AC 4413 (1)MITCHAM LIBRARY MlTZo BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1951 BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1951 MITCHAM : H- G. Mather, Ltd., Caxton Works, Lower Green 3 Borough of Mitcham HEALTH REPORT FOR 1951 To the Mayor, Aldermen and Councillors. Mr. Mayor, Ladies and Gentlemen, I have much pleasure in submitting my annual report for the year 1951. The general health in the Borough has been good. Measles tends to occur in cycles, and an outbreak in the early part of the year was easily the largest since it was made notifiable, a jump occurring from 354 cases in 1950 to 1,386 in 1951. There was also a slight increase in Whooping Cough, but both diseases were remarkably mild in that there were no deaths. Only one case of Poliomyelitis occurred, and the diagnosis was not absolutely certain. There was some slight degree of paralysis, which cleared up. There was an isolated case of Paratyphoid B which was, however, of a mild nature, the source of infection being unable to be discovered. There was, again, not a single case of Diphtheria in Mitcham. The death rate from Tuberculosis was down from last year's 0.5 per 1,000 to 0.33, which is just above that for England and Wales. The birth rate of 13.48, after correction by the comparability factor to correspond with the average age and sex grouping of the whole population, becomes 12.54 and was for the second year in succession the lowest recorded in Mitcham, which compares with 15.5 for England and Wales. 4 The actual death rate of 9.76 becomes 10.32 after applying the comparability factor, which was considerably better than that of 12.5 for the whole of the country. The infant mortality rate was low, being 25.47 compared with 29.6 for England and Wales. I wish to thank the Chairmen of the Committees for their friendly support, and all the members of the staff for their loyalty and service throughout the year. I have the honour to be, Ladies and Gentlemen, Your obedient servant, A. R. GRAHAM, Medical Officer of Health. Public Health Department, Mitcham Court, Mitcham. BOROUGH OF MITCHAM PUBLIC HEALTH COMMITTEE. Chairman - - Councillor Miss M. J. Faraday His Worship the Mayor (Alderman G. R. Madgwick, J.P.) Aldermen— Mrs. J. C. Ericson Mrs. H. E. Niven Mrs. E. Watson T. A. East, J.P. G. W. Pearce Councillors— Mrs. W. R. Martin E. E. Field E. J. Mills R. Stanley REPRESENTATIVES OF THE COUNCIL ON OTHER AUTHORITIES. WANDLE VALLEY JOINT SEWERAGE BOARD His Worship the Mayor (ex officio) Alderman W. Jeffery Councillors— F. S. Niven S. L. E. Saldanha NORTH-EAST DIVISIONAL HEALTH SUB-COMMITTEE (SURREY COUNTY COUNCIL) Aldermen— Mrs. H. E. Niven G. W. Pearce Councillors— Mrs. W. R. Martin A. S. Mingay R. Stanley 6 STAFF Medical Officer of Health A. R. Graham, M.B., Ch.B., D.P.H., Barrister-at-Law. Chief Sanitary and Meat Inspector. Petroleum Inspector Shops Act Inspector K. J. Gutteridge (1, 2) Assistant Sanitary and Meat Inspectors L. Gleed (1, 2, 3) (a) E. N. Montague (1, 2) E. J. Sluis (1, 2) L. M. Edwards (1, 2) (b) F. A. Evans (1, 2) 1. Certificate Sanitary Inspectors' Board. 2. Certificate Meat and Foods R.S.I. 3. Smoke Inspector's Certificate. Clerks (c) L. J. Bellingham (d) Miss V. Valentine (e) Mrs. V. E. Bevan (/) Miss M. Sanders (g) Mrs. R. Osborn (h) Miss B. J. Hogan (а) Resigned—31.7.51. (б) Commenced duties—5.11.51. (c) Commenced full-time duties—1.1.51 (ex 75 per cent. Surrey County Council). (d) Resigned—10.4.51. (e) Part-time—40 per cent. Surrey County Council. (/) Part-time—40 per cent. Surrey County Council. (g) Resigned—31.8.51. (h) Commenced full-time duties—20.8.51. 7 REPORT STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 2,916 acres Population, Census 1921 35,119 1981 56,856 Registrar-General's estimate of population midyear, 1951 67,010 Number of inhabited houses, 1921 7,150 1931 13,187 1951 18,945 Rateable Value, 1951 £552,743 Sum represented by a Id. rate £2,256 The Borough of Mitcham received its present status in 1934, having previously been an Urban District from 1915, when the Croydon Rural District, of which it formed part, was split up into separate areas. Mitcham is an irregular oval in shape, situated in North-East Surrey and is adjacent to the south-west border of the London metropolitan area. It is a fairly flat and low lying area, about 1/6th of it consisting of common land. Parts of Mitcham Common, which are inclined to be marshy, have been raised and levelled by the controlled tipping of refuse. Some nuisance of smell was present for a time in the summer months of 1951, but energetic measures were taken to abate it. There is one river in Mitcham, the Wandle, which forms the south-west and western boundary, separating Mitcham from Beddington & Wallington in the south and Carshalton in the west, as it runs a northwards course towards the Thames. The soil of Mitcham consists of up to 4 feet of top-soil, with about 10 ft. of gravel sub-soil, except for one or two parts where London clay comes to the surface. Below the gravel, London clay extends downwards for 200 to 300 ft, 8 Mitcham, with nearly 300 factories, has a great variety of industries, of which probably the chief ones are paint and varnish, chemical, rubber, margarine and dairy products. In 1951 there was little unemployment in the district. Although Mitcham is chiefly a working class area, there are no real slums and no back-to-back houses. Nearly two-thirds of the houses have been built since 1921 and more than 50 per cent, of all the roads are tree lined. Mitcham is now a fairly densely populated