ROMR 8 Romford Rural District Council. ANNUAL REPORT of the medical Officer of Helath. 1904. To the Romford Rural District Council. Gentlemen, I have the honour to put before you my Annual Report on the Sanitary Condition of the Romford Rural District, for the year ending December 31st, 1904. In accordance with the plan adopted in previous Reports, this Report is arranged in the following divisions:— I. Summary of Action taken during the year for Preventing the Spread of Disease. II. An account of the Sanitary Condition of the District generally. III. Statement of Enquiries made into Conditions Injurious to Health, and Proceedings thereon. IV. Table of Sickness and Mortality. 1.—Summary of Action taken to prevent the spread of Disease. No. Date. Locality. Disease. Source of Diseuse. Action taken. Result. 1 Jan. 8 to 14 Rainham - Diphtheria - 12 cases. 1 tens of the Epidemic to which reference in made in a subsequent part ot the report 2 ,, 14 South Homchurch Diphtheria - One case. Ditto 3 „ 14 to 25 Rainham - Diphtheria - Sixteen cases. Ditto 4 „ 16 North Hornohuroh Diphtheria - Three cases. Local nuisance. Remedied. Isolated at home. Disinfected No other case 5 ,, 25 Dagenham s Scarlet Fever - Three cases in two families. Removed to Hospital. Disinfected, &c. 6 ,, 27 Dagenhnm - Scarlet Fever - Two canes. Ditto 7 „ 28 Cor bets Tev - Scarlet Fever - One case. Ditto 8 „ 28 Dagenham - Scarlet Fever - Two cases. Ditto 0 ,, 29 Dagcnham - Scarlet Fever - Six cases. Ditto 10 Feb. 2 to 22 Rainham - Diphtheria Twenty-three cases u ,, 3 Dagenham - Scarlet Fever - One case 12 ,, 13 Dagenham - Scarlet Fever - Ditto 18 ,, 17 Dagenham - Scarlet Fever - Ditto. Removed 14 „ 18 Dagenham - Scarlct Fever - Two cases. Removed 14 „ 20 to 22 Dagenham - Scarlet Fever Ditto 16 , 24 Emerson Park, Hornohurch Diphtheria - One case. Cause obscure. Isolaton. Uninfected, &c. No other case 17 „ 23 Dagenham - Scarlct Fever - One ease, Isolation at home 18 Mar. 1 to 31 Rainham - Diphtheria - Sixteen cases 19 6 Dagenham, Station Road Diphtheria - Two oases in one family. Had sanitary condition of the locality. See subsequent part of the report. Case removed to Hospital B 4 No Date. Locality. Disease. Source of Disease. Action taken. Result. 20 Mar. 7 Dagenham, Station Road Diphtheria - One case. Bad Sanitary condition of the locality. See subsequent part of the report. Case removed to Hospital 21 „ 10 Dagenham, Hull Street Diphtheria - Three cases in one family. Local nuisance. Remedied Case removed to Hospital 22 ,, 14 Dagenham, Bull Street Diphtheria - One case in same family as No. 21 Case removed to Hospital 23 „ 15 Dagenham, Dewey Road Diphtheria - One case. Local nuisance 21 11 to 17 Cottage Homes, Hornchurch Diphtheria - sixteen cases. No insanitary condition. I believe the disease was caught by a child whilst walking in Park Road, there being a decided history of sewer gas smelt there. * The rest of the cases arising from personal infection All these cases were treated in the local infectious hospital which the Authorities have in the grounds 25 „ 16 Dagenham, Five Elms Diphtheria - One case. Contracted in Rainham. Isolated at home 26 „ 20 Station Road, Dagenham Diphtheria - One case. See No. 19 27 „ 20 Hornchurch Diphtheria - One case. Isolation 28 „ 23 Station Road, Dagenham Diphtheria - Three cases See No. 19 29 „ 23 Dagenham Scarlet Fever - One case. Contracted from No. 17. Removed to Hospital 30 ,, 26 Station Road, Dagenham Diphtheria - One case. See No. 19 31 „ 26 Up minster Enteric Fever - One case. Disease contracted away from home. Instruction, &c. No other case 32 April 1 South Hornchurch Diphtheria - Two cases in two adjoining houses Removed 33 „ 2 North Hornchurch Scarlet Fever - One case 34 „ 1-8 Rainham Diphtheria - Four cases. This was the end of the Rainham epidemic 35 ,, 1 Dagenham Scarlet Fever - One case. Removed 36 „ 2 Hornchurch Scarlet Fever - Ditto 5 No. Date. Locality. Disease. Source of Disease. Action taken. Result. 37 April 3 Five Elms Diphtheria - One case. Local nuisance. Removed 38 ,, 3 Dagenham Scarlet Fever - One case. Removed. 39 „ 4 Cottage Homes, Hornchurch Diphtheria - One case. See No. 16 40 „ 4 South Hornchurch Diphtheria - One case 41 ,, 4 Wennington Scarlet Fever - One case. Removed 42 ,, 7 South Hornchurch Diphtheria - One case 43 ,, 7 Dagenham, Station Road Diphtheria - Ditto. See No. 19 41 „ 9 Chequers' Lane, Dagenham Diphtheria - Two cases. Removed No other ease 45 ,, 12 North Homchurcb Diphtheria - One case. Local nuisance. Removed 46 ,, 12 Station Road, Dagenham Diphtheria - One case. See No. 19 No other case 47 „ 14 Dagenham Enteric Fever - One case. Contracted away from home. Removed No other case 48 ,, 14 Great Warley Scarlet Fever - One case. Ditto 49 „ 19 Dagenham Diphtheria - Two cases 50 ,, 9 Cottage Homes, Hornchurch Diphtheria - One case. See No. 24 51 „ 26 South Hornchurch Diphtheria - Ditto. Removed 52 „ 26 Dagenham Diphtheria - One case 53 „ 26 Station Road, Dagenham Diphtheria - Ditto. See No. 19 No other case 54 „ 29 Rainham Enteric Fever - One case. Contracted away from home. Removed No other cape 55 May 7 Chequers Lane, Dagenhum Small Pox - One case. Source of infection obscure, possibly the neighbouring West Ham Hospital. Removed. Inmates of house re-vaccinated. Quarantine for 10 days 56 „ 3 Station Road, Dagenham Diphtheria - One case. See No. 19. Removed 6 No Date. Locality. Disease. Source of Disease. Action taken. Result. 