BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1959 BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1959 MITCHAM H. G. Mather, Ltd., Caxton Works, Lower Green, 3 Borough of Mitcham HEALTH REPORT FOR 1959 To the Mayor, Aldermen and Councillors. Mr. Mayor, Ladies and Gentlemen, I have much pleasure in submitting my annual report for the year 1959. The general health in the Borough has been good and there was no special outbreak of infectious disease. The notifications of infectious diseases were 1,000 compared with 325 in 1958. The increase was mainly due to measles for which 1959 was a high year. There was one case of poliomyelitis, a mild paralytic one in a boy aged 2¼ years. This is the only case since September, 1957, and I think it can safely be said that this shows the beneficial effect of polio immunisation. Each year the number of cases for England and Wales becomes smaller and smaller, a trend which is seen even in the weekly figures. The decline in whooping cough notifications continued. This year there were only 17, the lowest figure for 20 years. The tuberculosis death rate fell from 0.08 to 0.03 which compares with 0.08 per 1,000 population for England and Wales. Notifications were 28 compared with 31 for the previous year. It is worthy of note that the number of cases on the tuberculosis register has decreased consistently over the last ten years and now shews a reduction of 34.5 per cent. for pulmonary and 75.1 per cent. for non-pulmonary cases as compared with 1950. Dysentery was notified in 10 cases as against 8 for 1958. There were no cases of paratyphoid. 4 The birth rate of 13.16 per 1,000 population becomes, after correction by the comparability factor, 12.76 compared with 16.5 for England and Wales. The death rate of 10.5 becomes, after correction by the comparability factor, 12.6 per 1,000 population, against 11.6 for England and Wales. It is most unusual for the death rate in Mitcham to be higher than in England and Wales. The increase was mainly due to deaths from respiratory disease, heart disease and cancer. There was no obvious cause for the increased rate. The previous year had shewn cancer death rate to be very low. The death rate from cancer for Mitcham in 1959 increased from 1.89 to 2.25 while that for England and Wales increased from 2.12 to 2.14 per 1,000 population. As regards infant mortality the local rate was 14.17 and the rate for England and Wales, 22.2 per 1,000 live births, the lowest ever recorded. A meals-on-wheels service was inaugurated in July and supplies 30 old people who are housebound with a hot meal twice a week. It is run by the W.V.S. and financed by the Borough Council, reports being received by the Public Health Committee. The scheme is to be extended to include more housebound old people and also to provide hot meals for able-bodied old people who attend the Old People's Welfare Centre in London Road. The service has been much appreciated. 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 D. W. Chalkley, J.P.) Aldermen— Mrs. L. Crump G. W. Pearce Councillors— Mrs. E. G. Baker W. J. Dungate A. S. Hutchin Mrs. J. E. Spalding E. J. Mills D. A. Small R. Taylor Representatives of the Council on Other Authorities: WANDLE VALLEY JOINT SEWERAGE BOARD His Worship the Mayor (ex-officio) Alderman T. J. Higgs Councillors— D. J. Hempstead L. A. Cobb NORTH-EAST DIVISIONAL HEALTH SUB-COMMITTEE (SURREY COUNTY COUNCIL) Alderman G. W. Pearce Councillors— L. A. Cobb D. Griffith R. Taylor 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) J. E. Higgs (1, 2) Pupil Public Health Inspector C. S. Smith (a) 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 (fe) 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) Commenced 1st September, 1959. (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, 1959 64,380 Density of Population, 1951 22.9 persons per acre Number of inhabited houses, 1921 7,150 „ „ „ 1931 13,187 „ „ „ 1959 19,900 Rateable Value, 1959 £1,103,203 Sum represented by a 1d. rate £4,510 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 fiat 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 improved during the year till it reached practically full employment, except for the hard core and 8 those in process of changing jobs. There were vacancies for all especially on the women's side. There is always a slight seasonal increase in unemployment at the very end of the year. Mitcham is chiefly a working class area. Nearly two-thirds of the houses have been built since 1921 and more than 50 per cent, of all roads are tree-lined. Virtually no building land is available except for the projected Phipps Bridge scheme on which preliminary work has been done in the way of site clearance. STATISTICS Live Births. Total Male Female Rate per 1,000 of population Legitimate 813 428 385 Illegitimate 34 21 13 Total 847 449 398 13.16 After correction by the comparability factor becomes 12.76 Illegitimate live births per cent. of total live births 4.01 Still Births. Total Male Female Rate per 1,000 total births Legitimate 12 5 7 Illegitimate — — — Total 12 5 7 13.97 Deaths. Total Male Female Rate per 1,000 of population 676 337 339 10.5 After correction by the comparability factor becomes 12.6 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 14.17 Legitimate infants per 1,000 live legitimate births 13.53 Illegitimate infants per 1,000 live