MIT 22 MITCHAM BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1953 BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1953 Mitcham: H. G. Mather, Ltd., Caxton Works, Lower Green. 3 Borough of Mitcham HEALTH REPORT FOR 1953 To the Mayor, Aldermen and Councillors. Mr. Mayor, Ladies and Gentlemen, I have much pleasure in submitting my annual report for the year 1953. The general health in the Borough has been good, and there was no outbreak of infectious disease to cause special alarm. The infectious diseases notifications were increased because of a rise in measles and whooping cough, although the number of cases of scarlet fever decreased. Poliomyelitis affected five people, but they were fairly mild cases, except for one case which died. Very much on the preventive side for the fourth year in succession, there was no case of diphtheria, and only two in the past six years, whereas before that cases averaged sixty per year. It was pleasing to note that deaths from tuberculosis were the lowest on record, for the second year in succession, the death rate being 0.15 per 1,000 population, compared with 0.19 last year and 0.24 for England and Wales. The figures for this industrial area used to be less favourable. The fifteen cases of dysentery were mostly single cases diagnosed on clinical grounds, not confirmed bacteriologically. The birth rate of 13.91, after correction by the comparability factor to correspond with the average age and sex grouping of the whole population, becomes 13.21, which compares with 15.5 for England and Wales. 4 The actual death rate of 9.23, which after applying the comparability factor becomes 10.52, compares with 11.4 for the whole country. The infant mortality rate is again the lowest recorded in Mitcham, and is 18.39 compared with 26.8 for England and Wales, which itself is the lowest ever recorded for this country. The death rate from cancer continues to rise and is now the highest ever, being 1.94 per 1,000 population. 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. 5 BOROUGH OF MITCHAM PUBLIC HEALTH COMMITTEE. Chairman Alderman Mrs. J. C. Ericson His Worship the Mayor (Councillor E. E. Mount, J.P.) Aldermen— Mrs. L. Crump Mrs. H. E. Niven G. VV. Pearce Councillors— Mrs. W. R. Martin E E. Field W. Lancaster E. J. Mills R. A. Spalding R. Stanley REPRESENTATIVES OF THE COUNCIL ON OTHER AUTHORITIES. WANDLE VALLEY JOINT SEWERAGE BOARD His Worship the Mayor (ex officio) Alderman W. Jeffery Councillors— D. W. Fido F. S. Niven NORTH-EAST DIVISIONAL HEALTH SUB-COMMITTEE (SURREY COUNTY COUNCIL) Aldermen— Mrs. H. E. Niven G. W. Pearce Councillors— Mrs. E. G. Baker Mrs. W. R. Martin 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) E. J. Sluis (1, 2) L. M. Edwards (1, 2) F. A. Evans (1, 2) 1. Certificate R.S.I, and Sanitary Inspectors' Examination Joint Board. 2. Certificate Meat and Foods R.S.I. 3. Smoke Inspector's Certificate. Clerks L. J. Bellingham Miss V. I. Hill (a) Miss M. Sanders (6) Miss K. E. Becket (а) Part-time—40 per cent. Surrey County Council. (b) Part-time—40 per cent. Surrey County Council. Commenced duties 13th January 1953. 7 REPORT STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 2,932 acres Population, Census 1921 85,119 1931 56,856 1951 (32,284 M.; 34,885 F.) 67,269 Registrar-General's estimate of population midyear, 1953 66,430 Density of Population, 1951 22.9 persons per acre Number of inhabited houses, 1921 7,150 1931 13,187 1953 19,421 Rateable Value, 1953 £574,590 Sum represented by a Id. rate £2,310 The Borough of Mitcham is an irregular oval in shape, situated in North-East Surrey adjoining the south-west border of the London metropolitan area. It is a fairly flat and low lying area, with some 600 acres of open space including the 440 acres of Mitcham Common. The River Wandle. which forms the south-west and western boundary, separates Mitcham from Beddington and 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 four feet of top-soil, with about ten feet 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 feet. Mitcham, with over 300 factories, has a great variety of industries, of which probably the chief ones are paint and varnish, chemical, engineering, margarine and dairy products. Unemployment which increased somewhat in the early months of the year subsequently decreased till there was practically no unemployment, the best month being July. 8 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 896 458 438 Illegitimate 28 16 12 - Total 924 474 450 13.91 After correction by the comparability factor becomes 18.21 Still Births. Total Male Female Rate per 1.000 total births Legitimate 24 12 12 Illegitimate 2 1 1 - Total 26 18 13 27.87 DEATH6. Total Male Female Rate per 1,000 of population 618 314 299 9.23 After correction by the comparability factor becomes 10.52 Deaths from pregnancy, childbirth and abortion:— Rate per 1,000 total births Number of cases 1 1.05 Deaths of infants under one year of age:— All infants per 1,000 live births 18.39 Legitimate infants per 1,000 live legitimate births 16.74 Illegitimate infants per 1,000 live illegitimate births 71.48 Deaths from:— Cancer (all ages) 129 Measles 2 Whooping cough (all ages) — Enteritis and Diarrhoea under two years of age 1 9 Percentage of Births Occurring in Institutions Year Total births Births in hospitals, etc. Percentage of births occurring in institutions 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 1952 929 749 80.62 1953 950 735 77.37 10 The birth rates, death rates per 1,000 of population, and the infantile mortality rates for the years 1934-53 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 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 11.32 12.5 25.47 29.6 1952 12.62 15 3 10.87 11.3 19.80 27.6 1953 13.21 15.5 10.52 11.4 18.39 26.8 11 Infant Mortality. During the year 17 deaths were registered of infants under one year of age:— Males Females Total Legitimate 7 8 15 Illegitimate — 2 2 Totals 7 10 17 as compared with 18 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 7 1 2 2 2 — 1-7 days 2 — 2 — — — 8 days- 1 mth. 2 — 1 — 1 — lmth. -12 mths. 6 — 1 — 3 2 Total 17 1 6 2 6 2 Eleven infants failed to survive the first month of life, and prematurity was certified as the cause of death of one of these cases. Maternal Mortality. During the year one death was registered as compared with one in 1952. Inquests. Inquests were held on 13 residents dying within the district and on 10 Mitcham residents who died outside the district, a total of 23. In addition, post-mortems without inquests were held on 90 residents dying within the district, and on 70 Mitcham residents who died outside the district, a total of 160. 