Ac.4413(1) HIT 27 BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1958 BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1958 MITCHAM H. G. Mather, Ltd., Caxton Works, Lower Green 3 Borough of Mitcham HEALTH REPORT FOR 1958 To the Mayor, Aldermen and Councillors. Mr. Mayor, Ladies and Gentlemen, I have much pleasure in submitting my annual report for the year 1958. The general health in the Borough has been good and there was no special outbreak of infectious disease. The notifications of infectious diseases fell from the high figure of 1,590 in 1957 to 325, mainly due to the decrease in measles, which tends to have a two-yearly cycle. There was no case of diphtheria, making nine years free of cases. There was no case of poliomyelitis. This has happened only once before in the last 12 years and was probably due, in great measure, to the large number of children immunised, possibly helped by the cold wet summer. It is of interest that there was a sharp drop in whooping cough notifications—to 45—which was the lowest in the 19 years since notification came into force. The peak year was 1951 when there were 420 cases, and the immunisation scheme in Surrey started the following year. The tuberculosis death rate remained at 0.08 compared with 0.10 per 1,000 population for England and Wales. Notifications increased from 22 in 1957 to 31 in 1958. Dysentery was notified in 8 cases against 47 for 1957. There was one case of paratyphoid but this was contracted in Ireland. 4 The birth rate of 14.34 per 1,000 population becomes, after correction by the comparability factor, 13.91 compared with 16.4 for England and Wales. The death rate of 9.57 becomes, after correction by the comparability factor, 11.48 per 1,000 population, against 11.7 for England and Wales. As regards infant mortality, the local rate was 20.46, and the rate for England and Wales, 22.6 per 1,000 live births, the lowest ever recorded. The death rate from cancer dropped again, from 2.06 to 1.89 while the rate for England and Wales rose again to 2.12 per 1,000 population. The death rate for lung cancer in Mitcham fell from 0.63 to 0.40 per 1,000 while the rate for England and Wales rose to 0.44. 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 (Alderman H. T. Simms, J.P.) Aldermen— Mrs. L. Crump G. W. Pearce Councillors— Mrs. W. R. Martin W. J. Dungate J. H. Kemp A. J. Pullman E. J. Mills J. E. Reece Representatives of the Council on Other Authorities: WANDLE VALLEY JOINT SEWERAGE BOARD His Worship the Mayor (ex-officio) Councillors— D. J. Hempstead L. A. Cobb H. V. Byford NORTH-EAST DIVISIONAL HEALTH SUB-COMMITTEE (SURREY COUNTY COUNCIL) Alderman G. W. Pearce Councillors— Mrs. W. R. Martin J. H. Kemp J. E. Reece 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) (a) 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 (b) Chief Clerk and Administrative Assistant—F. H. White (c) Senior Clerk—F. G. Taylor (d) Secretary—Miss V. I. Hill (e) Mrs. M. Drewett (e) Mrs. K. North. (a) Resigned 1st November, 1958. (b) 75 per cent. Surrey County Council duties. (c) 25 per cent. Surrey County Council duties. (d) 20 per cent. Surrey County Council duties. (e) 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, 1958 64,700 Density of Population, 1951 22.9 persons per acre Number of inhabited houses, 1921 7,150 „ 1931 13,187 „ 1958 19,896 Rateable Value, 1958 £989,807 Sum represented by a 1d. rate £3,990 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 situation deteriorated progressively during the year so that by the end of the year there was substantial unemployment which affected all classes except the most highly skilled. 8 Although Mitcham is chiefly a working class area, there are few houses that can be called slums. Under the recent 5-year slum clearance scheme only 54 houses had to be dealt with. Nearly twothirds 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 890 451 439 Illegitimate 38 14 24 Total 928 465 463 14.34 After correction by the comparability factor becomes 13.91 Illegitimate live births per cent. of total live births 4.09 Still Births. Total Male Female Rate per 1,000 total births Legitimate 16 12 4 Illegitimate — — — Total 16 12 4 17.24 Deaths Total Male Female Rate per 1,000 of population 619 337 282 9.57 After correction by the comparability factor becomes 11.48 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 20.48 Legitimate infants per 1,000 live legitimate births 17.97 Illegitimate infants per 1,000 live illegitimate births 78.95 9 Deaths from:— Cancer (all ages) 