illegitimate births - 9 Deaths from:— Cancer (all ages) 145 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 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 1959 859 604 70.32 10 The birth rates, death rates per 1,000 of population, and the infant mortality rates for the years 1940-59 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 1940 15.4 14.6 11.8 14.3 46.0 55 1941 13.57 14.2 11.06 12.9 55.4 59 1942 17.54 15.8 9.81 11.6 43.75 49 1943 18.75 16.5 10.77 12.1 36.2 49 1944 18.99 17.6 11.88 11.6 36.8 46 1945 18.01 16.1 10.19 11.4 31.83 46 1946 20.3 19.1 9.2 11.5 19.9 43 1947 21.39 20.5 9.47 12.0 38.60 41 1948 17.99 17.9 8.79 10.8 23.49 34 1949 16.45 16.7 9.17 11.7 24.48 32 After 1949 the actual Birth and Death Rates for Mitcham are modified by comparability factor to correspond with the average age and sex 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 1959 12.76 16.5 12.6 11.6 14.17 22.2 11 Infant Mortality During the year 12 deaths were registered of infants under one year of age:— Males Females Total Legitimate 5 7 12 Illegitimate — — — Total 5 7 12 as compared with 19 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 6 3 2 — — 1 1-7 days 5 3 — — 1 1 8 days - 1 mth. — — — — — — 1 mth.-12 mths. 1 — — — — 1 Total 12 6 2 — 1 3 Eleven infants failed to survive the first month of life, giving Mitcham a neo-natal mortality rate of 12.99 per 1,000 related live births as compared with 15.8 for England and Wales. Maternal Mortality During the year no deaths were registered, as in 1958. Inquests Inquests were held on 17 residents dying within the district and on 14 Mitcham residents who died outside the district, a total of 31. In addition, post-mortems without inquests were held on 83 residents 12 dying within the district, and on 62 Mitcham residents who died outside the district, a total of 145. The following table shows the results of the findings of these inquests:— Accidental death 12 Death from misadventure 4 Suicide 10 Open verdict 3 Homicide 2 Total 31 13 Deaths Registered During the Year 1959 Cause of Death Males Females Total 1 Tuberculosis, respiratory 1 1 2 2 Tuberculosis, other ... ... ... 3 Syphilitic disease 1 ... l 4 Diphtheria ... ... ... 5 Whooping cough ... ... ... 6 Meningococcal infections ... ... ... 7 Acute Poliomyelitis ... ... ... 8 Measles ... ... ... 9 Other infective and parasitic diseases 1 ... l 10 Malignant neoplasm, stomach 6 5 11 11 Malignant neoplasm, lung, bronchus 27 5 32 12 Malignant neoplasm, breast ... 25 25 13 Malignant neoplasm, uterus ... 4 4 14 Other malignant and lymphatic neoplasms 34 36 70 15 Leukaemia, aleukæmia 1 2 3 16 Diabetes 1 5 6 17 Vascular lesions of nervous system 22 51 73 18 Coronary disease, angina 93 56 149 19 Hypertension with heart disease ... 9 9 20 Other heart disease 24 40 64 21 Other circulatory disease 14 12 26 22 Influenza 2 5 7 23 Pneumonia 18 16 34 24 Bronchitis 42 16 58 25 Other diseases of respiratory system 6 1 7 26 Ulcer of stomach and duodenum 1 2 3 27 Gastritis, enteritis and diarrhoea 2 4 6 28 Nephritis and nephrosis 1 4 5 29 Hyperplasia of prostate 3 ... 3 30 Pregnancy, childbirth, abortion ... ... ... 31 Congenital malformations 3 1 4 32 Other defined and ill-defined diseases 17 24 41 33 Motor vehicle accidents 5 3 8 34 All other accidents 4 7 11 35 Suicide 7 4 11 36 Homicide and operations of war 1 1 2 All causes 337 339 676 14 Birth Rates, Death Rates, Analysis of Mortality and Notifications of Infectious Diseases in the Year 1959 England and Wales Mitcham Rates per 1,000 home population Births— Live 16.5 12.76 Still 0.35 0.19 121.0 13.97 Deaths— All causes 11.6 12.6 Malignant neoplasm—lung, bronchus 0.46 0.50 Whooping cough 0.001 ... Diphtheria ... ... Tuberculosis—all forms 0.08 0.03 Influenza 0.17 0.11 Acute Poliomyelitis 0.001 ... Pneumonia 0.59 0.53 Coronary disease—angina pectoris 1.87 2.31 Maternal mortality 0.38* ... Notifications (Corrected)— Scarlet Fever 1.05 1.07 Whooping Cough 0.73 0.26 Diphtheria 0.002 ... Measles 11.88 13.00 Acute Poliomyelitis— ... Paralytic 0.016 0.016 Non-Paralytic 0.006 ... Enteric or Typhoid Fever 0.003 ... Para-typhoid Fever 0.008 ... Meningococcal Infection 0.018 0.016 Erysipelas 0.070 0.062 Dysentery 0.784 0.16 Acute Encephalitis— Infective 0.003 ... Post-Infectious 0.003 ... Acute Pneumonia 0.59 0.34 Food Poisoning 0.11 0.42 Tuberculosis— Respiratory 0.54 0.40 Non-Respiratory 0.058 0.03 * Per 1,000 total dive 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.I. 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: MAL 7733). DISINFECTION The disinfection of houses is undertaken by the Council. Disinfection of bedding, etc., is done either at the Wandle Valley Isolation Hospital, or in the home. 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 1 Number of rooms disinfected by fumigator 45 Number of library books disinfected 494 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 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 may 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) There were some changes during the year. New Clinic.—The most important was the opening of the clinic at Wide Way which replaces that at Sherwood House which was too old and too small to cope with the increased population. Sessions actually commenced in October, 1959. 17 Physiotherapy Clinic.