57 May 3 Dagenham Scarlet Fever - One case. Removed 58 ,, 4 Chequers Lane, Dagenham Diphtheria - Three cases. Local nuisance. Cases removed 59 „ 9 Nortli Homchurch Diphtheria - One case 60 „ 9 Station Road, Dagenham Diphtheria - One case. Removed. See No. 19 61 „ 9 South Hornchurch Diphtheria - One case. Removed 62 ,, 9 Five Kims - Diphtheria - One case. Same house as No. 37. Removed 63 „ 9 Dagenham - Scarlet Fever - One case. Removed 64 ,, 14 Dagenham - Diphtheria - Ditto 65 ,, 14 Great Warley - Scarlet Fever - Ditto 66 „ 16 Hornchurch - Diphtheria - One case 67 „ 17 Cottage Homes - Diphtheria - One case. See No. 16 68 ,, 18 Great Warley - Scarlet Fever - One case. Removed 69 „ 19 Emerson Park - Scarlet Fever - Ditto 70 „ 21 Station Road Diphtheria - One case. See No, 19 71 „ 25 Cottage Homes - Diphtheria - Two cases. See No. 24 72 „ 25 Station Road - Diphtheria - One case. Removed. See No. 19 73 „ 30 Great Warley - Scarlet Fever - One case 74 June 1 Hornchurch - Diphtheria - One case. Removed 75 ,, 1 Dagenham - Diphtheria - One case 76 „ 15 Dagenham - Diphtheria - Ditto 77 15 Reacontree Heath Scarlet Fever - Four cases in one family. Not removed 78 19 to 20 Great Warley - Scarlet Fever - Four cases in two families. Injection supposed to be taken from previous case near Removed 79 21 Corbets Tey - Enteric Fever - One case. A doubtful one 7 No Date. Locality. Disease. Source of Disease. Action taken. Result. 80 June 22 Great Warley - Scarlet Fever - Two cases in same family. As No. 35. Removed 81 „ 23 North Horachurch Diphtheria - One case. Supposed to have been contracted in London. Removed No other case 82 „ 29 Dagenham - Scarlet Fever - Three cases in one family. Removed 83 July 6 North Hornchurch Diphtheria - One case. Contracted away from home. Isolation No other case 84 „ 10 Great Warley - Scarlet Fever - One case. Removed 85 „ 13 Broad Street, Dagenham Small Pox - One case. Contracted away from home. Same steps taken as in No. 55 No other case 86 15 Rainham - Scarlet Fever - Two cases. Infection brought from Dagenham. Removed No other case 87 ,, 25 Chadwell Heath - Diphtheria - One case 8* „ 25 Station Road, Dagenham Diphtheria - One case. Sec No. 19 89 „ 25 Dagenham - Scarlet Fever - One case 90 „ 29 Beacontree Heath Scarlet Fever - Ditto 91 Aug. 4 Great Warley - Enteric Fever - One case. Instruction, &c. 92 „ 4 Great Warley - Diphtheria - Two cases in same family. As No. 10 No other case 93 ,, 4 Cranham - Scarlet Fever - One case. The first of many which occurred in this neighbourhood during the next few months. The case was not removed, and infection was distinctly traceable from it 94 „ 4 to 13 Beacontree Heath Scarlet Fever - Three cases 95 „ 18 Cranham - Scarlet Fever - One case. See No. 23. Removed 96 „ 19 Dagenham - Scarlet Fever - One case. Removed 97 „ 19 Station Road, Dagenham Diphtheria One case. See No. 19 98 „ 20 Rainham - Enteric Fever - One case. Removed c 8 No. Date. Locality. Disease. Source of Disease. Action taken. Result. 99 Aug. 17 Dagenham - Diphtheria - One case Removed 100 „ 29 Dagenham - Diphtheria - Ditto 101 Sep. 4 Beacon tree Heath Scarlet Fever - Two cases (two dwellings). Removed 102 „ 5 to 7 Beacontree Heath Scarlet Fever - Three cases in one family. Removed 103 ,, 5 Beacontree Heath Scarlet Fever - Two cases. Removed. 103 ,, 5 Upminster - Scarlet Fever - One case. Removed 105 ,, 5 Station Road, Dagenham Scarlet Fever - One case 106 ,, 7 Station Road, Dagenham Scarlet Fever - One case. Removed 107 ,, 17 Upminster Scarlet Fever - Ditto 108 „ 17 Stati n Road, Dagenham Diphtheria - One case. See No. 19 109 ,, 17 Broad Street, Dagenham Diphtheria - Ditto 110 „ 17 Beacontree Heath Scarlet Fever - One case. Not removed 111 ,, 18 to 21 Upminster Scarlet Fever - Six cases. Removed 112 ,, 22 Chadwell Heath - Diphtheria - Two cases (two houses). Source obscure 113 „ 23 Beacontree Heath Diphtheria - One case. Removed 114 „ 24 South Horn church Diphtheria - One case. Infection from Beacontree heath. Removed 115 „ 26 Dagenham - Scarlet Fever - Two cases (two houses). Removed 116 „ 26 Upminster - Diphtheria- One case. Removed 117 ,, 29 Beacontree Heath Scarlet Fever - Two cases. Not removed 118 Oct. 2 Dagenham - Scarlet Fever - One case in same house as No. 115. Removed 119 ,, 3 to 5 Beacontree Heath Scarlet Fever - Two cases. Not removed 9 No. Date. Locality. Disease. Source of Disease, Action taken. Result. 