ISL 81 METROPOLITAN BOROUGH OF ISLINGTON ANNUAL (ABRIDGED) REPORT of the MEDICAL OFFICER OF HEALTH. V. FREEHAN, M.R.C.S., L.R.C.P., D.P.H. 1 9 4 2. Public Health Department, Town Hall, Upper Street, N.1. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington. I have the honour to submit the Annual Report for 1942, which is an interim report as directed by the Ministry of Health. Total Population figures are not quoted, but the vital statistics of the Borough furnish, in the main, a satisfactory picture, particularly for the fourth year of the War. There is a considerable decrease in the death rate and an increase in the birth rate over the previous year. The infant mortality rate at 54 per 1,000 live births shows a small decrease as compared with 1941, and it is of some interest to note that the mortality rate of 56 per 1,000 for illegitimate births is only very slightly higher than for all births. The tendency to an increase in Tuberculosis noted in 1941, is still a matter of some concern. During the past year the rate for new cases of pulmonary tuberculosis was 35% higher than in 1938, and 40% higher for non-pulmonary cases. The death rate for pulmonary tuberculosis has increased by 29% over 1938 and for non-pulmonary tuberculosis by 66%. The pulmonary tuberculosis figures are more favourable than for 1941, but the non-pulmonary figures are less favourable, although in the letter class the total numbers involved are comparatively small. Deaths from other violent causes were considerably lower. Maternity & Child Welfare work has increased in every way since 1941 and each of the Welfare Centres has had to open additional ante-natal children clinics. Increasing employment of women in industry has meant an ever-growing demand for the provision of Day Nursery accommodation for the children of women in war work and in 1942 a further 7 War-time Day Nurseries were opened, making 8 in all, and providing accommodation for 403 children. In addition, the Borough Council arranged to cooperate with the Regional Welfare Office of the Ministry of Labour and National Service in operating a scheme for the registration of Daily Guardians. This grew to considerable dimensions by the end of the year. The Council's Cleansing Station dealing with Scabies and other verminous conditions was greatly extended in 1942 by the doubling of its previous accommodation. The Public Health Committee appointed a state registered Nurse in Charge and additional attendants, including male attendants, were engaged. Diphtheria Immunisation made considerable progress in 1942. Towards the end of the year Health Visitors, both Borough Council and Voluntary Welfare Centre, commenced work on the special campaign requested by the Ministry of Health to encourage immunisation in children under 5 years of age by intensive home visiting. The attendances at Clinics showed a very great increase over 1941 which was itself a record year for the Borough. With regard to the staff, the Chief Clerk, Mr. W. J.Wolfe, retired after 48 years service and Messrs. George, Edis, McAdam, Owen and Causton of the permanent staff left during the year to join His Majesty's Forces. There were also many changes among the temporary staff. My thanks are again due to Dr. K.M.Hirst, Deputy Medical Officer of Health and to all members of the staff, both permanent and temporary, of the Public Health Department. I also desire to thank the Chairman and Members of the Public Health and Maternity & Child Welfare Committees for their continued understanding of the difficulties of the department brought about by war-time circumstances and their consideration in all matters. V. FREEMAN. Medical Officer of Health December, 1943. METROPOLITAN BOROUGH OF ISLINGTON SECTION A. GENERAL AND VITAL STATISTICS. Area of the Borough 