ISL83 LIBRARY metropolitan borough of islington ANNUL (ABRIDGED) REPORT of the ACTING MEDICAL OFFICER OF HEALTH KATHERINE M. HIRST, M.B.,B.3.,D.P.H. 1944. Public Hea3.th 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 1944. It is again an interim report, and sets out the work of the Public Health Department under the direction of the Medical Officer of Health, Dr. Freeman, who in April 1945 was released at the request of the Ministry of Health to join the Civil Affairs branch of the Army for work in occupied territories. The year 1944 was notable for the resumption of enemy activity over London, and Islington received a considerable share of 'fly-bomb' and rocket attacks, resulting in serious deterioration of social conditions, particularly housing. Also, as a result of these attacks two day nurseries were rendered unusable, but fortunately without casualties to children or staff, and three Welfare Centres were damaged but the work therein was not suspended. The dislocation of social life and the resultant movement of population increased the difficulties of maintaining the health services, and in general diminished attendances at the various clinics. Nevertheless, the health sex-vices of the Borough were maintained and even increased in some directions, and the general health of the Borough remains satisfactory. There has been a slight increase in the infant mortality rate and the general death rate, to both of which increases the deaths listed under "other violent causes" (including enemy action) have materially contributed. It is interesting to note that the small rise in the still-birth rate is confined entirely to legitimate births. There has, in fact, been a fall in the rate of illegitimate still-births. There has been no serious epidemic of infectious disease but the increased incidence of whooping cough and the rise in the number of deaths therefrom in children under 1 year old, illustrates the increasing relative importance of this disease as a serious factor in mortality in infancy and morbidity in older childhood. Diphtheria Immunisation has been maintained, and there were only two deaths from diphtheria, both in non-immunised children. As in most areas, Pulmonary tuberculosis again shows an increased incidence, but there has been a fall in the incidence of non-pulmonary tuberculosis, and the death rate from tuberculosis continues to fall slightly. Reference is made in the report to the completion of the day nursery programme; to new developments in relation to mass radiology, illegitimate children, and additional maternity beds; and to extension of work under the Scabies Order, and in rodent control. As in previous war years, shortage of staff has been a constant difficulty and there have been many changes, particularly among the temporary clerical staff; It is with regret that I have to record the death of Mr. L.H. Pearson, who had been a Sanitary Inspector with the Borough Council for 17 years. Mr, Cryer, Sanitary Inspector, was released from army service and resumed his rtuti.es with the Council in February, Miss Daniels, Sanitary Inspector under the Factories Act, retired in July after 29 years service with the Borough Gouncil, and Mr. Riling, District Sanitary Inspector, resigned in October on' obtaining appointment elsewhere. The vacancies caused have not yet been filled, I desire on behalf of the Medical Officer of Health to thank all members of the Public Health Department for loyal co-operation during a particularly difficult year, and to express appreciation of the courtesy and consideration shown by the Chairmen and members of the Public Hoalth and Maternity and Child Welfare Committees. K. M. Hirst Acting Medical Officer of Health October, 1945. 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 1944 -188,560 LIVE BIRTHS: Totals M. F. Legitimate 3,491 1,744- 1,747 Illegitimate 335 171 164 Birth rate per 1,000 estimated resident population. 