ORPINGTON URBAN DISTRICT COUNCIL REPORT For the Year 1941 on the Sanitary Conditions and Vital Statistics of the Urban District of Orpington by the Medical Officer of Health. Bromley: kentish district times co., ltd., 22, north street. 1 URBAN DISTRICT COUNCIL OF ORPINGTON. Gentlemen, I have pleasure in presenting my Annual Health Report for the year 1941, this being the nineteenth one presented by me as your Medical Officer of' Health. The Report is again this year curtailed as far as possible, and contains only such essential features as it is necessary to record. The population of the District as estimated by the Registrar-General for mid-year 1941 was 46,270, as compared with 48,700 last year. There has been a small decrease in the Birth Rate, this being 16.4 as against 17.5 last year. There was an increase in the Death Rate, viz., 12.3 per thousand of population, as against 10.9 last year. An increase also took place with respect to the Infantile Mortality Rate, viz., 51 per thousand registered births, as compared with 35 last year. This Rate is liable to fluctuation owing to the small numbers involved. The year has been a fairly satisfactory one from the point of view of incidence of Infectious Disease, the number of notification certificates received being 1,760, as compared with 505 last year. The increase is due to a much larger number of cases of Measles being notified. In submitting this Report I desire to place on record my appreciation of the assistance given to me by the Council and all its Officers. I would also like to express my thanks for the loyal and efficient services rendered by all members of the Public Health Department. Health Report for 1941. I am, Gentlemen, Your obedient Servant, P. N. CAVE, Medical Officer of Health. 2 URBAN DISTRICT COUNCIL OF ORPINGTON. Public Health Committee. Chairman: P. H. Baker, Esq. Vice-Chairman: J. R. Guthrie, Esq. Lt.-Col. K. M. Kirkhope, W. E. Hawken, Esq. W. H. Ayles, Esq. [c.i.e. F. J. Hyam, Esq., c.c. G. E. Barrett, Esq. H. J. Lester, Esq., F. J. Bell, Esq. j.p., f.s.a.a. C. L. Bruce, Esq. W. E. P. Loraine, Esq. C. F. Bulpitt, Esq. G. T. May, Esq. A. Carter-Wright, Esq. P. H. Powell, Esq. J. Da vies, Esq. A. L. Priest, Esq., j.p. G. E. Davis, Esq., G. R. Rickard, Esq. m.c., ll.b. S. RaWLINGS smith, esq. P. W. Dewberry, Esq. W. C. Sweatman, Esq. J. P. Earnshaw, Esq. W. J. Tarry, Esq. A. H. A. Grenger, Esq. e. Whiddon, Esq. Representatives on the West Kent Joint Hospital Board. C. L. Bruce, Esq. A. L. Priest, Esq., j.p. Representatives on the West Kent Main Sewerage Board. C. L. Bruce, Esq. A. L. Priest, Esq., j.p. STAFF. Medical Officer of Health: P. N. Cave, m.a., m.d., m.r.c.s., l.r.c.p., d.p.h. Sanitary Inspectors : J. A. Capon, c.r.s.i., m.s.i.a. (Chief Sanitary Inspector and Cleansing Superintendent). F. C. Crowe, m.r.s.i., m.s.i.a. (Deputy Chief Sanitary Inspector, Housing Inspector, Inspector under the Shop Acts, and Food and Drugs Inspector). W. T. Weedy, c.r.s.i., m.s.i.a. (Senior District Sanitary Inspector, and Inspector under the Shops Act). D. H. Livesey, m.r.s.i., m.s.i.a. (District Sanitary Inspector). With H.M. Forces. R. Taylor, c.r.s.i., m.s.i.a. (District Sanitary Inspector). D. Grantley Smith (Pupil Assistant). Hon. Salvage Officer: H. T. Cartmel Health Visitor: Mrs. L. Russell. Clerk and Shorthand Typist: Miss I. Chamberlain. 