DAD 43 METROPOLITAN BOROUGH OF PADDITON. Interim Annual Report of the Medical Officer of Health for the year 1943. POPULATION: The estimated civilian population for 1943, furnished by the Registrar-General, shows an increase over that for 1942, hut the figures are not available for publication. Live Births 1,569; Stillbirths 40; Deaths 1,390; Maternal Deaths 3; Infant Deaths 107; Maternal Mortality Rate 1.86; Infant Mortality Rate 68. CLASSIFICATION OF DEATHS. All ages. Under 1 year of age M F TOTAL M F TOTAL ALL CAUSES. 678 712 1590 70 37 107 Typhoid & paratyphoid, fevers - - - - - Cerebro-spinal fever 1 2 3 - 1 1 Scarlet fever - - - - - - Whooping cough 1 - 2 1 1 2 Diphtheria - - - - - - Pulmonary tuberculosis 52 22 74 - _ _ Other tuberculous diseases 4 1 5 - - - Syphilitic diseases 10 11 21 - - - Influenza 11 10 21 1 - 1 Measles 2 - 2 - - - Acute polio-myelitis and polio-encephalitis - - - - - - Acute infectious encephalitis - 1 1 - - - Cancer of buccal cavity and oesophagus (males) 17 - 17 - - - Cancer of uterus - 11 11 - - - Cancer of stomach and duodenum 30 10 40 - - - Cancer of breast - 22 22 - - - Cancer of all other sites 48 50 98 - - - Diabetes 4 6 10 - - - Intra-cranial vascular lesions 49 80 129 - -- - Heart disease 124 141 265 - - - Other circulatory diseases 26 61 87 - - - Bronchitis 40 47 87 3 3 6 Pneumonia 59 73 132 14 9 23 Other respiratory ciseases 11 6 17 1 - 1 Ulcer of stomach or duodenum 12 - 12 - - - Diarrhoea (under 2 years) 18 11 29 17 11 28 Appendicitis 5 2 9 - - - Other eigestive diseases 14 21 35 - - - Nephritis 15 15 30 - - - Puerperal sepsis - 1 l - - - Other maternal causes - 2 2 - - - Premature birth 11 3 14 11 3 14 Congenital malformation, birth injury, infantile disease 18 10 28 16 5 21 Suicide 8 2 10 - - - Road traffic accidents 6 5 11 - - - Other violent causes 30 19 49 3 1 4 All other causes 52 64 116 3 3 6 (2) NOTIFICATION OF INFECTIOUS DISEASE Total Cases Notified Cases Admitted to Hospitals Total Deaths Acute Encephalitis lethargics — — — „ Influenzal pneumonia 29 10 1 „ Primary pneumonia 53 34 3 „ Polio-encephalitis - - — „ Polio-myelitis 1 1 — „ Rheumatism 5 3 - Cerebro-spinal fever 9 9 2 Continued fever - - - Diphtheria 54 53 - Dysentery 94 89 1 Erysipelas 29 13 1 Food poisoning or suspected food poisoning 10 5 - Infective enteritis or summer diarrhoea 84 76 9 Malaria — - - Measles 592 138 2 Ophthalmia neonatorum 8 3 - Puerperal fever 3 3 - Puerperal pyrexia 23 21 - Scabies (notifiable from 1st Aug:1943) 246 5 - Scarlet fever 312 238 - Smallpox - - - Typhoid or enteric fever 3 3 - Whooping cough 142 53 1 DIPHTHERIA IMMUNISATION. During the year, 1421 children were fully inoculated, including 830 "schools" cases. One hundred and twenty five new cases attended the Clinic at St. Mary's Hospital. In support of the Central Publicity Campaign organised by the. Ministry of Health, steps were again taken to give publicity to the facilities available in the Borough by the insertion of the Ministry's advertisement in four local newspapers and by the exhibition of posters at Council premises, in Air Raid Shelters, and on shingle bins throughout the Borough. Leaflets were also distributed by the Health Visitors and made available for the public at the Council's offices and other establishments. In addition, local medical 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 clinic or by treating them under the scheme for immunisation by private practitioners. At the end of the year it was estimated that 56.5% of the child population under 5 years of age, and 65.8% between the ages of 5 and 15 years, were immunised. VACCINATION. The latest return available is for the year 1942. This shows that of the 1929 children whose births were registered during that year 62.0 per cent. were successfully vaccinated, and 11.4 per cent. were exempted on production of statutory declarations of conscientious objection. Insusceptibility, removals, deaths, not traced etc., account for the remaining-26.6 per cent. TUBERCULOSIS. Notification Register. New cases notified comprised 229 of pulmonary tuberculosis and 28 of non-pulmonary tuberculosis. The number of cases on the register at the end of the year was 772, as compared with cases at the end of the year 1942. The death rate for pulmonary tuberculosis was 0.82 as compared with 0.84 for the previous year, and for all forms of tuberculosis the death rate was 0.87 as against l.04. (3) Dispensary Treatment. Particulars of the work carried out are show in the following table: Paddington Tuberculosis Dispensary St Mary's Hospital Tuberculosis Dispensary No. of patients examined for 1st time (excluding contacts) 642 170 No. of above found tuberculous 133 40 No. of contacts examined 139 23 No. of contacts found tuberculous 4 -- No. of attendances at Dispensary 4703 2024 No. of visits by Tuberculosis Officers 282 103 No. of visits by Tuberculosis Nurses 2629 1088 No. of cases on Dispensary Register at end of year 503 261 MEDICINAL BATHS AND DISINFECTING STATION. These arrangements have continued to function satisfactorily throughout the year in spite of a further increase in the number of persons who required treatment. The number of persons suffering from scabies who received treatment during the year was 1069, comprising 338 males and 731 females, (adults other than school