ROM 7 ANNUAL REPORT OF THE Medical Officer of Health FOR THE ROMFORD URBAN DISTRICT For the Year 1906. ROMFORD: Wilson and Whitworth Ltd., Printers, High Street. ANNUAL REPORT. To the Romford Urban District Council. Gentlemen, I beg to present my Annual Report on the health of the Romford Urban District, for the year ending December 31st, 1906. 305 deaths were registered as having occurred in the Urban District of Romford, during 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. 98 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 deaths for the district were 207. The population of the district was estimated to be 16,260. The death-rate would 3 therefore be 12.1 per 1,000 of the population. The number of births registered during the year was 371, the birth-rate being 22.8 per 1,000. The following table shows the birth-rate and death-rate for the last five years. Romford. Birth Rate. Death Rate. 1902 29.5 12.2 1903 29.4 11.6 1904 28.4 10.06 1905 27.4 1.4 1906 22.8 12.1 I think the Council will be satisfied that Romford maintained its reputation for a low mortality. 4 I.—Summary of Action taken to prevent the spread of Disease. No Date. Locality. Disease. Source of Disease. Action taken. Result. 1 Jan. 1 Marks Road Diphtheria One case. Origin obscure. Removed to Hospital. No other case 2 „ 5 Hainault Road Scarlet Fever One case. Removed. No other case 3 „ 5 Drummond Road Diphtheria One case. Isolation at home. No other case 4 „ 5 Medora Road Diphtheria Ditto No other case 5 „ 27 Cromer Road Scarlet Fever Two cases. Infected by a case out of the district. Removed. No other case 6 Feb. 20 Victoria Road Diphtheria One case. Removed. No other case 7 „ 20 Shakespeare Road Enteric Fever One case, contracted away. Removed. No other case 8 Mar. 15 Victoria Road Diphtheria One case. 9 „ 12 Prospect Place Scarlet Fever One case. Contracted beyond the district. Removed. No other case 10 April 2 High Street Diphtheria One case. Local insanitary defect. Removed, No other case 11 „ 13 Marks Road Scarlet Fever - One case Contracted beyond the district. Removed. No other case 12 „ 26 Marks Road Diphtheria One case. Local insanitary condition. Removed. No other case 13 May 2 Richmond Road Diphtheria One case. Removed. No other case 14 „ 2 Market Place Diphtheria Two cases. Local insanitary defects. No other case 15 „ 12 Globe Road Diphtheria One case. Ditto 5 No. Date. Locality. Disease. Source of Disease. Action taken. Result. 16 May 25 Collier Row Diphtheria One case. Local sanitary defects. 17 „ 25 London Road Scarlet Fever One case. Contracted out of the district. Removed. No other case 18 June 15 Birkbeek Road Enteric Fever Ditto No other ease 19 „ 27 Knighton Road- Diphtheria One case. Local insanitary defects. Removed. No other case 20 July 10 Mawney Road Diphtheria Ditto No other case 21 „ 25 Mildmay Road Enteric Fever One case. Contracted out of the district. Removed. No other case 22 „ 26 Hamilton Road Scarlet Fever One case. Origin obscure. 23 „ 28 Marks Road Diphtheria One case. Local sanitary defect. Removed. No other case 24 „ 31 George Street Scarlet Fever One case. Origin obscure. Removed. No other case 25 „ 31 Prospect Place Scarlet Fever One case. Contracted in London. 26 „ 31 Prospect Place Scarlet Fever One case. Infected by previous case. Removed. No other case 27 „ 31 South Street Diphtheria Two cases. Local sanitary defects. 28 Aug. 1 Brentwood Road Scarlet Fever One case. Origin obscure. Removed. No other case 29 „ 9 Mawney Road Scarlet Fever Ditto No other case 30 „ 10 Wolseley Road Scarlet Fever Ditto No other case 31 „ 28 Victoria Road Diphtheria One case. Local sanitary defect. Removed. 32 „ 28 Eastern Road Diphtheria One case. Origin obscure. 33 „ 29 South Street Scarlet Fever One case. Brought from London. See No. 6 No Date. Locality. Disease. Source of Disease. Action taken. Result. 34 Sep. 16 Heath Park Scarlet Fever One case. Brought from London. 35 „ 19 London Road Scarlet Fever One case. Origin obscure. Removed. No other case 36 „ 21 Albion Place Diphtheria Ditto No other case 37 „ 22 Carlisle Road Scarlet Fever Three cases in one family. Disease brought by a visitor. Removed. 38 „ 24 Eastern Road Diphtheria One case. Contracted in London. 