 2 1 15 19 (2) From Death Returns 5 1 1 — 6 1 (e) Number of Cases removed from Register during 1949 48 43 4 8 52 51 (f) Number of Cases remaining on Register at end of 1949 393 303 54 47 447 350 Cases removed from the Register shown under (e) are accounted for as follows:— Found not to be T.B. Recovered Removed to another area Died at home Died at Sanatorium or other Institution  M F M F M F M F M F M F PULMON ARY 1 — 7 6 20 22 13 13 7 2 48 43 NO N - PULM ONAR Y - - 2 3 1 1 - 3 1 1 4 8 27 LABORATORY SERVICES Pathological specimens are forwarded for examination to the Central Public Health Laboratory at Hendon and to the Public Health Laboratory at Coppetts Wood Hospital, which laboratories are directed by the Medical Research Council for the Ministry of Health. The assistance of the technical staff attached to the laboratories 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 are as follows:— Throat and Nose Swabs Diphtheria bacilli 1 Haemolytic streptococci 160 Vincents angina 1 Negative 433 595 Faeces Shigella 1 Salmonella 11 Protoza 1 Negative 82 95 Sputum Tubercular smear 5 Other organisms 2 Negative 42 49 Pertussis Cough Plates — Postnasal swabs — Negative 2 2 Milk Ice cream 32 Pasteurized 23 55 Water Swimming Pools 19 19 Miscellaneous 349 349 1,164 28 POLIOMYELITIS, 1947-1949 In previous reports the occurrence of cases of poliomyelitis in the borough has been described. In 1947 there were 13 cases of poliomyelitis (and 7 cases of benign lymphocytic meningitis), in 1948 there were 4 cases and 34 in 1949. Table I below shows the age distribution of the cases and the number of deaths in each year. Tables II-IV give the details of the epidemics in 1947 and 1949 respectively. It will be seen that in 1947 the cases were fairly evenly dispersed over the borough, though the greater number occurred in the Muswell Hill Ward. In both years it was found that the poorer districts in the borough did not suffer more severely from the disease than other districts, indeed, in 1949, 24 of the cases occurred in the Highgate and Muswell Hill Wards. The peak of the epidemic in 1947 occurred somewhat later than that in 1949. In 1948 only 4 cases were diagnosed and this year does not afford any information of a comparative nature with the other two years under review. With regard to the 7 cases of benign lymphocytic meningitis in 1947 the annual report for that year says that "(they) 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." In the Tables in this report, these cases have been omitted from the statistics of poliomyelitis but in the light of experience it is probable that they were in fact a poliomyelitis infection of the non-paralytic type. TABLE I AGE AND SEX INCIDENCE OF CONFIRMED CASES OF POLIOMYELITIS Age Group 1947 1948 1949 Cases Death Cases Death Cases Death M. F. M. F. M. F. M. F. M F. M. F. o-5 - 1 - - 1 - - - 5 7 - - 5-15 4 1 - - 1 - - - 6 5 2 1 15-30 3 3 1 1 1 1 - - 2 4 2 - 30 & Over 1 1 1 - - - - - 3 2 - 1 Totals 8 6 2 1 3 1 - - 16 18 4 2 29 TABLE II CLASSIFICATION OF CASES OF POLIOMYELITIS, 1947 and 1949 1947 1949 Total number of cases notified or admitted to Hospitals as suspected cases 31 50 No. of confirmed cases of poliomyelitis 14 34 No. of cases of poliomyelitis known to have had paralysis 11 13 No. who died 3 6 No. of cases diagnosed as benign lymphocytic meningitis 7 — No. of cases found to have diseases other than myelitis 10 16 Rate per 1,000 population of confirmed cases 0.14 0.34 Nursing of confirmed cases In Hospital 11 31 At Home 3 3 Deaths In Hospital 2 5 At Home 1 1 TABLE III INCIDENCE BY MONTHS Month 1947 Confirmed Cases Benign Lymphocytic Meningitis 1947 Confirmed Cases Poliomyelitis 1949 Confirmed Cases Poliomyelitis January — 1 - February — — - March — 2 - April — 1 - May — - - June — 1 2 July — 1 16 August — 2 6 September 6 3 3 October — 1 6 November - 1 i December 1 1 TOTALS 7 14 34 TABLE IV INCIDENCE BY ELECTORAL WARDS Ward 1947 Confirmed Cases Benign Lymphocytic Meningitis 1947 Confirmed Cases Poliomyelitis 1949 Confirmed Cases Poliomyelitis Highgate - — 13 Muswell Hill 1 5 11 Crouch End - 1 1 Central Hornsey 2 2 2 North Haringey 1 1 1 South Haringey 1 2 2 Stroud Green 1 3 2 Finsbury Park 1 — 2 TOTALS 7 14 34 In reviewing the occurrence of the disease in the borough in these three years, no major significant fact has come to light in the epidemiology of the disease nor information with regard to assistance in the prevention other than the precautions taken in past years. In the 1949 epidemic, the following case relationships, however, came to light:— M.S. (female aged 4½) was taken ill on 12.6.49 with fever, headache, stiffness of the neck and aching limbs. During convalescence there was difficulty in walking. This illness was not notified. C.B. (female aged 6f) a contact of M.S. was taken ill on 19.6.49 with fever, was in bed for 4 days and made an uninterrupted recovery. C.D. (female aged 4¾) a contact of M.S. and staying in the same house as C.B. was taken ill 19.6.49 and notified as a case of poliomyelitis and confirmed as such. I.G. and M.G. (males aged 6 2/12 and 10½) contacts of C.B. did not have any illness as far as is known. R.L. (female aged 4 10/12) living next door to M.S. and a contact of her but not so far as is known of the others, was taken ill 11.7.49 and diagnosed as a case of poliomyelitis and confirmed. N.T (male aged 18 years) living next door to C.B. was taken ill and diagnosed as suffering from poliomyelitis on 9.7.49. He died 11.7.49. The elder brother of N.T. had a short illness a little while after N.T. died. P.T. younger brother of N.T. experienced no illness. About this time P.T. was in contact with P.W. (male aged 4 4/12) who fell ill and was diagnosed and confirmed as a case of poliomyelitis on Sunday, July 17th. On the previous Friday he had undertaken considerable physical exercise at school but he did not develop paralysis. By comparison a boy S.S. aged 7 in the same class as P.W. was notified and confirmed as a poliomyelitis case on the same day and he did have paralysis especially in the legs. It is difficult to build a hypothesis round these cases since it is not known whether the illness experienced by M.S. was an abortive case of poliomyelitis, though probable. Further it was not known whether M.S. was specifically exposed to infection; but the train of events occurring after 12.6.49 is not without interest. Emphasis is placed on the need for notification during an epidemic of all suspected cases, particularly where illness occurs in close contacts. In an intensive study of the epidemiology of poliomyelitis in Auckland, New Zealand (1948), Dr. Thompson found that there was a tendency for the onset of the illness in related cases to be grouped around the fifth and eighteenth days though the range was from 1 to 110 days. With regard to the spread of infection, Dr. Thompson feels that lax personal hygiene plays an important role. It is thought that the organism causing poliomyelitis may have a poor capacity for passing from person to person rather than a wide variation in its incubation period. There is much controversy concerning the epidemiology of this disease but within the limits of our present knowledge it would not be unreasonable to postulate that in the series of related cases instanced here that M.S. could well be the originator of the train of events occurring from 12.6.49 to 17.7.49. 30 PRINTED By R0BERJS& NEWTON LP 1 ondon '