C. 4413 (1) II nut 32 Library REPORT Of The Medical Officer of Health for the Year 1963 BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1963 MITCHAM H. G. Mather, Ltd., Caxton Works, Lower Green, 3 Borough of Mitcham HEALTH REPORT FOR 1963 To the Mayor, Aldermen and Councillors. Mr. Mayor, Ladies and Gentlemen, I have much pleasure in submitting my annual report for the year 1963. The general health in the Borough has been good and there was no special outbreak of infectious disease. The notifications of infectious diseases were 874 compared with 271 in 1962. The increase was due, mainly, to the larger number of measles notifications, 770 in 1963 as compared with 200 in 1962. There were no cases of poliomyelitis. Only two have occurred since 1957. Whooping cough notifications were 35 as compared with 16 for 1962, which was the lowest year on record. The figures for ordinary immunisation, mostly carried out with the triple antigen, against diphtheria, whooping cough and tetanus, continue at about 80 per cent. of all children up to one year of age, a very high rate. The tuberculosis death rate at 0.05 compares with 0.06 per 1,000 population for England and Wales. Notifications were 11 compared with 22 for the previous year. Ten years ago there were more than 100 each year. Dysentery was notified in 19 cases as against 8 for 1962. The figure for this disease is very variable. There were no cases of enteric fever. 4 The birth rate of 15.48 per 1,000 population compares with 18.2 for England and Wales both of which are the highest for over a decade. The crude death rate of 11.12 compares with 12.2 for England and Wales. It is generally below that of England and Wales. The death rate from cancer for Mitcham in 1963 was 2.29 while that for England and Wales was 2.18 per 1,000 population. Deaths from lung cancer however, decreased from 0.77 to 0.69 per 1,000 population compared with 0.52 for England and Wales. As regards infant mortality the local rate was extremely low at 10.18 and the rate for England and Wales 20.9 per 1,000 live births. The Home Safety Committee once again supported the national safety weeks. The competition for schoolchildren in 1963 took the form of answers to a quiz poster. The large entry of 1,400 was received and prizes were awarded. 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.—Smoke control work progressed steadily. A second smoke control area has been made and approved and comes into effect on 1st November, 1964. Survey work has begun on the third area. 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 G. W. Pearce, J.P. His Worship the Mayor (Councillor W. H. Sanderson, J.P.) Aldermen— Mrs. L. Crump (Vice-Chairman) E. J. Mills Councillors— D. A. Small Mrs. J. E. Spalding W. C. W. Eggleston A. S. Hutchin Mrs. J. E. Vowles J. W. Overy H. R. Veal Mrs. V. M. Bonner Representatives of the Council on Other Authorities: WANDLE VALLEY JOINT SEWERAGE BOARD His Worship the Mayor (Councillor W. H. Sanderson, J.P.) (ex-officio) Councillors— D. J. Hempstead S. W. M. Croft 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 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) 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) Additional Public Health Inspector (i) C. S. Smith (1) 1. Certificate R.S.H. and Public Health Inspectors' Examination Joint Board. 2. Certificate Meat and Foods R.S.H. 3. Smoke Inspector's Certificate. Clerks (a) Chief Clerk and Administrative Assistant—F. H. White (b) Senior Clerk—F. G. Taylor (c) Secretary—Miss V. I. Hill (d) Mrs. K. North (d) Miss V. Tucker (e) Mrs. W. Lyon (f) Mrs. B. Wallace Smoke Investigators. (g) W. Voller (h) A. R. Bannister (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) 40 per cent. Surrey County Council duties. (e) Smoke Control. Commenced duties 27.8.62. (f) Smoke Control. Commenced duties 1.10.62. (g) Commenced 1.10.62. (h) Commenced 22.7.63. (i) Appointed Public Health Inspector 6.7.63. 7 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, 1963 63,420 Density of Population, 1961 21.4 persons per acre Number of inhabited houses, 1921 7,150 „ 1931 13,187 „ 1962 20,370 Rateable Value, 1962 £3,273,696 Sum represented by a 1d. rate £13,375 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 the early part of 1963 there was an unusually large unemployment situation lasting till the end of April, due mainly to the very adverse winter. The demand for labour then steadily increased 8 coming boom-like in October. There was then no seasonal drop, the demand persisting for both skilled and unskilled workers. Progress on the Phipps Bridge Estate continues and by the end of the year a total of 195 dwellings had been completed and occupied. The three slum clearance areas submitted to the Minister in 1962 were confirmed early in 1963. During the year another nine areas involving 79 houses were submitted for the Minister's approval. The Meat Inspection Regulations, 1963, came into force during the year. The main provisions are:— Meat at slaughterhouses must be inspected; Meat must not be removed from a slaughterhouse until inspected; Meat inspected and passed as fit for human consumption must be marked; Local authorities may charge for the inspection; and The minimum period of notice of slaughter is extended from three hours to 24 hours. STATISTICS Live Births. Total Male Female Rate per 1,000 of population Legitimate 923 479 444 Illegitimate 59 24 35 Total 982 503 479 15.48 After correction by the comparability factor becomes 15.95 Illegitimate live births per cent. of total live births 6.01 Still Births. Total Male Female Rate per 1000 total births. Legitimate 8 4 4 Illegitimate 1 1 — Total 9 5 4 9.08 Deaths Total Male Female Rate per 1,000 of population 706 374 332 11.12 After correction by the comparability factor becomes 12.78. 