39 „ 25 Mawney Road Diphtheria One case. A case in this house two months previously. Drain in bad condition. Remedied. No other case 40 Oct. 7 S. Andrew's Road Enteric Fever One case. Origin obscure. Removed. No other case 41 „ 8 Albert Road Scarlet Fever Ditto No other case 42 „ 14 Albert Road Diphtheria One case. Contracted beyond the district. Removed. No other case 43 „ 17 London Road Enteric Fever Two cases. See No. 46. 44 „ 24 Victoria Road Scarlet Fever One case. Removed. No other case 45 „ 28 King Edward Road Scarlet Fever Ditto See No, 47 46 „ 29 London Road Enteric Fever Nine cases in a row of Cottages where two cases had been previously notified. (No. 43.) Foul refuse pit close to back of dwelling. Report to Council. Removed. No other case 47 „ 31 King Edward Road Scarlet Fever One case. Infected by No. 41. Removed. No other case 48 Nov. 6 George Street Scarlet Fever One case. Origin obscure Removed. No other case 49 „ 9 Carlisle Road Scarlet Fever Two cases. Infected by a return case from Hospital. Removed. No other case 7 No. Date. Locality. Disease. Source of Disease. Action taken. Result. 50 Nov. 22 Albert Road Enteric Fever One case. Contracted from home. Removed. N"o other ease 51 „ 22 Kings Road Diphtheria One case. Supposed to have been contracted out of the district. 52 „ 28 Princes Road Diphtheria One case. Infected by No. 51. 53 „ 29 London Road Diphtheria One case. Origin obscure. Removed. No other case 54 Dec. 4 Princes Road Diphtheria One case. Presumed to have been infected by No. 51 55 „ 4 St Andrew's Road Diphtheria One case. Origin obscure Removed . No other case 56 „ 18 Victoria Road Diphtheria Ditto No other case 57 „ 29 Pretoria Road Enteric Fever One case. Contracted in London. No other case 8 Small Pox. No case of this disease occurred in the District during the year. Scarlet Fever. 24 cases of this disease were notified. The disease occurred in isolated instances and nowhere assumed the character of an epidemic. No fatal case. Diphtheria. 26 cases were notified, several associated with defective sanitary conditions which were remedied by the action of the Sanitary Inspector. One death was caused by this disease. Enteric Fever. 17 cases occurred in the District, 5 of which were contracted away from home; 12 occurred in a row of cottages, and was attributed to a very foul collection of sewage within a few yards of the back of the houses.— This was remedied by the Landlord as soon as it was brought to his notice. 3 deaths resulted from this disease. Infantile Diarrhoea caused 18 deaths. This was much above the average. This disease was unusually prevalent in this and other Districts, a circumstance which was probably due to morbid changes taking place in the milk, owing to the exceptionally hot weather. Whooping Cough was prevalent to a considerable extent, and oaused 3 deaths. The death-rate from zymotic disease was 0 2. The death-rate from this class of disease for last five years being, respectively, 0.2, 0.8, 0.2, 0.4, 0.4, 0.2. 9 The following represent the total number of infectious diseases notified during the year:— Scarlet Fever 24 Diphtheria 26 Enteric Fever 17 Erysipelas 19 Puerperal Fever 2 Total 88 Every ease of Infectious Disease notified to me is reported to the Sanitary Inspector, who visits and reports to me in all cases which I do not personally investigate, and who also supplies disinfectants, sees to the patients 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 inspection of the various parts of the district have been made, a few samples of drinking water, whose purity was suspected, have been analysed by me, and when found to be impure the South Essex Company's water has been laid on. Insanitary conditions have where ascertained been remedied by the intervention of the Sanitary Inspector, a detailed report of such instances being incorporated with this report. 10 The following are instances in which my action as Medical Officer of Health was required, by your instructions, or by request of the Sanitary Inspector. Jan. 17th.—Knighton Road.—Complaint made of house refuse being deposited close to dwelling houses. On inspection it was found that all trace of nuisance had been obliterated. Jan. 17th.—Knighton Road.—Complaint being made that premises and drains were in an insanitary condition, inspection was made, and the same found to be in good oondition. Feb. 23rd.—Attwell's Yard.—Inspected two houses and certified them to be unfit for habitation. Notice served by Inspector, and houses satisfactorily repaired. Feb. 23rd.