BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1955 BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1955 MITCHAM H. G. Mather, Ltd., Caxton Works, Lower Green 3 Borough of Mitcham HEALTH REPORT FOR 1955 To the Mayor, Aldermen and Councillors. Mr. Mayor, Ladies and Gentlemen, I have much pleasure in submitting my annual report for the year 1955. The general health in the Borough has been good, and there was no special outbreak of infectious disease. The notifications of infectious diseases rose from the remarkably low figure of 450 for 1954 to 1,335, mainly due to measles. There were no cases of diphtheria, making seven years free of cases. The year 1955 was a bad year for poliomyelitis, being the third highest the country has had, but we were fortunate in having only seven cases in Mitcham. Five of the cases occurred in young adults and only two in children. Of the five adult cases it is of note that three occurred in women during pregnancy. Their babies have since been born and are very healthy, in spite of one being born six weeks prematurely. The death rate from tuberculosis keeps dropping so that 0.12 per 1,000 population is once again the lowest ever for Mitcham, and is less than that for England and Wales, which is 0.15. New notifications of tuberculosis also decreased again, dropping from 64 to 57. There were sixteen cases of food poisoning, the same as last year, and again mostly in single cases. Cases of dysentery were 17 as against 46 last year, and occurred irregularly throughout the year. They were mostly confined to separate families and were usually very mild. 4 The birth rate of 13.05, after correction by the comparability factor to correspond with the average age and sex grouping of the whole population, becomes 12.40, which compares with 15.0 for England and Wales. The actual death rate of 9.48, which after applying the comparability factor becomes 10.81, compares with 11.7 for the whole country. The infant mortality rate rose slightly to 15.20 compared with 24.9 for England and Wales, which is again the lowest recorded for the whole country. The death rate from cancer has risen to 2.02 and that of England and Wales has again risen to the highest ever, being 2.06 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 Her Worship the Mayor (Councillor Mrs. W. R. Martin, J.P.) Aldermen— Mrs. L. Crump G. W. Pearce Councillors— Mrs. B. G. E. Smart H. J. H. Beaumont D. W. Dines T. Fitzgibbons R. Stanley W. G. West Representatives of the Council on Other Authorities: WANDLE VALLEY JOINT SEWERAGE BOARD Her Worship the Mayor (ex-officio) Aldermen— D. W. Chalkley W. Jeffery Councillor E. E. Mount NORTH-EAST DIVISIONAL HEALTH SUB-COMMITTEE (SURREY COUNTY COUNCIL) Councillor Mrs. W. R. Martin, J.P. Alderman G. W. Pearce Councillors— D. W. Dines R. Stanley W. E. M. Townsend 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) (d) 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 (b) Miss C. F. M. Hollingsworth (c) Miss J. V. Burton (a) Part-time—40 per cent. Surrey County Council. (b) Part-time—40 per cent. Surrey County Council. Resigned 30th September, 1955. (c) Part-time—40 per cent. Surrey County Council. Commenced duties 17th October, 1955. Resigned 3rd December, 1955. (d) Resigned 6th November, 1955. 7 REPORT STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 2,932 acres Population, Census 1921 35,119 „ 1931 56,856 „ 1951 (32,384 M.; 34,885 F.) 67,269 Registrar-General's estimate of population mid-year, 1955 65,460 Density of Population, 1951 22.9 persons per acre Number of inhabited houses, 1921 7,150 „ 1931 13,187 „ 1955 19,289 Rateable Value, 1955 £591,739 Sum represented by a 1d. rate £2,411 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 the chief ones are paint and varnish, chemical, engineering, margarine and dairy products. The unemployment position was almost non-existent. Employers had especial difficulty in getting unskilled workers, so that there were seldom able-bodied men available. Those who were available were elderly. 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 Females Rate per 1,000 of population Legitimate 829 436 393 Illegitimate 26 14 12 Total 855 450 405 13.05 After correction by the comparability factor becomes 12.40 Still Births. Total Male Female Rate per 1,000 total births Legitimate 13 11 2 Illegitimate 1 1 — Total 14 12 2 16.11 Deaths. Total Male Female Rate per 1,000 of population 621 310 311 9.48 After correction by the comparability factor becomes 10.81 Deaths from pregnancy, childbirth and abortion: — Rate per 1,000 total births Number of cases 1 1.15 Deaths of infants under one year of age: — All infants per 1,000 live births 15.20 Legitimate infants per 1,000 live legitimate births 15.68 Illegitimate infants per 1,000 live illegitimate births Deaths from: — Cancer (all ages) 132 Measles Whooping cough (all ages) Enteritis and Diarrhoea under two years of age 9 Percentage of Births Occurring in Institutions Year Total births Births in hospitals, etc. Percentage of births occurring in institutions 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 1954 