ROM 4 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE ROMFORD URBAN DISTRICT For the Year 1902. Romford: Wilson and Whitworth Ltd., Steam Printers. ANNUAL REPORT. To the Romford Urban District Council. Gentlemen. I beg to present ray Animal Report on the Health of the Romfod Urban District, for the year ending December 31st, 1902. 172 deaths were registered as having occurred in the Urban District of Romford, fluxing the year; I do not include amongst this number those deaths which took place amongst the inmates of the Union Workhouse, except the deaths of actual residents of the district who have died there. 88 deaths were registered as having occurred at that Institution, mainly of aged people, most of whom came from those parts of the Romford Union beyond the limits of the Urban District. Eliminating these and including the deaths of town residents removed to the Union Workhouse, the 3 deaths for the district were 172. The population of the district was estimated to be 14,000. The death.rate would therefore be 12.2 per 1,000 of the population. The number of births registered during the year was 414, the birth.rate being 29 5 per 1,000. The following table shows the birth.rate and death.rate for the last five years. Romford Birth-rate Death-rate. 1898 28.5 15.2 1899 30.0 13.05 1900 28.9 13.1 1901 28.9 11.1 1902 29.5 12.2 I think the Council will be satisfied that Romford maintained its reputation for a low mortality. 1.—Summary of Action taken for preventing the spread of Disease. No. Date. Loeality. Disease. Source of Disease. Action taken. Result. 1 Jan. 5 Market Place Smallpox One case. Contracted at Grays. Removed to Dagenham Smallpox Hospital. Inmates of house re.vaccinated Premises, bedding, &c., disinfected. No further case, 2 ,, 5 High Street Smallpox This patient was a servant in one of the inns, and used to serve in the bar, a woman from an infectious house was known to have gone into this inn. the case was removed to Hospital, and the room she occupied disinfected, the bedding being burnt. No other case. 3 „ 6 Mawney Road . Smallpox A mild case. Clergyman who had baptized a child suffering with this disease. Isolated at home, being an extremely mild case, there being only half-adozen pustules over the whole body. House disinfected and bedding burnt. No other case. 4 Marks Road Smallpox One case. A relation of a family in Poplar Street, infected in December. Removed. Inmates re-vaccinated. Contact kept secluded and under observation for ten aays. No further case. 5 „ 9 Marks Road Smallpox One case. Origin obscure. Same precaution as in No. 4. No further ease. 6 „ 10 North Street Smallpox One case. A man engaged in the burial of smallpox cases. Removed. See No. 5. 7. » 10 Collier Row Smallpox One case. Presumably arising from infection introduced by the woman mentioned in No. 2. Removed. No other case. 5 No. Date. locality. Disease. Source of Disease. Action Taken. Result. 8 „ 13 Queen Street Smallpox Two cases. Mother and child. Infection probably brought by husband from Stratford. Removed. No other case. 9 „ 19 Market Place Smallpox One case. A woman whose husband had been removed suffering from smallpox, and who refused to be re.vaccinated. Removed. No other case. 10 23 Mildmay Road . Scarlet Fever . One case. Origin obscure. Declined to be removed. Premises disinfected. No other case. 11 „ 23 St. Andrew's Road Scarlet Fever . Ditto No other case. 12 „ 24 Marks Road Smallpox One case. Origin obscure. Removed. No other case. 13 „ 26 St. Andrew's Road Smallpox Ditto No other case. 14 „ 27 London Road Smallpox One Case. Contracted in Dart. ford. Removed. No other case. 15 „ 27 North Street Smallpox A case in same house the No. 6 case. Would not be re. vaccinated when the rest of the family were done. Removed. Fatal. No other ease. 16 „ 27 Marks Road Diphtheria One case. No other case. 17 Feb. 1 London Road Diphtheria Two cases in one house. Local sanitary defect. No other case. 18 „ 7 Waterloo Road . Smallpox One case. Removed. No other case. 19 „ 7 St. Andrew's Road Diphtheria One case. Local sanitary defect. No other case. 20 23 North Street Scarlet Fever One case. Isolated at home. Premises and clothing. &c., disinfected on recovery of patient. No other case. 21 23 Old Church Smallpox One case. Contracted at Dart. lord. Removed. No other case. 6 No Date. Locality. Disease. Source of Disease. Action taken. Result. 22 Mar. 2 Queen Street Scarlet Fever . Two cases. Origin obscure. Removed to hospital. No other case. 23 3 Market Place Diphtheria One case. Removed to hospital. No other case. 21 „ 4 London Road Scarlet Fever . Ditto No other case. 25 „ 14 Cotleigh Road Scarlet Fever . Ditto No other case. 26 „ 14 Grosvenor Road Diphtheria One case. 27 „ 14 London Road scarlet Fever . One case. Removed. No other case. 23 „ 15 Rush Green Smallpox Or e case. Removed. Evidently contracted in London. 