3 STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 20,842 Registrar-General's estimate of population, mid-1941 46,270 Number of occupied houses, December, 1941 15,556 Rateable Value of District, December, 1941 £473,031 Sum represented by a penny rate £1,700 Total. M. F. Birth Hate per 1,000 estimated population Live births Legitimate 729 365 364 Illegitimate 30 13 17 16.4 Total births 759 378 381 Stillbirths 21 12 9 Rate per 1,000 (live and still) births 28.3 Deaths 573 296 277 Death Rate per 1,000 of estimated population. 12.3 Rate per 1,000 (live and still) births. Deaths from puerperal causes: Puerperal Sepsis Nil — Other purperal causes Nil — Infant Deaths: No. of Deaths. All Infants 38 Rate per 1,000 live births 51 Legitimate infants 36 Rate per 1,000 legitimate live births 50 Illegitimate infants 2 Rate per 1,000 illegitimate live births 66 Deaths from Cancer (all ages) 71 Deths from Measles (all ages) 2 Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhoea (under 2 years) 4 4 HEALTH REPORT FOR 1941. Births.—During the year 759 Births were registered as belonging to this District, of which 378 were males and 381 were females. This gives a Birth Rate of 16.4 per thousand of population, as compared with 17.5 last year. Deaths.—The number of Deaths registered as belonging to this District was 573. This is equal to a Death Rate of 12.3 as againt 10.9 last year. Infant Deaths.—Thirty-eight deaths were registered as occurring in Infants under one year of age, the Infantile Mortality Rate being 51 per thousand registered births. The Infantile Mortality Rate for 1940 was 35. Orpington Urban England & District. Wales. Birth Rate 16.4 14.2 Death Rate 12.3 12.9 Infantile Mortality Rate 51 59 INFECTIOUS DISEASE. From the point of view of incidence of Infectious Disease the year 1941 has been a satisfactory one. The number of notifications received during the year was 1,760 as compared with 505 last year. This increase is due to a large increase in the number of cases of Measles and Whooping Cough notified, there being 1,225 cases of Measles and 323 cases of Whooping Cough notified during 1941 as compared with 324 and 12 respectively for the year 1940. The following Table shows the number of cases notified, together with the number removed to Hospital, and the total deaths. 5 Disease. Number notified. Removed to Hospital. Total Deaths. Scarlet Fever 66 60 — Diphtheria 69 65 4 Typhoid and Paratyphoid 10 2 — Erysipelas 10 — — Puerperal Pyrexia 12 — — Pneumonia 15 — 28* Cerebro-spinal Fever 15 5 2 Acute Poliomyelitis 5 — 2 Ophthalmia Neonatorum 3 — — Dysentery 7 — — Whooping Cough 323 — 1 Measles 1225 9 2 TOTALS 1760 131 39 *A11 forms. IMMUNISATION CLINIC. The following work has been carried out during the year : Number of sessions held 146 Number of attendances 7,197 Number of new cases 2,519 Number Tested M. F. Total Per Cent. Positive 393 472 865 83 Only children over 7 years of age were tested. 6 The monthly attendances were: January 592 July 1100 February 385 August 379 March 587 September 681 April 552 October 856 May 494 November 357 June 971 December 263 The number of new cases attending from each Ward was: Biggin Hill 126 Chelsfield 72 Crofton 469 Cudham 46 Downe 62 Goddington 287 Green St. Green 114 Knoll 431 St. Mary Cray 653 Knockholt 80 Farnborough 199 OPHTHALMIA NEONATORUM. The following are the particulars with respect to cases of Ophthalmia Neonatorum: Number of cases 3 Vision impaired — Vision unimpaired 3 Number treated at home — Number treated at hospital 3 Number removed from District — Number died — 7 Birth Rates, Civilian Death rates, Analysis of Mortality, Maternal Mortality and Case rates for certain Infectious Diseases in the year 1941. Provisional figures based on Weekly and Quarterly Returns : — England and Wales. 