MAL 6 Borough of Malden and Coombe Annual Report OP THE Medical Officer of Health and the Sanitary Inspector for the YEAR ENDED DECEMBER 31st 1942 Printed by J. B. Blackmore & Co. Ltd.. b5. Merton High Street, S.W.I* OFFICERS AND STAFF OF THE PUBLIC HEALTH DEPARTMENT. James Fanning, M.D., B.S. (Lond.), M.R.C.S., L.R.C.P., D.P.H Medical Officer of Health. Henry Tunbridge, M.R.San.I. Chief Sanitary and Foods Inspector. Douglas J. Hughes, C.R.San.I., Sanitary Inspector. †A. H. Newport, M.S.I.A., Sanitary Inspector. Arthur 0. Scott, Assistant Rat Officer. Oliver Elliott, General Assistant and Mortuary Keeper. †Frbderick W. W. Mitchell, Clerk. † On Active Service. TEMPORARY. Ernest C. Challis, Casualty Staff Officer. Mrs. V. E. McClellan, Shorthand Typist. Doris Cole, Clerk. Borough of Malden and Coombe ANNUAL REPORT of THE MEDICAL OFFICER OF HEALTH 1942 Public Health Department, Municipal Offices, New Malden. July, 1943. To the Mayor, Aldermen and Councillors of the Borough of Malden and Coombe. Ladies and Gentlemen, I have the honour to submit my Annual Report for the year 1942, which has been prepared in accordance with Ministry of Health Circular 2773. Although the Report has been abbreviated as much as possible, I have thought it desirable to comment on a number of points which have some importance at the present time. On the whole 1942 has been a good year with decreases in mortality rates and an increase in the birth rate. The low incidence of infectious disease, with the exception of tuberculosis, is a matter for satisfaction. I should like to record my appreciation of the work of the sanitary and clerical staff of the department which continues to be carried out under difficult conditions and at the same time.a tribute should be paid to those Civil Defence workers who have cheerfully helped the Public Health Department in various ways when requested to do so. I am, Mr. Mayor, Aldermen and Councillors, Your obedient Servant, JAMES FANNING, Medical Officer of Health, 2 STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area 3,162 acres. Registrar-General's estimate of resident population (mid-year 1942) 37,070 VITAL STATISTICS. Total. M. F. Live births 617 298 319 Birth rate per 1,000 (legitimate) 287 304 of the estimated (illegitimate) 11 15 resident population 16.6 Stillbirths 19 12 7 Rate per 1,000 total (live and still) births) 29.9 Deaths 336 168 168 Death rate per 1,000 of the estimated resident population 9.0 Deaths from Puerpreal causes:- Deaths. Rate per 1,000 Total (Live & Still) Births. Puerperal Sepsis 2 3.1 Death rates of Infants under one year of age:— All Infants per 1,000 live births 35.6 Legitimate Infants per 1,000 legitimate live births 35.5 Illegitimate Infants per 1,000 illegitimate live births 38.4 Deaths from Cancer (all ages) 63 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) Nil Deaths from Diarrhoea (under 2 years of age) 2 3 BIRTHS. During the year 617 live births were registered, an increase of 145 over last year's total. The rate per thousand was 16.6 compared with an average for England and Wales of 15.8. Of the total number 26 or 4.2 per cent. were illegitimate. The last two years have shown a decided increase in the illegitimate rate. DEATHS. During the year 336 deaths were registered, being 45 fewer than in 1941. The death rate per thousand population was 9.0 compared with an average of 11.6 for England and Wales. This represents a welcome reduction of the increased figures of the previous two years. Another satisfactory reduction was in the infantile mortality rate which was 35.6 per thousand live births and compares with 49.0 for the average of England and Wales. The unduly high rate of mortality among illegitimate children on which I have commented in previous reports has given place during the past two years to comparatively low rates. A table showing comparative birth, death and infantile mortality rates will be found on page 5. CAUSES OF DEATH. M. F. Total. Typhoid and paratyphoid fevers — - Cerebro-spinal fever — 1 1 Scarlet Fever — — — Whooping Cough — — — Diphtheria — — — Respiratory tuberculosis 13 8 21 Other forms of tuberculosis 1 2 3 Syphilitic diseases 4 — 4 Influenza — 1 1 Measles — — — Carried forward 18 12 30 4 Brought forward 18 12 30 Acute polio-myehitis and polioencephalitis — — — Acute inf : encephalitis — — — Cancer 31 32 63 Diabetes 1 2 3 Intra-cranial vascular lesions 6 23 29 