AC 4413(1) MIT 31 Library BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1962 BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1962 MITCHAM H. G. Mather, Ltd., Caxton Works, Lower Green 3 Borough of Mitcham HEALTH REPORT FOR 1962 To the Mayor, Aldermen and Councillors. Mr. Mayor, Ladies and Gentlemen, I have much pleasure in submitting my annual report for the year 1962. The general health in the Borough has been good and there was no special outbreak of infectious disease. The notifications of infectious diseases, at 271 compared with 960 in 1961, were the lowest since measles became a notifiable disease in 1940. The decrease was due mainly to its low incidence which was at its biennial ebb and to the small number of whooping cough notifications, which keeps on decreasing. There was one case of poliomyelitis, but it came from another area. It was the second notification since 1957. Whooping cough notifications at 16 were the lowest since notification began. The outbreaks of smallpox, brought in from Pakistan, which started in several areas of England and Wales in 1961, led to a widespread request for vaccination, but as there were no cases in this area the Ministry did not recommend general vaccination. The high smallpox vaccination rate for infants in Mitcham was maintained although the total number vaccinated was slightly less owing to the fact that babies are now being vaccinated later. The vaccination rate for children 1-4 years old is 73 per cent, compared with about 41 per cent, for England and Wales. Mitcham has probably the most highly vaccinated child population of any borough of its size 4 and more than any county borough whose records are submitted to the Ministry of Health. Last year the figures for ordinary immunisation, mostly with the triple antigen, against diphtheria, whooping cough and tetanus, amounted to about 80 per cent, of all children up to one year of age, again a very high rate. The tuberculosis death rate at 0.06 compares with 0.07 per 1,000 population for England and Wales. Notifications were 22 compared with 21 for the previous year. Ten years ago there were more than 100 each year. Dysentery was notified in eight cases as against 1 for 1961. The figure for this disease is very variable. There were no cases of enteric fever. The birth rate of 14.70 per 1,000 population compares with 18 for England and Wales. The crude death rate of 10.40 compares with 11.9 for England and Wales. It is generally below that of England and Wales. The death rate from cancer for Mitcham in 1962 was 2.23 while that for England and Wales was 2.19 per 1,000 population. Deaths from lung cancer however, increased from 0.61 to 0.77 per 1,000 population compared with 0.51 for England and Wales. As regards infant mortality the local rate was 14.94 and the rate for England and Wales, 20.7 per 1,000 live births, the lowest ever recorded. The Home Safety Committee participated in various National Safety Weeks and also organised a Home Safety Competition for the schoolchildren in the Borough which had about 2,000 entries. The Meals-on-Wheels service, run by the W.V.S., continued to supply meals on four days a week to the housebound and to old age pensioners at the London Road Old People's Welfare Club. Clean Air Act.— The first area, which is in the Pollards Hill region, has been inspected and details submitted to the Minister of 5 Housing and Local Government. The Minister has approved the scheme and the area becomes a smoke control area on 1st December, 1963. 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 Gendemen, Your obedient servant, A. R. GRAHAM, Medical Officer of Health. Public Health Department, Mitcham Court, Mitcham. 6 BOROUGH OF MITCHAM PUBLIC HEALTH COMMITTEE Chairman - Alderman G. W. Pearce, J.P. His Worship the Mayor (Alderman C. A. Norris, J.P.) Aldermen— Mrs. L. Crump (Vice-Chairman) E. J. Mills Councillors— E. E. Field A. S. Hutchin Mrs. J. E. Vowles J. W. Overy D. A. Small Mrs. J. E. Spalding H. R. Veal Representatives of the Council on Other Authorities : WANDLE VALLEY JOINT SEWERAGE BOARD His Worship the Mayor (Alderman C. A. Norris, J.P.) (ex-officio) Councillors— D. J. Hempstead R. E. Roberts W. Lancaster NORTH-EAST DIVISIONAL HEALTH SUB COMMITTEE (SURREY COUNTY COUNCIL) Aldermen— G. W. Pearce, J.P. Mrs. L. Crump Councillors— A. S. Hutchin H. R. Veal Mrs. J. E. Spalding 7 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) Additional Public Health and Meat Inspector, deputising for Chief Inspector G. E. Hayne (1, 2, 3) Additional Public Health and Meat Inspectors L. Gleed (1, 2, 3) J. E. Higgs (1, 2) E. J. Sluis (1, 2) Pupil Public Health inspector C. S. Smith 1. Certificate R.S.H. and Public Health Inspectors' Examination Joint Board. 2. Certificate Meat and Foods R.S.H. 3. Smoke Inspector's Certificate. Clerks (a) Chief Clerk and Administrative Assistant— F. H. White (6) Senior Clerk— F. G. Taylor (c) Secretary— Miss V. I. Hill (d, f) Mrs. M. Drewett (e, f) Miss V. Tucker (f) Mrs. K. North (a) 75 per cent. Surrey County Council duties. (b) 25 per cent. Surrey County Council duties. (c) 20 per cent. Surrey County Council duties. (d) Resigned 30th January, 1962. (e) Commenced 26th February, 1962. (f) 40 per cent. Surrey County Council duties. 8 REPORT STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 2,932 acres Population, Census 1921 35,119 „ 1931 56,856 „ 1951 67,269 „ 1961 63,653 Registrar-General's estimate of population mid-year, 1962 63,660 Density of Population, 1961 21.4 persons per acre Number of inhabited houses, 1921 7,150 „ 1931 13,187 „ 1962 20,339 Rateable Value, 1962 £ 1,136,289 Sum represented by a Id. rate £4,600 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, dairy products, and confectionery. In 1962 employment was high till the latter half, when there was a slackening demand due to a slower economic tempo. 