927 673 72.71 1955 869 628 72.28 10 The birth rates, death rates per 1,000 of population, and the infantile mortality rates for the years 1936-55 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 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 a comparability factor to correspond with the average age and sex distribution 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 1954 12.97 15.2 10.03 11.3 13.32 25.5 1955 12.40 15.0 10.81 11.7 15.20 24.9 11 Infant Mortality During the year 13 deaths were registered of infants under one year of age: — Males Females Total Legitimate 9 4 13 Illegitimate — — — Totals 9 4 13 as compared with 12 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 6 4 1 — — 1 1-7 days 2 — 1 1 — — 8 days - 1 mth. — — - — — — 1 mth. -12 mths. 5 - 2 — 3 — Total 13 4 4 1 3 1 Eight infants failed to survive the first month of life, and prematurity was certified as the cause of death of four of these cases. This gives Mitcham a neo-natal mortality rate of 9.36 per 1,000 related live births as compared with 17.3 for England and Wales. Maternal Mortality During the year one death was registered as compared with none in 1954. Inquests Inquests were held on 20 residents dying within the district and on six Mitcham residents who died outside the district, a total of 26. 12 In addition, post-mortems without inquests were held on 75 residents dying within the district, and on 75 Mitcham residents who died outside the district, a total of 150. The following table shows the results of the findings of these inquests: — Accidental death 6 Death from misadventure 7 Suicide 9 Natural causes 3 Open verdict 1 Total 26 13 Deaths Registered during the Year 1955 Cause of Death Males Females Total 1 Tuberculosis, respiratory 6 2 8 2 Tuberculosis, other ... ... ... 3 Syphilitic disease 2 1 3 4 Diphtheria ... ... ... 5 Whooping cough ... ... ... 6 Meningococcal infections ... ... ... 7 Acute Poliomyelitis 1 ... 1 8 Measles ... ... ... 9 Other infective and parasitic diseases ... 1 1 10 Malignant neoplasm, stomach 7 8 15 11 Malignant neoplasm, lung, bronchus 35 5 40 12 Malignant neoplasm, breast ... 11 11 13 Malignant neoplasm, uterus ... ... 5 5 14 Other malignant and lymphatic neoplasms 33 28 61 15 Leukaemia, aleukæmia 2 ... 2 16 Diabetes ... 3 3 17 Vascular lesions of nervous system 39 56 95 18 Coronary disease, angina 59 38 97 19 Hypertension with heart disease 1 7 8 20 Other heart disease 28 43 71 21 Other circulatory disease 16 23 39 22 Influenza ... 1 1 23 Pneumonia 17 21 38 24 Bronchitis 20 9 29 25 Other diseases of respiratory system 5 1 6 26 Ulcer of stomach and duodenum 4 6 10 27 Gastritis, enteritis and diarrhoea 2 2 4 28 Nephritis and nephrosis 2 3 5 29 Hyperplasia of prostate 6 ... 6 30 Pregnancy, childbirth, abortion ... 1 1 31 Congenital malformations 4 5 9 32 Other defined and ill-defined diseases 16 20 36 33 Motor vehicle accidents 2 2 4 34 All other accidents ... 3 3 35 Suicide 3 6 9 36 Homicide and operations of war ... ... ... All causes 310 311 621 14 Birth-Rates, Death-Rates, Analysis of Mortality and Maternal Mortality in the Year 1955 England and Wales Mitcham Rates per 1,000 home population Births— Live 15.0 12.40 Still 0.35 0.21 23.1 * 16.11* Deaths— All causes 11.7 10.81 Malignant neoplasm—lung, bronchus 0.39 0.61 Whooping cough 0.000 ... Diphtheria 0.000 ... Tuberculosis—all forms 0.15 0.12 Influenza 0.07 0.01 Acute Poliomyelitis 0.01 0.01 Pneumonia 0.49 0.58 Coronary disease—angina pectoris 1.59 1.48 Maternal mortality 0.64* 1.15* Notifications (Corrected)— Scarlet Fever 0.73 0.50 Whooping Cough 1.78 2.55 Diphtheria 0.004 ... Measles 15.61 16.17 Acute Poliomyelitis— Paralytic 0.08 0.06 Non-Paralytic 0.06 0.05 Enteric or Typhoid Fever 0.004 ... Para-typhoid Fever ... 0.019 ... Meningococcal Infection 0.03 ... Erysipelas 0.10 0.14 Dysentery 0.83 0.26 Acute Encephalitis— Infective 0.003 ... Post-Infectious 0.003 ... Acute Pneumonia 0.63 0.52 Food Poisoning 0.29 0.12 Tuberculosis— Respiratory 0.77 0.78 Non-Respiratory 0.11 0.09 * Per 1,000 total (live and still) 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.1. AMBULANCES The Ambulance service is supervised by the Surrey County Council. The ambulances work from the Ambulance Control Station, Hill House, Bishopsford Road, Morden (Telephone: Mitcham 2084). 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 6 Number of rooms disinfected by fumigator 102 Number of library books disinfected 582 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. 16 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 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 rhe 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, or occasionally to other hospitals such as the Nelson Hospital, Kingston Road, Merton, S.W.20. 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 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. CLINICS AND TREATMENT CENTRES (Under control of the Surrey County Council) 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. 