Heart disease 34 28 62 Other circulatory diseases 10 7 17 Bronchitis 8 6 14 Pneumonia 5 8 13 Other respiratory diseases 2 3 5 Ulcer of stomach and duodenum 5 — 5 Diarrhoea (under 2 years) 1 1 2 Appendicitis 2 1 3 Other digestive diseases 6 5 11 Nephritis 7 7 14 Puerperal or post-abortive sepsis — 2 2 Other maternal causes - — — Premature birth 5 3 8 Congenital malformations; birth injury; infant diseases 1 6 7 Suicide 1 — 1 Road traffic accidents 5 3 8 Other violent causes 8 5 13 All other causes 12 14 26 All causes 168 168 336 DEATHS. AGE GROUPS. Under 1 1-5 5-15 15-25 25-35 35-45 45-55 55-65 65-80 80 & over Total Males 10 1 4 3 11 13 19 38 51 18 168 Females 12 2 3 4 6 12 13 25 61 30 168 Totals 22 3 7 7 17 25 32 63 112 48 336 5 STATEMENT SHOWING WHERE DEATHS OCCURRED. In District. Surrey County Hospitals. London and other Hospitals. Other Districts. Total. 144 130 48 14 336 INFANTILE MORTALITY ♦ Number of deaths occurring in infants under one year of age during the past live years:— 1938 18 Legitimate 2 Illegitimate) 20 1939 12 „ 12 „ 24 1940 21 „ 3 „ 24 1941 18 „ None „ 18 1942 21 „ 1 „ 22 Average for past five years—21. CAUSES OF DEATH OF INFANTS UNDER ONE YEAR - OF AGE. Prematurity 8 Congenital diseases, Malformations, Birth injury 7 Gastro-Enteritis 2 Broncho pneumonia 1 Cerebro-spinal meningitis 1 Other 3 SUMMARY OF BIRTH, INFANTILE MORTALITY AND DEATH RATES FOR THE PAST FIVE YEARS. Year. Births. Infantile Mortality. Deaths. 1938 16.7 30.8 8.2 1939 15.4 39.0 9.3 1940 14.5 43.7 12.6 1941 13.8 38.1 11.2 1942 16.6 35.6 9.0 Average for past 5 years 15.4 37.4 10.0 6 MORTUARY. Seventeen bodies were brought to the Mortuary and a post mortem examination was made on each. H.M. Coroner for the district held inquests in two instances and the following verdicts were returned:— Accidental death 1 Suicide 1 RAINFALL, 1942. Table showing rainfall in the district during 1942, taken at the Sewage Disposal Works, California Road, New Malden:— January 2.51 inches. February 0.60 „ March 1.75 „ April 0.86 „ May 2.65 „ June 2.96 „ July 1.69 „ August 1.61 „ September 1.17 „ October 3.47 „ November 2.00 „ December 2.37 „ Total 23.14 „ Decrease on previous year 2.82 inches. Average for past 5 years 23.25 inches. NOTIFICATION OF INFECTIOUS DISEASES, 1942. DISEASES • Totals AGE GROUPS Under 1 1-2 2-3 3-4 4-5 5-10 10-15 15-20 20-35 35-45 45-65 Over 65 Diphtheria 8 — — — — 1 1 3 — 3 — — — Erysipelas 4 — — — — — — — — — 1 2 1 Pneumonia 12 1 1 — 1 — 1 1 — 3 1 2 1 Puerperal Pyrexia 5 — — — — — — — — 4 1 — — Scarlet Fever 48 — 2 3 6 8 24 — 4 — — — 1 Ophthalmia Neonatorum — — — — — — — — — — — — — Typhoid (including Paratyphoid — — — — — — — — — — — — — Cerebro-spinal Meningitis 6 1 1 — — — — 1 — 2 — 1 — Measles 360 5 24 33 32 47 181 21 7 8 2 — — Whooping Cough 28 — 2 4 0 7 8 — — 1 — — — Dysentery 28 — 11 6 8 — — — — — — 2 1 Totals 499 7 41 46 53 63 215 26 11 21 5 7 4 diseases WARDS Totals Coombe Dickerage Mount Cambridge Norbiton Park Central Burlington Malden St. James Diphtheria 8 2 4 — — 1 — 1 — — Erysipelas 4 — — — — — — 1 1 — Pneumonia 12 2 — — 1 2 2 — 1 2 Puerperal Pyrexia 5 1 1 — — — — 1 2 — Scarlet Fever 48 5 6 2 2 — 8 4 13 8 Cerebro-spinal Meningitis 6 2 1 — — 1 — — 1 1 Measles 360 33 56 26 44 45 24 52 33 47 Whooping Cough 28 4 1 2 3 1 — 4 7 6 Dysentery 28 26 — — — — 1 — 1 —. Totals 499 75 69 30 50 52 35 65 59 64 7 8 PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. SCARLET FEVER. The incidence of scarlet fever was extremely light until the last quarter of the year when the number of cases began to rise slightly. Forty-eight cases were notified during the year, a rate of 1.29 per 1,000 population. Thirty-nine cases were treated in hospital and nine at home. Two instances of "return case" infection occurred. DIPHTHERIA. The diphtheria incidence remained on a low level, eight cases being notified, a rate of 0.21 per 1,000 population. Of these three were adult cases. None of the cases had been previously immunised. Although it has never been claimed that it is impossible to contract diphtheria after immunisation, the value of the treatment proves itself year after year in this district. Invariably the diphtheria notifications are drawn from that section of the population which is still not immunised. Considering the comparatively high proportion of children which is in fact now immunised the most hardened sceptic would find it hard to explain away the freedom