PAD 40 metropolitan borough of paddington. abridged annual report of the medical officer of health for the year 1940. POPULATION. Registrar-General's estimate of Civilian Population 97,860. LIVE BIRTHS Total Males Females Birth-rate per 1,000 estimated civilian population, 1940. 15.90 Legitimate 1519 679 640 Illegitimate 237 125 112 Totals 1556 804 752 stillbirths 57 39 18 Rate per 1,000 (live & still)1 births 36 deaths 1766 835 931 Death Rate per 1,000 estimated civilian population 18.04 DEATHS FROM PUERPERAL CAUSES Rate per 1,000 (live and still) births Puerperal Sepsis 1 0.65 Other Puerperal Causes 3 1.96 Total 4 2.61 DEATHS OF INFANTS UNDER 1 YEAR OF AGE 88 Death Rates of infants under 1 year of age:- All infants per, 1,000 live births 59 Legitimate infants per 1,000 legitimate live births 54 Illegitimate infants per 1,000 illegitimate live births 89 DEATHS FROM TUBERCULOSIS Pulmonary (all ages) 72 Other forms (all ages) 14 Death Rate from Pulmonary Tuberculosis per 1,000 of the estimated civilian population 0.73 Tuberculosis. Death-Rate (all forms) 0.88 (continued) - 2 - CLASSIFICATION OF DEATHS. All Ages Under 1 year of age M F Total M F Total ALL CAUSES 835 931 1766 59 29 88 Typhoid & paratyphoid fevers - - - - - - Cerebro-spinal fever 7 7 14 5 — 5 Scarlet fever - - — - — - Whooping, cough - 1 1 - 1 1 Diphtheria l 1 2 — - — Pulmonary tuberculosis 45 27 72 - 1 1 Other tuberculous diseases 5 9 14 - - - Syphilitic diseases 19 7 26 2 - 2 Influenza 9 11 20 1 1 2 Measles - 1 1 — - - Acute polio-myelitis and polio-encephalitis - - - - - - Acute infectious encephalitis — — — — - - Cancer of buccal cavity and œsophagus 14 _ 14 - - - Cancer of uterus — 15 13 — - — Cancer of stomach and duodenum 11 22 33 - - - Cancer of breast — 32 32 - — — Cancer of all other sites 55 66 119 - — — Diabetes. 5 11 16 — — - Intra-cranial vascular lesions 38 78 116 — — - Heart disease 161 219 380 — — — Other circulatory diseases 27 54 61 - — - Bronchitis 87 53 140 2 2 4 Pneumonia 55 62 117 5 2 7 Other respiratory diseases 13 11 24 - — - Ulcer of stomach or duodenum 19 9 28 - — — Diarrhœa (under 2 years) 9 8 17 9 8 17 Appendicitis 6 5 11 - - - Other digestive diseases 18 15 33 2 — 2 Nephritis 21 23 44 - — — Puerperal sepsis — 1 1 — — — Other maternal causes - 3 3 — — - Premature birth 9 8 17 9 8 17 Congenital malformation, birth injury, infantile disease 21 6 27 20 4 24 Suicide 20 10 30 — - - Road traffic accidents 15 7 22 — - — Other violent causes 90 105 195 2 1 3 All other causes 57 66 125 2 1 3 (continued) - 3 - notification of infectious diseases Disease Total Cases Notified Cases Admitted to Hospital Total Deaths Acute Encephalitis lethargica 1 1 - „ Influenzal pneumonia 22 4 4 „ Primary pneumonia 80 57 6 „ Polio-encephalitis - - — „ Polio-myelitis 1 1 — „ Rheumatism 9 7 — Anthrax - - - Cerebro-spinal fever 24 24 4 Continued fever 3 2 - Diphtheria 42 40 2 Dysentery 3 3 - Erysipelas 43 21 1 Food poisoning or suspected food poisoning 6 - - Infective enteritis or summer diarrhœa 24 23 3 Malaria 4 4 - Measles 253 190 - Membranous croup — — - Ophthalmia neonatorum 20 18 - Puerperal fever 23 23 1 Puerperal pyrexia 17 16 - Scarlet fever 56 51 - Smallpox - - - Typhoid or enteric fever 5 3 - Whooping cough 24 10 - DIPHTHERIA IMMUNISATION. During the year 42 children were fully inoculated under the Council's Scheme, and 8 cases attended the Diphtheria Immunisation Clinic at St. Mary's Hospital. VACCINATION. The latest return available is for the year 1939. This shows that of the 2,192 children whose births were registered during that year 32.4 per cent were successfully vaccinated and 12.2 per cent were exempted on production of statutory declarations of conscientious objection. Insusceptibility, removals, deaths, not traced, etc., account for the remaining 55.4 per cent. TUBERCULOSIS. l68 eases of pulmonary tuberculosis and 37 cases of non-pulmonary tuberculosis were notified. The total number of cases on the register at the end of the year was 851. DISPENSARY TREATMENT. Paddington Tuberculosis Dispensary St. Mary's Hospital Tuberculosis Dispensary No. of patients examined for 1st time (excluding contacts) 502 124 No. of above found tuberculous 106 54 No. of contacts examined 117 42 No. of contacts found tuberculous 5 — No. of attendances at Dispensary- 3535 1919 No. of visits by Tuberculosis Officers 264 . 