ISL 80 METROPOLITAN BOROUGH OF ISLINGTON ANNUAL (ABRIDGED) REPORT of the MEDICAL OFFICER OF HEALTH: V. FREEMAN, M.R.C.S., L.R.C.P., D.P.H. 1941. Public Health Department, Town Hall, Upper Street, N.1, To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington. I beg to submit the Annual Report for 1941, which is again an interim statement. Dr. G. Clark Trotter, my predecessor, whose retirement was mentioned in the Annual Report for 1940, retired at the end of February 1941, and my responsibility for the Public Health Department is therefore for the last ten months of the year. In accordance with instructions received, total population figures are not quoted, but the birth rate is slightly loss than lost year, whilst the death rate is somewhat higher. The rate of deaths from puerperal causes shows a considerable increase on 1940, although the total numbers are small. The infant mortality rate, at 59 per 1,000 live births, is an increase upon the previous year, which was exceptionally low, but it is of some interest to note that total maternal mortality and infant mortality rates in Islington for both 1940 and 1941 are very close for both years to the corresponding rates for the whole of London. It should also be noted that deaths from other violent causes include those due to enemy action. In common with other areas, the rate of increase of the mortality and occurrence of now cases of tuberculosis gives some cause for concorn. In proportion to the population, there wore 40$ more now cases of pulmonary tuberculosis in 1941 than in 1938, and 23$ more non-pulmonary cases. The death rates from pulmonary tuberculosis showed an increase of 67$ and non-pulmonary tuberculosis of 55% for the same years. Those increases in both incidence and mortality no doubt reflect in part population changes due to call-up for the Armed Forces, but the general trond3 unfortunately repeat the experiences of the last war. Among the factors which may be responsible for this deterioration are increased strain duo to long hours of work, restricted facilities for holiday and recreation, blackout and poor ventilation, local overcrowding, shelter life during the 'blitz' period with disturbance of normal hours of sleep and rest, and food restrictions. It is not possible at present to express any accurate opinion on the relative importance of those factors. Additional work and responsibilities were placed upon the Department during the year arising out of the introduction of the Government's scheme for Wartime Nurseries. The first Wartime Nursery in the Borough, for 50 children, was opened towards the and of 1941 at the Council's pre-war nursery in Scholefield Road, and a number of other nursories wore also projected and opened later, of which mention will be made in the 1942 Report, Owing to the increase in scabies and verminous conditions, a scheme for the extension of the Council's Cleansing Station was submitted and approved. The scheme doubles the Council's existing facilities. The main features of Infectious Diseases (apart from tuberculosis) to bo recorded for 1941 are very considerable increases in both whooping cough and measles. The number of cases of dysentery also showed a marked rise. The Islington (Chicken-pox) Regulations 1930 wore rescinded by the Minister of Health, so that chickon-pox is no longer notifiable in Islington. With regard to Diphtheria Immunisation, clinic activities partially suspended during the earlier part of the war were recornmonced in January 1941, and there was nearly a fourfold increase in attendances over the best pre-war year, in spite of the smaller child population. This was very satisfactory, but still insufficient materially to affect the general incidence of diphtheria in the Borough. P.T.O. Shelter health, including 16 Medical Aid Posts in public and L.P.T.B. tube shelters, and the Casualty Services, comprising First Aid Posts, Mobile Units, Gas Cleansing Centres and Stretcher Parties, continued to be a