— For the first time in Mitcham a physiotherapy clinic under the Local Health Authority became available for the treatment of suitable cases referred by General Practitioners or Assistant Medical Officers. Formerly minor orthopaedic and other cases had to go to hospital for physiotherapy which was often a lengthy procedure. Child Guidance.— There used to be no clinic in Mitcham. With the availability of Sherwood House and an increasing number of cases, Sherwood House was adapted to give psychological and psychiatric treatment to children of all ages. It has the services of a psychologist, two part-time psychiatrists and a social worker. There are four sessions held weekly. Ante-Natal Clinics An ante-natal session is held at the Church Road Clinic every Tuesday, 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 Friday afternoon of the month. An ante-natal session is held at Wide Way Clinic on Friday mornings, and 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. Wide Way Clinic.—Every Thursday morning and Monday afternoon. Church Road Clinic.—Every Thursday afternoon and Wednesday afternoon. Meopham Road Clinic.—Every Wednesday afternoon. 18 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, Whooping Cough and Tetanus 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. 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. Wide Way Clinic.—Each Monday afternoon (immunisation only—in conjunction with Welfare Clinic), each Thursday morning (immunisation and vaccination in conjunction with Welfare Clinic), and each Wednesday morning. Poliomyelitis Immunisation A large number of sessions are held in schools and a large number on Saturday mornings and Tuesday evenings 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 19 under the supervision of a nurse; at Wide Way Clinic, with a doctor in attendance, on Wednesday mornings. Mothercraft Classes Wide Way Clinic.—Thursday, 2 p.m. Church Road Clinic.—Friday, 9.30 a.m. Ophthalmic Clinic An eye specialist attends Western Road Clinic on Thursday mornings and Wednesday afternoons, and Wide Way Clinic on the 1st, 3rd and 5th Tuesdays of the month, in the morning. Parentcraft Circle Church Road Clinic.—Monday, 3 p.m. Post-Natal Clinic The post-natal clinics at Church Road, Cavendish Road and Wide Way are now held in conjunction with the ante-natal clinics. Speech Clinic A session is held at Western Road Clinic on Tuesday (all day), and Thursday (all day). A speech therapist also holds a session at Wide Way Clinic on Friday afternoons. U.V. Radiation Clinics Sessions are held during the winter months, as follows: — Church Road Clinic.—Thursday mornings and Monday afternoons. Wide Way Clinic.—Tuesday afternoons, Friday afternoons. Day Nursery The Surrey County Council day nursery at Eagle House was closed during the year. There is now no day nursery in the Borough but, when necessary, children are found places in one of the Wimbledon or Merton and Morden nurseries or privately with child minders. 20 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. Over 80 parttime workers are usually employed. Enough workers can not be obtained to satisfy the full demand. 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 1959 48 Number of children affected 109 Number of visits paid 340 These figures include 91 visits paid to five problem family cases. 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 no cases in this category. 21 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 15 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. 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. 22 ERADICATION OF BED BUGS Number of Council houses found infested during the year, 30. Number of other houses found infested during the year, 11. Total number of houses disinfested during the year, 41. Methods employed:— 41 houses treated with insecticide spray. Number of houses disinfested of beetles, 101. Number of houses disinfested of other insects, 18. 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 Schools.—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. PREVENTION OF DAMAGE BY PESTS ACT, 1949 Two full-time and one part-time Rodent Operators were employed. Properties inspected 3,469 Complaints received 468 Number of treatments re rat infestation, including test baits, as result of inspection and complaints 874 Factory and business premises treated 104 Visits by Public Health Inspectors 80 23 One sewer maintenance treatment was carried out in the year; 60 manholes and two intercepting chambers were baited. A total of 10 baits were taken compared with 32 taken in 1958. 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 483 Nuisances found 339 Verbal Notices given 103 Verbal Notices complied with 81 Informal Notices served 229 Informal Notices complied with 148 Statutory Notices served 89 Statutory Notices complied with 82 Revisits 1,392 Houses inspected for defects 473 Visits made for this purpose 574 Drains tested and inspected 158 Private houses found verminous 6 Visits to butchers 176 Visits to slaughterhouses 806 Visits to dairies 21 Visits to retail milk shops 65 Visits to restaurant kitchens 292 Visits to ice-cream premises 50 Visits to bakehouses 50 Visits to other food premises 1,135 Number of notices served under Food Hygiene Regulations, 1955 8 Number of notices complied with 10 Visits to factories 342 Visits to workplaces 24 Visits to outworkers 59 24 Visits to stables 59 Visits to piggeries 41 Visits