12 The following table shows the results of the findings of these inquests:— Accidental death 16 Death from misadventure 1 Suicide 5 Natural death 1 Total 23 13 Deaths Registered during the Year 1953 Cause of Death Males Females Total 1 Tuberculosis, respiratory 9 1 10 2 Tuberculosis, other ... ... ... 3 Syphilitic disease ... 1 1 4 Diphtheria ... ... ... 5 Whooping cough ... ... ... 6 Meningococcal infections ... 1 1 7 Acute poliomyelitis 1 ... 1 8 Measles 2 2 9 Other infective and parasitic diseases ... 1 1 10 Malignant neoplasm, stomach 16 10 26 11 Malignant neoplasm, lung, bronchus 16 1 17 12 Malignant neoplasm, breast ... 17 17 13 Malignant neoplasm, uterus ... 3 3 14 Other malignant and lymphatic ... ... ... plasms 41 25 66 15 Leukaemia, aleuksemia 1 4 5 16 Diabetes ... ... ... 17 Vascular lesions of nervous system 19 49 68 18 Coronary disease, angina 49 43 92 19 Hypertension with heart disease 6 7 13 20 Other heart disease 28 45 73 21 Other circulatory disease 10 14 24 22 Influenza 2 6 8 23 Pneumonia 16 9 25 24 Bronchitis 38 22 60 25 Other diseases of respiratory system 6 ... 6 26 Ulcer of stomach and duodenum 5 2 7 27 Gastritis, enteritis and diarrhoea ... 1 1 28 Nephritis and nephrosis 6 6 12 29 Hyperplasia of prostate 6 ... 6 30 Pregnancy, childbirth, abortion ... 1 1 31 Congenital malformations 3 2 5 32 Other defined and ill-defined diseases 20 21 41 33 Motor vehicle accidents 4 ... 4 34 All other accidents 6 6 12 35 Suicide ... 4 1 5 36 Homicide and operations of war ... ... ... All causes 314 299 613 14 Birth rates, Death-rates, Analysis of Mortality, Maternal Mortality, and Case-rates for certain Infectious Diseases in the year 1953. (Provisional figures based on quarterly returns.) England and Wales 160 County Boroughs and Great Towns including London 160 Smaller Towns (Resident Populations 25,000 to 50,000 at 1951 census) London Administrative County Mitcham Rates per 1,000 home population Births— Live 15.5 17.0 15.7 17.5 13.21 Still 0.35 0.43 0.34 0.38 0.39 22.4* 24.8* 21.4* 21.0* 27.37* Deaths— All causes 11.4 12.2 11.3 12.5 10.52 Typhoid and Paratyphoid 0.00 0.00 — — 0.00 Whooping cough 0.01 0.01 0.00 0.00 0.00 Diphtheria 0.00 0.00 0.00 - 0.00 Tuberculosis 0.20 0.24 0.19 0.24 0.15 Influenza 0.16 0.15 0.17 0.15 0.12 Smallpox 0.00 0.00 0.00 — — Acute Poliomyelitis (including polioencephalitis) 0.01 0.01 0.01 0.01 0.01 Pneumonia 0.55 0.59 0.52 0.64 0.37 Notifications (corrected)— Typhoid fever 0.00 0.00 0.00 0.01 0.00 Paratyphoid fever 0.01 0.01 0.01 0.01 0.00 Meningococcal infection 0.03 0.04 0.03 0.03 0.00 Scarlet fever 1.39 1.50 1.44 1.02 1.29 Whooping cough 3.58 3.72 3.38 3.30 5.06 Diphtheria 0.01 0.01 0.01 0.00 0.00 Erysipelas 0.14 0.14 0.13 0.12 0.16 Smallpox 0.00 0.00 0.00 — — Mensles 12.36 11.27 12.32 8.09 13.37 Pneumonia 0.84 0.92 0.76 0.73 0.40 Acute Poliomyelitis cluding polioencephalitis) Paralytic 0.07 0.06 0.06 0.07 0 06 Non-paralytic 0.04 0 03 0.04 0.03 0.01 Pood Poisoning 0.24 0.25 0.24 0.38 0.25 Puerperal Pyrexia 18.23* 24.33* 12.46* 28.61* 11.57* Bates per 1,000 lire births Deaths underoneyear of age 26.8† 30.8 24.3 24.8 18.39 Deaths from diarrhoea and enteritis under two years of age 1.1 1.3 0.9 1.1 1.08 Maternal mortality Pregnancy, childbirth and abortion 0.76* Not available 1.05* Abortion— Mortality per million women aged 15-44 With sepsis 5 N ot availabl e Without sepsis 3 * Per 1,000 total (live and still) births, t 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. The ambulances are controlled from St. Helier Hospital (Telephone: Fairlands 8893), some of them being stationed at Mitcham Court. Disinfection The disinfection of houses is undertaken by the Council. Disinfection of bedding, etc., is done at 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 182 Number of library books disinfected 271 HOSPITALS The hospitals directly concerned with the Mitcham area are administered by the St. Helier Group Hospital Management J 6 Committee, which is situated at Carslialton, 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, or to the Grove Hospital, Tooting. 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 St. Helier Hospital, Carshalton. The Woodlands Maternity Home situated within the district was closed as a Maternity Home on the 31st May, 1953, and is due to reopen as an Old People's Home on the 18th January, 1954. The number of beds available will be 21. 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 9.30 a.m., and Friday at 9.30 a.m. A clinic is held for old cases only, on every fourth Wednesday at 5 p.m. A Refill Clinic is also held every Monday and Tuesday at 2 p.m., at Cumberland Hospital. The Cumberland Hospital, which is situated in Mitcham, deals only with Tuberculosis and has 100 beds available. 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. 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 every 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. Church Road Centre.—Sessions are held every Thursday afternoon and Wednesday afternoon. Meopham Road Clinic.