responsibility of tho Department to which much attention had to be given. The Chief Sanitary Inspector and Superintendent of the Public Health Department, Mr. G.J. Bridel, retired during the year, after 37 years of loyal and devoted service to the Council. It was decided not to fill the position during the war period, and Mr. Bhrtlett and Mr. Ashwcrth wore respectively appointed to the positions of Acting Senior Special and District Inspectors. There wore a number of other staff changes. Mr. E.G. Holmes, Sanitary Inspector under the Factory Acts, retired with tho good wishes of his colleagues aftor 22 years with tho Council, and new Sanitary Inspectors appointed were Miss K.Reader, Mr. T.W.Glew, Mr. F.H.W.Pedrick and Mr. M.F.G.Randall. With regard to the clerical staff, Mr, C.L.Durbin, Deputy Chief Clerk, loft to take another appointment; Mr. Bunch, a Senior Clerk, retired with 46 years' service; and Mr. Borrott, seconded to the Food Office from the Maternity and Child Welfare Department, left to join His Majesty's Forces. Two Disinfoctors, Mr. Malcolm and. Mr. Leonard, were also called up. Miss J.Bailey was appointed Secretary of tho Tuberculosis Care Committee. It is desired to thank tho staff of the Public Health Department for their loyalty and co-operation at all times, and willing response on tho part of many (both temporary and permanent members of the staff) to carrying out exceptional work over long or unusual hours of duty. I should also liko to thank the Chairmen and members of tho Public Health and Maternity and Child Welfare Committees for their courtesy and cohsideration. V. FREEMAN Medical Officer of Health November 1942, METROPOLITAN BOROUGH OF ISLINGTON SECTION A. GENERAL AND VITAL STATISTICS. Area of the Borough 3,092 acres. POPULATION Registrar Conoral's satinate of sivilian population, Mid-year 1941 LIVE BIRTHS Totals. M. F. Birth rate per 1,000 estimated resident population Legitimate 2.772 1,440 1,332 Illegitimate 214 100 114 2,986 1,540 1,446 STILL BIRTHS Totals. M. F. Rate per 1,000 total (Live & Still) births 26.72 Legitimate 76 38 38 Illegitimate 6 4 2 82 42 40 DEATHS. Totals M. F. Death rate (unadjusted) per 1,000 population 3,508 1,842 1,665 DEATHS FROM PUERPERAL CAUSES. • Deaths. Rate per 1,000 total births Puerperal Sepsis 6 2.27 Other puerperal causes 2 0.75 8 3.02 DEATH RATE OF INFANTS UNDER CNE YEAR OF AGE. All infants per 1,000 live births 59 Legitimate infants per 1,000 legitimate live births 57 Illegitimate infants per 1,000 illegitimate live births 85 NOTIFICATION OF BIRTHS The total number of notified births, including still births from all sources, was 2,345; of this number 131 were not notified by Midwives. MARRIAGES (Provisional figures). Marriages solemnised in the Borough during the year 2,575 Not available for publication. -1- CLASSIFICATION-OF DEATHS WITH AGE DISTRIBUTICN. CAUSES OF DEATH. AGES - BOTH SEXES. Under 1 year. 1 and under 5 5 and under 15 15 and under 4-5 45 and under 65 65 and upwards All ages TOTALS. M. F. All causes. 154 49 35 475 933 1,862 3,508 1,843 1,665 1. Typhoid & paratyphoid fevers _ _ _ _ — 1 1 1 — 2. Cerebrospinal fever 2 1 - 2 3 - 8 5 3 3. Scarlet Fever - - - - - - - - - 4. Whooping Cough 3 6 - - - - 9 4 5 5. Diphtheria - 6 5 - - 11 7 4 6. Tuberculosis of respiratory system. 2 5 1 127 68 17 220 138 82 7. Other forms of tuberculosis — 6 6 10 2 3 27 15 12 8. Syphilitic disease 1 - — 6 21 14 42 22 20 9. Influenza - 3 - 5 9 21 38 19 19 10.Measles 3 1 - - - - 4 3 1 11.Acute poliomyelitis and polioencephalitis — — — — — — — — — 12.Acute infectious encephalitis - - - 2 3 1 6 4 2 13.Cancer of buccal cavity and œ sophagus (m) — — _ — 13 28 41 41 — Cancer of uterus (F) - ■ - - 5 11 6 22 - 22 14.Cancer of stomach & duodenum - - - 7 40 49 96 51 45 15.Cancer of breast — - — 3 22 15 40 2 38 16. Cancer of all other sites - — - 15 96 151 262 147 115 17. Diabetes - — — 2 11 14 27 12 15 l8. Infra-cranial vascular lesions — — — 4 57 160 221 91 130 19. Heart disease - - 4 30 153 