122 Measles - Whooping cough (all ages) - Enteritis and Diarrhœa under two years of age - Percentage of Births Occurring in Institutions Year Total births Births in hospitals, etc. Percentage of births occurring in institutions 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 1958 944 670 70.97 10 The birth rates, death rates per 1,000 of population, and the infant mortality rates for the years 1939-58 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 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 1958 13.91 16.4 11.48 11.7 20.48 22.5 11 Infant Mortality During the year 19 deaths were registered of infants under one year of age:— Males Females Total Legitimate 10 6 16 Illegitimate — 3 3 Totals 10 9 19 as compared with 11 deaths last year. Deaths of Infants under One Year of Age The following table shows the principal causes of death in the various age groups:— Age No. Cause of Death Prematurity Congenital Defects Accidents of birth Infectious conditions Other conditions Under 24 hrs 8 3 4 — — 1 1-7 days 3 1 — — — 2 8 days - 1 mth. 2 — 1 1 — — 1 mth.-12 tilths. 6 — 1 — — 5 Total 19 4 6 1 — 8 Thirteen infants failed to survive the first month of life, giving Mitcham a neo-natal mortality rate of 15.09 per 1,000 related live births as compared with 16.2 for England and Wales. Maternal Mortality During the year no deaths were registered, as in 1957. Inquests Inquests were held on 16 residents dying within the district and on 10 Mitcham residents who died outside the district, a total of 26. In addition, post-mortems without inquests were held on 80 residents 12 dying within the district, and on 50 Mitcham residents who died outside the district, a total of 130. The following table shows the results of the findings of these inauests:— Accidental death 15 Death from misadventure 1 Suicide 6 Natural causes 2 Homicide 2 Total 26 13 Deaths Registered during the Year 1958 Cause of Death Males Females Total 1 Tuberculosis, respiratory 3 2 5 2 Tuberculosis, other ... ... ... 3 Syphilitic disease 1 ... 1 4 Diphtheria ... ... ... 5 Whooping cough ... ... ... 6 Meningococcal infections ... ... ... 7 Acute Poliomyelitis ... ... ... 8 Measles ... ... ... 9 Other infective and parasitic diseases 2 ... 2 10 Malignant neoplasm, stomach 10 8 18 11 Malignant neoplasm, lung, bronchus 22 4 26 12 Malignant neoplasm, breast ... 16 16 13 Malignant neoplasm, uterus ... 4 4 14 Other malignant and lymphatic neoplasms 31 25 56 15 Leukæmia, aleukæmia 1 1 2 16 Diabetes 1 4 5 17 Vascular lesions of nervous system 42 48 90 18 Coronary disease, angina 79 39 118 19 Hypertension with heart disease 2 4 6 20 Other heart disease 20 44 64 21 Other circulatory disease 15 14 29 22 Influenza 2 1 3 23 Pneumonia 12 8 20 24 Bronchitis 28 7 35 25 Other diseases of respiratory system 2 1 3 26 Ulcer of stomach and duodenum 9 2 11 27 Gastritis, enteritis and diarrhoea 3 1 4 28 Nephritis and nephrosis 1 3 4 29 Hyperplasia of prostate 9 ... 9 30 Pregnancy, childbirth, abortion ... ... ... 31 Congenital malformations 4 6 io 32 Other defined and ill-defined diseases 29 26 55 33 Motor vehicle accidents 2 1 3 34 All other accidents 5 7 12 35 Suicide 2 4 6 36 Homicide and operations of war ... 2 2 All causes 337 282 619 14 Birth-Rates, Death Rates, Analysis of Mortality and Notifications of Infectious Diseases in the Year 1958 England and Wales Mitcham Rates per 1,000 home population Births— Live 16.4 13.91 Still 0.36 0.25 21.52* 16.90* Deaths— All causes 11.7 9.57 Malignant neoplasm—lung, bronchus 0.44 0.40 Whooping cough 0.001 ... Diphtheria 0.000 ... Tuberculosis—all forms 0.097 0.08 Influenza 0.05 0 05 Acute Poliomyelitis 0.003 ... Pneumonia 0.53 0.31 Coronary disease—angina pectoris 1.87 1.82 Maternal mortality 0.43* ...* Notifications (Corrected)— Scarlet Fever 0.86 1.16 Whooping Cough 0.74 0.70 Diphtheria 0.001 ... Measles 5.75 2.66 Acute Poliomyelitis— Paralytic 0.031 ... Non-Paralytic 0.018 ... Enteric or Typhoid Fever 0.003 ... Para-typhoid Fever 0.004 0.015 Meningococcal Infection 0.019 ... Erysipelas 0.073 0.05 Dysentery 0.85 0.12 Acute Encephalitis— Infective 0.004 ... Post-Infectious 0.003 ... Acute Pneumonia 0.49 0.19 Food Poisoning 0.20 0.14 Tuberculosis- Respiratory 0.59 0.41 Non-Respiratory 0.08 0.06 * 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 operate 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 Nil Number of rooms disinfected by fumigator 74 Number of library books disinfected 396 HOSPITALS The hospitals directly concerned with the Mitcham area are administered by the St. Helier Group Hospital Management Committee, which is situated at Carshalton, Surrey, and itself comes under the South-West Metropolitan Regional Hospital Board. General Cases.