area, with the few available building sites being rapidly filled up. STATISTICS. Live Births. Total Male Female Rate per 1,000 of population Legitimate 875 451 424 Illegitimate 28 13 15 Total 903 464 439 13.48 After correction by the comparability factor becomes 12.54 Still Births. Total Male Female Rate per 1.000 total births Legitimate 21 8 13 Illegitimate 2 — 2 Total 23 8 15 24.84 Deaths. Total Male Female Rate perl,000 of population 654 337 317 9.76 After correction by the comparability factor becomes 10.32 Deaths from pregnancy, childbirth and abortion : — Rate per 1,000 total births Number of cases Nil Nil Deaths of infants under one year of age :- All infants per 1,000 live births 25.47 Legitimate infants per 1,000 live legitimate births 25.96 Illegitimate infants per 1,000 live illegitimate births 35.71 9 Deaths from :— Cancer (all ages)108 Measles Whooping cough (all ages) Enteritis and Diarrhoea under two years of age 1 Percentage of Birth Occurring in Institutions Year Total births Births in hospitals, etc. Percentage of births occurring in institutions 1932 1084 381 35.1 1933 1010 420 41.5 1934 982 428 43.5 1935 969 474 48.9 1936 1033 497 48.1 1937 976 501 51.3 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 70.37 1949 1129 832 73.69 1950 933 718 76.96 1951 926 703 75.92 10 The birth rates, death rates per 1,000 of population, and the infantile mortality rates for the years 1932-51 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 & Wales MITCHAM England & Wales MITCHAM England & Wales 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 After 1949 the actual Birth and Death Rates for Mitcham are modified by comparability factor to correspond with the average age and sex distributor of England and Wales. 1950 12.56 15.8 10.66 11.6 29.64 29.8 1951 12.54 15.5 10.32 12.5 25.47 29.6 11 Infant Mortality During the year 23 deaths were registered as occurring in infants under one year of age: — Males Females Total Legitimate 10 12 22 Illegitimate 1 — 1 Totals 11 12 28 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 3 1 1 — — 1 1-7 days 11 3 1 — 3 4 8 days - 1 mth. 3 - 1 — — 2 lmth. -12 mths. 6 — — — 1 5 Total 23 4 3 — 4 12 Seventeen infants failed to survive the first month of life, and prematurity was certified as the cause of death of four of these infants. Maternal Mortality. During the year no death was registered. In 1950 one death was registered in the disease or accident of pregnancy group. Inquests. Inquests were held on 15 residents dying within the district and on 14 Mitcham residents who died outside the district, a total of 29. In addition, the coroner held 64 post-mortems without 12 inquests on residents dying within the district, and on 76 Mitcliam residents who died outside the district, a total of 140. The following table shows the results of the findings of these inquests: — Accidental deaths 21 Deaths from misadventure 2 Suicides 4 Inattention at birth 1 Chronic alcoholism 1 Total 29 13 Deaths Registered dubing the Year 1951 Cause of Death Males Females Total 1 Tuberculosis, respiratory 11 8 19 2 Tuberculosis, other 1 2 3 3 Syphilitic disease 1 ... 1 4 Diphtheria ... ... ... 5 Whooping cough ... ... ... 6 Meningococcal infections ... 1 1 7 Acute poliomyelitis 1 ... l 8 Measles ... ... ... 9 Other infective and parasitic diseases ... 2 2 10 Malignant neoplasm, stomach 15 3 18 11 Malignant neoplasm, lung, bronchus 21 2 23 12 Malignant neoplasm, breast ... 5 5 13 Malignant neoplasm, uterus ... 6 6 14 Other malignant and lymphatic neoplasms 26 30 56 15 Leukaemia, aleukæmia 2 2 16 Diabetes 3 2 5 17 Vascular lesions of nervous system 26 33 59 18 Coronary disease, angina 43 29 72 19 Hypertension with heart disease 7 6 13 20 Other heart disease 37 64 101 21 Other circulatory disease 14 8 22 22 Influenza 5 8 13 23 Pneumonia 16 26 42 24 Bronchitis 41 19 60 25 Other diseases of respiratory system 5 ... 5 26 Ulcer of stomach and duodenum 10 2 12 27 Gastritis, enteritis and diarrhoea 1 4 5 28 Nephritis and nephrosis 1 2 3 29 Hyperplasia of prostate 3 ... 3 30 Pregnancy, childbirth, abortion ... ... ... 31 Congenital malformations 5 7 12 32 Other defined and ill-defined diseases 28 38 66 33 Motor vehicle accidents 7 4 11 34 All other accidents 4 5 9 35 Suicide 3 1 4 36 Homicide and operations of war ... ... ... All causes 337 317 654 14 Birth-rates, Death-rates, Analysis of Mortality, Maternal Mortality, and Case-rates for certain Infectious Diseases in the year 1951. (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 census) London Administrative County Mitcham Bates per 1,000 home population Births— Live 15.5 17.3 16.7 17.8 12.54 Still 0.36 0.45 0.38 0.37 0.34 Deaths— All causes 12.5 13.4 12.5 13.1 10.32 Typhoid and Paratyphoid 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 0.31 0.37 0.31 0.38 0.33 Influenza 0.38 0.36 0.38 0.23 0.19 Smallpox 0.00 0.00 0.00 ... — Acute Poliomyelitis (including polioencephalitis) 0.00 0.01 0.01 0.00 0.01 Pneumonia 0.61 0.65 0.63 0.61 0.63 Notifications (corrected)— Typhoid fever 0.00 0.00 0.00 0.01 0.00 Paratyphoid fever 0.02 0.03 0.02 0.01 0.01 Meningococcal infection 0.03 0.04 0.03 0.03 0.04 Scarlet fever 1.11 1.20 1.20 1.10 1.66 Whooping cough 3.87 3.62 4.00 3.11 6.27 Diphtheria 0.02 0.02 0.03 0.01 0.00 Erysipelas 0.14 0.15 0.12 0.15 0.12 Smallpox 0.00 0.00 0.00 - — Measles 14.07 13.93 14.82 14.64 20.69 Pneumonia 0.99 1.04 0.96 0.72 0.36 Acute Poliomyelitis (including polioencephalitis) Paralytic 0.03 0.03 0.03 0.02 0.01 Non-paralytic 0.02 0 02 0.03 0.02 0.00 Food Poisoning 0.13 0.15 0.08 0.23 0.06 