17 An ante-natal session is held at the Cavendish Road Clinic every second and fourth Monday morning during the month. An ante-natal session is held at Sherwood House Clinic on Wednesday afternoons for cases booked by midwives. X-Ray examinations necessary for expectant mothers are carried out at the Wilson Hospital. Child 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. Dental Clinics Dental services are provided for expectant and nursing mothers, toddlers and school children at the Church Road, Western Road and Meopham Road Clinics. Western Road, Mitcham.—Every day a.m. and p.m. Church Road, Mitcham.—Monday a.m. and p.m. Tuesday a.m. Wednesday a.m. and p.m. Thursday a.m. and p.m. Friday a.m. Meopham Road.—Every day a.m. and p.m. 18 Diphtheria and Whooping Cough Immunisation Vaccination against Smallpox (Under the direction of the Medical Officer of Health.) Clinics are held as follows: — Cavendish Road Clinic.—Each Monday afternoon in conjunction with Welfare Clinic. Church Road Clinic.—On 1st, 3rd and 5th Wednesdays of the month in the morning. Meopham Road Clinic.—Each Wednesday afternoon in conjunction with Welfare Clinic. St. Barnabas Clinic.—On 1st, 3rd and 5th Tuesdays of the month in the afternoon. Sherwood House Clinic.—Each Monday afternoon (immunisation only in conjunction with Welfare Clinic) and each Thursday morning (immunisation and vaccination in conjunction with Welfare Clinic). 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. Mothercraft Classes Cavendish Road Clinic.—Tuesday, 2 p.m. Church Road Clinic.—Tuesday, 2 p.m. Ophthalmic Clinic An eye specialist attends Western Road Clinic on Tuesday mornings and Wednesday afternoons. Parentcraft Circle Church Road Clinic.—Monday, 3 p.m. Post-Natal Clinic A post-natal clinic is held at Church Road Clinic on the first Monday in the month. 19 Speech Clinic A session is held at Western Road Clinic on Tuesday (all day), Wednesday (morning only), and Thursday (all day), when two speech therapists are in attendance. U.V. Radiation Clinics Sessions are held as follows: — Church Road Clinic.—Thursday mornings. Sherwood House Clinic.—Tuesday afternoons, Friday afternoons. Day Nursery The Surrey County Council provide one day nursery in Mitcham, at Eagle House, London Road, Mitcham, with 49 places. Health Visiting Health visitors are under the control of the Surrey County Council. 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 1955 ... 24 Number of children affected 53 Number of visits paid 188 20 National Assistance Act, 1948: Section 47 National Assistance (Amendment) Act, 1951 Removal to Suitable Premises of Persons in Need of Care and Attention There were seven cases that appeared to fall into this category, but five agreed to enter voluntarily a hospital for the chronic sick. One case died while arrangements were being made and only in one case had court action to be taken. In this last case, as there was no one to give him care and attention, the patient had to go to a hospital for the chronic sick. 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 five 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. 21 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. ERADICATION OF BED BUGS Number of Council houses found infested during the year, 20. Number of other houses found infested during the year, 22. Number of requisitioned, etc., houses found infested during the year, 10. Total number of houses disinfested during the year, 52. Methods employed: — 52 houses treated with insecticide spray. Number of houses disinfested of beetles, 54. Number of houses disinfested of other insects, 48. 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. 22 PREVENTION OF DESTRUCTION BY PESTS ACT, 1949 Two full-time and one part-time Rodent Operators were employed. Properties inspected 5,886 Complaints received 575 Number of treatments re rat infestation including test baits as result of inspection and complaints 965 Factory and business premises treated 105 Visits by Sanitary Inspectors 130 Two sewer maintenance treatments were carried out; 220 manholes were baited. Thirty-four intercepting chambers were also baited during the two maintenance treatments. 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 670 Nuisances found 478 Verbal Notices given 55 Verbal Notices complied with 35 Informal Notices served 409 Informal Notices complied with 230 Statutory Notices served 198 Statutory Notices complied with 180 Revisits 2,142 Houses inspected for defects 1,004 Visits made for this purpose 1,118 Drains tested and inspected 201 Private houses found verminous 10 Visits to butchers 98 Visits to slaughterhouses 800 Visits to dairies 9 Visits to retail milk shops 16 23 Visits to restaurant kitchens 250 Visits to ice-cream premises 50 Visits to bakehouses 31 Visits to other food premises 404 Number of notices served under Food and Drugs Act, 1938 7 Number of notices complied with 7 Visits to factories 145 Visits to workplaces 36 Visits to outworkers 32 Visits to stables 61 Visits to piggeries 61 Visits to marine stores 2 Visits to caravan yards 52 Smoke observations 31 Visits re infectious disease cases 165 Visits re smallpox contacts 7 Visits re food poisoning 29 Visits re rats