—The principal hospitals are the Wilson Hospital, which is situated within the district, and the St. Helier Hospital, 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 Beddingtcn 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 Cumberland Hospital, Mitcham, every Monday and Wednesday afternoon and Thursday morning. A clinic is held for old cases only, on every fourth Thursday at 5 p.m. The Cumberland Hospital, which has 100 beds available, deals principally with tuberculosis although an increasing number of other chest diseases are dealt with. 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. An ante-natal session is held at the Cavendish Road Clinic every second and fourth Monday morning of the month. 17 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 sessions are held at the following places:— Cavendish Road Clinic.—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 Clinic.—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. Church Road Clinic.—On 1st, 3rd and 5th Wednesdays of the month in the morning. 18 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). Poliomyelitis Immunisation A large number of sessions are held in schools and a large number on Saturday mornings at the various clinics, for children and adults. 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 Sherwood House Clinic.—Thursday, 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 The post-natal clinics at Church Road and Cavendish Road are now held in conjunction with the ante-natal clinics. 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 1958 30 Number of children affected 55 Number of visits paid 185 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 was only one case in this category and as the person concerned eventually entered hospital voluntarily no action was necessary. 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 13 caravans. The water has been of a consistently high standard of purity and there is no record of any case of infectious disease being transmitted by water. A large number of houses in the Borough have no supply of drinking water direct from the main, but are supplied from a tank in the roof. Provided the tank is properly covered and is cleansed regularly, it provides a satisfactory supply. RIVERS AND STREAMS Visits have been paid to all works suspected of discharging effluent into surface water sewers. CLOSET ACCOMMODATION The whole of the district is on the water carriage system, the houses being drained to the public sewer, then treated at the works of the Wandle Valley Joint Sewerage Board, situated in Mitcham. 21 PUBLIC CLEANSING A weekly collection of house refuse is carried out by direct labour. Ten refuse collection vehicles are in use. CLEAN AIR ACT, 1956 There are no Smoke Control Areas as yet, as the Council do not consider the area to be a bad one compared with the neighbouring metropolitan areas. Mitcham is, however, included with those areas and the position will be reviewed from time to time. ERADICATION OF BED BUGS Number of Council houses found infested during the year, 30. 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, 44. Methods employed:— 44 houses treated with insecticide spray. Number of houses disinfested of beetles, 106. Number of houses disinfested of other insects, 20. 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. Infectious Diseases.—Scholars in contact with cases of certain infectious diseases 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 the reason. 22 PREVENTION OF DAMAGE BY PESTS ACT, 1949 Two full-time and one part-time Rodent Operators were employed. Properties inspected 3,272 Complaints received 687 Number of treatments re rat infestation, including test baits, as result of inspection and complaints 1,134 Factory and business premises treated124 Visits by Public Health Inspectors 129 Two sewer maintenance treatments and one test treatment were carried out in the year; 270 manholes and five intercepting chambers were baited. A total of 32 baits were taken compared with 79 taken in 1957. 