to caravan yards 87 Smoke observations 75 Visits re infectious disease cases 222 Visits re smallpox contacts 4 Visits re food poisoning 22 Visits re rats and mice 80 Visits re Shops Acts 208 Visits re schools 20 Visits re Rent Act, 1957 114 Visits to refuse tipping site, Mitcham Common 46 Visits re refuse chutes 42 Visits to sewage works 14 Sundry visits 261 Character of Work Done Roofs repaired 73 Rainwater piping or gutters repaired or renewed 63 Yards paved or repaired 13 Dampness remedied 77 Water service pipes repaired 12 Waterclosets: Repairs to structure 4 Flushing apparatus repaired or renewed 12 New pans and traps fitted 12 Water storage cisterns cleansed, repaired or renewed 7 Water supply reinstated 8 Flooring of rooms repaired and sub-floor ventilation improved 43 Rooms cleansed 17 Sinks and handbasins repaired or renewed 5 Waste pipes and traps repaired or renewed 18 Window frames and sashes repaired or renewed 41 Window sills repaired or renewed 23 External brickwork (repaired, pointed or rendered) 22 Drains repaired or obstructions removed 89 Drains inspection covers renewed 5 Drains tested 46 25 Grid and mica flaps provided 3 Firegrates repaired (including surrounds and hearths) 8 Stoves, coppers, ranges, etc., repaired 3 Chimney stacks repaired 6 Staircases repaired 7 Doors repaired 11 Internal plaster repairs 87 Sash cords renewed 39 Dustbins provided 27 Accumulations removed 16 All ponds and ditches in the Borough where mosquito breeding was likely were sprayed with insecticide during the year and larger areas where mosquitoes were found to be breeding but spraying was impracticable, were treated with a fog generating 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 Public Health Act, 1936.— Summonses were issued against the occupiers of two caravans on vacant land in Bath Road in respect of non-compliance with notices for the abatement of a statutory nuisance and a contravention of section 292 of the Public Health Act, 1936, but as both caravans were removed out of the Borough on the day that the summonses were issued, the summonses could not be proceeded with. Summonses were issued against the occupiers of three caravans on vacant land in Bath Road for contravening the provisions of section 269 of the Public Health Act, 1936. At the Hearing at Wallington on the 5th August the Court imposed a fine of £5 and awarded one guinea costs to the Council in each case. Summonses were issued against the occupiers of two caravans on vacant land in Bath Road for contravening the provisions of section 269 of the Public Health Act, 1936. At the Hearing on 7th January, I960, the Court imposed a fine of £5 with costs of two guineas to the Council in one case and a fine of £3 in the other case. 26 Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929.—98 licences to store petroleum spirit and/or petroleum mixtures were issued for a total of 252,874 gallons Cinclusive 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 123 lbs. Sausages 47 lbs. Fruit 47 „ Fish 12 stone Pig spleens 50 „ Dried fruit 54 pkts. Corned beef 60 „ Eggs 15 doz. Bacon 76 „ Meat pies 68 Pork luncheon meat 12 „ Assorted 229 tins Ham 33 „ Yours faithfully, K. J. GUTTERIDGE, Chief Public Health Inspector. HOUSING STATISTICS Total Number of Inhabited Houses—19,900. Permanent buildings built by the Council before the war—1,461. Permanent buildings built by the Council after the war—2,341. Other Housing Accommodation Available:— A. Sundry properties 157 B. Temporary buildings, Arcon bungalows 345 C. Hutments, 320 originally, now reduced to 26 Therefore, total number of properties used for housing by the Mitcham Borough Council is 4,330 Number of People Rehoused About 10,600 applicants have registered since 1945, and the current list is still about 1,300, so that some 9,300 applicants have been dealt with. 27 Housing Situation There is no longer any requisitioned property. A small amount of building is at present going on at the Gaston Road, Lactagol and Brenley sites. The ambitious Phipps Bridge development scheme, estimated at about £2½ million, is to go ahead and certain preliminary work has been put in hand involving the clearance of sites. Rent Act, 1957 Twenty-six applications were made for Certificates of Disrepair. In two cases it was decided not to issue a certificate, in 10 cases undertakings were given by the various landlords and in the remaining 14 cases certificates were issued. Twelve certificates were cancelled during the year on application by landlords, the works specified having been completed. INSPECTION AND SUPERVISION OF FOOD One thousand seven hundred and eighty-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 10 Cafe & General Stores 2 Groceries 81 Roadside Snack Bars 2 Butchers 33 Fishmongers 8 Greengrocer & Fruiterers 60 Fried Fish Buffets 7 Greengrocer & General Fried Fish 5 Provisions 2 Bakers and Confectioners 14 Confectionery 74 Milk & Provisions 12 Chemists 16 Public Houses 30 Restaurants & Cafes 32 Off-Licences 10 Food premises by type, registered under Section 16, Food and Drugs Act, 1955. The storage and sale of ice-cream 158 The manufacture for sale of ice-cream 1 The preparation or manufacture of sausages, or potted, pressed, pickled or preserved food 38 28 Dairies registered under the Milk and Dairies Regulations, 1949 1 Number of inspections of registered food premises during the