—Sessions are held each Wednesday afternoon. Toddlers' Clinics for children between the ages of two to five years are held on Monday mornings, other than the first Monday in the month, 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 Tuesday and Friday afternoons. An ante-natal session is held at the Cavendish Road Clinic every 2nd and 4th Monday morning during the month. 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, toddiers and school children at the Church Road, Western Road and Sherwood House Clinics. 18 Speech Clinic An all day session is held at Western Road Clinic on Tuesday, Wednesday and Thursday when two speech therapists are in attendance. Opthalmic Clinic An eye specialist attends Western Road Clinic on Tuesday and Thursday mornings and Wednesday afternoons. Minor Ailments A session is held at Western Road Clinic on Monday and Friday mornings, with a doctor in attendance, and on Wednesday mornings under the supervision of a nurse. U.V. Radiation Clinics Sessions are held as follows:— Church Road Clinic: Monday afternoons, Thursday mornings. Sherwood House Clinic: Tuesday afternoons, Friday afternoons. Diphtheria and Whooping Cough Immunisation. Vaccination against Small Pox (Under the direction of the 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 Nursery The Surrey County Council provide one day nursery in Mitcham, at Eagle House, London Road. Mitcham, with 85 places. Health Visiting. Health visitors are under the control of the Surrey County Council. 19 There were nine Health Visitors employed in visiting the mothers and children in this district, under the supervision of a Divisional Superintendent Health Visitor. 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. 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 1953 17 Number of children affected 38 Number of visits paid 85 National Assistance Act, 1948: Section 47. Removal to Suitable Premises of Persons in Need of Care and Attention. There were no cases during the year that required action under the above-named Act or under the National Assistance (Amendment) Act, 1951. All authorities concerned co-operate to avoid court action if possible. One or two cases which might have required such action were persuaded to enter voluntarily Welfare or Hospital establishments. 20 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 18 caravans. The water has 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 was also made, two vehicles being used for this purpose, but this collection ceased on 31st March, 1953. Pig food is collected three times weekly, except for the months of June, July and August, when a daily collection is made. 21 ERADICATION OF BED BUGS Number of Council houses found infested during the year, 18. Number of other houses found infested during the year, 28. Number of requisitioned, etc., houses found infested during the year, 10. Total number of houses disinfested during the year, 56. Methods employed:— 56 houses treated with insecticide spray (inclusive of those treated on more than one occasion): Number of houses disinfested of beetles, 267. Number of houses disinfested of other insects, 184. 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. Two full-time and one part-time Rodent Operators were employed. 22 Properties inspected 6,317 Complaints received 454 Number of treatments re rat infestation including test baits as result of inspection and complaints 1,016 Factory and business premises treated 1ll Visits by Sanitary Inspectors 136 Two sewer maintenance treatments were carried out; 245 manholes were baited. 23 intercepting chambers were also baited during the two maintenance treatments. A ten per cent, test of all the sewer manholes in the district was also 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 earned out in the Borough by myself and the District Sanitary Inspectors: — Complaints received 797 Nuisances found 655 Verbal Notices given 120 Verbal Notices complied with 74 Informal Notices served 512 Informal Notices complied with 307 Statutory Notices served 195 Statutory Notices complied with 173 Revisits 2,654 Houses inspected for defects 796 Visits made for this purpose 867 Drains tested and inspected 841 Private houses found verminous 30 Visits re Building Licence applications — Visits to butchers 210 Visits to slaughterhouses 68 Visits to dairies 6 Visits to retail milk shops 20 23 Visits to restaurant kitchens 289 Visits to ice-cream premises 174 Visits to bakehouses 67 Visits to other food premises 562 Number of notices served under Food and Drugs Act, 1938 81 Number of notices complied with 20 Visits to factories 283 Visits to workplaces 51 Visits to outworkers 140 Visits to stables 70 Visits to piggeries 114 Visits to marine stores — Visits to caravan yards 128 Smoke observations 89 Visits re infectious disease cases 198 Visits re smallpox contacts 8 Visits re food poisoning 23 Visits re rats and mice 186 Visits re Shops Acts 184 Visits re schools 27 Sundry visits 208 Character of Work Done Roofs repaired 158 Rainwater piping or gutters repaired or renewed 144 Yards paved or repaired 3 Dampness remedied 168 Water service pipes repaired 16 Waterclosets: Repairs to structure 11 Flushing apparatus repaired or renewed 47 New pans and traps fitted 26 Water storage cisterns cleansed, repaired or renewed 14 Water supply reinstated 9 Flooring of rooms repaired and sub-floor ventilation improved 65 Rooms cleansed and redecorated 16 Sinks and handbasins repaired or renewed 5 24 Waste pipes and traps repaired or renewed 28 Window frames and sashes repaired or renewed 58 Window sills repaired or renewed 18 External brickwork (repaired, pointed or rendered) 39 Drains repaired or obstructions removed 106 Drain inspection covers renewed 8 Drains tested 90 Grid and mica flaps provided 2 Firegrates repaired (including surrounds and hearths) 20 Stoves, coppers, ranges, etc., repaired 8 Chimney stacks repaired 16 Staircases repaired 22 Doors repaired 16 Internal plaster repairs 198 Sash cords renewed 95 Dustbins provided 43 Accumulations removed ... 