608 795 363 432 20. Other diseases of the circulatory system _ — — — 30 76 106 62 44 21. Bronchitis 7 4 - 14 79 204 308 195 113 22. Pneumonia 32 6 - 28 59 107 232 131 101 23. Other respiratory diseases - 1 - 4 13 14 32 12 20 24. Ulceration of the stomach or duodenum — — — 7 26 19 52 39 13 25. Diarrhoea under 2 years of age 18 1 — — — — 19 9 10 26. Appendicitis - - 1 3 5 2 11 5 6 27. Other digestive diseases 1 - - 11 17 49 78 30 48 28. Nephritis - - 1 13 30 41 85 35 50 29. Puerperal and post-abortive sepsis — — — 6 — _ 6 — 6 30. Other maternal causes - . - - - 2 - — 2 — 2 31. Premature birth 35 - - - - - 35 22 13 32. Congenital malformations, birth injury, infantile disease 33 2 4 1 1 41 21 20 33. Suicide - - 1 10 10 6 27 12 15 34. Road traffic Accidents 1 - 2 5 7 12 27 21 6 35. Other violent causes 12 6 11 115 96 80 320 184 136 36. All other causes 4 1 3 35 51 163 257 140 117 -2- SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. MATERNITY AND CHILD SERVICES. WELFARE CENTRES There are four Voluntary Welfare Centres as follows, each of which has received a grant from the Borough Council for tho year ending March 31st, 1941. Amount of grant. North Islington Maternity Centre & School for Mothers, North £4,069 8 & 9 Manor Gardens, Hollo way, N.7. South Islington Mothers' and Babies' Welfare Centre, South £2,251 6, Cellophane Road, N.l. East Islington Mothers' and Babies' Welfare Centre., East £2,137 32, Dray ten Park, N.5. West Islington Infant Welfare Centre, 42 Richmond Avenue, N.l. West £1,692. SPEC IAL FIXTURES IN 1941. With the cessation of air raids over London after May 194-1, Child Welfare work tended to return towards normal, and attendance at the Welfare Centres increased. In the latter half of the year, the Government campaign urging more women to take up industrial employment, raised the need to make provision for the care of their children, and in November the first War-time Day Nursery in the borough was opened, at the Council's day nursery premises in Scholefield Road. In December, the Ministry of Food asked for the co-operation of Welfare Authorities in the distribution of vitamin products to young children, and the Maternity & Child Welfare Office and the Child Welfare Centres have been issuing, on behalf of the Ministry of Food, Government cod liver oil compound and fruit juices. SUMMARY. 1. Ante-Natal Clinics:- North South East West Total Number held weekly Number of expectant mothers who attended xx3 C3) -1 (1) 1 (1) 1 (1) 6 (5) 387 (452) 105 (153) 172 (193) 164 (122) 828 (920) 2. Post-Natal Clinics:- North South East West Total Number held weekly Number of mothers who attended XX1 (1) -1 (1) 1 (1) 1 (1) xx-4 (4) 94 (128) 17 (20) 54 (87) 32 (43) 197 (278) 3. Consultations for Children up to 5 years of ape. Total number of children who first attended at the centres during year, and who, on the date of their first attendance were:- North South East West Total (i) Under 1 year 711 (842) 360 (515) 316 (469) 423 (525) 1 1810 (2351) (ii) 1-5 years 159 (172) 81 (92) 76 (I30) 100 (101) ) 416 (495) (Figures for 1940 in brackets). xx North Centre - including one combined ante-natal and post-natal clinic. - South Centre - one each fortnightly. -3- 4. Home Visiting North South East West Total. Number of visits made to:- (i) Expectant mothers - (a) First visits 292 90 137 146 665 (b) Total visits 1330 179 495 370 2,374 (ii) Children under 1 year Total visits 3419 2767 2230 3359 11,775 (iii) Children 1-5 years Total visits 5701 4531 2475 6729 19,436 5. Number of children who attended at the centres during the year, and who, at the end of the year, were:- (i) under 1 year 591 399 249 336 1,575 (ii) 1-5 years 1144 553 446 820 2,963 MINICIPAL HEALTH VISITORS. One of the Council's Health Visitors was seconded for duty in a reception area in September of this year. In January, the work of the Health Visitors returned to more normal lines, and considerable time has had to be devoted in endeavouring to trace children drifting back to London from reception areas. Summary of Visits. Totals. 