126 County Boroughs and Great Towns including London. 148 Smaller Towns (Resident populations 25,000 to 50,000 at 1931 census) London Administrative County. Orpington Urban District Rates per 1,000 Civilian Population. Births : Live 14.2 14.7 16,4 8.9 16.4 Still 0.51 0.58 0.60 0.33 0.44 Deaths : All Causes 12.9 14.9 13.0 16.3 12.3 Typhoid and Paratyphoid Fevers 0.00 0.00 0.00 0.01 — Scarlet Fever 0.00 0.00 0.01 0.00 — Whooping Cough 0.06 0.07 0.06 0.04 0.02 Diphtheria 0.07 0.08 0.06 0.03 0.8 Influenza 0.19 0.17 0.20 0.15 0.18 Smallpox — — — — — Measles 0.03 0.03 0.03 0.02 0.04 Rates per 1,000 Live Births. Deaths under 1 year of age 59 71 56 68 51 Deaths from Diarrhoea and Enteritis under 2 years of age 5.1 7.5 4.6 6,8 5.4 Notifications : Rates per 1,000 Civilian Population. Typhoid Fever 0.03 0.02 0.03 0.04 Paratyphoid Fever 0.09 0.12 0.09 0.05 0.21 Cerebro-Spinal Fever 0.25 0.31 0.20 0.30 0.32 Scarlet Fever 1.47 1.49 1.61 1.01 1.42 Whooping Cough 4.39 4.37 4.50 3.50 6.98 Diphtheria 1.25 1.53 1.19 0.93 1.49 Erysipelas 0.30 0.36 0.27 0.50 0.21 Smallpox — — — — — Measles 10.33 8.27 10.47 4.77 26.47 Pneumonia 1.25 1.53 1.04 1.07 0.32 Maternal Mortality : (excluding abortion) Puerperal Infection (No. 147) Rates per 1,000 Total Births (i.e., Live and Still). 0.48 Not Available. — Others 1.75 Total 2.23 Notifications : Puerperal Fever 11.91 15.64 9.43 2.29 15.81 Puerperal Pyrexia 19.3§ A dash (—) signifies that there were no deaths. § Including Puerperal Fever. 8 TUBERCULOSIS. The following Table shows the number of new cases of Tuberculosis notified, together with the number of deaths registered:— Notified. Deaths. Males. Females. Total. Males. Females. Total. Pulmonary 35 31 66 13 10 23 Non-Pulmonary 10 9 19 4 1 5 Total 45 40 85 17 11 28 Treatment for cases of Tuberculosis is undertaken by the Kent County Council, and during the year the following number of patients have been treated: Number receiving sanatorium treatment 28 Number receiving dispensary treatment 13 Dispensary supervision only 148 PUBLIC HEALTH ACT, 1936 (Section 176). PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. No action under the above was required to be taken during the year. ISOLATION HOSPITAL. The District is served by the West Kent Joint Isolation Hospital, and the following number of patients from this District were admitted there during the year: Scarlet Fever 50 Diphtheria 65 Typhoid and Paratyphoid 2 Cerebro-spinal Fever 5 Measles 9 9 LABORATORY WORK. The County Laboratory at Maidstone carries out the bacteriological work in connection with this District, and during the year the following number of specimens have been examined there: — Positive, Negative. TOTALS. Swabs for Diphtheria 27 168 195 Sputa for Tubercle 32 71 103 Widals for Typhoid 1 — 1 Swabs for Haemolytic Streptococci 1 17 18 Blood for Paratyphoid 2 1 3 Swabs for Vincents Angina 1 2 3 TOTALS 64 259 323 In addition, the following number of emergency examinations have been made by Dr. J. Byers at the West Kent Joint Hospital Board's Laboratory: — Positive. Negative. TOTALS. Swabs for Diphtheria 28 146 174 Swabs for Haemolytic Streptococci û û û TOTALS 28 146 174 DRAINAGE. The houses in the main portion of the District are on the water carriage system, and most of the houses are connected to the public sewers. No extensions to the sewers were made during the year. 10 SANITARY STATISTICS. Number of houses connected to the sewers. No. of houses not connected to sewers. No. of houses not provided with a piped water supply. No. of wells still in use for purpose of domestic supply. 