20.29 3,826 1,915 1,911 STILL BIRTHS: Totals m. F. Legitimate 91 55 36 Illegitimate 10 8 2 101 63 38 Rate per 1,000 total (Live & Still) births 25.72 DEATHS: Totals M. F. 3,057 1,594 1,463 Death rate (unadjusted) per 1,000 population 16.21 DEATHS FROM PUERPERAL CAUSES: Deaths Rate per 1,000 total births. Puerperal Sepsis 3 0.76 Other Puerperal causes 5 1.27 8 2.03 DEATH RATE OF INFANTS UNDER 0NE YEAR OF AGE; All infants per 1,000 live births 48 Legitimate infants per 1,000 legitimate live births 46 Illegitimate infants per 1,000 illegitimate live births 69 NOTIFICATION OF BIRTHS: The total number of notified births, including still births from all sources, was 4,210; of this number 373 were not notified by midwivcs. MARRIAGES (Provisional figures). Marriages solemnised in the Borough during the year 1,731 1 CLASSIFICATION OF DEATHS WITH AGS DISTRIBUTION. AGES - BOTH SEXES. CAUSES OF DEATH Under 1 year 1 year and under 5 5 and under 15 15 ana under 45 45 and under 65 65 and upwards TOTALS. F. All AGES M. All causes 185 38 62 353 785 1,634 3,057 1,594 1,463 1. Typhoid & paratyphoid fevers - - - - - - - - - 2. Cerebrospinal fever 1 1 - 1 - - 3 2 1 3. Scarlet Fever - - 1 1 - - 2 1 1 4. Whooping Cough 18 1 - - - - 19 11 8 5. Diphtheria - 2 - - - - 2 1 1 6. Tuberculosis of respiratory - - - 82 59 21 162 104 58 7. Other forms of tuberculosis. 1 3 7 4 4 - 19 13 6 8. Syphilitic disease - 1 1 1 13 6 22 16 6 9. Influenza 1 - - 4 3 4 12 1 11 10. Measles 1 2 - - - - 3 1 2 11. Acute poliomyelitis and polioencephalitis - - - - - - - - - 12. Acute infectious encephalitis - - - 2 - - 2 2 - 13. Cancer of buccal cavity and oesophagus (M) - - - 1 12 12 25 25 - Cancer of uterus (F) - - - 4 13 11 28 - 28 14. Cancer of stomach & duodenum - - - 6 32 44 82 43 39 15. Cancer of breast - - - 5 25 8 38 - 38 16. Cancer of all other sites - - 1 17 87 137 242 128 114 17. Diabetes - - - 4 3 11 18 5 13 18. Intra-cranial Vascular lesions 1 - - - 27 159 187 77 110 19. Heart Disease - - 3 29 144 575 751 353 398 20. Other diseases of the circulatory system - - - 3 22 51 76 41 35 21. Bronchitis 4 1 - 6 74 127 212 148 64 22. Pneumonia 16 5 4 9 44 102 180 104 76 23. Other respiratory diseases - - 1 4 16 23 44 31 13 24. Ulceration of the stomach or duodenum - - - 8 29 30 67 51 16 25. Diarrhoea under 2 years of age 34 1 - - - - 35 18 17 26. Appendicitis - l 5 1 4 3 14 10 4 27. Other digestive diseases 1 1 4 3 11 34 54 20 34 28. Nephritis 1 - - 7 23 28 59 30 29 29. Puerperal and post-abortive sepsis - - - 3 - - 3 - 3 30. Other maternal causes - - - 5 - - 5 - 5 31. Premature birth 43 - - - - - 43 27 16 32. Congenital malformations, birth injury, infantile disease 41 2 2 5 6 1 57 33 24 33. Suicide - - - 4 7 8 19 14 5 34. Road traffic accidents 1 2 5 4 9 9 30 21 9 35. Other violent causes 12 10 20 104 79 122 347 172 175 36. All other causes 9 5 8 26 39 108 195 91 104 2 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. MATERNITY AND CHILD vvSI^AHE SERVICES. WELFARE CENTRES: The four Voluntary Welfare Centres in the Borough each received a grant from the Borough Council, for the year ending March 31st 1944, as under:- Amount of Grant: North Islington Infant Welfare Centre & School for Mothers, 6- 9, Manor Gardens, Holloway, N,7. £4,350. 0. 0d. South Islington Mothers' & Babies' Welfare Centre, 15, Popham Road, Essex Road, ,N»1. £1,600. 0. 0d. East Islington Mothers' & Babies' Welfare Centre, 32, Drayton Park, Highbury, N.5. £1,478. 8. 4d. West Islington Infant-Welfare Centre, 42, Richmond Avenue, N.l. £1,600. 0. 0d. Ante-Natal Clinics: The number of ante-natal mothers who attended the Ante-Natal Clinics again shews a considerable increase over the previous year. North: South: East: West: Total: Number held weekly 4 2 2 1 9 Number of expectant mothers who attended 1,142 383 334 392 2,251 Post-Natal Clinics: Number held weekly 1[???] 2[???] 2[???] 1[???] 6[???] Number of post-natal mothers who attended 160 22 67 20 269 [???]Combined Ante-Natal and Post-Natal. Clinics, included also in the weekly number of ante-natal clinics. Centre Attendances: There has been a slight diminution in the number of children attending the Welfare Centres, which was undoubtedly due to evacuation and dislocation of home life following enemy activity. 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 984 493 420 498 2,395 (ii) Over 1 year of age 104 43 51 54 252 Number of children who attended at the Centres during the year, and who, at the end of the year, were:- North: South: East: West: Total: (i) Under 1 year 866 399 329 422 2,016 (ii) 1-5 years 1,483 660 650 501 3,694 3 Home Visiting by Welfare Centre Health Visitors: North: South: East: West: Total: Number of Visits made to: (i) Expectant mothers- (a) First visits 737 459 514 313 2,023 (b) Total visits 4,262 723 1,404 762 7,151 (ii) Children under 1 yearTotal visits 3,656 3,030 2,781 3,225 12,692 (iii) Children 1-5 yearsTotal visits 5,080 3,504 2,616 6,973 18,173 Home Visiting by Municipal Health Visitors: TOTALS: 1. Births, First Visits, Infants under 1 year 3,301 2. Births, Re-visit3, Infants under 1 year 4,2l6 3. Visits to children between 1st and 2nd years 2,692 4. Visits to children between 2nd and 5th