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 528 Nuisances found 387 Verbal Notices given 125 Verbal Notices complied with 77 Informal Notices served 256 Informal Notices complied with 156 Statutory Notices served 96 Statutory Notices complied with 88 Revisits 1,420 Houses inspected for defects 567 Visits made for this purpose 650 Drains tested and inspected 147 Private houses found verminous 9 Visits to butchers 192 Visits to slaughterhouses 816 Visits to dairies 18 23 Visits to retail milk shops 37 Visits to restaurant kitchens 324 Visits to ice-cream premises 61 Visits to bakehouses 37 Visits to other food premises 1,080 Number of notices served under Food Hygiene Regulations, 1955 11 Number of notices complied with 11 Visits to factories 311 Visits to workplaces 46 Visits to outworkers 86 Visits to stables 81 Visits to piggeries 65 Visits to caravan yards 131 Smoke observations 84 Visits re infectious disease cases 165 Visits re smallpox contacts 3 Visits re food poisoning 15 Visits re rats and mice 129 Visits re Shops Acts 38 Visits re schools 16 Visits re Rent Act, 1957 277 Visits to refuse tipping site, Mitcham Common 57 Visits re refuse chutes 84 Visits to sewage works 10 Sundry visits 204 Character of Work Done Roofs repaired 94 Rainwater piping or gutters repaired or renewed 65 Yards paved or repaired 14 Dampness remedied 86 Water service pipes repaired 13 Waterclosets: Repairs to structure 7 Flushing apparatus repaired or renewed 20 New pans and traps fitted 23 Water storage cisterns cleansed, repaired or renewed 4 Water supply reinstated 6 24 Flooring of rooms repaired and sub-floor ventilation improved 61 Rooms cleansed 4 Sinks and handbasins repaired or renewed 10 Waste pipes and traps repaired or renewed 11 Window frames and sashes repaired or renewed 44 Window sills repaired or renewed 18 External brickwork (repaired, pointed or rendered) 18 Drains repaired or obstructions removed 100 Drains inspection covers renewed 8 Drains tested 43 Grid and mica flaps provided 9 Firegrates repaired (including surrounds and hearths) 13 Stoves, coppers, ranges, etc., repaired 5 Chimney stacks repaired 6 Staircases repaired 12 Doors repaired 14 Internal plaster repairs 115 Sash cords renewed 50 Dustbins provided 44 Accumulations removed 8 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. LEGAL PROCEEDINGS Mitcham Urban District Council Act, 1923.—Summonses were issued against a landlord in respect of non-compliance with notices requiring the provision of dustbins at three of his properties. At the Hearing on 30th April the maximum penalty of £1 with £1 Us. costs was imposed in each case. 25 Public Health Act, 1936.—A summons was issued against the occupier of a caravan in Bath Road in respect of a contravention of Section 269 of the Public Health Act, 1936, by using the land as a site for a moveable dwelling for more than 42 consecutive days. At the Hearing on 3rd September the Court imposed a fine of £2 and made an Order for the removal of the caravan within 14 days with provision for a further penalty if the Order was not complied with. The Council was awarded £1 Is. costs. Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929.—104 licences to store petroleum spirit and/ or petroleum mixtures were issued for a total of 231,624 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 158 lbs. Sultanas 30 lbs. Pork 4 „ Pork luncheon meat 144 „ Corned beef 120 „ Ham 13 „ Veal 25 „ Fish 140 „ Chicken 4 „ Luncheon meat 15 „ Pineapple pieces 81 „ Assorted 201 tins Your faithfully, K. J. GUTTERIDGE, Chief Public Health Inspector HOUSING STATISTICS Total Number of Inhabited Houses—19,896. Permanent buildings built by the Council before the war—1,461. Permanent buildings built by the Council after the war—2,319. Other Housing Accommodation Available:— A. Requisitioned and sundry properties180 B. Temporary buildings, Arcon bungalows 345 26 C. Hutments, 320 originally, now reduced to 74 Therefore, total number of properties used for housing by the Mitcham Borough Council is 4,379 Number of People Rehoused About 10,300 applicants have registered since 1945, and the current list is still about 1,300, so that some 9,000 applicants have been dealt with. Housing Situation The outlook is still rather bad as regards new housing. Very few houses could be built in 1958 as there is no available land in Mitcham apart from the Phipps Bridge area due for development 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 in their developments outside Mitcham are participating in a scheme at Frimley and Camberley to the extent of 250 dwellings. Slum Clearance The sites in High Street, Colliers Wood, and Byegrove Road are occupied. There remain a few families in Love Lane and Church Place not yet re-housed. All the tenants in Nicholls Cottages, Gaston Road, have been rehoused and the site is to be developed. At the end of the year twelve cottage flats on the Cedars Estate will be built, and the Mitcham Borough Council is co-operating with the Mitcham Old People's Housing Association in the conversion of 112, Tamworth Lane into 18 flatlets for old people. Rent Act, 1957 One hundred and one applications were made for Certificates of Disrepair. In 73 cases undertakings to carry out the work were received from the various landlords, but six of these undertakings were not accepted. In the remaining 34 cases certificates were issued. Twenty certificates were subsequently cancelled on application by the landlords, the works having been completed. 