and mice 130 Visits re Shops Acts 35 Visits re schools 22 Visits to Refuse Tipping Site, Mitcham Common 83 Sundry visits 138 Character of Work Done Roofs repaired 168 Rainwater piping or gutters repaired or renewed 108 Yards paved or repaired 7 Dampness remedied 188 Water service pipes repaired 15 Waterclosets: Repairs to structure 13 Flushing apparatus repaired or renewed 35 New pans and traps fitted 36 Water storage cisterns cleansed, repaired or renewed 11 Water supply reinstated 5 Flooring of rooms repaired and sub-floor ventilation improved 66 Rooms cleansed and redecorated 45 Sinks and handbasins repaired or renewed 7 Waste pipes and traps repaired or renewed 25 24 Window frames and sashes repaired or renewed 44 Window sills repaired or renewed 29 External brickwork (repaired, pointed or rendered) 40 Drains repaired or obstructions removed 129 Drains inspection covers renewed 8 Drains tested 78 Grid and mica flaps provided 2 Firegrates repaired (including surrounds and hearths) 21 Stoves, coppers, ranges, etc., repaired 2 Chimney stacks repaired 8 Staircases repaired 19 Doors repaired 15 Internal plaster repairs 187 Sash cords renewed 82 Dustbins provided 34 Accumulations removed 9 All ponds and ditches in the Borough where mosquito breeding was likely were sprayed with insecticide twice during the year. LEGAL PROCEEDINGS Caravans, Bath Road.—A summons was issued against an owner of a caravan in respect of non-compliance with an Order of the Court, made on 11th December, 1952, prohibiting her using her caravan for human habitation in the Borough, other than on a licensed site. At the hearing on 5th January, 1955, the Court imposed a fine of £2 with £1 Is. costs. Section 94, Public Health Act, 1936.—Summonses wert issued against a company of property owners in respect of non-compliance with notices served for the abatement of statutory nuisances at two of their properties, but, as the necessary works had been completed prior to the date of the hearing, the summonses were withdrawn. Petroleum (Regidations) 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 211,386 gallons (inclusive of cellulose solutions). 25 Petroleum (Regulation) Acts, 1928, and 1936, and Petroleum (Carbide of Calcium) Order, 1929.—Two licences were issued for the storage of 1,224 lbs. of carbide of calcium. Unsound Food Dealt With Beef 404½ lbs. Ham 12 lbs. Pork 161 >5 Dripping 166 55 Corned beef 94 55 Lard 40 55 Rabbit 98 55 Beef steak pudding 1 55 Ewe mutton 46 55 Fish 182 55 Lamb 49 33 Raisins 20 55 Lambs' hearts 18 55 Tomato puree 30 55 Lambs' livers 20 55 Brazil nuts 33 55 Ox livers 61 55 Butterfat 1,406 55 Fat 53 55 Skimmed milk 56 55 Jellied veal 12 53 Russian salad 15½ 55 Whalemeat 14 35 Cheese 7 55 Stewed steak 3 55 Tomato ketchup 1 gal. Kidneys 37 55 Eggs 96 No. Luncheon meat 72 55 Assorted 336 tins Yours faithfully, K. J. GUTTERIDGE, Chief Sanitary Inspector. HOUSING STATISTICS Total Number of Inhabited Houses—19,289. Permanent buildings built by the Council before the war—1,461. Permanent buildings built by the Council after the war—2,186. Other Housing Accommodation Available: — A. Requisitioned and sundry properties 296 B. Temporary building, Arcon bungalows 345 C. Hutments, 320 originally, now reduced to 108 D. Gunsite hutments, 61 originally, now reduced to 6 E. Therefore, total number of properties used for housing by the Mitcham Borough Council is 4,402 26 Number of People Rehoused. About 9,400 applicants have registered since 1945, and the current list is still about 1,400, so that some 8,000 applicants have been dealt with. 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, where possible. 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. One hundred and eighty-four houses are now occupied. The Mitcham Borough Council is increasing the number of aged persons' dwellings being built; there are now 98. 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. 27 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 15 Groceries 82 Butchers 36 Continental Butchers (Horseflesh) 1 Greengrocer & Fruiterers 61 Greengrocer & General Provisions 2 Confectionery 72 Confectioner & Greengrocers 1 Chemists 18 Restaurants 6 Cafes 28 Roadside Snack Bars 3 Fishmongers 10 Fried Fish Buffets 5 Fried Fish 9 Bakers and Confectioners 17 Milk & Provisions 13 Public Houses 28 Off-Licences 12 Food premises by type, registered under Section 14, Food and Drugs Act, 1938. The storage and sale of ice-cream 141 The manufacture for sale of ice-cream 4 The preparation or manufacture of sausages, or potted, pressed, pickled or preserved food 40 Dairies registered under the Milk and Dairies Regulations, 1949 1 Number of inspections of registered food premises during the year 160 All condemned food is incinerated at the Refuse Destructor, Garth Road, Morden, by arrangement with the Merton and Morden Urban District Council. 