years 6,540 5. Visit re Stillbirths 70 6. Deaths, Visits re Infants under 1 year 40 7. Deaths, Visits re children 1-5 years 4 8. Anrc-natal Home. Visits 1,516 9. Puerperal Fever, Home Visits 20 Puerperal Pyrexia, Home Visits 11 10. Attendances at Welfare Centres 305 11. Other work by direction (which includes Clinics and Visits re Diphtheria Immunisation) 5,456 12. Visits declined 4 13. Visits-house shut 5,927 14. Visits inopportune 40 Total Visits 30,142 The work of the Health Visitors during the summer of 1944 was again greatly hampered, this time by the Flying-bomb attack. Evacuation of expectant mothers and young children, as well as school children, was re-commenced, and there was a great deal of movement among the population. Health Visitors during this period gave their time in rotation to the Casualty Services, and during the height of the attack one health visitor was detailed to be always available in this connection, if required. Another Health Visitor (from one of the Voluntary Welfare Centres) was seconded at the request of the Ministry of Health to open a home in a Preoption area for evacuated expectant mothers. Nevertheless, the work done by the Health Visitors increased during 1944. CHILD LIFE PROTECTION: Number of persons on register prepared to receive children at end of year 25 Number of children at end of year 34 TRAINING OF STUDENT HEALTH VISITORS. At the request of the Royal College of Nursing, two students attended during the year of 1944. The North Centre and South Centre and the Council's Health Visitors all co-operated in the training of these students. 4 HOME HELPS: In June 1944 the Council extended the Home Help Scheme to include the provision of Home Helps to women incapacitated by illness not associated with pregnancy and who had children under five in their care, in addition to providing Home Helps to confinement cases and women incapacitated daring pregnancy. Authority was given in 1943 for the appointment of three whole-time Home Helps, but at that time it was only possible to appoint one of these. During l944 three whole-time continuously employed Home Helps were engaged, but the. same difficulties as in previous war years continued to be experienced in obtaining suitable women for inclusion on the Panel of Home Helps for intermittent work under the. Scheme, Neverthe[???], 169 cases were attended during the year, the cost to the Council being £935. 1s. 10d. SUPPLY OF SUPPLEMENTARY QUANTITIES OF MILK TO MOTHERS AND YOUNG CHILDREN: As set out in the Annual Report of last year, 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 liquid milk or 1s. 2d. for dried milk, or free, according to the Ministry of Food Assessment Scale. Children up to the age of 12 months are also eligible for a supplementary quantity, of liquid or dried milk, and in respect of those eases where the first pint or packet is assessed as free, the Council have agreed to pay the cost of the supplementary quantity. During 1944, the total quantity of milk supplied in this way and paid for by the Council was:- Pints of Milk 7,590-£136. 3s. 3¼3. No. of Recipients-233. Lbs. of Dried-Milk 3,138¼-£146. 9s. 6d. SUPPLY OF VITAMIN PREPARATIONS FOR EXPECTANT MOTHERS AND CHILDREN UNDER 5: The Voluntary Welfare Centres continued to act as Distributing Centres on behalf of the Ministry of Food in connection with Vitamin products, in the form of Cod Liver Oil Compound and Orange Juice, for Expectant Mothers and Children under Five. PRIORITY DOCKETS FOR SHEETS FOR EXPECTANT MOTHERS: Owing to the acute difficulty of obtaining utility sheets, the Ministry of Health, in conjunction with the Board of Trade, initiated a scheme for the supply of priority dockets to expectant mothers being confined at home, to enable them to have priority in the purchase of utility sheets from retailers, and Maternity and Child Welfare Authorities were asked to issue these dockets on a certificate, from a certified midwife. The issue of the dockets commenced in November, 1944, and up to the end of the year 53 dockets we're issued, to 23 mothers. MATERNITY HOSPITAL GRANTS: Contributions for Maternity cases admitted to beds at Maternity Hospitals at the rate of 10s, per case for a percentage of notified births were made as follows:- University College Hospital 129 cases. Royal Free Hospital 86 cases. ADDITIONAL MATERNITY SCHEME: Owing to the acute shortage of beds in London Hospitals for confinement cases, the London County Council, in co-operation. with Metropolitan Boroughs, initiated an Additional Maternity Bed Scheme for these case requiring Hospital confinements who could not otherwise obtain admission to a Hospital. The Islington Borough Council, under this Scheme, was allocated 4 beds per month (total of 8 cases) at the Royal Northern Hospital and 6 beds per month (total of 12 cases) at the Mothers Hospital, Clapten, the booking of these beds to be arranged through the Medical Officer of Health. The Additional Maternity Bed Scheme commenced in July, 1944 and up to the end of the year 35 bookings had been arranged at the Royal Northern Hospital, and 30 bookings at the Mothers' Hospital. 