of this group from attack. (At the end of the year it was estimated that of the children living in the district age 1-5, 55 per cent, have been immunised and of children age 5-15, 65 per cent, have been immunised). At the end of the year arrangements were being made to make personal calls at the homes of those children who still remain unprotected, and it is hoped that good results will ensue. The total number of children immunised during the year was 1,589, the highest figure yet reached in one year. The following statistics refer to immunisation carried out during the year :— Number of cases completing treatment by M.O.H. during the year (pre-school children 597, school children 914) 1,511 9 Number of cases treated by private doctors under the Council's Scheme 78 Number of Schick tests 97 Total number of attendances at Clinic 1,805 CEREBROSPINAL MENINGITIS. Six cases of meningococcal meningitis were notified, none of which had any apparent connection with the others. One case proved fatal, an infant of seven months. MEASLES. Measles reached epidemic prevalence during the first half of the year, but then rapidly subsided. In all, three hundred and sixty cases were notified. Most cases were of a mild type, although eighteen were treated in hospital. Measles serum derived from commercial sources was asked for and supplied in 7 cases. There is not yet sufficient evidence to compare its efficiency with that which used to be collected locally. WHOOPING COUGH. Only twenty-eight cases of whooping cough were notified. Of these two were treated in hospital. There were no deaths. DYSENTERY. An outbreak of Sonne dysentery occurred in connection with a children's residential nursery. It afforded a good example of the importance which should be attached to apparently minor diarrhæal disturbances in young children and also of the danger associated with the short term residence of young children in nurseries. A condition of sub-acute and chronic diarrhoea with relapses had been prevalent at the nursery for some months before the position came to light, and although the originating ease was doubtful the infection was obviously being kept alive 10 by case to case transference. There were no very typical symptoms other than diarrhoea, and only in one out of a large number of specimens examined was the Sonne bacillus isolated. This however was sufficient to confirm suspicions as to the cause. The infection was only brought to an end by the exclusion of all children under two years of age. A proportion of these young children showed relapses over a period of months, and it was found that very little reliance could be placed on bacteriological examination as a criterion of their fitness to mix with others. They were therefore persistent reservoirs of infection. As I have indicated on previous occasions it is probable that this type of infection is as frequent as the common "cold," but is is usually only among young children that the condition is ever serious. The gravity of the infection when young children are involved is emphasised by the fact that six deaths had occurred over some months before the necessity for drastic action was fully appreciated. SCABIES. Scabies still remained a "nuisance disease" and showed little sign of abating during the year. One of the chief causes of its spread is the reluctancee of people to admit that they may have contracted the disease, and even the unwillingness of doctors to diagnose it. Many cases do not conform to the familiar text-book description, and the only safe rule to follow at the present time is to consider every itching eruption to be due to scabies until it has been proved something else. The policy of relying on home laundry only for the disinfestation of clothing has been continued, and has now been adopted as the official policy of the Ministry of Health. It has not yet been found necessary to use central cleansing stations. The convenience of most householders is better suited by treatment in the home, and this has been carried out with the willing help of Civil Defence personnel in co-operation with the patients themselves. The proprietary poly- 11 sulphide ointment previously used is now being replaced by a benzyl benzoate emulsion. Botli preparations are effective, but the latter is less "messy." During. 