1. Births, First Visits, Infants under 1 year 2,137 2. Births, Re-visits, Infants under 1 year 3,113 3. Visits to children between 1st and 2nd years 2,858 4.Visits to children between 2nd and 5th years 8,343 5. Visits re Stillbirths 41 6. Deaths, Visits re Infants under 1 year 42 7. Deaths, Visits re Children 1-5 years 4 8. Ante-natal Home visits 1,358 9. Puerperal(Fever, Home Visits (pyrexia, Home visits 2 10. Attendances at Welfare Centres 163 11. Other work by direction 4,085 12. Visits declined - 13. Visits House Shut 7,623 14. Visits Inopportune 10 TOTAL VISITS 29,779 CHILD-LIFE PROTECTION. Number of persons on register prepared to receive children at end of year 35 Number of children at end of year 42 HOME HELPS. 87 cases were attended by Home Helps, the cost to the Council being £245.7.11d. SUPPLY OF SUPPLEMENTARY QUANTITIES OF MILK TO MOTHERS AND YOUNG CHILDREN. Under the National Milk Scheme certain quantities of liquid and/or Dried Milk are supplied to all expectant mothers and children under 5, either at 2d. a pint for wet milk, or l/2d. a packet for Dried Milk, or free, according to a Ministry of Food Assessment Scale. Children up to the age of 12 months are also eligible for a supplementary quantity of wet or Dried Milk, and in respect of those cases where the first pint or packet is assessed as free the Council have agreed to bear the cost of the supplementary quantity. During 1941 the total quantity of milk so supplied through the Council scheme and paid for by the Council was:- 1721 pints of liquid milk £25.16. 5d. I8I8¼ lbs, of Dried milk £90.16.11d. No. of recipients of all above - 561. -4- SUPPLY OP VITAMIN PREPARATIONS FOR CHILDREN UNDER FIVE. The Ministry of Health in conjunction with the Ministry of Food initiated a scheme to provide Vitamin products in the form of Fruit Juice for children up to the age of 2 years and Cod Liver Oil for all children up to the age of 5 years. Maternity & Child Welfare Authorities were asked to co-operate in the distribution of those products. The Scheme came into force at the beginning of December 1941, and the Maternity & Child Welfare Office in the Town Hall and the Voluntary Welfare Centres co-operated in the distribution of the Fruit Juice and Cod Liver Oil. SUPPLEMENTARY COUPONS FOR EXPECTANT MOTHERS. Tho Ministry of Health in conjunction with the Board of Trade agreed that Welfare Authorities should co-operate in respect of a special issue of coupons to enable expectant mothors to buy materials for the garments which should be made for a baby before its birth. This scheme came into operation on August 5th, and arrangements were made to circularise all Medical Practitioners, Midwives, and Hospitals with Ante-Natal Clinics so that this supplementary issue of coupons became as widely known as possible. Special Certificates were provided by the Council for signature by a Medical Practitioner or Midwife which the expectant mother had to produce in order to obtain the supplementary coupons. From August 5th to the end of December 194-1, 1644 Expectant Mothers resident in the Borough of Islington were issued with supplementary coupons on the production of a Medical Certificate complying with Board of Trade regulations. DAY NURSERIES. The Council's Grants to the Islington Day Nurseries, evacuated to the country, were continued by grants of:- Lower Holloway Day Nursery £260. South Islington (Pro Patria) Day Nursery £600 A grant was also continued to the Claremont Mission Day Nursery - £50. A war-time Day Nursery, accommodating 50 children, was opened on the 25th November in the premises used for the Miriam Price Coleman Day Nursery and Clinics Centre. MATERNITY HOSPITAL GRANTS Contributions for maternity cases admitted to beds at Maternity Hospitals at the rate of 10/- per case were:- University College Hospital £36. 0. 0. NURSING IN THE HOME. The following payments were made to the North London Nursing Association:- Maternity & Child Welfare £5. 