5 EMERGENCY OBSTETRIC MIT: This service was called out twice during 1944. The patient in each case made a good recovery. PROVISION OF DENTURES FUR EXPECTANT AND NURSING MOTHERS: The Borough Council approved a scheme commencing April 1st 1944 for assisting expectant and nursing mothers to obtain dentures supplied through either the North or the South Islington Welfare Centre or Eastman's Dental Clinic. The number of mothers assisted through this scheme during 1944 was 17 at a total cost to the Borough Council of £44. 10s. 1ds INVALID CHILDREN'S AID ASSOCIATION: A grant of £100 was paid to the Invalid Children's Aid Association for their work for Islington children under 5 years of age during 1944. NURSING IN THE HOME: The Borough Council this year approved the payment of a grant of £200 per annum to the North London District Nursing Association in respect of the nursing of Islington children under 5 years of age in the home. The Borough Council also contribute at the rate of 2/- per visit to necessitous cases of maternity complications for which the services of a North London District Nurse are called in. £17. 2s. 0d. was also paid by the Borough Council during 1944 to the Association in respect of the nursing in the home of Public Health cases. DAILY GUARDIAN. SERVICE: The Daily Guardian Service, details of which have been set out in last year's annual report, continued to provide for the care of a number of children of mothers in work for whom accommodation could not be found in the Day Nurseries. At the end of the year 74 Daily Guardians were on the register of women approved for this Service and were caring for 115 children. VOLUNTARY DAY NURSERIES: The Council's grants to the Islington Voluntary Day Nurseries, evacuated to the country, were as under:- Lower Holloway Day Nursery £260 South Islington (pro Patria) D/N £300 WAR-TIME DAY NURSERIES: A further Day Nursery was opened during 1944, i.e. at Vale House, Tufnell Park Road, making a total of 14 Nurseries opened in the Borough and providing accommodation for 810 children, premises for another Nursery at Highgate Hill were also completed, but the opening of this Nursery was postponed. Two of the Nurseries were badly damaged and rendered unusable by 'fly-bomb' raiding, one at Packington Street, and the other at Liverpool Road. The damage was caused when the premises were empty so that there was no loss of life in either case. But it reduced the number of Nurseries available to 12, with a total accommodation for 727 children. During the evacuation of children the Ministry of Health requested the temporary reduction, if possible, of the number of Day Nurseries in the Metropolitan area, and asked for the loan of staff and equipment thereby released for Reception areas. A few members of the staff of the Islington Nurseries were temporarily transferred to a residential nursery in Norwich to which also the equipment of the Packington Street Nursery wa3 sent. It was under these arrangements of the Ministry of Health that the opening of the Highgate Hill Nursery was postponed. The Borough Council's War-time Day Nursery programme was completed during the year, and the following is the list of the Nurseries that were provided:- - (See next page:- 6 Places: Scholefield Road, N.19 55 265, Camden Road, N.7 66 160, Hornsey Lane, N.6 64 34, Huntingdon Street, N.l 33 6, Clephane Road, N.l 60 21, Packington Street, N.l 33 21, Plimsoll Road, N.4 47 Pembroke Street, N.l. 50 547, Liverpoo1 Road, N.l. 50 8 & 9, Canonbury Place, N.l. 76 Legard Road, N.5. 