3,092 acres. POPULATION Registrar General's estimate of civilian population, Mid-year 1942 LIVE BIRTHS Totals. M. F. Legitimate 3,117 1,592 1,525 Illegitimate 251 150 121 Birth rate per 1,000 estimated resident 3,368 l,722 1,546 population. STILL BIRTHS Totals. M. F. Legitimate 106 52 44 Illegitimate 10 5 5 Rate per 1,000 total (Live & Still) births 33.29 116 57 49 DEATHS Totals. M. F. 2,852 1,426 1,426 Death rate (unadjusted) per 1,000 population. DEATHS FROM PUERPERAL CAUSES. Deaths. Rate per 1,000 total births Puerperal Sepsis 2 0.57 Other puerperal causes 6 1.72 8 2.29 DEATH RATE OF INFANTS UNDER ONE YEAR OF AGE. All infants per 1,000 live births 54 Legitimate infante per 1,000 legitimate live births 53 Illegitimate infants per 1,000 illegitimate live births 56 NOTIFICATION OF BIRTHS. The total number of notified births, including still births from all sources, was 3,582; of this number 419 were not notified by midwives. MARRIAGES (provisional Figures). Marriages solemnised in the Borough during the year 2,353 Not available for publication. 1 CLASSIFICATION OF DEATHS AGE DISTRIBUTION. CAUSES OF DEATH AGES - BOTH SEXES. TOTALS. All causes Under 1 year 1 and under 5 5 and under 15 15 and under 45 45 and under 65 65 and upwards All ages. M. F. 181 30 41 310 758 1,532 2,852 l.,426 1,426 1. Typhoid & paratyphoid fevers - - - - - - - - - 2. Cerebrospinal fever 1 — 1 — — — 2 1 1 3. Scarlet Fever — - - — — — — - - 4. Whooping Cough 8 4 - - - - 12 8 4 5. Diphtheria - 1 1 - - - 2 2 — 6. Tuberculosis of respiratory system 1 1 4 97 54 16 173 108 65 7. Other forms of tuberculosis 1 4 5 9 6 3 28 13 15 8. Syphilitic disease - - - 1 5 9 15 9 6 9. Influenza - - - 4 5 3 12 4 8 10. Measles - 2 - - - - 2 1 1 11. Acute poliomyelitis and polioencephalitis - - - — — - - - - l2. Acute infectious encephalitis - - - 5 4 - 9 4 5 13. Cancer of buccal cavity and cesophagus (M); - - - - 6 18 24 24 - Cancer of uterus (F) - - - 5 16 7 28 - 28 14. Cancer of stomach & duodenum - - - 2 38 45 85 52 33 15. Cancer of breast - - - 9 14 16 39 1 38 16. Cancer of all other sites - - 2 15 112 135 264 154 110 17. Diabetes - - - 2 7 11 20 7 13 18. Intro-cronial vascular lesions - - - 4 50 167 221 84 137 19. Heart disease - - 1 37 157 460 655 267 368 20. Other diseases of the circulatory system - - - 4 25 80 109 60 49 21. Bronchitis 9 3 2 4 53 119 190 109 81 22. Pneumonia 15 2 1 14 48 92 172 96 76 23. 0ther respiratory diseases - 1 1 6 l2 21 41 22 19 24. Ulceration of the stomach or duodenum - - - 3 18 18 39 26 13 25. Diarrhoea under 2 years of age 29 1 - - - - 30 18 12 26. Appendicitis - - - 2 3 6 11 6 5 27. Other digestive diseases 1 1 2 4 23 32 63 29 34 28. Nephritis 1 2 - 11 16 44 74 35 39 29. Puerperal and post-abortive sepsis - - - 2 - - 2 - 2 30. Other maternal causes - - - 5 1 - 6 — 6 31. Premature birth 53 - - - - - 53 21 32 32. Congenital malformations, birth injury, infantile disease 48 1 - 3 1 2 55 32 23 33. Suicide -- - - 9 11 6 26 13 13 34. Road treffic accidents - - 8 3 9 10 30 21 9 35. Other violent causes 7 3 9 7 21 42 89 42 47 36. All other causes 7 4 4 43 43 170 271 137 134 - 2 - SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. MATERNITY AND CHILD WELFARE SERVICES. WELFARE CENTRES There are four Voluntary Welfare Centres as follows, each of which has received a grant from the Borough Council for the year ending March 31st, 1942. Amount of Grant: North Islington Maternity Centre and School for Mothers, 8 & 9 Manor Gardens, Holleway, N.7. Forth £ 3,510 ' South Islington Mothers' and Babies' Welfare Centre, 6, Clophane Road. N.l. South £ 1,323 East Islington Mothers' and Babies' Welfare Center, 32, Drayton Park, N.5. East £1,430 West Islington Infant Welfare Centre, 42, Richmond Avenue, N.l. West £ 1,533 SUMMARY: 1. Ante-Natal Clinics:- North South East West