MIT 26 BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1957 BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1957 MITCHAM H. G. Mather, Ltd., Caxton Works, Lower Green 3 Borough of Mitcham HEALTH REPORT FOR 1957 To the Mayor, Aldermen and Councillors. Mr. Mayor, Ladies and Gentlemen, I have much pleasure in submitting my annual report for the year 1957. The general health in the Borough has been good and there was no special outbreak of infectious disease with the exception of a pandemic of Influenza which started in the Far East early in the year, reaching this country in the autumn. It was fortunate that it was of a relatively mild type with few fatalities, in view of the fact that large numbers of the population were affected. Children were particularly susceptible, with up to 50% becoming absentees in many schools. The notifications of infectious diseases rose from the rather low figure of 322 for 1956 to 1,590, mainly due to the increase in measles, which tends to have a two-yearly cycle. There were no cases of diphtheria, making eight years free of cases. Much attention is now paid to poliomyelitis and in the progress of the immunisation campaign. By the end of 1957, 2,191 children had been immunised out of 2,968 who registered. More immunisations would have been carried out but it was limited by the supply of vaccine. No cases of poliomyelitis occurred in the immunised group. There were two cases of poliomyelitis in non-immunised children and one man, two cases being of moderate severity and one non-paralytic. The tuberculosis death rate resumed its downward trend, 0.08 against 0.20 for 1956 and comparing with 0.11 per 1,000 population 4 for England and Wales. Notifications also decreased from 31 in 1956 to 22 in 1957. Dysentery was notified in 47 cases against 60 for 1956. The birth rate of 13.58 per 1,000 population becomes, after correction by the comparability factor, 13.05 compared with 16.1 for England and Wales. The death rate of 9.15 becomes, after correction by comparability factor, 11.07 per 1,000 population, against 11.5 for England and Wales. As regards infant mortality, both the local rate, 12.36, and the rate for England and Wales, 23.0 per 1,000 live births, are the lowest ever recorded. Amid the general decline of diseases cancer is the only one to advance. Although this year in Mitcham the death rate at 2.06 per 1,000 population dropped slighdy from 2.08, in the country as a whole it continued its upward trend to 2.09. I wish to thank the Chairmen of the Committees for their unfailing 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 T. J. Higgs, J.P.) Aldermen— Mrs. L. Crump G. W. Pearce Councillors— Mrs. W. R. Martin Mrs. B. G. E. Smart C. A. Norris A. J. Pullman G. J. Shearing G. W. Rudd Mrs. N. V. Gurney Representatives of the Council on Other Authorities: WANDLE VALLEY JOINT SEWERAGE BOARD His Worship the Mayor (ex-officio) Aldermen— D. W. Chalkley W. Jeffery Councillor H. V. Byford NORTH-EAST DIVISIONAL HEALTH SUB-COMMITTEE (SURREY COUNTY COUNCIL) Alderman G. W. Pearce Councillors— Mrs. W. R. Martin Mrs. N. V. Gurney G. J. Shearing W. E. M. Townsend 6 STAFF Medical Officer of Health A. R. Graham, M.B., Ch.B., D.P.H., Barrister-at-Law Chief Public Health and Meat Inspector Petroleum Inspector Shops Act Inspector K. J. Gutteridge (1, 2) Assistant Public Health and Meat Inspectors L. Gleed (1, 2, 3) E. J. Sluis (1, 2) L. M. Edwards (1, 2) J. E. Higgs (1, 2) 1. Certificate R.S.H. and Public Health Inspectors' Examination Joint Board. 2. Certificate Meat and Foods R.S.H. 3. Smoke Inspector's Certificate. Clerks (a) Chief Clerk and Administrative Assistant—F. H. White (b) Senior Clerk—L. J. Bellingham (c) F. G. Taylor (d) Secretary—Miss V. I. Hill (e) Miss M. Sanders (f) Mrs. M. Drewett (g) Mrs. K. North. (a) 75 per cent. Surrey County Council duties. (b) Resigned 13th March, 1957. (c) Commenced duties 14th March, 1957. 25 per cent. Surrey County Council duties. (d) 20 per cent. Surrey County Council duties. (e) Resigned 8th November, 1957. 40 per cent. Surrey County Council duties. (f) 40 per cent. Surrey County Council duties. (g) Commenced duties 11th November, 1957. 40 per cent. Surrey County Council duties. 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, 1957 64,930 Density of Population, 1951 22.9 persons per acre Number of inhabited houses, 1921 7,150 „ 1931 13,187 „ 1957 19,860 Rateable Value, 1957 £989,175 Sum represented by a 1d. rate £3,975 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 fairly flat and low lying, 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 once more deteriorated a little from the previous year of almost full employment, but there was still a continuing demand for the more highly skilled. In engineering the 8 supply nearly met the demand. Women workers were absorbed without difficulty. Although Mitcham is chiefly a working class area, there are few houses that can be called 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 roads are tree-lined. Apart from a projected scheme at Phipps Bridge and one or two isolated sites that become vacant there is no building land available. STATISTICS Live Births. Total Male Female Rate per 1,000 of population Legitimate 850 470 380 Illegitimate 32 14 18 Total 882 484 398 13.58 After correction by the comparability