9 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 10.18 Legitimate infants per 1,000 live legitimate births 8.67 Illegitimate infants per 1,000 live illegitimate births 33.89 Deaths from:— Cancer (all ages) 147 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 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 1963 991 756 76.4 10 The birth rates, death rates per 1,000 of population, and the infant mortality rates for the years 1944-1963 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 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 1963 15.95 18.2 12.78 12.2 10.18 20.9 11 Infant Mortality During the year 10 deaths were registered of infants under one year of age:— Males Females Total Legitimate 4 4 8 Illegitimate 1 1 2 Total 5 5 10 as compared with 14 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:— Cause of Death Age No. Prematurity Congenital Defects Accidents of birth Infectious conditions Other conditions Under 24 hrs 5 4 1 — — — 1-7 days 4 3 - — — 1 8 days - 1 mth. — — — — — — 1 mth.-12 mths. 1 — 1 - — — Total 10 7 2 — — 1 Nine infants failed to survive the first month of life, giving Mitcham a neo-natal mortality rate of 9.17 per 1,000 related live births as compared with 14.2 for England and Wales. Maternal Mortality For the eighth successive year, no deaths were registered. Inquests Inquests were held on 26 residents dying within the district and on 20 Mitcham residents who died outside the district, a total of 46. In addition, post-mortems without inquests were held on 107 residents dying within the district, and on 47 Mitcham residents who died outside the district, a total of 154. 12 The following table shows the results of the findings of these inquests:— Accidental death 22 Death from misadventure 6 Suicide 10 Natural causes 3 Homicide 2 Open verdict 3 Total 46 13 Deaths Registered During the Year 1963 Cause of Death Males Females Total 1 Tuberculosis, respiratory 1 2 3 2 Tuberculosis, other ... ... ... 3 Syphilitic disease ... ... ... 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 11 9 20 11 Malignant neoplasm, lung, bronchus 41 3 44 12 Malignant neoplasm, breast ... 16 16 13 Malignant neoplasm, uterus ... 4 4 14 Other malignant and lymphatic neoplasms 27 30 57 15eukaemia, aleukæia 4 2 6 16 Diabetes 7 2 9 17 Vascular lesions of nervous system 33 59 92 18 Coronary disease, angina 97 47 144 19 Hypertension with heart disease 4 4 8 20 Other heart disease 21 49 70 21 Other circulatory disease 12 10 22 22 Influenza 2 3 5 23 Pneumonia 20 27 47 24 Bronchitis 35 17 52 25 Other diseases of respiratory system 1 4 5 26 Ulcer of stomach and duodenum 6 2 8 27 Gastritis, enteritis and diarrhoea ... 1 1 28 Nephritis and nephrosis 2 1 3 29 Hyperplasia of prostate 7 ... 7 30 Pregnancy, childbirth, abortion ... ... ... 31 Congenital malformations 2 1 3 32 Other defined and ill-defined diseases 23 18 41 33 Motor vehicle accidents 5 6 11 34 All other accidents 8 6 14 35 Suicide 2 8 10 36 Homicide and operations of war 2 ... 2 All causes 374 332 706 14 Birth Rates, Death Rates, Analysis of Mortality and Notifications of Infectious Diseases in the Year 1963 England and Wales Mitcham Rates per 1,000 home population Births— Live 18.2 15.95 Still 0.32 0.14 17.2* 9.08* Deaths— All causes 12.2 12.78 Malignant neoplasm—lung, bronchus 0.52 0.69 Whooping cough ... ... Diphtheria ... ... Tuberculosis—all forms 0.06 0.05 Influenza 0.07 0 08 Acute Poliomyelitis ... ... Pneumonia 0.77 0.74 Coronary disease—angina pectoris 2.29 2.27 Maternal mortality 0.28* ... Notifications (Corrected)— Scarlet Fever 0.37 0.44 Whooping Cough 0.74 0.55 Diphtheria 0.001 ... Measles 12.78 12.14 Acute Poliomyelitis— Paralytic 0.001 ... Non-Paralytic 0.0003 ... Enteric or Typhoid Fever 0.005 ... Para-typhoid Fever 0.007 ... Meningococcal Infection 0.013 ... Erysipelas 0.033 0.05 Dysentery 0.67 0.29 Acute Encephalitis— Infective 0.002 ... Post-Infectious 0.003 0.016 Acute Pneumonia 0.30 0.22 Food Poisoning 0.12 0.031 Tuberculosis— Respiratory 0.35 0.16 Non-Respiratory 0.05 0.016 * Per 1,000 total (live and still) births. 15 GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA LABORATORY FACILITIES Most of the bacteriological examinations for this district were carried cut at the Emergency Public Health Laboratory at Epsom, including bacteriological examinations of milk, water and ice-cream. The chemical analysis of milk, water and foodstuffs was carried out by the Public Analyst, Daniel D. Moir, M.Sc., F.R.I.C., 16, Southwark Street, London, S.E.l. AMBULANCES The Ambulance service is supervised by the Surrey County Council. The ambulances operate from the Ambulance Control Station, Hill House, Bishopsford Road, Morden (Telephone: 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 25 Number of library books disinfected 371 HOSPITALS The hospitals directly concerned with the Mitcham area are administered by the St. Helier Group Hospital Management Committee, which is situated at Carshalton, Surrey, and itself comes under the South-West Metropolitan Regional Hospital Board. 