1. 3. Visits (Public Health) £17.11. 3. BACTERIOLOGICAL EXAMINATIONS. TOTAL POSITIVE NEGATIVE For Diphtheria Bacilli 521 45 478 Tubercle Bacilli 185 26 159 Typhosus Bacilli 3 1 2 PROVISION OF INSULIN. 20 patients received assistance during the year, the cost to the Borough Council was £52.15.11d. ISLINGTON CREMATORIUM. There were 67 cremations during the year at the Council's Crematorium at East Finchley. -5- SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. SUMMARY OF WORK DONE BY DISTRICT SANITARY INSPECTORS. During the year 23,431 inspections (including re-inspections),, were carried out by the Sanitary Inspectors, made up as follows:- House to House inspections 976 » t Other premises inspected 3,962 Re-inspection's, Calls made, etc. 18,023 Ice Cream Premises inspected . . - Dairies and Milk Purveyors' premises' inspected 32 Inspections - Council's property 6 Stables inspected 3 Yards inspected 32 Urinals attached to Public Houses inspected 40 Children & Young Persons Acts 13 Premises re Vermin 81 Premises re Rats and mice 258 Premises (re Water Certificates) inspected - Rag and Bone Dealers 2 Smoke observations 3 23,431 Notices served - Intimation (Public Health (London) Act, 1936) 1,794 Notices served - Statutory (Public Health (London) Act, 1936) 179 CLEANSING STATION. Number of children (L.C.C. Scheme) cleansed 4,832 Number of adults treated 701 Number of baths 1,894 The following work was also carried out for persons referred by the Borough of:- No. of adults treated No. of baths. Stoke Newington 47 123 St. Pancras 7 20 Persons from Public Shelters No. 14 Baths 29. # DISINFECTION. During the year 917 disinfections were carried out after cases of infectious or other'diseases. In addition 262 rooms were disinfected for the presence of vermin. At the disinfecting station 62,208 articles of bedding, etc., were disinfected. -6- DISINFESTATION. HYDROGENIDE FUMEGATION. No. of times Large Chamber used. Furniture and effects of families rehoused including furniture and effects for use by Homeless Persons 106 Bunks and bunk fitments 3 No. of tines Small Chamber used. Miscellaneous (pianos, mattresses, etc.) 3 TOTAL 112 Thanks are due to the Cleansing Department for their assistance in working tho boiler plant at Ash burton Grove Depot. FACTORIES. The number of inspections, re-inspections & calls etc. was 7,548 416 defects were found, and remedied in 325 instances. RATS AND MICE (DESTRUCTION) ACT, 1919. 251 complaints were received and 491 inspections carried out. 53 notices were served and 23 defective drains repaired. SUMMARY OF PROSECUTIONS DURING YEAR 194-1. Statute Total Prosecutions Successful Dismissed Amount of Withdrawn Penalties Costs Received Public Health (London) Act 1936 6 5 1 – – £15.15.0 Food & Drugs Act, 1938 2 1 1 – – 5. 5.0. 8 6 2 – – £21. 0.0. SECTION D. HOUSING. Work under the Housing Act has been at a standstill owing to the War, but 4 underground rooms have been made to comply with regulations. -7- SECTION E. INSPECTION AND SUPERVISION OF FOOD. MILK AND DAIRIES ORDER, 1926. Summary of Register. Number on Reg. 31.12.40. Additions to Reg. Removals from Reg. No. on Reg. 31.12.41 Dairies 194 4 36 162 Purveyors of Milk in sealed containers only 458 19 92 385 Registered Purveyors of Milk dealing from registered premises outside the Borough 93 1 94 Arising from routine inspections it was found that 92 purveyors of milk (in sealed cartons only) ceased selling milk and 36 premises had ceased to exist as dairies and were remuved from the register. SUMMARY OF VISITS BY MILK & DAIRIES INSPECTOR. DAIRIES. Routine inspections 514 Inspections for registration of 4 518 MILK-SHOPS (Milk sold in sealed containers' only) . Routine inspections 576 Inspections for registration, of 19 595 DAIRIES AND MILK SHOPS INSPECTED UNDER THE MILK (Special Designations) ORDER, 1936. 41 VEHICLES INSPECTED. 