57 No. of visits by Tuberculosis Nurses 2540 1688 4 DISINFECTION. The number of rooms disinfected after the occurrence of infectious disease was 339 and the weight of bedding removed for disinfection amounted to approximately 20 tons. CLEANSING OF VERMINOUS PERSONS. 208 adults and 119 children receive treatment during the year. CLEANSING OF VERMINOUS ROOMS. Notices under Section 123 of the Public Health (London) Act were served with respect to 18 premises, the verminous rooms numbering 27 all of which were satisfactorily dealt with. BACTERIOLOGICAL WORK. The number of examinations made was 347, which included 195 for diphtheria and 138 for tuberculosis. Eight of th former and 12 of the latter were positive. RENT AND MORTGAGE INTEREST (RESTRICTIONS) ACTS. Six applications for certificates were made, 5 of which were granted. FACTORIES ACT, 1937. Inspections totalled 381. Defects found numbered 15, all of which had been remedied by the end of the year. No legal proceedings were necessary. BAKEHOUSES. At the end of the year the number of level bakehouses was 17, and of underground 26. Inspections numbered 399. SHOPS ACTS. First inspections numbered 26, and re-inspections 1,379. No exemption certificates were applied for, and no legal proceedings were necessary. WORK OF THE DISTRICT INSPECTORS. Number of complaints received 1,233 Number of first inspections 1,245 Number of re-inspections 10,029 The following articles, damaged by enemy action, were also surrendered during the year. Butter 80 lbs. Margarine, cooking fats, suet, etc., 261 lbs. Sugar 629 lbs. Cheese 173 lbs. Milk, liquid 146 pints Tea 164 xbs. Wines, etc 99 bottles Cereals 837 lbs. Salt, Condiments,etc 431 packets Confectionery, sweets 1542 lbs. TENEMENT HOUSES. No houses were added to the Register during the year, the number remaining at 2,403. Inspections totalled 5,155 and legal proceedings were instituted in respect of 45 nuisances and contraventions of the Byelaws. A number of tenement houses were inspected in connection with annual cleansing and notices were served where necessary. FOOD SUPERVISION. Five hundred samples were taken during the year, of which 3 (0.6 per cent) were found to be adulterated. Two hundred and fifty-three of these samples were of milk, 1 (0.39 per cent) being not genuine. Legal proceedings were taken with respect to a sample of minced meat which contained 1,158 parts per million of sulphur dioxide, contrary to the provisions of the Public Health (Preservatives in Food) Regulations 1925-1927. Proceedings were also instituted in two cases with regard to the sale of food intended for, but unfit for, human consumption. The weight of unsound food surrendered by tradesmen and dealers for destruction was 10 tons, 12 cwts., 0 qrs., 11 lbs. -5- Cakes, biscuits, etc 514 lbs. Bread 383 lbs. Canned goods, milk, meat, fish, fruit 987 tins Jams 234 jars Sauces, etc. 236 bottles Fresh fruit & vegetables 1833 lbs. Meal portions, prepared 309 Dried fruit 161 lbs. Eggs 132 fresh 32 lbs. dried Meat, fish, bacon 325 lbs. Oxo 864 cubes Eighteen visits were paid to the one slaughter-house in the Borough, for the short period during which it operated at the beginning of the year. The number of animals slaughtered comprised 12 bullocks and 30 sheep. Four hundred and seventy-seven inspections of the 195 dairies and milkshops were made, and 4,868 inspections of food purveyors' premises, which number approximately. 1,000. Licences issued under the Milk (Special Designations) Order 1936 numbered 86, (67 in respect of "Pasteurised" and 19 in respect of "Tuberculin Tested" milk). Four samples of "Pasteurised" milk were taken, which, with one exception, complied with the prescribed test. MATERNITY AND CHILD WELFARE. The Health Visitors who were employed on Air Raid Precautions work at the end of 1939 resumed their normal duties early in the year, but the services of those officers have been utilised from time to time in connection with Evacuation, Billeting and other Civil Defence Duties. The home visiting work of the Health Visitors during the year is summarised in the appended table:- First