AL 4413 (1) MITCHAM MIT 19 BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1950 BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1950 MITCHAM: H. G. Mather, Ltd., Caxton Works, Lower Green 3 Borough of Mitcham HEALTH REPORT FOR 1950 To the Mayor, Aldermen and Councillors. Mr. Mayor, Ladies and Gentlemen, I have much pleasure in submitting the annual report for the year 1950. The year 1950 was a very good one as regards infectious diseases, for although the incidence of disease rose the severity remained of a low order. Whooping cough notifications were almost doubled from last year, but no deaths occurred. The 16 cases of dysentery notified were mild cases referred on clinical grounds only and where bacteriological examinations could be made they proved negative. Probably the most outstanding point of interest is that for the first time within record there was no case of diphtheria, which followed on only one case in 1949. This compares with an average of 60 cases per year for the 20-year period 1927-1946, so that as a result of immunisation there must have occurred a tremendous saving of lives and illness as well as a considerable saving in nursing and hospital services; and immunisation has proved itself to be a preventive measure of the highest value. Although the incidence of poliomyelitis was fairly high for England and Wales there were only two cases in Mitcham, both being of a mild character. Notification of tuberculosis rose from 106 to 117 cases, while the 34 deaths gave a death rate of .5 per 1,000, which is above 4 that for England and Wales, although this has been the case for some time now, and may have some reference to the fact that Mitcham is fairly densely populated. The birth rate dropped to 13.51, which is the lowest yet recorded in Mitcham and compares with 15.8 for England and Wales, although the death rate of 9.19 is much better than the 11.6 for the rest of the country. The infantile mortality of 29.64 is almost identical with that for England and Wales. Although so much has been done in building and re-housing, the housing problems still cause great concern. With regard to clean food, all food premises in the Borough have been carefully examined and a special record kept with points being awarded. They were found on the whole to be satisfactory, with some minor adjustments necessary. I am, Ladies and Gentlemen, Your obedient servant, A. R. GRAHAM, Medical Officer of Health. Public Health Department, Mitcham Court, Mitcham. 5 BOROUGH OF MITCHAM PUBLIC HEALTH COMMITTEE. Chairman Councillor Miss M. J. Faraday The Worshipful the Mayor (Alderman T. A. East, J.P.) Aldermen— Mrs. J. C. Ericson Mrs. H. E. Niven Mrs. E. Watson G. R. Madgwick G. W. Pearce Councillors— Mrs. L. Crump Mrs. W. R. Martin E. Gulliver E. J. Mills J. M. Togwell REPRESENTATIVES OP THE COUNCIL ON OTHER AUTHORITIES. WANDLE VALLEY JOINT SEWERAGE BOARD The Worshipful the Mayor (ex officio) and Councillor F. S. Niven NORTH.EAST DIVISIONAL HEALTH SUB-COMMITTEE (SURREY COUNTY COUNCIL) Aldermen— Mrs. J. C. Ericson Mrs. H. E. Niven G. W. Pearce H. T. Simms Councillor— J. M. Togwell 6 STAFF Medical Officer of Health A. R. Graham, M.B., Ch.B., D.P.H., Barrister-at-Law. (Commenced duties April 1, 1950) A. W. Johns, M.R.C.S., L.R.C.P., D.P.H. (Acting Medical Officer of Health till end of March, 1950) Chief Sanitary and Meat Inspectoi. Petroleum Inspector Shops Act Inspector K. J. Gutteridge (1, 2) Assistant Sanitary and Meat Inspectors L. Gleed (1, 2, 3) E. N. Montague (1, 2) E. J. Sluis (1, 2) L. M. Edwards (1) 1. Certificate Sanitary Inspectors' Board. 2. Certificate Meat and Foods R.S.I. 3. Smoke Inspector's Certificate. Clerks (a) L. J. Bellingham (b) Miss V. Valentine (c) Mrs. V. E. Bevan (d) Miss M. Sanders (e) Mrs. R. Osborn (a) Part-time—75 per cent. Surrey County Council. (b) Part-time—75 per cent. Surrey County Council. (c) Commenced duties 6.3.50. Part-time—40 |>cr cent. Surrey County Council. (d) Part-time—40 per cent. Surrey County Council. (e) Full-time—Borough of Mitcham. 7 REPORT STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 2,916 acres Population, Census 1921 35,119 ,, „ 1931 56,856 Registrar-General's estimate of population midyear, 1950 67,430 Number of inhabited houses. 1921 7,150 ,, ,, ,, 1931 13,187 ,, ,, ,, 1950 18,652 Rateable Value, 1950 £535,660 Sum represented by a 1d. rate £2,163 STATISTICS. Live Births. Total Male Female Rate per 1,000 of population Legitimate 873 445 428 Illegitimate 38 20 18 Total 911 465 446 13.51 Still Births. Total Male Female Rate per 1.000 total births Legitimate 20 13 7 Illegitimate 2 2 Total 22 13 9 23.58 Deaths. Total Male Female Rate perl,000 of population 620 327 293 9.19 Deaths from pregnancy, childbirth and abortion:— Rate per 1,000 total births Number of cases . 1 1.07 8 Deaths of infants under one year of age :— All infants per 1,000 live births 29.64 Legitimate infants per 1,000 live legitimate births 26.85 Illegitimate infants per 1,000 live illegitimate births 105.26 Deaths from:— Cancer (all ages) 102 Measles - Whooping cough (all ages) - Diarrhœa (under two years of age) 1 Percentage of Births Occurring in Institutions Year Total births Births in hospitals, etc. Percentage of births occurring in institutions 1931 1148 370 32.3 1982 1084 381 35.1 1983 1010 420 41.5 1934 982 428 43.5 1935 969 474 48.9 1936 1033 497 48.1 1937 976 501 51.8 1938 1028 569 56.3 1939 966 518 53.7 1940 854 453 53.0 1941 737 408 55.4 1942 986 518 52.5 1943 1048 727 69.4 1944 996 678 68.1 1945 993 661 66.5 1946 1290 845 65.5 1947 1405 956 68.0 1948 1215 855 70.87 1949 1129 832 78.69 1950 933 718 76.96 9 The birth rates, death rates per 1,000 of population, and the infantile mortality rates for the years 1931-50 are shown in the following table: — Year Births per 1,000 population Deaths per 1,000 population Infant Mortality per 1,000 live births MITCHAM England A Wales MITCHAM England it Wales MITCHAM England & Wales 