27 INSPECTION AND SUPERVISION OF FOOD One thousand seven hundred and forty-nine inspections were made of food premises other than slaughterhouses. The premises were on the whole satisfactory with some minor adjustments necessary. Food premises by type of business. General Stores 23 Cafe & General Stores 2 Groceries 68 Roadside Snack Bars 2 Butchers31 Fishmongers 7 Greengrocer & Fruiterers 58 Fried Fish Buffets 3 Greengrocer & General Fried Fish 9 Provisions 4 Bakers and Confectioners 13 Confectionery69 Milk & Provisions 12 Chemists 14 Public Houses 30 Restaurants & Cafes ... 34 Off-Licences 12 Food premises by type, registered under Section 16, Food and Drugs Act, 1955. The storage and sale of ice-cream 152 The manufacture for sale of ice-cream 1 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 284 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 dye and disposed of to fat and bone merchants. FOOD AND DRUGS ACT, 1955 Formal Samples. Eighty-eight formal samples were taken as follows:— Milk 41 Extra White Flour ... 1 Chewing Gum 1 Rolls 1 28 Tomato Ketchup 1 Prunes 1 French Beans 1 Frankfurters 1 Jam 1 Steak & Kidney Pie 1 Fruit Sauce 2 Stoned Dates 1 Curry Powder 2 College Puddin 1 Custard Powder 1 Bicarbonate of Soda 1 Sardines 1 Saveloy Sausage1 Munchmallow 1 Gelatine 1 Lard 1 Beef Sausage 1 Margarine 1 Pure Cream 1 Lemon Curd 1 Rheumatic Tablets 1 Raspberry Special Fruit New Zealand Cheddar Product 1 Cheeese 1 Fish Paste 1 Horseradish Relish 1 Ground Almonds 2 Beef Soup Mix 1 Pure Malt Vinegar 1 Celery Soup 1 Flavouring Essence 1 Tomato Juice 1 Buttered Cheese 1 Butter 1 Tartaric Acid 1 Sweets 4 Glycerin of Thymol 1 Informal Samples Fifty-six informal samples were taken as follows:— Self Raising Flour 2 Cockles 1 Orange Squash 2 Minced Chicken 1 Marzipan 2 Lemon Juice 1 Chutney 1 Pure Ground Coffee 1 Ground Nut Oil 1 Dressed Crab 1 Irish Stew 1 Plain Flour 1 Instant Whip 1 Chocolate Macaroon Double Cream 4 Biscuits 1 Marzipan Fruits 1 Chicken in Jelly1 Tomato Ketchup 1 Instant Coffee 1 Orange Juice 1 Sweet Mango Chutney1 Swiss Roll 1 Swiss Trifle Pack2 Cream of Asparagus Soup 1 Chocolate Sponge Mixture 1 Cream of Leek Soup 1 Sardines 1 Demerara Sugar 1 Orange Marmalade 1 29 Pork Luncheon Meat 2 Custard Cream Biscuits 1 Canadian Salmon 1 Pickled Onions 1 Rice Pudding1 Jamaica Ginger Cake 1 Pilchards in Tomato 1 Coffee Flavoured Beverage 1 Spread Orange 1 Rose hip Syrup 1 Milk 1 Blackcurrant Syrup 1 Jellied Eels 3 Icing Sugar1 Whelks 2 Olive Oil1 The following samples were not up to standard and warning letters were sent to the firms concerned: — Informal.—Cream of leek soup, cream of mushroom soup, minced chicken and pork luncheon meat. Complaints from the public relating to food were as follows: — One of a spider in a milk botde. One of a dirty milk botde. One of insects in sweets. One of insects in rusks. One of pieces of wood in jam. One of string in a loaf of bread. One of a loaf contaminated by paint. One of maggotts in chocolates. Warning letters were sent to the firms concerned in these cases. Ice-Cream One establishment in the Borough is registered for the manufacture of ice-cream and 152 for the storage of ice-cream. Sixty-one visits were paid during the year. Two samples of ice-cream were taken and examined for bacteriological purity. The results are tabulated below: — Provisional Grade. I II III IV Coliforms absent 2 — — — Coliforms present in 1 /10th ml — — — — Facal coli present (in addition to above) _ _ ___ 30 Bacteriological Examination of Cups and Glasses Eighty-one swabs were taken from tea cups at various catering establishments and nine swabs were taken from beer glasses at various public houses during the year, and were submitted to the Public Health Laboratory for bacteriological examination. The results are tabulated below:— Tea Cup Swabs. Result Colony Count (per cup). Coliforms Faecal Coli Satisfactory. Unsatisfactory. Present. Absent. Present. Absent. Under 100 2 67 — 1 69 — 100-200 — 3 — — 3 — 200-500 1 7 1 — — 8 500-1,000 - - - - - - 1,000-1,500 1 — — 1 1 — 1,500-2,000 - - - - - - 2,000 and over — — — — — — Total 4 77 1 2 73 8 Beer Glass Swabs. Result Colony Count Coliforms Faecal Coli Satisfactory. Unsatisfactory. (per glass). Present. Absent. Present. Absent. Under 100 — 7 — — 7 — 100-200 - - - - - - 200-500 — 1 — — — 1 500-1,000 - - - - - - 1,000-1,500 - - - - - - 1,500-2,000 1 — 1 — — 1 2,000 and over - - - - - - Total 1 8 1 7 2 The result of the swabs was sent to the establishments concerned. 