11 All ponds and ditches in the Borough where mosquito breeding was possible were sprayed with insecticide twice during the year. Section 94, Public Health Act, 1936.—One application was made to the Justices for a summons against a property owner who failed to cany out works of repair. The Court made an Order for the works to be carried out within 28 days and awarded the Council £2 2s. costs. Section 68, Mitcham Urban District Council Act, 1923.—One application was made to the Justices requiring the provision of a dustbin and, although the dustbin was provided before the hearing, the Court imposed a fine of £1 with £1 1s. costs. Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929.—102 licences to store petroleum spirit and/or petroleum mixtures were issued for a total of 211,935 gallons (inclusive of cellulose solutions). Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Carbide of Calcium) Order, 1929.—3 licences were issued for the Legal Proceedings 25 storage of 2,344 lbs. (plus 448 lbs. temporary re-supply) of carbide of calcium. Unsound Food Dealt With. Beef 2,592 lbs. Ground Rice 94 lbs. Pork 16 „ Semolina 55 „ Corned Beef 42 „ Lentils 4 „ Rabbit 90 „ Marzipan Cake 8 „ Liver 50 „ Potatoes 2,240 „ Chicken 35 „ Mincemeat 32 „ Tongue 8 „ Butter 3 „ Jellied Veal 12 „ Biscuits 14 „ Stewed Steak 20 „ Cheese 36 „ Minced Beef Loaf 4 „ Sugar 1,816 „ Pressed Pork 4 „ Milk Powder 2,058 „ Luncheon Meat 32 „ Cereals 81 pkts. Sausages 47 „ Xmas Puddings 2 No. Ham 162 „ Eggs 120 „ Bacon 27 „ Condensed Milk 25 tins Brisket 2 Tinned Foods 827 „ Fish 672 „ Assorted 15 bottles and jars Currants 46 „ Yours faithfully, K. J. GUTTERIDGE, Chief Sanitary Inspector. Housing Statistics Total Number of Inhabited Houses—19,421. Permanent buildings built by the Council before the war— 1,461. Permanent buildings built by the Council after the war— 1,564. Other Housing Accommodation Available: — A. Requisitioned and sundry properties 354 B. Temporary buildings. Arcon bungalows 345 C. Hutments, 320 originally, now reduced to 129 26 D. Gunsite hutments, 61 originally, now reduced to 18 E. Therefore total number of properties used for housing by the Mitcham Borough Council is 3,871 Number of People, Rehoused. About 8,700 applicants have registered since 1945, and the current list is still about 2,500, so that some 6,200 applicants have been dealt with. The actual number of people including children who have been rehoused is about 6,900. 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 weather, although much has been spent on improvements. The numbers are gradually being reduced and the Mitcham Borough Council is acquiring the sites for permanent housing purposes. 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. A housing estate is also being constructed outside the borough at Banstead in conjunction with the neighbouring authorities of Merton and Morden Urban District Council and the Borough of Sutton and Cheam. The Mitcham Borough Council is increasing the number of aged persons' dwellings being built. The post-war housing is also making provision for the communal needs of the occupants of the 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) 796 (ft) Number of inspections made 867 27 2. Remedy of Defects during the Year:— Number of dwelling houses rendered fit in consequence of informal action by the local authority or their officers 255 Number of dwelling houses rendered fit in consequence of formal action by the local authority or their officers 162 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 (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 — Proceedings under Section 11 of the Housing Act, 1936:— (1) Number of houses in which demolition orders were made (2) Number of houses closed in pursuance of an undertaking given by the owners and still in force 2 Proceedings tinder Section 12 of the Housing Act, 1936:— (1) Number of houses in which closing orders were made for underground rooms (2) Parts of buildings closed 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 28 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. Food premises by type of business. General Stores 14 Restaurants 6 Groceries 80 Ice-Cream Manufacturers 4 Butchers 35 Cafes 23 Continental Butchers (Horseflesh) 3 Cafe & General Stores 2 Roadside Snack Bars 4 Greengrocer & Fruiterers 59 Fishmongers 11 Greengrocer & General Provisions 2 Fried Fish Buffets 5 Fried Fish 12 Confectionery 74 Bakers and Confectioners 18 Confectioner & Greengrocers 2 Milk & Provisions 13 Public Houses 28 Chemists 11 Food premises by type, registered wider Section 14, Food and Drugs Act, 1938. The storage and sale of Ice Cream 130 The manufacture for sale of Ice Cream 4 The preparation or manufacture of sausages, or potted, pressed, pickled or preserved food 38 Dairies registered under the Milk and Dairies Regulations, 1949 1 Number of inspections of registered food premises during the year 279 All condemned food is incinerated at the Council's Refuse Destructor, Homewood Road. 29 FOOD AND DRUGS ACT, 1938 Formal Samples. Eighty-throe formal samples were taken as follows.