1931 19.2 15 8 9.8 12.3 42 66 1932 18.0 15 3 8.4 12.0 43 65 1933 16.1 14.4 8.8 12.3 37.1 64 1934 15 6 14.8 9.1 11.8 51 6 59 1935 15.6 14 7 7.7 11.8 49.5 57 1936 15.4 14.8 9.1 12.1 48.0 59 1937 14.3 14.9 8.5 12.4 43.4 58 1938 15.1 15.1 8.3 11.6 38.0 53 1939 15.2 15.0 8.6 12.1 31.0 50 1940 15.4 14.6 11.8 14.3 46.0 55 1941 13.57 14.2 11.06 12 9 55.4 59 1942 17.54 15.8 9.81 11.6 43.75 49 1943 18.75 16.5 10.77 12.1 36.2 49 1944 18.99 17.6 11.88 11.6 36.8 46 1945 18.01 16.1 10.19 11.4 31.83 46 1946 20.3 19.1 9.2 11.5 19.9 43 1947 21.39 20.5 9.47 12.0 38.60 41 1948 17.99 17.9 8.79 10.8 23.49 34 1949 16.45 16.7 9.17 11.7 24.48 32 1950 13.51 15.8 9.19 11.6 29 64 29.8 10 Infant Mortality During the year 27 deaths were registered as occurring in infants under one year of age:— Males Females Total Legitimate 13 10 23 Illegitimate 3 1 4 Totals 16 11 '27 as compared with '27 deaths last year. The following table shows the principal causes of death in the various age groups: — Deaths of Infants under One Year of Age. Age No. Cause of Death Prematurity Congenital Defects Accidents of birth Infectious conditions Other conditions Under 24 hrs... 9 2 7 — — — 1 - 7 days 6 — 6 — — — 8 days - 1 mth. 1 — 1 — — — 1 mth. -12 mths. 11 — 2 1 8 — Total 27 2 16 1 8 — Sixteen infants failed to survive the first month of life, and prematurity was certified as the cause of death of two of these infants. Maternal Mortality. During the year one death was registered. In 1949 one death was registered due to disease or accident of pregnancy. Inquests. Inquests were held on 14 residents dying within the district and on 16 Mitcham residents who died outside the district, a total of 30. In addition, the coroner held 70 post-mortems without 11 inquests on residents dying within the district, and on 61 Mitcham residents who died outside the district, a total of 131. The following table shows the results of the findings of these inquests: — Accidental deaths 12 Deaths from misadventure 5 Suicides 7 Open verdict 3 Natural causes 2 Due to war operations 1 Total 30 12 Deaths Registered during the Year 1950 Cause of Death Males Females Total 1 Tuberculosis, respiratory 20 11 31 2 Tuberculosis, other 2 1 3 3 Syphilitic disease 2 1 3 4 Diphtheria ... ... ... 5 Whooping cough ... ... ... 6 Meningococcal infections ... 2 ... 7 Acute poliomyelitis ... ... ... 8 Measles ... ... ... ... 9 Other infective and parasitic diseases 1 ... 1 10 Malignant neoplasm, stomach 11 6 17 11 Malignant neoplasm, lung, bronchus 21 2 23 12 Malignant neoplasm, breast ... 12 12 13 Malignant neoplasm, uterus ... 5 5 14 Other malignant and lymphatic neoplasms 28 17 45 15 Leukaemia, aleukæpmia 1 5 6 16 Diabetes ... 4 4 17 Vascular lesions of nervous system 31 36 67 18 Coronary disease, angina 62 23 85 19 Hypertension with heart disease 11 10 21 20 Other heart disease 29 57 86 21 Other circulatory disease 10 16 26 22 Influenza ... 2 2 23 Pneumonia 15 14 29 24 Bronchitis 28 19 47 25 Other diseases of respiratory system ... 1 1 26 Ulcer of stomach and duodenum 3 3 6 27 Gastritis, enteritis and diarrhoea ... 1 1 28 Nephritis and nephrosis 3 3 6 29 Hyperplasia of prostate 5 ... 5 30 Pregnancy, childbirth, abortion ... 1 1 31 Congenital malformations 8 5 13 32 Other defined and ill-defined diseases 26 26 52 33 Motor vehicle accidents 1 1 2 34 All other accidents 3 7 10 35 Suicide 5 2 7 36 Homicide and operations of war 1 ... 1 All causes 327 293 620 13 Birth rates, Death-rates, Analysis of Mortality, Maternal Mortality, and Case-rates for certain Infectious Diseases in the year 1950. (Provisional figures based on quarterly returns.) England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns (Resident Populations 25,000 to 50,000 at 1931 ccnsus) London Administrative County Mitcham Bates per 1,000 home population Births— Live 15.8 17.6 16.7 17.8 13.51 Still Deaths— 0.37 0.15 0.38 0.36 0.33 All causes 11.6 12.3 11.6 11.8 9.19 Typhoid and Paratyphoid 00.0 0.00 0 00 0.00 0.00 Whooping cough 0.01 0.01 0.01 0.01 0.00 Diphtheria 0.00 0.00 0.00 0.00 0.00 Tuberculosis 0.36 0.42 0.33 0.39 0.50 Influenza 0.10 0.09 0.10 0.07 0.03 Smallpox — — — — — Acute Poliomyelitis (including polioencephalitis) 0.02 0.02 0.02 0.01 0 00 Pneumonia 0.46 0.49 0.45 0.48 0.43 Notifications (corrected)— Typhoid fever 0.00 0 00 0.00 0.01 0.01 Paratyphoid fever 0.01 0 01 0.01 0.01 0.00 Meningococcal infection 0.03 0.03 0.02 0 03 0.01 Scarlet fever 1.50 1.56 1.61 1.23 1.63 Whooring cough 3.60 3.97 3.15 3.21 5.74 Diphtheria 0.02 0.03 0.02 003 0.00 Erysipelas 0.17 0.19 0.16 0.17 0.10 Smallpox 0 00 0.00 — — — Measles 8.39 8.76 8.36 6.57 5.25 Pneumonia 0.70 0.77 0 61 0.50 0.42 Acute Poliomyelitis (including polioencephalitis) Paralytic 0.13 0.12 0.11 0 08 0 03 Non-paralytic 0.05 0 05 0.06 0.05 0.00 Food Poisoning 0.17 0.16 0.14 0.25 0.04 Bates per 1,000 live births Deaths under one year of age 29.8" 33.8 29.4 26.3 29.64 Deaths from diarrhoea and enteritis under two years of age 1.9 2.2 1.6 1.0 1.09 Rates per 1,000 total births (live and still) Notifications (corrected)— Puerperal fever ... 5.81 7.43 4.33 6.03 0.00 Puerperal pyrexia Maternal mortality... Pregnancy,childbirth and abortion ... ... 0.86 Not available 1.07 Abortion— Mortality per million women aged 15-44 N ot availabl e With sepsis 7 I Without sepsis 4 ) • Per 1,000 related live births. 