factor becomes 13.05 Stall Births rate per 1,000 births. Total Mak Female total births Legitimate 17 6 11 Illegitimate — — — Total 17 6 11 19.27 Deaths Rate Per 1,000 Total Male Female of population 594 302 292 9.15 After correction by the comparability factor becomes 11.07 Deaths from pregnancy, childbirth and abortion: — Rate per 1,000 total births Number of cases Nil — Deaths of infants under one year of age: — All infants per 1,000 live births 12.36 Legitimate infants per 1,000 live legitimate births 11.76 Illegitimate infants per 1,000 live illegimate births 31.25 9 Deaths from: — Cancer (all ages) 134 Measles - Whooping cough (all ages) - Enteritis and Diarrhoea under two years of age - 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 1956 888 661 74.44 1957 899 650 72.22 10 The birth rates, death rates per 1,000 of population, and the infantile mortality rates for the years 1938-57 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 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 distributions 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 1956 12.91 15.7 11.49 11.7 13.73 23.8 1957 13.05 16.1 11.07 11.5 12.36 23.0 11 Infant Mortality During the year 11 deaths were registered of infants under one year of age: — Males Females Total Legitimate 3 7 10 Illegitimate 1 — 1 Totals 4 7 11 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 4 2 1 — — 1 1-7 days 1 — — — — 1 8 days - 1 mth. — — — — — — 1 mth. -12 mths. 6 1 1 —- 2 2 Total 11 3 2 — 2 4 Five infants failed to survive the first month of life, giving Mitcham a neo-natal mortality rate of 5.7 per 1,000 related live births as compared with 16.5 for England and Wales. Maternal Mortality During the year no deaths were registered, as in 1956. Inquests Inquests were held on 15 residents dying within the district and on 7 Mitcham residents who died outside the district, a total of 22. 12 In addition, post-mortems without inquests were held on 65 residents dying within the district, and on 71 Mitcham residents who died outside the district, a total of 136. The following table shows the results of the findings of these inquests: — Accidental death 13 Death from misadventure 1 Suicide 6 Natural causes 2 Open verdict — Total 22 13 Deaths Registered during the Year 1957 Cause of Death Males Females Total 1 Tuberculosis, respiratory 3 ... 3 2 Tuberculosis, other 1 1 2 3 Syphilitic disease 3 ... 3 4 Diphtheria ... ... ... 5 Whooping cough ... ... ... 6 Meningococcal infections ... ... ... 7 Acute Poliomyelitis ... ... ... 8 Measles ... ... ... 9 Other infective and parasitic diseases 1 1 2 10 Malignant neoplasm, stomach 15 8 23 11 Malignant neoplasm, lung, bronchus 38 3 41 12 Malignant neoplasm, breast ... 13 13 13 Malignant neoplasm, uterus ... 2 2 14 Other malignant and lymphatic neoplasms 26 29 55 15 Leukaemia, aleukæmia 1 2 3 16 Diabetes ... 3 3 17 Vascular lesions of nervous system 24 53 77 18 Coronary disease, angina 55 38 93 19 Hypertension with heart disease 8 3 11 20 Other heart disease 25 57 82 21 Other circulatory disease 10 14 24 22 Influenza 5 5 10 23 Pneumonia 15 12 27 24 Bronchitis 22 12 34 25 Other diseases of respiratory system 4 2 6 26 Ulcer of stomach and duodenum 9 2 11 27 Gastritis, enteritis and diarrhoea 1 3 4 28 Nephritis and nephrosis 1 1 2 29 Hyperplasia of prostate 4 ... 4 30 Pregnancy, childbirth, abortion ... ... ... 31 Congenital malformations 2 3 5 32 Other defined and ill-defined diseases 15 20 35 33 Motor vehicle accidents 5 ... 5 34 All other accidents 5 3 8 35 Suicide 4 2 6 36 Homicide and operations of war ... ... ... All causes 302 292 594 14 Birth-Rates, Death Rates, Analysis of Mortality and Maternal Mortality in the Year 1957 England and Wales Mitcham Rates per 1,000 home population Births— Live 16.1 13.05 Still 0.37 10.26 21.92* 119.27* Deaths— All causes 11.5 9.15 Malignant neoplasm—lung, bronchus 0.43 0.63 Whooping cough 0.000 ... Diphtheria 0.000 ... Tuberculosis—all forms 0.11 0.08 Influenza 015 0.15 Acute Poliomyelitis 0.01 ... Pneumonia 0.52 0.41 Coronary disease—angina pectoris 1.70 1.43 Maternal mortality 0.47* ... Notifications (Corrected)— Scarlet Fever 0.65 0.28 Whooping Cough 1.89 2.01 Diphtheria 0.001 ... Measles 14.11 20.91 Acute Poliomyelitis— Paralytic 0.071 0 03 Non-Paralytic 0.037 0.015 Enteric or Typhoid Fever 0.003 ... Para-typhoid Fever 0.007 ... Meningococcal Infection 0.023 ... Erysipelas 0.079 0.06 Dysentery 0.64 0.72 Acute Encephalitis— Infective 0.004 ... Post-Infectious 0.003 0 03 Acute Pneumonia 0.73 0.37 Food Poisoning 0.20 0.06 Tuberculosis— Respiratory 0.65 0.32 Non-Respiratory 0.08 0.015 * 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.l. 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 7 Number of rooms disinfected by fumigator 55 Number of library books disinfected 717 HOSPITALS The hospitals direcdy concerned with the Mitcham area are administered by the St. Helier Group Hospital Management Committee, which is situated at Carshalton, Surrey, and itself comes under the South-West Metropolitan Regional Hospital Board. General Cases.—The principal hospitals are the Wilson Hospital, which is situated within the district, and the St. Helier Hospital, 16 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 that should occur would be 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, 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 and St. Helier Hospitals. Child Welfare Clinics Infant Welfare sesssions are held at the following places: — Cavendish Road Welfare Centre.