12781 3011 393 6 Sanitary Conveniences. W.C.'s Pan or Pail Closets. Midden Privies. Ashpits separate from Midden Privies. Cesspools No. of No. of houses into. 15465 294 13 – 2289 2704 WATER SUPPLY. The mains of the Metropolitan Water Board supply the greater portion of the District. In some outlying parts, however, water is obtained from deep wells, and from rain water collected from the roofs of houses and stored in tanks. During the year 53 samples of water from the piped supply were submitted for examination. PUBLIC CLEANSING. The collection of house refuse throughout the District is carried out by direct labour, the greater portion of the District having a weekly collection. No alteration in the collection or method of disposal took place during the year. CESSPOOL EMPTYING. No special action was taken with regard to the emptying of cesspools during the year. The Council undertake the emptying of private cesspools as circumstances permit. 11 HOUSING. 1. Inspection of Dwelling Houses during the year:— (1) (a) Total number of houses inspected for housing defects (under Public Health or Housing Acts) 229 (b) Number of inspections made for the purpose 614 (2) (a) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 — (b) Number of inspections made for the purpose — (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation — (4) Number of dwelling houses (exclusive to those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 146 2. Remedy of Defects during the year without Service of Formal Notices. Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their Officers 114 3. Action under Statutory Powers during the Year:— (a) Proceedings under sections 9, 10 and 16 of the Housing Act, 1936: — (1) Number of dwelling houses in respect of which notices were served requiring repairs — (2) Number of dwelling houses which were dered fit after service of formal notices :— (a) By owners — (b) By Local Authority in default of owners — (b) Proceedings under the Public Health Acts: — (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 3 (2) Number of dwelling houses in which defects were remedied after service of formal notices: — (a).By owners 3 (b) By Local Authority in default of owners — 12 (c) Proceedings under sections 11 and 13 of the Housing Act, 1936 : — (1) Number of dwelling houses in respect of which Demolition Orders were made — (2) Number of dwelling houses demolished in suance of Demoliton Orders — (d) Proceedings under section 12 of the Housing Act, 1936: — (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made — (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit — 4. Housing Act, 1 936.—Overcrowding. (a) (i) Number of dwelling houses overcrowded at the end of the year 55 (ii) Number of families dwelling therein 65 (iii) Number of persons dwelling therein 200 (b) Number of new cases of overcrowding reported during the year 4 (c) (1) Number of cases of overcrowding relieved during the year 2 (2) Number of persons concerned in such cases 14 (d) Particulars of any cases in which dwelling houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding — (e) Any other particulars with respect to crowding you may consider it desirable to report — Number of new houses erected during the year: — By the Local Authority — By other persons 24 13 HEALTH VISITOR. The Council employs one full-time Health Visitor, who works under the supervision of the Medical Officer of Health. The following is a summary of the work