70 Windsor Street, N.l. 68 Mitford Road, N.19 68 Tufnoll Parle Road, N 70 Highgate Hill, N.19 50 Total 860 The continued high employment of women resulted in full use being made of the War-time Day Nurseries except during the height of the 'flying-bomb' attacks, when the attendances were considerably reduced. During this time the staffs of the Nurseries worked under extremely difficult conditions with the children spending long periods in the air-raid shelters of the Nurseries. With the diminution of enemy activity attendances rose again and at the end of the year there were waiting lists at all the Nurseries, It is not surprising that under the difficult conditions prevailing there were a number of minor outbreaks of infectious diseases, but there was no serious epidemic, and on the whole the health of the children was well maintained, SUPPLY OF RUBBER TEATS FOR BABIES BOTTLES: During 1944 a generous supply of rubber teats was received from America via the Women's Voluntary Service, for distribution to those mothers who were unable to obtain these for their babies bottles owing to the acute shortage. These were distributed as required through the Welfare Centres and the Maternity and Child Welfare Office. [???] Arising out of the Ministry of Health Circular No. 2866 (Revised), a survey was trade daring the year relating to the health and social conditions of illegitimate children in the Borough based on the records of the Health Visitors. In November 1944 arrangements were made for the whole of the work in relation to unmarried mothers and illegitimate children to be allocated to one special Health Visitor working in co-operation with the moral welfare workers,, hospital almoners, and other social agencies in the Borough, premature BABIES: Arising out of Ministry of Health Circular No, 20, arrangements were made from July 1944 for the birth weight of infants to be recorded on the birth notification where such weight is 5½1hs. or less. A follow-up of the notifications of these premature births showed the following results for the last six months of 1944:- Born in Hospital 39-of which 6 died within 24 hours and 29 survived beyond the age of one month. Born at Home 25-of which 3 died within 24 hours and 21 survived beyond the age of one month. On the completion of this survey consideration was given to the need for special arrangements in the following year for premature infants born at home. 7 OTHER PUBLIC HEALTH SERVICES. BACTERIOLOGICAL EXAMINATIONS: Total Positive Negative For Diphtheria Bacilli 473 14 459 Tubercle Bacilli 119 12 107 Typhosus Bacilli 1 1 — PROVISION OF INSULIN: 20 Patients received assistance during the year, the cost to the Borough Council was £71. 6. 2d. ISLINGTON CREMATORIUM: There were 66 Cremations during the year at the Council's Crematorium at East Finchley. SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. SUMMARY OF WORK DON'S BY DISTRICT SANITARY INSPECTORS. During the year 32,689 inspections (including re-inspections), were carried out by the District Sanitary Inspectors, made up as follows House to House inspections 1,579 Other promises inspected 5,425 Re-inspections, Calls made, etc. 25,685 32,689 Special matters dealt with when making the above visits:- Council's property l6l Stables 30 Yards 432 Uririals attached to Public House 137 Premises for Foster children 22 Premises re vermin 1,194 Premises re Rats and Mice 2,255 Premises re Water Certificates — Smoke Observations — Certificates of Essentiality 278 Shops 201 Non-effective visits 3,158 Notices served - Intimation (public Health (London) Act, 1936) 2,942 Notices served-Statutory (public Health (London) Act, 1936 425 8 SCABIES AND VERMIN: Treatment Treatment for scabies and vermin was carried out at the Public Health Department, Seven Sisters Road (Cleansing Station), as under:- [???] Scabies Vermin Children under 5 years Number treated 513 276 " of baths given 1,309 — " of treatments — 298 L.C.C. Children Number treated 1,095 3,081 " of baths given 4,304 - Adults Number treated 1,804 429 H " of baths given 3,961 - " of treatments - 485 H 1 of this number was given baths for body lice. [???]92 Contacts were given baths. Home visiting. Follow-up home visiting for cases of scabies and vermin was carried out by the Assistant Nurses of the Cleansing Station as under:- Families visited Re-visits Ineffective visits Treated at home Total Scabies 3,088 530 1,800 - 5,418 Vermin 2,021 168 914 106 3,209 The prevalence of Scabies and the increase in the number of verminous persons, (in part at least attributable to the increase in Shelter life again during this year), made it necessary to appoint an additional Assistant Nurse at the Cleansing Station to carry out the requirements under the Scabies Order. DISINFECTION AND PIS INFESTATION: During the year 647 disinfections were carried out after cases of infectious or other diseases. In addition, 262 rooms and 104 shelters were disinfested for vermin. At the disinfecting station 51,685 articles of bedding, etc., were treated for infection or infestation, HYDROGEN-CYANIDE FUMIGATION: No. of times Large Chamber used. Furniture and effects of families rehoused including those of Homeless Persons 21 Private persons - furniture and effects Nil No. of times Small Chamber used. Miscellaneous (mattresses, divans, etc.) 5 TOTAL 26 Thanks are due to the Cleansing Department for their assistance in working the boiler plant at Ashburton Grove Depot. 