Rom 2 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the URBAN SANITARY DISTRICT OF ROMFORD FOR THE YEAR 1898. To the Romford Urban District Council. Gentlemen, I beg to present my Annual Report on the Health of Romford, for the year ending December 31st, 1898. 226 deaths were registered as having occurred in the Romford Urban District, during the year; of these sixtysix occurred amongst non-residents of the town, a number which had to be deducted from the total number of deaths registered in order to form a proper estimate of the mortality of the town itself. Making this necessary deduction from the total number of deaths which took place in the Urban District, I estimate the number of deaths to have been 160. The population of Romford, which in 1891 was 8,408, may now, I think, be fairly estimated to be 10,500, so that the death-rate for the past year was 152 per 1,000 of the population. 2 The number of births registered during the year was 300, the birth-rate therefore being 28.5 per 1,000. The following table shows the Birth-rate and Deathrate for the last six years. Romford. Birth-Rate. Death-Rate 1893 35.1 17.1 1894 32.3 14.3 1895 32.5 15.1 1896 35.8 12.3 1897 32.9 12.3 1898 28.5 15.2 Of the whole number of deaths, 9 were caused by zymotic diseases, the death-rate from this class of disease, which may be called preventable diseases, for the last four years, being respectively, 14, 17, 0 9, and 0.8 per 1,000 of the population. Seventy - four cases of infectious diseases were notified during 1898, a number considerably less than in the previous year, when 110 cases occurred. The improvement, however, although satisfactory, ought not to be considered as sufficient. A town of 10,500 inhabitants ought not to have 74 cases of infectious disease, when there has been no wave of epidemic disease (Scarlet Fever, for instance) passing over it. There must be a Sanitary failing somewhere, and I think it is to be found as suggested in a subsequent part of this report. The following table shows the causes of death, arranged in alphabetical order. There were registered during the year deaths of 8 persons who had exceeded the age of 80 years, whilst 2 persons died at the age of over 90; 53 children died under the age of one year. 3 Membranous Croup 1 Cancer 7 Diarrhœa, &c. 33 Diphtheria 1 Disease of Brain 8 Disease of Heart 17 Disease of Liver 8 Disease of Kidney 2 Injuries 6 Erysipelas 1 Measles 4 Phthisis 6 Pulmonary Affections (Bronchitis, &c.) 22 Premature Birth (Debility, &c.) 4 Rheumatic Fever 1 Senile Decay 15 Scarlet Fever 1 Typhoid Fever 3 Whooping Cough 5 Other Diseases 15 Total 160 Comparing the mortality (15.2 per 1000) during the past year with previous years, will obviously prompt you to require from me an opinion as to the cause of this rate being higher than the average, during the past year. I think the cause is to be found in the great prevalence of diseases of the gastro-intestinal type (Diarrhœa, &c.), amongst young children during the hot dry weather of the latter part of the summer. This condition which was at that time very prevalent over the whole of the country, is to be accounted for by climatic influence, exaggerated to some extent by 4 improper feeding of young children, and in some instances undoubtedly affected by faulty sanitary condition of dwellings. Thirty-three deaths were caused by Diarrhœa, a number something like three times the number in average years from that disease. I personally investigated most of these cases, and in a few instances, where, owing to faulty traps, &c., sanitary defects existed, these were remedied by my calling in the assistance of the Sanitary Inspector. In other cases 1 had no doubt of the disease being caused by the escape of sewer gas through unflushed closet pans. Summary of Action taken during the Year for preventing the spread of disease:— During the year, 74 cases of infectious disease were notified, the different diseases occurring as tabled below. Scarlet Fever 22 Diphtheria 23 Typhoid Fever 18 Erysipelas 11 74 It will be noticed that the number of cases of infectious diseases notified shows a satisfactory diminution. To some extent this may, I hope, be accounted for by your having made arrangements with the Ilford Urban Council to receive in their Isolation Hospital at Chadwell Heath any cases from this district. Cases have been so removed and in several instances (especially in Scarlet Fever), members of a 5 family have been promptly removed, and the disease thereby as promptly stopped from spreading. I heartily congratulate the Council that they have at length succeeded in arranging with the Rural Council for co-operation in the Isolation Hospital about to be built for this district, and I hope in my next Annual Report to be able to testify to its great utility as a means of preventing the spread of infectious disease. The general practice, in the action taken to prevent the spread of infectious disease is to give instructions (either personally or through the Sanitary Inspector) as to isolation, &c., to supply disinfectants, and in necessary cases the Sanitary Inspector disinfects the premises, bedding, &c. I append special remarks on the various infectious diseases which prevailed. Scarlet Fever.