Rates per 1,000 live births Deaths underoneyear of age 29.6* 33.9 27.6 26.4 25.47 Deaths from diarrhoea and enteritis under two years of age 1.4 1.6 1.0 0.7 1.11 Rates per 1,000 total births (live and still) Notifications (corrected)— Puerperal fever 10.66 13.77 8.08 14.90 14.04 Puerperal pyrexia Maternal mortality Pregnancy, childbirth and abortion 0.79 Not available 0.00 Mortality per million women aged 15-44 Abortion— With sepsis 7 Not availabl e Without sepsis 4 * Per 1,000 related live births, 15 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. The chemical analysis of milk, water and foodstuffs was carried out by 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 Valley 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 32 Number of rooms disinfected by fumigator 200 Number of library books disinfected 420 16 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, and itself comes under 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 Croydori General Hospital. Treatment can also be obtained from the outpatients' departments of many of the London hospitals. 17 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 ever} Monday afternoon. St. Barnabas Church Hall, Gorringe 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). 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 An Ante-natal session is held at the Church Road Clinic every Tuesday and Friday morning, and a clinic for cases booked by midwives is held on Friday afternoons. X-Ray examinations necessary for expectant mothers are carried out at the Wilson Hospital. 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. 18 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 afternoons, Friday afternoons. Diphtheria Immunisation and Vaccination Against Smallpox. (Under the direction of the Local Medical Officer of Health.) 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 one day nursery in Mitcham, at Eagle House, London Road, Mitcham, with 85 places. The other day nursery at Robinson Road, Colliers Wood, was closed on 31st July, 1951. 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. 19 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 1951 31 Number of children affected 56 Number of visits paid 136 National Assistance Act, 1948: Section 47. Removal to Suitable Premises of Persons in Need of Care and Attention. There were two cases during the year. 1. An elderly woman of 75, aged and infirm, was living in very insanitary conditions, her aged husband being no longer able to cope with her. Action had to be taken urgently under the National Assistance (Amendment) Act, 1951, then subsequently under Section 47 for an extension. She was sent to a Surrey County Council Welfare Establishment, where she is likely to remain, and further extensions will probably be necessary. 2. An elderly woman of 84, aged and infirm, was living in very insanitary conditions, her aged husband being no longer able to look after her. She was sent to a Surrey County Council Welfare Establishment, but died after a short period. 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. 20 The water lias been of a consistently high standard of purity and there is no record of any case of infectious disease being 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. 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, 47. Number of other houses found infested during the year, 14. Number of requisitioned, etc., houses found infested during the year, 4. Total number of houses disinfested during the year, 51. Methods employed: — No houses treated with sulphur dioxide. 51 houses treated with insecticide spray (inclusive of those treated on more than one occasion). 21 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 of beetles, 130. Number of houses disinfested of spiders and other insects, 24. 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. Medical Inspection.—The medical inspection of school children is carried out by the School Health Service of the Surrey County Council. Closure of Schools.—No school has been closed by the local authority during the year by reason of infectious disease. 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 a 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. PREVENTION OF DESTRUCTION BY PESTS ACT, 1949. Three full-time and one part-time Rodent Operators were employed, one leaving for another post in November, 1951. Properties inspected 11,505 Complaints received 619 Number of treatments re rat infestation including test baits as result of inspection and complaints 1,603 Factory and business premises treated 75 Visits by Sanitary Inspectors 155 22 Two sewer maintenance treatments were carried out; 113 manholes were baited. 177 intercepting chambers were also baited during the two maintenance treatments. 