16 General Cases.—The principal hospitals are the Wilson Hospital, which is situated within the district, and the St. Helier Hospital, Carshalton, which caters for all types of cases. The Nelson Hospital at Merton and the London hospitals are also used. Infectious Diseases.—Cases usually go to the Wandle Valley Isolation Hospital at Beddington Corner, Mitcham Junction, or to 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 on first, third and fifth Friday afternoons, and a clinic for cases booked by midwives is held on Tuesday afternoons. 17 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 Monday afternoon and Thursday morning. Church Road Clinic.—Every Wednesday afternoon and Thursday afternoon. Meopham Road Clinic.—Every Wednesday afternoon. Toddlers' Clinics for children between the ages of two to five years are held monthly 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. 18 Western Road, Mitcham.—Every weekday morning and afternoon. Church Road, Mitcham.—Monday morning and afternoon; Tuesday morning; Thursday morning; Friday 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 first, third and fifth Wednesdays of the month in the morning. Meopham Road Clinic.—Second and fourth Mondays of the month in the afternoon. St. Barnabas Clinic.—On first, third and fifth 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 Poliomyelitis immunisation is by oral vaccine at ordinary immunisation 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.—Wednesday, 2 p.m. Church Road Clinic.—Friday, 9.30 a.m. Cavendish Road Clinic.—Thursday, 2 p.m. 19 Ophthalmic Clinic An eye specialist attends Western Road Clinic on Wednesday afternoons, and Wide Way Clinic on Tuesday mornings. Parentcraft Circle Church Road Clinic.—Monday, 2 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 Wednesday (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, continues to function successfully, although enough workers cannot be recruited to satisfy the full demand. At present there are 73 home helps in the Mitcham area covering a weekly case load of 291 households. The Neighbourly Help scheme, which started in 1962, provided useful help in a number of cases. 20 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 1963 57 Number of children affected 151 Number of visits paid 410 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 to a Geriatric Unit for an initial period of three weeks. Subsequently the person agreed to remain in hospital and a renewal order was not required. 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 21 caravans. 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. 21 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 Thirteen samples from the Alfred Mizen school swimming baths and 21 from the Corporation baths were sent for bacteriological examination during the year. One sample from the school baths was not satisfactory but investigation shewed no obvious cause and further samples 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 The Borough of Mitcham (No. 1) Smoke Control Order, covering an area of 118 acres containing 1,122 properties, came into operation on 1st December, 1963. Survey of the second area was completed in 1963 and the Borough of Mitcham (No. 2) Smoke Control Order comes into effect on 1st November, 1964. 4,077 visits were made by the smoke investigators. 22 ERADICATION OF BED BUGS Number of Council houses found infested during the year, 9. Number of other houses found infested during the year, 3. Total number of houses disinfested during the year, 12. Methods employed:— Twelve houses treated with insecticide spray. Number of houses disinfested of beetles, 26. Number of houses disinfested of other insects, 12. 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 3,766 Complaints received 491 Number of treatments re rat infestation, including test baits, as result of inspection and complaints 817 Factory and business premises treated 86 Visits by Public Health Inspectors 79 23 Two sewer maintenance treatments were carried out in the year; 265 manholes were baited. A total of 33 baits were taken compared with 61 taken in 1962. THE ANNUAL REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR To the Mayor, Aldermen and Councillors. Mr. Mayor, Ladies and Gendemen, 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 475 Nuisances found 386 Verbal Notices given 161 Verbal Notices complied with 114 Informal Notices served 224 Informal Notices complied with 123 Statutory Notices served 74 Statutory Notices complied with 63 Revisits 1,637 Houses inspected for defect 619 Visits made for this purpose 638 Drains tested and inspected 127 Private houses found verminous 3 Visits to butchers 202 Visits to slaughterhouses 512 Visits to dairies 29 Visits to retail milk shops 42 Visits to restaurant kitchens 372 Visits to ice-cream premises 32 Visits to bakehouses 31 Visits to other food premises 1,371 Number of notices served under Food Hygiene Regulations, 1955 52 Number of notices complied with 46 Visits to factories 314 24 Visits to workplaces 34 Visits to outworkers 89 Visits to stables 48 Visits to piggeries 38 Visits re Smoke Control 211 Visits to caravan yards 59 Smoke and noise observations 216 Visits re infectious disease cases 172 Visits re smallpox contacts - Visits