—Twenty-two cases of this disease occurred in various parts of the town. The disease did not assume an epidemic form. Measles—Prevailed to a considerable extent. Being a nonnotifiable disease, not much could be done to prevent it spreading through the medium of school attendance. If this disease was made notifiable, as is now done by a good many Sanitary Councils, much more could be done by your Sanitary Officials towards preventing it assuming such an epidemic form as it did last year, As it is, children from families where there are cases of Measles are allowed by their parents to attend school, thus communicating the disease far and wide. Luckily the disease occurred during the time the weather was warm, and taus the mortality 6 (which in Measles in cold weather is frequently large, owing to the pulmonary complications which attend this disease) was small. Otherwise I have no doubt that, so prevalent was the disease, there would have been a large number of deaths to have reported. I beg to offer this suggestion of making Measles a notifiable disease to your serious consideration. Diphtheria—Numbered 23 cases, 1 death being caused by this disease. A large proportion of these cases were undoubtedly due to the facility existing for the eseape of sewer gas, owing to the faulty condition of the waterclosets connectcd with nearly the whole of the cottage property of the town. Typhoid Fever.—Seventeen cases occurred, of which 4 were fatal. An Account of the Sanitary Conditions of the District at the end of the year, and of enquiries made and advice given respecting conditions injurious to the Public Health. At the end of the year there was no infectious disease existing in the Town. Periodical inspections of the various parts of the district have been made, a few samples of drinking water, whose purity was suspected, have been submitted to me for analysis by the Sanitary Inspector, and where found to be contaminated, the South Essex Company's water has been laid on. The various bake-houses and slaughter-houses have been inspected and found in a satisfactory condition. 7 On this occasion, the provision of an Isolation Hospital so necessary to enable us to check the spread of infectious disease, being now assured, there is nothing special for me to report under this head, except to repeat the warnings I have previously given of the danger arising from the fact of so many cottages having no means of flushing the water-closets. Tables of mortality and of sickness compiled in accordance with the requirements of the Local Government Board's, instructions are appended to this report. I am, Gentlemen, Your obedient Servant, ALFRED WRIGHT, The Lodge, Romford. February 18th, 1899. 8 9 TABLE (A). TABLE (A). Table of Deaths during the Year 1898, in the Romford Urban Sanitary District classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities. (Columns for Population and Births are in Table B.) Mortality from all Causes, at subjoined ages. Mortality from subjoined causes, distinguishing deaths of children under flve years of age At all Ages Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Small-pox. Scarlatina. Diphtheria. Membranous Croup Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery Rheumatic Fever. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. Injuries. All other Diseases. Total. Typhus. Enteric or Typhoid. Continued Relapsing Puerperal) (a) (b) (c) (d) (e) (f) (g) (h) (i) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. Romford 160 53 19 7 6 42 33 Under 5 ... ... 1 1 ... ... ... ... ... ... ... 3 5 30 ... ... 5 ... ... ... 27 72 5 upwds. ... 1 ... ... ... 4 ... ... ... ... 1 1 ... 3 2 5 16 13 ... 4 38 88 Totals 160 53 19 7 6 42 33 Under 5 ... ... 1 1 ... ... ... ... ... ... ... 3 5 30 ... ... 5 ... ... ... 27 72 5 upwds. ... 1 ... ... ... ... 4 ... ... ... ... 1 1 3 2 5 16 13 ... 4 33 88 The subjoined numbers have also to be taken into account in judging of the above records of Mortality Deaths occurring outside the district among persons belonging thereto ... ... ... ... ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Deaths occurring within the district among persons not belonging thereto 60 3 2 1 5 22 27 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 4 5 5 upwds. ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 3 8 10 ... 3 30 55 10 11 TABLE (B). V TABLE (B). Table of Population, Births, and of New Cases of Infectious Sickness, coming to the knowledge of the Medical Officer of Health, during the year 1898, in the Romford Urban Sanitary District; classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics. Population at all Ages. Registered Births. Aged under 5 or over 5. New Cases of Sickness in each Locality, coming to the knowledge of the Medical Officer of Health. Small-pox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Census. Last Estimated to middle of 1897. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) 1 2 3 4 5 6 7 8 9 10 11 Romford 8,403 10,500 300 Under 5 ... 6 8 1 ... ... ... ... ... ... ... 5 upwds. 16 15 18 11 8,498 10,500 300 Under 5 ... 6 8 1 ... ... ... ... ... ... ... 5 upwds. ... 16 15 ... ... 18 ... ... ... ... 11 PRINTED AT THE “ESSEX TIMES” OFFICE, HIGH STREET, ROMFORD.