9 For skilled engineering and allied occupations there was a continuing demand, but for others an increase in unemployment rising towards the end of the year. Work on the Phipps Bridge Estate is proceeding satisfactorily and at the end of the year, the first stage comprising 84 dwellings, a laundry and a boiler house, had been completed and occupied. Three areas have been inspected with a view to further slum clearance and proposals submitted to the Ministry. Confirmation had not been received at the end of the year. STATISTICS Live Births. Total Male Female Rate per 1,000 of population Legitimate 896 488 408 Illegitimate 40 22 18 Total 936 510 426 14.70 After correction by the comparability factor becomes 14.41 Illegitimate live births per cent, of total live births 4.27 Still Births. Total Male Female Rate per 1000 total births Legitimate 19 12 7 Illegitimate — — — Total 19 12 7 19.90 Deaths Total Male Female Rate per 1,000 of population 662 370 292 10.40 After correction by the comparability factor becomes 12.37 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 14.94 Legitimate infants per 1,000 live legitimate births 15.85 Illegitimate infants per 1,000 live illegitimate births Nil 10 Deaths from:— Cancer (all ages) 142 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 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 1960 971 704 72.5 1961 934 690 73.87 1962 955 683 71.5 11 The birth rates, death rates per 1,000 of population, and the nfant mortality rates for the years 1943-1962 are shown in the ollowing 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 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 1960 14.42 17.1 11.12 11.5 22.26 21.9 1961 14.26 17.4 12.06 12.0 18.32 21.6 1962 14.41 18.0 12.37 11.9 14.94 20.7 12 Infant Mortality During the year 14 deaths were registered of infants under one year of age: — Males Females Total Legitimate 13 1 14 Illegitimate — — — Total 13 1 14 as compared with 17 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 Cause of Death No. Prematurity Congenital Defects Accidents of birth Infectious conditions Other conditions Under 24 hrs 7 3 3 1 — — 1-7 days 4 2 1 — — 1 8 days - 1 mth. 1 — 1 — — - 1 mth.-12 mths. 2 — — — 1 1 Total 14 5 5 1 1 2 Twelve infants failed to survive the first month of life, giving Mitcham a neo-natal mortality rate of 12.8 per 1,000 related live births as compared with 15.1 for England and Wales. Maternal Mortality For the seventh successive year, no deaths were registered. Inquests Inquests were held on 20 residents dying within the district and on 9 Mitcham residents who died outside the district, a total of 29. In addition, post-mortems without inquests were held on 86 residents 13 dying within the district, and on 40 Mitcham residents who died outside the district, a total of 126. The following table shows the results of the findings of these inquests:— Accidental death 11 Death from misadventure 1 Suicide 13 Natural causes 2 Resulting from the operations of war 1 Open verdict 1 Total 29 14 Deaths Registered During the Year 1962 Cause of Death Males Females Total 1 Tuberculosis, respiratory 4 ... 4 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 1 1 2 10 Malignant neoplasm, stomach 8 7 15 11 Malignant neoplasm, lung, bronchus 43 6 49 12 Malignant neoplasm, breast ... 20 20 13 Malignant neoplasm, uterus ... 4 4 14 Other malignant and lymphatic neoplasms 33 19 52 15 Leuksemia, aleukaemia 1 1 2 16 Diabetes 1 1 2 17 Vascular lesions of nervous system 22 35 57 18 Coronary disease, angina 105 66 171 19 Hypertension with heart disease 2 4 6 20 Other heart disease 26 40 66 21 Other circulatory disease 14 18 32 22 Influenza ... 1 1 23 Pneumonia 18 21 39 24 Bronchitis 34 10 44 25 Other diseases of respiratory system 2 1 3 26 Ulcer of stomach and duodenum 2 1 3 27 Gastritis, enteritis and diarrhoea 2 2 4 28 Nephritis and nephrosis 2 3 5 29 Hyperplasia of prostate 10 ... 10 30 Pregnancy, childbirth, abortion ... ... ... 31 Congenital malformations 3 1 4 32 Other defined and ill-defined diseases 22 18 40 33 Motor vehicle accidents 2 2 4 34 All other accidents 5 4 9 35 Suicide 6 6 12 36 Homicide and operations of war 1 ... 1 All causes 370 292 662 15 Birth Rates, Death Rates, Analysis of Mortality and Notifications of Infectious Diseases in the Year 1962 England and Wales Mitcham Rates per 1,000 home population Births— Live 18.0 14.41 Still 0.33 0.30 18.1* 19.90* Deaths— All causes 11.9 12.37 Malignant neoplasm— lung, bronchus 0.51 0.77 Whooping cough ... ... Diphtheria ... ... Tuberculosis— all forms 0.07 0.06 Influenza 0.07 0.015 Acute Poliomyelitis ... ... Pneumonia 0.66 0.61 Coronary disease— angina pectoris 2.20 2.69 Maternal mortality 0.35* ...* Notifications (Corrected)— Scarlet Fever 0.33 0.53 Whooping Cough 0.18 0.25 Diphtheria ... ... Measles 3.96 3.13 Acute Poliomyelitis— Paralytic 0.005 0.016 Non-Paralytic 0.001 ... Enteric or Typhoid Fever 0.003 ... Para-typhoid Fever 0.003 ... Meningococcal Infection 0.012 0.016 Erysipelas 0.38 0.094 Dysentery 0.66 0.13 Acute Encephalitis— Infective 0.002 ... Post-Infectious 0.002 ... Acute Pneumonia 0.27 0.05 Food Poisoning 0.11 0.016 Tuberculosis— Respiratory 0.39 0.28 Non-Respiratory 0.05 0.06 * Per 1,000 total (live and still) births. 16 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 38 Number of library books disinfected 381 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. 17 General Cases.— The principal hospitals are the Wilson Hospital, which is situated within the district, and the St. Helier Hospital, Carshalton, which caters for all types of cases. The Nelson Hospital at Merton and the London hospitals are also used. Infectious Diseases.— Cases usually go to the Wandle Valley Isolation Hospital at Beddington Corner, Mitcham Junction, or to St. Georges Hospital, Tooting. Smallpox Cases.— By agreement with the South-East Metropolitan Regional Hospital Board, any cases that might 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 morning, and a clinic for cases booked by midwives is held on Tuesday afternoons. 