120 Oct. 4 Chadwell Heath Scarlet Fever - Three cases (two houses). Two removed 121 „ 6 Rainham - Enteric Fever - One case. Disease contracted from home. Instructions, &c. No other case 122 ,, 6 New Road, Dagenham Scarlet Fever - One case. Removed 123 ,, 7 Dagenham - Scarlet Fever - Ditto 121 „ 8 Station Road Dagenham Scarlet Fever - Ditto 125 ,, 9 Four Wants Road, Dagenham Scarlet Fever - One case Infected from Beacontree Heath. Removed 12G „ 9 North Hornchurch Diphtheria - Two cases in one house. No insunitary condition 12; „ 13 Station Road, Dagenham Diphtheria - One case. See No. 19 128 ,, 16 New Road, Dagenham Scarlet Fever - One case. Removed 22 j ,, 19 to 31 Upminster - Scarlet Fever - Five cases. Removed 130 „ 19 Beacontree Heath Scarlet Fever - One case in a house where a previous ease had refused removal. (See 30). Removed with the other one 131 „ 19 Hornchurch - Scarlet Fever - One case. Infection obscure. Instructions, Ac. No other case 123 „ 22 New Road, Dagenham Enteric Fever - One case 133 „ 25 Upminster - Scarlet Fever - One case in a house where two previous cases had occurred. Removed 134 22 to 24 Beacontree Heath Diphtheria - Three cases in two houses where previous cases had refused removal. Removed 135 „ 30 Hagenham - Scarlet Fever - One case. Removed. 136 „ 10 North Hornchurch Scarlet Fever - One case. Origin obscure. No insanitary condition 137 Nov. 1 New Road, Dagenham Diphtheria - Two cases in two houses. Removed 10 No. Date. Locality. Disease. Source of Disease, Action taken. Result. 138 Nov. 1 to 13 Upminster - Scarlet Fever - Four cases. Removed 189 ,, 6 Beacontree Heath Scarlet Fever - Asked to see a reported case of Diphtheria. Thought it not to be Diphtheria, corroborated by bacteriological examination 140 ,, 6 Beacontree Heath Diphtheria - Two cases in a house where a previous case had not been recognised. Removed 141 ,, 6 Station Road, Dagenham Scarlet Fever - One case. Removed 142 ,, 6 Craaham - Scarlet Fever - Ditto No other case 143 ,, 6 Hacton - Diphtheria - Ditto No other case 141 ,, 10 New Road, Dagenham Diphtheria - One case. Removed 145 ,, 11 to 17 Upminster - Scarlet Fever - Three cases. Removed 146 „ 13 New Road, Dagenham Scarlet Fever - One case, next door to No. 114. Removed 147 „ 18 Hook's Hall, Dagenham Scarlet Fever - Seven cases in one house. There had been an unrecognised case here, infected from Beacontree Heath. A milk supplying business carried on at the premises. This was at once stopped. All the cases were removed 148 ,, 17 South Hornchurch Scarlet Fever - One case. 149 ,, 17 New Road. Dagenham Scarlet Fever - One case. Removed. 150 ,, 20 to 29 Beaeontree Heath Scarlet Fever - Nine eases in five houses. Eight removed 151 „ 25 Hornchurch - Scarlet Fever - One case. Infection supposed to be brought from an Upminster case. Removed No other case 152 „ 25 to 28 Station Road, Dagenham Scarlet Fever - Two cases from a previous case. Removed 153 „ 28 Rainham - Diphtheria - One case. Origin obscure. Removed to London Hospital Fatal 154 Dec. 2 Dagenham - Diphtheria - Three cases in one house. Removed. Local insanitary condition 11 No. Date. Locality. Disease. Source of Disease, Action taken. Result. 155 Dec. 2 Chequers Lane, Dagenham Diphtheria - One case. Removed 156 ,, 3 Rainham - Diphtheria - One case. Fatal 157 „ 8-19 Beacontree Heath Scarlet Fever - Three cases in one House. One Removed 158 „ 4 Chequers Lane, Dagenham Scarlet Fever - One case next door to No. 15a, , Removed 159 „ 6 Upminster - Diphtheria - One case. Removed. Scarlet fever developed after removal to Hospital 160 „ 8-19 Upminster - Scarlet Feve r • Two cases. Removed 161 ,, 11 Dagenham - Scarlet Fever - One case in a house previously infected. Removed 162 ,, 12 Chequers Lane. Dagenham Scarlet Fever - One case next door to No. 158 163 „ 13 to 17 Station Road. Dagenham Scarlet Feve r - One case in previously infected house. Removed 164 „ 13 to 17 Station Road, Dagenham Diphtheria - One case in same house as No. 163. Removed 165 „ 25 Hooks Hall, Dagenham Scarlet Fever - One case in same house as No. 147. Removed. 166 „ 27 Dagenham - Scarlet Fever - Two cases in one house. Removed 167 „ 30 Chadwell Heath - Scarlet Fever - Two cases. Infection brought from London. Isolated at home. Disinfected No other case D 12 I received notice of 356 cases of infectious disease during the year. The different diseases are thus tabulated :— Scarlet Fever 146 Enteric Fever 12 Diphtheria 179 Erysipelas 19 356 220 of these cases were removed to the Isolation Hospital. The following is a succinct account of the difierent infectious diseases requiring action by your sanitary officials during the year. My practice is to request the Sanitary Inspector to visit each house as soon as I receive notification of the existence of infectious disease there, visiting myself subsequently all those cases which I consider require my doing so. Small Pox.—Two cases of this disease were notified. Both occurred at I'agenham. Both, in the course of their avocation, went within the infective zone of the "West Ham Small Pox Hospital, which is situated in the neighbourhood. Scarlet Fever.—146 cases were notified, the large number occurring in the Parish of Dagenham. Many of these cases were traceable to School infection. Twenty-two cases occurred in, and in the neighbourhood of, Upminster Here, also, School infection was the chief factor, at first, in spreading the disease ; afterward careless intermixing of dwellers in infected and non-infected houses, helped to spread the disease. Enteric Fever was not very prevalent, 12 cases having been notified during the year. Diphtheria, which was very prevalent in and around the village of Rainham during the previous year, did not cease until about April, since when this locality has been free from this disease. 99 cases came from Dagenham, 22 from Upminster and neighbourhood. 