— Milk 47 Ice-Cream 7 Batter Mixture 1 Orange Squash 1 Beef Sausages 3 Vitamin Pellets 1 Chippolata, Pork 1 Vitamin Capsules 1 Beef Sausage Meat 1 Plum Jam 1 Youngberry Jam 1 Raspberry Jam 1 Ground Almonds 1 Vitamin B.l. Powder 1 Pork Brawn 1 Cough Syrup 1 Ruby Wine 1 Strawberry Jelly Creams 1 Synthetic Cream Powder 1 Malt Vinegar 1 Sweetened Cake Flour with Egg 1 Honey, Glycerine & Blackcurrant Children's Cough Mixture 1 Pork Sausages 3 Processed Cheese 1 Pork Sausage Meat 1 Pork Pie 1 Popcorn 1 Informal Samples. Sixty-five informal samples were taken as follows:— Iced Fancies 1 Meat Pudding 1 Processed Cheese 2 Beef Steak Pie 1 Chocolate Sponge Mixture 1 Flour 2 Dressed Crab 1 Medicinal Glucose 2 Welsh Rarebit 1 Single Cream 3 Cheese and Celery Spread 1 Double Cream 5 Cheese Spread 1 Glucose Drink 1 Full Cream Sweetened Condensed Milk 2 Swiss Roll 2 Bicarbonate of Soda 1 Harlequine Roll 1 Medicinal Liquid Paraffin 1 Cochineal Colouring 1 Sulphur and Yeast Tablets 1 Tomato Puree 1 Steak Pudding 1 Marshmallow Creme 1 Sterilised Cream 1 Salmon and Shrimp Paste 2 Junior Aspirin 1 Horseradish Relish 1 Savoury Spread with Cooked Meat 1 Gorgonzola 1 30 Tea Cake Mixture 2 Rose Hip and Orange 1 Tomato Soup 1 Madelaine Sweetened Mixture 1 Chicken Noodle Soup 1 Beef Suet 3 Pineapple in Syrup 1 Coffee and Chicory 1 Orange Squash 1 Sweetened Sponge Mixture 1 Battenburg Cake 1 Bridal Icing Sugar 1 Cod Liver Oil Emulsion 1 Ground Almonds 1 Harlequin Xmas Pudding 1 Cod Liver Oil 1 Soup 1 Bloater Paste 1 Throat Sweets 1 Sardines 1 Honeycomb Mould 1 All samples were satisfactory with the exception of one formal (batter mixture 1), and four informal samples (Chocolate Sponge Mixture 1, Full Cream Sweetened Condensed Milk 1, Medicinal Glucose 1, Orange Squash 1). A warning letter was sent in four of these cases, the exception being full cream sweetened condensed milk. As a result of the analyst's examaination of the sample of condensed milk a consignment of this milk was surrendered for destruction. On complaints being received the following cases were reported to the Public Health Committee:— Three dirty milk bottles. One of mouldy bread. One of foreign body in a tin of Irish Stewed Steak. Legal action was taken against the company in the case of two dirty milk bottles and fines of £25 in each case were imposed on the company, together with a total of £16 16s. costs. In the remaining cases all the firms concerned received warning letters. Ice-Cream. Four premises in the Borough are registered for the manufacture of ice-cream, and 130 for the storage of ice-cream. One hundred and seventy four visits were paid during the year. Forty samples of ice-cream were taken and examined for bacteriological purity. Seven samples were also tested for fat content. The results are tabulated below:— 31 Provisional Grade. I II III IV Coliforms absent 20 — — — Coliforms present in l/10th ml 15 1 4 — Fæecal coli present (in addition to above) — — — — Fat Content 3-4 per cent. 4-5 per cent. 5-6 per cent. 6-7 per cent. 7-8 per cent. — — — — 2 8-9 per cent. 9-10 per cent. 10-11 per cent. 11-12 per cent. 12-13 per cent. 1 2 1 1 — Bacteriological Examination of Cups and Glasses. Eighty-two swabs were taken from tea cups at various catering establishments and twenty-eight swabs were taken from beer glasses at various public houses during the year, and were submitted to the Public Health Laboratory for bacteriological examination. The results are tabulated below:— Tea Cup Swabs. Result— Colony Count (per cup) Coliforms. Faecal Coli. Satisfactory. Unsatis factory Present. Absent. Present. Absent. Under 100 3 49 — 3 52 — 100-200 8 4 — 3 — 7 200-500 4 9 1 3 — 13 500-1,000 1 1 — 1 — 2 1,000-1,500 2 2 — 2 — 4 1,500-2,000 — 2 — — — 2 2,000 and over 1 1 — 1 — 2 Total 14 68 1 13 52 30 Beer Glass Swabs. (Per Glass) Under 100 — 15 — — 15 — 100-200 1 — — 1 — 1 200-500 1 1 1 — — 2 500-1,000 — 1 — — — 1 32 Result— Colony Count (per cup) Coliforms. Faecal Coli. Satisfactory. Unsatisfactory, Present. Absent. Present. Absent, 1,000-1,500 1 — — 1 — 1 1,500-2,000 1 — — 1 — 1 2,000 and over 6 1 — 6 — 7 Total 10 18 1 9 15 18 The result of the swabs was sent to the establishments concerned. MILK (SPECIAL DESIGNATION) (PASTEURISED AND STERILISED MILK) REGULATIONS, 1949 AND 1950. During the year the Council granted the following number of licences under the above-named Regulations:— Dealer's (Pasteuriser's) Licences 1 Dealer's Licences— Pasteurised 20 Sterilised 40 Supplementary Licences— Pasteurised 17 Sterilised 17 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) 14 Supplementary Licences (Tuberculin Tested) 17 One hundred and sixty three samples of Graded Milk were submitted for bacteriological examination, and all were found to be satisfactory. BAKEHOUSES The number of bakehouses in the district is 10. Sixty-seven visits have been paid. 33 DAIRIES There is one registered dairy and pasteurising establishment within the district. During the year six visits of inspection were paid. SLAUGHTERHOUSES There are two registered slaughterhouses in the Borough; 68 visits have been paid. Slaughter of Animals Act, 1933 Seven licences were issued to slaughtermen in accordance with the requirements of the above Act. MEAT INSPECTION Carcases Inspected and Condemned Cattle, excluding cows Cows Sheep and Lambs Pigs Number killed ... 1 Calf ... 170 Number inspected ... 1 Calf ... 170 All diseases except tuberculosis: Whole carcases condemned ... ... ... ... Carcases of which some part or organ was condemned ... ... ... 6 Percentage of the number inspected affected with disease other than tuberculosis ... ... ... 3.53 Tuberculosis only: Whole carcases condemned ... ... ... ... Carcases of which some part or organ was condemned ... ... ... 3 Percentage of the number inspected affected with tuberculosis ... ... ... 1.76 FOOD PREPARING FACTORIES There are 17 factories which are engaged in the manufacture and preparation of food products. All of these have been systematically visited. 34 INFORMAL ACTION TAKEN UNDER SECTION 13, FOOD AND DRUGS ACT, 1938. Number of notices served, 31. Number of notices complied with, 20. PIGGERIES There are 30 piggeries in the Borough. One hundred and four teen visits were paid during the year. PET ANIMALS ACT, 1951 Six licences were issued to occupiers of pet shops. 35 FACTORIES ACT, 1937 I.