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. Mr. Mayor, 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: — Complaints received 1,004 Nuisances found 884 Verbal Notices given 135 Verbal Notices complied with 80 Informal Notices served 668 Informal Notices complied with 446 Statutory Notices served 269 Statutory Notices complied with 253 Revisits 3,210 Houses inspected for defects 926 Visits made for this purpose 1,057 Drains tested and inspected 300 Private houses found verminous 20 Visits re Building Licence applications 10 Visits to butchers 190 Visits to slaughterhouses 66 Visits to dairies 95 Visits to restaurant kitchens 140 Visits to ice-cream premises 188 Visits to bakehouses 44 Visits to other food premises 395 Number of notices served under Food and Drugs Act, 1938 42 Number of notices complied with 33 Visits to factories 147 23 Visits to workplaces 3 Visits to outworkers 166 Visits to stables 38 Visits to piggeries 77 Visits to marine stores 1 Visits to caravan yards 86 Smoke observations 24 Visits re infectious disease cases 174 Visits re smallpox contacts 25 Visits re food poisoning 11 Visits re rats and mice 155 Visits re Shops Acts 44 Visits re schools 5 Sundry visits 445 Character of Work Done Roofs repaired 234 Rainwater piping or gutters repaired or renewed 249 Yards paved or repaired 14 Dampness remedied 223 Water service pipes repaired 24 Waterclosets: Repairs to structure 35 Flushing apparatus repaired or renewed 55 New pans and traps fitted 52 Water storage cisterns cleansed, repaired or renewed 26 Water supply reinstated 6 Flooring of rooms repaired and sub-floor ventilation improved 110 Rooms cleansed and redecorated 149 Sinks and handbasins repaired or renewed 17 Waste pipes and traps repaired or renewed 35 Window frames and sashes repaired or renewed 137 Window sills repaired or renewed 63 External brickwork (repaired, pointed or rendered) 45 Drains repaired or obstructions removed 132 Drain inspection covers renewed 15 Drains tested 76 24 Grid and mica flaps provided 11 Firegrates repaired (including surrounds and hearths) 67 Stoves, coppers, ranges, etc., repaired 17 Chimney stacks repaired 32 Staircases repaired 28 Doors repaired 40 Internal plaster repairs 446 Sash cords renewed 135 Dustbins provided 55 Accumulations removed 10 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.—Twenty applications were made to the Justices for Nuisance Orders against property owners, under Section 94, Public Health Act, 1936. The results were as follows:— Six summonses were withdrawn before the respective hearings as the necessary works had been completed. Fourteen summonses were abated prior to hearing, the court awarding the Council £2 2s. 0d. costs and 3s. 6d. court costs in each case, a total of £31 17s. 0d. Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929.—Ninety-five licences to store petroleum spirit and/or petroleum mixtures were issued for a total of 203,984 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. Unsound Food Dealt With. Beef 1,189 lbs. Fruit 59 jars Corned Beef 176¾ „ Fruit, bottled 48 bottles Kidney 5 „ Fruit, tinned 192 lbs. Liver 7½ „ Apples 80 lbs. Veal 47 „ Prunes 30 lbs. 25 Leg of Mutton 2¾ „ Cereals 6 pkts. Rabbit 34 „ Cereals & Fruit 18 pkts. Luncheon Meat 12 „ Oatmeal 3½ lbs. Sausages 40 „ Biscuits 3 lbs. Ham 1,061¾ „ Scone Mix 39 pkts. Fish 49¼ stne. Jellies 3 pkts. Cheese 32 lbs. Semolina 1 pkt. Sugar 116 „ Sauce 2 bottles Milk Powder 390 „ Tinned Foods 1,396 tins Dried Milk 80 „ Assorted 89 bottles & jars Yours faithfully, K. J. GUTTERIDGE, Chief Sanitary Inspector. Housing Statistics Total Number of Inhabited Houses—18,945. Permanent buildings built by the Council before the war— 1,461. Permanent buildings built by the Council after the war— 1,052. Other Housing Accommodation Available:- Requisitioned and sundry properties 423 Temporary buildings, Arcon bungalows 325 Hutments, 320 originally, now reduced to 266 Gunsite Hutments, 61 originally, now reduced to 33 Therefore total number of properties acquired during and since the war is 2,119. Number of People Rehoused. About 8,000 applicants have registered since 1945, and the current list is still about 3,000, so that some 5,000 applicants have been dealt with. The actual number of people, including children, who have been rehoused is about 5,000. Types of Accommodation. The Nissen huts and gunsite hutments were built to last only a few years, and do not always give protection against the 26 weather, although much has been spent on improvements. The numbers are gradually being reduced. The temporary Arcon bungalows, however, give very good housing accommodation. The chief new development is that of building large blocks of flats to get the greatest number of families rehoused with a limited building space available. The post-war housing is also making provision for the communal needs of the occupants of new estates by proposed community centres, erection of garages, etc. 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) 926 (b) Number of inspections made 1,057 2. Remedy of Defects during the Year:- Number of defective dwelling houses rendered fit in consequence of informal action by the local authority or their officers 400 Number of dwelling houses rendered fit in consequence of formal action by the local authority or their officers 244 3. Action under Statutory Powers During the Year:- Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936: — (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 27 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 — 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 — INSPECTION AND SUPERVISION OF FOOD Clean Food Campaign. Examinations are made of all food premises, the desirable features carefully assessed and marks awarded on a special form. The premises were on the whole satisfactory with some minor adjustments necessary. In addition the following measures were taken during the year: — Clean Food Exhibition.