re food poisoning 15 Visits re rats and mice 79 Visits re Shops Acts 79 Visits re schools 15 Visits re Rent Act, 1957 86 Visits to sewage works 20 Sundry visits 611 Character of Work Done Roofs repaired 58 Rainwater piping or gutters repaired or renewed 60 Yards paved or repaired 1 Dampness remedied 64 Water service pipes repaired 16 Waterclosets: Repairs to structure 6 Flushing apparatus repaired or renewed 19 New pans and traps fitted 16 Water storage cisterns cleansed, repaired or renewed 3 Water supply reinstated 16 Flooring of rooms repaired and sub-floor ventilation improved 24 Rooms cleansed 18 Sinks and handbasins repaired or renewed 16 Waste pipes and traps repaired or renewed 12 Window frames and sashes repaired or renewed Window sills repaired or renewed 17 External brickwork (repaired, pointed or rendered) 20 Drains repaired or obstructions removed 89 Drains inspection covers renewed 6 25 Drains tested 23 Grid and mica flaps provided 5 Firegrates repaired (including surrounds and hearths) 4 Stoves, coppers, ranges, etc., repaired 3 Chimney stacks repaired 8 Staircases repaired 5 Doors repaired 5 Internal plaster repairs 62 Sash cords renewed 22 Dustbins provided 53 Accumulations removed 32 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 There were no legal proceedings in 1963. PETROLEUM LICENCES Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929.—One hundred and one licences to store petroleum spirit and/or petroleum mixtures were issued for a total of 248,390 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. Unsound Food Dealt With Beef 224 lbs. Stewing steak 16 lbs. Ham 177 „ Liver 10 „ Corned beef 91 „ Potatoes 26 cwts. 26 Luncheon meat 20 lbs. Cakes 18cwt. Lamb 35 „ Eggs 30 doz. Pork 367 „ Frozen foods 826 pkts. Ox tongue 12 „ Assorted packets and Fish 91 „ tins 2,048 Yours faithfully, K. J. GUTTERIDGE, Chief Public Health Inspector. HOUSING STATISTICS Total Number of Inhabited Dwellings—20,370 Housing properties now owned by the Council amount to 4,524, including 340 temporary dwellings. During the year a further 111 new dwellings were handed over for letting, all of them on the Phipps Bridge estate, to which reference was made in last year's report. There were five fewer temporary dwellings than last year, arising from the fact that a start was made on the demolition of 35 temporary bungalows built on land zoned for recreation ground use and which has to be cleared by September, 1965. During the year a total of 253 families were rehoused from the waiting list, 185 in Mitcham, 64 in the Frimley and Camberley Urban District under the Town Expansion Scheme with which this Council is associated, and four in new towns. The number of new registrations, however, increased, and at the end of the year the Housing Register stood at 1,313, a net increase of 11 over the previous year. There was an appreciable increase in the proportion of elderly applicants on the waiting list during the year. Rent Act, 1957 Twenty applications were made for Certificates of Disrepair during the year. In 16 cases undertakings were given by the various 27 landlords and in the remaining four cases certificates were issued. One certificate was cancelled during the year on application by landlord, the works specified having been completed. INSPECTION AND SUPERVISION OF FOOD Two thousand and seventy-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 13 Roadside Snack Bars 2 Groceries 67 Fishmongers 9 Butchers 33 Fried Fish Buffets 8 Greengrocer & Fruiterers 52 Fried Fish 3 Greengrocer & General Provisions 4 Bakers and Confectioners 14 Milk & Provisions 11 Confectionery 73 Public Houses 30 Chemists 15 Off-Licences 13 Restaurants & Cafes 31 Multiple Food Stores 7 Cafe & General Stores 1 Food premises by type, registered under Section 16, Food and Drugs Act, 1955. The storage and sale of ice-cream 154 The manufacture for sale of ice-cream 3 The preparation or manufacture of sausages, or potted, pressed, pickled or preserved food 43 Dairies registered under the Milk and Dairies (General) Regulations, 1959 1 Number of inspections of registered food premises during the year 305 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. 28 FOOD AND DRUGS ACT, 1955 Formal Samples. Forty formal samples were taken as follows:— Milk 39 Saveloys 1 Informal Samples. One hundred and fifteen informal samples were taken as follows:— Almond Marzipan 1 Honey 1 Coscopin 1 Salt 1 Ferrodic Tablets 1 Ham Flavoured Green Pea Soup 1 Vitavel 1 Glenalmond Cake 1 Sandwich Spread 1 Irish Stew 1 Chicken Capri 1 Hot Dog Sausages in Brine 1 Strawberry Milkshake Syrup 1 Drinking Chocolate with Fat Free Milk 1 Jam Sponge Pudding 1 Macaroni and Veal in Savoury Sauce 1 Real Crab Spread with Butter 1 Orange Juice Artificial Cream Buns 1 Steak and Kidney Pie 1 Processed Peas Pure Almond Marzipan 1 "Surprise" Peas 1 Antibiotic Anaesthetic Throat Tablets 1 Pure Butter (Unsalted) 1 Tomato Soup 1 Actal 1 Imported German Salami 1 Ethnine 1 "New" Jam (Raspberry) 1 Golden Syrup Sweet Pudding 1 Sage and Onion Stuffing 1 Tomato Paste Raspberries in Sugar 1 Tomato Sauce 1 "Ready to Eat" Potato Chips 1 Rivella Digestif (Sparkling Drink) 1 Margarine containing 10 per cent. Butter Cheesy Crisps 1 "Kenco" Breakfast Coffee 1 Real Cornish Butter 1 Coffee and Chicory Essence 1 Pure Vegetable Fat 1 Tetley Tea Bags 1 Pure Dairy Butter 1 Cream of Chicken Soup 