29 „ 24 Marlboro' Road . Scarlet Fever . One case. Removed. No other case. 30 „ 21 Hainauit Road . Scarlet Fever . One case. Isolation at home. See No 32 and 34. 3! „ 25 Marks Road Smallpox One case. Origin obscure He. moved. No other case. 32 „ 26 Hainauit Road . Scarlet Fever . One case. In same house as No. 30 33 " 27 Marlboro' Road . Scarlet Fever . One case. In same house as No. 29. Removed. No other case. 34 „ 28 Hainauit Road . Scarlet Fever . One case. In same house as No. 30. 35 Apl. 4 Vine Street Smallpox One Case. Removed. 36 „ 6 Willow Street Smallpox Ditto. 37 „ 7 Willow Street Smallpox One case. Infection at Stratford. Removed. No other case. 38 „ 8 Albert Road Smallpox One case. Origin uncertain.. Removed. No other case. 39 „ 8 Albert Road Smallpox Ditto No other case. 40 „ 10 Queen Street Scarlet Fever One case. Removed. No other case. 41 „ 11 Shaftesbury Road Scarlet Ftver Ditto No other case. 7 No. Date. Locality. Disease. Source of Disease. Action taken. Result. 42 „ 19 Como Street Diphtheria One care. No other case. 43 „ 20 Birkbeck Road . Smallpox Two cases. Infection by a relative. Removed. One other case here. See No. 14 „ 23 Church Lane Smallpox One case. Infection by a relative. Removed. One other case here. See No. 45 May 2 Marlboro' Road . Enteric Fever . One case. Imported. Instructions, &c. No other case. 46 „ 2 Church Lane Smallpox One case in same house as No. 41. No other case 47 .. 2 Birkbeck Road Smallpox One case in same house as No, 43. Very Slight. No other case. 48 „ 3 Marks Road Smallpox One case. Removed. 49 „ 8 Queen Street Scarlet Fever . Ditto No other case. 50 „ 9 Shaftesbury Road Smallpox Ditto See No. 51 „ 10 Queen Street Diphtheria One case. No other case. 52 „ 15 Queen Street Diphtheria Ditto 53 „ 17 George Street Scarlet Fever Two cases. Removed. No other case. 54 „ 18 London Road Smallpox One case. Contraction at Dart. ford. No other case. 55 „ 19 Shaftesbury Road Smallpox One case. Father of children previously irfected (No. 50). This man refused to be re. vaccitated with the rest of the family on the first case occur. ing. He died in Hospital. 56 „ 21 Victoria Road Diphtheria One case. Local Sanitary defect. No other case. 57 „ 21 George Street Scarlet Fever Three cases removed. No other case. 58 „ 27 Palm Road Scarlet Fever . One case. 59 June 7 „ 8 „ 12 Diphtheria six cases. Infected by a case outside the district, attending school. 8 No Date. Locality. Disease. Source of Disease. Action taken. Result. 60 July 28 Waterloo Road . Diphtheria One case. No other case. 61 28 St. Andrews Road Diphtheria Ditto No other case. 62 Aug. 7 George Street Diphtheria Ditto No other case. 63 „ 7 Waterloo Road . Diphtheria Ditto No other case. 64 ,, 11 Factory Terrace . Diphtheria One ease. Local Sanitary defect. 65 „ 11 Salisbury Road . Enteric Fever . Oue case. Local Sanitary defect. Removed. No other case. 66 „ 12 „ 14 Albert Road Scarlet Fever . Two cases. Removed. 67 „ 28 George Street Enteric Fever . One case. Removed. No other case. 68 29 Sept. 8 Salisbury Road . Enteric Fever . Two cases from same honse as No. 65. Removed. No other case. 69 „ 9 Old Church Diphtheria One case. No other case. 70 „ 9 Victoria Road Scarlet Fever . Ditto No other case. 71 Oct. 1 Old Church Scarlet Fever . One case. Removed. No other case. 72 „ 9 Albert Road Enteric Fever . Ditto No other case. 73 „ 14 Hamilton Road . Diphtheria One case. No other case. 74 „ 14 London Road Scarlet Fever . One case, Removed. No other case. 75 „ 23 Queen Street Scarlet Fever . Ditto No other case. 76 „ 23 Waterloo Road . Enteric Fever . Ditto No other case. 77 „ 23 Mavrney Road Enteric Fever . One case. 78 ,, 28 Birkbeck Road . Scarlet Fever . One case. Removed. No other case. 79 Nov. 6 Marks Road Enteric Fever . Two cases. 80 „ 12 London Road Scarlet Fever . One case. Removed. No other case. 9 No. Date. Locality. Disease. Source of Disease. Action taken. Result. 81 „ 12 George Street Diphtheria One case. No other case. 82 Dec. 6 Market Place Scarlet Fever . Ditto No other case. 83 „ 12 Birkbeck Road . Scarlet Fever . One case. Removed. No other case. 84 „ 16 Marks Road Searlet Fever . Two cases. 