POP 53 Public Health Department, Poplar Town Hall,Bow Road,E.3. 15th July, 1928. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Poplar. Sir, Ladies and Gentlemen, I have much pleasure in presenting my Annual Report for the year 1947, which, in accordance with the Ministry of Health Circular 170???/47 is prepared on the lines of that for 1946 and is an Abridged Interim Report. POPULATION. The Registrar-General's estimate of the civil population is 73,490, an increase over the previous year's figure (69,010). BIRTHS. There was an increase in the number of live births and the birth rate (26.7) is the highest recorded for the Borough since 1921. STILL BIRTHS. The number of still births shows a slight incrcase over that for 1946, the rate per 1,000 total births being 24.8 as compared with 23.1 in 1946. DEATHS. The number of deaths at all ages was 994, and the death rate 13.5 as compared with 13.1 for 1946. The death rate for London as a whole was 12.8. Since 1946 approximately one-sixth of the Poplar deaths were of persons over 80 years of age. Six deaths occurred from Whooping Cough; 2 from Diphtheria (in neither of these had the child been immunised) and 2 from Measles. All these deaths were of children under 5 years of age. There wore no deaths from Scarlet Fever. MATERNAL MORTALITY. Only one maternal death was recorded during the year. INFANT MORTALITY. After the record figure of 30 in 1946 (the lowest ever recorded in the Borough) it is disappointing to find the figure for 1947 as high as 40. This is just below the figure of 41 for England and Wales, but is higher than the London rate of 37. Factors in this increased rate of 40 were a higher proportion of deaths due to prematurity (27% in 1947 as compared with 17% in 1946) and an increase in deaths from non-tuberculous respiratory diseases (29:.5% in 1947 as compared, with 20.7% in 1946). The proportion of infantile deaths due to congenital malformations, etc., fell from 28.3% in 1946 to 20.5$ in 1947. INFECTIOUS DISEASE. The most noticeable thing is the increase during the year of the number of cases of Whooping Cough which totalled some 406 over the number for the previous year. There was, however, a considerable drop in the number of cases of Measles and the Scabies cases were 253 as compared with 484 in the previous year. Only 10 cases of Diphtheria occurred in the year, 9 of them being in nonimmunised children. TUBERCULOSIS. The figures for Tuberculosis are not very different from those of 1946 and the deaths from both respiratory and non-respiratory forms remain much the same. INFANTILE PARALYSIS. The Borough escaped relatively lightly during the epidemic of infantile paralysis and only nine definite cases were confirmed; one death occurred, but was assigned to causes other than poliomyelitis. -2- STAFF. Sanitary Inspectors. It is interesting to note that the work of the Sanitary Inspectors is now comparable with their work before the War. The work carried out in 1947 exceeded the 1938 level. Staff Changes. Mrs. D. McConney, Female Sanitary Inspector, resigned in November. The duties she had carried out were distributed among the remaining Sanitary Inspectors and the Establishment Committee decided not to fill the vacancy caused by her resignation. Miss I. Farrelly, Health Visitor, who commenced duty in January 1947 resigned in the following December. Some changes in the staff of the Council's Day Nursery inevitably occurred during the year. Other changes were:Resignations: Mr. A. Begg, Sanitary Inspector's Assistant. Mr. C. Whitelock, Sanitary Inspector's Assistant. Mr. G. Goach, Non-Resident Porter Ruston Street Clinic. Mr. J. Cannon, Porter Day Nursery, on account of ill-health. Dr. E. M. Layman, Clinic Medical Officer. Appointments: Mr. K.L. Dolling, Sanitary Inspector's Assistant(Later resigned). Mr. W.J. Crone, Sanitary Inspector's Assistant. Mr. W. Hicks, Non-Resident Porter Ruston Street Clinic. Miss E.A. Kite, Home Help (full-time). Mrs. E. Clayton, Home Help(part-time). Dr. G. Montgomery, Clinic Medical Officer. National Health Service Act. I write this shortly after the