—Every Monday afternoon. St. Barnabas Church Hall, Gorringe Park Avenue.—Every Tuesday afternoon. Sherwood House, Commonside East.—Every Thursday morning and Monday afternoon. Church Road Centre.—Every Thursday afternoon and Wednesday afternoon. Meopham Road Clinic.—Every 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 weekday morning and afternoon. Church Road, Mitcham.—Every weekday morning and afternoon. Meopham Road.—Every weekday morning and afternoon. Diphtheria and Whooping Cough Immunisation Vaccination against Smallpox Clinics are held as follows: — Cavendish Road Clinic.—Each Monday afternoon in conjunction with Welfare Clinic. 18 Church Road Clinic.—On 1st, 3rd and 5th Wednesdays of the month in the morning. Meopham Road Clinic.—Each Wednesday afternoon in con junction with Welfare Clinic. St. Barnabas Clinic.—On 1st, 3rd and 5th Tuesdays of the month in the afternoon. Sherwood House Clinic.—Each Monday afternoon (immunisa tion only—in conjunction with Welfare Clinic) and each Thursday morning (immunisation and vaccination in conjunction with Welfare Clinic). Minor Ailments Sessions are 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; at Sherwood House Clinic, with a doctor in attendance, on Wednesday mornings. 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 Thursday 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, and at Cavendish Road Clinic on the second Monday in the month. Speech Clinic A session is held at Western Road Clinic on Tuesday (all day), Wednesday (morning only), and Thursday (all day), when two speech 19 therapists are in attendance. A speech therapist also holds a session at Sherwood House Clinic on Friday (all day). U.V. Radiation Clinics Sessions are held during the winter months, as follows: — Church Road Clinic.—Thursday mornings and Monday afternoons. 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 are 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 1957 41 Number of children affected 113 Number of visits paid 351 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 two cases that fell into this category, both resulting in Court action and the admission of the person concerned to hospital. In one case application was made for an extension of the court order but the application was rejected by the Court. The person concerned was so ill, however, he could not leave hospital and eventually went to the annexe for convalesence, which he appreciated very much. At a later date he went back to his home where although he is helpless he is kept going by the services of home helps. 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 17 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, situated in Mitcham. PUBLIC CLEANSING A weekly collection of house refuse is carried out by direct labour. Ten refuse collection vehicles are in use. ERADICATION OF BED BUGS Number of Council houses found infested during the year, 15 Number of other houses found infested during the year, 10. Number of requisitioned, etc., houses found infested during the year, 4. Total number of houses disinfested during the year, 29. Methods employed: — 29 houses treated with insecticide spray. Number of houses disinfested of beetles, 50. Number of houses disinfested of other insects, 7. 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 public health 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 Shools.—No school has been closed by the local authority during the year by reason of infectious disease, although at one time in the autumn the world-wide spread of "Asian Flu " caused up to 50 per cent. of the children in some schools to be absent. Infectious Diseases.—Scholars in contact with cases of certain infectious diseases are excluded from school, the period of the 22 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 the reason. PREVENTION OF DAMAGE BY PESTS ACT, 1949 Two full-time and one part-time Rodent Operators were employed. Properties inspected 7,423 Complaints received 824 Number of treatments re rat infestation including test baits as result of inspection and complaints 937 Factory and business premises treated 67 Visits by Public Health Inspectors 243 Two sewer maintenance treatments carried out; 264 manholes were baited. Eleven intercepting chambers were also baited during the two maintenance treatments. THE ANNUAL REPORT OF THE CHIEF PUBLIC HEALTH 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 Public Health Inspectors: — Complaints received 534 Nuisances found 359 Verbal Notices given 113 Verbal Notices complied with 65 Informal Notices served 210 Informal Notices complied with 119 Statutory Notices served 89 Statutory Notices complied with 86 Revisits 1,595 23 Houses inspected for defects 658 Visits made for this purpose 755 Drains tested and inspected 153 Private houses found verminous 5 Visits to butchers 220 Visits to slaughterhouses 812 Visits to dairies 13 Visits to retail milk shops 47 Visits to restaurant kitchens 334 Visits to ice-cream premises 70 Visits to bakehouses 42 Visits to other food premises 1,215 Number of notices served under Food Hygiene Regulations, 1955 17 Number of notices complied