1 29 Mint Jelly 2 Minced Beef and Gravy 1 Apple Juice with Added Vitamin C 1 Nestle's Milk 1 Turkey and Ham Pie 1 Veal and Ham Meat Paste 1 Pork Sausages and Preservative 1 Meat Pudding Hamburgers 1 White Grapes in Syrup 1 Plum Pudding 1 Pure Vegetable Oil 1 Sucron 1 Ground Almonds 1 Sweet Bake Mix 1 Spanish Rice 1 Orange Squash 1 Pease Pudding 1 Finest Pure Creamery Butter 1 Sunny Spread 1 Macaroni Pudding 1 Ice Cream 5 Strawberry Jam 1 Garden Peas 1 Onion Salt 1 Evaporated Milk 1 Dairy Cream Sponge with Real Cream 1 Home Bread Mix 1 Double Devon Cream 1 "Roselle" 1 Lunch Tongues 1 Ginger Marmalade 1 Savoury Fritter Mixture 1 Burma Sauce 1 Jelly Creams (Lemon) 1 Cheddar Cheese 1 Jelly de Luxe (Orange) 1 Pork Sausages 1 Jelly (Pineapple Flavour) 1 Pickled Beetroots 1 Cheese Spread with Shrimps 1 Pork Luncheon Meat 1 Curried Chicken and Mushrooms 1 Self Raising Flour 1 "Carmelle" with Caramel Topping 1 Turkey Supreme 1 London Grill 1 Custard Powder 1 Lemon Flavour Foam Crystals (Fully Sweetened) 1 Junior Dinner 1 Cherry Pie Filling 1 Danish Blue Cheese 1 Beef Curry with Rice 1 Cærphilly Cheese 1 Minced Beef Loaf 1 Peanut Butter 1 Pure Malt Vinegar with Caramel and Salt 1 Curry Powder 1 All samples were satisfactory except for three which were improperly labelled. They were, Vienna sausage, dried peas and cherry pie filling. 30 Letters were sent to the firms concerned and the labels were revised. Complaints from the public relating to food were as follows:— Grey matter in a loaf. Mouldy steak and kidney pie. Mouldy sponge cake. Hide and hair in steak and kidney pie. Mouldy pork pie. Black mark in a loaf. Wasp in a loaf. Warning letters were sent to the firms concerned. Ice-Cream Three establishments in the Borough are registered for the manufacture of ice-cream and 154 for the storage and sale of ice-cream. Thirty-two visits were paid during the year. Bacteriological Examination of Cups and Glasses Eighty-nine swabs were taken from tea cups at various catering establishments and 11 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. Coliform Bacilli. Bact. Coli Result Colony Count (per cup). Type I. Satisfactory. Unsatisfactory. Present. Absent. Present. Absent. Under 100 3 74 2 1 75 2 100-200 1 4 — 1 4 1 200-500 5 — — 5 5 — 500-1,000 - - - - - - 1,000-1,500 — 1 — — — 1 1,500-2,000 - - - - - - 2,000 and over 1 — 1 — — 1 Total 10 79 3 7 84 5 31 Beer Glass Swabs Coliform Bacilli. Bact. Coli Result Colony Count (per glass). Type I. Satisfactory. Unsatisfactory. Present. Absent. Present. Absent. Under 100 — 5 — — 5 — 100-200 - - - - - - 200-500 1 2 — 1 3 - 500-1,000 1 — — 1 — 1 1,000-1,500 - - - - - - 1,500-2,000 - - - - - - 2,000 and over 1 1 — 1 — 2 Total 3 8 — 3 8 3 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 (Pre-packed Milk) Licences— Pasteurised 1 Sterilised 3 Pasteurised and Tuberculin Tested 1 Pasteurised, Sterilised and Tuberculin Tested 3 One hundred and seventy-four samples of graded milk were submitted for bacteriological examination. All were satisfactory save four from a milk vending machine. On representations being made to the supplier, milk of a different designation was supplied and further samples from the machine were satisfactory. BAKEHOUSES The number of bakehouses in the district is five. Thirty-one visits have been paid. DAIRIES There is one registered dairy and pasteurising establishment within the district. During the year 29 visits of inspection were paid. 32 SLAUGHTERHOUSES During the year 512 visits were made to the slaughterhouse. SLAUGHTER OF ANIMALS ACT, 1958 Thirteen licences were issued to slaughtermen in accordance with the requirements of the above Act, two being licences to slaughter only under supervision. 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) 175 18 192 474 14,364 Number Inspected 175 18 192 474 14,364 All diseases except tuberculosis and cysticerci: Whole carcases condemned ... ... ... 3 37 Carcases of which some part or organ was condemned 12 ... ... 7 1641 Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 6.9 ... ... 2.1 11.7 Tuberculosis only: Whole carcases condemned ... ... ... ... ... Carcases of which some part or organ was condemned ... ... ... ... 13.1 Percentage of the number inspected affected with tuberculosis ... ... ... ... 0.9 FOOD PREPARING FACTORIES There are 16 factories which are engaged in the manufacture and preparation of food products. All of these are systematically visited. 33 INFORMAL ACTION TAKEN UNDER THE FOOD HYGIENE (GENERAL) REGULATIONS, 1960 Number of notices served, 52. Number of notices complied with 46. PIGGERIES There are five piggeries in the Borough. Thirty-eight visits were paid during the year. PET ANIMALS ACT, 1951 Four licences were issued to occupiers of pet shops. 34 FACTORIES ACT, 1961 1.—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 20 34 ... ... 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 2 307 314 ... ... 2 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 3 ... ... ... ... 3 TOTAL ... 327 348 ... ... ... 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 ... ... ... ... ... 4 Overcrowding (S.2) 5 ... ... ... ... ... 5 Unreasonable temperature (S.3) 6 1 1 ... ... ... 6 Inadequate ventilation (S.4) 7 1 1 ... ... ... 7 Ineffective drainage of floors (S.6) 8 ... ... ... ... ... 8 Sanitary Conveniences (S.7) (a) Insufficient 9 1 1 ... ... ... 9 (b) Unsuitable or defective 10 17 17 2 2 ... 