—A successful exhibition was held, with the help of the Ministry of Agriculture and Fisheries and other interested parties, at the Baths Hall, Mitcham, from Saturday, 7th April, to Friday 13th April. About 3,000 people attended, of whom almost 700 were children. Apart from the film annexe and the stage which was used for demonstrations, there were 18 exhibition stands consisting of a larger number of exhibits, as listed below. The film shows, which took place two-hourly in the side room, were nearly always full to capacity and were seen by 1,625 persons. The cookery demonstrations proved of great interest and the Gas and Electricity Boards expressed their pleasure that they were so well attended, 28 At the Brains Trust Meeting held on Wednesday, 11th April, under the Chairmanship of Professor Andrew Topping, a lively and interesting debate was given and appreciative comments were received afterwards. A booklet containing clean food hints, to help both the housewife and the caterer, was sent out to every home in Mitcham. List of Exhibition Stands, in Brief. 1. Rats and Mice.—Live exhibits with methods of rodent control. 2. Meat.—Exhibit by the Institute of Meat, which aimed at encouraging the practice of hygiene in the meat trade. 3. Milk.—Miniature pasteurisation plant shown and measures to ensure pure milk. 4. Wet Fish.—A modern refrigerated " shop window "—in direct contrast with the open-fronted fish shop. 5. Ice-Cream.—A model of modern ice-cream pasteurising equipment. 6. Baker.—Showing how the baker's goods may be protected from contamination. 7. Gas.—Uses of gas in the service of clean food. 8. Fish Frying.—A stand showing modern hygienic fishfrying equipment. 9. Ministry of Food.—The stand illustrated the clean and dirty shop and how the Food Byelaws are designed to protect your health. 10. Cateringr Hygiene.—Contrasting desirable and undesirable features of a small cafe, kitchen and toilet. 11. Electricity.—How electricity may further the ideal of clean food. 12. Mothercraft.—A stand of particular interest to the young mother, arranged by the Health Visitors and Dental Hygienist of the Surrey County Council. 13. Refrigeration.—Modern refrigeration plant demonstrated, 20 14. Mitcham Foods.—A display of food hygienically prepared and wrapped in Mitcham Factories. 15. Detergents.—New washing and sterilising preparations demonstrated. 16. Dish Washing.—An exhibition of modern mechanical aids to cleanliness of crockery and glassware. 17. The Public Health Department.—Exhibits by the Public Health Department and the Public Analyst. 18. Personal Hygiene.—This exhibit showed how food can become infected by those who handle it, and the organisms usually responsible. FOOD AND DRUGS ACT, 1938 Formal Samples. Forty-five formal samples were taken as follows: — Milk 36 Tinned Cambridge Sausages 1 Beef Sausages 2 Pork Sausages 2 Beef Sausage Meat 1 Chippolata Sausages 1 Baking Powder 1 Ice-cream 1 Informal Samples. Seventy-four informal samples were taken as follows: — Tomato Ketchup 3 Asparagus Soup 1 Horseradish Sauce 1 Mint in Vinegar 1 Meat Paste 2 Lemon Squash 1 Sauce 4 Golden Raising Powder 2 Beef Soup 1 Chocolate Cup 1 Chicken Noodle Soup 1 Lemonade Crystals 1 Pork Sausages 1 Curry 1 Cooked Rabbit 1 Coconut Cake Filling 2 Solid Pack Apples 1 Sparkling Ale 2 Salmon and Anchovy Fish Chocolate Cream Filled Paste 1 Wafers 1 Brisling in Tomato 1 Marshmallow Creme 1 Herrings in Tomato 1 Vinegar 1 30 Swiss Roll 1 Granulated Sugar 1 Meat Soup 1 Meat Pie 1 Desiccated Coconut 1 Tomato Soup 1 White Pepper 1 Peanut Butter 1 Cake Mixture 2 Sardines in Oil 1 Double Cream 1 Pure Honey 1 Spaghetti and Sausages in Synthetic Cream 1 Tomato Sauce 1 Gelatine White Fondant 1 Sponge Mixture Garden Peas 1 Butter Luncheon Meat 1 Ice-cream 18 Crabmeat 2 All samples were satisfactory, with the exception of one formal (tinned Cambridge sausage) and two informal samples (coconut cake filling and meat pies); a warning letter was sent in each of these cases. Three summonses, regarding dirty milk bottles, were applied for, and fines of (1) £20 and £8 8s. 0d. costs, (2) £5 and £3 13s. 0d. costs. (3) £5 and £3 13s. Od. costs, were awarded. Ice-Cream. Four premises in the Borough are registered for the manufacture of ice-cream, and one hundred and twenty-seven for the storage of ice-cream. One hundred and eighty-eight visits were paid during the year. Sixty samples of ice-cream were taken and examined for bacteriological purity. Nineteen samples were also tested for fat content. The results are tabulated below:- Provisional Grade. I ii III iv Coliforms absent 18 8 2 — Coliforma present in l/10th ml 14 6 11 1 Fæcal coli present (in addition to above):- In 1 ml. — — — — In l/10th ml. 1 — 1 — In l/100th ml. - - — - 31 Fat Content 3-4 4-5 5-6 6-7 7-8 per cent. per cent. per cent. per cent. per cent. — — 1 1 1 8-9 9-10 10-11 11-12 12-13 percent. percent. percent. percent. percent. 2 4 8 6 1 Tea Cup Swabs Twelve swabs were taken from tea cups at various catering establishments during the year, and were submitted to the Public Health Laboratory for bacteriological examination. The results are tabulated below: — Colony Count (per cup) Coliforms. Fæcal Coli. Result- Satisfactory. Unsatis factory. Present. Absent. Present. Absent. Under 100 — 3 — — 3 — 100-500 2 — — 2 — 2 500-1,000 2 2 — 2 — 4 1,000-1,500 - - - - - - 1,500-2,000 — 1 — — — 1 Over 2,000 1 1 — 1 2 Total 5 7 5 3 9 Communications were sent to all establishments informing them of the result of the swabs. 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 23 Sterilised 29 Supplementary Licences— Pasteurised 18 Sterilised 17 32 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) 18 Supplementary Licences (Tuberculin Tested) 17 One hundred and thirty-three samples of Graded Milk were submitted for bacteriological examination. One hundred and thirty-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 13. Forty-four visits have been paid. DAIRIES There is one registered dairy and pasteurising establishment within the district. During the year 26 visits of inspection were paid. SLAUGHTERHOUSES There are two registered slaughterhouses in the Borough; 66 visits have been paid. 33 MEAT INSPECTION Carcases Inspected and Condemned Cattle, excluding cows Cows Sheep and Lambs Pigs Number killed 1 ... ... 