with 17 Visits to factories 276 Visits to workplaces 37 Visits to outworkers 98 Visits to stables 84 Visits to piggeries 69 Visits to marine stores 3 Visits to caravan yards 61 Smoke observations 80 Visits re infectious disease cases 203 Visits re smallpox contacts — Visits re food poisoning 7 Visits re rats and mice 243 Visits re Shops Acts 44 Visits re schools 22 Visits re Rent Act, 1957 234 Visits to refuse tipping site, Mitcham Common 109 Visits re refuse chutes 84 Visits to sewage works 19 Sundry visits 252 Character of Work Done Roofs repaired 81 Rainwater piping or gutters repaired or renewed 56 24 Yards paved or repaired 4 Dampness remedied 90 Water service pipes repaired 9 Waterclosets: Repairs to structure 4 Flushing apparatus repaired or renewed 17 New pans and traps fitted 19 Water storage cisterns cleansed, repaired or renewed 2 Water supply reinstated 7 Flooring of rooms repaired and sub-floor ventilation improved 34 Rooms cleansed — Sinks and handbasins repaired or renewed 4 Waste pipes and traps repaired or renewed 11 Window frames and sashes repaired or renewed 43 Window sills repaired or renewed 8 External brickwork (repaired, pointed or rendered) 16 Drains repaired or obstructions removed 87 Drains inspection covers renewed 5 Drains tested 38 Grid and mica flaps provided 3 Firegrates repaired (including surrounds and hearths) 7 Stoves, coppers, ranges, etc., repaired 4 Chimney stacks repaired 5 Staircases repaired 7 Doors repaired 7 Internal plaster repairs 89 Sash cords renewed 16 Dustbins provided 14 Accumulations removed 4 All ponds and ditches in the Borough where mosquito breeding was likely were sprayed with insecticide three times during the year and larger areas where mosquitoes were found to be breeding, and spraying was impracticable, were treated with a fogging apparatus with satisfactory results. Disinfestation of dust chutes at the Council's blocks of flats was carried out by means of the high pressure fogging apparatus which was most effective: all school canteens were similarly treated. 25 LEGAL PROCEEDINGS Public Health Act, 1936.—Summonses were issued against the occupiers of two caravans in Bath Road in respect of non-compliance with notices served for the abatement of a statutory nuisance. One caravan was removed before service of the summons and at the Hearing on October 16th, 1957, the Court made an Order against the occupier of the second caravan for the abatement of the nuisance within 28 days and for the payment of £2 2s. costs. Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929.—100 licences to store petroleum spirit and/ or petroleum mixtures were issued for a total of 220,174 gallons (inclusive of cellulose solutions). 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 143½ lbs. Barley Sugar 775 lbs. Pork 71 „ Ham 326½ „ Corned beef 131 „ Fish 210 „ Suet 35 „ Calves' livers 2½ „ Lamb 181 „ Butter 1,008 „ Lambs' livers 20 „ Luncheon meat 150 „ Pig spleens 28 „ Cooked Bacon 16½ „ Pork luncheon meat 125 „ Oatmeal 7 „ Jellied veal 12 „ Assorted 189 tins 6 jars Your faithfully, K. J. GUTTERIDGE, Chief Public Health Inspector HOUSING STATISTICS Total Number of Inhabited Houses—19,860. Permanent buildings built by the Council before the war—1,461. Permanent buildings built by the Council after the war—2,283. 26 Other Housing Accommodation Available: — A. Requisitioned and sundry properties 168 B. Temporary buildings, Arcon bungalows 345 C. Hutments, 320 originally, now reduced to 87 Therefore, total number of properties used for housing by the Mitcham Borough Council is 4,344 Number of People Rehoused About 10,100 applicants have registered since 1945, and the current list is still about 1,300, so that some 8,800 applicants have been dealt with. Housing Situation The outlook is rather grim as regards new housing. Very few houses could be built in 1957 as there is no available land in Mitcham with the exception of the projected scheme for the Phipps Bridge area some time in the future, and isolated sites that become vacant. The few slum clearance areas serve in turn to rehouse those who are displaced. The Council have been forced to go outside Mitcham in their search for building space. In a joint scheme at Banstead, 232 dwellings were constructed for Mitcham Corporation. Mitcham is also to participate in a scheme at Frimley and Camberley to the extent of 250 dwellings. Slum Clearance During the year the re-development was begun of the three sites, two in High Street, Colliers Wood, and one in Bailey Road, which were scheduled for slum clearance under the Housing Act, 1936, and the Housing Rents & Repairs Act, 1954, and acquired by Compulsory Purchase Orders in 1956. By the end of the year dwelling-houses were being erected. Two further areas were made the subject of Compulsory Purchase Orders in 1957 comprising 29 houses in all. Apart from the above, under section 17 of the Housing Act, 1957, demolition orders were made in respect of two houses and one cottage was made the subject of a closing order. 