85 „ 30 Collier Row Enteric Fever . One case. 10 Smallpox was very prevalent in the neighbourhood, and Romford suffered commensurately with other localities. The Council willingly adopted every suggestion made by me in regard to steps necessary to prevent the spread of the disease. Luckily we had not, like some district?, to make hurried arrangements for the reception of cases of smallpox, the Council's agreement with the West Ham Smallpox Hospital at Dagenham enabling it to send all our cases there as soon as notified, and all cases occurring in the district (with the exception of two extremely slight cases) were at once removed. Persons who had been in contact with the disease were re.vaccinated, with very few exceptions, and all contacts were isolated (most being kept at the Council's expense) for a period of fourteen days. With regard to re.vaccination, it is interesting to note that not one person who had been in contact with the disease, and was subsequently re.vaccinated, became infected, whereas two persons who obstinately refused to be re.vaccinated contracted the disease and died. The Council distributed handbills advising re.vaccination, and this was very generally adopted. I consider that the epidemic was kept well in hand, for although no less than 43 cases occurred in the district, there were only one or two instances where other persons became infected by the disease in the same house, practically all the cases having been contracted in London or in other infected localities. 11 Scarlet Fever was unusually prevalent during the year, hut large as the number of oases (48) was, it at no time assumed an epidemic form. 24 of these cases were removed to the Isolation Hospital. Diphtheria. 37 cases were notified, few of a severe type. Only one, which was a very bad one, was removed to the Hospital. Enteric Fever. 14 cases of this disease occurred, some of them traceable to local insanitary conditions, which were subsequently remedied. Six cases were removed to the Isolation Hospital. Zymotic disease caused 13 deaths. Smallpox 8 Measles 2 Diphtheria 2 Enteric Fever 1 The death.rate from this class of disease (unusually large owing to the smallpox epidemic which prevailed in the neighbourhood) was 0 5 per 1,000 of the population. This is, notwithstanding the increased Zymotic mortality mentioned above, is very satisfactory ; the rate for the last five years being 0.8, 0.2, 0.8, 0.2, and 05. 12 The following represent the total number of infectious disease notified during the year. Smallpox 13 Scarlet Fever 18 Diphtheria 37 Enteric Fever 14 Erysipelas 20 Puerperal Fever 4 Total 163 Every case of Infectious disease notified to me is reported to the Sauitary Inspector, who visits and reports to me in all cases which I do not personally investigate, and who also supplies disinfectants, sees to the patient's removal to the Isolation Hospital, when such a course is adopted, and disinfects the premises, bedding, clothing, &c. At the end of the year the district was in a healthy condition, few cases of Infectious disease having been notified. Periodical inspections of the various parts of the district have been made, a few samples of drinking water, whose purity was suspected, have been analysed by mo, and when found to be impure the South Essex Company's water has been laid on. Insanitary conditions have in certain instances been remedied by the intervention of the Sanitary Inspector. 13 Every case of Infectious disease notified to me is visited by the Sanitary Inspector or by myself. Disinfectants are supplied where required, and the patient's removal to the Isolation Hospital effected in those cases which are advised or sanctioned by the Medical Attendant. The bedding, clothing, &c., are subsequently disinfected by the Inspector. The various bake.houses and slaughter.houses have been inspected and found in a satisfactory condition. Tables of mortality and of sickness, compiled in accordance with the requirements of the Local Government Board's instructions, are appended to this report. In the last Annual Report I drew the Council's attention to certain necessary improvements required in the Sanitary condition of the district. (1) The provision of a system for the Collier Row and part of the Harold Wood wards ; and (2) The curbing, channeling, and making.up of those roads where houses have beeu extensively erected. The first of these is now in course of construction. The second still remain a very desirable feature in the sanitary improvement of the district. I have the honour to be, Gentlemen, Your obedient Servant, ALFRED WRIGHT, Medical Officer of Health. 