13 The subjoined table shews the degree in which infectious disease prevailed in the various parishes of the district. Dugenham, Be.icontrce and Chadwell Heaths. Havering. : lovnchurch. I'pminster. Crunliam, and Corbets Tey. j Great War ley. Rainham aid I '.Vennington. Small Pox 2 — - - - - Scarlet Fever 99 1 11 22 8 5 Diphtheria „ , ...... 57 - 42 5 5 70 Enteric Fever 3 2 3 0 1 S Erysipelas 7 - 6 4 - 2 i'uerperal Fever 1 1 168 1 63 33 14 81 II.—An account of the Sanitary condition of the District at the end of 1904. In complying with this section of the Local Government Board's instruction to Medical Officers of Health, I proceed to give, as in previous years, a short account of the sanitary state of the District, under the same heads of localities as are given in the statistical tables. Dagenham, Bkacontree Heath, and Chadwell Heath.— Villages and scattered groups of houses, all situate in the parish of Dagenham, and occupying a very wide area, standing on gravel and on London clay, some (part of Dagenham village and immediate neighbourhood) on alluvium. Population, 6,700. Agricultural. Water supply mainly from South Essex Company. The village of Dagenham is in a bad sanitary condition, owing to the ground being saturated by years' overflowing cesspools and slop-water Most of 14 the cottages supplied with pail closets, emptied once a week by the Sanitary Authority. A system of scavenging is in force. Dust-bins are periodically emptied by the Authority. There still exists a condition of soil sodden by sewage overflow from cesspools, and which nothing but some system of drainage will relieve and until this is done the village must continue to be in a bad sanitary conditions. Birth-rate, 362. Death-rate, 1504. Death-rate from zymotic disease, 2.06 per 1,000 of the population. A complete system of sewage removal has been decided upon, and is now in course of construction. Noak Hill stands high on London clay. Population, 260. Birth-rate, 7 3. Death-rate, 3 8. Death-rate from zymotic disease, Nil. "Water supply from private wells. Havering stands high on pebble sand, bounded by London and boulder clay. Population, 405. Agricultural. Privies. Water supply from wells and from South Essex Company. Some of the out-lying parts of the parish badly supplied, the source in these instances being from ponds. Birth-rate, 26-9. Death-rate, 4 9 Death-rate from zymotic disease, Nil. Hornchurch.—Large village and scattered groups of houses extending over a large parochial area. Part of the parish adjoiuing the town of Romford, and really constituting a portion of that town. Stands mostly on gravel and partly on London clay, some small portion of the parish running down to the Thames and alluvial. Population, 6,800, principally agricultural, foundry works and a brewery in the village. A very extensive system of sewerage for the village is now completed and a sanitary improvement of great value has been effected. A system of sewerage for the outlying locality of Harold Wood is also now in operation. Birth-rate, 23.7. Deathrate, 11 "7. Death-rate from zymotic disease, 0 5. Upminster, Cranham, and Corbets Tey.—Adjacent villages, standing on high ground, mostly brick earth, some gravel. Population, 1,950. Agricultural. Water supply mostly from South Essex Company; some wells. Birth-rate, 23.5. Death-rate, 14.3. Deathrate from zymotic disease, 0 5. 15 Hornchurch.—Large village and scattered groups of houses extending over a large parochial area. Part of the parish adjoining the town of Romford, and really constituting a portiou of that town. Stands mostly on gravel and partly on London clay, some small portion of the parish running down to the Thames and alluvial. Population, 6,800, principally agricultural, foundry works and a brewery in the village. A very extensive system of seweragn fur the village is now completed and a sanitary improvement of gi eat value has been effected. A system of sewerage for the outlying locality of Harold Wood is also now in operation. Birth-rate, 24.7. Deathrate, 117. Death-rate from zymotic disease, 0.2. Upminster, Cranham, and Corbets Tey.—Adjacent villages, standing on high ground, mostly brick earth, some gravel. Population, 1,950. Agricultural. Water supply mostly South E<sex Company ; some wells. Birth-rate, 23 5. Death-rate-14.3 Death-rate from zymotic disease, 0.5. Part of the system of sewerage in Coibets Tey is, in my opinion, insufficiently ventilated. This has been reported to Council by me, and is now in course of being remedied by the erection of several ventilating shafts. Complaints are frequent from residents of the bad smell given off at the sewage outfall works. Great Warley stand high on London clay. The most thickly populated part of the parish joins the town of Brentwood, in the Billericay Union, the larger area of the parish having scattered houses. Groups of houses. Population, 2,000. Agricultural. Water supply mainly from South Essex Water Company; some of the more sparsely inhabited part badly from wells and ponds. Birth-rate, 26-5. Deathrate, 7.0 Death-rate from zymotic disease, nil. Rainham and Wennington lie low on gravel and alluvium at the edge of the Thames. Marshy. Village of 2,200 inhabitants. Agricultural, Factories, some offensive, and river traffic. Tidal stream runs through Rainham to the Thames, about one mile distant. A very serious outbreak of Diphtheria prevailed here in 1903, and was continued up to about April, 1904. This formed the subject of reports and caused an official inspection from Dr. Mivart, oue of H.M Inspec- e 16 tors. The very bad sanitary condition of the village is now, I hope, in course of amendment, as after many difficulties and unavoidable delay, a system of sewerage is now being rapidly carried out. Birth-rate, 26.5. Death-rate, 17.7. Death-rate from zymotic disease, 2 2. III.