appointed day for the coming into force of the National Health Service Act, and the Maternity and Child Welfare Services, which the Borough Council has administered for so many years, have now been transferred to the London County Council, while the Council's Tuberculosis Dispensary has gone to the Regional Hospital Board. We have been particularly fortunate in Poplar in having in our midst the Royal College of St. Katharine, which has been responsible for the Maternity and Child Welfare services over roughly a third of the Borough. The Royal College has carried out pioneer work in these services, and the association between the College and the Borough has at all times been most cordial and happy. Before the advent of the new Act, the Royal College had decided to relinquish Maternity and Child Welfare work and to explore other fields of Social Service, but agreed to carry on in Poplar until the appointed day. I wish the Royal College all success in whatever venture it may undertake in the future, and I hope that the link with Poplar will remain unbroken. With regard to the transferred services, it is hoped that the new regime will lead to their steady development and expansion. The Borough Council has handed over a going concern of which it can be justly proud. In conclusion, I am grateful to members of the Council for their continued support and to the staff of the department for their loyal co-operation. I am, Sir, Ladies and Gentlemen, Your obedient servant, G. 0. MITCHELL, Medical Officer of Health. -3- STATISTICS. Summary for 1947. AREA: 2136 acres. POPULATION: At Census 1931 155,089. 1 Registrar-General's estimated civil population 1947 73,490. BIRTH RATES: Poplar. London. Eng. & Wales. Poplar. 1946. Live births 26.7 25.7 22.7 20.5 Still births 0.68 0.61 0.49 0.50 DEATH RATES: All causes 13.5 13.1 12.8 12.0 Tuberculosis: of respiratory system 0.87 0.88 ? 0.47 other forms 0.07 0.09 ? 0.08 all forms 0.94 0.97 0.55 INFANT MORTALITY: Rates per 1,000 live births 40 30 37 41 MATERNAL MORTALITY: Rates per 1,000 0.50 Nil total births ? 1.17 Total Males Females LIVE BIRTHS: Legitimate 1895 1018 877 Birth rate per 1,000 population 26.7 25.7 Illegitimate 70 40 30 1965 10 58 907 STILL BIRTHS: 50 23 27 Rate per 1,000 total births 24.8 23.1 DEATHS-all ages 994 532 412 Rate per 1,000 population 13.5 13.1 DEATHS FROM PUERPERAL CAUSES: Puerperal sepsis - )Rate per 1,000 Other maternal causes 1 ) total births 0.50 Nil INFANTILE MORTALITY RATES: All infants per 1,000 live births 40 30 Legitimate infants per 1,000 legitimate births 39 29 Illegitimate infants per 1,000 illegitimate births 57 38 -4- CAUSES OF DEATH AT ALL AGES. The 994 deaths at all ages were classified by the Registrar-General as follows:- Age groups: Totals: 1946. Totals. 0- 1- 5- 15- 45- 65 & over M. F. P. Typhoid & paratyphoid fevers • • . . • . • • • • Cerebrospinal fever 1 • • . • . • 1 1 . Scarlet fever • . « . • . • • • • Whooping cough 4 2 • . • . 2 4 6 2 Diphtheria • • 2 . • . 2 • 2 1 Tuberculosis of respiratory system . • • 32 24 8 42 22 64 61 Other forms of tuberculosis • 3 • • 1 1 1 4 5 6 Syphilitic disease • • • • 5 2 2 5 7 6 Influenza • • 1 • 2 5 6 2 8 13 Measles • 2 • • • • 2 • 2 • Acute poliomyelitis and polioencephalitis • . • • • • • • • • Acute infective encephalitis • • . 1 • • 1 • 1 • Cancer of: (a) buccal cavity and oesophagus (M) • • • 2 6 8 • 8 9 (b) uterus (F) • • • 1 3 3 • 7 7 5 Cancer of stomach and duodenum • • • 9 11 10 10 20 24 Cancer of breast • • « 7 5 9 1 20 21 8 Cancer of all other sites . • 1 12 27 55 55 40 95 87 Diabetes . • • • • 3 2 1 3 6 Intracranial vascular lesions • • 1 8 58 39 28 67 78 Heart disease . • 1 11 35 173 119 106 225 261 Other diseases of the circulatory system . • • • 12 49 43 18 61 38 Bronchitis . • • 4 38 95 99 44 143 98 Pneumonia 17 . • 3 9 21 35 18 53 38 Other respiratory diseases . • • 1 2 3 4 2 6 12 Ulcer of stomach or duodenum . • • • 6 8 9 5 14 10 Diarrhoea (under 2 years) 4 • • • • * 2 2 4 6 Appendicitis • • • 1 • 1 2 • 2 3 Other digestive diseases 1 • 4 4 6 11 5 16 12 Nephritis 1 • • 3 5 6 8 7 15 10 Puerperal and post-abortive sepsis • • • • • t • • • • Other maternal causes • • • 1 • • • 1 1 • Premature birth 21 • • • • • 9 12 21 9 Congenital malformations, birth injury, etc. 16 . • 3 2 • 13 8 21 18 Suicide • . • 1 2 1 2 2 4 6 Road traffic accidents . . 