30 MISCELLANEOUS VISITS 64 1,248 (The District Sanitary Inspectors also made 32 visits to Dairies and Milk Purveyors' premises - vide their Summary of work). ICE CREAM PREMISES. Number of premises on the Register at the end of 1940 553 Number of premises added during the year Nil Number of premises removed during, the year 40 Number of premises on the Register at end of 1941 513 Routine inspections 235 ARTIFICIAL CREAM PREMISES. Number of premises on Register at end of 1941 4 Routine Inspections 6 During the year 20 notices intimating nuisances or defects were served, and 29 warning letters sent to Dairymen, Milk Purveyors, and Ice Cream Vendors drawing their attention to the contravention of the Acts and Regulations relating to their businesses. MILK (Special Designations) ORDER, 1936. During the year 1941 the following applications wore made for licences -8- under the provisions of the above Order, to enable the persons to sell specially Designated Milk:- Licences ranted under the Milk (special Designations) Order, 1936 & 1938. Designation. No. of applications made and granted. Tuberculin Tested (Dealer) 20 Tuberculin Tested (Supplementary) 3 Tuberculin Tested (Pasteurised) - Accredited (Dealer) - Accredited (Supplementary) — Pasteurised (Pasteuriser) 1 Pasteurised (Dealer) 58 Pasteurised (supplementary) _6 88 UNDERGROUND BAKEHOUSES. No. of Premises 51 " " Routine Inspections 216 " " Intimation Notices served 8 " " Letters sent 2 PHARMACY & POISON'S ACT, 1933, etc. No. of visits made 448 " " letters sent 6 MEAT AND OTPIER FOODS. The Inspector of Heat and Other Foods (Mr. A.W. Haydock) reports that during the year six private slaughter houses for the preparation of butchers' meat held licences, but owing to the control of meat supplies by the Ministry of Pood no slaughtering of animals was carried on at these premises. One slaughter house for the slaughter of horses for human consumption was licensed. This was visited 112 times and 409 horses were slaughtered during the year. slaughtering establishments of the Ministry of Pood is situated in this Borough. Pood destroyed or otherwise disposed of so as to prevent its use for human consumption totalled 17 tons, 6 cwt., 0 qtrs., 12 lbs. VISITS MADE TO SHOPS ETC. , BY THE INSPECTOR OP MEAT AND OTHER FOODS WERE AS FOLLOWS.: During the year 939 visits were paid to various food shops, markets, stalls,etc. DISEASES OF ANIMALS ACT - ANTHRAX ORDER, 1928. On three occasions during the year, the above Order relating to animals was applied in the Borough, the infected material was destroyed and premises disinfected, as required by the Ministry. PENSIVE TRADES. The offensive trades operating in the Borough are three tripe dressers, five gut scrapers and one knackers' yard. Twenty five visits were made during the year and no breach of the Regulations was observed. Three skin dressers are under the supervision of the Inspector of Workshops. BY-LAWS FOR THE PROTECTION OF FOOD. By-laws for this purpose were made under Public Health (London) Act, 193&, and came into force during 1937. No prosecution has been taken during the period under review. -9- SLAUGHTERMEN'S LICENCES. 3 new applications for licences were received, and granted after investigations, making a total of 21+ licensed slaughtermen on the register at the end of the year. FOOD & DRUGS ACT, 1958. 826 samples (246 formal, 580 informal), were submitted to the Public Analyst for examination. Of these 17 were adulterated (or 2.06 per cent.), as shown in the following summary:- Formal. Informal. Beef sausage 1 Salmon and shrimp paste 2 Mixed sausage 1 Pork sausage 3 Pork Brawn 1 Pork Brawn 1 Coffee 1 Shredded suet with flour 1 Tapioca 1 Sulphur ointment 1 Beef sausage 1 Drinking chocolate 1 Milk 1 Lemon juice 1 SHOPS ACT, 1954. The visits made were 777. In addition the Inspector made 724 visits for other reasons, e.g., War Damaged foodstuffs, etc. SECTION F. PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES. TUBERCULOSIS: NEW CASES AND MORTALITY DURING 1941. Age Periods NEW CASES. DEATHS. Respiratory N on-Respiratory