—An account of the enquiries as to the conditions injurious to health existing in the district, and of the proceedings relating to such conditions in which advice has been given, &c., &c. In addition to the cases of infectious diseases recorded in Section 1 of this report, the following insanitary conditions, &c, necessitated official interference by the Sanitary Inspector, who called in my assistance when necessary. These instances of nuisances, &c., are included in the list detailed in a later portion of this report. Dagenham, Beacontrbe and Chadwell Heaths.—Jan. 2nd. — Swine kept as a nuisance. Notice. Removed. Jan. 4th.—Foul drain and closet. Notice. Cleansed. Jan. 7th.—Foul ditch. Ditto Jan. 12th.—Foul privies and cesspit. Ditto Jan. 26th.—Six houses with no drainage. Notice. Remedied. Feb. 4th.—Swine kept causing nuisance. Ditto Feb. 5th.—Foul cesspit. Notice. Cleansed. Feb. 8th.—Foul ditch. Ditto Feb. 9th.—Foul closet and drain. Notice. Cleansed. Feb. 9th.—Accumulation of refuse. Notice. Removed. 17 Feb. 9th.—Foul cesspool and privy. Notice. Cleansed. Feb. 9th.—Foul ditch. Ditto Feb. 11th.—Accumulation of manure. Ditto Feb. 12th.—Foul ditch. Ditto Feb. 16th.—Foul cesspit and drain. Ditto Feb. 22nd.—Ditto Ditto March 6th.—Accumulation of refuse. —Notice. Removed. March 7th.—Insufficient sanitary accommodation. Notice. Remedied. March 11th.— Ditto Notice. Remedied. March 1 \th. —Foul cesspit. Ditto March 14th.—Foul accumulation. Ditto March 14th.—Foul ditch. Ditto March 14th.—Foul cesspool. Ditto March 14th.—Untrapped drain. Ditto March 17th.—Ditto Ditto March 21st.—Foul cesspit and drain. Ditto March 22nd.—Accumulation of refuse. Notice. Removed. March 24th.—Foul ditch. Notice. Cleansed. March 25th.—Foul drain and cesspit. Notice. Cleansed. March 28th.— Ditto Ditto March 31st.—Cowshpd filthy, excessive accumulation of manure on premises. Notice. Cleansed. Visited these premises with the Inspector at a later date and found everything satisfactory. 18 April 4th.—Foul drain and cesspit. Notice. Cleansed. April 6th.—Ditto Ditto April 6th.—Foal ditch. Ditto April 7th.--Accumulation of refuse. Notice. Removed. April 9th.—Foul cesspit. Notice. Cleansed. April 11th.—Cottage with insufficient sanitary accommodation, dirty premises from imperfect gutters. Notice. Remedied. April 15th.—Foul ditch. Ditto April 16th.—Accumulation of refuse. Ditto April 18th. Foul drain and insanitary premises. Ditto April 20th.—Ditto Ditto April 22nd.—Foul cesspit. Ditto April 23rd. —Accumulation of refuse. Removed. April 25th. —Koul drain. Notice. Cleansed. May 4th.—Insufficient sanitary accommodation. Notice. Remedied. May 6th. —Foul cesspool. Notice. Cleansed. May 7th.— Ditto Ditto May 11th.— Ditto Ditto May 13th.—Accumulation of refuse. Ditto May 20th. —Foul drain and cesspit. Ditto June 1st.—Foul cesspit. Ditto June 3rd.- Damp premises. Ditto 19 June 7th.—Foul cesspit. Notice. Cleansed. June 16th.—Defective drainage. Ditto June 17th.—Foul cesspit. Ditto June 18 th.— Ditto Ditto June [8th.—Swine kept so as to be a nuisance. Notice. Removed. June 27th.—Overcrowding in a house. Notice. Remedied. July 15 th.—House with no drainage. Notice to construct cesspool and drain. Complied with. July 22nd.—Foul cesspit and drain. Notice. Cleansed. July 22tul.—Foul ditoh. Ditto July 26th.—Defective closet. Notice. Remedied. July 30th.—Swine causing a nuisance. Ditto Aug. 4th.—Defective drainage. Ditto Aug. 22nd.—Foul drain. Ditto Aug. 24th.—Foul ditch. Ditto Aug. 27th.—Foul drain. Ditto Aug. 27th.—Accumulation of refuse. Ditto Aug. 29th.—Foul drain. Ditto Aug. 29th.—Smoke nuisance. Ditto Sept. lst—Foul w.c. Ditto Sept. 8th.—Foul drain. Ditto Sept. 10 th.—Foul drain and cesspool. Ditto Sept. 10th.— Defective drain and dilapidated houses. Two houses condemned. 20 Sept. 11 th.—Swine causing nuisance. Notioe. Removed. Sept. I Ith.—Foul cesspit. Notice. Cleansed. Sept. 19 th.—Ditto Ditto Sept. 22nd.—Ditto Ditto Sept. 23rd.— Ditto Ditto Sept. 26th.—Foul ditch. Ditto Oct. 1st.—Accumulation of refuse. Ditto Oct. 5th.—Foul cesspools and drain. Ditto Oct. 6th.—Ditto Ditto Oct. 6th.—Defective drainage. Notice. Remedied. Oct. 10th.—Ditto Ditto Oct. 10th.—Foul ditch. Notice. Cleansed. Oct. 10th.—Accumulation of refuse. Notice. Cleansed. Oct. 17 th.—Ditto Ditto Oct. 17th.—Foul drain and cesspool Ditto Oct. 17 th. —Ditto Ditto Oct. 17th.—Swine causing a nuisance. Removed. Oct. 21th.—Foul cesspits. Notice. Cleansed. Oct. 28th.—Foul drain. Ditto Nov. 3rd. —Ditto Ditto * Nov. 14th.—Insanitary premises. Notice. Remedied. Nov. 14th.- Accumulation of refuse. Removed. 21 Nov. 17th.