14 GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA LABORATORY FACILITIES. Most of the bacteriological examinations for this district were carried out at the Emergency Public Health Laboratory at Epsom, including bacteriological examinations of milk, water and ice-cream. Examinations were also carried out in respect of certain infectious diseases at the Wandle Valley Isolation Hospital where 52 swabs for Diphtheria and 7 sputa for Tuberculosis were examined during the year. The chemical analysis of milk, water and foodstuffs was carried out bv the Public Analyst, Daniel D. Moir. M.Sc., F.R.I.C., 16, Southwark Street, London, S.E.I. AMBULANCES The Ambulance service is supervised by the Surrey County Council. Two ambulances are stationed at Mitcham Court, Telephone No. Mitcham 3082. If an ambulance is not available telephone Fairlands 8893 (St. Helier Hospital). Disinfection The disinfection of houses is undertaken by the Council. Disinfection of bedding, etc., is done by the Wandle Vallej Isolation Hospital. No charges are made for disinfections carried out in cases of notifiable infectious disease. Public library books which have been in contact with cases of infectious disease are disinfected at the Public Health Department. Number of disinfections carried out by Wandle Valley Isolation Hospital 37 Number of rooms disinfected by fumigator 231 Number of library books disinfected 243 15 HOSPITALS The hospitals directly concerned with the Mitcham area are administered by the St. Helier Group Hospital Management Committee, which is situated at Carshalton, Surrey. This group is itself contained within the South-West Metropolitan Regional Hospital Board. General Cases.—The principal hospitals are the Wilson Hospital which is situated within the district, and the St. Helier Hospital, Carshalton, which caters for all types of cases. The Nelson Hospital at Merton and the large London hospitals are also used. Infectious Diseases.—Cases usually go to the Wandle Valley Isolation Hospital at Beddington Corner, Mitcham Junction. Other hospitals nearby, namely, the Grove Hospital, Tooting, and the Cuddington Isolation Hospital, Banstead, are also used frequently. Smallpox Cases.—By agreement with the South-East Metropolitan Regional Hospital Board, any cases are admitted to the Joyce Green Hospital, Dartford, Kent, upon application. Maternity Cases.—Expectant mothers, if home conditions or medical history do not permit of home confinement, are admitted to the Woodlands Maternity Home situated within the district, or to the St. Helier Hospital, Carshalton, if hospital treatment is required. Tuberculosis Cases.—The Regional Hospital Board is responsible for providing the specialist services for the tuberculous, also for institutional treatment. Dr. J. M. Hill is the chest physician for Mitcham patients and holds a clinic at the St. Helier Hospital, Carshalton, every Monday at 9.30 a.m., Wednesday at 1.50 p.m., Thursday at 1.50 p.m., and Friday at 9.30 a.m. A clinic is held, for old cases only, on every fourth Wednesday at 5.30 p.m. Venereal Diseases Clinics.—Confidential treatment can be obtained at the St. Helier Hospital, Carshalton, and the Croydon General Hospital. Treatment can also be obtained from the outpatients' departments of many of the London hospitals. 16 CLINICS AND TREATMENT CENTRES (Under Control of the Surrey County Council) Welfare Clinics Infant Welfare Centres are held at the following places: — Cavendish Road Welfare Centre.—Sessions are held every Monday afternoon. St. Barnabas Church Hall, Gorringc Park Avenue.— Sessions are held every Tuesday afternoon Sherwood House, Commonside East.—Sessions are held every Thursday morning, and Monday afternoon (weighing). Church Road Centre.—Sessions are held every Thursday afternoon, and Wednesday afternoon (weighing session). Meopham Road Clinic.—Sessions are held each Wednesday afternoon. Toddlers' Clinics for children between the ages of two to five years are held on alternate Monday mornings by appointment. Ante-Natal Clinics Ante-natal clinic is held at the Church Road Clinic. Sessions are held every Tuesday and Friday morning, and a clinic for cases booked by midwives is held on Friday afternoons. X-Ray examinations are carried out at the Wilson Hospital when necessary for expectant mothers. Post-Natal Clinic A post-natal clinic is held at Church Road Clinic on the first Monday in the month. Dental Clinics Dental services are provided for expectant and nursing mothers, toddlers and school children at the Church Road, Western Road and Sherwood House Clinics. 17 Minor Ailments A clinic is provided at Western Road. U.V. Radiation Clinics Sessions are held as follows : — Church Road Clinic: Monday afternoons, Thursday mornings. Sherwood House Clinic: Tuesday mornings, Friday afternoons. Diphtheria Immunisation Clinics and Vaccination Against Smallpox Clinics are held as follows: — Meopham Road Clinic Monday afternoons Church Road Clinic Wednesday mornings Cavendish Road Clinic Thursday afternoons Day Nurseries The Surrey County Council provide two day nurseries in Mitcham, one at Eagle House, London Road, Mitcham, with 85 places, and the other at Robinson Road, Colliers Wood, with places for 50 children. Health Visiting. Health visitors are under the control of the Surrey County Council. There were eight Health Visitors employed in visiting the mothers and children in this district. Every Health Visitor carries out the combined duties of District Health Visitor and School Health Visitor. Home Help Service The Home Help Service, which is under the control of the Surrey County Council, has proved most successful. Applications for assistance are made to the Divisional Medical Officer at Mitcham Court. 18 National Society for Prevention of Cruelty to Children The Society does very valuable work in the Borough and there is very close co-operation between the officials of the Public Health Department and the officers of the Society. Number of Mitcham cases dealt with in 1950 32 Number of children affected 54 Number of visits paid 103 SANITARY CIRCUMSTANCES OF THE AREA WATER SUPPLY Except for eight houses in Goat Road, supplied by the Sutton Water Company, the whole of Mitcham is supplied by the Metropolitan Water Board. A few factories have an additional supply from deep wells. There are six licensed caravan yards, each with a stand pipe, supplying altogether a total of 16 caravans. The water has been of a consistently high standard of purity and no case of infectious disease has been transmitted by water. A large number of houses in the Borough have no supply of drinking water direct from the main, but are supplied from a tank in the roof. Provided the tank is properly covered and is cleansed regularly, it provides a satisfactory supply. RIVERS AND STREAMS Visits have been paid to all works suspected of discharging effluent into surface water sewers. CLOSET ACCOMMODATION The whole of the district is on the water carriage system, the houses being drained to the public sewer, then treated at the works of the Wandle Valley Joint Sewerage Board. 