LEW 30 METROPOLITAN BOROUGH OF LEWISHAM. ANNUAL REPORT (ABRIDGED) of the MEDICAL OFFICER OF HEALTH. for the year 1942. BY John W. Miller, M.B., Ch.B, D.P.H. Medical Officer of Health. Public Health Department, Lewisham Town Hall, Catford, S.E.6. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Lewisham. Mr. Mayor, Ladies and Gentlemen, I have the honor to submit my Annual Report on the health and sanitary conditions of the Borough for the year 1942. In consequence of war time restrictions it is again an abridged report, prepared on the lines indicated by the Ministry of Health. The statistics for the year indicate that the health standards of the Borough are being maintained satisfactorily not withstanding the war conditions. The Birth Rate at 16.8 per 1000 and the Death Rate at 12.0 per 1,000 compare favourably with the mean of the previous five years at 13.9 and 12.5 per 1,000 respectively. . In the course of the year six Day Nurseries were established by the Council for the care of children of mothers in war time employment for which an increasing demand was found to exist. At the time of writing this report, these Nurseries are occupied almost to their full capacity. I take this opportunity of expressing my gratitude to the members of the Council for their support and consideration during the year. The Public Health staff, both permanent and temporary, have worked well during the year under difficult conditions, and I desire also to record my indebtedness to them. I am, Mr. Mayor, Ladies & Gentlemen, Your obedient Servant, Johan W. Leuline. October, 1943. Medical Officer of Health. SUMMARY OF STATISTICS FOR THE YEAR 1942. Area of Borough 7.015 acres. Rateable Value £1,781,519 Estimated Product of 1d. Rate £6,300 Population Census 1931, 219,953. "Estimated figure for 1942 not available for publication. Approximate Number of Inhabited Houses 52,000 Number of Live Births:- 2,732 Males. Females (a) Legitimate 1,328 1,261 (b) Illegitimate 74 69 TOTAL 1,402 1,330 Birth Rate. 16.88 Total Still-births:- (a) Legitimate 99. (b) Illegitimate 6. Still-birth Rate per thousand births. 38. Number of Deaths:Males 1,013 Females 942 TOTAL 1,955 Death Rate 12.0 Number of Infant Deaths:- (a) Legitimate 94 (b) Illegitimate 9 Infant Mortality Rate:- (a) All Infants per thousand Births 37.7 (b) Legitimate Infants per thousand Legitimate Births 36.3 (c) Illegitimate Infants per thousand Illegitimate Births 62.9 Number of Maternal Deaths:- (a) Puerperal Sepsis 4 (b) Other Puerperal Causes 5 Number of Deaths from Measles (all ages) 0 „ „ „ „ Whooping Cough 4 „ „ „ „ Diarrhoea (under 2 years) 12 „ „ „ „ Tuberculosis 131 „ „ „ „ Cancer 311 CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE DURING THE YEAR 1942. List No. CAUSES OF DEATH. Ages at Death Under 1 year 1 and under 5 5 and under 15. 15 and under 45. 45 and under 65 65 and upwards TOTALS All Ages. 1. Typhoid & Paratyphoid Fevers – – – – 1 – 1 2. Corebro Spinal Fever 1 – – 1 1 1 4 3. Scarlet Fever 1 – – – – – 1 4. Whooping Cough 3 1 – – – – 4 5. Diphtheric. – – 1 – – – 1 6. Tuberculosis of Respiratory System – – – 68 42 8 118 7. Other Forms of Tuberculosis 1 2 1 5 4 – 13 8. Syphilitic Diseases – – – 2 15 6 23 9. Influenza – – – 2 5 3 10 10. Measles — – – – – – – 11. Ac. Poliomyelitis & Polioencephalitis – 1 1 – – – 2 12. Ac. Infectious Encephalitis (Lethargic) – – – – – - – 13. Cancer, Buccal Cavity & Oesophagus – – – 1 13 16 30 14. Cancer, Stomach & Duodenum – – – 3 17 30 50 15. Cancer, Breast – – – 2 18 9 29 16. Cancer, all other sites – - – 16 69 117 202 17. Diabetes – – 1 3 2 14 20 18. Vascular Lesions 1 –" – 4 39 123 167 19. Heart diseases – – 3 26 99 370 498 20. Other Circulatory Diseases – – – 2 14 29 45 21. Bronchitis 5 – – 3 31 79 118 22. Pneumonia 21 3 4 7 17 38 90 23. Other Respiratory Diseases – 3 1 3 9 8 24 24. Ulcer, Stomach & Duodenum – – – 2 14 10 26 25. Diarrhoea (under 2 years) 10 2 – – – – 12 26. Appendicitis – – – 1 1 3 5 27. Other Digestive Diseases 5 1 – 1 19 27 53 28. Nephritis – – 2 5 9 20 36 29. Puerperal & Post Abortive Sepsis – – – 4 – – 4 30. Other Maternal Causes – – – 5 – – 5 31. Premature Birth 26 – – – – – 23 32. Congenital Malfomations, Birth Injury, Infantile Diseases 23 – – 1 – 1 25 33. Suicide – – – 1 13 1 15 34. Road Traffic Accidents – – – 2 1 5 8 35. Other Violent Causes 4 3 3 11 11 37 69 36. All other causes 2 5 2 35 33 144 221 TOTAL ALL CAUSES 103 21 19 216 497 1099 1955 INFECTIOUS DISEASES. Number of cases notified (omitting Tuberculosis) and Deaths during the year 1942. Disease. Total cases Notified. Cases admitted to Hospital Total Deaths. Cerebro-Spinal Fever 25 25 4 Diphtheria 53 53 1 Dysentery 34 34 – Encephalitis Lethargica – – – Enteric Fever 2 2 1 Erysipelas 52 38 – Food Poisoning 4 – – Measles 858 117 – Ophthalmia Neonatorum 4 2 - Pneumonia 103 27 90 Polio Myelitis 5 5 - Puerperal Fever 3 3 – Puerperal Pyrexia 27 27 4 Scarlet Fever 255 255 1 Whooping Cough 254 66 4 TOTALS. 1,679 654 105 TUBERCULOSIS. The number of new cases notified during the year 1942 and the number of deaths (together with comparative figures for the previous year) were as follows:- NEW CASES NOTIFIED DEATHS. 1941. 1942. 1941. 1942. Pulmonary 261 284 137 118 Non-pulmonary 54 70 19 13 TOTALS. 315 354 156 131 The age distribution of the New Cases notified and the Deaths from Tuberculosis are shown in the following table:- AGE GROUPS NEW CASES DEATHS. Pulmonary Non pulmonary TOTALS. Pulmonary Non pulmonary TOTALS. M. F. M. F. M. F. M. F. Under 1 year – – – – – – – 1 – 1 1 to 5 years 2 2 6 5 15 – – 1 1 2 5 to 10 „ 4 1 9 3 17 – – 1 – 1 10 to 15 „ 7 2 9 4 22 – – 3 – 3 15 to 20 „ 22 29 6 4 61 64 46 1 5 116 20 to 25 „ 22 32 2 7 63 25 to 35 „ 26 27 – 3 56 35 to 45 „ 35 13 2 3 53 45 to 55 „ 21 11 – 2 34 5 3 8 55 to 65 „ 19 2 1 3 25 65 & upwards 6 1 – 1 8 TOTALS. 164 120 35 35 354 69 49 7 6 131 PROVISION OF HEALTH SERVICES IN THE BOROUGH. Maternity and Child Welfare. The Council's Maternity Home which was closed on the outbreak of war was opened as a Day Nursery on the 25th May, 1942, after some necessary structural alteration. Otherwise the Maternity and Child Welfare Services were maintained practically on the pre war basis during the year under review. Diphtheria Immunisation. In compliance with the instructions of the Ministry of Health, steps were taken to give publicity to this subject by the display of posters and distribution of informative leaflets. The Council's Health Visitors were temporarily relieved of some of their routine duties in order to prepare lists and make special visits to parents of un-immunised children and persuade them to have immunisation carried out. This and the national publicity campaign, resulted in a large increase in the number of children immunised, as shown in the following comparative statement: NUMBER OF CHILDREN IMMUNISED. 1941. 1942. Under five years of age. 824 2,368 Five years and over 2,276 2,736 TOTALS. 3,100 5,104 Under the Council's Immunisation scheme, which was adopted in March, 1935, the work of Immunisation was only undertaken by Medical Practitioners at their surgeries, but the arrangement commenced in 1941 under which a doctor in the employ of this Council undertook the work in the London County Council Schools was continued. The following table shows the number of cases of Diphtheria and the number of deaths, since the Immunisation scheme was introduced:- Year. No. of cases of Diphtheria Notified. Number Immunised No. of Deaths from Diphtheria. 