10 (c) Not separate for sexes 11 2 2 ... 1 ... 11 Other offences (not including offences relating to Homework) 12 ... ... ... ... ... 12 TOTAL 22 22 2 3 ... 36 3.—Outwork (Sections 110 and 111):— Nature of Work Section 110 Section 111 M/c line No. Number of out-workers in August list required by Sect. 110 (1) (c) Number of cases of default in sending lists to the Council Number of prosecutions for failure to supply lists Number of instances of work in unwholesome, premises Notices served Prosecutions M/c line No. (1) (2) (3) (4) (5) (6) (7) (8) (9) Wearing apparel Making, etc. 13 74 13 Cleaning and washing 14 14 Household linen 15 2 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 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 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 66 44 TOTAL 160 38 PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASE NOTIFICATIONS The total number of confirmed notifications received during 1963 was 874. 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 172 Public Health Inspectors to smallpox contacts — Total 172 Rooms disinfected after infectious disease 25 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 ... 3 ... ... 1 1 ... ... 1 ... ... ... 147 ... 1 ... ... ... ... 154 February ... 3 ... ... ... 3 ... ... ... ... ... ... 162 1 1 ... ... ... ... 170 March ... 7 ... ... 1 7 ... ... ... ... ... ... 158 ... ... ... ... ... ... 173 April ... 4 ... ... ... ... 1 ... ... ... ... ... 76 ... ... ... ... ... ... 81 May ... 2 ... ... ... 1 1 ... 4 ... ... ... 86 2 ... ... ... ... ... 96 June ... 4 ... ... ... ... ... ... 9 ... ... ... 74 1 ... ... ... ... ... 88 July ... 2 ... ... ... ... ... ... 4 ... ... ... 48 ... ... ... ... ... ... 54 August ... ... ... ... ... ... ... ... 1 ... ... ... 11 ... ... ... ... ... ... 12 September ... ... ... ... ... ... ... ... ... ... ... ... 3 3 ... ... ... ... 1 7 October ... ... ... ... ... ... ... ... ... ... ... ... 4 2 ... ... ... ... ... 6 November ... 1 ... ... 1 ... ... ... ... ... ... ... 1 8 ... ... ... ... ... 11 December ... 2 ... ... ... 2 ... ... ... ... ... ... ... 18 ... ... ... ... ... 22 Totals — 28 — — 3 14 2 — 19 — — - 770 35 2 — — — 1 874 Infectious Disease Notifications, 1944/63 Disease 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 1963 Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 97 147 95 62 35 57 89 110 111 225 86 47 33 56 18 75 69 24 32 34 28 Diphtheria 10 63 32 4 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Typhoid Fever ... 1 ... ... ... ... ... 1 ... ... ... 1 ... 1 ... ... ... ... ... ... ... Puerperal Pyrexia 5 8 6 9 3 ... 2 ... 13 23 11 3 1 ... ... ... ... 5 1 1 2 Meningococcal 3 3 1 2 1 1 ... 1 3 1 ... 2 ... 1 ... ... 1 1 1 1 ... Infections Erysipelas 13 16 25 9 18 6 12 7 8 14 11 6 9 7 4 3 4 5 6 6 3 Measles 112 739 358 533 818 252 354 354 1386 591 888 131 1059 50 1358 172 847 162 850 200 770 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 4 ... 2 2 6 3 8 2 1 4 ... l ... ... ... ... 2 1 1 ... ... Neonatorum Acute Encephalitis: Infective ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Post-Infectious ... ... ... ... ... ... ... 1 ... ... ... ... ... 2 ... ... ... ... ... 1 Pneumonia 37 33 41 37 30 13 19 28 24 26 27 16 34 19 24 12 22 10 7 3 14 Malaria 1 ... 1 ... 1 ... ... ... ... 1 ... 1 ... ... ... ... ... ... 1 ... ... Whooping Cough 166 96 234 216 117 149 212 387 420 112 336 183 167 103 130 45 17 118 58 16 35 Food Poisoning ... 5 1 ... ... ... 6 3 4 10 17 12 8 11 4 9 27 6 2 1 2 Dysentery 67 13 6 1 2 5 7 16 7 16 15 46 17 60 47 8 10 6 1 8 19 Paratyphoid ... ... 1 2 ... ... ... ... 1 ... ... 1 ... 1 ... 1 ... ... ... ... ... Totals 515 1126 807 888 1033 490 717 911 1980 1027 1396 450 1335 322 1590 325 1000 338 960 271 874 40 41 Smallpox There were no cases or contacts in 1963. The last case was in 1932. Vaccination Against Smallpox Number vaccinated in 1963. Age at date of vaccination. Under 1 1 2-4 5-14 15 or over Total Primary vaccinations 90 130 6 8 10 244 Revaccinations — — 6 13 27 46 The following table shews the number of children who have received smallpox vaccination and the percentage of children vaccinated:— Age at 31.12.63 (born in:—) Under 1 1-4 5-9 10-14 Total 1963 19621959 19581954 19531949 Number of children who 90 2,519 2,398 2,552 7,559 have received smallpox vaccination Estimated child population (mid-year) 482 3,564 4,198 4,394 12,643 Percentage of children vaccinated against smallpox 18.7 70.6 56.9 58.1 59.8 Routine vaccination of babies is now carried out in their second year following a recommendation by the Ministry of Health. Scarlet Fever The number of cases of scarlet fever notified during the year was 28 as compared with 34 in 1962, equivalent to a case rate of 0.44 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 fourteenth year in succession, whereas cases used to average 60 per year. Immunisation and reinforcing doses were available to every child whose parents gave consent. 42 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 1963. 