162 Number inspected 1 ... ... 162 All diseases except tuberculosis: Whole carcases condemned ... ... ... 2 Carcases of which some part or organ was condemned Percentage of the number inspected affected with disease other than tuberculosis ... ... ... 1.23 Tuberculosis only: Whole carcases condemned ... ... ... ... Carcases of which some part or organ was condemned ... ... ... .. Percentage of the number inspected affected with tuberculosis ... ... ... ... FOOD PREPARING FACTORIES There are 12 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, 42. Number of Notices complied with, 33. PIGGERIES There are 28 piggeries in the Borough. Seventy-seven visits were paid during the year. 34 FACTORIES ACT, 1937 I.—Inspections for purposes of provisions as to health (including inspections made by Sanitary Inspectors): — 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 15 13 ... ... 1 (ii) Factories not included in (i) to which Section 7 is enforced by the Local Authority 2 262 120 7 ... 2 (iii) Other Premises under the Act (excluding out-workers' premises) 3 16 1 ... ... 3 TOTAL ... 293 134 7 ... ... 35 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) 4 2 2 ... ... ... 4 Overcrowding (S.2) 5 ... .. ... ... 5 Unreasonable temperature (S.3) 6 ... ... ... ... ... 6 Inadequate ventilation (S.4) 7 ... ... ... ... 7 Ineffective drainage of floors (S.6) 8 ... ... ... ... 8 Sanitary Conveniences (S.7) ... ... ... (a) Insufficient 9 3 3 ... ... ... 9 (6) Unsuitable or defective 10 11 11 ... 6 ... 10 (c) Not separate for sexes 11 1 1 ... 1 ... 11 Other offences (not Including offences relating to Homework) 12 7 7 ... ... ... 12 TOTAL 60 24 24 ... 7 ... 60 36 3.—Outwork (Sections 110 and 111): — Nature of Work M/c line No. Section 110 Section 111 M/c line No. No. of out-workers in August list required by 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 (1) (2) (3) (4) (6) (6) (7) (8) (9) Wearing apparel Making, etc. 13 100 13 Cleaning and washing 14 14 Household linen 15 15 Lace, lace curtains and nets 16 16 Curtains and furniture hangings 17 17 Furniture and upholstery 18 18 Electro-plate 19 19 File making 20 20 Brass and brass articles 21 21 Fur pulling 22 22 Iron and steel cables and chains 23 23 Iron and steel anchors and grapnels 24 24 Cart gear 25 25 Locks, latches and keys 26 26 Umbrellas, etc. 27 27 Artificial flowers 28 28 37 Nets, other than wire nets 29 29 Tents 30 30 Sacks 31 31 Racquet and tennis balls 32 32 Paper bags 33 33 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 34 8 34 Brush making 35 35 Pea picking 36 36 Feather sorting 37 37 Carding, etc., of buttons, etc. 38 38 Stuffed toys 39 39 Basket making 40 40 Chocolates and sweetmeats 41 41 Cosaques, Christmas crackers, Christmas stockings, etc. 42 20 42 Textile weaving 43 3 43 Lampshades 44 1 44 TOTAL 70 132 70 38 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASE NOTIFICATIONS The total number of confirmed notifications received during 1951 was 1,980. Contacts, Suspects, Etc. The Medical Officer of Health is called in consultation by medical practitioners to see patients in their homes, as required. Visits Sanitary Inspectors in common infectious diseases 174 „ „ to small pox contacts 25 Total 199 Rooms disinfected after infectious disease 200 39 The monthly incidence of infectious disease was:— Small Pox Scarlet Fever Diphtheria Typhoid Fever Erysipelas Pneumonia Puerperal Pyrexia Ophthalmia Neonatorum Dysentery Meningococcal Infections Poliomyelitis Paralytic Poliomyelitis Non- Paralytic Measles Whooping Cough Food Poisoning Paratyphoid Malaria Acute Encephalitis Infective Acute Encephalitis Post-Infectious Totals January ... 5 ... ... 2 3 1 ... ... ... ... ... 167 97 ... ... ... ... ... 275 February ... 4 ... ... ... 7 2 ... 1 ... ... ... 296 110 ... ... ... ... ... 420 March ... 23 ... ... ... 2 ... 1 1 ... ... 490 58 1 ... ... ... ... 576 April ... 12 ... ... ... ... ... 1 1 ... ... 190 31 ... ... ... ... ... 235 May ... 15 ... ... ... ... 1 ... ... ... ... ... 134 32 ... ... ... ... ... 182 June ... 15 ... ... ... 3 1 ... ... ... ... ... 91 47 ... ... ... ... 1 168 July ... 8 ... ... ... 2 ... ... 1 1 ... ... 10 16 ... ... ... ... ... 38 August ... 6 ... ... ... 1 1 ... ... ... ... ... 5 6 ... ... ... ... ... 19 September ... 2 ... ... ... ... 4 ... ... ... ... ... 1 10 ... ... ... ... ... 17 October ... 4 ... ... 2 2 1 ... ... ... ... ... ... 7 ... ... ... ... ... 16 November ... 8 ... ... ... 3 1 ... 1 ... ... ... 1 3 ... ... ... ... ... 17 December ... 9 ... ... 4 1 1 1 2 ... 1 ... 1 3 3 1 ... ... ... 27 Totals ... 111 ... ... 8 24 13 1 7 3 1 ... 1386 420 4 1 ... ... 1 1980 40 Infectious Disease Notifications, 1932-51. Disease 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 1950 1951 Small Pox 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 174 240 392 143 171 192 150 61 48 75 175 212 97 147 95 62 35 57 89 110 111 Diphtheria 32 40 83 80 101 89 64 27 36 72 25 42 10 63 32 4 ... 1 1 ... ... Typhoid Fever 3 3 ... 3 5 ... 1 ... ... ... ... 1 1 ... ... 1 Puerperal Pyrexia 4 9 6 4 11 5 4 7 2 2 6 3 5 8 6 9 3 ... 