19 PUBLIC CLEANSING A weekly collection of house refuse is carried out by direct labour. Eight refuse collection vehicles are in use. A weekly collection of paper salvage is also made, two vehicles being used for this purpose. Pig food is collected three times weekly, except for the months of June, July and August, when a daily collection is made. ERADICATION OF BED BUGS Number of Council houses found infested during the year, 143. Number of other houses found infested during the year, 20. Number of requisitioned, etc.. houses found infested during the year, 44. Total number of houses disinfested during the year, 187. Methods employed: — 6 houses treated with sulphur dioxide. 181 houses treated with insecticide spray (inclusive of those treated on more than"one occasion). No private house was treated by the Council staff, but advice was given and material supplied at cost price on request. Number of houses disinfested for beetles, 84. Number of houses disinfested for spiders and other insects, 23. SCHOOLS The supervision of the public elementary schools is under the control of the Education Department of the Surrey County Council. The sanitary fittings, etc., however, are inspected periodically by the sanitary inspector. All schools have a constant supply of water from the mains of the Metropolitan Water Board, 20 Medical Inspection.—The medical inspection of school children is carried out hy the School Health Service of the Surrey County Council. Closure of Schools.—No school has been closed by the local authority during the year. Infectious Diseases.—Scholars in contact with a case of infectious disease are excluded from school, the period of the exclusion being that set out in memorandum of the County School Medical Officer to the Surrey Education Committee. The head teacher of the school concerned is always notified of this exclusion and the reason for same. PREVENTION OF DESTRUCTION BY PESTS ACT, 1949. Three full-time and one part-time Rodent Operators were employed. House to house inspections 10,181 Complaints received 410 Number of treatments re rat infestation including test baits as result of inspection and complaints ... 1,942 Factory and business premises treated 101 Visits by Sanitary Inspectors 197 Two sewer maintenance treatments were carried out; 144 manholes were baited. 156 intercepting chambers were also baited on the route of one maintenance treatment. A ten per cent, test of the sewer manholes in the district was carried out. THE ANNUAL REPORT OF THE CHIEF SANITARY INSPECTOR To the Mayor, Aldermen and Councillors of Mitcham Madam, Ladies and Gentlemen, I beg to submit a summary of the visits and works carried out in the Borough by myself and the District Sanitary Inspectors: — Number of complaints received 1,238 Visits re complaints and sundries 1,455 21 Revisits 3,670 Houses inspected for defects 1,222 Number of nuisances discovered 1,075 Number of intimation notices served 803 Number of intimation notices complied with 554 Number of statutory notices served 262 Number of statutory notices complied with 240 Visits to butchers 215 Visits to other food shops 453 Visits to ice-cream shops 280 Visits to factories 129 Visits to slaughter houses 72 Visits to restaurant kitchens 165 Visits to stables 47 Visits to outworkers' premises 8 Visits to marine stores — Visits to caravan yards. 42 Visits re building licence applications 82 Details of visits to other premises are enumerated in other sections of the report. Character of Work Done Roofs repaired 281 Rainwater piping or gutters repaired or renewed 250 Yards paved or repaired 27 Dampness remedied 222 Water service pipes repaired 40 Waterclosets: Repairs to structure 61 Flushing apparatus repaired or renewed 89 New pans and traps fitted 78 Water storage cisterns cleansed, repaired or renewed 24 Water supply reinstated 8 Flooring of rooms repaired and sub-floor ventilation improved 164 Rooms cleansed and redecorated 229 Sinks and handbasins repaired or renewed 48 Waste pipes and traps repaired or renewed 62 Window frames and sashes repaired or renewed 187 22 Window sills repaired or renewed 89 External brickwork (repaired, pointed or rendered) 88 Drains repaired or obstructions removed 195 Drain inspection covers renewed 26 Drains tested 82 Grid and mica flaps provided 11 Firegrates repaired (including surrounds and hearths) 88 Stoves, coppers, ranges, etc., repaired 33 Chimney stacks repaired 27 Staircases repaired 21 Doors repaired 91 Internal plaster repairs 952 Sash cords renewed 181 Dustbins provided 69 Accumulations removed 35 All ponds and ditches in the Borough where mosquito breeding was possible were sprayed with insecticide twice during the year. Twenty-six visits were paid for this purpose. Legal Proceedings.—Twelve applications were made to the Justices for Nuisance Orders against property owners under Section 94, Public Health Act, 1936. The results were as follows: — Nine summonses were dismissed, with one guinea costs in each case, as works were completed before the hearing of summonses. On three summonses, the Magistrates made an order for the carrying out of works within 56 days and awarded one guinea costs in each case. Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929.—Ninety-six licences to store petroleum spirit and/or petroleum mixtures were issued for a total of 191,734 gallons (inclusive of cellulose solutions). Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Carbide of Calcium) Order, 1929.—Three licences were issued for the storage of 2,344 lbs. (plus 448 lbs. temporary re-supply) of carbide of calcium. 23 Unsound Food Dealt With. Beef 1,514 lbs. Tinned Foods 1,256 tins Corned Beef 75¼ ,, Almonds. 30 lbs. Ham 77¼ „ Apples 112 „ Bacon 8 lbs. 10 ozs. Potatoes 336 „ Fish 25 stone Flour 197½ „ Whelks ... 10 galls. Barley 34 „ Eggs 135 doz. Oatmeal 30 „ Butter ... 16 lbs. " Cereoca " 18 Margarine 41 „ Pastry Mix 57 packets Milk Powder 413 „ Salad Cream 11 bottles Sugar 742 „ Pickles 24 „ Cheese 24½ „ Bottled Fruit 4 Yours faithfully, K. J. GUTTERIDGE, Chief Sanitary Inspector. Housing Statistics 1. Inspection of Dwelling Houses during the Year.—- (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 1,222 (b Number of inspections made for the purposes 1,316 2. Remedy of Defects during the Year without Service of Formal Notices : — Number of defective dwelling houses rendered fit in consequence of informal action by the local authority or their officers. 548 Number of dwelling houses rendered fit in consequence of formal action by the local authority or their officers 215 3. Action under Statutory Powers During the Year: — Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:-- 24 (1) Number of dwelling houses in respect of which notices were served requiring repairs 1 (2) Number of dwelling houses which were rendered fit after service of informal notices: — (a) By owners — (b) By local authority in default of owners 1 Proceedings under Section 11 of the Housing Act, 1936: — (1) Number of houses in which demolition orders were made 1 Proceedings under Section 12 of the Housing Act, 1936: — (1) Number of houses in which closing orders were made for underground rooms 1 4. Rent and Mortgage Interest (Restrictions) Act, 1920-1938. Number of certificates issued to occupiers that houses were not in a reasonable state of repair 2 INSPECTION AND SUPERVISION OF FOOD Byelaws with respect to handling, wrapping and delivery c food and sale of food in the open air were confirmed by th Minister of Food on February 11, 1950, and came into operatio on March 19, 1950. FOOD AND DRUGS ACT, 1938 Formal Samples. Seventy-eight formal samples were taken as follows:— Milk 57 Beef Suet Sausages, Sausage Meat 10 Flour Malt Vinegar 2 Swiss Roll Non-brewed Vinegar 1 Lemon Curd Cake 1 Gelatine Pepper Compound 1 Table Jellies 25 Informal Samples. Fifty-nine informal samples were taken as follows:— Blancmange, Custard Powders, etc. 7 Digestion Tablets 1 Saccharine Tablets 1 Sa n d w i c h Spreads, Pastes, etc. 5 Sage and Onion Stuffing 1 Tomato Soup 1 Dessert Pudding Mixtures 4 Beef Cubes 1 Cake 1 Pepper Compound 4 Table Jellies 1 White Pepper 2 Apple Juice 1 Milk 4 Tinned Spaghetti and Yoghourt 1 Sausages 1 Milk Whipping Compound 1 Luncheon Meat 1 Sild 1 Pickles, Sauces, Salad Cream, etc. 5 Broth 1 Ground Ginger 1 Swiss Roll 2 Flavouring 1 Sausage Meat 1 Breadcrumbs 1 Pie Crust 1 Icing 1 Gravy Powder 1 Nougat 1 Baking Powder 1 Honey 1 Aspirin Tablets 1 Rice 1 One case, regarding a dirty milk bottle, was dismissed on the grounds that the offence had been committed at the premises where the milk was bottled, and that the address of those premises was outside the jurisdiction of the Court. Proceedings were instituted against a manufacturer for an infringement of the Labelling of Food Order, 1946, and the Defence (Sale of Food) Regulations, 1943, in respect of an article sold as pepper compound. A fine of £1 and £5 5s. costs were awarded on each of two summonses. Ice-Cream. Four premises in the Borough are registered for the manufacture of ice-cream, and one hundred and twelve for the storage of ice-cream. Two hundred and eighty visits were paid during the year. 26 One hundred and twelve samples of ice-cream were taken and examined for bacteriological purity. Fourteen samples were also tested for fat content. The results are tabulated below: — Provisional Grade. I II Ill IV Coliforms absent 42 18 8 2 Coliforms present in l/10th ml 11 13 14 4 Ffecal coli present (in addition to above):— In 1 ml. — — — — In l/10th ml. — 1 1 — In 1/100th ml. — — — — Fat Content 3-4 per cent. 4-5 per cent. 5-6 per cent. 6-7 per cent. 7-8 per cent. — 1 2 3 1 8-9 per cent. 9-10 per cent 10-11 per cent. 11-12 per cent. 2 3 1 1 MILK (SPECIAL DESIGNATION) (PASTEURISED AND STERILISED MILK) REGULATIONS, 1949 AND 1950. During the year the Council granted the following number of licences under the aboved-named Regulations: — Dealer's (Pasteuriser's) Licences 1 Dealer's Licences— Pasteurised 22 Sterilised 33 Supplementary Licences— Pasteurised 14 Sterilised 13 MILK (SPECIAL DESIGNATION! (RAW MILK) REGULATIONS, 1949 AND 1950. During the year the Council granted the following number of licences under the above-named Regulations: — Dealer's Licences (Tuberculin Tested) 16 Supplementary Licences (Tuberculin Tested) 13 27 One hundred and forty-three samples of Graded Milk were submitted for bacteriological examination. One hundred and forty-one samples were satisfactory and two were unsatisfactory. Communications were sent to the dairies regarding the unsatisfactory samples. BAKEHOUSES The number of bakehouses in the district is 11. Seventy-two visits have been paid. DAIRIES There is one registered dairy and pasteurising establishment within the district. During the year 13 visits of inspection were paid. SLAUGHTERHOUSES There are two registered slaughterhouses in the Borough; 72 visits have been paid. MEAT INSPECTION Carcases Inspected and Condemned Cattle, excluding cows Cows Sheep and Lambs Pigs Number killed ... ... ... 156 Number inspected ... ... ... 156 All diseases except tuberculosis: ... ... ... Whole carcases condemned ... ... ... 1 Carcases of which some part or organ was condemned ... ... ... 1 Percentage of the number inspected affected with disease other than tuberculosis ... ... ... 