1935 314 236 14 1936 247 448 4 1937 328 1,027 11 1938 469 1,406 23 1939 137 686 8 1940 78 220 6 1941 82 3,100 8 1942 55 5,104 1 The accompanying chart, showing the incidence of Diphtheria in Lewisham from 1921 to 1942 and the cumulative immunisations that have been carried out in the Borough since the inception of the scheme in 1935, is of interest. Metropolitan Borough of Lewisham CHART SHOWING DIPHTHERIA INCIDENCE AND DIPHTHERIA IMMUNISATIONS WAR TIME NURSERIES. Towards the end of 1941 representations were received from the Ministry of Health that there was need for the establishment of Day Nursery, facilities in the Borough for the care of the children of mothers in War Time employment. The matter was carefully investigated and the Council eventually decided to establish the under mentioned six nurseries which were opened during the year on the dates stated:– NURSERY ACCOMODATION PROVIDED. DATE OPENED. St. Peter & St. Paul's Home, Lushington Road, Bellingham, S.E.6. 80 11th May, 1942. Ladywell Institution, Ladywell Road, S.E.13. 60 18th May, 1942. 41 Rushey Green, Catford, S.E.6. 40 25th May, 1942. Shaftesbury House, 67 Perry Rise, Forest Hill, S.E.23. 60 20th July, 1942. L.C.C. Nursery School, St. Norbert's Road, Honor Oak, S.E.4. 60 10th August, 1942. 163 Shroffold Road, Downham Estate. 56 26th October, 1942. Health Visitors - Summary of Visits:- Expectant Mothers 1,769 Infants under one year 7,224 Children 1 - 5 years 15,257 Infant Welfare Centres. Attendances - Babies 2,334 Children 1-5 years 5,158 New Cases - Babies 2,826 Children 1-5 years 1,008 Ante-Natal Clinics. Total Attendances 2,188 SANITARY INSPECTION. The following is a brief summary of the Sanitary Inspector's work during the year. Inspections. Dairies and Milk Purveyors 288 After Infectious Disease 1,725 Drainage Work 926 Rat infestation 526 Overcrowding 19 Factories end Workshops 996 Outworkers 569 For other nuisances 1,261 Air Raid Shelters 437 Food Shops 176 Pharmacy and Poisons Acts 43 Miscellaneous 1,445 Meat Shops and Depots 514 Re-inspection 4,855 Notices Served. Intimation Notices 1136 Statutory Notices 209 Rent Restrictions Acts certificates 13 CLEANSING AND DISINFECTION OF VERMINOUS PERSONS. Since the outbreak of war there has been a rising incidence of Scabies in the Borough, as shown by the following figures of cases treated at the Council's Cleansing Stations:- YEAR. CASES TREATED. YEAR. CASES TREATED. 1937 147 1940 357 1938 256 1941 928 1939 155 1942 2,943 Owing to the increase in the prevalence of this disease, the facilities available for treatment at the one Bathing Centre were found to be inadequate, and early in the year the Council considered the mater, and decided to provide additional accommodation in Gas Cleaning Section of one of the First Aid Posts, which was adapted for the purpose. The Scabies Order, which came into force on 28th October, 1941, was resigned to assist Local Authorities to ascertain and treat cases of Scabies and the powers of the Order extend to verminous conditions generally. Inspection and Supervision of Food. Number of samples purchased and submitted under the Food and Dings Act to the Public Analyst for examination 826 Samples found to be adulterated:- Formal samples None Informal Samples 7 The inspection of Meat was carried out daily at the Government Meat Depot situated in the Borough. In the course of these inspections 2 tons 10 cwts. of Meat and offals were condemned as unsound. Owing to the centralising of slaughtering only occasional killings of animals took place at the licensed Slaughter Houses in the Borough, where 94 carcases were examined. The total quantity of food surrendered as unfit for human consumption, upon inspection by the Sanitary Inspector, is stated below. Where possible this was passed to the Salvage authorities. Cheese 3 cwts. Meat 4 tons 3 cwt. Canned Fruit & Vegetables 1,674 tins. Vegetables & Fruit 1 ton 5 cwts. Canned Milk 680 tins. Eggs 21 dozen Milk. 41 Licences for the sale of Pasteurised Milk and 11 licences for the sale of Tuberculin Tested Milk were granted during the year.