Total Number held weekly - xx 3 1 1½ 1 6½ Number of expectant mothers who attended - 699 209 204 224 1,336 2, Post-Natal Clinics:- Number held weekly - xx 1 1 1½ 1 4½ Number of mothers who attended - 138 32 59 35 264 3, Consultations for Children up to 5 years of age Total number of children who first attended at the Centres during the year, and who, on the date of their first attendance were:- North South East West Total (i) Under 1 year 727 436 468 526 2,157 (ii) 1-5 years 1,388 106 140 102 1,743 xx North Centre - including one combined ante-natal and post-natal Clinic. 4. Home Visiting:- North South East West Total Number of visits made to - (i) Expectant mothers - (a) 1 First visits 536 194 273 215 1,218 (b) Total visits 2,313 302 817 520 .3,952 (ii) Children under 1 year - Total visits 4,155 3,897 3,537 3,440 15,029 (iii) Children 1-5 years - Total visits 5,744 4,384 3,123 7,079 20,330 3 5. Number of children who attended a the Centres during the year, and who, at the end of the year were:- North South East West Total (i) Under 1 year 727 386 370 432 1,915 (ii) 1-5 years 1,388 770 579 876 3,613 MUNICIPAL HEALTH VISITORS: One of the Council's Health Visitors has been seconded to other work for the Ministry of Health, and the temporary Health Visitor, who had been appointed in order to cope with extra work caused through Civil Defence etc., resigned at the end of August, and no other appointment was made in her place. The normal work of the Health Visitors had been resumed by the beginning of this year, but visiting gradually became more difficult owing to the increasing number of women engaged on war-work. At the end of the year the Ministry of Health urged the use of Health Visitors in a special drive in connection with the Diphtheria Immunisation of children under 5. The Health Visitors also had additional work at the Councils Diphtheria Immunisation Clinics. The Child Protection Visitor took over, in addition to her other work, the visiting of prospective Daily Guardians and reporting as to the suitability of them and their homes for registration under the Council's Scheme. Summary of Visits: Totals 1. Births, First Visits, Infants under 1 year 2,911 2. Births, Re-visits, Infants under 1 year 4,014 3. Visits to children between 1st and 2nd years 3,419 4. Visits to children between 2nd and 5th years 7,807 5. Visits re Stillbirths 92 6. Deaths, Visits re Infants under 1 year 62 7. Deaths, Visits re children 1-5 years 4 8. Ante-natal Home Visits 1,426 (Fever, Home Visits 1 9. Puerperal (pyrexia Home Visit 1 10. Attendances at Welfare Centres 309 11. Other work by direction (which includes Clinics and visits re Diphtheria Immunisation) 4,127 12. Visits declined 15 13. Visits house shut 6,463 14. Visits Inopportune 13 Total Visits 30,864 CHILD LIFE PROTECTION: Number of persons on register prepared to receive children at end of year 41 Number of children at end of year 48 HOME HELPS: 138 cases were attended during the year, the cost to the Council being £374. 4. 10d. The number of hours worked by Home Helps was increased in September 1942 from 30 to 40 hours per week, and the rate of pay brought into line with the local rates of the Joint Industrial Council. This meant an increase in the cost of the services of a Home Help from 30/11d per, week to 50/5d per week. The number of approved Home Helps on the Council's Panel become less during 1942, and there were many difficulties in satisfactorily working the scheme. 4 supply of supplementry quantites of milk to mothers AND young children. Under the National Milk Scheme certain quantities of liquid 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 the Linistry 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 pay the cost of the supplementary quantity. During 1942, the total quantity of milk supplied in this way and paid for by the Council was:- No. of Recipients 458 Pints of Milk 6,893½ £125. 