DAD 42 METROPOLITAN BOROUGH OF PADDINGTON Interim Annual Report of the Medical Officer of Health for the year 1942. population: The estimated civilian population for 1942, furnished by the Registrar-General, shows an increase over that for 1941, but the figures are not available for publication. Live Births 1,3971 Stillbirths 47; Deaths 1,268. Maternal Deaths 4; Infant Deaths 78; Maternal Mortality Rate 2.77; Infant Mortality Rate 56. CLASSIFICATION OF DEATHS All Ages Under 1 year of age M F total M F Total all CAUSES 608 660 1268 47 31 78 Typhoid & paratyphoid fevers - - - - - - Cerebro-spinal fever 1 1 2 - - - Scarlet fever - - - - - - Whooping cough 2 2 4 1 2 3 Diphtheria - 1 1 - - - Pulmonary tuberculosis 41 29 70 - - - Other tuberculous diseases 4 13 17 - 1 1 Syphilitic diseases 10 2 12 - - - Influenza 5 2 7 - - - Measles 1 - 1 1 - 1 Acute polio-myelitis and polio-encephalitis - - - - - - Acute infectious encephalitis - - - - - - Cancer of buccal cavity and oesophagus (males) 9 - 9 - - - Cancer of uterus - 19 19 - - - Cancer of stomach and duodenum 14 15 29 - - - Cancer of breast 1 28 29 - - - Cancer of all other sites 65 65 130 - - - Diabetes 2 3 5 - - - Intra-cranial vascular lesions 35 62 97 1 — 1 Heart disease 132 156 288 1 - 1 Other circulatory diseases 30 24 54 - - - Bronchitis 4.1 46 87 1 2 3 Pneumonia 40 34 74 4 4 0 Other respiratory diseases 6 5 11 - - - Ulcer of stomach or duodenum 10 3 13 - - - Diarrhoea (under 2 years) 6 4 10 6 4 10 Appendicitis 3 2 5 - - - Other digestive diseases 9 23 32 1 1 2 Nephritis 6 9 15 - - - Puerperal sepsis - 3 3 - - - Other maternal causes - 1 1 - - - Premature birth 12 11 23 12 11 23 Congenital malformation, birth injury, infantile disease 20 9 29 17 5 22 Suicide 14 4 18 - - - Road traffic accidents 8 4 12 - - - Other violent causes 26 25 51 2 1 3 All other causes 55 55 110 — — — NOTIFICATION OF INFECTIOUS DISEASES Total Cases Notified Cases Admitted to Hospitals Total Deaths Acute Encephalitis lethargica — - - — " Influenzal pneumonia 11 - - - " Primary pneumonia 96 75 - 8 " Polio-encephalitis - - - - " Polio-myelitis 1 1 - - " Rheumatism 2 1 - - (2) Cerebro-spinal fever 11 10 2 Continued fever - — — Diphtheria 38 37 1 Dysentery 35 28 3 Erysipelas 28 17 - Food poisoning or suspected food poisoning 6 - - Infective enteritis or summer diarrhoea 27 26 3 Malaria 3 3 — Measles 707 132 1 Ophthalmia neonatorum 6 5 - Puerperal fever 5 5 - Puerperal pyrexia 3 38 1 Scarlet fever 110 97 - Smallpox - - - Typhoid or enteric fever 1 1 - Whooping Cough 23 91 4 DIPHTHERIA IMUNISATION. During the year, 1961 children were fully inoculated, including 893 "schools" cases. Fifty-six cases attended' the Clinic at St. Mary's Hospital. Following the receipt of Ministry of Health Circulars Nos.2627 and 2677 steps were taken to give as wide publicity as possible to the facilities for immunisation available in the Borough. These included the insertion in three local newspapers of the stereos provided by the Ministry and the exhibition of posters at Council premises and on shingle bins throughout the Borough. Leaflets were also distributed by the Health Visitors and Women Sanitary Inspectors and made available for the public at the Council's offices and other establishments. In addition to the foregoing, the parents of all unimmunised children under 5 years of age were approached by the Health Visitors in accordance with Ministry of Health Circular No.2713, and local practitioners were circularised asking them to support the campaign generally and to take special steps regarding their own patients, either by referring them to the Council's immunisation clinic or by treating them under the scheme for immunisation by private practitioners At the end of the year it was considered that 66.7% of the child population under 5 years of age, and 68.4% between the ages of 5 and 15 years, had been immunised. VACCINATION. The latest return available is for the year 1941. This shows that of the 1,218 children whose births were registered during that year, 56.8 per cent. were successfully vaccinated, and 11.2 per cent. were exempted on production of statutory declarations of conscientious objection. Insusceptibility, removals, deaths, not traced etc., account for the remaining 32.0 per cent. TUBERCULOSIS. Notification Register. New cases notified comprised 195 of pulmonary tuberculosis and 40 of non-pulmonary tuberculosis. The number of cases on the register at the end of the year was 782, as compared with 729 cases at the end of the year 1941. Dispensary Treatment. As from 1st April 1942 there was an adjustment 01 the districts served by the two Dispensaries, a portion of the Borough formerly in the area of the St. Mary's Hospital Dispensary being transferred to the area of the paddington Tuberculosis Dispensary. The death rate for pulmonary tuberculosis was 0.84 as compared with 1.09 for the previous year, and for all forms of tuberculosis the death rate was 1.04 as against 1.25. Particulars of the work carried out are shown in the following table: Paddington