year 312 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. Ninety formal samples were taken as follows:— Milk 47 Cheese and Tomato Spread 1 Redcurrant Jelly Jam 1 Pork Luncheon Meat 1 Margarine (10% Butter) 7 Rich Fruit Cake 1 Sultanas 1 Beef Sausages 2 Coconut Culinary Flavour 1 Cream 1 Meat Pudding 1 Ground Cinnamon 1 Pure Dairy Butter 5 Blackcurrant Jam 1 Beef Pudding 1 English Cheddar Cheese 1 Processed Peas 1 Indigestion Tablets 1 Mint in Vinegar 1 Toothache Tincture 1 Pork Sausage Meat 1 Fresh Shrimps Pure Lard 1 (Confectionery) 1 Pure Dripping 1 Lemonade Powder 1 Tablets of Aspirin 1 Table Jelly 1 White Pepper 1 Gravy Powder 1 Orange Squash 1 Jam Pudding (Plum) 1 Peeled Potatoes 1 Pork Sausages 1 Informal Samples Eighty-eight informal samples were taken as follows:— Batter and Pancake Mixture 1 Split Tin Loaf 1 Sponge Sandwich with Double Cream 1 Pure Butter Filling 1 Golden Glucose Syrup 1 Potted Crab with Butter 1 Mustard 1 Stoned Dates (Pasteurised) 1 Pure Ground Coffee 1 29 Red Salmon 3 Variety Cheese Spread 1 Peaches in Syrup 1 Cheese Spread with Shrimp 1 Butter Cake 1 Chicken and Veal Pie 1 Steak and Kidney Pie 2 Dried Fruit Mixture 1 Vienna Sausages 1 Mayonnaise 1 Tea Cakes Mixture 1 Chop Sauce 1 Celery Salt 1 Danish Cream 1 Coffee Cream Biscuit 1 Chicken and Mushrooms Sardines in Olive Oil 2 in White Sauce 1 Black Currants 1 Raspberries in Syrup 1 Process Cheese Spread Hamburgers in Rich Gravy 1 with Mushrooms 1 Instant Coffee 1 Cornish Fairings (Ginger) 1 Synthetic Cream Powder 1 Chocolate Sponge Mixture 1 Pork Sausages 1 Energen Orange 1 Casserole Steak 1 Sugarless Black Cherry Coffee 1 Preserve 1 Golden Oat Cereal 1 Gruyere Process Cheese 1 Cottage Cheese 1 Self Raising Flour 1 Instant Tea 1 Puff-kins (Breakfast Cereal) 1 Lemonade 1 Pure Dairy Cream 1 Orange Squash 1 Butter Crisps (Sugar Pears in Syrup 1 Confectionery) 1 Strawberry Jam 1 Pickled Red Cabbage 1 Tea 1 Stewed Steak 1 Garden Peas 1 Vegetable Juices 1 Non-Alcoholic Drink 1 High Protein Cereal 1 Processed Cheese 1 Ravioli in Tomato Sauce 1 Rice Pudding 1 Jellied Eels 3 Concentrated Essence 1 Cockles 2 Cheese Sandwich (Biscuits) 1 Whelks 2 Yeast Extract (Marmite) 1 Dairy Ice Cream 4 Milk Chocolate Mallows 1 Ice Cream 1 Frankfurter Sausages in Malt and Honey Fruit Loaf 1 Brine 1 Corned Beef 1 30% Bran Flakes 1 Chicken and Ham Horseradish Relish 1 Luncheon Meat 1 Lemon Juice 1 30 The following samples were not up to standard and warning letters were sent to the firms concerned:— Informal.—Pork luncheon meat, high protein Breakfast Cereal. Complaints from the public relating to food were as follows:— Three of mould in a loaf. Three of a dirty milk bottle. Two of mould in a meat pie. One each of:— Contaminated lemonade. Maggots in chocolate. A foreign body in a loaf. Maggots in dried fruit. A maggot in dried milk powder. A contaminated loaf. A "sour" loaf. A caterpillar in tinned tomatoes. Warning letters were sent to the firms concerned. Ice-Cream One establishment in the Borough is registered for the manufacture of ice-cream and 158 for the storage and sale of ice-cream. Fifty visits were paid during the year. Seven samples of ice-cream were taken and examined for bacteriological purity. The results are tabulated below:— Provisional Grade. I II III IV Coliforms absent 6 1 — — Coliforms present in l/10th ml — — — — Faecal coli present (in addition to above) — — — — Bacteriological Examination of Cups and Glasses Eighty-three swabs were taken from tea cups at various catering establishments and seventeen 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:— 31 Tea Cup Swabs. Colony Count (per cup). Coliforms Faecal Coli Result Satisfactory. Unsatisfactory. Present. Absent. Present. Absent. Under 100 2 66 — 2 68 — 100-200 2 1 1 1 — 3 200-500 5 — — 5 — 5 500-1,000 — 1 — — — 1 1,000-1,500 — 1 — — — 1 1,500-2,000 - - - - - - 2,000 and over 3 2 2 1 — 5 Total 12 71 3 9 68 15 Beer Glass Swabs. Colony Count Coliforms Faecal Coli Result Satisfactory. Unsatisfactory. (per glass). Present. Absent. Present. Absent. Under 100 — 13 — — 13 — 100-200 — 2 — — — 2 200-500 - - - - - - 500-1,000 1 — 1 — — 1 1,000-1,500 - - - - - - 1,500-2,000 - - - - - - 2,000 and over 1 — — 1 — 1 Total 2 15 1 1 13 4 The result of the swabs was sent to the establishments concerned and visits were paid to premises where the results were unsatisfactory. 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 39 Sterilised 49 Supplementary Licences— Pasteurised 15 Sterilised 16 32 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) 22 Supplementary Licences (Tuberculin Tested) 15 One hundred and sixty-three 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. Fifty visits have been paid. DAIRIES There is one registered dairy and pasteurising establishment within the district. During the year twenty-one visits of inspection were paid. SLAUGHTERHOUSES There are two licenced slaughterhouses in the borough; 806 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, three being licences to slaughter under supervision only. 33 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) 122 25 2798 3212 13,524 Number Inspected 122 25 2798 3212 13,524 All diseases except tuberculosis and cysticerci: Whole carcases condemned 1 1 2 ... 46 Carcases of which some part or organ was condemned 9 4 3 130 786 Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 8.19 20.0 0.18 4.05 6.15 Tuberculosis only: Whole carcases condemned ... ... ... ... 