10. 9½d do. 1,457 Lbs. of Dried Milk 4,295¼ £202. 8. 4d SUPPLY OF VITAMIN PREPARATION FOR CHILDREN UNDER FIVE. As was reported in the Annual Report for l941, the Ministry of Health in conjunction with the Ministry of Food initiated a scheme to provide Vitamin products in the form of Fruit Juice 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 these products. The Scheme, which came into force in 1941, meant that the Maternity & Child Welfare Office at the Town Hall and the Voluntary Welfare Centres agreed to act as Distributing Centres for those vitamin products. It was found, however, during the middle of the year that owing to prossure of other work and call-up for the Forces of staff, that the Maternity & Child Welfare Office was unable to deal with this distribution, and accordingly the Ministry of Food were asked if they could make other arrangements. The Voluntary Welfare Centres continued to act as Distributing Centres, but in July those wishing to obtain these vitamins at the Town Hall were asked to obtain them from the Milk Office section of the Food Office instead of at the Maternity &. Child Welfare Office. SUPPLEMENTARY COUPONS FOR EXPECTANT MOTHERS. The above Scheme, reported in 1941, continued throughout this year, and during the year 3,763 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, at the Maternity & Child Welfare Office. MATERNITY HOSPITAL GRANTS. Contributions for Maternity cases admitted to beds at Maternity Hospitals at the rate of 10/- per case were:- University College Hospital £42. 6. 8d. Royal Free Hospital £2. 12. 0d. (Scheme altered September 1942 - in both cases to 10/- per case for a percentage of notified Births - i.e. University College Hospital 33% and Royal Free Hospital 20%). NURSING IN THE HOME. The following payments were made to the North London District Nursing Association during the year:- Visits - Maternity. & Child Welfare £21. 4. 0d. - Public Health £7. 9. 0d. DAY NURSERIES. A further 7 War-time Day Nurseries were opened in the Borough, with the approval of the Ministry of Health, during 1942, making 8 in all as listed under, providing accommodation for 403 children. An ever increasing demand for the care of the children of women in industry or wishing to go into industry made it apparent that more Day Nurseries would be required and proposals were submitted to the Ministry of Health accordingly. Places Scholefield Road N.19. 55 265, Camden Road N.7. 66 160, Hornsey Lane N.6. 64 34/5, Huntingdon Street N.1. 33 6, Clephane Road N.1. 55 23/2, Packington Street N.1. 33 23/3, Plimsoll Road N.4. 47 Pembroke Street N.1. 50 403 Total Nursery Places. 5 The Council's Grants to the Islington Day Nurseries, evacuated to the country, were continued, and were as under:- Lower Holloway Day Nursery £260 South Islington (Pro Patria) Day Nursery £600 DAILY GUARDIAN SERVICE. In addition to the Day Nurseries, the Borough Council in co-operation with the Ministry of Labour and National Service provided a Daily Guardian Service. Briefly, this Service is the registration of suitable women for the care in their own homes of one or more children belonging to women who wish to work or are already working. These women are, in the first instance, recommended by the Child Protection Visitor, and in each case a visit is paid by the Visitor to the home of the prospective Daily Guardian. The women, if approved, become eligible for a Government grant of 4/- per week in respect of each child they take into their care. This provides for day-time care only, and the Daily Guardian must conform to the rules and regulations of the scheme as laid down by the Borough Council which include regular visits with the