28 FOOD AND DRUGS ACT, 1938 Formal Samples. Twenty-nine formal samples were taken as follows: — Milk 17 Pork Sausage 2 Sweet White Wine 1 Curry Powder 1 White Pepper 1 Butter 1 Margarine 2 Beef Suet 1 Brawn 1 Baking Powder 1 Black Jack Lollies 1 Informal Samples Eighty informal samples were taken as follows: — Vegetable Soupmix 1 Jelly Creams 1 Chocolate Sponge Mixture 1 Lemon Cream Wafers 1 Enriched Sliced Loaf 1 Sponge Pudding 1 Blackcurrant Juice, Vitamin C Health Drink 1 Droxalin Acid Absorbent Tablets 1 Chocolate Cake Mix 1 Pork Pie 1 Olive Oil 1 Table Mustard 1 Chandy 1 Chocolate Covered Roll 1 Bicarbonate of Soda 1 Ice-Cream 13 Pure Cream 1 Fish Paste 1 English Lard 1 Pure Malt Vinegar 1 Coffee and Chicory 1 Blancmange Powder 1 Butter Toffee 1 Sweetened Sponge Mixture 1 Instant Pudding 2 Gravy Powder 1 Ground Rice 1 Sausage Food 1 Margarine 4 Margarine (10 per cent. Butter) 2 American Lard 1 Beef Suet 1 Vegetable Ghee 1 Cheese Spread 2 Cheese Spread with Mustard 1 Cheese and Celery Spread 1 Cheese and Tomato Spread 1 Cheese Spread with the Gorgonzola Flavour 1 Gruyere Cheese 1 Savoury Cheese 1 Marshmallow Creme 1 Marshmallow Cubes 1 Cheese Straws 1 Lollipops 1 29 Plain Flour 1 Lemon Squash 1 Xmas Pudding 1 Honey 1 Gravy Salt 1 Lik-Bits 1 Lollies 1 Frig-Ice 1 Glucose Tablets 1 Sweet Cigarettes 1 Cooking Fat 1 Mixed Fruit 1 Soya Flour 1 Lemon Juice 1 Pineapple Chunks 1 Bubbly Chewing Gum 1 Foam Crystals 1 Table Jelly Crystals 1 All samples were satisfactory with the exception of three informal samples (chocolate cake mix 1, Tizer 1, and savoury cheese 1). A warning letter was sent to the firms concerned with the unsatisfactory samples. On complaints being received the following cases were reported to the Public Health Committee:— One of contamination of a mineral water bottle. One of insect infestation of a bar of chocolate. One of a foreign body in a Lolly. One of foreign matter in a loaf of bread. Warning letters were sent to the firms concerned in these cases. Ice-Cream Four premises in the Borough are registered for the manufacture of ice-cream and 141 for the storage of ice-cream. Fifty visits were paid during the year. Twenty-four samples of ice-cream were taken and examined for bacteriological purity. Thirteen samples were also tested for fat content. The results are tabulated below: — Provisional Grade 1 II Ill IV Coliforms absent 13 6 5 — Coliforms present in l/10th ml — — — — Fascal coli present (in addition to above) — — - — 30 Fat Content 4 5 6 7 8 per cent. per cent. per cent. per cent. per cent. — 1—11 9 10 11 12 13 per cent. per cent. per cent. per cent. per cent. 3 4 111 Bacteriological Examination of Cups and Glasses Ninety-six swabs were taken from tea cups at various catering establishments and ten 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. Colony Cournt (per cup) Coliforms Faecal Coli Result Satisfactory. Unsatisfactory Present. Absent. Present Absent. Under 100 5 58 1 4 62 1 100-200 5 6 — 5 — 11 200-500 2 7 — 2 — 9 500-1,000 - - - - - - 1,000-1,500 - - - - - - 1,500-2,000 1 — — 1 — 1 2,000 and over 9 3 — 8 — 12 Total 22 74 1 20 62 34 Beer Glass Swabs (per glass). Under 100 — 6 — — 6 — 100-200 - - - - - - 200-500 — 1 - — - 1 1,000-1,500 1 — — 1 - 1 1,500-2,000 - - - - - - 2,000 and over 2 — — 2 — 2 Total 3 7 — 3 6 4 The result of the swabs was sent to the establishments concerned. 31 MILK (SPECIAL DESIGNATION) (PASTEURISED AND STERILISED MILK) REGULATIONS, 1949 to 1953 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 26 Sterilised 46 Supplementary Licences— Pasteurised 16 Sterilised 17 MILK (SPECIAL DESIGNATION) (RAW MILK) REGULATIONS, 1949 to 1954 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) 16 One hundred and fifty samples of Graded Milk were submitted for bacteriological examination. One hundred and forty-nine samples were satisfactory and one was unsatisfactory. A communication was sent to the dairy concerned regarding the unsatisfactory sample. BAKEHOUSES The number of bakehouses in the district is seven. Thirty-one visits have been paid. DAIRIES There is one registered dairy and pasteurising establishment within the district. During the year nine visits of inspection were paid. 32 SLAUGHTERHOUSES There are two registered slaughterhouses in the Borough; 800 visits have been paid. SLAUGHTER OF ANIMALS ACT, 1933 TO 1954 Thirteen licences were issued to slaughtermen in accordance with the requirements of the above Act. MEAT INSPECTION Carcases and Offal Inspected and Condemned in Whole or in Part. Cattle, excluding cows Cows Calves Sheep and Lambs Pigs Number killed (if known) 74 6 99 6 11,642 Number inspected 74 6 99 6 11,642 All diseases except tuberculosis and cysticerci: Whole carcases condemned ... ... ... ... 26 Carcases of which some part or organ was condemned ... ... ... ... 660 Percentage of the number inspected affected with disease other than tuberculosis and cysticerci ... ... ... ... 5.89 Tuberculosis only: Whole carcases condemned ... ... ... ... 6 Carcases of which some part or organ was condemned 7 ... ... ... 148 Percentage of the number inspected affected with tuberculosis 9.46 ... ... ... 1.32 FOOD PREPARING FACTORIES There are 17 factories which are engaged in the manufacture and preparation of food products. All of these are systematically visited. INFORMAL ACTION TAKEN UNDER SECTION 13, FOOD AND DRUGS ACT, 1938 Number of notices served, 7. Number of notices complied with, 7. 