1.28 Tuberculosis only: Whole carcases condemned ... ... ... ... Carcases of which some part or organ was condemned ... ... ... ... Percentage of the number inspected affected with tuberculosis ... ... ... ... 28 FOOD PREPARING FACTORIES There are 16 other premises in which food is prepared for human consumption. All of these have been systematically visited. INFORMAL ACTION TAKEN UNDER SECTION 13, FOOD AND DRUGS ACT, 1938. Number of Notices served, 70. Number of Notices complied with, 45. PIGGERIES There are 23 piggeries in the Borough. Seventy-five visits were paid during the year. FACTORIES ACT, 1937 I.—Inspections for purposes of provisions as to health (including inspections made by Sanitary Inspectors): — 29 Premises M/c line No. Number on Register Number of M/c line No. Inspections Written notices Occupiers prosecuted (1) (2) (3) (4) (5) (6) (7) (i) Factories in which Sections 1, 2, 3, 4, and 6 are to be enforced by Local Authorities 1 14 13 2 ... 1 (ii) Factories not included in (i) to which Section 7 applies (a) Subject to the Local Authorities (Transfer of Enforcement) Order, 1938 2 249 94 6 ... 2 (6) Others 3 ... ... ... ... 3 (iii) Other Premises under the Act (excluding out-workers' premises) 4 8 9 1 ... 4 TOTAL 271 116 9 ... ... 30 2.—Cases in which defects were found: — Particulars M/c line No Number of cases in which defects were found Number of cases in which prosecutions were instituted M/c lino No Found Remedied Referred To H.M. Inspector By H.M. Inspector (1) (2) (3) (4) (5) (6) (7) (8) Want of cleanliness (S.l) 6 5 6 ... 1 ... 5 Overcrowding (S.2) 6 ... ... ... ... ... 6 Unreasonable temperature (S.3) 7 ... ... ... ... ... 7 Inadequate ventilation (S.4) 8 1 1 ... ... ... 8 Ineffective drainage of floors (S.6) 9 ... ... ... ... ... 9 Sanitary Conveniences (S.7) ... ... ... ... ... ... ... (a) Insufficient 10 5 6 ... 1 ... 10 (b) Unsuitable or defective 11 14 12 ... 3 ... 11 (c) Not separate for sexes 12 ... ... ... ... ... 12 Other offences (not including offences relating to Homework) 13 2 2 ... ... ... 13 TOTAL ... 27 27 ... 5 ... ... 31 8.—Outwork (Sections 110 nnd 111): Nature of Work M/c line No. Section 110 Section 111 No. of out-workers in August list required bv Sect. 110 (1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions M/c line No. (1) (2) (3) (4) (5) (6) (7) (8) (9) Wearing apparel Making, etc. 14 93 14 Cleaning and washing 15 15 Household linen 16 16 Lace, lace curtains and nets 17 17 Curtains and furniture hangings 18 18 Furniture and upholstery 19 19 Electro-plate 20 20 File making 21 21 Brass and brass articles 22 22 Fur pulling 23 23 Iron and steel cables and chains 24 24 Iron and steel anchors and grapnels 25 25 Cart gear 26 26 Locks, latches and keys 27 27 Umbrellas, etc. 28 28 Artificial flowers 29 29 32 3.—Outwork (Sections 110 and 111) continued:— Nets, other than wire nets 30 30 Tents 31 31 Sacks 32 32 Racquet and tennis balls 33 33 Paper bags 34 34 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 35 22 35 Brush making 36 36 Pea picking 37 37 Feather sorting 38 38 Carding, etc., of buttons, etc. 39 39 Stuffed toys 40 7 40 Basket making 41 • 41 Chocolates and sweetmeats 42 42 Cosaques, Christmas crackers, Christmas stockings, etc. 43 29 43 Textile weaving 44 44 Lampshades 45 1 45 TOTAL ... 152 ... 33 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASE NOTIFICATIONS The total number of confirmed notifications received during 1950 was 911. Contacts, Suspects, Etc. The Medical Officer of Health is called in consultation by medical practitioners to see patients in their homes, as required. Visits Made by No. Sanitary Inspectors in common infectious diseases 251 To small pox contacts 12 Total 263 Rooms disinfected after infectious disease 231 34 The monthly incidence of infectious disease was: — Small Pox. Scarlet Fever Diphtheria Typhoid Fever Erysipelas Pneumonia Puerperal Pyrexia Ophthalmia Neonatorum Dysentery Meningococcal Infections Poliomyelitis Measles Whooping Cough Food Poisoning Paratyphoid Malaria Totals January ... 16 ... ... 1 5 ... ... 1 ... ... 12 6 ... ... ... 41 February ... 9 ... ... 2 7 ... ... ... ... ... 77 6 ... ... ... 102 March ... 13 ... ... ... 5 ... ... ... ... ... 95 1 ... ... ... 114 April ... 19 ... ... ... 3 ... ... ... ... ... 34 11 ... ... ... 67 May ... 17 ... ... ... ... ... ... 1 ... ... 8 31 ... ... ... 57 June ... 3 ... ... 1 1 ... ... 7 ... ... 6 22 ... ... ... 40 July ... 6 ... ... 1 ... ... 1 ... ... ... 38 26 3 ... ... 75 August ... 5 ... ... ... 1 ... ... ... ... ... 16 25 ... ... ... 47 September ... 8 ... 1 ... 3 ... 1 1 ... ... 8 30 ... ... ... 52 October ... 7 ... ... ... 2 ... ... 2 ... 1 4 38 ... ... ... 54 November ... 2 ... ... 1 1 ... ... 2 ... 1 7 112 ... ... ... 126 December ... 5 ... ... 1 ... ... ... 2 ... ... 49 79 ... ... ... 136 Totals ... 110 ... 1 7 28 ... 2 16 1 2 354 387 3 ... ... 911 35 Infectious Disease Notifications, 1931-50. Disease 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1.1.48 to 4.7.48 5.7.48 to 31.12.48 1949 ] Small Pox 4 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 105 174 240 392 143 171 192 150 61 48 75 175 212 97 147 95 62 35 57 89 110 Diphtheria 49 32 40 83 80 104 89 64 27 36 72 25 42 10 63 32 4 ... 1 1 ... Typhoid Fever 3 3 3 ... 3 5 ... 1 ... ... ... ... 1 ... 1 ... ... ... ... ... 1 Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Undulant Fever ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Puerperal Pyrexia 9 4 9 6 4 11 5 4 7 2 2 6 3 5 8 6 9 3 ... 2 ... Anthrax ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Infections ... 1 4 1 1 3 1 2 1 13 12 6 8 3 3 1 2 1 1 ... 1 Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 17 11 31 30 20 22 16 8 19 17 19 7 22 13 16 25 9 18 6 12 7 Measles ... ... ... ... ... ... ... ... ... 301 194 599 651 112 739 358 533 818 252 354 354 Acute Diarrhoea ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Poliomyelitis ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 2 3 11 2 2 6 2 Ophthalmia Neonatorum 3 4 2 2 4 3 1 3 3 1 3 10 4 4 2 2 6 3 8 2 Encephalitis Lethargica 1 1 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... Pneumonia 45 52 37 45 35 36 32 43 ... 