18 Ante-natal supervision for some St. Helier bookings is undertaken at Mitcham clinics. An ante-natal session is held at the Cavendish Road Clinic every Friday afternoon. 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 and Friday morning. 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. 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. Child Guidance Clinic This is held on four days a week, at Sherwood House, by appointment. It has the services of a psychiatrist, a psychologist and a social worker. 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. 19 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, Tetanus and Poliomyelitis 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.— Second and fourth Mondays of the month in the afternoon. 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 Special clinics are not required now. Practically all poliomyelitis immunisation is by oral vaccine at ordinary clinics. 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 Wide Way Clinic on Wednesday mornings, with a doctor in attendance. Mothercraft Classes Wide Way Clinic.— Thursday, 2 p.m. Church Road Clinic.— Friday, 9.30 a.m. Cavendish Road Clinic.— Thursday, 2 p.m. 20 Ophthalmic Clinic An eye specialist attends Western Road Clinic on Thursday mornings and Wednesday afternoons, and Wide Way Clinic on Tuesday mornings. 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 held in conjunction with the ante-natal clinics. Speech Clinic A session is held at Western Road Clinic on Tuesday (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. Health Visiting Health Visitors are under the control of the Surrey County Council. There are nine Health Visitors, who are under the supervision of a Divisional 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 90 parttime workers are usually employed. Enough workers cannot be obtained to satisfy the full demand although we are not far short. A Neighbourly Help scheme was started during the year since when some old people become infirm, the help of a neighbour who is at hand may save the necessity for removal to hospital. 21 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 1962 ... 57 Number of children affected 153 Number of visits paid 444 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 one case in this category and an Order was obtained for the removal of the person concerned and detention in a County Council welfare establishment for three months. As the person concerned accepted the situation it was not necessary to apply for an extension of the Order. 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 22 caravans. 22 The standard of purity of the water was maintained at the usual high level. There is no record in the Borough 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. SWIMMING BATHS Eleven samples from the Alfred Mizen school swimming baths and 13 from the Corporation baths were sent for bacteriological examination during the year. All were satisfactory. 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 In the winter a weekly collection of house refuse is carried out and in the summer more frequently. Eleven refuse collection vehicles are in use. CLEAN AIR ACT, 1956 During the year staff were engaged and work commenced on Smoke Control. A house to house inspection has been made of the first area which will be declared a smoke control area on 1st December, 1963. ERADICATION OF BED BUGS Number of Council houses found infested during the year, 7. Number of other houses found infested during the year, 4. Total number of houses disinfested during the year, 11. 23 Methods employed:— Eleven houses treated with insecticide spray. Number of houses disinfested of beedes, 57. Number of houses disinfested of other insects, 26. 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 4,157 Complaints received 694 Number of treatments re rat infestation, including test baits, as result of inspection and complaints 1,118 Factory and business premises treated 156 Visits by Public Health Inspectors 178 Two sewer maintenance treatments were carried out in the year; 306 manholes were baited. A total of 61 baits were taken compared with 47 taken in 1961. 24 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 473 Nuisances found 358 Verbal Notices given 154 Verbal Notices complied with 103 Informal Notices served 182 Informal Notices complied with 122 Statutory Notices served 45 Statutory Notices complied with 51 Revisits 1,523 Houses inspected for defects 460 Visits made for this purpose 470 Drains tested and inspected 155 Private houses found verminous 11 Visits to butchers 183 Visits to slaughterhouses 460 Visits to dairies 24 Visits to retail milk shops 43 Visits to restaurant kitchens 307 Visits to ice-cream premises 52 Visits to bakehouses 48 Visits to other food premises 1,240 Number of notices served under Food Hygiene Regulations, 1955 16 Number of notices complied with 16 Visits to factories 307 Visits to workplaces 26 Visits to outworkers 86 Visits to stables 55 Visits to piggeries 29 Visits re poliomyelitis survey 115 25 Visits re Smoke Control 293 Visits to caravan yards 48 Smoke and noise observations 87 Visits re infectious disease cases 123 Visits re smallpox contacts 6 Visits re food poisoning 17 Visits re rats and mice 178 Visits re Shops Acts 56 Visits re schools 11 Visits re Rent Act, 1957 94 Visits to sewage works 14 Sundry visits 546 Character of Work Done Roofs repaired 60 Rainwater piping or gutters repaired or renewed 49 Yards paved or repaired 5 Dampness remedied 61 Water service pipes repaired 4 Waterclosets: Repairs to structure 8 Flushing apparatus repaired or renewed 13 New pans and traps fitted 11 Water storage cisterns cleansed, repaired or renewed 2 Water supply reinstated 5 Flooring of rooms repaired and sub-floor ventilation improved 32 Rooms cleansed 19 Sinks and handbasins repaired or renewed 16 Waste pipes and traps repaired or renewed 10 Window frames and sashes repaired or renewed 13 Window sills repaired or renewed 16 External brickwork (repaired, pointed or rendered) 24 Drains repaired or obstructions removed 74 Drains inspection covers renewed 21 Drains tested 28 Grid and mica flaps provided 4 Firegrates repaired (including surrounds and hearths) 12 Stoves, coppers, ranges, etc.; repaired 1 26 Chimney stacks repaired 11 Staircases repaired 4 Doors repaired 7 Internal plaster repairs 58 Sash cords renewed 11 Dustbins provided 29 Accumulations removed 27 All ponds and ditches in the Borough where mosquito breeding was likely were sprayed with insecticide twice 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 Noise Abatement Act, 1960.