33 PIGGERIES There are 29 piggeries in the Borough. Sixty-one visits were paid during the year. PET ANIMALS ACT, 1951 Five licences were issued to occupiers of pet shops. 34 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 in which Sections 1, 2, 3, 4, and 6 are to be enforced by Local Authorities 1 37 1 ... ... 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 2 258 134 3 ... 2 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 3 22 9 ... ... 3 TOTAL ... 317 144 3 ... ... 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 line 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 3 3 ... ... ... 4 Overcrowding (S.2) 5 1... ... ... ... ... 5 Unreasonable temperature (S.3) 6 ... ... ... ... ... 6 Inadequate ventilation (S.4) 7 1 1 ... ... ... 7 Ineffective drainage of floors (S.6) 8 ... ... ... ... ... 8 Sanitary Conveniences (S.7) (a) Insufficient 9 1 1 ... 1 ... 9 (b) Unsuitable or defective 10 1 1 ... ... ... 10 (c) Not separate for sexes 11 ... ... ... ... ... 11 Other offences (not including offences relating to Homework) 12 3 2 ... 2 ... 12 TOTAL 60 9 8 ... 3 ... 60 36 3.—Outwork (Sections 110 and 111): — Nature of Work M/c line No. Section 110 Section 111 M/c line No. Number of out-workers in August list required by Sect. 110 (1) (c) Number of cases of default in sending lists to the Council Number of prosecutions for failure to supply lists Number of instances of work in unwholesome premises Notices served Prosecutions (1) (2) (3) (4) (5) (6) (7) (8) (9) Wearing Making, etc 13 158 13 apparel Cleaning and washing 14 1 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 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 29 34 Brush making 35 35 Pea picking 36 36 Feather sorting 37 37 Carding, etc., of buttons, etc. 38 38 Stuffed toys 39 7 39 Basket making 40 40 Chocolates and sweetmeats 41 41 Cosaques, Christmas crackers, Christmas stockings, etc. 42 44 42 Textile weaving 43 1 43 Lampshades 44 8 44 TOTAL 70 248 70 38 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASE NOTIFICATIONS The total number of confirmed notifications received during 1955 was 1,335. 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 to common infectious diseases 165 Sanitary Inspectors to smallpox contacts 7 Total 172 Rooms disinfected after infectious disease 102 39 The monthly incidence of infectious disease was:— Smallpox Scarlet Fever Diphtheria Typhoid Fever Erysipelas Pneumonia Puerperal Pyrexia Ophthalmia Neonatorum Dysentery Meningo cocca Infections Poliomyelitis Paralytic Poliomyelitis Non-Paralytic Measles Whooping Cough Food Poisoning Paratyphoid Malaria Acute Encephalitis Infective Acute Encephalitis Post-Infectious Totals January ... 2 ... ... ... 3 ... ... 1 ... ... ... 21 9 ... ... ... ... ... 36 February ... 1 ... ... 1 1 ... ... 5 ... ... ... 55 9 ... ... ... ... ... 72 March ... 1 ... ... ... 8 ... ... 4 ... ... ... 470 18 ... ... ... ... ... 501 April ... 2 ... ... 1 7 ... ... ... ... ... ... 335 24 1 ... ... ... ... 370 May ... 2 ... ... 2 3 ... ... ... ... ... ... 118 11 ... ... ... ... ... 136 June ... 5 ... ... 2 1 ... ... 3 ... ... ... 32 17 3 ... ... ... ... 63 July ... 4 ... ... 2 ... 1 ... 4 ... ... ... 24 27 1 ... ... ... ... 63 August ... 2 ... ... ... 2 ... ... ... ... ... 1 2 15 ... ... ... ... ... 22 September ... 1 ... ... ... ... ... ... ... ... 3 2 2 4 1 ... ... ... ... 13 October ... 3 ... ... ... 1 ... ... ... ... 1 ... ... 7 1 ... ... ... ... 13 November ... 6 ... ... ... 1 ... ... ... ... ... ... ... 10 1 ... ... ... ... 18 December ... 4 ... ... 1 7 ... ... ... ... ... ... ... 16 ... ... ... ... ... 28 Totals ... 33 ... ... 9 34 1 ... 17 ... 4 3 1059 167 8 j ...| ... ... ... 1335 40 Infectious Disease Notifications, 1936-55. Disease 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 1954 1955 Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 171 192 150 61 48 75 175 212 97 147 95 62 35 57 89 116 111 225 86 47 33 Diphtheria 104 89 64 27 36 72 25 42 10 63 32 4 ... 1 1 ... ... ... ... ... ... Typhoid Fever 5 ... 1 ... ... ... ... 1 ... 1 ... ... ... ... ... 1 ... ... ... l ... Puerperal Pyrexia 11 5 4 7 2 2 6 3 5 8 6 9 3 ... 2 13 23 11 3 1 Meningococcal 3 1 2 1 13 12 6 8 3 3 1 2 1 1 ... 1 3 1 2 ... Infections Erysipelas 22 16 8 19 17 19 7 22 13 16 25 9 18 6 12 7 8 14 11 6 9 Measles ... ... ... ... 301 194 599 651 112 739 358 533 818 252 354 354 1386 591 888 131 1059 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ......... ... ... ... ... ... Acute Poliomyelitis: Paralytic ... 1 ... ... ... ... ... ... ... 2 3 11 2 2 6 2 1 4 4 ... 4 Non-Paralytic ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 Ophthalmia 3 1 3 3 i 3 10 4 4 ... 2 2 6 3 8 2 1 4 ... 1 ... Neonatorum Acute Encephalitis: Infective ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Post-Infectious ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Pneumonia 36 32 43 ... 30 22 20 50 37 33 41 37 30 13 19 28 24 26 27 16 34 Malaria ... ... ... ... ... ... ... 1 1 ... 1 ... 1 ... ... ... ... 1 ... 1 ... Whooping Cough ... ... ... 