Tuberculosis Dispensary St.Mary's Hospital Tuberculosis Dispensary No. of patients examined for 1st time (excluding contacts) 546 l6l No. of above found tuberculous 102 39 No. of contacts examined 116 19 No. of contacts found tuberculous 1 4 (3) No. of attendances at Dispensary 3984 1780 No. of visits by Tuberculosis Officers 293 104 No. of visits by Tuberculosis Nurses 2254 1346 No. of cases on Dispensary Register at end of year 450 243 EDICINAL BATHS AND DISINFECTING STATION. These arrangements have Continued to function satisfactorily throughout the year in spite of in increased number of persons who have required treatment. During August two additional bath cubicles were taken ever for women, and another female attendant was subsequently engaged. The number of persons suffering from scabies who received treatment during the year was 845, comprising 313 males and 532 females, (adults Other than school children). The number of verminous persons cleansed was 107 (29 males, 78 females). other than of bedding etc. disinfected during the year after infectious disease was approximately 23½ tons. In addition about 6½ tons of Redding etc. in use by the Civil Defence Services of the Borough receivel treatment. The number of rooms disinfected, after the occurrence of infectious disease was 211. CLEANSING OF VERMINOUS ROOMS. Notices under Section 123 of the Public Health (London) Act, 1936, were served with respect to 11 premises, the verminous rooms concerned being 15, which were satisfactorily dealt with. Many premises, however, were dealt with without recourse to the service of notices, and the owners or occupiers of 46 premises took advantage of the arrangements v.hereby the Council spray rerminous rooms at a charge of 7s. 6d. a room. Seventy-four rooms Were so dealt with. BACTERIOLOGICAL WORK. The number of examinations made was 320, Which included 192 for diphtheria, and 115 for tuberculosis. Eight of the former and 7 of the latter were positive. RENT AND MORTGAGE INTEREST (RESTRICTIONS) ACTS. Two applications for certificates were received, and in respect of one a certificate was issued, FACTORIES ACT, 1957. Two hundred and twenty-eight inspections and visits were paid. BAKEHOUSES. At the end of the year the number of level bakehouses was 14, and of basement bakehouses 26. Inspections numbered 97. SHOPS ACTS. Inspections of all kinds numbered 879. No exemption certificates were applied for, and no legal proceedings were necessary. WORK OF THE DISTRICT INSPECTORS. Owing to calls on the inspectorial staff for other duties, only three Sanitary Inspectors were available for dealing with complaints and carrying out routine inspection of premises. The particulars given below include inspections of tenement houses, which have not been recorded separately. Number of complaints received 1132 Number of first inspections 1298 Number of reinspections 6106 Legal proceedings were instituted in 57 instances for offences under the Public Health (London) Act, 1936 or for contraventions of the Bye-laws. FOOD SUPERVISION. Five hundred samples were taken during the year, of which 9 (1.5 per cent.) were found to be adulterated. Two hundred and nineteen of these samples were of milk, and 4 (1.8 per cent.) were found to be not genuine. Particulars of legal proceedings taken under the Food and Drugs Act, 1938, are given below:- Offence Result of summons Issuing label falsely describing Dismissed. No order as to costs. foodstuff. Jelling chocolate sweetmeat unfit Fined £30. £5. 5s. costs. for human consumption. (4) Selling chocolate sweetmeat unfit for human consumption. Selling chocolate sweetmeat containing an added substance. Fined £20. £5. 5s. costs. Heard in conjunction with above 2 summonses and marked "not separately dealt with." The weight of diseased and unsound food of all kinds surrendered by tradesmen and dealers for destruction was 12 tons 15 cwts 2 qrs. 3 lbs. No slaughtering of animals took place in the Borough during the year. Four hundred and ten inspections of the 180 dairies and milkshops were made, and 4,564 inspections of food purveyors' premises, which number approximately 1,000. Licences issued under the Milk (Special Designations) Orders numbered 65 (45 in respect of "Pasteurised" and 18 in respect of "Tuberculin Tested" milk). Nine samples of "Pasteurised" and 1 of "Tuberculin Tested" milk were taken, all of vhich complied with the prescribed conditions. PHARMACY AND POISONS ACT, 1955. At the close of the year the Register of persons entitled to sell poisons in Part II of the Poisons List contained 8l entries. MATERNITY AND CHILD Y-ELFARE. Miss D.K.Newington, Health Visitor, v.ho had been acting as Alatron of the evacuated nursery at Ascot, resumed her normal duties on the 28th September. Miss M.MacLean and Miss E.M.Candler continued to be employed with the First Aid Post Service and the Rehousing Department, respectively. The staff engaged on health visiting at the end of the year numbered 11 (including the Superintendent and 1 temporary Health Visitd In order to meet the increased