— Legal proceedings were instituted, under the above Act, against a street vendor for sounding loudspeaker chimes on an ice-cream vehicle outside the permitted hours. At the hearing on 5th July the defendant pleaded guilty and was fined £2 with £2 2s. costs. Food and Drugs Act, 1955.— Legal proceedings were instituted, under the above Act, against a firm of bakers in respect of a case of bird droppings in a loaf of bread. At the hearing on 29th November the defendants pleaded guilty and were fined £50 with £5 5s. costs. PETROLEUM LICENCES Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929.— One hundred and five licences to store petroleum spirit and/or petroleum mixtures were issued for a total of 261,573 gallons (inclusive of cellulose solutions). Petroleum (Carbide of Calcium) Order, 1929.— Two licences were issued for the storage of 1,224 lbs. of carbide of calcium. 27 Unsound Food Dealt With Beef 44 lbs. Ham 102 „ Corned beef 162 „ Luncheon meat 12 „ Lamb 42 „ Jellied veal 4 „ Ox tongue 10 „ Fish 45 „ Yours faithfully, K. J. GUTTERIDGE, Chief Public Health Inspector. HOUSING STATISTICS Total Number of Inhabited Dwellings— 20,339 The total number of housing properties now owned by the Council is 4,407 including 345 temporary dwellings. This year saw the completion and occupation of the first 84 dwellings of the most ambitious housing scheme yet undertaken by this Council. The scheme provides for an eventual total of 776 houses, flats and maisonettes, heated from a central oil fired boiler installation and provided with a communal laundry. Included in the scheme will be 245 one-bedroomed flats, a proportion of which will be designated for occupation by elderly persons. In addition to the above a small scheme of six elderly persons' flats was completed and let. During the year, 124 families were rehoused from the waiting list, leaving 1,292 applications on the register at the end of the year. Rent Act, 1957 Fourteen applications were made for Certificates of Disrepair during the year. In 12 cases undertakings were given by the various landlords and in the remaining two cases certificates were issued. Two certificates were cancelled during the year on application by landlords, the works specified having been completed. 28 INSPECTION AND SUPERVISION OF FOOD One thousand eight hundred 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 15 Cafe & General Stores 1 Groceries 84 Roadside Snack Bars 2 Butchers 41 Fishmongers 10 Greengrocer & Fruiterers 57 Fried Fish Buffets 8 Greengrocer & General Fried Fish 3 Provisions 2 Bakers and Confectioners 17 Confectionery 75 Milk & Provisions 12 Chemists 15 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 179 The manufacture for sale of ice-cream 2 The preparation or manufacture of sausages, or potted, pressed, pickled or preserved food 44 Dairies registered under the Milk and Dairies (General) Regulations, 1959 1 Number of inspections of registered food premises during the year 302 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. Forty-four formal samples were taken as follows: — Milk 38 Pork Sausages 1 Polony 1 Saveloys 1 Pure Dairy Butter 1 Pork Luncheon Meat 1 Colonial Cheddar Cheese 1 29 Informal Samples. One hundred and eleven informal samples were taken as follows: — Corned Beef Loaf 1 Pure Malt Vinegar 1 Mushroom Ketchup 1 Vienna Sausages 1 Chocolate Sponge Mix 1 Spaghetti Bolognese 1 Spaghetti in Tomato Sauce with Cheese 1 "Mystery" tins 3 Calves Foot Jelly (Lemon Flavour) 1 Royal Sunny Spread 1 Mushroom Soup 1 Pilchards in Tomato 1 Chopped Cured Pork 1 Seeded Arcadian Raisins 1 Seafood Dressing 1 Vanilla Flavour Dessert 1 Corned Beef 2 Luncheon Meat Loaf 1 Steak Cutlets in Meat Gravy 1 Cohoe Fancy Salmon Steak 1 Sweetened Sponge Mix 1 Chocolate Dessert Powder 1 Sultanas 1 Machine Skimmed Condensed Milk 2 Bubble Gum 1 Irish Stew 1 Pure Butter 1 Evaporated Milk 1 Dramal (Food Concentrate) Chocolate Flavoured 1 Quick Gel (Jelly) Lemon 1 Pure Malt Vinegar with Caramel 1 Bread Sauce 1 Shredded Beef Suet 1 Sauce Tartar 1 Cooking Oil 1 Tomato Sauce 1 Cooked Ham 1 Steak and Kidney Pudding 1 Super Value Pack (Sweets) 1 Sweet Mango Chutney 1 Mixed Dried Fruit 1 Corn Crisps (Ready Salted) 1 Stuffed Pork Roll 1 Malt Vinegar with Salt and Caramel 1 Pure Cream 1 Hamburger Relish 1 Sponge Pudding 1 American Hamburgers 1 Sliced Beef in Gravy 1 Flag Sauce 1 Hot Dog Relish 1 Mint Vinegar 1 Chop Sauce 1 Seedless Raisins 1 Tea 1 Ground White Pepper 1 Blackcurrant Health Drink 1 30 Light Meat Tuna 1 Lancashire Hot Pot 1 Almond Flavour 1 Pure Almond Marzipan 1 Creamed Mushrooms 1 Liquorice Allsorts 1 Frankfurters 2 Milk Shake Syrup 1 West India Treacle 1 Orange Sponge Pudding and Sauce Mix 1 Minestrone 1 West Indian Marmalade 1 Instant Potato 1 Egg Macaroni Noodles 1 Sauer Kraut 1 White Sauce 1 Margarine plus 10 per cent. Butter 1 American Lard 1 Soya Sauce 1 Mint Sauce 1 Horseradish Sauce 1 Horseradish and Beetroot Sauce 1 Paradise Fruits (Jam Centres) 1 Ginger Beer (Old English) 1 Noodles with Egg 1 Ice Cream 5 Batter and Pancake Flour 1 Iced Spongelets Mix 1 American Cake Mix 1 Ground Rice 1 Unsweetened Full Cream Evaporated Milk 1 Curry Powder 1 Condensed Tomato Puree 1 Steamed Chocolate Pudding 1 Lancashire Rarebit 1 Dressed Crab 1 Steaklets 1 Cheese Flaps in Tomato Sauce 1 Beechams' Powders (Tablet Form) 1 Christmas Pudding 1 Stuffing 3 Orange Drink 1 The following samples were not up to standard and warning letters were sent to the firms concerned: — Informal.