30 22 20 50 37 33 41 37 30 13 19 28 Malaria ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... 1 ... ... ... Whooping Cough ... ... ... ... ... ... ... ... 4 16 186 161 162 166 96 234 216 117 149 212 387 Food Poisoning ... ... ... ... ... ... ... ... 4 4 6 11 ... ... 5 1 ... ... ... 6 3 Dysentery ... ... ... ... ... ... ... ... ... ... ... ... 4 67 13 6 1 2 5 7 16 Paratyphoid ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... Totals 242 288 368 560 293 357 338 275 125 468 591 1021 1161 515 1126 807 888 1033 490 717 911 36 Small Pox No case of small pox was notified during the year 1950. Scarlet Fever The number of cases of scarlet fever notified during the year was 110 as compared with 89 in 1949, equivalent to a case rate of 1.63 per 1,000 population. The disease has continued mild in character; no death due to this cause was recorded. Of the total number of cases notified 61 were treated in hospital and 49 cases were treated at home. Diphtheria No case of diphtheria was notified during the year. Immunisation and reinforcing doses were available to every school child whose parents gave consent. Diphtheria Immunisation There are three clinics situated within the district, within relatively easy reach of everyone, as well as immunisation sessions held in the schools. Efforts have continued during the year to obtain the immunisation of every child before the first birthday. The health visitors urge mothers at the welfare centres, and at home visits, to have their children immunised, making special visits in difficult cases. A birthday greeting letter is sent at the approach of the first birthday, making an appointment for immunisation for those infants not yet immunised. The following figures show the number of children immunised during the year:— Under five .. 720 Five—14 .. 405 Total 1,125 37 The following figures show the number of the child population considered immunised at December 31, 1950: — Age at 31.12.50 i.e. born in year Under 1 1950 1 1949 2 1948 3 1947 4 1946 5 to 9 1941-1945 10 to 14 1936-1940 Total under 15 Number immunised 24 707 892 956 922 3805 3598 10904 Estimated mid-year population 1950 6828 8642 14470 The percentage immunised is as follows: — Under five 60.07% Five—14 85.66% The number of birthday greetings sent in 1950 was 643. Typhoid Fever One case was notified during the year, the source of infection unknown, the case not being diagnosed for several weeks. Diarrhcea and Enteritis Under Two Years of Age One death was registered during the year. Encephalitis Lethargica No case was notified during the year. Erysipelas Seven cases were notified. No cases were removed to hospital. Puerperal Pyrexia No case was notified during the year. Pneumonia Twenty-eight cases of primary pneumonia were notified during the year. The number of deaths from all forms of pneumonia, some of which are not notifiable, was 29, of which 15 were males and 14 females. 38 Meningococcal Infections. Two female deaths were returned in the Registrar-General's figures, but no notification was received at this office. Influenza During the year two female deaths from influenza were recorded. The previous year eight deaths were registered. Prevention of Blindness This comes under the control of the Surrey County Council. Ophthalmia Neonatorum During the year two cases of ophthalmia neonatorum were notified. Poliomyelitis Two cases of poliomyelitis, both paralytic were notified during the year, the diagnosis was subsequently confirmed in both cases. In one case there was mild paralysis of the left arm and shoulder; while in the other case there was moderate paralysis of the right hand, together with mild paralysis of the right leg. School Notifications The school intimation notices of infectious disease are always compared with the notifications received from the medical practitioners. If any case on the school return is found to be unnotified, investigations are made in order to find out if the patient is receiving medical attention. The school notices also give fairly accurate estimates of the prevalence of non-notifiable infectious disease, such as chicken pox, mumps, etc. The numbers were as follows:— Chicken pox 140 Mumps 69 Jaundice 3 Ringworm 3 Measles 121 Whooping cough 119 Scarlet fever 40 Impetigo 3 Scabies 1 39 Cancer The number of deaths from cancer registered during the year was 102. of which 60 were males and 42 were females. The site distribution for 1950 was as follows: — Digestive organs 17 cases Respiratory organs 23 „ Breast 12 „ Genito-urinary organs 5 , Other sites 45 „ 102 The following table shows the number of deaths from cancer, together with the death rate as compared with England and Wales: — Year Number of Deaths Death Rate per 1,000 of population Mitcham England and Wales 1931 81 1.41 1.48 1932 68 1.0 1.51 1933 52 .86 1.52 1934 70 1.1 1.56 1935 61 1.0 1.58 1936 80 1.2 1.61 1937 76 1.1 1.63 1938 103 1.5 1.66 1939 73 1.12 1.64 1940 94 1.55 1.66 1941 84 1.6 1.67 1942 104 1.9 1.698 1943 95 1.7 1.74 1944 83 1.6 1.7 1945 103 1.9 1.74 1946 108 1.74 1.76 1947 103 1.60 1.86 1948 111 1.67 1.85 1949 124 1.85 1.87 1950 102 1.51 1.89 40 Tuberculosis During fche year 117 new cases of tuberculosis were notified viz.:— Males Females Total Pulmonary 69 50 109 Non-Pulmonary 3 5 8 Totals 62 55 117 Fourteen cases were transferred into the Borough as follows:— Males Females Total Pulmonary 3 9 12 Non-Pulmonary — 2 2 Totals 3 11 14 The total number of deaths registered as occurring from tuberculosis was:— Males Females Totalp Pulmonary 20 11 31 Non-Pulmonary 2 1 8 Totals 22 12 34 England and Wales Mitcham Death rate from tuberculosis, all forms, per 1,000 population 0.36 0.50 41 The following table shows the number of new cases, the typft of disease and the deaths from tuberculosis during the year. age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRcspiratory M. F. M. F M. F. M. F. Under 1 year ... ... ... ... ... ... ... ... 