children to the appropriate voluntary welfare centre. The scheme commenced on the 1st July 1942, and by the end of the year 97 women were approved and registered as Daily Guardians providing for the care of 152 young children under the age of 5 years. The voluntary welfare centres agreed to cooperate with the Borough Council in the working of this scheme. TRAINING OF STUDENT HEALTH VISITORS - on request of Royal College of Nursing. One student commenced October, 1942. North Centre and Council Health visitors co-operated. EMERGENCY UNIT & OBSTETRIC CONSULTANT SERVICE. This service was called out twice during 1942. INVALID CHILDRENS' AID ASSOCIATION. A grant of £35 was made to the Invalid Children's Aid Association. OTHER PUBLIC HEALTH SERVICES. BACTERIOLOGICAL EXAMINATION. Total Positive Negative For Diphtheria Bacilli 788 54 734 Tubercle Bacilli 158 19 139 Typhosus Bacilli 5 1 4 PROVISION OF INSULIN. 14 Patients received assistance during the year, the cost to the Borough Council was £ 79. 16. 0d. ISLINGTON CREMATORIUM. There were 50 Cremations during the year at the Council's Crematorium at East Finchley. 6 SECTION SANITARY CIRCUMSTANCES OF THE AREA. SUMMARY OF WORK DONE BY DISTRICT SANITARY INSPECTORS. During the year 38,377 inspections (including re-inspections), were carried out by the Sanitary Inspectors, made up as follows:- House to House inspections 1,643 Other promises inspected. 6,077 Re-inspections, Calls made, etc. 29,659 Ice Cream Premises inspected Dairies and Milk Purveyors' premises inspected - Inspections - Council's property 22 Stables inspected 2 Yards inspected 22 Urinals attached to public Houses inspected 30 Children & Young Persons Acts 23 Premises re Vermin 301 Premises re Rats and mice 590 Premises (re Water Certificates) inspected - Rag and Bone dealers - Smoke observations 8 38,377 Notices served - Intimation (public Health (London) Act, 1936) 3,486 Notices served - Statutory (Public Health London) Act, 1936) 583 CLEANSING STATION. Scabies Vermin Children under 5 years - Number treated 489 79 "of baths given 1,800 - " of treatments - 95 L.C.C. Children -Number treated 1,206 2,528 " of baths given 6,923 - Adults -Number treated 1,371 146 + " of baths given 4,538 - " of treatments - 175 + 34 of this number were given baths for body lice. DISINFECTION. During the year 1,002 disinfections were carried out after cases of infectious or other diseases. , , In addition 347 rooms were disinfected for the presence of vermin. At the disinfecting station 96,624 articles of bedding, etc., were disinfected. 7 DISINFESTATION. HYDROGEN-CYANIDE FUMIGATION. No. of times Large Chamber used. Furniture and effects of families rehoused including furniture and effects for use by Homeless Persons 68 Bunks and bunk fitments 14 . No. of times Small Chamber used. Miscellaneous (mattresses, divans, etc.) 11 TOTAL 93 Thanks are due to the Cleansing Department for their assistance in working the boiler plant at Ashburton Grove Depot. FACTORIES. The nuuber of inspections, re-inspections & calls, etc. was 5,212. 542 defects were found, and remedied- in 410 instances. Number of notices served was 132. RATS AND MICE (DESTRUCTION) ACT, 1919. 460 complaints were received and 787 inspections carried out. 88 notices were served and 22 defective drains repaired. SUMMARY OF PROSECUTIOS DURING YEAR 1942. Total Amount of Costs Statute Prosecutions Successful Dismissed Withdrawn Penalties Received Public Health (London) Act 1936 26 20 1 5 - £46.7.0. Food & Drugs Act, 1938 4 4- - £104.10.0 £29.8.0. Factories Act, 1937 2 - 1 1 - £10.10.0. 32 24 2 6 £104.10.0 £86.5.0. SECTION D. HOUSING. Work under the Housing Act has been at a standstill owing to War conditions, the resultant lack of labour and materials prohibiting any extensive repairs being carried out. 8 SECTIONE. INSPECTION AND SUPERVISION OF FOOD. MILK AND DAIRIES ORDER, 1926. Summary of Register. Number on Reg. 31.12.41 Additions to Reg. Removals from Reg. No. on Reg. 31.15.42. Dairies. 