—Two slaughter houses without license. Notice. Closed. Nov. 18th.—Accumulation of refuse. Removed. Nov. 28th.—Defective drainage. Notice Remedied. Dec. 3rd.—Foul drains and cesspit. Notice. Cleansed. Dec. 3rd.—Ditto Ditto Dec. 5th.—Two houses unfit for habitation. Condemned and closed. Dec. 9th.—Swine causing nuisance. Removed. Havering :— May 25th.—Foul cesspits and dilapidated closets. Notice to cleanse cesspits, and to erect new closets and provide earth-pans. Complied with. July 18th.—Havering School.—Cesspools and drains foul. Notice to cleanse and to ventilate drain. Complied with. July 18th.—Ditto—Foul ditcb, from drain discharging into it. Notice to disconnect. Complied with. Aug. 17th.—Foul cesspits and ditch. Notice. Cleansed. Hornchurch :— Jan. 4th.—Hornchurch.—Sink directly connected with drain. Diphtheria. Notice to disconnect. Complied with. Jan. 7th.—Ditto—Twelve cottages with foul closets. Notice. Cleansed. Jan. 7th.—Ditto—Blocked drain. Notice. Cleansed. Jan. 8th. — Harold Wood.—Premises insanitary, drains not connected with sewer. Notice. Remedied. 22 Jan. 8th.—Harold Wood.—Premises insanitary, drains not connected with sewer. Notice. Remedied. Jan. 8th.—Globe. Road.—Blocked drain. Notice. Cleansed. Feb. 8th.—Hornchurch.—Two cottages not connected with sewer, and with no water supply. Notice not complied with. Proceedings threatened, and required work done. Feb. 8th.—Ditto—Four cottages with insufficient sanitary accommodation. Drains empty in ditch. Proceedings threatened. Nothing done. Feb. 15th.—Squirrels Heath.—Foul cesspit. Notice to fill in cesspit and provide pail-closets Complied with. Feb. 18th.—Hornchurch.—Blocked drain. Notice. Cleansed. March 4th.—Ditto Ditto March 14th.—Harold Wood.—Ditto Ditto March 17th.—Douglas Road.—Defective closet. Notice. Remedied. March 31st.— South Hornchurch.—Foul cesspits. Notice. Cleansed. April 14th.—Hornchurch.—Blocked drain. Notice. Cleansed. April 14th.— North Hornchurch.—Accunmlation of refuse. Notice. Removed. April 16th.—Havering-Well.—Decomposing vegetable refuse in a gravel pit close to houses. Notice. Removed. April 23rd.— Harold Wood.—Blocked drain. Notice. Cleansed. April 26th. —Ditto—Foul ditch from drain from cowshed. Notice to connect with sewer. Complied with. April 29th. — Hornchurch.—Blocked drain. Notice. Cleansed. 23 May 4th.—Ardley Green.—Blocked drain. Notice. Cleansed. May 9th.—Hornchurch.—Foul pail-closets. Notice to connect with sewer. Complied with. May 9th.—Ardley Green.—Blocked drain. Notice. Cleansed. June 13th.—Hornchurch.—Accumulation of manure and butchers' offal near houses. Notice. Removed. Aug. 8th.—Ditto—Premises dirty and causing a nuisance. Notice. Aug. 8th.—Ditto—Defective water supply to cottages. Notice. Remedied. Aug. 27th.Harold Wood.—Cesspool in connection with premises connected with sewer, not filled up. Notice to do so. Complied with. Sept. 7th.— North Hornchurch.—Foul refuse deposited in old gravel pit close to house. Notice. Removed. Sept. 14th.—Hornchurch.—Complaint of sewer gas from a fresh air inlet to drain. Notice. Removed. Sept. 15th.—Abbs Cross Cottage.—Water thought to be impure, Examined and found to be good. Sept. 15th.— Victoria Cottage.—Ditto ditto Sept. 15th.—Visited Selborue dust shoot on land adjoining river Thames. Ten acres of land being gradually covered with refuse (street sweepings. condemned tinned fruit, &c., brought from London), forming immense heap gradually causing spontaneous combustion, much smoke emitted. Reported to Council that as the nearest house, with the exception of the caretaker's is a mile away, no interference was necessary. 24 Sept 23rd.—Hornchurch.—Water (sewer) in cellar of house. Notice. Remedied. Oct. 12th.—Ditto.—Accumulation of refuse of manure close to houses. Notice. Removed. Oct 29th.—Ardley Green —Public house with defective drain. Notice to connect with sewer. Nothing done. Oct. 29th.—Harold Wood.—Ditto Complied with. Nov. 2nd.—Hornchurch.—Blocked draiu. Drain improperly laid. Notice. Remedied. Nov. 10th.—Ditto.—Ditto. Drain connection with an old drain which fouls a ditch. Notice to connect with sewer. Complied with. Nov. 10 th.—Ditto ditto Nov. 14th.—Ditto.—Capron Cottages.—Reported upon previously Notice served. Nothing as yet done. Nov. 14th.—Ardley Green —Defective drain. Notice to disconnect from ditch, which was fouled by sewerage, and to connect with sewer. Nothing done. Dec. 15th.—Hornchurch. — Accumulation of refuse &c., uear houses. Notice. Removed. Dec. 15 th.—Ditto.—Ditto Ditto Dec. 29th.—North Hornchurch.—Ditto Ditto Dec. 31st.—Hornchurch.—Blocked drain. Notice. Cleansed. Upminster, Cranham, Cokbets Tey: —Jan. 21th.— Upminster.— Foul cesspool and dilapidated closets. Notice to cleanse cesspool, repair closet, and connect with sewer. Complied with. 25 July 6th.—Cranham.—Foul cesspool. Cleansed. Drain connection with sewer, after notice served. Aug. 27th.—Ditto.—Foul cesspool. Notice. Cleansed. Oct. LOM.—Ditto—Notice served upon owner of 27 cottages, to connect with sewer. Complied with. Oct. 10th.— Upmimter Common.—Compliant having been made to the Council that a great nuisance was caused by the sewerage works at the outfall of the Brentwood sewerage system, which is situated here, I visited the works and made a detailed examination. I could find nothing to justify complaint and reported to council. Oct. 17th.