children). The number of verminous persons cleansed was 99 (29 males 70 females). The weight of bedding etc. disinfected during the year after infectious disease was approximately 19½ tons. In addition, about 5½ tons of bedding etc. in use by the Civil Defence Services of the Borough received treatment. The number of rooms disinfected after the occurrence of infectious disease was 478, and 210 library books were dealt with. CLEANSING OF VERMINOUS ROOMS. Notices under Section 123 of the Public Health (London) Act, 1936, were served with respect to 30 premises. In addition many premises were dealt with without recourse to the service of notices, and the owners or occupiers of 107 premises took advantage of the arrangements whereby the Council spray verminous rooms at a charge of 7s. 6d. a room. One hundred and seventy-eight were so dealt with. BACTERIOLOGICAL WORK. The number of examinations made was 386, which included 205 for diphtheria, and 150 for tuberculosis. Two of the former and 14 of the latter were positive. RENT AND MORTGAGE INTEREST (RESTRICTIONS) ACTS. Three applications for certificates were received, and were all granted. FACTORIES ACT. 1937. Three hundred and seventeen inspections and visits were paid. BAKEHOUSES. At the end of the year the number of level bakehouses was 14, and of basement bakehouses 26, which shows no change on the previous year. Inspections numbered 103. SHOPS ACTS. Inspections of all kinds numbered 767. No exemption certificates were applied for, and no legal proceedings were necessary. WORK OF THE DISTRICT INSPECTORS. At the beginning of the year three Sanitary Inspectors were available for dealing with complaints and carrying out routine inspection of premises. An additional Inspector became available on the 1st March, and another one on the 13th Dec:, making a total of five at the end of the year. The particulars given below include inspections of tenements houses, which have not been recorded separately. Number of complaints received 1550 Number of first inspections 1697 Number of re-inspections 6479 (4) Legal proceedings were instituted in 19 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 7 (1.4 per cent.) were found to be adulterated. Two hundred and fifty-eight of these samples were of milk, and 4 (1.5 Per cent.) were found to be not genuine. Legal proceedings were instituted- in' three instances in respect of the sale of milk containing added water. The summonses were dismissed under the Probation of Offenders Act. The weight of diseased and unsound food of all kinds surrendered by tradesmen and dealers for destruction was approximately 18½ tons. No slaughtering of animals took place in the Borough during the year. Four hundred and eighty-four inspections of the 116 dairies and milkshops were made, and 4298 inspections of food purveyors' premises, which number approximately 1,000. Licences issued under the Milk (Special Designations) Orders numbered 61 (46 in respect of "Pasteurised" and 15 in respect of "Tuberculin Tested" milk). No samples of "Pasteurised" or of "Tuberculin Tested" milk were taken during the year. In August a slight outbreak of food poisoning occurred amongst the patients in St Mary's Hospital, four cases being notified, one of which proved fatal. In all the cases the bacillus aertrycke was isolated. An exhaustive investigation was made, but it was not possible to ascertain the source of the infection. RATS AND MICE. Mr. Harrison, the Food Inspector and Rodent Officer, has made the following report for the year:- "Where rat infestations were found to be present in food premises situated in the Borough they were only of a 'minor secondary' degree This condition also applied in the case of mice. Where infestations were found the usual methods of baiting and trapping were employed, whilst in certain cases repair to drains, rat proofing, and removal of lumber, etc, were found necessary. For the last three months of the year, in accordance with an instruction from the Infestation Branch of the Ministry of Food, a publicity campaign was carried on throughout the Borough. The general public was asked to report the presence of any rats to the Public Health Office or to any of the wardens' posts, and as a result 183 complaints were received. In addition the sewers were baited during the week commencing the 13th December, 1943, under a Direction served on the Council by the Ministry of Food. On four consecutive days pre-baiting took place at 494 entrances and on the fifth day poison baiting was done. Altogether about 487 lbs. of poison bait was used and the estimated number of rats killed was 4755. The executive part of this work was carried out by the Sewers Section, Borough Engineer's Department, whilst I myself provided the materials for the baits, superintended the mixing of the baits, and acted throughout in an advisory capacity." MATERNITY AND CHILD WELFARE. Miss M. MacLean and Miss E.M.Candler, Health Visitors, 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 12 (including the Superintendent and 3 temporary health visitors). Home visiting. First visits to children under 1 year. 1236 Revisits 9664 10900 Visits to children ages 1-5 years 11214 First visits to expectant mothers 1074 Revisits 1236 2310 (5) Other visits: Sickness (including Puerperal Fever, Puerperal