9 FACTORIES: The number of inspections, re-inspections and calls, etc. was 4,975. 329 defects were found, and remedied in 292 instances. Number of notices served was 194. There was an unfilled vacancy for one inspector under the Factories Act, 1937, during the whole of the year. RATS MP IPSE (DESTRUCTION) ACT, 1919: 482 complaints were received and 952 inspections carried out. 25 notices were served and 37 defective drains repaired. INFESTATION ORDER, 1943: Sewer Treatment. Under the above Order, following on a first baiting in December last year., a systematic second baiting of the sewers was carried out in January this year, and 7 men wore specially engaged as Rodent Operators working along with the Sower Inspectors. The result of this treatment was the calculated destruction of 3,600 rats. Surface Baiting. Three Rodent Operators wore employed throughout the year on this work, and the following premises were baited:- Houses 905, Shops 250, Factories 29, Land 27, Stables 13, A.R.P. Depots 3, Pay Nurseries 7, Shelters 49, Warehouses 1, Churches 2, Banks 1, Flats 4, Furniture Stores 3, Licensed Promise's 4, Warden Posts 4, Hotels 1, Schools 1, Yards 1, making a total of 1,305. SUMMARY• OF PROSECUTIONS DURING YEAR 1944: Statute Total Prosecutions Successful Dismissed Withdrawn Adjourned 'Sine die' Amount of Penalties Costs Public Health) (London) Act,) 1936) 12 6 - 4 2 - £ll.ll.0d. Food & Drugs) Act, 1938) 9 4 4 1 - £35.0.0d. £23.2.0d. Factories) Act, 1937) 2 - 1 1 - - £3. 3.0d. L.C.C.Drainage) Bye-laws, 1934) 1 - 1 - - - - 24 10 6 6 2 £35.0.0d. £37.l6.0d. SECTION D. HOUSING: Work under the Housing Act has again been at a standstill, as a consequence of the lack of labour and materials prohibiting any extensive repairs being carried out. Repair and Maintenance of Buildings (Circular 2871)(Certificates of Essentiality). The number of houses inspected in connection with the above Circular was 266, the majority of visits being carried out in conjunction with the War Damage Surveyors. Requisitioned Properties. Supervision has been maintained of repairs or reconstruction of drainage and sanitary fitments in properties which have been requisitioned by the Council with a view to ensuring compliances with the Bye-laws where practicable. 10 SECTION E. inspection and supervision of food. MILK AMD DAIRIES ORDER, 1926: Summary of Register. Number on Reg 31.12.43. Additions to Reg. Removals from Reg. No. on Reg. 31.12.44. Dairies. 159 3 3 159 Purveyors of Milk in sealed containers only. 335 3 1 337 Registered Purveyors of Milk dealing from registered premises outside the Borough. 94 - - 94 SUMMARY OF VISITS BY MILK & DAIRIES INSPECTORS: DAIRIES. Routine inspections 986 Inspections for registration of 6 992 MILK-SHOPS (Milk sold in sealed containers only)• Routine inspections 302 Inspections for registration of 2 304 DAIRIES AND MILK-SHOPS INSPECTED UNDER THE MILK (Special Designations) REGULATIONS 1936-1943): 82 VEHICLES INSPECTED: 60 MISCELLANEOUS VISITS: 84 1,522 During the year 7 notices intimating nuisances or defects were served, and 17 warning letters cent to Dairyman and Milk Purveyors, drawing their attention to the contravention of the Acts and Regulations relating to their businesses. MILK (Special designations) REGULATIONS 1936-1943. The following applications were granted:- Designation Tuberculin Tested (Dealer) 29 Tuberculin Tested (Supplementary) 6 Accredited (Dealer) — Accredited (Supplementary) — Pasteurised (Pasteuriser) 1 Pasteurised (Dealer) 65 Pasteurised (Supplementary) 8 109 UNDERGROUND BAKEHOUSES: No. of Promises 69 H " " Routine Inspections 44 " " Intimation Notices served 1 H of which, one was closed and two were destroyed by enemy action during the year. 11 PHARMACY & POISONS ACTS: No. of visits made 413 FOOD & DRUGS ACT, 1938: Now of visits made for inspection of food 1,236 Visits-made to shops etc. — During the year 1,634 visits were paid to various shops, stalls, etc. (For other visits see item re-Inspector of Meat and Other foods). Total weight of food condemned was:- 35 tons 9 cwts. 1 qr. 7 lbs. (See also items under Meat and