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 1963 1962 1961 1960 1959 1954-8 194953 Total A. Primary Course against: Diphtheria 340 494 46 14 8 60 8 970 Whooping Cough 339 488 42 13 7 7 — 896 Tetanus 340 494 44 13 6 10 - 907 B Reinforcing injection against: Diphtheria - 83 364 42 27 573 256 1345 Whooping Cough — 81 347 31 16 69 1 545 Tetanus — 83 356 36 20 109 5 609 Table shewing percentage of child population immunised against diphtheria:— Age at 31.12.63 (born in: —) Under 1 1-4 5-9 10-14 Total 1963 19621959 19581954 19531949 Number of children who have received diphtheria immunisation 340 2,787 3,385 4,363 10,875 Estimated child population (mid-year) 482 3,564 4,198 4,399 12,643 Percentage of children immunised against diphtheria 70.5 77.9 80.6 99.1 86.0 43 Poliomyelitis There were no cases of poliomyelitis during the year. Since 1957 there have been only two cases notified in Mitcham, one in 1959 and one in 1962, the latter having been contracted elsewhere but not diagnosed till reaching Mitcham. The following table shews the phenomenal decrease in notifications of poliomyelitis in England and Wales since 1957, the first full year of immunisation against the disease. Notifications of Poliomyelitis. Year Paralytic Non-Paralytic Total 1957 3,175 1,666 4,841 1958 1,410 587 1,997 1959 733 289 1,022 1960 258 125 383 1961 765 181 946 1962 212 60 272 1963 39 12 51 Polio Vaccination Numbers immunised in 1963. Year of Birth Primary courses Third doses Fourth doses 1963 99 2 — 1962 583 12 — 1961 118 50 1 1943-1960 94 36 328 1942 and before 72 35 8 Total 966 135 337 The total number immunised since the beginning of polio vaccination is now 25,506. Practically all poliomyelitis immunisation is carried out now with oral vaccine. Only 38 doses of salk vaccine were given during the year. Enteric Fever There were no cases of enteric fever during the year. 44 Diarrhoea and Enteritis Under Two Years of Age No death was registered during the year. Food Poisoning Outbreaks There were two notified cases in 1963. The cause, in both cases, was Salmonella Typhimurium, but the source could not be ascertained. Encephalitis There was one post infectious case during the year. The patient was removed to hospital. Erysipelas There were three cases notified in 1963. All were treated at home. Puerperal Pyrexia There were two cases of puerperal pyrexia during the year. Pneumonia Fourteen case of primary pneumonia were notified during the year. The number of deaths from all forms of pneumonia, some of which are not notifiable, was 47, of which 20 were males and 27 females. Meningococcal Infections There were no cases during 1963. Influenza In 1963 there were five deaths from influenza. Ophthalmia Neonatorum There were no cases of opthalmia neonatorum during 1963. 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 45 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 172 Mumps 163 Ringworm - Rubella 90 Influenza 30 Glandular fever 6 Cancer The number of deaths from cancer registered during the year rose slightly to 147, of which 83 were males and 64 females. This compares with 142 in 1962. The trend for England and Wales is continuing upwards. The site distribution for 1963 was as follows:— Stomach 20 cases Respiratory organs 44 „ Breast 16 „ Genito-urinary organs 4 „ Other sites 63 „ Total 147 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 1000 of population Mitcham. England and Wales. 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 46 Year. Number of Deaths. Death Rate per 1,000 of population Mitcham. England and Wales. 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 1963 147 2.29 2.18 Deaths in Mitcham from Leukæmia and Lung Cancer, 1954-1963 Year. Deaths from Leukæmia. Deaths from Lung Cancer. 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 1963 6 44 The deaths from lung cancer in Mitcham declined from 49 in 1962 to 44, less than one third of all deaths from cancer, while the rate for leukæmia was rather higher than average. This figure is, however, very variable. 47 Tuberculosis During the year 11 new cases of tuberculosis were notified, viz:— Males Females Total Pulmonary 7 3 10 Non-Pulmonary — 1 1 Totals 7 4 11 Nine cases were transferred into the Borough as follows:— Males Females Total Pulmonary 5 4 9 Non-Pulmonary — — — Totals 5 4 9 The total number of deaths from tuberculosis was:— Males Females Total Pulmonary 1 2 3 Non-Pulmonary — — — Totals 1 2 3 England and Wales. Mitcham. Death rate from tuberculosis, all forms, per 1,000 population 0.063 0.05 The following table shows the number of new cases, the type of disease and the deaths from tuberculosis during the year:— 48 Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. Under 1 year ... ... ... ... ... ... ... ... 1 year to 4 years ... ... ... 1 ... ... ... ... 5 years to 9 „ ... ... ... ... ... ... ... ... 10 „ „ 14 „ ... ... ... ... ... ... ... ... 15 „ „ 19 „ ... ... ... ... ... ... ... ... 20 „ „ 34 „ 1 2 ... ... ... ... ... ... 35 „ „ 44 „ 1 ... ... ... ... ... ... ... 45 „ „ 64 „ 4 1 ... ... 1 1 ... ... 65 „ and upwards 1 ... ... ... ... 1 ... ... Totals 7 3 ... 