1942, 282 infested persons from 117 families received treatment. This number does not include those who received treatment as contacts only. CASE RATES PER 1,000 POPULATION FOR CERTAIN INFECTIOUS DISEASES. England and Wales. Borough of Maiden 6c Coombe. Smallpox 0.00 0.00 Scarlet fever 2.19 1.29 Diphtheria 1.05 0.21 Typhoid fever 0.01 0.00 Paratyphoid fever 0.01 0.00 Cerebro-spinal fever 0.14 0.16 Erysipelas 0.30 0.10 *Puerperal pyrexia 12.61 7.8 *1,000 total births (i.e., live and stillbirths). TUBERCULOSIS. Age Periods NEW CASES DEATHS Respiratory Non-Respiratorv Respiratory Male Female Male Female Male Female Male Female 0 — — — — — — — — ] — — 2 — — — 1 5 2 3 — 1 — — 1 1 15 4 12 — 3 — — — — 25 5 4 1 3 3 4 — — 35 6 4 — 2 4 1 — — 45 1 — — — 2 — — — 55 3 3 — — 1 2 — — 65 & upwards 4 — — — 3 1 — — Totals 25 26 1 11 13 8 1 2 There was a further increase in the number of new eases of both pulmonary and non-pulmonary forms of tuberculosis, although there was a fall in the death rate. The increase in new cases was especially marked in the age groups 15-25 and to a less extent 5-15 and especially 12 in the female sex. There can be little doubt that the increase is associated with the stresses of life arising directly from war conditions and especially with the absorption of so many young people into industry. The housing shortage compels tuberculous families to live under more crowded conditions than they would normally, and this is a serious difficulty which is constantly recurring at the present time. To some extent the figures are magnified by the discovery of early disease in those who are about to join or who have just joined the various branches of the forces, and in one way this is an advantage. Notification of tuberculosis was on the whole satisfactory. There were eight cases during the year which did not come to light until after death. The facilities for chest X-ray examination offered by arrangement with the Kingston Victoria Hospital was made use of by four cases. At the end of the year the following number of cases was shown to be suffering from disease and living in the district, an increase of 13 cases compared with the previous year:— Pulmonary. Non-Pulmonary. Males 90 16 Females 70 22 CASES REMOVED TO TOLWORTH ISOLATION HOSPITAL. Scarlet fever (including one re-admission) 39 Suspected scarlet fever 6 Diphtheria 6 Diphtheria "carrier" 1 Suspected diphtheria 6 Cerebro-spinal fever 4 Suspected cerebro-spinal fever 1 Dysentery 28 Measles14 Whooping cough 2 . 13 Erysipelas 3 Suspected erysipelas 1 Chicken pox 3 Scabies and Impetigo 7 Pneumonia 4 Miscellaneous 7 132 CASES MOVED TO OTHER ISOLATION HOSPITALS. Diphtheria 2 Measles 4 NUMBER OF NOTIFICATIONS RECEIVED YEARLY FOR, THE PAST SIX YEARS. 1937 1938 1939 1940 1941 1942 Scarlet Fever 39 68 96 46 23 48 Diphtheria 22 22 6 5 7 8 Enteric Fever (including Paratyphoid) 4 2 1 5 1 Erysipelas 4 6 11 2 6 4 Pneumonia 19 24 24 18 20 12 Encephalitis Lethargica Puerperal Pyrexia 3 12 9 2 1 5 Cerebro-Spinal Fever — 1 — 15 6 6 Acute Poliomyelitis 1 1 — — — — Ophthalmia Neonatorum 2 — 1 — — — Dysentery 12 2 — — 2 28 Malaria - - - - - - *Measles —' — — 409 232 360 *Whooping Cough — —, — 13 133 28 Tuberculosis (all forms) 46 37 38 49 53 63 *Notifiable since November, 1939. 14 GENERAL PROVISION OP HEALTH SERVICES IN THE AREA. The following table shows the number of pathological examinations during the past year:— Disease. Results. Totals. Positive. Negative. Tuberculosis Sputa 4 28 32 Scarlet Fever Swabs 2 7 9 Diphtheria Swabs 3 122 125 Dysentery Faeces 8 95 103 do. Blood 1 12 13 do. Urine — 1 1 Totals 18 265 283 A number of samples of milk were submitted for bacterial count or the presence of tuberculosis, details of which will be found in the report of the Sanitary Inspector. There has been no change in the general provision of health services as recorded in my annual report for 1938. 15 SANITARY ADMINISTRATION. ANNUAL REPORT OF THE SANITARY INSPECTOR 1942 Public Health Department, Municipal Offices, New Maldkn. To the Mayor, Aldermen and Councillors. Ladies and Gentlemen, I have the pleasure to submit my twenty-third annual report of work accomplished and matters of interest concerning the Sanitary Department. In view of the exceptional circumstances this will necessarily again be greatly curtailed. . For the purpose of abating nuisances and executing repairs to render houses fit for human habitation, the following notices were served:— Preliminary. Formal. Notices served 123 23 Complied 101 17 Remain outstanding 21 6 It was not necessary to institute proceedings for the abatement of nuisances or other sanitary matters. SCABIES. Much time was spent and many visits made in connection with the treatment of persons suffering from Scabies. 