2 2 2 5 5 8 13 9 Other violent causes 6 • 4 5 6 15 21 15 36 16 All other causes 1 • 1 10 13 17 27 15 42 54 ALL CAUSES Males 41 5 9 64 146 317 582 553 Females 37 7 4 39 76 249 • 412 353 Persons 78 12 13 103 222 566 994 906 ' INFANTILE DEATHS. It will be seen from the above table that there were 78 deaths of children under one year of age, and it should be noted that of the 78 no fewer than 37 were due to premature birth, congenital malformations and birth injury, etc. while a further S3 were due to respiratory diseases. -5- GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. NURSING IN THE HOME. Grants were made to two Nursing Societies. The number of visits paid by Nurses from these societies was 150 6. WELFARE CENTRES. a, Tuberculosis Dispensary-see page 14. b. Maternity and Child Welfare Clinics at 31st December, 1947. 1. Borough Council. Ruston Street Infant Consultation. Thursdays 10 . 30-12.30 and 2-4. Ante-natal Tuesdays 10 . 30-12 . 30 and Wednesdays 2-4. Wellington Way Ante-natal Mondays & Fridays 2-4. Infant Consultation Wednesdays 2-4. Dental Tuesdays Wednesdays 2-4. 10-12. / Sunlight Tuesdays & 9.30-12,30 and Thursdays 2-4. Saturdays 9.30-11.30. 154 Poplar High Infant Consultation Mondays 2-4. Ante-Natal Tuesdays 2-4. Sunlight Mondays & Wednesdays Fridays 9.30-12 . 30. 9.30-11.30. Sewing and Mo thereraft Thursdays 2-4. 54 West Ferry Road Infant Consultation Wednesdays 10 . 30-12.30 and 2-4. Ante-natal Mondays Fridays 10.30-12.30 and 2-4. 2. Royal College of St. Katharine. All Hallows Hall Infant Consultation Tuesdays 2-4. St.Michael's Hall Infant Consultation Mondays 2-4. Trinity Hall Infant Consultation Wednesdays 10.30-12.30. The numbers of attendances at the Maternity & Child Welfare Clinics were Borough Council. Royal College of St. Katharine. Total. 1946. 28,358 10,60 2 38,960 31,992. -6- VISITS PAID BY HEALTH VISITORS. The numbers of visits paid by the Health Visitors were Borough Council. Royal College of St. Katharine. Total. 1946. 19,759 26,886 46,645 48,040. CARE OF PREMATURE INFANTS. 167 premature babies were born during 1947 - 18 at home and 149 in hospital. 110. 17 of those born at home survived at the end of one 10. month, and of those born in hospital 9 died during the first 7. 24 hours and 138 survived at the end of one month. 87. The arrangements for the care of premature infants, outlined in previous reports, continue to operate. Equipment loaned during 1947 to mothers of premature infants included: 4 treasure cots with detachable linings 4 4 hot water bottles 3 3 weighing scales 2 CARE OF ILLEGITIMATE CHILDREN. Upon the recommendation of the Metropolitan Boroughs' Standing Joint Committee the Council continued their contribution of £64 per annum to the scheme formulated by the Standing Joint Committee. CHILD LIFE PROTECTION. Visits to mothers and fester children 15 9 Foster mothers under supervision during 1947 2 2 " children " " " " 1 1 EMERGENCY OBSTETRIC SERVICE. During the year this service was called upon for three cases, the fee of £5. 5s. per case 2 being paid by the Borough Council. Two of the patients were removed to hospital. OBSTETRIC CONSULTANT. It was not necessary to call in a Consultant to any case during the year. STERILE MATERNITY OUTFITS. One outfit was sold during the 7 year. CONVALESCENT TREATMENT. 