4 16 186 161 162 166 96 234 216 117 149 212 387 420 112 336 183 167 Food Poisoning ... ... ... 4 4 6 11 ... ... 5 1 ... ... ... 6 3 4 10 17 12 8 Dysentery ... ... ... ... ... ... ... 4 67 13 6 1 2 5 7 16 7 16 15 46 17 Paratyphoid ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... 1 ... ... 1 ... Totals 357 338 275 125 468 591 1021 1161 515 1126 807 888 1033 490 717 911 1980 1027 1396 450 1335 41 Smallpox No case of smallpox was notified during the year 1955. The last case was in 1932. Scarlet Fever The number of cases of scarlet fever notified during the year was 33 as compared with 47 in 1954, equivalent to a case rate of 0.50 per 1,000 population. This disease has continued mild in character. Of the total number of cases notified 10 were treated in hospital and 13 were treated at home. Diphtheria No case of diphtheria was notified for the sixth year in succession and only two in the past eight 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 five 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. 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 433 6 439 Five to fourteen years 133 1,053 1,186 Totals 566 1,059 1,625 The following figures show the number of the child population considered immunised at 31st December, 1955:— 42 Age at 31.12.55, i.e. born in year Under 1 1955 1 to 4 1954-1951 5 to 9 1950-1946 10 to 14 1945-1941 Under 15 Total Last complete course of injections (whether primary or booster) A. 1951-1955 18 2006 3913 3089 9035 B. 1941-1950 — — 645 507 1152 C. Estimated mid-year child population 832 4018 9553 14415 Immunity Index 100 A/C 3.16 49.93 73.39 62.68 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): — 43 Enteric Fever No case was notified during the year. Diarrhcea and Enteritis Under Two Years of Age No 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, 1955. 18 338 51 17 8 34 - 466 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, 1955. - - - - 3 27 1 31 44 Food Poisoning Outbreaks There were sixteen cases of food poisoning in 1955 comprising four family outbreaks, together with four single cases. The illness was caused by Salmonella Typhimurium in twelve cases and Samonella Thompson in four cases. The source of the disease could not be discovered. Encephalitis Lethargica No case was notified during the year. Erysipelas Nine cases were notified. Three cases were removed to hospital. Puerperal Pyrexia One case was notified during the year. Pneumonia Thirty-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 38, of which 17 were males and 21 females. Meningococcal Infections No case was notified during the year. Influenza During the year one death was recorded. The previous year no death was registered. 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 The year 1955 was a bad year for poliomyelitis, being the third highest the country has had, but we were fortunate in having only seven cases in Mitcham. 45 Five of the cases occurred in young adults and only two in children. Of the five adult cases it is of note that three occurred in women during pregnancy. Their babies have since been born and are very healthy, in spite of one being born six weeks prematurely. As regards the severity of the cases, one young adult unfortunately died, and one of the young mothers had fairly severe paralysis affecting the leg and spine, but she now walks without splints. Of the remaining five cases three were non-paralytic and two were mild but require occasional treatment. 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 126 Mumps 6 Ringworm 1 Rubella 5 Impetigo 4 Jaundice 10 Influenza 67 Tonsillitis 2 Conjunctivitis 1 Cancer The number of deaths from cancer registered during the year was 132, of which 75 were males and 57 were females. The trend for England and Wales is continuing upwards, with Mitcham slighdy below that for the country as a whole. The site distribution for 1955 was as follows: — 46 Digestive organs 15 cases Respiratory organs 40 „ Breast 11 „ Genito-urinary organs 5 „ Other sites 61 „ Total 132 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 1 Mitcham England and Wales 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 1ll 1.67 1.85 1949 124 1.85 1.87 1950 102 1.51 1.89 1951 108 1.61 1.90 1952 128 1.91 1.94 1953 129 1.94 1.95 1954 108 1.64 2.04 1955 132 2.02 2.06 Tuberculosis During the year 57 new cases of tuberculosis were notified, viz: — 47 Males Females Total Pulmonary 28 23 51 Non-Pulmonary 1 5 6 Totals 29 28 57 Thirty-four cases were transferred into the Borough as follows: — Males Females Total Pulmonary 11 21 32 Non-Pulmonary 1 2 — 2 Totals 13 21 34 The total number of deaths from tuberculosis was: — Males Females Total Pulmonary 6 2 8 Non-Pulmonary — — — Totals 6 2 8 England and Wales Mitcham Death rate from tuberculosis, all forms, per 1,000 population 0.15 0.12 The following table shows the number of new cases, the type of disease and the deaths from tuberculosis during the year: — 48 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 . 1 ... ... ... ... ... ... ... 5 years to 9 „ ... ... ... ... ... ... ... ... 10 „ „ 14 „ ... 1 ... 2 ... ... ... ... 