16 INFECTIOUS DISEASES. The following number of rooms were disinfected for the under-mentioned causes:— Scarlet Fever 41 Diphtheria 7 Tuberculosis 40 Vermin— Houses 1 Rooms 5 Typhoid or Paratyphoid and Dysentery 9 Puerperal Pyrexia 13 Cerebro-Spinal Fever 3 Other 5 124 Two Public Elementary Schools were disinfected throughout during the year. One hundred and thirty-seven books from the Public Library and Schools were disinfected for various reasons. Thirty-seven loads of bedding were removed for steam disinfection and four for destruction. In addition to the above, 178 blankets, 69 mattresses, 39 cushions and pillows from various posts and shelters have been disinfected or disinfested. WATER SUPPLY. The drinking water for the district is supplied by the Metropolitan Water Board and consists of Thames derived stored water, filtered and terminally chlorinated. FOOD AND DRUGS ACT, 1938. During the year 121 samples were submitted to the Public Analyst for analysis. These comprised the following:— 17 ARTICLES. ANALYSED. Adulterated or below standard. Formal. Informal Total. Formal. Informal Total. Flour, Self-raising 1 15 16 1 — 1 Flour, Plain — 4 4 — — — Milk — 25 25 — — — Tea — 8 8 — — — Cheese — 13 13 — — — Butter — 6 6 — — — Lard — 7 7 — — — Margarine — 5 5 — 5 5 Saccharine 1 — 1 1 — 1 Baking Powder — 5 5 — 1 1 Tonic Wine — 1 1 — 1 1 Pepper — 3 3 — — — Gin — 1 1 — — — Jam — 2 2 — — — Egg Flakes — 1 1 — — — Coffee — 3 3 — — — Semolina — 2 2 — — — Dried Fruits — 2 2 — — — Rice — 2 2 — — — Curry Powder — 9 2 — — — Egg Substitute Powder — l 1 — — — Custard Powder Substitute — 2 2 — — — Cocoa — ' 4 4 — — '— Mustard — 1 1 — — — Pickles — 1 1 — — — Whisky 1 2 3 — 1 1 3 118 121 2 8 10 Notes in regard to samples shown as adulterated or deteriorated. Self-raising flour.—The raising ingredients of this sample consisted of a mixture of acid calcium ammonium phosphate and sodium bicarbonate. Due to the fact that the sample was taken owing to complaint the Ministry of Health was communicated with but in view of the reply no further action was taken. Margarine.—Each of these samples contained Boric Acid. The Public Health (Preservatives in Food) Regulations forbids the addition of preservatives in Margarine and for this reason the Public Analyst returned them as being non-genuine. Under the Emergency Powers (Defence) Regulations, however, the addition of Borax is permitted under licence by the Ministry of Food. No action therefore was taken. 18 Saccharine.—Although Saccharine was asked for sweetening tablets were supplied. These contained saccharine but under strength. In view of the explanation given by the firm no action was taken except that a warning was given. Baking Powder.—One informal sample contained less than 8 per cent. of available carbon-dioxide. A formal sample of the same brand could not be obtained. Tonic Wine.—Although this sample has been listed as an informal sample it was really brought to the office by a purchaser. The district was afterwards searched for a formal sample but none could be found. Whisky.—An informal sample was found to contain six per cent. of excess water. A formal sample taken was genuine. It is extremely difficult to obtain sufficient whisky for analysis without disclosing one's identity. OVERCROWDING. A few eases of overcrowding were reported or found in the course of visits. These had to be dealt with sympathetically and it was not always possible to obtain an abatement of the conditions, although in several cases this was accomplished. Only in one instance were the circumstances such that formal action had to be taken. Applications to be supplied with the permitted numbers for houses necessitated visits to and the measurement of 10 houses. FOOD SUPPLY. As far as possible, watch is kept on premises where foodstuffs are prepared or sold, which includes slaughterhouses, butchers and fishmongers' shops, bake-houses, dairies, cowsheds, etc. The following unfit foodstuffs were voluntarily surrendered and destroyed or handed over for salvage:— Beans 40 tins Meats (various) 78 „ Fish 22 „ Fruits and Vegetables 85 „ Milk 146 „ Soup 21 „ Marmalade and Jam 2 jars Eggs 42 19 Lentils 542 lbs. Sweets 