Other Foods, and Shops Act, 1934)• RAG FLOCK ACT, 1911, etc: During the year 6 visits were made to premises to ascertain if rag flock was being sold, No Sales were being made or rag flock being used. MEAT AND OTHER- FOODS: Five private slaughterhouses continued to bo licensed, but owing to the control of meat supplies by the Ministry of Food no slaughtering of animals was carried out, One slaughterhouse for horses for human consumption was licensed. This was visited 47 times and 325 horses were slaughtered. Slaughtermen's Licences:- Licences expired at the end of this year and 16 applications for renewal were granted for a throe-year period, Visits and Inspections:- During the year 861 visits were paid to various food shops, markets, stalls, etc. Food destroyed or otherwise disposed of so as to prevent its use for human consumption totalled 16 tons, 3 cwts, 0 qrs. 24 lbs. (See also item under Food & Drugs Act, 1938)• Bye-Laws for the Protection of Food:- Bye-Laws for this purpose were made under the Public Health (London) Act, 1936, and came into force during 1937. No prosecution has been taken during the period under review. DISEASES OF ANIMALS ACT - ANTHRAX ORDER, 1928: On no occasion during the year was the above Order, relating to animals, applied in the Borough, OFFENSIVE TRADES: The offensive trades operating in the Borough are three tripe dressers, five gut scrapers and one knackers' yard. Fourteen visits were made during the year and no breach of the Regulations was observed. Three skin dressers were under the supervision of the Sanitary Inspector carrying out duties under the Factories Act, 1937, but one of these was destroyed by enemy action during the year. 12 FOOD & DRUG ACT, 1938 (Sampling): 1,135 samples (531 formal, 604 informal) were submitted to the Public Analyst for examination. Of these 27 wore adulterated (or 2.38 per cent), as shown in the following summary:- Formal Milk 10 Gelatine 1 Dripping 1 Sausages 2 Cream Sponge 1 Informal Milk 1 Gelatine 3 Dripping 2 Sausages 2 Vinegar 2 Frozen Fruit Juice 1 Anti Gas Ointment No. 2 1 SHOPS ACT, 1934: The visits made were 2,338. In addition, 345 visits wore made in respect of war damage to food, and in this connection 7 tons, 11 cwts. 2 qrs. 22 lbs. of food were condemned for human consumption, (See also item, under Food and Drug Act, 1938). A further 169 inspections were made of war damaged retail premises. SECTION F. PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES. TUBERCULOSIS: NEW CASES AND MORTALITY DURING 1944: NEW CASES. DEATHS. Age Periods Respiratory Non-Respiratory Respiratory Non-Rospiratory M. P. M. P. M. P. M. P. 0- - - 1 1 - - - 1 1- 6 5 4 2 - - 2 1 5- 10 6 9 6 - - 2 1 15- 30 38 8 17 2 4 4 1 25- 97 107 9 12 18 31 2 2 35- 58 26 3 1 18 10 - - 45- 41 9 4 1 22 7 2 - 55- 40 13 2 - 29 5 1 1 65- and upwards 17 9 - - 17 4 - - Total for All ages 299 213 40 40 106 61 13 7 592 187 There has been a decrease in the rate of new cases of non-respiratory tuberculosis. Rate per 1,000 population: new cases - pulmonary 2.71, non-pulmonary 0.42: deaths - pulmonary 0.88, non-pulmonary 0.10. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS 1930: The total number of cases of tuberculosis on the Register as at 3l3t December, 1944 was:- 1,882 (Pulmonary - Males 908, Females 683: Non-Pulmonary - Males 151, Females 140). 13 DISPENSARY REGISTERS; Pulmonary Adults. Children. Non-Pulmonary Adults. Children. TOTAL Adults. Children GRAND TOTAL 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. 656 494 67 53 62 73 42 54 718 567 109 107 1,501 WORK OF THE TUBERCULOSIS DISPENSARIES: North South Number of attendances 6,624 3,967 New cases and contacts examined 1,906 680 Number of visits by Tuberculosis Officers 224 92 Number of visits by Nurses 977 1,593 LIGHT TREATMENT: 14 Patients received "Light" treatment, the cost to the Council being - £37.l8.0d. MASS RADIOLOGY: Arrangements were made for persons residing or working in the Borough to be examined at a Mass Radiology Unit with a view to the early detection of pulmonary tuberculosis in its symptomless stages. The Unit was sot up by the London County Council in promises in an adjoining Borough. Examination was voluntary and the reports confidential. A considerable number of the staff of the Borough Council attended for examination (including Civil Defence and Day Nursery staffs), and a largo number of firms in the Borough wore also approached and some were able to make arrangements for their employees to attend. The following information has been received from the London County Council regarding the first working period of the Mass Radiology Unit Employer: Total Examined: Referred for Larger Films: Probably T.B. Men Women Total Men Women Total Men Women Total Islington Borough Council. 