—Inspections for purposes of provisions as to health (including inspections made by Sanitary Inspectors):— Premises (1) M/c line No. (2) Number on Register (3) Number of M/c line No. (7) Inspections (4) Written notices (5) Occupiers prosecuted (6) (i) Factories ill which Sections 1, 2, 3, 4, and 6 are to be enforced by Local Authorities 1 21 28 3 ... 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 2 271 213 6 ... 2 (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 3 24 22 3 ... 3 TOTAL ... 316 263 12 ... ... 36 2.—Cases in which defects were found: — Particulars (1) M/c line No. (2) Number of cases in which defects were found Number of cases in which prosecutions were instituted (7) M/c line No. (8) Found (3) Remedied (4) Referred To H.M. Inspectoi (5) By H M. Inspector (6) Want of cleanliness (S.l) 4 3 3 ... ... ... 4 Overcrowding (S.2) 5 ... ... ... ... ... 5 Unreasonable temperature (S.3) 6 1 1 ... ... ... 6 Inadequate ventilation (S.4) 7 3 3 ... ... ... 7 Ineffective drainage of floors (3.6) 8 ... ... ... ... ... 8 Sanitary Conveniences (8.7) (a) Insufficient 9 4 4 ... ... ... 9 (6) Unsuitable or defective 10 6 6 ... ... ... 10 (c) Not separate for sexes 11 ... ... ... ... ... 11 Other offences (not including offences relating to Homework) 12 3 3 ... 1 ... 12 TOTAL 60 20 20 ... 1 ... 60 37 3.—Outwork (Sections 110 and 111): — Nature of Work (1) M/c line No. (2) Section 110 Section 111 M/c line No. (9) No. of out-workers in August list required by Sect. 110 (1) (c) (3) No. of cases of default in sending lists to the Council (4) No. of prosecutions for failure to supply lists (6) No. of instances of work in unwholesome premises (6) Notices served (7) Prosecutions (8) Wearing apparel Making, etc. 13 139 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 1 28 38 3.—Outwork (Sections 110 and 111) continued :— 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 13 34 Brush making 35 35 Pea picking 36 36 Feather sorting 37 37 Carding, etc., of buttons, etc. 38 38 Stuffed toys 39 6 39 Basket making 40 40 Chocolates and sweetmeats Cosaques, Christmas crackers, 41 41 mas stockings, etc. 42 35 42 Textile weaving 43 1 43 Lampshades 44 4 44 TOTAL 70 199 70 39 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASE NOTIFICATIONS The total number of confirmed notifications received during 1953 was 1,396. 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 198 „ „ to small pox contacts 8 Total 206 Rooms disinfected after infectious disease 182 40 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 ... 10 ... ... ... 9 2 ... ... ... ... ... 237 5 ... ... ... ... ... 263 February ... 3 ... ... 1 7 ... ... ... ... ... ... 321 7 ... ... ... ... ... 339 March ... 15 ... ... 2 5 2 ... 2 ... ... ... 223 7 ... ... ... ... ... 256 April ... 8 ... ... ... 1 1 ... 1 ... 1 ... 80 29 ... ... ... ... ... 121 May ... 10 ... ... 1 2 3 ... 4 ... 1 ... 11 39 1 ... ... ... ... 72 June ... 5 ... ... ... ... ... ... 1 ... ... ... 5 40 1 ... ... ... ... 52 July ... 11 ... ... ... ... ... ... ... ... ... ... 4 46 ... ... ... ... ... 61 August ... 4 ... ... 2 ... 1 ... ... ... ... ... 3 90 4 ... ... ... ... 104 September ... 2 ... ... ... ... 1 ... ... ... 2 1 ... 30 2 ... ... ... ... 38 October ... 7 ... ... 3 1 ... ... 6 ... ... ... 1 15 9 ... ... ... ... 42 November ... 6 ... ... 1 ... ... ... 1 ... ... ... 2 16 ... ... ... ... ... 26 December ... 5 ... ... 1 2 1 ... ... ... ... ... 1 12 ... ... ... ... ... 22 Totals ... 86 ... ... 11 27 11 ... 15 ... 4 1 888 336 17 ... ... ... ... 1396 41 Infectious Disease Notifications, 1934-53. Disease 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 1952 1953 Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 392 143 171 192 150 61 48 75 175 212 97 147 95 62 35 57 89 110 111 225 86 Diphtheria 83 80 101 89 64 27 36 72 25 42 10 63 32 4 ... 1 1 ... ... ... ... Typhoid Fever ... 3 5 ... 1 ... ... ... ... 1 ... 1 ... ... ... ... 1 ... ... ... Puerperal Pyrexia 6 4 11 5 4 7 2 2 6 3 5 8 6 9 3 ... 2 ... 13 23 11 Meningococcal Infections 1 1 3 1 2 1 13 12 6 8 3 3 1 2 1 1 1 3 1 ... Erysipelas 30 20 22 16 8 19 17 19 7 22 13 16 25 9 18 6 12 7 8 14 11 Measles ... ... ... ... ... ... 301 194 599 651 112 739 358 533 818 252 354 354 1386 591 888 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Poliomyelitis: Paralytic ... ... ... 1 ... ... ... ... ... ... ... 2 3 11 2 2 6 2 1 4 4 Non-Paralytic ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Ophthalmia Neonatorum 2 4 3 1 3 3 1 3 10 4 4 ... 2 2 6 3 8 2 1 4 ... Acute Encephalitis: Infective ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Post-Infectious ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... Pneumonia 45 35 36 32 43 ... 30 22 20 50 37 33 41 37 30 13 19 28 24 26 27 Malaria ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... 1 ... ... ... ... 1 ... Whooping Cough ... ... ... ... ... 4 16 186 161 162 166 96 234 216 117 149 212 387 420 112 336 Food Poisoning ... ... ... ... ... 4 4 6 11 ... ... 5 1 ... ... ... 6 3 4 10 17 Dysentery ... ... ... ... ... ... ... ... ... 4 67 13 6 1 2 5 7 16 7 16 15 Paratyphoid ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... 1 ... ... Totals 560 293 857 338 275 125 468 591 1021 1161 515 1126 807 888 1033 490 717 911 1980 1027 1396 42 Small Pox No case of small pox was notified during the year 1953. The last case was in 1932. Scarlet Fever The number of cases of scarlet fever notified during the year was 86 as compared with 225 in 1952, equivalent to a case rate of 1.29 per 1,000 population. This disease has continued mild in character; no death due to this cause was recorded. Of the total number of cases notified 34 were treated in hospital and 52 were treated at home. Diphtheria No case of diphtheria was notified for the fourth year in succession and only two in the past six years, whereas before that cases averaged sixty per year. Immunisation and reinforcing doses were available to every school child whose parents gave consent. Diphtheria Immunisation There are three clinics 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. Because of the prevalence of poliomyelitis in the region all school and clinic immunisations were stopped during August, September and October, 1953. The clinic immunisations started slowly but were back to normal by the end of December. School immunisation could not be restarted until January 1954, because of the holidays, which also meant that certain schools missed the annual visit for immunisations so that boosting doses in some cases are overdue. 