visits to children under 1 year of age 1,214 Revisits 5,570 6,584 Visits to children between the ages of 1 and 5 years 8,051 First visits to expectant mothers 1,139 Revisits 845 1,984 Other visits - Sickness (including Puerperal Fever, Puerperal Pyrexia, Ophthalmia Neonatorum and Infantile Diarrhoea .171 Miscellaneous (including ineffective calls) 5,330 5,501 (Continued) - 6 - Infant Consultations:- 300 sessions, 18,753 attendances by 2,706 children. Ante- and Post - Natal Clinics:- 103 sessions, 1,439 attendances by 492 expectant or recently confined mothers. Dental Treatment:- 24 nursing or expectant mothers received treatment under arrangements made with Mr. F.H. Brinckley Tofts,. L.D.S., R.C.S. (Eng.) Home Helps:- Provided in 60 cases. Maternity Beds:- 112 women were delivered in the ward reserved at St. Mary's Hospital. One case of Puerperal Pyrexia and two cases of Puerperal Fever were notified. There were 7 stillbirths and 2 deaths within ten days of birth. Extra Nourishment:- 1,036 new applications were received, of which 934 were granted. Approximate cost £2,095. With the introduction of the National Milk Scheme the majority of the cases came under the new arrangement. Grants in excess of the Government standard, where needed on medical grounds, continue to be made in necessitous cases under the Council's scheme, as well as issues of ancillary foods, medicines, etc. National Milk Scheme:- This scheme came into operation on the 21st July, 1940, and the Medical Officer of Health was appointed to act as Milk Officer. The number of beneficiaries during the year-was 4,738, of whom 1,352 were supplied free. Convalescence:- Three mothers with their babies were sent to convalescent homes, and 9 children were sent away under arrangements with the Invalid Children's Aid Association. Child Life Protection:- 709 visits and inspections were made. At the close of the year the Register contained the names of 22 persons who had charge of 33 children. HOUSING. No operations under the Housing Act, 1936 were undertaken during the year in respect of redevelopment, clearance, demolition and closing. On the 21st August, 1940, the Minister of Health informed the Council that in view of the receipt of satisfactory proposals from the owners for the reconstruction of the properties included in the Falconer Mews Clearance Order, 1939, he had decided not to confirm the Order. Following the execution of approved works to render the rooms fit for human habitation, the closing orders on six basement premises were determined or varied. One other basement premises was made fit for human habitation without recourse to formal proceedings. Of persons living in premises the subject of clearance or closing orders made prior to the year under review, 3 were rehoused on London County Council Estates, 6 were accommodated on Paddington Borough Council Estates; and 234 secured accommodation of a private nature through their own efforts. No notices were served during the year under Section 9 of the Housing Act, 1936. Seven communications were, however, sent to owners drawing attention to defects liable to be dealt with under this section. These communications resulted in the defects being remedied. (Continued) - 7 - During the year, one case of illegal overcrowding was discovered and abated by service of notice on the landlord under section 59(5) of the Housing Act, 1936. Number of dwellings overcrowded at the end of the year 672 Number of families dwelling therein 672 Number of persons dwelling therein 3258 units Number of new cases of overcrowding reported during the year 9 Number of cases of overcrowding relieved during the year 22 Number of persons concerned in such cases 96 units Seventeen of the overcrowded families were provided with accommodation on London County Council Estates. Three further families were rehoused by the County Council on medical grounds. During the year the Associated Fumigators, Limited, under an agreement with the Council removed and treated the furniture, etc., of 13 families with hydrogen cyanide gas. The cost of the work was £32. 5. 0. G. E. Oates M.D., M.R.C.P.(London),D.P.H.(Cambridge). Barrister-at-Law. Medical Officer of Health. 15th August, 1941. CBK. «