25 cases were sent away during the 21 year through the agency of the Invalid Children's Aid Association, an increase of 4 on last year's number. The grant to the Invalid Children's Aid Association was increased to £1.10s. per week for four weeks for each child, such grant to be extended to six weeks if at the end of four weeks a medical report is received from the Convalescent Home stating the child needs at least another two weeks convalescent treatment. Several cases referred by Poplar Hospital have been dealt with on the same terms. The attention of the Metropolitan Boroughs' Standing Joint Committee was drawn to the difficulty of obtaining convalescent treatment for children under 5 and also for nursing mothers and their babies. As a result of this a reply was received from the Minister of Health intimating that the provision of such convalescence would no doubt be considered by the Regional Hospital Boards under the National Health Service Act. -7- PROVISION OF SURGICAL INSTRUMENTS BY THE INVALID CHILDREN'S AID ASSOCIATION. Splints were supplied by the Association to one child. SUPPLY OF SHEETS FOR EXPECTANT MOTHERS. The arrangements made in 1944 for the issue of priority dockets to expectant mothers continued in operation and 498 dockets were issued. 1946. 479. MILK SCHEME (Maternity and Child Welfare). One application for free milk was received and was granted. In addition 544 packets of dried milk were sold at the special reduced prices. 292. DISTRIBUTION OF COD LIVER OIL AND FRUIT JUICES. The arrangements made in 1941 with the Looal Deputy Food Officer continual to operate. DAY NURSERY. The Day Nursery in Tidey Street continued to function throughout the year. The highest attendance on any one day was 47 and the number on the register at the end of the year was 53. 41. 41. Throughout the year there has been a long list of children awaiting admission. No outbreak of illness which would necessitate the temporary closure of the Nursery occurred during the year. Additional Day Nursery Accommodation. The need for an additional Day Nursery was discussed with the London County Council in view of the passing of the maternity and child welfare work to that authority in 1943. At the suggestion of the London County Council efforts were made to find a site in the Poplar area. Representations were made to the Ministry of Health who stated that even if the need were established it was unlikely the Minister would approve the erection of a Day Nursery for a considerable time owing to the position of controlled materials. The London County Council's Education programme includes the establishment of Nursery Schools and Nursery Classes in various parts of the Borough but this does not help to solve the •immediate problem. HOME AND DOMESTIC HELP SCHEME. The scheme continued in operaticn during the year and the staff was increased to two full-time and two part-time helpers. 31 cases were dealt with: 27 Home Help and 4 Domestic Help. PROVISION OF INSULIN FOR DIABETICS. Under the Council's Scheme liability for the cost of providing insulin was accepted for one new case. 2. At the end of the year two cases were receiving this assistance. SANITARY CIRCUMSTANCES OF THE AREA. REPAIR OF HOUSES AND ABATEMENT OF NUISANCES. A speacial report was submitted to the Public Health and the Housing and Town Planning Committees detailing the difficulties which were being encountered in securing the abatement of nuisances under the Public Health (London) Act. Notices served regarding occupied properties which had been classified "Total loss" by the War Damage Commission created further difficulties through the abandonment of properties by the owners and in one instance by a Magistrate making a Closing Order at the request of the owner. The attention of the Minister of Health was drawn to these difficulties but no immediate solution has been found. -8- DISTRICT SANITARY INSPECTORS' WORK. The total number of inspections and reinspections carried out by the District Sanitary Inspectors was 31,087. 1946. 29,055. Number of: Inspections 10,659 Reinspections 20,428 31,087 Intimations served 4,489 3,618. Notices served 2,378 1,861. Final notices served 784 621. Nuisances abated 5,146 3, 650. Legal Proceedings taken 70 23. Abatement Orders made (including 1 Closing Order) 29 9. Work done after issue of Summons 41 10. The volume of work performed by the Inspectors exceeded the 1938 level. HOUSES-LET-IN-LODGINGS, SEAMEN'S AND COMMON LODGING HOUSES. Number of inspections: Houses-let-in-lodgings 727 802. Seamen's lodging-houses 100 (including 6 nightly inspections) 238. Common Lodging-houses 185 (including10 nightly inspections) . Other visits 44 Visits re Scabies