— Sauce tartar, seedless raisins. Three samples, mint sauce, white sauce and corn crisps were improperly labelled. Letters were sent to the firms concerned requesting amendment of the labels. Complaints from the public relating to food were as follows: — Four of foreign matter in bread. Three of a dirty milk bottle. 31 One each of: — Contaminated cream soda. Infested sage and onion stuffing. Mouldy steak and kidney pie. Contaminated Tizer. Glass in cake. Warning letters were sent to the firms concerned. Ice-Cream Two establishments in the Borough are registered for the manufacture of ice-cream and 179 for the storage and sale of ice-cream. Fifty-two visits were paid during the year. Ten samples of ice-cream were taken and examined for bacteriological purity. The results are tabulated below:— I Provisional II Grade. Ill IV 7 — 3 — Bacteriological Examination of Cups and Glasses Seventy-five swabs were taken from tea cups at various catering establishments and 13 swabs were taken from beer glasses at various public houses during the year, and were submitted to the Public Health Laboratory for bacteriological examination. The results are tabulated below:— Tea Cup Swabs. Colony Count (per cup). Coliform Bacilli. Bact. Coli Type i. Result Satisfactory. Unsatisfactory. Present. Absent. Present. Absent. Under 100 8 60 3 5 65 3 100-200 1 1 — 1 — 2 200-500 1 — — 1 — 1 500-1,000 — 2 — — — 2 1,000-1,500 — 1 — — — 1 1,500-2,000 — — — — — — 2,000 and over 1 — — 1 — 1 Total 11 64 3 8 65 10 32 Beer Glass Swabs. Colony Count (per glass). Coliform Bacilli. Bact. Coli Type I. Result Satisfactory. Unsatisfactory. Present. Absent. Present. Absent. Under 100 2 9 — 2 11 — 100-200 — 1 — — 1 — 200-500 — 1 — — — 1 500-1,000 - - - - - - 1,000-1,500 - - - - - - 1,500-2,000 - - - - - - 2,000 and over - - - - - - Total 2 11 - 2 12 1 The results of the swabs were sent to the establishments concerned and visits were paid to premises where the results were unsatisfactory. MILK (SPECIAL DESIGNATION) REGULATIONS, 1960 During the year the Council granted the following number of licences: — Dealer's Licences— Pasteurised 8 Sterilised 5 Tuberculin Tested 2 One hundred and sixty-eight samples of Graded Milk were submitted for bacteriological examination. Two were unsatisfactory, but subsequent samples from the same suppliers were up to standard. BAKEHOUSES The number of bakehouses in the district is five. Forty-eight visits have been paid. DAIRIES There is one registered dairy and pasteurising establishment within the district. During the year 24 visits of inspection were paid. 33 SLAUGHTERHOUSES During the year 460 visits were made to the slaughterhouse. SLAUGHTER OF ANIMALS ACT, 1958 Eight licences were issued to slaughtermen in accordance with the requirements of the above Act. MEAT INSPECTION Carcases and Offal Inspected and Condemned in Whole or in Part. Cattle, excluding cows Cows Calves Sheep and Lambs Pigs Number killed (if known) 178 43 392 533 12,550 Number Inspected 178 43 392 533 12,550 All diseases except tuberculosis and cvsticerci: Whole carcases condemned 1 ... ... ... 41 Carcases of which some part or organ was condemned 18 ... 1 3 1263 Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 10.67 ... 0.26 0.56 10.04 Tuberculosis only: Whole carcases condemned ... ... ... ... ... Carcases of which some part or organ was condemned ... ... ... ... 55 Percentage of the number inspected affected with tuberculosis ... ... ... ... 0.44 FOOD PREPARING FACTORIES There are 16 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 (GENERAL) REGULATIONS, 1960 Number of notices served, 16. Number of notices complied with, 16. 34 PIGGERIES There are five piggeries in the Borough. Twenty-nine visits were paid during the year. PET ANIMALS ACT, 1951 Four licences were issued to occupiers of pet shops. 35 FACTORIES ACT, 1961 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 9 26 ... 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 2 319 307 ... ... 2 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 3 ... ... ... ... 3 TOTAL ... 328 333 ... ... ... 36 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 ... ... ... ... ... 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 14 14 ... ... ... 10 (c) Not separate for sexes 11 ... ... ... ... ... 11 Other offences (not including offences relating to Homework) 12 1 1 ... ... ... 12 TOTAL ... 15 15 ... ... ... ... 37 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 59 13 Cleaning and washing 14 14 Household linen 15 1 15 Lace, lace curtains and nets 16 16 Curtains and furniture hangings 17 3 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 38 3.— Outwork (Sections 110 and 111) continued :— Nets, other than wire nets 29 29 Tents 30 30 Sacks 31 31 Racquet and tennis balls 32 32 Paper bags 33 33 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 34 7 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 8 42 Textile weaving 43 43 Lampshades 44 106 44 TOTAL 184 39 PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASE NOTIFICATIONS The total number of confirmed notifications received during 1962 was 271. 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 123 Public Health Inspectors to smallpox contacts 6 Total 129 Rooms disinfected after infectious disease 38 40 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 ... 7 ... ... ... ... ... ... 1 ... ... ... 3 3 ... ... ... ... ... 14 February ... 2 ... ... ... 1 ... ... 2 ... ... ... 3 ... ... ... ... ... ... 8 March ... 4 ... ... 1 ... ... ... ... ... ... ... 6 ... ... ... ... ... ... 11 April ... 2 ... ... ... ... ... ... ... ... ... ... 5 ... ... ... ... ... ... 7 May ... 5 ... ... ... 2 ... ... ... ... ... ... 1 2 ... ... ... ... ... 10 June ... 1 ... ... ... ... ... ... 1 ... ... ... 