Respiratory Non-Respiratory M. F. M. F. M. F. M. F. 0- – 2 – – – 2 – – 1- 4 3 3 3 1 4 4 2 5- 7 2 7 4 - 1 5 1 15- 51 54 5 10 72 55 4 6 25- 45 43 2 3 35- 53 17 2 – 53 15 - 2 45- 30 10 1 2 55- 23 3 1 3 65 and upwards 18 4 1 2 12 5 2 1 Total for all ages. 231 138 22 27 138 82 15 12 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS 1950. The total number of cases of tuberculosis on the Register as at 31st December, 1941 was:- 1,493 (Pulmonary - Males 730, Females 522; Non-pulmonary - Males 120, Females 121.) -10- DISPENSARY REGISTERS: ' ' Pulmonary. N on-Pulmonary. TOTAL GRAND TOTAL Adults Children Adults Children Adults Children Number of definite cases of tuberculosis on Dispensary Registers at end of the year M. F. M. F. M. F. M. F. M. F. M. F. 618 463 52 45 68 81 49 42 686 544 101 87 1,418 WORK OF THE TUBERCULOSIS DISPENTSARIES. North South Number of attendances 3,450 2,784 New casea and contacts examined 747 316 Number of visits by Tuberculosis Officers 232 101 Number of visits by Nurses 827 1,860 LIGHT TREATMENT 2 patients received "Ultra Violet Ray" treatment, the cost to the Council being - £2.16.0d. TUBERCULOSIS CARE COMMITTEE Miss Bennett became Acting Temporary Secretary at the beginning of the year and Miss J. Bailey was appointed as Temporary Secretary on 7th July 1941. 305 new eases came to the notice of the Committee; 684 interviews were conducted. 1735 letters sent, and 806 visits made. ARTIFICIAL PTE1THOTHORAX. 83 patients received treatment at a total cost of £300. 6. 0. EXTRA NOURISHMENT 99 cases received extra nourishment at a total cost of £398.12,6. BEDS AND BEDDING. 1 patient, is still provided with bed find bedding. DENTAL TREATMENT 5 patients received treatment with assistance under the Council's scheme. -11- NOTIFIABLE INFECTIOUS DISEASES AMD DEATHS LURING THE YEAR 194-1. DISEASES. No. of notifications. No. of Deaths. Cases removed to hospital Scarlet Fever 237 _ 225 Diphtheria 174 11 174 Enteric Fever (including Paratyphoid) 13 1 12 Puerperal Fever 8 4 7 Puerpera 1 Pyrexia 49 - 35 Acute Primary & Influenzal Pneumonia 141 16 13 Ophthalmia Neonatorum 23 - 21 Encephalitis Lothr.rgica 1 5 1 Cerebro-Spinal Fever 48 8 48 Anthrax - - - Dysentery- 73 5 73 Malaria - - - Erysipelas 120 3 70 *Chicken Pox 153 - 41 Measles 1013 4 314 Whooping Cough 841 8 338 Acuto Poliomyelitis 2 - 2 Acute Polioencephalitis 1 - 1 Ceased to be notifiable from 1st September 1941. SMALLPOX AND VACCINATICN. No case of smallpox was notified. Of the 3658 births returned on the "Birth List Sheets" during 1940, 1307 were successfully vaccinated. DIPHTHERIA IMMUNISATION. Diphtheria immunisation was recommenced with the re-opening of Clinics on the 1st January, when a considerable number of applications was received as a result of local propaganda work and aided by broadcasts by the Ministry of Health. This was followed in the Borough by intensive propaganda through L.C.C. Schools and Welfare Centres and very satisfactory attendances were maintained throughout the year. In all, 230 clinics wore held, at which attendances totalled 15,860, giving an average attendance per session of 68.95. The sessions were held as under North Islington Welfare Centre, Manor Gardens, N,7. 53 First Aid Post, Mildmay Conference Hall, Newington Green, N.l 39 First Aid Post, London Fever Hospital, Liverpool Road, N.l 53 At London County Council Schools in Borough 85 230 Number of children who received full course of immunisations:- Under 5 years 1,400 Over 5 years 1,86l 3,261 Of the above, 1,782 were Post-Schick-Tested and in only 5 cases were further injections necessary. In addition to the above, 1,136 children were Primary SchickTested, with a negative result, and did not therefore require immunisation, so that the total number of children seen at the Clinics during the year who were either protected or found to be immune was 4,397. There were also 228 Islington children dealt with by the London County Council at the schools they attended in St. Pancras. -12-