and verminous conditions 116 Informal notices served 63 28 Notices served 17 10 Final notices served 14 9 Nuisances abated 59 21 Legal proceedings taken 3 HOUSING INSPECTOR. Number of: Rehousing enquiries (P.B.C.547:L.C.C.798:Others 59) 1404 Complaints of overcrowding 11 Inspections, etc. of underground rooms and individual unfit houses 97 Inspections of P.B.C.hutments 70 Miscellaneous visits 663 2245 CLOSURE OF BASEMENT ROOMS. During the year Closing Orders were made in respect of basement rooms at 8 properties. METROPOLITAN BOROUGH OF POPLAR. ABRIDGED INTERIM REPORT on the health of the Borough during 1947 by G. 0. MITCHELL, M.D., M.R.C.P., D.P.H., Medical Officer of Health. -9- • DISINFESTATION INSPECTOR. 1946. Total number of inspections, etc. 2,229 1,997 Number of rooms disinfested 1,353 1,115 Number of articles disinfested 5,932 2,474 The treatment of Scabies is referred to on a later page. REHOUSING AND DISINFESTATION. The practice of inspecting present accommodation, bedding and furniture of prospective tenants of temporary dwellings and new permanent houses continued throughout the year. Disinfestation prior to removal was found to be necessary in 24 instances. 12. DESTRUCTION OF MOTHS. The arrangement to assist members of the public in the destruction of moths by offering the use of the Council's disinfecting plant continued. Advantage of this was taken in one instance, no charge being made. 2. WATER SUPPLY. Generally, this service is provided and maintained by the Metropolitan Water Board direct from the mains. Examinations of the water are made by the Board. No complaints were received during the year. Following upon the flooding of the Lee Bridge Works of the Metropolitan Water Board early on Saturday, 15th March, pumping was immediately stopped and alternative arrangements were made by the Board for a supply of water to the areas affected. The Town Clerk was informed of the position soon after noon. During the week-end repeated warnings regarding boiling of water wore broadcast, and police loudspeaker cars toured the Borough. As an additional precaution a letter was sent on 17th March to all food manufacturers, caterers, ice cream makers and public houses in the Borough, and the Sanitary Inspectors and Health Visitors were instructed to impress on members of the public the importance of boiling the water. Leaflets were also printed for distribution from clinics, libraries, schools, the Rates Department, etc. Fortunately it did not prove necessary to supplement the water supply in Poplar by the use of tankers. Daily sampling was carried out by the Water Board at many scattered points in the areas affected. On 29th March it was announced there would be ho further necessity for boiling drinking water. No case of illness which could be attributed to infected water was notified in the Borough. LONDON UNDERGROUND WATER - Wells and Borings. In a letter dated August, 1947, the Minister of Health drew attention to the possibility of pollution from disused wells or borings of water obtained from the chalk under London and suggested that a survey of the position might usefully be undertaken at that time. A comprehensive report dealing with (i) private wells in Poplar which are now disused, (ii) private wells in Poplar in use for commercial purposes only, and (iii)private wells in Poplar used for drinking, and including details -10- of chemical analyses and bacteriological examinations of water from wells in use was prepared and after submission to the Public Health Committee was forwarded to the Minister of Health. From the investigations there was nothing to indicate any pollution of water from the chalk in this area. WATER CERTIFICATES (Public Health (London) Act, 1936. Certificates were issued in respect of 421 new dwellings (217 Borough Council; 201 London County Council; and Lee Conservancy Board 3). 1946. 285. RENT, etc. RESTRICTION ACTS. Certificates under these Acts were issued as follows:- to Tenants 212 198. to Owners 56 57. RODENT CONTROL. The Council's Contributory Scheme has continued to operate during the year; work at dwellinghouses has continued, and the routine treatment of sewers has been carried out. The establishment of 6 ratcatchers was maintained throughout the year. Allocation of working time was as follows:- 55½ man/weeks to dwelling house complaints. 