27 Rent Act, 1957 Ninety-two applications were made for Certificates of Disrepair. Two cases did not warrant the issue of certificates and in 58 cases undertakings to carry out the work were received from the various landlords. In the remaining 32 cases certificates were issued. Three certificates were subequently cancelled on application by the landlords, the works having been completed. INSPECTION AND SUPERVISION OF FOOD Twelve hundred and fifteen inspections were made of food premises. The premises were on the whole satisfactory with some minor adjustments necessary. Food premises by type of business. General Stores 21 Cafe & General Store 1 Groceries 74 Roadside Snack Bars 2 Butchers 34 Fishmongers 8 Greengrocer & Fruiterers 55 Fried Fish Buffets 4 Greengrocer & General Provisions 2 Fried Fish 10 Bakers and Confectioners 15 Confectionery 72 Milk & Provisions 13 Chemists 18 Public Houses 30 Restaurants & Cafes 37 Off-Licences 12 Food premises by type, registered under Section 16, Food and Drugs Act, 1955. The storage and sale of ice-cream 142 The manufacture for sale of ice-cream 3 The preparation or manufacture of sausages, or potted, pressed, pickled or preserved food 33 Dairies registered under the Milk and Dairies Regulations, 1949 1 Number of inspections of registered food premises during the year 130 28 All condemned food is either incinerated at the Refuse Destructor, Garth Road, Morden, by arrangement with the Merton and Morden Urban District Council, or treated with technical dye and disposed of to fat and bone merchants. FOOD AND DRUGS ACT, 1955 Formal Samples. One hundred and seven formal samples were taken as follows: — Milk 53 Vanilla Flavouring 1 Cream of Mushroom Soup 1 Sild 1 Pineapple Pieces 1 Syrup of White Pine 1 Jam 2 Flour 1 Tomato Sauce 1 Beef Sausage 1 " Royal " Sunny Spread 1 Margarine 2 Honey 1 Cheese Food 1 Double Devon Cream 1 Vinegar 1 Pork Sausage 1 Baking Powder 1 Cambridge Sausage 1 Butter 2 Ferguzade 1 Condensed Milk 1 Fishpaste 1 Hamburgers 1 Sweets 6 Camphorated Oil 1 Jelly 2 Tea 1 Influenza Mixture 2 Cream of Tartar 1 Grapefruit Juice 1 Sausage with Beans in Tomato Sauce 1 Milkshake 1 Veal and Ham Roll 1 Pork Luncheon Meat 2 Minced Chicken 1 Tomato Juice 1 Meat Pudding 1 Coffee Essence 1 Rice Pudding 1 Fish Fingers 1 Gelatine 1 Pastry Mix 1 Horseradish Sauce 1 Informal Samples Forty-one informal samples were taken as follows: — Blackcurrant Syrup 1 Instant Chocolate Icing 1 Olive Oil 1 Biscuits 1 Condensed Milk 1 Minced Fruit Pie 1 29 Double Cream 1 Pickled Onions 1 Bicarbonate of Soda 1 Sardines 2 Sweets 1 Garden Peas 3 Rhubarb 1 Custard Powder 1 Ready Mix Ice Cream 1 Canadian Flap Jacks 1 Table Salt 1 Sugar 1 Cheese 1 Liver Salts 1 Dressed Crab 1 Skip SunKaplus 1 Cheese with Ham 1 Swiss Roll 1 Minced Turkey 2 Pickling Spice 1 Batter Mix 1 Butterfat 2 Frankfurter Sausages 1 Luncheon Meat 2 Fish Paste 1 Pepper 1 Tomato Puree 1 Soft Icing Fondant 1 Curry Powder 1 The following samples were not satisfactory and warning letters were sent to the firms concerned: — Formal.—Pork sausage with beans in tomato sauce, cream of mushroom soup, minced turkey, Ferguzade, tomato juice, milk shake. Informal.—Cake mixture, luncheon meat. On complaints being received the following cases were reported to the Public Health Committee: — One of a foreign body in sponge cake. One of a foreign body in bacon. One of a foreign body in orange squash. One of a foreign body in a cut loaf. One of a mouldy sausage roll. Warning letters were sent to the firms concerned in these cases. Ice-Cream Three premises in the Borough are registered for the manufacture of ice-cream and 142 for the storage of ice-cream. Seventy visits were Daid during the vear. Eight samples of ice-cream were taken and examined for bacteriological purity. The results are tabulated below: — 30  Provisional Grade. I II III IV Coliforms absent 7 1 — — Coliforms present in 1 /10th ml — — — — Faecal coli present (in addition to above) - - - - Bacteriological Examination of Cups and Glasses Ninety swabs were taken from tea cups at various catering establishments and eleven 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 cnp). Coliforms Faecal Coli Satisfactory. Unsatisfactory. Present. Absent. Present. Absent. Under 100 1 58 — 1 59 — 100-200 — 7 — — 3 4 200-500 1 15 — 1 8 8 500-1,000 — 1 — — — 1 1,000-1,500 2 1 — 2 — 3 1,500-2,000 2,000 and over 1 3 1 — — 4 Total .. 5 85 1 4 70 20 Beer Glass Swabs. Result Colony Count (per glass). Coliforms Faecal Coli Satisfactory. Unsatisfactory. Present. Absent. Present. Absent. Under 100 — 8 — — 8 — 100-200 — —— — — — — 200-500 — — — — — — 1,000-1,500 — 1 — — — 1 1,500-2,000 — — — — — — 2,000 and over 1 1 — 1 — 2 Total 1 10 — 1 8 3 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 29 Sterilised 55 Supplementary Licences— Pasteurised 17 Sterilised 18 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) 19 Supplementary Licences (Tuberculin Tested) 17 One hundred and seventy-three samples of Graded Milk were submitted for bacteriological examination. All were satisfactory. BAKEHOUSES The number of bakehouses in the district is six. Forty-two visits have been paid. DAIRIES There is one registered dairy and pasteurising establishment within the district. During the year thirteen visits of inspection were paid. SLAUGHTERHOUSES There are two registered slaughterhouses in the borough; 812 visits have been paid. SLAUGHTER OF ANIMALS ACTS, 1933 TO 1954 Thirteen licences were issued to slaughtermen in accordance with the requirements of the above Acts. 32 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) 58 33 2642 865 13,215 Number Inspected 58 33 2642 865 13,215 All diseases except tuberculosis and cysticerci: Whole carcases condemned ... ... ... ... 