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:— 31 Dealer's (Pasteuriser's) Licences 1 Dealer's Licences— Pasteurised 36 Sterilised 60 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) 24 Supplementary Licences (Tuberculin Tested) 16 One hundred and sixty samples of Graded Milk were submitted for bacteriological examination. One was unsatisfactory and a warning letter was sent to the firm concerned. BAKEHOUSES The number of bakehouses in the district is six. Thirty-seven visits have been paid. DAIRIES There is one registered dairy and pasteurising establishment within the district. During the year eighteen visits of inspection were paid. SLAUGHTERHOUSES There are two registered slaughterhouses in the borough; 816 visits have been paid. SLAUGHTER OF ANIMALS ACTS, 1933 TO 1958 Fifteen 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) 108 52 2840 1579 15,623 Number Inspected 108 52 2840 1579 15,623 All diseases except tuberculosis and cysticerci: Whole carcases condemned ... ... ... ... 67 Carcases of which some part or organ was condemned ... 11 2 34 773 Percentage of the number inspected affected with disease other than tuberculosis and cysticerci ... 21.14 0.07 2.16 4.74 Tuberculosis only: Whole carcases condemned ... ... ... ... 9 Carcases of which some part or organ was condemned ... 3 ... ... 102 Percentage of the number inspected affected with tuberculosis ... 5.77 ... ... 0 71 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, 11. Number of notices complied with, 11. PIGGERIES There are 15 piggeries in the Borough. Sixty-five visits were paid during the year. PET ANIMALS ACT, 1951 Four licences were issued to occupiers of pet shops. 33 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 16 34 ... ... 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 2 297 268 ... ... 2 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 3 5 9 ... ... 3 TOTAL ... 318 311 ... ... ... 34 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 Ref To H.M. Inspector erred By H.M. Inspector (l) (2) (3) (4) (5) (6) (7) (8) Want of cleanliness (S.l) 4 ... ... ... ... ... 4 Overcrowding (S.2) 5 ... ... ... ... ... 5 Unreasonable temperature (S.3) 6 ... ... ... ... ... 6 Inadequate ventilation (S.4) 7 ... ... ... ... ... 7 Ineffective drainage of floors (S.6) 8 ... ... ... ... ... 8 Sanitary Conveniences (S.7) (a) Insufficient 9 ... ... ... ... ... 9 (b) Unsuitable or defective 10 3 3 ... ... ... 10 (c) Not separate for sexes 11 ... ... ... ... ... 11 Other offences (not including offences relating to Homework) 12 2 2 ... ... ... 12 TOTAL 5 5 ... ... ... 35 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 34 13 apparel Cleaning and washing 14 2 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 36 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 5 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 16 42 Textile weaving 43 43 Lampshades 44 6 44 TOTAL 63 37 PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASE NOTIFICATIONS The total number of confirmed notifications received during 1958 was 325. 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 165 Public Health Inspectors to smallpox contacts 3 Total 168 Rooms disinfected after infectious disease 74 38 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 ... 3 ... ... ... 5 ... ... ... ... ... ... ... 17 1 ... ... ... ... 26 February ... 3 ... ... ... 1 ... ... ... ... ... ... 1 5 ... ... ... ... ... 10 March ... 5 ... ... ... 1 ... ... ... ... ... ... ... 7 ... ... ... ... ... 13 April ... 3 ... ... ... 1 ... ... ... ... ... ... 5 2 ... ... ... ... ... 11 May ... 2 ... ... ... ... ... ... ... ... ... ... 5 1 ... ... ... ... ... 8 June ... 3 ... ... ... 2 ... ... 1 ... ... ... 18 3 ... ... ... ... ... 27 July ... 3 ... ... ... ... ... ... ... ... ... ... 30 1 ... ... ... ... ... 34 August ... 1 ... ... ... ... ... ... 1 ... ... ... 4 2 3 ... ... ... ... 