16 " " sewer treatments. 4½ " lost in sickness. 224 " to contributory scheme work. In 1946, one man's time was accounted for by treatments in dwelling-houses for which no charge was made; this year this work has consumed an extra 5½ man/weeks. (A) Contributory Scheme. At the end of the year there were 152 contributors, compared with 124 at December 1946. Treatments carried out: 1274 treatments applied to 165 premises of 160 contributors. 1,035. 5 treatments applied to 2 P.B.C.premises. 10. 976 rats and 189 mice have been found fead. 2,563 rats/ 305 mice. Estimated kill per M.O.F. formula is 4715 rats. 31,326. 96,643 prebaits and 12,001 poison baits have been laid at 32,007 baiting points. 229,076/16,040. 42,807. 3654 visits and inspections have been made by the Rodent Officers. 3,976. 6998 visits to apply treatments have been made by the Ratcatchers. 7,599. Infestation Analysis. Jan. 1947 Intake .1947. Dec. 1947. Dec.1946. Reservoir infestation(exceeds 50 rats) • • • . Major " (20-50 rats) 6 17 5 6 Minor " ( 0-20 " ) 5 19 40 51 Slight " 67 • 115 67 Premises classed as slight infestations are those which have been cleared of rate but are liable to reinvasion owing to their situation or the nature of the business carried on. -11- (B) Dwelling Houses. 607 complaints relating to 490 premises were investigated. 1946. 502/454. 27 complaints relating to 24 premises were outstanding at the end of the year. 21/25. 1389 inspections were made by the Rodent Officers. 1,271. 3090 visits to apply treatments were made by the Ratcatchers. 2,769. 117 rats and 149 mice were found dead. 280rats/67mice. Premises treated: 470 dwelling-houses. 359. 5 small shops. 38. 12 business premises of which 10 entered Contributory Scheme . 42. 5 licensed premises. 5. 10 P.B.C. and L.C.C. Cause of complaints: 101 related to rats of unknown origin. 140. 63 attributable to defective drains. 69. 11 ,, ,, sewer works in progress. 2. 194 were found to be mice only. 120. 28 ,, ,, ,, ,, birds. 22. 1 was ,, ,, ,, moths. 1. 42 related to war debris removal. 22. 1 ,, ,, rats from P.L.A. area. 13. 49 were found to be without foundation. 64. (C) Rodents found dead in 1947. Rats. Mice. Contributory Scheme premises 976 rats, 189 mice. 2,563 305 Dwelling-houses 117 ,, .149 ,, 280 67 Sewers 14 ,, . 248 • Total 1157 ,, 338 ,, 250 . open spaces 3,341 372 (D) Materials used (all premises and sewers): 55 cwts. Sausage rusks. 68 lb.Zinc phosphide. 12 " Wheat. 10¼ Arsenicus oxide. 5 " Rolled oats. 4 " Red squill. 1½ " Middlings. 2 " Barium carbonate. 150 1b. Flour. 4 " Antu. (E) Sewer Treatments: The 6th, 7th and 8th sewer maintenance treatments were carried out in January, June and December in conjunction with the Works Department and the Ministry of Food (Infestation Division) with the results shown:- Treatment No. When treated. No. of manholes. No take. Small take. Good take. Complete take. %take. 1st. Dec. 1943 1566 856 229 334 147 45 2nd. Jany. 1944 1720 1508 149 56 7 12 3rd. May 1944 1665 1281 129 151 104 24 4th. Jany. 1946 1181 354 171 184 47 2 70 5th. June 1946 1452 824 291 175 162 44 6th. Jany. 1947 1500 1013 137 170 180 32½ 7th. June 1947 1680 1399 116 113 52 17 8th. Dec. 1947 1701 1269 10 5 125 20 2 25 -12- FACTORIES ACT, 1937. During the year 140 3 inspections were made and defects or nuisances were found at 79. Of these 70 were remedied. 1946. 702. 150. 131. INSPECTION AND SUPERVISION OF FOOD. The Meat and Food Inspectors made 3,786 inspections of premises where food is prepared, stored or sold. 4,173. ICE CREAM (HEAT TREATMENT, etc.) REGULATIONS, 1947. These Regulations came into operation from 1st May, 1947, except for the requirements relating to thermometers which will not come into operation until a date to be appointed by the Minister. A leaflet giving a brief resume of the Regulations was sent to all persons registered for the sale and manufacture of ice cream and to restaurants and cinemas. 