81 „ Fish (Wet) 805 „ Bacon 76 „ Onions 107 „ Cheese 243 „ Lard 8 „ Coffee 80i „ Porridge Meal 96 „ Meat (Fresh) 34 ozs. The above shows rather a large increase over previous years but is explained by the fact that all provision merchants now notify me when they have unsound food, especially rationed goods. They must produce my certificate before obtaining replacements. A copy of the certificate is also supplied to the Food Office so that the appropriate number of points coupons can be given to the person concerned. There now remain only two slaughterhouses in the district; one has been used on isolated occasions. SHOPS ACTS. The whole of these Acts are administered by my Department. There appears to have been no instance of intentional evasion. ERADICATION OF BED BUGS. During the year the following number of houses were found to be infested with bed bugs:— Infested. Disinfested. (a) Council houses 1 1 do. (rooms) 5 5 (b) Other houses 3 3 Every house becoming vacant on the Corporation's Estates is carefully inspected before re-letting. Advice has also been given to a number of house owners, and several houses have been treated by outside contractors without notice from my department. HCN is known to have been used in two or three cases. 20 MILK. During the year the following licences were issued under the Milk (Special Designations) Orders. Dealers. Tuberculin tested 7 Pasteurised 7 Pasteurisers' licences 1 Supplementary. Tuberculin tested 6 Pasteurised. 5 Sixty-two samples of milk were submitted for examination and in ten instances they were also examined for the presence of Tubercle bacilli by animal experiment with negative results. In a number of instances high counts were recorded and can mostly be accounted for by the prevailing abnormal conditions. Many of the samples reported upon unfavourably were bottled and produced outside the district and active investigations were made to find the cause of the trouble. The rationalisation scheme which came into force during the year caused some temporary difficulties and complaints were received, not only in regard to the rapid souring of the milk but of poor quality. In regard to the former the complaints were justified in some instances but in regard to the latter this was disproved. Nine samples of pasteurised milk were submitted to the phosphatase test, and in each case a negative result was returned. SMOKE ABATEMENT. Except for some isolated instances regarding laundry chimneys no complaints were received in regard to smoke nuisances. The trouble appeared mostly to be due to inferior or unsuitable fuel. 21 RATS AND MICE DESTRUCTION. The amount and importance of this branch of public health work has greatly increased. There can be no doubt that this is recognised by the Government because of the enormous damage done to foodstuffs by these rodents and more attention will undoubtedly be directed to the problem. Although this district compared with many cannot be said to be badly infested, nevertheless your Rat Officer finds his time more than fully occupied dealing with the requests and complaints which reach him. The far greater number of householders keeping poultry and animals has undoubtedly tended to increase the rat population in the district and to produce greater problems than normally exist during peace time. I feel the time is not far distant when further assistance will have to be asked for. MISCELLANEOUS. Some mention should be made of a nuisance which occurred at a certain factory and occupied a considerable amount of time. It would perhaps be improper at the present time to give details of the process which created the smell, with rats and plagues of flies and crickets in addition. Suffice to say that little could be done to avoid some smell but strenuous efforts were made to minimize the nuisance of the rats and insects. The work carried on is one of national importance and towards the end of the year had more or less ceased. Should war conditions make it necessary for the process to be recommenced it is hoped, with the experience gained in the past, that similar conditions will not recur. The co-operation of the Government Department concerned will do much to assist towards this end but the very nature of the work makes it impossible altogether to avoid some nuisance. I am, Mr. Mayor, Aldermen and Councillors, Your obedient Servant, HENRY TUNBRIDGE, Chief Sanitary Inspector.