Pyrexia, Ophthalmia Neonatorum and Infantile Diarrhoea) 408 Miscellaneous (including ineffective calls) 4996 5404 The number of children on the Health Visitors' lists at the close of the year was 4962. Infant consultations:- 356 sessions, 22,146 attendances by 2,698 children. Ante- and Post-Natal Clinics:- 101 sessions, 1,899 attendances by 1,899 expectant or recently confined mothers. Dental Treatment:- 51 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 87 cases. Maternity Beds:- 104 women were delivered in the beds reserved at St Mary's Hospital. One case of Puerperal Pyrexia was notified. There were three stillbirths and one death within 10 days of birth. Extra Nourishment:- 8l new applications were received, of which 78 were granted. Approximate expenditure, including ancillary foods, medicines, etc. £86. Convalescence:- Three mothers were sent to convalescent homes, and 5 children were sent away under arrangements with the Invalid Children's Aid Association. Child Life Protection:- 449 visits and inspections were made. At the close of the year the Register contained the names of 31 persons, who had charge of 37 children. No legal proceedings were necessary. Consideration was given to the question of improving the arrangements in connection with Foster Mothers for children under 5 years of age with a view to removing some of the weaknesses hitherto existing,such as non-payment of fees with consequent financial loss to the foster mother, and failure to secure the attendance of the children at the Council's Welfare Centres. A scheme was accordingly introduced by which the Council becomes responsible for the collection of the parents' contributions and the subsequent payments to the foster mothers. Daily Guardians:- 50 persons were registered for the care of 60 children. At the end of the year the Register contained the names of 58 Guardians who had charge of 68 children. Perambulator Scheme:- During the year an additional 24 perambulators were acquired, the number available for hire being now 73 (including 3 twin perambulators). Head Lice:- Special attention has been paid to this matter by the Health Visitors on the lines suggested by Ministry of - Health Circular N0.2831, dated the 2nd July, 1943, both in the course of home visiting and at the various consultations. Suitable combs have been made available for loan if required, and where necessary, children are referred to the Cleansing Station for treatment. far-Time Day Nurseries:- St.Jude's Nursery, 88, Bravington Road was opened on the 31st May, 1943, and Peach Street Nursery on the 2nd July, 1943. Details of the nurseries in operation at the end of the year are given below:- Accommodation. 0-2 yrs, 2-5 yrs. TOTAL. Westbourne, Great Western Road 20 30 50 Maida Vale, 14,Blomfield Road 25 27 52 St.Jude's, 88,Bravington Road 27 18 45 Peach Street 29 33 62 accommodation is also provided,at the Queen's Park Day Nursery, 66 Lancefield- Street, for 26 children between the ages of 2 and 5 years, although not formally approved by the Ministry of Health as a War time Day Nursery. Details of attendances are given in the following table:- Days open Attendances Average Attendance New Children Westbourne. Full days. 257 10,488 40.8 66 Saturdays. 50 1,254 25.1 Maida Vale. Full days 257 10,406 40.5 59 Saturdays 50 1,313 26.2 St. Jude's. Full days. 151 5,250 34.7 68 Saturdays. 29 552 19.0 Peach Street. Full days. 129 4,994 38.7 99 Saturdays. 25 590 23.6 Queen's Park. Full days. 257 5,355 20.8 27 Saturdays. 50 521 10.4 At the end of the year work had been commenced on the erection of a hutted nursery on the bombed site of Nos. 34/46, Marylands Road and tenders had been invited for the erection of another hutted nursery on the site of Nos. 38/46, Westbourne Park Road. There are two nursery schools in the Borough, provided by the London County Council, viz., at Senior Street School, and at Beauchamp Lodge, Warwick Crescent. 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, 26 secured accommodation of a private nature through their of efforts, and 5 were rehoused on London County Council Estates. Of the 127 cases of overcrowding on the Register at the end 194.2: 16 were found to have been abated by removal, and. a further 20 by a natural reduction in the size of the family, or on ing additional accommodation; 42 were found to be temporarily abated in consequence of memory of the family having been evacuated or serving with H.M.F03 41 were still overcrowded; and 8 could not be investigated as no one could be found to answer inquiries; 24 new cases of overcrowding were discovered during the year. Three overcrowded families were provided with accommodation London County Council Estates, and three other families were rehouses by the County Council on medical grounds. Legal proceedings were instituted against the owner of No. 2A, Bridstow Place for permitting the premises to be used for house habitation contrary to the terms of an undertaking in force. The de ant pleaded guilty and was fined £20 and ordered to pay £5.5s.0d.co PHARMACY AND POISONS ACT. 1933. At the close of the year the Regis of persons entitled to sell poisons in Part 11 of the Poisons List contained 80 entries, against 81 at the end of 1942. G.E. Oates. M.D., M.R.C.P. (London) D.P.H. (Cambri Barrister-at-Law -