42 samples of ice cream were examined; Grade 1-4; Grade 2-11; Grade 3-16; Grade 4-11. Of the unsatisfactory samples 11 were reported to the appropriate Medical Officer of Health and letters were sent to the manufacturers. The remainder were followed up by our own Inspectors. REPORT OF THE PUBLIC ANALYSTS. The number of samples examined was 707 and the number found to be adulterated was 35 or 4.9 per cent. 722. 37, 5.l%. During the ten years 1938-47 the average number examined was 699 and the percentage adulterated was 4.1. 708. 3.7% The Public Analysts commented in their report "This is the third consecutive year in which no milk adulteration has been found". PREVALENCE OF, and CONTROL OVER INFECTIOUS DISEASES. The numbers of cases notified (corrected for "altered diagnosis" cases) and the deaths were Cases. Deaths. Cases. Deaths. Scarlet Fever 145 (35) • 151 • Diphtheria 10 (10) 2 9 1 Typhoid and paratyphoid fevers • (11) • 1 • Erysipelas 23 • 21 1 Puerperal fever 3 (2) • 1 • Puerperal pyrexia 17 (16) lc 15 • Cerebrospinal fever 6 (6) lb 5 • Ophthalmia neonatorum 3 (2) » 1 • Measles 712 (59) 2 871 • Whooping cough 590 (38) 6 184 2 Primary pneumonia 91 (19) 14c 93 10 c Influenzal pneumonia 18 (5) 2c 24 lc Dysentery 13 (10) 0 10 • Zymotic enteritis 46 (42) 4 15 6 Malaria 2 (2) • 1 • Acute poliomyelitis 9 9) 1 • • Acute encephalitis lethargica • 1d 0 • 1688 266) 1402 Scabies(excluding 1 non-civn.) 253 11) 484 Totals 1941 ( 277) 1386 The numbers in brackets are the numbers treated in hospital during the year. -13- 1946. Notes: a. Cause of death:Obstruction of bronchus. Lymphosarcoma. P.M. b. Not notified-reported by Coroner after p.m. c. Notified cases only. d. Chronic case. Cause of death: Postencephalitic Parkinsonism. ACUTE POLIOMYELITIS. The Borough escaped relatively lightly during the epidemic of Acute Poliomyelitis which reached its peak in August. 18 cases were notified, but in only 9 cases was the diagnosis confirmed. Nil. One patient died, the cause being certified as "Acute Anterior Poliomyelitis. Uraemia. Chronic nephritis" and the death has been assigned to Chronic Nephritis by the Registrar-General. Nil. As a precautionary measure swimming galas arranged for 11th, 23rd, and 26th September were cancelled. SMALLPOX. On 11th March information was received from the Medical Officer of Health, Stepney, that a case of Smallpox had been removed from Mile End Hospital on 9th March. The patient had been employed at the Empire Memorial Sailors' Hostel, Commercial Road, E. He was taken ill on the 3rd March, removed to Mile End Hospital on 5th March. A diagnosis of Smallpox was made on 9th March and the patient was transferred to a special hospital. Between 30 and 40 contacts were followed up in this Borough. These contacts included (a) Staff and visitors to the Hostel; (b) patients from and visitors to Mile End Hospital; and (c) persons who had travelled in the ambulance which removed the patient to Mile End Hospital. Particular attention was paid to inmates of Lodging Houses. A letter was sent to all doctors practising in the Borough calling their attention to the case and requesting their co-operation in dealing with suspected cases. The Sanitary Inspectors, Health Visitors, Disinfecting Staff and some of the Office Staff were revaccinated as a precautionary measure. Except for a second case in the affected ward at Mile End Hospital on 21st March no further cases occurred. DIPHTHERIA PROPHYLAXIS. The immunisation clinics at the Council's Tuberculosis Dispensary and the Maternity and Child Welfare Centre at 54, West Ferry Road, and the Infant Consultation Clinics held by the Royal College of St. Katharine functioned throughout the year, as also did the arrangements with local practitioners. Summary of immunisations:- a. at Borough Council and Royal College of St. Katharine Clinics 1,318 1,118 346 b. at London County Council centres 279 c. by Private practitioners 90 72 1,7687 1,536 -14- TUBERCULOSIS. 