42 Carcases of which some part or organ was condemned 2 2 1 6 750 Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 3.45 6.06 0.04 0.69 5.99 Tuberculosis only: Whole carcases condemned ... .. ... ... 3 Carcases of which some part or organ was condemned 2 2 ... ... 97 Percentage of the number inspected affected with tuberculosis 3.45 6.06 ... ... 0.75 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 THE FOOD HYGIENE REGULATIONS, 1955 Number of notices served, 17. Number of notices complied with, 17. PIGGERIES There are 20 piggeries in the Borough. Sixty-nine visits were paid during the year. PET ANIMALS ACT, 1951 Four licences were issued to occupiers of pet shops. FACTORIES ACT, 1937 I.—Inspections for purposes of provisions as to health (including inspections made by Public Health Inspectors): — Premises M/c line No. Number on Register Number of M/c line No. Inspections Written notices Occupiers prosecuted (1) (2) (3) (4) (5) (6) (7) (i) Factories in which Sections 1,2, 3, 4, and 6 are to be enforced by Local Authorities 1 18 37 ... ... 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 2 296 276 2 ... 2 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 3 ... Nil ... ... 3 TOTAL ... 314 313 2 ... ... 33 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 1 1 ... ... ... 4 Overcrowding (S.2) 5 ... ... ... ... ... 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 ... ... ... 9 (b) Unsuitable or defective 10 ... ... ... 1 ... 10 (c) Not separate for sexes 11 ... ... ... ... ... 11 Other offences (not including offences relating to Homework) 12 ... ... ... ... ... 12 TOTAL . 3 3 ... 1 ... 34 3.—Outwork (Sections 110 and 111): — Nature of Work 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 M/c line No. (1) (2) (3) (4) (5) (6) (7) (8) (9) Wearing / Making, etc 13 28 13 apparel I Cleaning and washing 14 14 Household linen 15 15 Lace, lace curtains and nets 16 16 Curtains and furniture hangings 17 17 Furniture and upholstery 18 18 Electro-plate 19 19 File making 20 20 Brass and brass articles 21 21 Fur pulling 22 22 Iron and steel cables and chains 23 23 Iron and steel anchors and grapnels 24 24 Cart gear 25 25 Locks, latches and keys 26 26 Umbrellas, etc. 27 27 Artificial flowers 28 28 35 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 2 34 Brush making 35 35 Pea picking 36 36 Feather sorting 37 37 Carding, etc., of buttons, etc. 38 38 Stuffed toys 39 39 Basket making 40 40 Chocolates and sweetmeats 41 41 Cosaques, Christmas crackers, Christmas stockings, etc. 42 9 42 Textile weaving 43 43 Lampshades 44 3 44 TOTAL 42 36 37 PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASE NOTIFICATIONS The total number of confirmed notifications received during 1957 was 1,590. Contacts, Suspects, Etc. The Medical Officer of Health is called in consultation by medical practitioners to see patients in their homes, as required. Visits Public Health Inspectors to common infectious diseases 203 Public Health Inspectors to smallpox contacts Nil Total 203 Rooms disinfected after infectious disease 55 The monthly incidence of infectious disease was: — Smallpox 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 ... 2 ... ... 1 2 ... ... 18 ... ... ... 27 9 ... ... ... ... ... 59 February ... 2 ... ... 2 4 ... ... 20 ... ... ... 114 7 ... ... ... ... 1 150 March ... 1 ... ... ... 4 ... ... 4 ... ... ... 529 11 ... ... ... ... 1 550 April ... 1 ... ... ... 2 ... ... ... ... ... ... 353 13 ... ... ... ... ... 369 May ... 1 ... ... ... ... ... ... ... ... ... ... 221 12 ... ... ... ... ... 234 June ... 1 ... ... 1 ... ... ... ... ... 2 ... 81 8 ... ... ... ... ... 93 July ... 2 ... ... ... ... ... ... ... ... ... ... 24 3 1 ... ... ... ... 30 August ... 1 ... ... ... 1 ... ... 1 ... ... 1 5 17 1 ... ... ... ... 27 September ... 3 ... ... ... ... ... ... 4 ... ... ... ... 21 2 ... ... ... ... 30 October ... 1 ... ... ... 3 ... ... ... ... ... ... 2 5 ... ... ... ... ... 11 November ... ... ... ... ... 2 ... ... ... ... ... ... 1 13 ... ... ... ... ... 16 December ... 3 ... ... ... 6 ... ... ... ... ... ... 1 11 ... ... ... ... ... 21 Totals ... 18 ... ... 4 24 ... ... 47 ... 2 1 1358 130 4 ... ... ... 2 1590 38 Infections Disease Notification, 1938-57 Disease 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 1956 1957 Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 150 61 48 75 175 212 97 147 95 62 35 57 89 110 111 225 86 47 33 56 18 Diphtheria 64 27 36 72 25 42 10 63 32 4 ... 1 1 ... ... ... ... ... ... ... ... Typhoid Fever 1 ... ... ... ... 1 ... 1 ... ... ... ... ... 1 ... ... ... 1 ... 1 ... Puerperal Pyrexia 4 7 2 2 6 3 5 8 6 9 3 ... 2 ... 13 23 11 3 1 ... Meningococcal 2 1 13 12 6 8 3 3 1 2 1 1 ... 1 3 1 2 ... 1 ... Infections Erysipelas 8 19 17 19 7 22 13 16 25 9 18 6 12 7 8 14 11 6 9 7 4 Measles ... ... 301 194 599 651 112 739 358 533 818 252 354 354 1386 591 888 131 1059 50 1358 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Poliomyelitis: Paralytic ... ... ... ... ... ... ... 2 3 11 2 2 6 2 1 4 ... 4 5 2 Non-Paralytic ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 8 1 Ophthalmia 3 3 1 3 10 4 4 ... 2 2 6 3 8 2 1 4 .. 