162 - 5 157 Purveyors of Milk in sealed container's only. 385 7 50 342 Registered Purveyors of Milk dealing from registered premises outside the Borough 94 1 2 93 Arising from routine inspections it was found that 50 purveyors of milk (in sealed cartons only) ceased selling milk and 5 promises had ceased to exist as dairies and were removed from the register. SUMMARY OF VISITS BY MILK & DAIRIES INSPECTOR. DAIRIES. Routine inspections 476 Inspections for registration of 2 478 MILK-SHOPS (Milk sold in scaled containers only). Routine inspections 381 Inspections for registration of 7 388 DAIRIES AND MILKSHOPS INSPECTED UNDER THE MILK (Special Designations) Regulations 1936-1941. 62 VEHICLES INSPECTED. 92 MISCELLANEOUS VISITS. 147 ICE CREAM PREMISE. Number of premises on the Register at the end of 1941 513 Number of premises added during the year 2 Number of promises removed during the year Number of premises on the Register at end of 1942 515 Routine inspections 99 ARTIFICIAL CREAM PREMISES. Number of premises on Register at end of 1942 4 Routine inspections 2 During the year 12 notices intimating nuisances or defects were served, and 28 warning letters sent to Dairymen and Milk Purveyors, drawing their attention to the contravention of the Acts and Regulations relating to their businesses. MILK (special Designations) Regulations 1936 - 1941. During the year 1942 the following applications were made for licences 9 under the provisions of the above Regulations, to enable the persons to sell specially Designated Milk:- Licences granted under the Milk (Special Designations) Regulations, 1936 - 1941. Designation. No. of applications made and granted. Tuberculin Tested (Dealer) 19 Tuberculin Tested (Supplementary) 5 Accredited Dealer) — Accredited (Supplementary) — Pasteurised (Pasteuriser) 1 Pasteurised (Dealer) 60 Pasteurised (Supplementary) 5 90 UNDERGROUND BAKEHOUSE. No. of Promises 47 " " Routine Inspections 198 " " Intimation Notices served 16 " " Letters sent 1 PHARMACY & POISONS ACTS. No. of visits made 536 FOOD & DRUGS ACT, 1938. No, of visits made for inspection of food, 243. MEAT AND OTHER FOODS. The Inspector of Meat 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 Food 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 49 times and 698 horses were slaughtered during the year. Food destroyed or otherwise disposed of so as to prevent its use for human consumption totalled 21 tons, 13 cwts., 3 qrtrs., 8 lbs. VISITS MADE TP SHOPS ETC., BY THE INSPECTOR OF MEAT AND OTHER FOODS WERE AS FOLLOWS:- During the year 943 visits were paid to various food shops, markets, stalls, etc. DISEASES OF ANIMALS ACT - ANTHRAX ORDER, 1928. On one occasion during the year, the above order relating to animals was applied in the Borough, the infected material was destroyed and promises disinfected, as required by the Ministry. QFFENSIVE TRADES. The offensive trades operating in the borough are three tripe dressers, five gut scrapers and one knackers' yard. Fifteen visits were made during the year and no breach of the Regulations was observed. Three skin dressers arc 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, 1936, and came into force during 1937. No prosecution has been taken during the period under review. 