KIN 063 BOROUGH OF KINGSTON-UPON-THAMES. Annual Report OF THE Medical Officer of Health For the Year ending 31st December, 1919. Kingston-upon-Thames: Phillipson's Press, Ltd., Printers, St. Jambs' Road. REPORT OF THE MEDICAL OFFICER OF HEALTH. Municipal Offices, July, 1920. Gentlemen, Total Births were 667. Males 354, Females 313. 25 Males and 30 Females were illegitimate. Population for Birth Rate was 38,700. Birth rate was 17.2 per 1000. Population for Death Rate was reckoned at 87,151. Total Deaths were 529. Males 267, Females 262, showing a Death Rate of 15.9 per 1000. Deaths under 1 year were 51. Males 29, Females 22, giving an Infant Mortality of 76.4 per 1000 births. Zymotic Death Rate was .78 per 1000, a comparatively low figure. Zymotic Deaths numbered 29. 4 CAUSES OF DEATHS. (Civilians only). Causes of Death. Males. Females. All Causes 267 262 Measles 1 - Scarlet Fever 1 1 Whooping Cough 2 2 Diphtheria and Croup 8 6 Influenza 26 23 Erysipelas 1 — Pulmonary Tuberculosis 25 14 Tuberculous meningitis — 8 Other Tuberculous Diseases 6 2 Cancer, malignant disease 19 29 Rheumatic Fever — 1 Meningitis 1 — Organic Heart Disease 23 31 Bronchitis 20 14 Pneumonia (all forms) 15 15 Other Respiratory Diseases 5 1 Diarrhoea (under 2 years) 4 4 Appendicitis and Typhilitis — 1 Alcoholism 1 — Nephritis and Bright's Disease 10 6 Puerperal Fever — 1 Parturition, apart from Puerperal Fever — — Congenital Debility, etc. 12 10 Violence, apart from Suicide 16 9 Suicide 2 — Other defined diseases 69 89 Special Causes (including above)— Poliomyelitis 1 — 5 Causes of Deaths—(Contd.) Causes of Death. Males. Females. Deaths of Infants under 1 year of age 29 22 Illegitimate 3 7 Total Births 354 313 Legitimate 329 283 Illegitimate 25 30 Population for Birth Rate 38,700. „ for Death Rate 37,151. DISEASES. Measles.—This was made notifiable in January. 123 cases occurred, principally mild in type, only 1 death took place. Measles showed throughout all wards, Canbury and Hill Wards had most prevalence. Scarlet Fever.—98 cases were reported—not of severe type —2 deaths resulted. 45 cases were sent to Isolation Hospitals. Norbiton Ward and Canbury Ward suffered most. Diphtheria—142 cases were reported, 70 were sent to Hospital, 14 deaths took place. Norbiton Ward presented almost half of total number of cases. Pneumonia.—Was made notifiable in January. 25 cases were reported, generally accompanying or following Influenza, which prevailed during the first quarter of the year. 30 deaths occurred. Enteric.—1 case occurred in Kingston Workhouse Infirmary. Polio-Encephalitis.—1 case was reported and died. Encephalitis Lethargica—4 cases reported. These were all of obscure origin; 2 died. 6 Opthalmia Neonatorum.—6 cases came under notice. 2 were under care of Health Visitors, 2 at Infirmary, and 2 were taken out of town. All cases under treatment in town did well. Erysipelas.—10 cases, all due to climatic influences, were reported. 1 death occurred. Puerperal Fever—1 case was reported, and died. Malaria.—4 cases, all from abroad. These men were placed under hospital treatment in London. Tuberculosis—64 cases. Pulmonary cases numbered 52; the remaining 12 were affected in various other organs. 50 deaths. In January the Borough had recovered from the epidemic of Dysentery of the last quarter of 1918. Influenza had also dwindled very much, and by April had disappeared. The cold damp days, and raw climatic conditions would account largely for the Influenza, and, in my opinion, for much of the Diphtheria at all periods, provided any other such cases were scattered in our midst. The influence of Cinema Shows, Theatres, and crowded tram cars and over-crowded houses must be borne in mind in this direction. Means of travel too are now so easy that communication of disease from individual to individual is not difficult. I did not find that schools were a cause of the spread of disease. Care and caution are fully exercised in these institutions. There was no case of Dysentery, Trench Fever, Anthrax. Rabies or Small Pox. Antitoxin was issued through my office to Medical Practitioners for use in Diphtheria cases, and from reports I gather that prevention of the disease among contacts, and mitigated symptons in those attacked, were attributable to the early use of Antitoxin. 7 ''Mothers and Rabies Welfare" was taken over by the Corporation in April, after having been started by voluntary effort in July, 1915. The details of work in Centre are arranged by the Voluntary Committee, and four ladies from this Committee have been co-opted in the Maternity and Child Welfare Committee of the Corporation, and attend regularly all monthly meetings. Two Health Visitors divide between them the visiting in the Borough, and attend the Centre meetings each Friday, as well as Committee meetings. There is also an Attendant Lady Doctor at Centre, and voluntary lady helpers. The work is constant and hard for all those engaged. Immense benefits are being derived by the women and children and attendances at Centre tend to increase. Milk, dried milk, Virol, etc., are supplied, sometimes free, and in many cases at reduced prices. Mothers are also taught dressmaking for the benefit of their babies, and general sanitary care of infants and themselves. There is no Maternity Hospital in Kingston at present, but it is hoped to provide beds at the District Nursing Association Home, where, for a fee of two or three guineas per week, mothers can be received for confinements. Kingston Day Nursery is invaluable in looking after children while mothers are obliged to go to daily work. Medical inspection of the Nursery is made regularly every week. Illigitimate children with their mothers, if no friends or relatives are at hand, can be admitted to a Hostel at Epsom for a year, at the expense of the Corporation. Mothers are trained to earn a living meanwhile in the Hostel, and partly contribute to their maintenance. Milk inspection in Kingston is carried out by the County Council under the Food and Drugs Acts. 8 The supply, I have personally found good and wholesome, and the arrangements for distribution adequate. Those dairies and cowsheds in the Borough I have inspected with our Veterinary Surgeon were found generally satisfactory. SCAVENGING, ETC. Kingston is a "W.C." town, there are no earth closets, no privies and no cesspools. The Borough Surveyor's Department carries out the emptying of movable ashbins weekly, and in certain cases every two days. There are few complaints. The sanitary conditions of the schools were in a satisfactory state. No epidemic occurred, nor was it necessary to close any school for any reason. There was no excessive exclusions of individual children for verminous conditions; the general health and cleanliness having been good. The Sanitary Inspector has given me the following figures :— Inspections Made 3310 Notices Served Written 196 Verbal 43 239 Defects Discovered 1803 Defects Remedied 930 SAM. BROWNE, M.D., Medical Officer of Health. 1st July, 1920.