2 1 ... ... ... ... ... 5 July ... 1 ... ... ... ... ... ... ... ... ... ... 2 3 ... ... ... ... ... 6 August ... 2 ... ... 1 ... 1 ... 1 ... 1 ... 6 ... ... ... ... ... ... 13 September ... ... ... ... ... ... ... ... ... ... ... ... 6 ... ... ... ... ... ... 6 October ... 2 ... ... 2 ... ... ... 2 ... ... ... 18 1 ... ... ... ... ... 25 November ... 5 ... ... 2 ... ... ... ... ... ... ... 76 6 1 ... ... ... ... 90 December ... 3 ... ... ... ... ... ... 1 ... ... ... 72 ... ... ... ... ... ... 76 Totals — 34 — — 6 3 1 — 8 1 1 — 200 16 1 ... ... — — 271 41 Infectious Disease Notifications, 1943/62 Disease 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 1960 1961 1962 Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 212 97 147 95 62 35 57 89 110 111 225 ... 47 33 56 18 75 69 24 32 34 Diphtheria 42 10 63 32 4 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... Typhoid Fever 1 ... 1 ... ... ... ... ... 1 ... ... ... 1 ... 1 ... ... ... ... ... ... Puerperal Pyrexia 3 5 8 6 9 3 ... 2 ... 13 23 11 3 1 ... ... ... ... 5 1 1 Meningococcal 8 3 3 1 2 1 1 ... 1 3 1 ... 2 ... 1 ... ... 1 1 1 1 Infections Erysipelas 22 13 16 25 9 18 6 12 7 8 14 11 6 9 7 4 3 4 5 6 6 Measles 651 112 739 358 533 818 252 354 354 1386 591 888 131 1059 50 1358 172 847 162 850 200 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Poliomyelitis: Paralytic ... ... 2 3 11 2 2 6 2 1 4 4 ... 4 5 2 ... 1 ... ... 1 Non-Paralytic ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 8 1 ... ... ... ... ... Ophthalmia Neonatorum 4 4 ... 2 2 6 3 8 2 1 4 ... 1 ... ... ... ... 2 1 1 ... Acute Encephalitis: Infective ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Post-Infectious ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 2 ... ... ... ... ... Pneumonia 50 37 33 41 37 30 13 19 28 24 26 27 16 34 19 24 12 22 10 7 3 Malaria 1 1 ... 1 ... 1 ... ... ... ... 1 ... 1 ... ... ... ... ... ... 1 ... Whooping Cough 162 166 96 234 216 117 149 212 387 420 112 336 183 167 103 130 45 l7 118 58 16 Food Poisoning ... ... 5 1 ... ... ... 6 3 4 10 17 12 8 11 4 9 27 6 2 1 Dysentery 4 67 13 6 1 2 5 7 16 7 16 15 46 17 60 47 8 10 6 1 8 Paratyphoid ... ... ... 1 2 ... ... ... ... 1 ... ... 1 ... 1 ... 1 ... ... ... ... Totals 1161 515 1126 807 888 1033 490 717 911 1980 1027 1396 450 1335 322 1590 325 1000 338 960 271 42 Smallpox At the beginning of the year there was an outbreak in various parts of England but there were no cases notified in Mitcham although there were six contacts kept under surveillance. The last case was in 1932. Vaccination Against Smallpox The following table shows the number vaccinated during the year: — Age at date of vaccination. Under 1 1 2-4 5-14 15 or over Total Number vaccinated 562 90 183 778 250 1,863 Number re-vaccinated — 2 48 545 456 1,051 Percentage of children vaccinated against smallpox. Age at 31.12.62 (born in: -) Under 1 1962 1-4 19611958 5-9 19571953 10-14 19521948 Total Number of children who 562 2,635 2,657 2,462 8,316 have received smallpox vaccination Estimated child population (mid-year) 912 3,588 4,351 4,925 13,776 Percentage of children vaccinated against smallpox 61.6* 73.4 60.8 50.0 60.4 * During the year the schedule of vaccination and immunisation was varied and the suggested age for first smallpox vaccination was nine months with implications that it might be increased to over one year. For thesis purposes an investigation was made by an Assistant Medical Officer of Health into the state of vaccination against smallpox in Mitcham over a period of six years ending on December, 1961. It is perhaps worthy to record some of the findings. Most primary vaccinations in England have been done for many decades in babies under 1 year, which has been the basis of the index of vaccination used by the Ministry of Health. 1. In Mitcham in 1961 75 per cent, of all babies under 1 year were vaccinated, compared to 41 per cent, in England and 43 Wales, and for the six-year period till the end of 1961 the average was 73 per cent, in Mitcham. This is probably greater than that for any borough of its size and certainly greater than for county boroughs who have to submit their figures to the Ministry of Health. 2. Clinic doctors, including the Divisional Medical Officer, carried out 77 per cent, of vaccinations against 23 per cent, by general practitioners. Of the clinic doctors the Divisional Medical Officer carried out the bulk of vaccinations, almost one third of all vaccinations in the borough. 3. Vaccinations carried out by the Divisional Medical Officer personally were also the most successful in the 1,341 babies vaccinated during 300 sessions over the six-year period. 4. From this series it appears that the multiple pressure method of vaccination should be 100 per cent, successful. 5. It has always been assumed that some babies are not susceptible to vaccination, but in this series it seems that 100 per cent, were successfully vaccinated. (One case only was doubtful as it could not be followed up through leaving the district.) 6. In this series of 1,341, all vaccinations were successful at the very first attempt, except for two cases, one of which was successfully vaccinated the following week and the other which left the district. This gives a success rate of 99.85 per cent., which must be the highest ever recorded for a series sustained over such a period of time over 300 clinic days. 7. It also shows the quality of the vaccine, which was always sent by post and was sometimes not used till six days after receipt. 8. The best antiseptic for cleansing the vaccination area was ether, because it dried instantaneously and obviously did not kill the vaccine. 9. It also showed that a loose sterile dressing could be applied right away without affecting the success of vaccination and without needing to wait for vaccine lymph to dry on the arm. 10. The high success rate also helped to encourage mothers to attend for immunisation procedures. In Mitcham between 90-95 per cent, of all babies born attend clinics. 