10 SLAUGHTERMAN'S LICENCES: One application for the renewal of a licence was received, and granted after investigation, making a total of 25 licensed slaughtermen on the register at the end of the year. FOOD & DRUGS ACT, 1938. (Sampling): 874 samples (367 formal, 507 informal), were submitted to the public Analyst for examination. Of these 9 were adulterated (or 1.03 per cent) , as shown in the following summary:- Formal. Milk 3 Gin 1 Whisky 1 Phosaquin Tonic 1 Informal. Sausages 1 Fruit Squashes 2 SHOPS ACT, 1934. The visits made were 2,892. In addition, the Inspector made 162 visits for other reasons, e.g. foodstuffs, rats, etc. SECTION F. PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES. TUBERCULOSIS: NEW CASES AND MORTALITY DURING 1942. NEW CASES. DEATHS. Age Periods Respiratory N on-Respiratory. Respiratory Non-Respiratory M. F. M. F. M. F. M. F. 0- 1 1 - - - 1 - 1 1- 5 3 — 5 - 1 - 4 5- 3 1 4 6 3 1 2 3 15- 21 25 8 7 25- 78 69 6 8 48 49 7 2 35- 44 20 2 - 45- 37 13 3 2 43 11 2 4 55- 31 6 - - 43 11 2 4 65- and upwards 12 4 - 2 14 2 2 1 Total for All Ages. 232 142 23 30 108 65 13 15 427 201 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS 1930. The total number of cases of tuberculosis on the Register as at 31st December, 1942 was:- 1490 (Pulmonary - Males 745, Females 519: Non-Pulmonary - Males 119, Females 107). 11 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. 578 412 47 37 50 55 26 40 628 467 73 77 1,245 WORK OF THE TUBERCULOSIS DISPENSARIES. North South Number of attendances 4,459 3,639 New cases and contacts examined 984 413 Number of visits by Tuberculosis Officers 201 130 Number of visits by Nurses 1,127 1,537 LIGHT TREATMENT: 5 patients received "Light" treatment, the cost to the Council being - £7. 19. 0d. TUBERCULOSIS CARE COMMITTEE. 305 new cases came to the notice of the Committee; 684 interviews were conducted, 761 visits were made and 2,233 letters sent. A very acceptable gift of clothing from Queen Mary's Needlework Guild was received and the receipts from the Christmas "Seal Sale" amounted to £217. 7. 9d. ARTIFICIAL PNEUMOTHORAX. 95 patients received treatment at a total cost of £353. 14. 6d. EXTRA NOURISHMENT: 118 cases received extra nourishment at a total cost of £491. 13. 10d. BEDS AND BEDDING: 6 patients were provided with bed and bedding on loan. DENTAL TREATMENT. 4 patients received treatment with assistance under the Council's scheme. 12 NOTIFIABLE INFECTIOUS DISEASES AND DEATHS DURING THE YEAR 1942. DISEASES. No. of Notifications. No. of Deaths Cases removed to hospital. Scarlet Fever 438 1 418 Diphtheria 201 2 201 Enteric Fever (including Paratyphoid) 1 - 1 Puerperal Fever 9 2 9 Puerperal Pyrexia 65 - 54 Acute Primary & Influenzal Pneumonia 86 6 16 Ophthalmia Neonatorum 20 - 9 Encephalitis Lethargica - 10 - Cerebro-Spinal Fever 19 2 19 Anthrax - • - Dysentery 41 1 39 Malaria - - - Erysipelas 92 - 60 Measles 1481 2 359 Whooping Cough 361 13 130 Acute Poliomyelitis - - - Acute Polioencephalitis - — — SMALLPOX AND VACCINATION: No case of smallpox was notified. Of the 2,319 births returned on the "Birth List Sheets" during 1941, 1,002 were successfully vaccinated. In addition, 837 children, whose births Occurred elsewhere, were vaccinated in the Borough. DIPHTHERIA IMMUNISATION. In all, 347 clinics wore held, at which attendances totalled 23,520, giving an average attendance per session of 67.70. The sessions were held as under:- North Islington Welfare Centre, Manor Gardens, N.7. 73 First Aid Post, Mildmay Conference Hall, Newington Green, N.1. 53 First Aid Post, London Fever Hospital, Liverpool Road, N.1. 52 At London County Council Schools in Borough. 126 War-Time Day Nurseries 43 347 Number of children who received full course of immunisations:- Under 5 years 3,508 Over 5 years 2,226 5,734 Of the above, 3,429 were post-Schick-Tested and in 42 cases further injections were necessary. In addition to the above 893 children were Primary Schick-Tested, with a negative result, and did not therefore require immunisation. The total number of children seen at the clinics during the year who were either protected or found to be immune was 7,405. - 13 -