1 1 2 ... ... New cases coming to the knowledge of the Medical Officer of Health during the year through death returns and posthumous notifications:— Age Periods 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total Pulmonary: Males ... ... ... ... ... ... ... ... ... ... ... ... ... Nil Pulmonary Females ... ... ... ... ... ... ... ... ... ... ... ... ... Nil Non-Pulmonary: Males ... ... ... ... ... ... ... ... ... ... ... ... ... Nil Non-Pulmonary: Females ... ... ... ... ... ... ... ... ... ... ... ... ... Nil 49 Home Safety In 1963 the Home Safety Committee once again supported, by the distribution of posters and leaflets, the various national campaigns; in particular "Buying and Selling for Safety in the Home" and "Fire Prevention". Special attention was paid to danger from fireworks and from Christmas decorations. A competition was again held for schoolchildren, this year in the form of a quiz poster on dangers in the home. One thousand four hundred entries were received and prizes were presented by the Mayor. Rospa were invited to send a representative, who gave a talk on water safety. Meals-on-Wheels Under the able supervision of Mrs. Forsdick, the Centre Organiser, the Meals-on-Wheels had another successful year. Meals are distributed by the W.V.S. and other voluntary workers, on four days a week, to the housebound and to the old age pensioners at their club in London Road. Five thousand five hundred and twenty-nine meals were supplied during the year. The supply of meals continued satisfactorily under the new caterer, Mrs. L. Frost, who supplied all the old people with a traditional Christmas dinner free of charge. A gift of a free New Year dinner was made by friends of the W.V.S. Miniature Mass Radiography There were no general public sessions during 1963 but a number of factories in the Borough were visited by the mobile unit. Statistics are shown below:— Male Female Total number examined 3,340 2,220 Pulmonary tuberculosis (active) 4 — Primary lung cancer — — The main non-tuberculous abnormalities revealed were abnormal heart conditions, bacterial and virus infections of the lung and pulmonary fibrosis. 50 The above figures do not apply to Mitcham residents only, as a number of employees come from outside Mitcham. 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 During the year the Committee continued to help patients and, where necessary, their families. Assistance is given towards extra nourishment, beds and bedding, occupational therapy, education, clothing, provision of wireless and television and payment of licence fees, holidays, fares for relatives to visit, pocket money for patients, removal expenses, internal decorations, hire purchase arrears, insurance, etc., etc. The fund necessary for this work is mostly raised through the efforts of the voluntary committee. The help given improves the morale of the patient and/or his family. The proportion of T.B. cases dealt with continues to diminish each year. 51 INDEX page Abortion, Deaths 9, 13 Ambulances 15 Ante-Natal Clinics 16, 17 Area 7 Bacteriological Examination of Cups and Glasses 30, 31 Bakehouses 31 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 from 9, 45, 46 Caravans 20 Causes of Deaths 9, 11-14 Chief Public Health Inspector's Report 23-26 — — — Inspector, Visits by 23, 24 Child Guidance Clinic 17 Child Welfare Clinics 17 Clean Air Act, 1956 21 Cleansing, Public 21 Clinics 16-19 Closet Accommodation 21 Committees, Health, Members of 5 Dairies 31 Death Rates 9, 10, 11, 14 Deaths 8-14 Dental Clinics 17, 18 Diarrhoea and Enteritis 9, 44 Diphtheria 41, 42 Diphtheria Immunisation 41, 42 52 PAGE Disinfection 15, 38 Encephalitis Lethargica 44 Enteric Fever 44 Erysipelas 44 Factories Act, 1937 34-35 — — — Defects Found — — — Inspections 34 Food and Drugs Act, 1955 28-31 — — — — Section 16 27 — Hygiene, General Regulations, 1960 33 — Dealt with, Unsound 25-26 — Inspection and Supervision of 27-32 — Preparing Factories 32 — Poisoning 44 — — Case Rates 14 — Sampling 28-30 General Provision of Health Services for the Area 15-21 Health Visiting 19 Home Help Service 19 Home Safety 49 Hospitals 15, 16 Houses, Disinfection of 15 — Inhabited 7, 26 Housing Statistics 26 Ice Cream 30 Immunisation and Vaccination Clinics 18 Infant Mortality 9, 10, 11 Infectious Disease Case Rates 14 — — Contacts 38 — — Hospitals 16 — — Monthly Incidence of 39 — — Notifications 39-45 — — — School 45 — — Public Health Inspector's Visits 24, 38 Influenza 44 Inquests 11, 12 53 PAGE Laboratory Facilities 15 Legal Proceedings 25 Library Books, Disinfection of 15 Maternal Mortality 9, 11, 13 Maternity, Hospital Treatment 16 Meals-on-Wheels 4, 49 Measles, Case Rates 13, 14 — Deaths from 9, 13, 14 Meat Inspection 32 Meningococcal Infection 44 Milk (Special Designation) Regulations 31 Mortality, Analysis of 14 National Assistance Act, 1948, Section 47 20 N.S.P.C.C 20 Neonatal Mortality 11 Ophthalmia Neonatorum 44 Outworkers (Section 11 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 (Regulations) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929 25 Petroleum (Regulations) Acts, 1928 and 1936, and Petroleum Carbide of Calcium Order, 1929 25 Piggeries 33 Pneumonia 44 Poliomyelitis 43 — Immunisation 43 Population 7 Post-Natal Clinics 19 Public Cleansing 21 Puerperal Pyrexia 44 Public Analyst 15 Radiography, Miniature Mass 49 Rateable Value 7 Rent Act, 1957 26, 27 54 PAGE Rivers and Streams 21 Rodent Operations 23 Rooms Disinfected, Number of 15, 38 Sanitary Circumstances of the Area 20-21 Scarlet Fever 41 Schools 22 Slaughterhouses 32 Slaughter of Animals Act, 1958 32 Smallpox 41 — Vaccination 41 — Vaccination Clinics 18 — Hospital 15 Smoke Control Areas 21 Social Conditions 7, 8 Staff 6 Statistics 8-14 — Housing 26 — Vital 14 Still Births 8 Tuberculosis 47-48 — Care Committee 50 — Clinic 16 Unsound Food dealt with 25 Venereal Disease Clinic 16 Visits by Public Health Inspectors 23-24 Water Supply 20 Whooping Cough, Deaths from 9, 13, 14 — — Immunisation 42