15 „ „ 19 ... 7 ... ... ... ... ... ... 20 „ „ 34 12 10 ... 2 1 1 ... ... 35 „ „ 44 3 2 ... ... ... ... ... ... 45 „ „ 64 „ 10 1 1 3 1 ... ... 65 „ and upwards 2 2 ... ... 2 ... ... ... Totals 28 23 1 5 6 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- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total Pulmonary: Males ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 Pulmonary: Females ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Pulmonary: Males ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Pulmonary: Females ... ... ... ... ... ... ... ... ... 1 ... ... 1 49 The sources from which information as to the above-mentioned cases was obtained are as follows: — Number of Cases Pulmonary NonPulmonary Death Returns (a) From Local Registrar . . ... ... (b) Transferable deaths from Registrar General ... 1 Posthumous notifications from doctors 1 ... 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 25.00. Non-notified tuberculosis deaths ... ••• 2 Total tuberculosis deaths 8 Miniature Mass Radiography A mass radiography unit comes to Mitcham every year and is granted free use of the Vestry Hall (Town Hall). In 1955 the unit carried out its work from 22nd August to 23rd September and the following summary was supplied by the Medical Director of the Unit, Dr. F. J. H. Walters: — Male. Female. Total number examined 2,767 2,649 Pulmonary tuberculosis active 4 3 Pulmonary tuberculosis inactive 131 117 Non-tuberculous abnormalities 63 38 Carcinoma of lung 3 — The above figures do not apply to Mitcham residents only, as anyone may make use of the service whether resident or non-resident. The examination is of value in the early diagnosis and treatment of pulmonary tuberculosis and other non-tuberculous abnormalities. 50 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. 51 INDEX page Abortion, Deaths 8, 13 Ambulances 15 Ante-Natal Clinics 16, 17 Area 7 Bacteriological Examination of Cups and Glasses 30 Bakehouses 31 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 44 Books disinfected, Library 15 Cancer 45, 46 — Deaths from 8, 45, 46 Caravans 20 Causes of Deaths 8, 11-13 Chief Sanitary Inspector's Report 22-25 — — Inspector, Visits by 22, 23 Cleansing, Public. 21 Clinics 16-19 Closet Accommodation 21 Committees, Members of Health 5 Cups and Glasses, Examination of 30 Dairies 31 Day Nursery 19 Death Rates 8, 10, 14 Deaths 8,10-14,43-49 Dental Clinics 17 Diarrhoea and Enteritis 8, 43 Diphtheria 41 Diphtheria Immunisation 41, 42 — — Clinics 18 52 PAGE Disinfection 15, 38 Encephalitis Lethargica 44 Enteric Fever 43 Eradication of Bed Bugs 21 Erysipelas 44 Factories Act, 1937 34-37 — — — Defects found 35 — — — Inspections 34 — — — (Sections 110 and 111) Outwork 36, 37 Food and Drugs Act, 1938 28, 29 — — — — Section 13 32 — — — — Section 14 27 — Dealt with, Unsound 25 — Inspection and Supervision of 27-32 — Preparing Factories 32 — Campaign, Clean 27 — Poisoning 44 — — Case Rates 14 General Provision of Health Services for the Area 15-20 Health Visiting 19 Home Help Service 19 Hospitals 15, 16 Houses, Disinfection of 15 — Inhabited 7, 25 Housing Statistics 25, 26 Ice Cream 29, 30 Immunisation and Vaccination Clinics 18 — Diphtheria 41, 42 — Whooping Cough 42, 43 Infant Mortality 8, 10, 11 Infectious Disease Case Rates 14 — — Contacts 38 — — Hospitals 16 Infectious Disease, Monthly Incidence of 39 — — Notifications 38, 40 — — — School 45 — — Sanitary Inspectors' Visits 38 Influenza 44 53 PAGE Inquests 11,12 Inspection and Supervision of Food 27-32 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, 13 Meat Inspection 32 Meningococcal Infection 44 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 and 1950 31 Milk (Special Designation) (Raw Milk) Regulations, 1949 and 1950 31 Mortality, Analysis of 14 National Assistance Act, 1948, Section 47 20 N.S.P.C.C 19 Notification, Infectious Disease 14,38-40 — School 45 Nursery, Day 19 Opthalmia Neonatorum 44 Outworkers (Sections 110 and 111—Factories Act, 1937) 36, 37 Persons in Need of Care and Attention 20 Pests Act, 1949, Prevention of Destruction by 22 Pet Animals Act, 1951 33 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 25 Piggeries 33 Pneumonia 44 Poisoning, Food 44 Poliomyelitis 44, 45 Population 7 Post-Natal Clinic 18 Public Cleansing 21 54 PAGE Puerperal Pyrexia 44 Public Analyst 15 Radiography, Miniature Mass 49, 50 Rateable Value 7 Rivers and Streams 20 Rodent Operations 22 Rooms Disinfected, Number of 15, 38 Samples, Food 28-30 Sanitary Circumstances of the Area 20, 21 — Inspectors, Chief's Report 22-25 Scarlet Fever 41 Schools 21 — Notifications 45 Slaughterhouses 32 Slaughter of Animals Act, 1933 32 Smallpox 41 — Vaccination Clinics 18 — Hospital 16 Social Conditions 7, 8 Staff 6 Statistics 7-14 — Housing 25, 26 — Vital Still Births 8 Supervision of Food, Inspection and 27-32 Swabs, Tea Cups 30 Tuberculosis 46-49 — Care Committee 50 — Clinic 16 Unsound Food dealt with 25 Veneral Diseases Clinic 16 Visits by Sanitary Inspectors 22, 23, 38 Vital Statistics Water Supply 20 Welfare Clinics 17 Whooping Cough, Deaths from 8, 13, 14 — — Immunisation 42, 43