11 September ... 1 ... ... 1 ... ... ... 3 ... ... ... 3 2 2 ... ... ... ... 13 October ... 11 ... ... 1 2 ... ... ... ... ... ... 10 1 ... ... ... ... ... 25 November ... 21 ... ... ... ... ... ... 2 ... ... ... 55 1 ... ... ... ... ... 79 December ... 19 1 ... ... ... 1 ... ... ... 41 3 3 ... ... ... ... 68 Totals ... 75 ... ... 3 12 ... ... 8 ... ... ... 172 45 9 1 ... ... ... 325 39 Infectious Disease Notifications, 1939-58 Disease 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 1958 Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 61 48 75 175 212 97 147 95 62 35 57 89 110 111 225 86 47 33 56 18 75 Diphtheria 27 36 72 25 42 10 63 32 4 ... 1 1 ... ... ... ... ... ... ... ... ... Typhoid Fever ... ... ... ... 1 ... 1 ... ... ... ... ... 1 ... ... ... 1 ... 1 ... ... Puerperal Pyrexia 7 2 2 6 3 5 8 6 9 3 ... 2 ... 13 23 11 3 1 ... ... ... Meningococcal Infections 1 13 12 6 8 3 3 1 2 1 1 ... 1 3 1 ... 2 ... 1 ... ... Erysipelas 19 17 19 7 22 13 16 25 9 18 6 12 7 8 14 11 6 9 7 4 3 Measles ... 301 194 599 651 112 739 358 533 818 252 354 354 1386 591 888 131 1059 50 1358 172 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Poliomyelitis: Paralytic ... ... ... ... ... ... 2 3 11 2 2 6 2 1 4 4 ... 4 5 2 ... Non-Paralytic ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 8 1 ... Ophthalmia 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 ... 30 22 20 50 37 33 41 37 30 13 19 28 24 26 27 16 34 19 24 12 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 45 Food Poisoning 4 4 6 11 ... ... 5 1 ... ... ... 6 3 4 10 17 12 8 11 4 9 Dysentery ... ... ... ... 4 67 13 6 1 2 5 7 16 7 16 15 46 17 60 47 8 Paratyphoid ... ... ... ... ... ... ... 1 2 ... ... ... ... 1 ... ... 1 ... 1 1 Totals 125 468 591 1021 1161 515 1126 807 888 1033 490 717 911 1980 1027 1396 450 1335 322 1590 325 40 Smallpox No case of smallpox was notified during the year 1958. The last case was in 1932. Scarlet Fever The number of cases of scarlet fever notified during the year was 75 as compared with 18 in 1957, equivalent to a case rate of 1.17 per 1,000 population. This disease has continued mild in character. Of the total number of cases notified six were treated in hospital and 69 were treated at home. Diphtheria No case of diphtheria was notified for the ninth year in succession and only two in the past twelve years, whereas before that cases averaged sixty per year. Immunisation and reinforcing doses were available to every 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 790 73 863 Five to fourteen years 84 67 151 Totals 874 140 1,014 The following figures show the number of the child population considered immunised at 31st December, 1958:— 41 Age at 31.12.58, i.e. born in year Under 1 1958 1 to 4 1957-1954 5 to 9 1953-1949 10 to 14 1948-1944 Under 15 Total Last complete course of injections (whether primary or booster) A. 1954-1958 247 2366 2990 3541 9144 B. 1944-1953 — — 724 1355 2059 C. Estimated mid-year child population 904 3489 10238 14631 Immunity Index 100 A/C 26.22 67.81 63.79 62.49 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 1958 588 124 17 23 10 9 771 B. Number of children who received a secondary (reinforcing) injection during 1958 - 1 1 2 42 34 2 76 42 Poliomyelitis There was no case during the year, the second time this has occurred in the last 14 years. This was probably helped by the extensive vaccination of children and by the rather inclement weather. Poliomyelitis Vaccination During the year the scheme was extended to the age group 16 to 25 years. There was a very poor initial response of less than 2 per cent. For children under 15 the response was good so that during the year 7,395 children had been vaccinated. The total of all children immunised by the end of 1958 was 9,586 out of 15,631 children, that is 61.3 per cent. and each had received two or more doses of vaccine. Large numbers of applications for vaccination were still coming in, however, at the end of the year. Fortunately, the question left to parents as to whether they should ask for Salk or British manufactured vaccine, for the most part died out, as did the British testing of Salk vaccine, which was additional to tests in America. It is a pity that other measures, such as not giving a poliomyelitis injection within two weeks of other injections and giving only single injections in the summer months, are still not rescinded at a time when some countries are giving a four in one vaccine. Enteric Fever There was one case of enteric fever during the year, a case of paratyphoid which