44 Scarlet Fever The number of cases of scarlet fever notified during the year was 34 as compared with 32 in 1961, equivalent to a case rate of 0.53 per 1,000 population. This disease has continued mild in character. Two cases were removed to hospital. Diphtheria No case of diphtheria was notified for the thirteenth year in succession, whereas cases used to average sixty per year. Immunisation and reinforcing doses were available to every child whose parents gave consent. Immunisation Against Diphtheria, Whooping Cough and Tetanus There are five clinics within relatively easy reach of everyone, as well as immunisation sessions held in the schools. Every effort is made to have as many babies as possible immunised before their first birthday, the policy nowadays being to give the triple antigen against diphtheria, whooping cough and tetanus. The following table shews the number of children immunised and reinforced against diphtheria, whooping cough and tetanus in 1962. Whooping cough immunisation is not carried out in schools as it is intended primarily for children under five years old. Number of children receiving:— Year of Birth 1962 1961 1960 1959 1958 1953-7 194852 Total A. Primary Course againsi: Diphtheria 278 380 37 19 9 86 24 833 Whooping Cough 278 377 37 16 9 15 3 735 Tetanus 278 380 38 20 10 33 15 774 B Reinforcing injection against: Diphtheria — 25 46 14 9 609 317 1020 Whooping Cough — 24 40 11 5 56 6 142 Tetanus — 25 42 8 2 73 7 157 45 Table shewing percentage of child population immunised against diphtheria:— Percentage of children who have been immunised against diphtheria. Age at 31.12.62 (born in:—) Under 1 1962 1-4 19611958 5-9 19571953 10-14 19521948 Total Number of children who have received diphtheria immunisation 278 2,833 3,814 4,541 11,466 Estimated child population (mid-year) 912 3,588 4,351 4,925 13,776 Percentage of children immunised against diphtheria 30.7 78.6 87.6 92.2 83.2 Poliomyelitis There was one case of poliomyelitis during the year. This occurred in the child of a travelling showman and the disease was contracted before entry to Mitcham. For England and Wales the number of cases goes down year by year, for which the immunisation campaigns are undoubtedly responsible. Polio Vaccination Practically all poliomyelitis immunisation is now carried out by oral vaccine. Numbers immunised in 1962 Primary courses Third doses Fourth doses 0-18 years— Salk 225 386 97 Oral 514 551 701 Total 739 937 798 Over 18 years— Salk 221 571 8 Oral. 85 380 4 Total 306 951 12 46 The total number immunised since the inception of the scheme is 24,540 which includes 15,687 persons 0-18 years of age. Oral immunisation against poliomyelitis commenced early in 1962. It was found unnecessary to carry on with evening sessions so that immunisations are dealt with at the usual day clinics. Enteric Fever There were no cases of enteric fever during the year. Diarrhcea and Enteritis Under Two Years of Age No death was registered during the year. Food Poisoning Outbreaks There was one notified case in 1962. The cause was salmonella Give, but the source could not be ascertained. Encephalitis Lethargica There were no cases notified during the year. Erysipelas As in 1961 six cases were notified. One was removed to hospital. Puerperal Pyrexia There was one case of puerperal pyrexia during the year. Pneumonia Only three 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 39, of which 18 were males and 21 females. Meningococcal Infections One case was notified during the year. Influenza As in 1961, there was only one death from influenza. 47 Ophthalmia Neonatorum There were no cases of ophthalmia neonatorum during 1962. 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: — Chicken pox 211 Mumps 3 Ringworm — Rubella 212 Influenza 28 Glandular fever 4 Cancer The number of deaths from cancer registered during the year declined slighdy to 142, of which 85 were males and 57 females. This compares with 145 in 1961. The trend for England and Wales is continuing upwards. The site distribution for 1962 was as follows: — Stomach 15 cases Respiratory organs 49 „ Breast 20 „ Genito-urinary organs 4 „ Other sites 54 „ Total 142 48 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. 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 1959 145 2.25 2.14 1960 144 2.25 2.16 1961 145 2.27 2.17 1962 142 2.23 2.19 Deaths in Mitcham from Leukaemia and Lung Cancer, 1953-1962 Year. Deaths from Leukaemia. Deaths from Lung Cancer. 1953 5 17 1954 4 27 1955 2 40 1956 3 36 1957 3 41 1958 2 26 1959 3 32 1960 8 36 1961 6 39 1962 2 49 49 The deaths from lung cancer in Mitcham rose from 39 in 1961 to 49, rather more than one third of all deaths from cancer, while the rate for leukemia reverted to the normal low figure. Tuberculosis During the year 22 new cases of tuberculosis were notified, viz:— Males Females Total Pulmonary 14 4 18 Non-Pulmonary — 4 4 Totals 14 8 22 Fifteen cases were transferred into the Borough as follows: — Males Females Total Pulmonary 7 8 15 Non-Pulmonary — — — Totals 7 8 15 The total number of deaths from tuberculosis was: — Males Females Total Pulmonary 4 — 4 Non-Pulmonary — — — Totals 4 — 4 England and Wales. Mitcham. Death rate from tuberculosis, all forms, per 1,000 population 0.07 0.06 The following table shows the number of new cases, the type of disease and the deaths from tuberculosis during the year: — 50 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 1 ... ... ... ... ... ... 5 years to 9 „ ... ... ... ... ... ... ... ... 10 „ „ 14 „ ... ... ... ... ... ... ... ... 15 „ 19 ... 2 ... ... ... ... ... ... 20 ,, „ 34 4 1 ... ... ... ... ... ... 35 „ „ 44 „ 2 ... ... 1 ... ... ... ... 45 „ „ 64 6 ... ... 2 3 ... ... ... 65 ,, and upwards 1 ... ... 1 1 ... ... ... Totals 14 4 ... 4 4 ... ... ... 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 ... ... ... ... ... ... ... ... ... ... 2 ... ... 