—Corbets Tey.—Cottages dilapidated, damp and unfit for habitation. Notice. Remedied. Oct. Ylth.—Ditto.—Accumulation of refuse near houses. Notice. Removed. Great Wari.ey :— Feb. 1 Ith.—Great Warl"y.—Defective closet pans. Notice. Remedied. Feb. 21th.—Ditto—Foul cesspools and drains. Notice. Cleansed. March 9th.— Warley Mount —Houses (good-class) having a private system of sewerage by filter beds, &c., causing an offensive nuisanco in neighbourhood. Reported to Council, advising arrangements to be made by which the houses could be drained into the Brentwood Sewage System. This was done and the nuisance remedied. June. 20th.—Great Warley.—Foul cesspool and ditch. Notice. Cleansed. June 20th.—Ditto Ditto July 18th.—Ditto—Cottage damp and dilapidated. Notice to repair and connect with sewer. Complied with. 26 Aug. 9th.—Ditto—Defective water supply to cottages. Notice. Remedied. Aug. 9th.—Ditto—Blocked drain. Notice. Cleansed. Sept. 23rrf.—Ditto—Foul ditch. Notice. Cleansed. Oct. 7th.—Ditto—Overorowded cottage. Notice. Remedied. Oct. 7th.—Ditto—Cottage dilapidated, &c., and unfit for habitation. Notice. Nothing done. Oct. 12th.—Ditto Ditto Oct 12th.—Foul ditch. Notice. Cleansed. Oct. 12tn.—Defective sanitary accumulation. Notice. Remedied. Oct. 19th.—House damp and defective water supply. Condemmed. Oct. 22nd.—Foul ditch. Notice. Cleansed. Oct. 23rd.—Ditto Ditto Rainham and Wknnington:—Jan. 6th.—Foul drains and closets. Notice Cleansed. Jan. 11lth.—Untrapped drain. Notice. Remedied. Jan 22nd—Accumulation of manure. Removed. Jan. 27th.—Foul cesspool. Notice. Cleansed. Feb. 11th.— Insufficient drainage to cottages. Notice. Remedied. Feb. 14th.—Foul drain and closets Notice. Remedied. Feb. 26th. — Foul ditch. Notice. Cleansed. April 13th.—Foul cesspit. Notice. Cleansed. 27 April 27th.—Defective drain and accumulation of sewage. Notice. Remedied. March 2nd.—Foul drain and cesspits. Notice. Remedied. March 20th.-Uncovered drain. Notice. Remedied. March 20th. — Accumulation of sewage. Notice. Remedied. June 9th.—Cottage overcrowded. Notice. Remedied. June 11th.—Accumulation of refuse. Notice. Remedied. June 18th.—Foul cesspit. Notice. Remedied. June 23rd.—Foul ditch. Notice. Remedied. June 29th —Accumulation of refuse. Notice. Remedied. July 25th.—Insufficient sanitary accommodation. Notice. Remedied. July 25th.—Defective drainage. Notice. Remedied. « July 28th.—Defective closets. Notice. Remedied. Sept. 13th.—Foul drain and accumulation of refuse. Notice. Remedied. Sept. 29th.—Ditto Ditto. Oct. 12th.—Foul drain. Notice. Remedied. Oct. 12th.—Foul drain and cesspits. Notice. Remedied. Nov. 2nd.—Ditto Ditto Nov. 7th.—Ditto Ditto 28 Nov. 16th.—Foul drain and cesspit. Notice. Remedied. Nov. 16 th.—Insufficient sanitary accommodation. Notice. Remedied. Nov. 16th.—Ditto Ditto The following is a complete list of the nuisances, &c., reported hy the Sanitary Inspectors, in which action has been taken by them, my aid being called in in those instances which were considered necessary. Nuisances abated 568 Filthy houses cleansed 3 Overcrowding abated 6 Houses repaired 14 Houses closed 10 Wells closed, water impure 1 Pail closets provided 9 W.C's repaired &c., 14 Samples of water analysed 19 Total 644 Many sanitary improvements have been effected in the district during the past year. Good roads have been made in various parts of the district recently developed into residential localities (Emerson Park especially) are being put in hand. A complete system of sewerage has been adopted for Rainham and the very extensire area of most of the Parish of Dagenham—both of which have been unavoidably delayed to the disappointment of the Council, by unavoidable difficulties. The Rainham sewerage system is well advanced in construction, and the Dagenham system is now also in hand. 29 Tables of mortality, &c., compiled according to the requirements of the Local Goverment Board, are included with this report. The Birth and Death Rates are shown in the following table for the last five years. Locality. 1900. 1901. 1902. 1903. 1904 Birth. Rate. DEAth. Rate. Birth Ratk. DeAth. Rate. Birth. Ratk. DEath. Rate. Birth. Rate. Death R atE. Birth. Rate. Death. Rate. Dagenham, Beacontree and Chad well HeaLhs 34.7 16.8 35.9 14 3 35.8 11.08 35.2 12.7 36.2 15.04 Havering . 15.7 9.8 28.9 9.8 13.6 11.4 10 Nil 26 9 4.9 Hornchurch . 3.6 14.0 25.7 11.8 27.6 12.9 22.9 8.5 23.7 11.7 Upminster. Cranham, and Corhets Tey. 25.4 15.3 25.7 10.6 22.1 10.0 21.4 12.04 23.5 14.3 Great Warley 35.5 15.2 29.4 20.0 29.8 8.7 92.9 14.7 26.5 7.0 Rainham & Wennington 33.4 9.06 31.2 18.7 35.2 17'1 48.3 18.2 26.5 17.7 Disease of a zymotic character proved fatal in 20 instances. The death.rate from this class of disease for the entire district having been 0 9 per 1,000. The following table shows the nature and distribution of fatal zymotic disease in the different localities of the district. 