1946. Dispensary Clinics: Mondays 6 p.m. Tuesdays 2 p..m. Thursdays 10'a.m. & 2 p.m. Fridays 10 a.m. Number of attendances at the Dispensary 3,776 3, 540. Number of new cases examined 394; contacts 257 651 709. (Tuberculous 91; non-tuberculous 535; diagnosis incomplete 25) 111; 527. 71. Number of visits to homes by Health Visitors 3,227 4,402. Number of sputum specimens examined 469 506. Number of X-ray examinations at St. Andrew's Hosp. 843 800. Additional statistics. In addition to the 3,227 visits paid by the Health Visitors for Dispensary purposes 71 non-Dispensary visits were paid under the Tuberculosis Regulations, 1930. 101. Reports to Chairmen of Medical Boards 12 19. Patients sent away for institutional treatment 171 183. Patients in receipt of extra nourishment from the Dispensary during the year 57 68. Patients in receipt of extra nourishment from the Dispensary at 31st December 33 28. Reporta on child contacts sent to Divisional School Medical Officers 29 29. Letters to General Practitioners concerning patients 398 420. Reports to General Practitioners on official forms 39 52. Progress reports from General Practitioners 1 • Clinical reports from London County Council 76 111. Reports to Ministry of Pensions 45 12. Shelters on loan during the year • Shelters on loan 31st December • Beds and bedding on loan during the year 10 5. 2 beds and bedding on loan at 31st December 9 2. During the year 19 new cases and 31 old cases 21; 27. have attended Brompton, Colindale, London Chest and St. Andrew's Hospitals for 711 artificial 723. thorax refills. During the year 8 children were boarded out 6. under the London County Council contact scheme. DENTAL TREATMENT AT ST. ANDREW'S HOSPITAL. Two patients 1. were referred to St. Andrew's Hospital for treatment (one patient, extraction; one patient, 2. scalings). TUBERCULOSIS ALLOWANCES. The Government Scheme for the provision of allowances for persons giving up work to undergo treatment of pulmonary tuberculosis has continued to operate as part of the Dispensary service. Sessions held by Tuberculosis Assessment Officer 50 51. Adjudications made 537 544. New applications 61 66. Cases reviewed 476 478. Patients in receipt of allowances on 31/12/47 53 54 The Ministry of Health approved the continued payment of Tuberculosis Allowances for an extended period in one case. -15- 1946. NUMBER OF NEW CASES AND DEATHS. The numbers of new cases reported and deaths during the year were:- New cases. Deaths. Death rate per 1,000 population. Pulmonary 158 64 0.87 0.88 Other forms 24 5 0.07 0.09 182 69 0.94 0.97. The percentage of non-notified cases to total deaths was 11.6 7.5. The number of cases on the Tuberculosis Register at 31st December was 601. 598. The number of cases on the Tuberculosis Dispensary Register at 31st December was:- Definitely tuberculous 498 (T.b.plus 244) 502 (215) Diagnosis not completed 40 85 538 587 MASS MINIATURE RADIOGRAPHY. The employees of the larger firms in the Borough and officers and employees of the Borough Council were given an opportunity of attending the London County Council Mass Miniature Radiography Unit at the Bethnal Green Hospital. The results were as follows:- 826 persons were examined (585 men; 241 women) 21 were referred for large films. 9 (1.1% of the total) were referred to their own Doctors as being probably Tuberculous. SCABICS. 254 cases of Scabies were notified during the year. 484. The number of visits paid by the Sanitary Inspectors was 374. 773. 1,122 treatments were given at the Council's Cleansing Stn. 2,180. Of these 105 were given at 51 evening sessions. 98. Adults 291 (151 moles; 140 females) 568. Children 831 (40 2 ” ; 429 ” ) 1,612 3 premises and 17,244 articles were disinfested. 25: 30,294. CLEANSING OF VERMINOUS PERSONS AND CHILDREN. The total number of cleansings carried out at the Council's Cleansing Station was 990:- 1,048. Adults 61 (42 males; 19 females) 56. Children 929 (296 ” ;633 ” ) 992. PUBLIC EDUCATION IN HEALTH. 255 lectures were given at 233. 17 centres, the attendances numbering approximately 23,073. 18,801. VENEREAL DISEASE. As in previous years the Council approved the display of posters at the various establishments controlled by the Council.