carried out by her during the year: — Cases Visited. No. of Visits. Tuberculosis. Primary—Pulmonary 66 66 Non-Pulmonary 19 19 Re-Visits—Pulmonary 98 123 Non-Pulmonary 21 30 Measles 507 518 Scarlet Fever 4 9 Small Pox and Diphtheria contacts 18 18 Other visits 397 413 TOTAL 1130 1196 The visits to cases of Tuberculosis, etc., have been as follows: — Tuberculosis Primary. Tuberculosis Revisits. Other Visits. P. N.P. P. N.P. January 3 1 18 4 25 February 9 5 5 1 66 March 4 — 19 5 106 April 3 — — – 114 May 2 3 — — 156 June 12 2 — — 157 July 5 5 — — 40 August 6 — — — 45 September 6 — 9 1 33 October 8 1 23 4 64 November 3 1 22 6 66 December 5 1 27 9 59 TOTALS 66 19 123 30 931 14 MATERNITY AND CHILD WELFARE. The work in connection with Maternity and Child Welfare in this District is under the control of the Kent County Council. The following Clinics and Centres have been established in this District: — ANTE-NATAL CLINICS. Address. Sessions held. Total attendances. Orpington—Methodist Hall 1st, 3rd and 5th Tuesdays. Fridays at 10.0 a.m. 1167 St. Mary Cray— St. Andrew's Hall 2nd and 4th Wednesday afternoons 414 INFANT WELFARE CENTRES. Chelsfield—Reading Room 1st and 3rd Tuesday afternoons 319 Cudham—Village Hall 1st and 3rd Wednesday afternoons 308 Biggin Hill—Big Tea Pot Pavilion, Main Road Thursday afternoons 1335 Downe—Gospel Hall 2nd and 4th Tuesday afternoons 276 Farnborough— Methodist Church Hall Friday 2.30 p.m. 1349 Green Street Green— Baptist School Room Friday 2.0 p.m. 2171 Orpington— Methodist Church Hall Mondays and Tuesdays 5851 Petts Wood— St. Francis Hall Thursday afternoons 1317 St. Mary Cray— St. Andrew's Hall Tuesday afternoons 2189 15 SCHOOLS. It was not found necessary to close a school on account of the prevalence of Infectious Disease amongst the scholars. The following certificates were, however, issued covering low attendances: — Chelsfield—Pratts Chicken Pox and 3 weeks, ended 30th Bottom Council Measles May, 1941. Downe Council Measles 1 week ended 30.5.41. Do. Do. 1 week ended 13.6.41. Orpington —Chislehurst Measles and Road Council Infants Chicken Pox 5 weeks ended 30.5.41. Orpington— Farnborough Council Infants Measles, Colds and Coughs 4 weeks ended 14.3.41. Orpington— Wellington Road Council Measles 1 week ended 2.5.41, REGULATED TRADES. Number. No. of Visits. Defects. No. found. No, Remedied Dairies 75 87 4 4 Cowsheds Slaughterhouses— Licensed 17 13 — — Registered — — — — Bakehouses 20 8 — – Piggeries 16 3 1 1 Other food preparing places 270 380 — – Factories 172 3 — — Workplaces Common Lodging Houses 1 2 — — TOTALS 571 496 5 5 16 MILK (SPECIAL DESIGNATIONS ORDER), 1936. The Council granted the following number of Licences under the above Order during the year: — Tuberculin Tested 6 Pasteurised 10 MILK SUPPLY. During the year 51 samples were submitted for examination, of which 33 were satisfactory and 18 were unsatisfactory. MEAT. The following Table shows the work done in connection with the slaughtering of animals for human consumption :— CARCASES INSPECTED AND CONDEMNED. Cattle excluding Cows. Cows. Calves. Sheep and Lambs. Pigs. Number killed (if known) — — — — 8 Number inspected All diseases except — — — — 8 Tuberculosis — — — — — Whole carcases condemned — — — — — Carcases of which some part or organ was condemned — — — — 1 Percentage of the number inspected affected with disease other than Tuberculosis — — — — 12½ Tuberculosis only :— Whole carcases condemned — — — — — Carcases of which some part or organ was condemned — — — — — Percentage of the number inspected