8 Carcases of which some part or organ was condemned. ... ... ... ... 56 Percentage of the number inspected affected with tuberculosis ... ... ... ... 0.47 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, 8. Number of notices complied with, 10. PIGGERIES There are 6 piggeries in the Borough. Fifty-nine visits were paid during the year. PET ANIMALS ACT, 1951 Four licences were issued to occupiers of pet shops. 34 FACTORIES ACT, 1937 I.—Inspections for purposes of provisions as to health (including inspections made by 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 13 15 ... ... 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 2 292 329 3 ... 2 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 3 ... ... ... ... 3 TOTAL ... 305 344 3 ... ... 35 2.—Cases in which defects were found:— Particulars M/c line No. Number of cases in which defects were found Number of cases in which prosecutions were instituted M/c line No. Found Remedied Referred To H.M. Inspector By H.M. Inspector (1) (2) (3) (4) (5) (6) (7) (8) Want of cleanliness (S.l) 4 1 1 ... ... ... 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 ... ... ... ... ... 10 (c) Not separate for sexes 11 ... ... ... ... ... 11 Other offences (not including offences relating to Homework) 12 3 3 ... ... ... 12 TOTAL ... 4 4 ... ... ... ... 36 3.—Outwork (Sections 110 and 111):— Nature of Work M/c line No. Section 110 Section 111 M/c line No. Number of out-workers in August list required by Sect. 110 (1) (c) Number of cases of default in sending lists to the Council Number of prosecutions for failure to supply lists Number of instances of work in unwholesome premises Notices served Prosecutions (1) (2) (3) (4) (5) (6) (7) (8) (9) Wearing apparel Making, etc. 13 44 13 Cleaning and washing 14 14 Household linen 15 2 15 Lace, lace curtains and nets 16 16 Curtains and furniture hangings 17 17 Furniture and upholstery 18 18 Electro-plate 19 19 File making 20 20 Brass and brass articles 21 21 Fur pulling 22 22 Iron and steel cables and chains. 23 23 Iron and steel anchors and grapnels 24 24 Cart gear 25 25 Locks, latches and keys 26 26 Umbrellas, etc. 27 27 Artificial flowers 28 28 37 3.—Outwork (Sections 110 and 111) continued:— Nets, other than wire nets ... 29 29 Tents 30 30 Sacks 31 31 Racquet and tennis balls ... 32 32 Paper bags ... 33 33 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 34 6 34 Brush making 35 35 Pea picking 36 36 Feather sorting 37 37 Carding, etc., of buttons, etc. 38 1 38 Stuffed toys 39 39 Basket making 40 40 Chocolates and sweetmeats 41 41 Cosaques, Christmas crackers, Christmas stockings, etc. 42 10 42 Textile weaving 43 43 Lampshades 44 10 44 TOTAL 73 38 PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASE NOTIFICATIONS The total number of confirmed notifications received during 1959 was 1,000. 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 222 Public Health Inspectors to smallpox contacts 4 Total 226 Rooms disinfected after infectious disease 45 39 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 ... 14 ... ... ... 1 ... ... ... ... ... ... 139 3 ... ... ... ... ... 157 February ... 12 ... ... ... 12 ... ... 2 ... ... ... 219 2 1 ... ... ... ... 248 March ... 13 ... ... ... 4 ... ... 5 ... ... ... 193 1 6 ... ... ... ... 222 April ... 5 ... ... 1 2 ... ... 1 ... ... ... 125 3 6 ... ... ... ... 143 May ... 8 ... ... 1 ... ... 1 1 ... ... ... 127 2 1 ... ... ... ... 141 June ... 2 ... ... ... 1 ... ... ... ... ... ... 32 1 1 ... ... ... ... 37 July ... ... ... ... ... ... ... ... ... ... ... ... 9 1 ... ... ... ... ... 10 August ... 4 ... ... 1 ... ... ... ... ... ... ... 2 ... 4 ... ... ... ... 11 September ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... 3 October ... 5 ... ... ... 1 ... ... ... ... ... ... ... 1 3 ... ... ... ... 10 November ... 6 ... ... ... 1 ... ... 1 ... ... ... ... 2 5 ... ... ... ... 15 December ... ... ... ... 1 ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... 3 Totals ... 69 ... ... 4 22 ... 2 10 1 1 ... 847 17 27 ... ... ... ... 1000 40 Infectious Disease Notifications, 1940/59 Disease 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 1959 Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 48 75 175 212 97 147 95 62 35 57 89 110 111 225 86 47 33 56 18 75 69 Diphtheria 36 72 25 42 10 63 32 4 ... 1 1 ... ... ... ... ... ... ... ... ... ... Typhoid Fever ... ... ... 1 ... 1 ... ... ... ... ... 1 ... ... ... 1 ... 1 ... ... ... Puerperal Pyrexia 2 2 6 3 5 8 6 9 3 ... 2 ... 13 23 11 3 1 ... ... ... ... Meningococcal 13 12 6 8 3 3 1 2 1 1 ... 1 3 1 ... 2 ... 1 ... ... 1 Infections Erysipelas 17 19 7 22 13 16 25 9 18 6 12 7 8 14 11 6 9 7 4 3 4 Measles 301 194 599 651 112 739 358 533 818 252 354 354 1386 591 888 131 1059 50 1358 172 847 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Poliomyelitis: Paralytic ... ... ... ... ... 2 3 11 2 2 6 2 1 4 4 ... 4 5 2 ... 1 Non-Paralytic ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 8 1 ... ... Ophthalmia 1 3 10 4 4 ... 2 2 6 3 8 2 l 4 ... 1 ... ... ... ... 2 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 22 Malaria ... ... ... 1 1 ... 1 ... 1 ... ... ... ... 1 ... 1 ... ... ... ... ... Whooping Cough 16 186 161 162 166 96 234 216 117 149 212 387 420 112 336 183 167 103 130 45 17 Food Poisoning 4 6 11 ... ... 5 1 ... ... ... 