1 ... ... ... Neonatorum Acute Encephalitis: Infective ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Post-Infectious ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 2 Pneumonia 43 ... 30 22 20 50 37 33 41 37 30 13 19 28 24 26 27 16 34 19 24 Malaria ... ... ... ... ... 1 1 ... 1 ... 1 ... ... ... ... 1 ... 1 ... ... ... Whooping Cough ... 4 16 186 161 162 166 96 234 216 117 149 212 387 420 112 336 183 167 103 130 Food Poisoning ... 4 4 6 11 ... ... 5 1 ... ... ... 6 3 4 10 17 12 8 11 4 Dysentery ... ... ... ... ... 4 67 13 6 1 2 5 7 16 7 16 15 46 17 60 47 Paratyphoid ... ... ... ... •• ... ... ... 1 2 ... ... ... ... 1 ... ... 1 ... 1 ... Totals 275 125 468 591 1021 1161 515 1126 807 888 1033 490 717 911 1980 1027 1396 450 1335 322 1590 39 40 Smallpox No case of smallpox was notified during the year 1957. The last case was in 1932. Scarlet Fever The number of cases of scarlet fever notified during the year was 18 as compared with 56 in 1956, equivalent to a case rate of 0.28 per 1,000 population. This disease has continued mild in character. Of the total number of cases notified four were treated in hospital and 14 were treated at home. No cases of diphtheria was notified for the eighth year in succession and only two in the past eleven years, whereas before that cases averaged sixty per year. Immunisation and reinforcing doses were available to every school child whose parents gave consent. 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 the child population considered immunised at 31st December, 1957: — Diphtheria Diphtheria Immunisation 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 phophylaxis): — Immunised. Reinforced. Total. Under five years 631 100 731 Five to fourteen years 116 1,686 1,802 Totals 747 1,786 2,533 41 Age at 31.12.57, i.e. born in year Under 1 1957 1 to 4 1956-1953 5 to 9 1952-1948 10 to 14 1947-1943 Under 15 Total Last complete course of injections (whether primary or booster) A. 1953-1957 219 2233 3493 3237 9182 B. 1943-1952 — — 764 1263 2027 C. Estimated mid-year child population 896 3951 9729 14576 Immunity Index 100 A/C 24.44 56.51 69.17 62.97 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): — 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 diphtheria pertussis prophylactic) during 1957 476 104 18 7 6 11 1 623 B. Number of children who received a secondary (reinforcing) injection during 1957 — - - 3 53 65 3 124 42 Poliomyelitis There were three cases during the year, a man and a boy who had moderate paralysis and a boy who was non-paralytic. None had been immunised. Poliomyelitis Vaccination The scheme for vaccinating children in age groups 1947-1954 with British vaccine was continued during the year, and further age groups—1955-1956—were also included. Of a total of 2,968 children who were registered, 2,191 had been vaccinated by the end of 1957. In December the Ministry of Health decided to extend the scheme by importing Salk vaccine, and registrations were invited from children born in 1943-1946 and 1957, expectant mothers, and the families of certain classes who were likely to be at special risk such as doctors, ambulance drivers, and nurses. Vaccination of these groups commenced early in 1958. Enteric Fever There were no cases of enteric fever during the year. Diarrhcea and Enteritis Under Two Years of Age No death was registered during the year. Food Poisoning Outbreaks There were four single cases of food poisoning in 1957. The illness was caused by S. Typhimurium in one case, by S. Heidelberg in one case and in two cases the cause was unknown. The source could not be discovered in any of the cases. Encephalitis Lethargica Two cases of post-infectious encephalitis were notified during the year. Erysipelas Four cases were notified. Two cases were removed to hospital. 43 Puerperal Pyrexia No case was notified during the year. Pneumonia Twenty-four cases of primary pneumonia were notified during the year. The number of deaths from all forms of pneumonia, some of which are not notifiable, was 27, of which 15 were males and 12 females. Meningococcal Infections None was notified during the year. Influenza During the year ten deaths were recorded, six more than the year before. There was a pandemic of influenza type A which started in the Far East in the early part of the year reaching this country in the autumn. It was called Asian flu and was fortunately of a mild type causing few deaths. It was, however, of such a wide-spread nature that at some schools up to 50 per cent. of the pupils were absent. Ophthalmia Neonatorum During the year no case of ophthalmia neonatorum was notified. Prevention of Blindness This comes under the control of the Surrey County Council. School Notifications The school intimation notices of infectious disease are 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: — 44 Chicken pox 56 Mumps 496 Ringworm — Rubella 85 Impetigo — Jaundice 3 Influenza 1,454 Tonsillitis — Conjunctivitis — Cancer The number of deaths from cancer registered during the year was 134, of which 79 were males and 55 females. The trend for England and Wales is continuing upwards, with the case rate for Mitcham about equal to that for the country as a whole. The site distribution for 1957 was as follows: — Digestive organs 23 cases Respiratory organs 41 „ Breast 13 „ Genito-urinary organs 2 „ Other sites 55 „ Total 134 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. 