2 13 Meningococcal Infections 1 4 1 1 8 1 2 1 13 12 6 8 3 3 1 2 1 1 1 3 Erysipelas 11 31 30 20 22 16 8 19 17 19 7 22 13 16 25 9 18 6 12 7 3 Measles ... ... ... ... ... ... ... ... 301 194 599 651 112 739 358 533 818 252 354 354 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1386 Acute Poliomyelitis: ... Paralytic ... ... ... ... ... 1 ... ... ... ... ... ... ... 2 3 11 2 2 6 2 1 Non-Paralytic ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Ophthalmia Neonatorum 4 2 2 4 3 1 3 3 1 3 10 4 4 2 2 6 3 8 2 1 Acute Encephalitis : ... Infective 1 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... Post-Infectious ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia 52 37 45 35 36 32 43 ... 30 22 20 50 37 33 41 37 30 13 1 Q no 1 Malaria ... ... ... ... ... ... ... ... ... ... 1 1 1 1 io lo 24 Whooping Cough ... ... ... ... ... ... ... 4 16 186 161 162 166 96 234 216 117 149 919 Food Poisoning ... ... ... ... ... ... ... 4 4 6 11 ... 5 1 ... ... 6 OO 1 3 420 4 Dysentery ... ... ... ... ... ... ... ... ... ... ... 4 67 13 6 1 2 5 7 16 7 Paratyphoid ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... i 1 Totals 288 368 560 293 357 338 275 125 468 591 1021 1161 515 1126 807 888 1033 490 717 911 1980 41 Small Pox No case of small pox was notified during the year 1951. The last case was in 1932. The number of cases of scarlet fever notified during the year was 111 as compared with 110 in 1950, equivalent to a case rate of 1.66 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 53 were treated in hospital and 58 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. 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 and reinforced during the year: — Scarlet Fever Diphtheria Immunisation Immunised. Reinforced. Total. 610 2,591 Under five years 5 to 14 years 596 235 14 2,356 Totals 831 2,370 3,201 42 The following figures show the number of the child population considered immunised at 31st December, 1951: — Age at 31.12.51 i.e. born in year Under 1 1951 1 1950 2 1949 3 1948 4 1947 5 to 9 1942-1946 10 to 14 1937-1941 Total under 15 Number immunised 19 474 674 832 959 4912 3939 11809 Estimated mid-year population 1951 5764 8861 14625 The percentage immunised is as follows: — Under five 51.32% Five—Fourteen 99.88% The total of immunised children is probably on the high side because of the difficulty in finding out the number who should no longer be recorded due to death or transfer out of the district. The number of birthday greetings sent in 1951 was 379. Enteric Fever. No cases of typhoid fever were notified during the year, but there was one case of paratyphoid B. This belonged to a rare group but the source of infection could not be discovered. The case was mild in nature. Diarrhœa and Enteritis Under Two Years of Age One death was registered during the year. Food Poisoning Outbreaks There was one outbreak which affected three persons in one household, and one in the house next door. There were no fatalities, and all tests of foodstuffs and faeces examinations proved negative. Encephalitis Lethargica No case was notified during the year, 43 Erysipelas Eight cases were notified. No case was removed to hospital. Puerperal Pyrexia Thirteen cases were notified during the year. The increased number was probably due to the wider scope following the revised definition of Puerperal Pyrexia under the 1951 regulations. Pneumonia Twenty-four 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 42, of which 16 were males and 26 females. Meningococcal Infections. Three cases occurred during 1951. There was one female death. Influenza During the year thirteen deaths from influenza were recorded, five males and eight females. The previous year two deaths were registered. Prevention of Blindness This comes under the control of the Surrey County Council. Ophthalmia Neonatorum During the year one case of ophthalmia neonatorum was notified. Poliomyelitis One isolated case of poliomyelitis occurred, belonging to the paralytic group, although it affected only very slightly the right thigh. There was some doubt as to whether it really was a case. 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. 44 The school notices also give information of the prevalence of non-notifiable infectious disease, such as chicken pox, mumps, etc. The numbers were as follows:— Chicken pox 212 Mumps 243 Ringworm 1 Impetigo 5 Rubella 8 Hepatitis 1 Cancer The number of deaths from cancer registered during the year was 108, of which 62 were males and 46 were females. The site distribution for 1951 was as follows: — Digestive organs 18 cases Respiratory organs 23 „ Breast 5 „ Genito-urinary organs 6 „ Other sites 56 „ Total 108 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 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 45 Year Number of Deaths Death Rate per 1,000 of population Mitcham England and Wales 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 1951 108 1.61 — Tuberculosis During the year 121 new cases of tuberculosis were notified viz.:— Males Females Total Pulmonary 62 54 116 Non-Pulmonary 3 2 5 Totals 65 56 121 Twenty-six cases were transferred into the Borough as follows:- Males Females Total Pulmonary 7 17 24 Non-Pulmonary — 2 2 Totals 7 19 26 The total number of deaths registered as occurring from tuberculosis was:— Males Females Total Pulmonary 11 8 19 Non-Pulmonary 1 2 3 Totals 12 10 22 England and Wales Mitcham Death rate from tuberculosis, all forms per 1,000 population 0.31 0.33 46 The following table shows the number of new cases, the typo of disease and the deaths from tuberculosis during the year. Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. Under 1 year ... ... ... ... ... ... ... ... 1 year to 4 years ... 3 ... ... ... ... ... ... 5 years to 9 4 1 ... ... ... ... ... ... 10 „ „ 14 1 ... ... 1 ... ... ... ... 15 „ „ 19 4 12 ... ... ... ... ... ... 20 ,, 34 ,, 19 29 2 1 2 3 1 35 „ „ 44 „ 16 6 ... ... 4 ... 1 ... 45 „ „ 64 „ 14 3 1 ... 2 4 1 65 „ and upwards 4 ... ... ... 3 1 ... ... Totals 62 54 3 2 11 8 1 2 New cases coming to the knowledge of the Medical Officer of Health during the year through Death returns; and Posthumous notifications: Age Periods 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total Pulmonary : males ... ... ... ... ... ... ... 1 ... ... ... 1 Pulmonary: females ... ... ... ... ... ... ... ... 1 ... ... 1 Non-Pulmonary: males ... ... ... ... ... ... ... ... ... ... ... ... Non-Pulmonary: females ... ... ... ... ... ... ... ... ... ... ... ...... 47 The sources from which information as to the abovementioned cases was obtained are as follows: — No. of Cases Pulmonary NonPulmonary Death Returns (a) From Local Registrar 1 ... (6) Transferable deaths from Registrar General 1 ... Posthumous notifications from doctors ... ... 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 2 Total tuberculosis deaths 22 Percentage of non-notified tuberculosis deaths 9.09 Miniature Mass Radiography This unit comes to Mitchani every year and is granted free facilities at the Vestry Hall (Town Hall). Several new cases come to light at each visit, and treatment is then instituted. 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 and 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 are given to hardship cases, 48 Assistance is 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. The Committee has the onerous task of raising the larger portion of the funds necessary, the Chairman having great pleasure in expressing thanks to all those who helped, especially with the Christmas Seal Campaign, which resulted in the record figure of £258 12s. 8d. for 1951. 49 INDEX PAGE Abortion, Deaths 8, 11, 13, 14 Ambulances 15 Ante-Natal Clinics 17 Area 7 Bakehouses 32 Bed Bugs, Eradication of 20 Bedding, Disinfection of 15 Birth Rates 8, 10, 14 Births, Illegitimate 8 — In Institutions 9 — Live 8 — Still 8 Blindness, Prevention of 43 Books disinfected, Library 15 Cancer 44 — Deaths from 9, 44 Causes of Deaths 11-13 Chief Sanitary Inspector's Report 22-25 — — Inspector, Visits by 22 Cleansing, Public 20 Clinics 17, 18 Closet Accommodation 20 Committees, Members of Health 5 Dairies 32 Day Nurseries 18 Death Rates 8, 10, 14 Deaths 8-14, 44-47 Dental Clinics 17 Diarrhoea and Enteritis 42 — Deaths from 9, 14 Diphtheria 41 Immunisation 41, 42 — Clinics 18 Disinfection 15, 38 Encephalitis Lethargica 42 Eradication of Bed Bugs 20 50 PAGE Erysipelas 43 Factories Act, 1937 34-37 — — Defects found 35 Inspections 34 — — (Sections 110 and 111) Outwork 36, 37 Food and Drugs Act, 1938 29 — — — — Section 13 33 — Dealt with, Unsound 24, 25 — Inspection and Supervision of 29, 30 — Preparing Factories 33 — Campaign, Clean 27 — Exhibition, Clean 27-29 — Poisoning 42 — — Case Rates 14 General Provision of Health Services for the Area 15 Health Visiting 18 Home Help Service 18 Hospitals 16 Houses, Disinfection of 15 — Inhabited 7, 25 — Inspection of Dwelling " 27 Housing Act, 1936 (Sections 9, 10 and 16) 26 — — — (Section 11) 27 — — — (Section 12) 27 — Statistics 25 Ice Cream 30 — — Samples 30, 31 Immunisation and Vaccination Clinics 18 — Diphtheria 41, 42 Infant Mortality 8, 10, 11 Infectious Disease Case Rates 14 — — Contacts 38 — — Hospitals 16 — Monthly Incidence of 39 — — Notifications 38, 40 — — School 43, 44 — — Sanitary Inspectors' Visits 38 Influenza 43 51 PAGE Inquests 11 Inspection and Supervision of Food 27 Laboratory Facilities 15 Legal Proceedings 24 Library Books, Disinfection of 15 Maternal Mortality 8, 11, 13 Maternity, Hospital Treatment 16 Measles Case Rates 14 Deaths from 9, 13 Meat Inspection 33 Meningococcal Infection 43 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 and 1950 31 Milk (Special Designation) (Raw Milk) Regulations, 1949 and 1950 32 Mortality, Analysis of 14 National Assistance Act, 1948, Sect. 47 19 — Amendment Act, 1951 19 N.S.P.C.C. 19 Notifications, Infectious Disease 14, 38, 40 — School 43, 44 Nurseries, Day 18 Ophthalmia Neonatorum 43 Outworkers (Sect. 110 and 111—Factories Act, 1937) 36, 37 Persons in Need of Care and Attention 19 Pests Act, 1949, Prevention of Destruction by 21, 22 Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929 24 Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Carbide of Calcium) Order. 1929 24 Piggeries 33 Pneumonia 43 Poisoning, Food 42 Poliomyelitis 43 Population 7 Post-Natal Clinic 17 Public Cleansing 20 Puerperal Pyrexia ,,, ,,, 43 52 PAGE Public Analyst 15 Rateable Value 7 Rent and Mortgage Interest (Restrictions) Act, 1920/1938 27 Rivers and Streams 20 Rodent Operations 21 Rooms Disinfected, number of 15, 38 Samples, Food 29, 30 Sanitary Circumstances of the Area 19 Inspectors, Chief's Report 22-25 Scarlet Fever . 41 Schools 21 — Notifications 43, 44 Slaughterhouses 32 Smallpox 41 — Vaccination Clinics 18 — Hospital 16 Social Conditions 7, 8 Staff, Personnel 6 Statistics 7-14 Housing 25-27 — Vital 7 Still Births 8 Supervision of Food, Inspection and Swabs, Tea Cups 31 Tuberculosis 45-47 — Care Committee 47, 48 — Clinic 16 Typhoid Fever 42 Unsound Food dealt with 24, 25 Venereal Diseases Clinics 16 Visits by Sanitary Inspectors 22, 23, 38 Vital Statistic ? Water Supply 19 Welfare Clinics Whooping Cough, Deaths from 13 — — Cases 39