6 3 4 10 17 12 8 11 4 9 27 Dysentery ... ... ... 4 67 13 6 1 2 5 7 16 7 16 15 46 17 60 47 8 10 Paratyphoid ... ... ... ... ... ... 1 2 ... ... ... ... 1 ... ... 1 ... 1 ... 1 ... Totals 468 591 1021 1161 515 1126 807 888 1033 490 717 911 1980 1027 1396 450 1335 322 1590 325 1000 41 Smallpox No case of smallpox was notified during the year 1959. The last case was in 1932. Scarlet Fever The number of cases of scarlet fever notified during the year was 69 as compared with 75 in 1958, equivalent to a case rate of 1.07 per 1,000 population. This disease has continued mild in character. Of the total number of cases notified three were treated in hospital and 66 were treated at home. Diphtheria No case of diphtheria was notified for the tenth year in succession and only two in the past thirteen 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 592 53 645 Five to fourteen years 68 1,356 1,424 Totals 660 1,409 2,069 42 The following figures show the number of the child population considered immunised at 31st December, 1959:— Age at 31.12.59, i.e. born in year Under 1 1959 1 to 4 1958-1955 5 to 9 1954-1950 10 to 14 1949-1945 Under 15 Total Last complete course of injections (whether primary or booster) A. 1955-1959 237 2490 3062 3863 9652 B. 1945-1954 — — 742 1464 2206 C. Estimated mid-year child population 842 3492 10161 14495 Immunity Index 100 A/C 28.15 71.31 68.16 66.59 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 or the triple tetanus, diphtheria, whooping cough antigen):— Age at date of final injection (as regards A) or of re-inforcing injection (as regards B) Total Under 1 1 2 3 4 5 to 9 10 to 14 A. Number of children who completed a course of inoculation with pertussis vaccines (including combined vaccines) 575 72 21 15 9 9 2 703 B. Number of children who received a secondary (reinforcing) injection during 1959 — 1 — 5 40 41 5 92 43 Poliomyelitis There was one case of mild paralytic poliomyelitis during the year, the first since September, 1957. The immunisation campaign was undoubtedly responsible for the diminishing number of cases. For England and Wales the number of cases goes down considerably year by year and even week by week. Polio Vaccination The scheme was once again extended and now includes all up to 40 years of age. Numbers vaccinated in 1959 Primary courses Third injections Children 3,049 7,577 Adults 3,516 1,214 The total number inoculated since the inception of the scheme is 15,613, which includes 12,635 children or 80.7 per cent. of the estimated child population. The response from the group age 25 to 40 was very poor at first. As a result of the anti-polio campaign there was a temporary increase which soon subsided, making this the least responsive of all groups. Enteric Fever There were no cases of enteric fever during the year. Diarrhœa and Enteritis Under Two Years of Age No death was registered during the year. Food Poisoning Outbreaks There were 27 notified cases in 1959 and a further 37 cases resulting from an outbreak in a factory. Of the 27 notified cases there were four family outbreaks involving a total of 13 people and 14 single cases. The illness was caused by S. Typhimurium in three cases, S. Bredeney in one case, S. Anatum in one case and, in the case of the factory outbreak, by C1. Welchii. In the remaining 22 cases the cause was not known. The factory outbreak was found to be due to infected meat but in all other cases the source could not be ascertained. 44 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 Twenty-two 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 34, of which 18 were males and 16 females. Meningococcal Infections One case was notified during the year. Influenza During the year seven deaths were recorded, as against three the year before. Ophthalmia Neonatorum During the year two cases of ophthalmia neonatorum were 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:— 45 Chicken pox 79 Mumps 22 Ringworm — Rubella 133 Impetigo 1 Jaundice 5 Influenza 297 Glandular fever 1 Cancer The number of deaths from cancer registered during the year was 145, of which 68 were males and 77 females. The trend for England and Wales is continuing upwards. The site distribution for 1959 was as follows:— Digestive organs 11 cases Respiratory organs 32 „ Breast 25 „ Genito-urinary organs 4 „ Other sites 73 „ Total 145 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. 1940 94 1.55 1.66 1941 84 1.6 1.67 1942 104 1.90 1.698 1943 95 1.7 1.74 1944 83 1.6 1.7 1945 103 1.91 1.74 1946 108 1.74 1.76 1947 103 1.60 1.86 1948 111 1.67 1.85 1949 124 1.85 1.87 1950 102 1.51 1.89 46 Year. Number of Deaths. Death Rate per 1,000 of population Mitcham. England and Wales. 1951 108 1.61 1.90 1952 128 1.91 1.94 1953 129 1.94 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 1959 145 2.25 2.14 Tuberculosis During the year 28 new cases of tuberculosis were notified, viz:— Males Females  Pulmonary 17 9 26 Non-Pulmonary 1 1 2 Totals 18 10 28 Thirty-six cases were transferred into the Borough as follows:— Males Females Total Pulmonary 17 16 33 Non-Pulmonary 2 1 3 Totals 19 17 36 The total number of deaths from tuberculosis was:— Males Females Total Pulmonary 1 1 2 Non-Pulmonary — — — Totals 1 1 2 England and Wales. Mitcham. Death rate from tuberculosis, all forms, per 1,000 population 0.08 0.03 47 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 „ ... ... ... ... ... ... ... ... 