affected with Tuberculosis — — — — — SHOPS AND OFFICES. Inspections of shops and offices are made as circumstances permit. No contraventions were dealt with during the year. 17 FOOD AND DRUGS ACT, 1938. The powers under the Food and Drugs Act, 1938, are under the control of the Council, and during the year 240 samples were taken (60 formal and 180 informal) and submitted to the Analyst for examination. Two formal and 1 informal samples were reported as being not genuine. The following Table shows the number and description of the samples taken : — FORMAL SAMPLES.. Description of Samples. Number of Samples submitted. Number genuine. No. not genuine. Butter 1 1 — Margarine 1 1 — Milk (new) 51 51 — Tincture of Quinine 2 — 2 Saccharine Tablets 1 1 — Beef Sausages 2 2 — Soup Powder 1 1 — Malt Vinegar 1 1 — INFORMAL SAMPLES. Description of Sample. Number of Samples submitted. Number genuine. No. not genuine. Aspirin tablets 3 3 — Baking Powder 1 1 — Barley Kernels 1 1 — Barley (patent) 1 1 — Barley (pearl) 1 1 — Tinned Beans 1 1 — Blancmange Powder 1 1 — Boracic Acid Powder 2 2 — Camphorated Oil 2 2 — Castor Oil 4 4 — Cheese Powder 1 1 — Cinamon and Quinine 1 1 — Coffee 4 4 — Cocoa 6 6 — Cod Liver Oil 2 2 — Cornflour 3 3 — Cough Mixture 1 1 — Curry Powder 2 2 — Custard Powder 3 3 — Custard Pudding Powder 1 1 — Egg Substitute 4 4 — Epsom Salts 2 2 — Fish Paste 5 5 — Fish Roll 1 1 — Flour 5 5 — Bun Flour 1 1 — Friars Balsam 5 5 — 18 INFORMAL SAMPLES (Contd.) Description of Sample. Number of Samples submitted. Number genuine. No. not genuine. Glucose Powder 1 1 — Glycerine 1 1 — Glycerine, honey and lemon with Ipecacuanha 1 1 — Browning Gravy 1 1 — Horse Radish Cream 1 1 — Tincture of Iodine 4 4 — Lemon Essence 1 1 — Lemon Juice Substitute 1 1 — Meat Paste 4 4 — Malted Milk 1 1 — Mint Sauce 1 1 — Rolled Oats 1 1 — Ointment (anti-gas No. 2) 1 1 — Do. Boracic 5 5 — Do. Sulphur 6 6 — Do. Zinc 4 4 — Olive Oil 1 1 — Onion Extract 1 1 — Paraffin (liquid) 2 2 — Peas (tinned) 5 5 — Pepper 2 2 — Pepper (white) 6 6 — Piccallilli 1 1 Pickles 4 4 -~ Pills (iron) 1 1 — Tincture of Quinine 4 3 1 Rice 11 11 — Rice (flaked) 1 1 — Rice (ground) 4 4 — Saccharine Tablets 1 1 — Sago 1 1 — Sal Volatile 4 4 — Salad Oil 1 1 — Salt 2 2 — Sardines (tinned) 2 2 — Sausages (Beef) 1 1 — Sauce (Mustard) 1 1 — Sauce 3 3 — Semolina 2 2 — Sild. (tinned) 1 1 — Soda (bicarbonate) 2 2 A —-- Soup (tinned) 4 4 •I —-— Soup (cubes) 1 1 —" Spice (mixed) 1 1 •i — Spice (pickling) 1 r\ 1 o — Table Jelly 2 2 — Cream of Tartar 1 1 — Tomato Ketchup 2 2 — Vinegar 2 2 — Vinegar (malt) 4 4 — 19 Action taken with regard to samples found to be not genuine:— No. of Sample. Description. Nature of Adulturation. Action taken. 316 Ammoniated Tincture of Quinine Deficient in Quinine Sulphate to the extent of 35% Formal Sample taken. 321 Do. Deficient in Quinine Sulphate to the extent of 33.7% Further Sample taken. 327 Do. Deficient in Quinine Sulphate to the extent of 39.4% Wholesaler fined £5, Costs £7 7s. 0d. Retailer ordered to pay £3 3s. 0d. costs. SWIMMING BATHS AND POOLS. There is one public swimming pool and one privately owned swimming bath in the District. Inspections were made during the year, and 110 action was found necessary. CAMPING SITES. No licences for Camping Sites were issued during the year. SMOKE ABATEMENT. No action was found necessary to be taken with regard to nuisances from smoke. ERADICATION OF BED BUGS. Council Houses.