14 ISOLATION HOSPITAL. The following cases were admitted into the Isolation Hospital from the Urban District during the year. This includes two persons who were sent from the Union Infirmary, not belonging to the Urban District. Recovered. Died. Scarlet Fever 35 35 — Diphtheria 5 5 — Enteric Fever 17 16 1 The nursing and general treatment of the patients in the Hospital has been most satisfactory, and I am able to assure the Council that they possess a most valuable help in fighting Infectious disease in the existence of such a well.appointed Hospital. In every case the patient's friends have expressed themselves as most grateful for the treatment received in that Institution. 15 TABLE I. Vital Statistics of Whole District during 1902 and Previous Years. Year. Population estimated to Middle of each Year. Births. Total Deaths Rrgistered in the District. Total Deaths in Public Institutions in the District. Deaths of Non-residents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all ages belonging to the District. Under 1 yr. of age At all Ages. Number. Rate. Number. Rate per 1 000 Births registered. Number. Rate. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1892. 1893. 1S94. 1895. 1896. 1897. 1898. 1899. 1900. 13,500 398 28.7 42 3.1 226 16.7 66 55 171 12.6 1901. 13,655 305 28.9 65 4.02 232 16.9 80 16 152 11.1 Aver. ages for rears 1892. 1901 1902. 14,000 414 29.5 42 3.0 251 17.9 88 79 4 172 12.2 Area of District in acres (exclusive of area covered by water), 5,629. Total population at all ages, 13,656 Number of inhabited houses, 2.805 At Census of 1901. Average number of persons per house, 4.8 16 1 2 Institutions within the District receiving Sick and Infirm persons from outside the District. Institutions outside the District receiving Sick and Infirm persons from the District. Romford Union Workhouse. Small-Pox Hospital, Dagenham. Romford Cottage Hospital. Isolation Hospital. 17 TABLE 11 ROMFORD URBAN DISTRICT. Names of Localities. ROMFORD WARDS. COLLIER ROW WARD. HAROLD WOOD WARD Year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered . Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under ; 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered . Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered . Deaths at all Ages. Deaths under 1 year. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. 1892 1893 1594 1895 8,060 292 134 40 1896 9,200 330 109 40 1897 9,500 313 127 37 1898 10.000 326 132 31 1899 10,500 324 141 32 1900 11,000 318 161 36 1901 13,656 395 152 55 Averages of Tears 1892 to 1901. 1902 14,000 414 172 42 *Part of Rural District incorporated. 18 TABLE III. Cases of Infectious Disease notified during the Year 1902, in the Romford Urban District. Notifiable Disease. Cases notified in Whole District. No. of Cases removed to Hospital. At all Ages. At Ages —Years. 1 2 3 4 5 6 7 Under 1. 1 to 5. 6 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox 43 1 2 11 16 13 ... Cholera ... ... ... ... ... ... ... Diphtheria 37 7 20 10 ... ... ... Membranous Croup ... ... ... ... ... ... ... Erysipelas 20 ... ... ... 3 17 ... Scarlet Fever 48 ... 31 12 5 ... ... Typhus Fever ... ... ... ... ... ... ... Enteric Fever 14 ... ... 2 12 ... ... Relapsing Fever ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... Puerperal Fever 4 ... ... ... ... 4 ... Plague ... ... ... ... ... ... ... Totals 166 8 53 35 36 34 ... 19 TABLE [V. Causes of, and Ages at, Death during Year 1902. Romford Urban District. Causes of Death. Deaths in or Beloning to whole District at subjoined Ages. Total Deaths in Public Institutions in District. 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 8 2 ... ... 1 5 ... UNION WORKHOUSE. Measles 2 1 1 ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... Whooping-cough 2 2 ... ... ... ... ... Diphtheria and Membranous Croup 2 ... ... 2 ... ... ... Croup ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... Enteric 1 ... ... ... 1 ... ... Other contind ... ... ... ... ... ... ... Epidemic Influenza 3 1 ... ... ... 2 ... Cholera ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... Diarrhœa 2 2 ... ... ... ... ... Enteritis 5 3 2 ... ... ... ... Puerperal Fever 1 ... ... ... ... 1 ... Erysipelas ... ... ... ... ... ... ... Other septic Diseases ... ... ... ... ... ... ... Phthisis 13 ... ... 1 1 11 ... Other tubercular Discases 10 3 3 3 ... 1 ... Cancer, Malignant Disease 17 ... ... ... ... 7 10 Bronchitis 9 1 1 ... ... 2 6 Pneumonia 14 3 4 ... 1 4 2 Pleurisy ... ... ... ... ... ... ... Other Diseases of Respiratory Organs 3 1 1 ... ... 1 ... Alcoholism Cirrhosis of Liver ... ... ... ... ... ... ... Venereal Diseases ... ... ... ... ... ... ... Premature Birth 14 14 ... ... ... ... ... Diseases and Accidents of Parturition ... ... ... ... ... ... ... Heart Diseases 16 ... ... 1 1 7 ... Accidents 3 ... ... ... 1 2 ... Suicides ... ... ... ... ... ... ... Senile Decay 9 ... ... ... ... ... 9 All other Causes 29 9 3 1 1 6 9 All Causes 163 42 10 8 7 49 42 38