was, however, contracted in Ireland. Diarrhcea and Enteritis Under Two Years of Age No death was registered during the year. Food Poisoning Outbreaks There were nine cases of food poisoning in 1958. Three were single cases and in two instances three members of a family were affected. The illness was caused by S. Typhimurium in one case and 43 by S. Newport in two cases. In the remaining six cases the cause was unknown. The source could not be discovered in any of the cases. Encephalitis Lethargica There were no cases notified during the year. Erysipelas Four cases were notified. None was removed to hospital. Puerperal Pyrexia No case was notified during the year. Pneumonia Twelve 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 20, of which 12 were males and 8 females. Meningococcal Infections None was notified during the year. Influenza During the year three deaths were recorded, as against ten the year before. 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 44 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 364 Mumps 47 Ringworm 1 Rubella 25 Impetigo 7 Jaundice 6 Influenza 13 Tonsillitis — Conjunctivitis — The number of deaths from cancer registered during the year was 122, of which 63 were males and 59 females. The trend for England and Wales is continuing upwards, while the case rate for Mitcham is rather lower than that for the country as a whole. The site distribution for 1958 was as follows:— Digestive organs 18 cases Respiratory organs 26 „ Breast 16 „ Genito-urinary organs 4 „ Other sites 58 „ Total 122 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. X England and Wales. 1939 73 1.12 1.64 1940 94 1.55 1.66 45 Year. Death Rate per 1,000 of population Number of Deaths. Mitcham. England and Wales. 1941 84 1.6 1.67 1942 104 1.90 1.698 1943 95 1.7 1.74 1944 83 1.6 1.7 1945 103 1.91 1.74 1946 108 1.74 1.76 1947 103 1.60 1.86 1948 111 1.67 1.85 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 1958 122 1.89 2.12 Tuberculosis During the year 31 new cases of tuberculosis were notified, viz:— Males Females Total Pulmonary 14 13 27 Non-Pulmonary 1 3 4 Totals 15 16 31 Twenty-nine cases were transferred into the Borough as follows:— Males Females Total Pulmonary 10 18 28 Non-Pulmonary — 1 1 Totals 10 19 29 46 The total number of deaths from tuberculosis was: — Male; i Females Total Pulmonary 3 2 5 Non-Pulmonary — — — Totals 3 2 5 England and Wales. Mitcham. Death rate from tuberculosis, all forms, per 1,000 population 0.10 0.08 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 ... 1 ... ... ... ... ... ... 5 years to 9 „ ... 1 ... ... ... ... ... ... 10 „ „ 14 „ ... 2 ... ... ... ... ... ... 15 „ „ 19 2 1 ... ... ... ... ... ... 20 „ „ 34 7 7 1 1 ... ... ... ... 35 „ „ 44 „ ... ... ... ... 1 ... ... ... 45 „ 64 5 ... ... 1 3 ... ... ... 65 „ and upwards ... 1 1 ... ... ... ... ... Totals 14 13 2 2 4 1 ... ... 47 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 ... ... ... ... ... ... ... ... ... ... ... ... ... Nil Pulmonary Females ... ... ... ... ... ... ... ... ... ... ... 1 1 2 Non-Pulmonary: Males ... ... ... ... ... ... ... ... ... ... ... ... ... Nil Non-Pulmonary: Females ... ... ... ... ... ... ... ... ... ... ... ... ... .Nil 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 ... (b) 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 There was no visit in 1958 but one was due in early 1959. 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 Clean Air Act 21 Cleansing, Public 21 Clinics 16-19 Closet Accommodation 20 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 50 PAGE Encephalitis Lethargica 43 Enteric Fever 42 Erysipelas 43 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 Immunisation and Vaccination Clinics 17, 18 —Diphtheria 40, 41 —Poliomyelitis 42 —Whooping Cough 41 Infant Mortality 8, 10, 11 Infectious Disease Case Rates — — Contacts 37 — — Hospitals — — Monthly Incidence of 38 — — Notifications 37-40, 42, 43 — — — School 43 — — Public Health Inspectors' Visits Influenza 43 51 PAGE Inquests 11, 12 Laboratory Facilities 15 Legal Proceedings 24, 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 30, 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 47 Rateable Value 7 52 PAGE Rent Act, 1957 26 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 to 1958 31 Slum Clearance 26 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 Venereal Disease Clinic 16 Visits by Public Health Inspectors 22, 23, 37 Water Supply 20 Welfare Clinics 17, 18 Whooping Cough, Deaths from9, 13, 14 — — Immunisation 41