demand for the services of Home Helps, an additional woman was engaged and commenced duty on the 14th December. Home visiting during the year is summarised in the appended table First visits to children under 1 year of age 1559 Revisits 6256 7595 Visits to children between the ages of 1 and 5 years 8465 First visits to expectant mothers 947 Revisits l008 1955 Other visits:Sickness (including Puerperal Fever, Puerperal Pyrexia, Ophthalmia Neonatorum and Infantile Diarrhoea) 107 Miscellaneous (including ineffective calls) 4710 4817 The number of children on the Health Visitors' lists at the close of the year was 4295* Infant consultations:- 356 sessions, 19,740 attendances by 2307 children. Ante- and Post-Natal Clinics:- 105 sessions, 1,578 attendances by 487 expectant or recently confined mothers Dental Treatment:- 11 nursing or expectant mothers received treatment under arrangements made with Mr.F.H.Brinkley Tofts, L.D.S., R.C.S. (Eng.) Home Helps:- Provided in 59 cases. Maternity Beds:- 88 women were delivered in the beds reserved at St. Mary's Hospital. One case of Puerperal Pyrexia was notified. Then was one stillbirth and two deaths within 10 days of birth. Extra Nourishment:- 107 new applications were received of which 89 were granted. Approximate expenditure, including ancillary foods, medicines, etc. £75. 5 Convalescence:- Three mothers with their babies and one mother without were sent to convalescent homes, and 6 children v ere sent away under arrangements with the Invalid Children's Aid Association. Child Life Protection:- 247 visits and inspections were made. At the close of the year the Register contained the names of 24 persons, who had charge of 36 children. Legal proceedings were taken in one instance in respect of failure to register as a foster mother, the defendant being sentenced to six weeks imprisonment. Daily Guardians:- 64 persons were registered for the care of 92 children. At the end of the year the Register contained the names of 48 Guardians who had charge of 66 children. PERAMBULATOR SCHEME. In order to meet the difficulties occasioned by the scarcity and high prices of perambulators it was decided to introduce a hiring scheme and a stock of 49 perambulators was accordingly acquired. These are hired out subject to: (a) the payment of a deposit of 30/- which is refunded on the return of the perambulator in a satisfactory condition; (c) the payment in advance of a weekly charge of 1/-; (c) the hirer being a resident of the Borough for the previous twelve months; and (d) the execution of a form of agreement. It is felt that the -scheme has been -successful in helping to ease the situation, WAR- TIME DAY NURSERIES. In addition to the Westbourne Day Nursery, which was in operation throughout the year, the Maida Vale Day Nursery was opened at 14 Blomfield Read on the 14th September. The former provides accommodation for 50 children (20 under 2 years of age ana 30 between 2 and 3 years) and the latter for 52 children (25 under 2 and 27 between 2 and 5). Accommodation is also available at the Queen's Park Day Nursery, 66 Lancefield Street, for 26 children between the ages of 2 and 5 years, although its formal approval by the Minister of Health as a War-time Nursery has not been received. Details of attendances are given below: Westbourne Maida Vale Queen's Park Full Satur- Full Satur- Full Saturdays days days days days days Days open 257 51 78 14 257 51 Attendances 10522 1440 2450 276 5355 517 Average attendance 41 28 31 19 21 10 New children 91 70 32 At the end of the year work had been commenced on the adaptation of St. Jude's Vicarage, 88 Bravington Road, for use as a nursery, and the approval of the Ministry of Health had been obtained to the erection of Hutment Nurseries on the bombed sites in Marylands Road and Peach street. (6) HOUSING. Following the execution of approved works one basement premises was made fit for human habitation. Of persons living in premises the subject of clearance or closing orders made prior to the year under review, 55 secured accommodation of a private nature through their own efforts. Of the 205 cases of overcrowding on the Register at the end of 1941: 65 were found to have been abated by removal; and a further 17 by a natural reduction in the size of the family, or on obtaining additional accommodation; 45 were found to be temporarily abated in consequence of members of the family having been evacuated or serving with H.M.Forces; 58 were still overcrowded; and 20 could not be investigated as no one could be found to answer inquiries. Four new cases of overcrowding were discovered during the year. Two of the overcrowded families were provided with accommodation on London County Council Estates. During the year the Associated Fumigators, Limited, under an agreement with the Council, removed and treated the furniture, etc., of 2 families with hydrogen cyanide gas. The cost of the work was £6. 10s. Od. G. E. Oates. M.D., M.R.C.P.(London) D.P.H.(Cambridge) Barrister-at-Law Medical Officer of Health. 20th August, 1945. SS.