30 Dagenham Havering. Upminster, Hornchurch. Rainham. Great Warley. Measles 2 - - - 2 . - Diphtheria 9 - - 1 1 - Enteric Fever - - - - - - Scarlet Fever 2 - 1 - - - ISOLATION HOSPITAL. The following cases were admitted into the Isolation Hospital from the Rural district during the year. Recovered. Died. Scarlet Fever 144 140 4 Diphtheria 95 85 9 Enteric Fever 4 4 — I have, as in previous reports, much pleasure in. testifying to the satisfactory way in which, as far as I know, the duties of inspection, &c, are carried out by the Sanitary Inspectors. Area and population of district: Area, in acres 32,245 Population 20,415 General death-rate 13.4 per 1,000. Infant death-rate (under 1 year) 47 per 1,000. I am, Gentlemen, Your obedient Servant. ALFRED WRIGHT. The Lodge, Romford, March 10th, 1905. 31 TABLE I. Vital Statistics of Whole District during 1904 and Previous Years. ROMFORD RURAL DISTRICT. Year. Population estimated to Middle of each Year. Births. Total Deaths Registkrkd 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 1894. 1895. 1896. 1897. 1898. 16,400 551 33.5 66 101.6 250 15.2 12 262 15 .9 1899. 16,770 593 35.3 84 141.6 256 15.1 9 265 15.3 1900. 17,380 476 27.3 26 54.6 255 14.6 11 266 15.3 1901. 18,990 569 29.9 90 157.9 266 14.007 16 7 5 271 14.2 1902. 19,500 585 30.0 62 105.9 435 22.3 201 201 7 211 12.2 1903. 20,000 623 36.1 68 108.1 248 12.4 13 6 22 264 13.2 Averages for rears 1391. 1903 1901. 20,415 551 26.8 96 274 13.4 16 2 21 293 14.3 * Rates in columns 4, 8, and 13. calculated per 1,000 of estimated population. Area of District in acres (exclusive of area covered by water), 32,245. Total population at all ages, 18,990. Number of inhabited houses, 3.955 At Census of 1901. Average number of persons per house. 4.7 Is the Union Workhouse within the District?—Yes. TABLE 11. Vital Statistics of Separate Localities in 1904 and previous ye rs. ROMFORD RURAL DISTRICT. Names of Localities. Dagenham, Beacontree, and Chad well Heath. Noak Hill. Havering. Hornchurch. Upminster, Cranham, and Corbets Tey. Great Warley. Raineam and Wennington. 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. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. a. b. c. d. a. b. e. d. a. b c. d. a. b. c. d. a. b. c. d. a. b. e. d. a. b. c. d. 1894 l895 1896 1897 1898 5, 20 160 83 33 £00 7 3 4,700 131 61 13 1,990 43 31 4 1,890 62 22 3 2,300 72 17 4 1899 5,200 181 61 23 SOD 13 1 4,800 166 76 27 2,000 40 21 5 1,930 60 29 3 2,340 62 33 14 1900 5,500 181 90 31 504 5 5 3 5,060 168 70 15 2,020 51 31 4 1.970 30 30 12 2,390 79 25 10 1901 6,00 228 87 41 259 5 2 407 11 4 6,100 165 76 25 1,874 20 20 3 1,900 56 30 11 2.080 65 39 14 1902 6,300 223 69 18 259 4 4 406 7 6 1 6,610 177 83 24 1,900 19 19 5 1,910 58 17 3 2,100 74 36 13 1903 6,500 229 83 35 260 6 8 4C0 4 6.800 191 58 13 1,910 41 28 4 1,920 59 29 8 2,160 93 33 6 Averages of Years 1891 to 1903. 1904 6,700 246 102 38 260 2 1 405 7 2 6,900 164 88 32 1,950 46 28 5 2,000 53 14 6 2,200 54 39 15 33 TABLE 111. Cases of Infectious DisRask notified during thE Year 1904, in thE. Romford RuRAL DiSTRIct Notifiable DisrasE,. Cases notified in Whole District. Total CaseS notified in each Locality. At all Ages. At Ages — Years. Dagenham, Beacon tree and j Chad well Heaths Noak Hill. Havering. Hornchurch. Upminster, Cranham, and Corbets Tey. i Great Warley. Rainham and Wennington. Under 1. I to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox 2 ... ... ... 2 ... ... 2 ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 179 ... 49 96 6 28 ... 57 ... ... 42 5 5 70 Membranous Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 19 ... ... ... ... 19 ... 7 ... ... 6 4 ... 2 Scarlet Fever 144 ... 33 98 14 1 ... 99 ... 1 11 22 8 5 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 12 ... ... ... 8 4 ... 3 ... ... 3 2 1 3 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 2 ... ... ... ... 2 ... ... ... ... 1 ... ... 1 Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 360 ... 82 194 30 54 ... 168 ... 1 63 33 14 81 Isolation Hospital—Rush Green, Dagenham. 34 Causi TABLE 5s of, and agk8 at, death RuK4L E IV. during Year 1904, Romford istrict. Causes of Dkath. Dkaths in or belonging to whole District at subjoined Ages. Deaths in oi belonging to Localities (at all Ages). Total Dkaths in Public Institu- ion8 in District. All A ges Under 1 year. 1 and under 5. f 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Dagenham, Beacontrce and Chad well H'ths. Noak Hill Havering Hornchurch Upminster, Cranham, and Corbets Tey Great Warley Rainham and Wennington Small-Pox "1 Measles... 5 1 4 2 1 2 Scarlet Fever 4 2 2 2 1 1 2 Whooping-cough 5 3 2 1 2 2 Diphtheria and branous Croup ' ... 11 2 8 1 9 1 1 8 Croup 2 2 1 1 j Typhus Fever < Enteric ( Other contin'd ... Epidemic Influenza ... ... Cholera Plague Diarrhoea 4-2 32 7 2 1 19 13 2 8 Enteritis 5 1 5 2 2 1 Puerperal Fever Erysipelas Other septic Diseases Phthisis 12 1 8 3 3 5 2 1 i Other tubercular Diseases 8 2 3 i 2 1 Cancer, Malignant Disease 10 1 5 4 4 6 1 1 1 Bronchitis 21 4 1 6 10 4 6 a Pneumonia 13 G 0 2 3 4 5 2 L 4 4 Pleurisy Other Diseases of Inspiratory Organs ... Alcoholism i Cirrhosis of Liver 1 " ... Venereal Diseases Premature Birth 13 13 5 5 3 Diseases and Accidents of Parturition Heart Diseases 29 1 2 10 16 11 8 3 3 3 Accidents G ... i 4 1 2 1 1 2 Suicides 2 ... 1 1 1 1 All other causes 86 29 5 2 2 15 33 32 1 1 29 10 7 6 All Causes 27-J 96 30 17 8 53 70 102 1 2 88 28 14 39 14 PRINTED AT THE " ESSEX TIMES" OFFICE, ROMFORD.