10 „ „ 14 ... ... 1 ... ... ... ... ... 15 „ „ 19 ... 3 ... ... ... ... ... ... 20 „ „ 34 4 2 ... ... ... 1 ... ... 35 „ „ 44 ... ... ... ... ... ... ... ... 45 „ „ 64 „ 8 2 ... ... ... ... ... ... 65 „ and upwards 5 1 ... ... 1 ... ... ... Totals 17 9 1 1 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 ... ... ... ... ... ... ... ... ... ... ... ... ... Nil Pulmonary Females ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Non-Pulmonary: Males ... ... ... ... ... ... ... ... ... ... ... ... ... Nil Non-Pulmonary: Females ... ... ... ... ... ... ... ... ... ... ... ... ... Nil 48 The sources from which information as to the above-mentioned cases was obtained are as follows:— Number of Cases Pulmonary NonPulmonary Death Returns (a) From Local Registrar ... ... (b) Transferable deaths from Registrar General ... ... Posthumous notifications from doctors 1 ... The percentage of non-notified tuberculosis deaths (i.e., new cases coming to the knowledge of the Medical Officer of Health after death of the case) is nil. Non-notified tuberculosis deaths Nil Total tuberculosis deaths 2 Miniature Mass Radiography A mass radiography unit visits Mitcham nearly every year and is granted the free use of the Vestry Hall (Town Hall). In 1959 the unit was in Mitcham from January 13th to February 2nd. The following summary was supplied by the Medical Director of the unit, Dr. F. J. H. Walters:— Male Female Total number examined 1,889 1,829 Pulmonary tuberculosis (active) 4 2 Primary lung cancer 5 — The main non-tuberculous abnormalities revealed were abnormal heart conditions, bacterial and virus infections of the lung and pulmonary fibrosis. The above figures do not apply to Mitcham residents only as the service is open to anyone, resident or not. The examination is of value in the early diagnosis and treatment of pulmonary tuberculosis and non-tuberculous abnormalities. 49 Mitcham, Beddington and Wallington Care Committee for Tuberculosis and Diseases of the Chest Functions of the Committee 1. To alleviate want or distress amongst those suffering from tuberculosis and diseases of the chest, 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. 50 INDEX PAGE Abortion, Deaths 8, 13 Ambulances 15 Ante-Natal Clinics 17 Area 7 Bacteriological Examination of Cups and Glasses 30, 31 Bakehouses 32 Bed Bugs, Eradication of 22 Bedding, Disinfection of 15 Birth Rates 8, 10, 14 Births, Illegitimate 8 — In Institutions 9 — Live 8 — Still 8 Blindness, Prevention of 44 Cancer 45, 46 — Deaths from9, 45, 46 Caravans 20 Causes of Deaths 9, 11-14 Chief Public Health Inspector's Report 23-26 — — Inspector, Visits by 23, 24 Clean Air Act 21 Cleansing, Public 21 Clinics 16-19 Closet Accommodation 21 Committees, Health, Members of 5 Dairies 32 Day Nursery 19 Death Rates 8, 10, 11, 14 Deaths 8-14 Dental Clinics 18 Diarrhoea and Enteritis 9, 43 Diphtheria 41 Diphtheria Immunisation 41, 42 — — Clinics 18 Disinfection 15, 38 51 PAGE Encephalitis Lethargica 44 Enteric Fever 43 Erysipelas 44 Factories Act, 1937 34-37 — — — Defects found 35 — — — Inspections 34 — — — (Sections 110 and 111) Outwork 36, 37 Food and Drugs Act, 1955 28-30 — — — — Section 16 27, 28 — Hygiene Regulations, 1955 33 — Dealt with, Unsound 26 — Inspection and Supervision of 27-32 — Preparing Factories 33 — Poisoning 43 — — Case Rates 14 — Sampling 28-30 General Provision of Health Services for the Area 15-20 Health Visiting 19 Home Help Service 20 Hospitals 15, 16 Houses, Disinfection of 15 — Inhabited 7, 26 Housing Statistics 26 Ice Cream 30 Immunisation and Vaccination Clinics 17, 18 — Diphtheria 41, 42 — Poliomyelitis 43 — Whooping Cough 42 Infant Mortality 8, 10, 11 Infectious Disease Case Rates 14 — — Contacts 38 — — Hospitals 16 — — Monthly Incidence of 39 — — Notifications 38-41, 43, 44 — — — School 44, 45 — — Public Health Inspectors' Visits 38 Influenza 44 52 PAGE Inquests 11, 12 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 33 Meningococcal Infection 44 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 and 1950 31 Milk (Special Designation) (Raw Milk) Regulations 1949 and 1950 32 Mortality, Analysis of 14 National Assistance Act, 1948, Section 47 20 N.S.P.C. 20 Neonatal mortality 11 Ophthalmia Neonatorum 44 Outworkers (Sections 110 and 111—Factories Act, 1937) 36, 37 Persons in Need of Care and Attention 20 Pests Act, 1949, Prevention of Damage by 22, 23 Pet Animals Act, 1951 33 Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929 26 Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum Carbide of Calcium Order, 1929 26 Piggeries 33 Pneumonia 44 Poliomyelitis 43 Population Post-Natal Clinics 18 Public Cleansing 21 Puerperal Pyrexia 44 Public Analyst 15 Radiography, Miniature Mass 48 Rateable Value 53 PAGE Rent Act, 1957 27 Rivers and Streams 21 Rodent Operations 22, 23 Rooms Disinfected, Number of 15, 38 Sanitary Circumstances of the Area 21 Scarlet Fever 41 Schools 22 Slaughterhouses 32 Slaughter of Animals Act, 1933 to 1958 32 Smallpox 41 — Vaccination Clinics 18 — Hospital 16 Social Conditions 7, 8 Staff 6 Statistics 7-14 — Housing 26 — Vital 14 Still Births 8 Tuberculosis 46-48 — Care Committee 49 — Clinic 16 Unsound Food dealt with 26 Venereal Disease Clinic 16 Visits by Public Health Inspectors 23-25, 38 Water Supply 21 Welfare Clinics 16-19 Whooping Cough, Deaths from 9, 13, 14 — — Immunisation 18, 42