461 349 810 20 14 34 4 3 7 Others: 163 361 524 11 13 24 5 3 8 Total 624 710 1,334 31 27 58 9 6 15 The Unit was available again later for Islington and was still in operation at the end of the year. TUBERCULOSIS CARE COMMITTEE: 133 patients have been helped with cash or in kind, and others have been referred to organisations for assistance. Receipts from the Christmas "Seal Sale" amount to £252. 14. 5d. 14 maintenance allowances scheme: Number of patients receiving weekly allowance in last week of year 1944 131 Number of applications brought before Assessment Officer 1,825 Number of new cases 179 Number of reapplications (by patients who had returned to work and become ill again) 9 Number of renewals on existing orders 818 Number of orders adjusted, etc 633 Number of patients returning to full time work 81 Number of deaths 27 Other 'Cease payments' 78 1,825 Amount paid out in allowances during the year £10,646. 4. 11d. ARTIFICIAL PNEUMOTHORAX: 121 Patients received treatment at a total cost of £644. 8. 9d. EXTRA NOURISHMENT: 81 cases received extra nourishment at a total cost of £407. 9. 7d. beds and bidding: 11 patients were provided with bod and bedding on loan. DENTAL TREATMENT: 9 patients received treatment with assistance under the Council's scheme. NOTIFIABLE INFECTIOUS DISEASES AND DEATHS DURING THE YEAR 1944: DISEASES. No. of Notifications, No. of Deaths. Cases removed to hospital. Scarlet Fever 314 - 250 Diphtheria 94 2 94 Enteric Fever (including paratyphoid) 3 — 3 Puerperal Fever 19 4 18 Puerperal Pyrexia 32 - 28 Acute Primary & Influenzal Pneumonia 123 11 41 Ophthalmia Neonatorum 24 - 14 Encephalitis Lethargica - 2 - Cerebro-Spinal Fever 15 3 15 Anthrax - - - Dysentery 172 1 147 Malaria 7 - 6 Erysipelas 81 2 38 Measles 627 2 148 Whooping Cough 806 16 204 Acute Poliomyelitis - - - Acute Polioencephalitis - - - Scabies 1,391 - - The notification of each of the common infectious diseases shows a reduction on the previous year with the exception of Whooping Cough in which there has been a moderate increase. Malaria and Dysentery also show an increase, the former, and possibly the latter also, being associated with the movements of members of the armed forces. Scabies also shows an actual increase in the number of notifications as compared with the previous year, but was only notifiable for the latter part of the year 1943. 15 SMALLPOX AND VACCINATION: No case of smallpox was notified. Of the 4,006 births returned on the "Birth List Sheets" during 1943, 2098 were successfully vaccinated. In addition, 1,035 children, whose births occurred elsewhere, were vaccinated in the Borough. DIPHTHERIA IMMUNISATION: Fly-bomb raiding during the summer and the autumn of this year interfered considerably with the work of the immunisation clinics, diminishing attendances at the Borough clinics and suspending work altogether in the London County Council schools, where immunisation was not resumed until November. The Council's whole-time Medical Officer for diphtheria immunisation resigned in August, and in view of the reduced attendances at the clinics at that time it was found possible to continue with medical officers on a sessional basis. Under 5 5/I5 Estimated number of children immunised at 31.12.44 50% 80% Total Attendances at all Clinics 19,494 Sessions held 456 Average attendance 42.75% Sessions held as under:- North Islington Branch Library 74 First Aid Post, London Fever Hospital 52 " " " Mildmay Conference Hall 51 " " " Tibberton Square (New Clinic opened) 1 Community Hall, Blythe Mansions 22 West Islington Youth Centre, Carleton Road (New Clinic opened) 22 London County Council Schools in Borough 148 War-Time Day Nurseries 86 Number of children who received full course immunising injections Under 5 5/l5 Total 2,064 1,101 3,165 Number of children who were Primary Schick Tested with negative result and therefore did not require immunisation. 227 Number of children immunised whilst evacuated and tested with a negative result in Islington. 933 Number of L.C.C. Cases tested in Islington with negative result. 29 Number of children retested with negative result. 395 In addition to above 3,411 children were Post Schick Tested with a negative result. There have been only two deaths from diphtheria in the Borough during the year, both in children under five who had not been immunised. 16