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 45 1945 103 1.91 1.74 1946 108 1.74 1.76 1947 103 1.60 1.86 1948 111 1.67 1.85 1949 124 1.85 1.87 1950 102 1.51 1.89 1951 108 1.61 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 1956 135 2.08 2.07 1957 134 2.06 2.09 Tuberculosis During the year 22 new cases of tuberculosis were notified, viz: — Males Females Total Pulmonary 11 10 21 Non-Pulmonary — 1 1 Totals 11 11 22 Thirty-one cases were transferred into the Borough as follows: — Males Females Total Pulmonary 15 15 30 Non-Pulmonary 1 — 1 Totals 16 15 31 The total number of deaths from tuberculosis was: — Males Females Total Pulmonary 3 — 3 Non-Pulmonary 1 1 2 Totals 4 1 5 England and Wales. Mitcham. Death rate from tuberculosis, all forms, per 1,000 population 0.11 0.08 46 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 „ ... ... ... ... ... ... ... ... 10 „ „ 14 „ ... ... ... ... ... ... ... ... 15 „ 19 „ 2 4 ... ... ... ... ... ... 20 „ „ 34 „ 3 2 ... 1 ... ... ... ... 35 „ „ 44 „ 1 2 ... ... ... ... ... ... 45 „ „ 64 „ 5 1 ... ... 1 ... 1 ... 65 „ and upwards ... 1 ... ... 2 1 ... ... Totals 11 10 ... 1 3 1 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- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total Pulmonary: Males ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Pulmonary Females ... ... ... ... ... ... ... ... ... ... ... ... ... Nil Non-Pulmonary: Males ... ... ... ... ... ... ... ... ... ... ... ... ... Nil Non-Pulmonary: Females ... ... ... ... ... ... ... ... ... ... ... ... 1 1 47 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 1 ... (c) Transferable deaths from Registrar General 1 ... 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 40. Non-notified tuberculosis deaths 2 Total tuberculosis deaths 5 Miniature Mass Radiography A mass radiography unit comes to Mitcham every year and is granted free use of the Vestry Hall (Town Hall). In 1957 the unit carried out its work from 15th June—13th July, and also from 13th —17th June at Colliers Wood. The following summary was supplied by the Medical Director of the Unit, Dr. F. J. H. Walters: — Male. Female. Total number examined 3,586 3,233 Pulmonary tuberculosis active — 1 Pulmonary tuberculosis inactive 90 60 Non-tuberculous abnormalities 68 45 Of 6,819 people examined in all, 6,261 were examined at the Vestry Hall and 558 at Colliers Wood. 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. 48 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. 49 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 43 Cancer 44, 45 — Deaths from 9, 44, 45 Caravans 20 Causes of Deaths 9, 11-14 Chief Public Health Inspector's Report 22-25 — — Inspector, Visits by 22, 23 Cleansing, Public 21 Clinics 16-19 Closet Accommodation 21 Committees, Health, Members of 5 Dairies 31 Day Nursery 19 Death Rates 8, 10, 11, 14 Deaths 8-14 Dental Clinics 17 Diarrhoea and Enteritis 9, 42 Diphtheria 40 Diphtheria Immunisation 40, 41 — — Clinics 17, 18 Disinfection 15, 37 Encephalitis Lethargica 42 50 PAGE Enteric Fever 42 Erysipelas 42 Factories Act, 1937 33-36 — — — Defects found 34 — — — Inspections 33 — — — (Sections 110 and 111) Outwork 35, 36 Food and Drugs Act, 1955 27-29 — — — — Section 16 27 — Hygiene Regulations, 1955 32 — Dealt with, Unsound 25 — Inspection and Supervision of 27-32 — Preparing Factories 32 — Poisoning 42 — — Case Rates 14 — Sampling 28, 29 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, 26 Housing Statistics 25, 26 Ice Cream 29 Immunisation and Vaccination Clinics 17, 18 — Diphtheria 40, 41 — Poliomyelitis 42 — Whooping Cough 41 Infant Mortality 8, 10, 11 Infectious Disease Case Rates 14 — — Contacts 37 — — Hospitals 16 — — Monthly Incidence of 38 — — Notifications 37-40, 42, 43 — — — School 43 — — Public Health Inspectors' Visits 37 Influenza 43 Inquests 11, 12 51 PAGE Laboratory Facilities 15 Legal Proceedings 25 Library Books, Disinfection of 15 Maternal Mortality 8, 11, 13 Maternity, Hospital Treatment 16 Measles, Case Rates 14 — Deaths from 9, 13 Meat Inspection 32 Meningococcal Infection 43 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 Neonatal mortality 11 Ophthalmia Neonatorum 43 Outworkers (Sections 110 and 111—Factories Act, 1937) 35, 36 Persons in Need of Care and Attention 20 Pests Act, 1949, Prevention of Damage by 22 Pet Animals Act, 1951 32 Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929 25 Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum Carbide of Calcium Order, 1929 25 Piggeries 32 Pneumonia 43 Poliomyelitis 42 Population 7 Post-Natal Clinics 18 Public Cleansing 21 Puerperal Pyrexia 43 Public Analyst 15 Radiography, Miniature Mass 48 Rateable Value 7 Rent Act, 1957 27 52 PAGE Rivers and Streams 20 Rodent Operations 22 Rooms Disinfected, Number of 15, 37 Sanitary Circumstances of the Area 20, 21 Scarlet Fever 40 Schools 21 Slaughterhouses 31 Slaughter of Animals Act, 1933 31 Smallpox 40 — Vaccination Clinics 17, 18 — Hospital 16 Social Conditions 7, 8 Staff 6 Statistics 7-14 — Housing 25, 26 — Vital 14 Still Births 8 Tuberculosis 45-47 — Care Committee 48 — Clinic 16 Unsound Food dealt with 25 Venereal Disease Clinic 16 Visits by Public Health Inspectors 22, 23, 37 Water Supply 20 Welfare Clinics 17, 18 Whooping Cough, Deaths from 9, 13, 14 — — Immunisation 41