—Eighteen Council houses were disinfested during the year. Strict supervision is exercised in regard to possible infestations, and advice given when necessary. In all cases where infestation is found the necessary action is taken by the Council to exterminate the vermin. Other Houses.—Four other houses were disinfested during the year. "When infestation is brought to the Council's notice the premises are inspected and advice and assistance given to the occupiers. Zaldecide insecticide is used in connection with disinfestations. 20 NURSING FACILITIES. No change has been made in the nursing facilities for the District during the year. LEGAL PROCEEDINGS. Particulars. Result. For failure to comply with a notice requesting the remedying of dampness in a house Fined £5, together with £1 1s. 0d. costs. Prosecution under Food and Drugs Act, 1938.—Ammoniated tincture of quinine being deficient in quinine sulphate to the extent of 39.4% Wholesaler fined £5 and £7 7s. 0d. costs. Retailer ordered to pay £3 3s. 0d. costs. NURSING AND MATERNITY HOMES. The County Council has delegated to the District Council the powers relating to Nursing and Maternity Homes. There are two registered Homes in this District, the number of beds available being 3 for maternity cases and 5 for other cases. ADOPTIVE ACTS AND BYE-LAWS. No Acts or Bye-laws were adopted during the year. RIVERS AND STREAMS. Supervision is paid to all watercourses within the District. In one instance pollution was discovered in a tributary stream to the River Cray. The matter was reported to the Engineer of the Kent Rivers Catchment Board for attention. 21 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1941. Disease. At all ages. At ages—years. Removed to Hospital. Total Deaths. Under 1 year. 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 25 25 to 45 45 to 65 65 and over. Scarlet Fever 66 3 5 3 5 27 10 8 4 1 •• 50 .. Diphtheria 69 2 1 5 6 3 24 15 5 6 1 1 65 4 Typhoid and Paratyphoid 10 .. .. .. .. .. .. 1 5 3 1 .. 2 .. Erysipelas 10 .. .. .. .. .. .. .. .. 2 3 5 .. .. Puerperal Pyrexia 12 .. .. .. ..••.. .. .. .. 1 11 .. .. .. Pneumonia 15 1 .. .. .. .. .. 2 .. 6 4 2 .. †28 Measles 1225 24 87 112 127 96 642 92 26 17 2 •• 9 2 Cerebro-spinal Meningitis ] 5 .. .. .. .. .. 3 2 2 5 3 •• 5 2 Whooping Cough 323 29 23 48 50 37 132 4 .. 4 1 .. .. 1 Acute Poliomyelitis 5 .. .. 2 .. .. 1 .. 1 1 .. .. .. 2 Opthalmia Neonatorum 3 3 ., .. .. .. .. .. .. .. .. .. .. .. Dysentry 7 .. 2 1 1 .. 1 1 1 .. .. .. .. .. TOTALS 1760 59 116 168 187 141 830 127 49 59 16 8 131 39 † all forms 22 DEATHS REGISTERED AS OCCURING DURING THE YEAR. Cause of Death Males. Females. TOTALS. Typhoid Fever – – – Cerebro-spinal Fever – 2 2 Scarlet Fever – – – Whooping Cough 1 – 1 Diphtheria 3 1 4 Tuberculosis of respiratory system 13 10 23 Other Tuberculous diseases 4 1 5 Syphilitic diseases 1 1 2 Influenza 2 7 9 Measles 1 1 2 Poliomyelitis and Polioencephalitis – 2 2 Acute Infantile Encephalitis – – – Cancer of bronchial cavity 4 7 11 Cancer of Stomach and Duodenum 6 3 9 Cancer of the Breast – 9 9 Cancer (all other forms) 23 19 42 5 3 8 Diabetes Inter cranial vesc. lesions 23 21 44 Heart Disease 81 89 170 Other Diseases of Circulating System 9 6 15 Bronchitis 17 20 37 Pneumonia 14 14 28 Other respiratory diseases 2 6 8 Ulcer of Stomach and Duodenum 9 1 10 Diarrhoea (under 2 years) 3 1 4 Appendicitis 1 – 9 1 16 Other digestive diseases 7 Nephritis 5 1 6 Post and post-obort. sepsis – – – Other maternal causes – – – Premature birth 7 1 8 Congenital malformation and birth injury 5 10 15 Suicide 1 1 2 Road traffic accidents 5 — 5 Other violent causes 15 12 27 All other causes 29 19 48 TOTALS 296 277 573