43 The following figures show the number of children immunised and reinforced during the year (this includes those children who received the combined diphtheria and whooping cough prophylaxis):— Immunised. Reinforced. Total. Under five years 441 38 479 Five to 14 years 115 1,003 1,118 Totals 556 1,041 1,597 The following figures show the number of the child population considered immunised at 31 st December, 1953:— Age at 31.12.53, i.e. born in year Under 1 1953 1 to 4 1952-1949 5 to 9 1948-1944 10 to 14 1943-1939 Under 15 Total Last complete course of injections (whether primary or booster) A. 1949-1953 14 2212 3849 2707 8782 B. 1948 or earlier - - 405 444 849 C. Estimated midyear child population 923 4208 9482 14613 Immunity Index 100A/C 1.52 52.57 73.83 60.10 Whooping Cough Immunisation This is carried out at the same clinics as diphtheria immunisation, but special visits to schools are not made as this inoculation is intended primarily for children under five years old. The following figures show the number of children immunised and reinforced during the year (this includes those children who received the combined diphtheria and whooping cough prophylaxis):— 44 Enteric Fever. NO case was notified during the year. Diarrhæa and Enteritis Under Two Years of Age One death was registered during the year. Age at date of final injection (as regards A) or of re-inforcing injection (as regards B) Under 1 1 2 3 4 5 to 9 10 to 14 Total A Number of children who completed a course of inoculation with pertussis vaccines (including suspended diphtheria pertussis prophylactic and adsorbed diphtheria pertussis prophylactic) during the year ended 31st December, 1953. 13 299 69 30 26 41 1 479 B Number of children who received a secondary (reinforcing) injection (i.e. subsequently to primary immunisation at an earlier age) during the year ended 31st December, 1953. - - - - - 9 2 11 45 Food Poisoning Outbreaks There were seventeen cases of food poisoning in 1953 comprising two family outbreaks which affected three members of one family and five in the other, together with nine single cases. The outbreak affecting three members in the same family was caused by the classical type of food poisoning, Salmonella Typhimurium, the first case arising in the son while returning from a holiday in France and subsequently being transmitted to his parents. The disease affected father and son very severely. The other family outbreak was milder and was possibly due to Staphylococcus Aureus which was found in two cases. In the single cases the cause could not be discovered, as there is usually insufficient evidence. Encephalitis Lethargica No case was notified during the year. Erysipelas Eleven cases were notified. Three cases were removed to hospital. Puerperal Pyrexia Eleven cases were notified during the year. Pneumonia Twenty-seven 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 25, of which 16 were males and 9 females. Meningococcal Infections. No case occurred during 1953. Influenza During the year eight deaths, of which two were males and six females, were recorded. The previous year one death was registered. 46 Prevention of Blindness This comes under the control of the Surrey County Council. Ophthalmia Neonatorum During the year no case of ophthalmia neonatorum was notified. Poliomyelitis There were five cases affecting one adult, one youth, and three young children. The adult case was non-paralytic, while the others had some degree of paralysis, two very slight, one moderate, and one very severe, which probably affected the respiratory muscles, causing death. 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 information of the prevalence of non-notifiable infectious disease, such as chicken pox, mumps, etc. The numbers were as follows:— Chicken pox 185 Mumps 11 Ringworm 1 Rubella 15 Scabies 2 Shingles 1 Impetigo 2 Jaundice 1 Influenza 285 Skin Disease 1 Cancer The number of deaths from cancer registered during the year was 129, of which 73 were males and 56 were females. 47 The incidence of deaths from cancer has been steadily growing and the rate of 1.94 per 1,000 population is the highest recorded. The rate for Mitcham is usually below that for England and Wales, the figure for the past year not being available yet. The site distribution for 1953 was as follows:— Digestive organs' 26 cases Respiratory organs 17 „ Breast 17 „ Genito-urinary organs 3 „ Other sites 66 „ Total 129 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 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 1.90 1.698 1943 95 1.7 1.74 1944 83 1.6 1.7 1945 103 1.91 1.74 1946 108 1.74 1.76 1947 103 1.60 1.86 1948 111 1.67 1.86 1949 124 1.85 1.87 1950 102 1.61 1.89 48 Year Number of Deaths Death Rate per 1,000 of population Mitcham England and Wales 1951 108 1.61 1.90 1952 128 1.91 1.94 1953 129 1.94 — Tuberculosis During the year 85 new cases of tuberculosis were notified, viz:— Males Females Total Pulmonary 52 27 79 Non - Pulmonary 1 5 6 Totals 53 32 85 Thirty-five cases were transferred into the Borough as follows:— Males Females Total Pulmonary 16 18 34 Non-Pulmonary — 1 1 Totals 16 19 35 The total number of deaths from tuberculosis was:— Males Females Total Pulmonary 9 1 10 Non-Pulmonary — — — Totals 9 1 10 England and Wales Mitcham Death rate from tuberculosis, all forms, per 1,000 population 0.24 0.15 49 The following table shows the number of new cases, the type 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 ... ... ... ... ... ... ... ... 