1 year to 4 years 1 4 1 ... ... ... 1 ... 5 years to 9 ,, 1 1 ... ... ... ... ... ... 10 „ „ 14 2 4 ... ... ... ... ... ... 16 „ 19 8 8 ... 2 ... ... ... ... 20 „ „ 34 26 31 1 3 1 2 1 ... 35 „ „ 44 „ 12 4 ... 3 4 3 ... ... 45 „ „ 64 13 6 1 ... 10 5 ... 1 65 „ and upwards 2 1 ... ... 4 1 1 ... Totals 65 59 3 8 19 11 3 1 New cases coming to the knowledge of the Medical Officer of Health during the year through (a) Death returns; (b) Posthumous notifications: Age Periods 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total Pulmonary : males ... ... ... ... ... ... ... ... ... 1 1 2 Pulmonary: females ... ... ... ... ... ... ... 2 ... ... 1 3 Non-Pulmonary: males ... ... ... ... ... ... ... ... ... ... ... ... Non-Pulmonary: females ... ... ... ... ... ... ... ... ... 1 ... 1 42 The sources from which information as to the abovementioned cases was obtained are as follows: — No. of Cases Pulmonary NonPulmouary Death Returns (a) From Local Registrar 3 ... (6) Transferable deaths from Registrar General 2 1 Posthumous notifications Number of cases removed from register during 1950:— Reason Pulmonary Non-Pulmonary Total Cases Males Females Total Males Females Total Withdrawal of notification ... ... ... ... ... ... ... Recovery from disease 5 3 8 ... 1 1 9 Death 19 8 27 3 ... 3 30 Removed from district 21 27 48 1 ... 1 49 The ratio of non-notified tuberculosis deaths (i.e., new cases coming to the knowledge of the Medical Officer of Health after death of the case) to the total tuberculosis deaths is as follows: — Non-notified tuberculosis deaths 6 Total tuberculosis deaths 34 Percentage of non-notified tuberculosis deaths 17.64 43 Mitcham, Beddington and Wallington Tuberculosis Care Committee Functions of the Committee 1. To alleviate want or distress amongst those suffering from tuberculosis, providing where necessary, extra nourishment, clothing, bedding, coal, surgical appliances, travelling expenses nnd help in the home. 2. To care for the families of patients who are in sanatoria so that their changed economic circumstances shall not result in impaired health, and that the sufferer shall not be harassed by undue anxiety. Christmas gifts were given to hardship cases. Assistance was given towards extra nourishment, beds and bedding, occupational therapy material, education, clothing, provision of wireless, holidays, fares for relatives to visit, pocket money for patients, removal expenses, etc., etc. The Committee also carry for distribution a stock of milk foods, blankets and sheets. The help given improves the morale of the patient or the well being of his or her family. 44 INDEX PAGE Abortion, Deaths 13 Ambulances 14 Analysis of Mortality 13 Ante-Natal Clinics 16 Area 7 Bakehouses 27 Bed Bugs, Eradication of 19 Bedding, Disinfection of 14 Birth Rates 9, 13 Births, Illegitimate 7 — In Institutions 8 — Live 7 — Still 7 Blindness, Prevention of 38 Books disinfected, Library 14 Cancer — Deaths from 8, 39 Causes of Deaths 10, 12 Chief Sanitary Inspector's Report 20 Inspector, Visits by 21 Cleansing, Public 19 Clinics 16, 17 Closet Accommodation 18 Dairies 27 Day Nurseries 17 Death Rates 8, 13 Deaths 7-12, 40-42 Dental Clinic 16 Diarrhoea and Enteritis 8 — Deaths from 13 Diphtheria — Immunisation 36, 37 — — Clinic 17 — Specimens Examined 14 Disinfection 14 45 PAGE Encephalitis I,ethargica 37 Enteritis, Diarrhoea and 8, 13 Eradication of Bed Bugs 19 Erysipelas37 Factories Act, 1937 28-32 — Defects found 30 — — Inspections 29 — (Sections 110 and 111) Outwork 31-32 Food and Drugs Act (1938) 24 — Action Taken 28 — Dealt with, Unsound 23 — Inspection and Supervision of 24, 25 — Preparing Factories 28 General Provision of Health Services for the Area 14 Health, Visiting 17 Home Help Service 17 Hospitals 15 Houses, Disinfection of 14 Housing Act, 1936 (Sect. 9, 10 and 16) 23, 24 (Sect. 11) 24 (Sect. 12) 24 Housing Statistics 23 Ice-Cream 25 Samples 26 Immunisation Clinic, Diphtheria 17 Diphtheria 36; 37 Infant Mortality 8-10, 13 Infectious Disease, Ambulances 14 — Case rates 13 — Contacts 33 — Hospital 15 — Incidence of 34 — Prevalence of and Control over 33 — — Notifications 33, 35 — — — School 38 Influenza 38 Inhabited Houses 7 46 PAGE Inquests 10, 11 Inspection and Supervision of Food 24 Laboratory, Emergency Public Health, Epsom 14 Facilities 14 Legal Proceedings 22, 25 Library Books Disinfected, number of 14 Maternal Mortality 7, 10, 13 Maternity, Hospital Treatment 15 Measles, Deaths from 8 Meat Inspection 27 Meningococcal Infection 38 Milk (Special Designation) (Raw Milk) Regulations (1949 and 1950) 26 Mortality Analysis of 13 — Infant 8-10 Maternal 13 N.S.P.C.C. 18 Notifications, Infectious Disease 33, 35 School 38 Ophthalmia Neonatorum 38 Personnel, Committee 5 — Staff 6 Pests Act, 1950, Prevention of Destruction by 20 Petroleum (Consolidation Act), 1928 Piggeries 28 Pneumonia 37 Poliomyelitis 38 Population 7 Post-Natal Clinic 16 Prevention of Blindness 38 Proceedings, Legal 22, 25 Public Cleansing 19 Puerperal Fever 13 Pyrexia 13, 37 Public Analyst 14 Rateable Value 7 Rivers and Streams 18 47 PAGE Rooms Disinfected, number of 14 Samples, Food 24, 25 Sanitary Circumstances of the Area 18 — Inspectors, Chief's Report 20 Scarlet Fever 36 Schools 19 — Notifications 38 Slaughterhouses 27 Small Pox 36 Clinics 17 Hospital 15 Social Conditions 7 Statistics 7 — Housing 23 — Vital 7 Still Births 7 Streams, Rivers and 18 Supervision of Food, Inspection and 24 Toddlers' Clinics 16 Tuberculosis 40-42 — Care Committee 43 Cases 15, 40, 41 Deaths 40, 41 Specimens examined 14 Typhoid Fever 37 Unsound Food dealt with 23 U.V. Radiation Clinics 17 Venereal Diseases Clinics 15 Visits by Sanitary Inspectors 20, 21 Vital Statistics 7 Water Supply 18 Welfare, Clinics 16 Whooping cough, Deaths from 8