2 Pulmonary Females ... ... ... ... ... ... ... ... ... ... ... ... ... Nil Non-Pulmonary: Males ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 Non-Pulmonary: Females ... ... ... ... ... ... ... ... ... ... ... ... ... Nil The sources from which information as to the above-mentioned cases was obtained are as follows: — 51 Number of Cases Pulmonary NonPulmonary Death Returns (a) From Local Registrar 1 — (b) Transferable deaths from Registrar General 1 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 75 per cent. Non-notified tuberculosis death 3 Total tuberculosis deaths 4 Home Safety The Home Safety Committee during the year took part in various National Safety campaigns: Fire Prevention, Broken Glass, Water Safety and First Aid in the Home. Notices and leaflets were distributed to factories, shops and clinics, and bookmarks were issued through the public libraries. A competition in the form of an essay on Safety in the Home was organised for schoolchildren in the Borough and was highly successful, about 2,000 entries being completed. Following representations by the Committee, a film projector and film strips were purchased to augment lectures and demonstrations. Five thousand copies of a booklet " Safety in the Home " were distributed to children and old people. Meals-on-Wheels The Meals-on-Wheels service, run by the W.V.S., continued to supply meals on four days a week to the housebound and to old age pensioners at the London Road Old People's Welfare Club. Mrs. Topay, who has been an enthusiastic and generous caterer since the scheme began, has given up her restaurant, but the supply of meals is being satisfactorily continued by her successor. 52 Miniature Mass Radiography During the year the mass radiography unit held three general public sessions in various parts of the borough and also carried out a survey at a large factory. Male Female Total number examined 1,550 1,790 Pulmonary tuberculosis (active) 4 1 Primary lung cancer 1 — 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 available to any member of the public. The examination is of value in the early diagnosis and treatment of pulmonary tuberculosis and non-tuberculous abnormalities. 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. 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 and television, holidays, fares for relatives to visit, pocket money for patients, removal expenses, etc., etc. During this year's harsh winter, help was given with fuel bills and in one instance an oil heater was provided. Assistance was also given with internal decorations, hire purchase arrears and insurance. 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. 53 The number of non-T.B. cases dealt with is, for the first time, greater than the number of notified T.B. patients. 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. This is becoming more difficult each year. 54 INDEX page Abortion, Deaths 9, 14 Ambulances 16 Ante-Natal Clinics 17, 18 Area 8 Bacteriological Examination of Cups and Glasses 31, 32 Bakehouses 33 Bed Bugs, Eradication of 22, 23 Bedding, Disinfection of 16 Birth Rates 9, 11, 15 Births, Illegitimate 9 — In Institutions 10 — Live 9 — Still 9 Blindness, Prevention of 47 Cancer 47, 48 — Deaths from 10, 47, 48 Caravans 21 Causes of Death 10, 12-15 Chief Public Health Inspector's Report 24-26 — — — Inspector, Visits by 24, 25 Child Guidance Clinic 18 Child Welfare Clinics 18 Clean Air Act, 1956 22 Cleansing, Public 22 Clinics 17-20 Closet Accommodation 22 Committees, Health, Members of 6 Dairies 32 Death Rates 9, 11, 12, 15 Deaths 9-15 Dental Clinics 18-19 Diarrhoea and Enteritis 10, 46 Diphtheria 44 Diphtheria Immunisation 44, 45 55 PAGE Disinfection 16, 39 Encephalitis Lethargica 46 Enteric Fever 46 Erysipelas 46 Factories Act, 1937 35-36 — — — Defects found 36 — — — Inspections 35 Food and Drugs Act, 1955 28-31 — — — — Section 16 28 — Hygiene, General Regulations, 1960 33 — Dealt with, Unsound 27 — Inspection and Supervision of 28-33 — Preparing Factories 33 — Poisoning 46 — — Case Rates 15 — Sampling 28-31 General Provision of Health Services for the Area 15-21 Health Visiting 20 Home Help Service 20, 21 Home Safety 51 Hospitals 16, 17 Houses, Disinfection of 16 — Inhabited 8, 26 Housing Statistics 27 Ice Cream 31 Immunisation and Vaccination Clinics 19 Infant Mortality 9, 11, 12 Infectious Disease Case Rates 15 — — Contacts 39 — — Hospitals 17 — — Monthly Incidence of 40 — — Notifications 39-47 — — — School 47 — — Public Health Inspector's Visits 25, 39 Influenza 46 Inquests 12, 13 Laboratory Facilities 16 56 PAGE Legal Proceedings 26 Library Books, Disinfection of 16 Maternal Mortality 9, 12, 14 Maternity, Hospital Treatment 17 Meals-on-Wheels 4 Measles, Case Rates 15 — Deaths from 10, 14 Meat Inspection 33 Meningococcal Infection 46 Milk (Special Designation) Regulations 32 Mortality, Analysis of 14 National Assistance Act, 1948, Section 47 21 N.S.P.C.C 21 Neonatal mortality 12 Ophthalmia Neonatorum 47 Outworkers (Sections 11 and 111—Factories Act, 1937) 37, 38 Persons in Need of Care and Attention 21 Pests Act, 1949, Prevention of Damage by 23 Pet Animals Act, 1951 34 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 34 Pneumonia 46 Poliomyelitis 45 — Immunisation 45, 46 Population 8 Post-Natal Clinics 20 Public Cleansing 22 Puerperal Pyrexia 46 Public Analyst 16 Radiography, Miniature Mass 52 Rateable Value 8 Rent Act, 1957 27 Rivers and Streams 22 Rodent Operations 23 57 PAGE Rooms Disinfected, Number of 16, 39 Sanitary Circumstances of the Area 21-23 Scarlet Fever 44 Schools 23 Slaughterhouses 33 Slaughter of Animals Act, 1958 33 Smallpox 42 — Vaccination 42, 43 — Vaccination Clinics 19 — Hospital 17 Smoke Control Areas 22 Social Conditions 8, 9 Staff 7 Statistics 8-15 — Housing 27 — Vital 15 Still Births 9 Tuberculosis 49-51 — Care Committee 52 — Clinic 17 Unsound Food dealt with 27 Venereal Disease Clinic 17 Visits by Public Health Inspectors 24, 25 Water Supply 21 Whooping Cough, Deaths from 10, 14, 15 — — Immunisation 44