5 years to 9 „ 1 2 ... 1 ... ... ... ... 10 „ „ 14 „ 8 ... ... ... ... ... 15 „ „ 19 3 1 ... ... ... ... ... ... 20 „ „ 34 „ 15 11 ... 3 2 ... ... ... 35 „ „ 44 „ 7 4 ... ... ... ... ... ... 45 „ „ 64 ,, 17 ... 1 ... 5 1 ... ... 65 „ and upwards 8 1 ... 1 2 ... ... ... Totals 52 27 1 5 9 1 ... ... 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 1 3 Pulmonary: females ... ... ... ... ... ... ... ... ... ... ... ... Non-Pulmonary: males ... ... ... ... ... ... ... ... ... ... ... ... Non-Pulmonary: females ... ... ... ... ... ... ... ... ... ... ... 50 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 ... (b) Transferable deaths from Registrar General 2 ... Posthumous notifications from doctors ... ... The percentage of non-notified tuberculosis deaths (i.e., new cases coming to the knowledge of the Medical Officer of Health after death of the case) is 30.00. Non-notified tuberculosis deaths 3 Total tuberculosis deaths 10 Miniature Mass Radiography A mass radiography unit comes to Mitcham every year and is granted free use of the Vestry Hall (Town Hall). In 1953 the unit carried out its work from 22nd June to 20th July, and the following summary was supplied by the Medical Director of the Unit, Dr. F. J. H. Walters:— Male. Female. Total number examined 3.040 3.666 Pulmonary tuberculosis active 9 3 Pulmonary tuberculosis inactive 130 97 Non-tuberculosis abnormalities 97 69 Cases outstanding 24 18 The above figures do not apply to Mitcham residents only, as anyone may make use of the service whether resident or nonresident. The examination is of value in the early diagnosis and treatment of pulmonary tuberculosis and other non-tuberculous abnormalities. 51 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. 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 task of raising the larger portion of the funds necessary, the bulk coming from the sale of Christmas seals and donations from voluntary associations. 52 INDEX page Abortion, Deaths 8. 13, 14 Ambulances 15 Ante-Natal Clinics 17 Area 7 Bacteriological Examination of Cups and Glasses 31, 82 Bakehouses 32 Bed Bugs, Eradication of 21 Bedding, Disinfection of 15 Birth Rates 8, 10, 14 Births, Illegitimate 8 — In Institutions 9 — Live 8 — Still 8 Blindness, Prevention of 46 Books disinfected, Library 16 Cancer 46, 47, 48 — Deaths from 8, 46 Caravans 20 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 Cups and Glasses, Examination of 31, 32 Dairies 33 Day Nursery 18 Death Rates 8, 10, 14 Deaths 8,10-14,46-50 Dental Clinics 17 Diarrhoea and Enteritis 44 — Deaths from 8, 14 53 PAGE Diphtheria 42 Diphtheria Immunisation 42, 43 — — Clinics 18 Disinfection 15, 39 Encephalitis Lethargica 45 Enteric Fever 44 Eradication of Bed Bugs 21 Erysipelas 45 Factories Act, 1937 35-38 — — Defects found 36 Inspections 35 — — (Sections 110 and 111) Outwork 37, 38 Food and Drugs Act, 1938 29, 30 — — — — Section 13 34 — Section 14 28 — Dealt with, Unsound 25 Inspection and Supervision of 28-34 — Preparing Factories 33 — Campaign, Clean 28 — Poisoning 45 Case Rates 14 General Provision of Health Services for the Area 15-19 Health Visiting 18, 19 Home Help Service 19 Hospitals 15,16 Houses, Disinfection of 15 Inhabited 7, 25 Inspection of Dwelling 26, 27 Housing Act, 1936 (Sections 9, 10 and 16) 27 — — (Section 11) 27 — — (Section 12) 27 Statistics 25-27 Ice Cream 30, 31 — — Samples 30, 31 Immunisation and Vaccination Clinics 18 Diphtheria 42, 43 Infant Mortality 8, 10, 11 54 PAGE Infectious Disease Case Rates 14 — — Contacts 39 — — Hospitals 16 Infectious Disease, Monthly Incidence of 40 — — Notifications 39, 41 — — — School 46 — Sanitary Inspectors' Visits 39 Influenza 45 Inquests 11, 12 Inspection and Supervision of Food 28-34 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 8, 18 Meat Inspection 33 Meningococcal Infection 45 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 and 1950 32 Milk (Special Designation) (Raw Milk) Regulations, 1949 and 1950 32 Mortality, Analysis of 14 National Assistance Act, 1948, Section 47 19 N.S.P.C.C 19 Notifications, Infectious Disease 14, 39, 40, 41 School 46 Nursery, Day 18 Ophthalmia Neonatorum 46 Outworkers (Sections 110 and 111—Factories Act, 1937) 37. 38 Persons in Need of Care and Attention 19 Pests Act, 1949, Prevention of Destruction by 21, 22 Pet Animals Act, 1951 34 Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929 24 55 PAGE Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Carbide of Calcium) Order, 1929 24, 25 Piggeries 34 Pneumonia 45 Poisoning, Food 45 Poliomyelitis 46 Population 7 Post-Natal Clinic 17 Public Cleansing 20 Puerperal Pyrexia 45 Public Analyst 15 Radiography, Miniature Mass 50 Rateable Value 7 Rent and Mortgage Interest (Restrictions) Act, 1920/1938 27 Rivers and Streams 20 Rodent Operations 21, 22 Rooms Disinfected, Number of 15, 39 Samples, Food 29-32 Sanitary Circumstances of the Area 20, 21 — Inspectors, Chief's Report 22-25 Scarlet Fever 42 Schools 21 Notifications 46 Slaughterhouses 33 Slaughter of Animals Act, 1933 33 Small Pox 42 — Vaccination Clinics 18 Hospital 16 Social Conditions 7, 8 Staff 6 Statistics 7-14 — Housing 25-27 — Vital 7 Still Births 8 Supervision of Food, Inspection and 28-34 Swabs, Tea Cups 31, 32 56 page Tuberculosis 48-50 — Care Committee 51 — Clinic 16 Unsound Food dealt with 25 Venereal Diseases Clinics 16 Visits by Sanitary Inspectors 22-24, 39 Vital Statistics 7 Water Supply 20 Welfare Clinics 17 Whooping Cough, Deaths from 8 — — Cases 40 — — Immunisation 43, 44