—Well Yard.—Inspected a house here and certified it as unfit for habitation. Notice served by Inspector, and house satisfactorily repaired. Feb. 23rd.—Well Yard.—Inspected a house and certified it to be overcrowded. Notice served by Inspector, and nuisance abated. May 7th.—Bird's Farm, Collier Row.—Inspected a farm house, and certified it as unfit for habitation. Notice served by Inspector, and house closed. 11 May 7th.—Bird's Farm. Collier Row.—Inspected cowsheds, stables, etc. Notice served by Inspector to ventilate, drain, re-pave, and limewash these buildings. Work carried out. May 13th.—London Road.—Bone boiling carried on on premises here, causing a serious nuisance. Notice served by Inspeotor. Business removed to Rural District, where similar notice was served, and the business was discontinued. July 9th.—Slaughter House, St. Andrew's Road.—Inspected the carcases of three beasts which had been slaughtered. One was certified as unlit for food, and this was removed to Mr. Pool's yard for conveyance to a knacker's yard. Licensee was cautioned, no proof being obtained that the carcase was intended for human food. July 17th.—Mowbray's Farm, Prospect Place.—Inspected this house and certified part of it to be in insanitary condition. Notice served by Inspector. Nothing was done here in obedience to notice. July 18th.—White Hart Lane, Collier Row.—Cowsheds inspected and certified to be unfit for use as such. Notice served. Use of cowsheds discontinued, and new buildings now in oourse of ereotion. July 20th.—Slaughter House, St. Andrew's Road.— Examined the offal of a beast which had been slaughtered 12 here. Certified that the beast had suffered from tuberculosis. The carcase was stated to have been taken to a knacker's yard at Bow. Sept. 3rd.—Willow Street.—Houses in this street with an imperfect water supply, the well having dried up during the dry weather. Notices served by Inspector. Wells deepened, and a plentiful supply of water obtained, which, or, being analysed by me, was found to be good. Nov. 5th.—Mowbray's Farm, Prospect Place.—This farm house (visited July 17th), was again inspected. Further defects were discovered. Notice again served by Inspector. House closed by owner. Nov. 5th.—Crown Cottages, London Road.—Several inspections of these cottages, where cases of Enteric Fever had occurred. Found a large accumulation of refuse (some foecal) at the rear of the houses. This was carted away and buried, and arrangements made by the landlord for proper disposal of refuse, etc. Dec. 4th.—St. Malo, Junction Road.—Attended with the Inspector when testing the drains here, several cases of sore throat having occurred amongst members of the family. Drains found to be defective. These were re-laid, and the insanitary condition thus remedied. Dec. 19th.—Carcase of a slaughtered pig brought to me by the Inspector for examination, and found to be fit for human consumption. 13 The Dairies, Bakehouses, Slaughter Houses, and Cowsheds have been periodically inspected. No insanitary conditions have been discovered except one instance of a bakehouse, where coal in considerable quantity was kept in the bakehouse where bread was made. This sanitary defect was pointed out to the occupier and remedied. The lodging houses (two) have been periodically inspected, and at the present time there is nothing insanitary to report as to their condition. The following is a succinct account of the work done by the Sanitary Inspector, in some of which, where necessary, he has consulted me as to the proceedings connected therewith. Nuisances abated 329 Convictions at Petty Sessions 8 Filthy houses cleansed 2 Houses disinfected 45 Overcrowding abated 1 Houses placed in habitable repair 3 Houses closed 1 Improved water supply 1 Wells closed 1 Houses connected with sewer 4 Privies abolished 4 Privies and w.c.'s repaired, &c. 29 Cisterns cleansed, &c. 1 Animals improperly kept 5 Water analysed 5 14 Tables of mortality and of sickness, compiled in accordance with the Local Government Board's instructions, are appended to this report. I have the honour to be, Gentlemen, Your obedient Servant, ALFRED WRIGHT, March 14th, 1907. Medical Officer of Health. ISOLATION HOSPITAL The following cases were admitted into the Isolation Hospital from the Urban District during the year. Recovered. Died. Scarlet Fever 22 22 — Diphtheria 20 20 — Enteric Fever 6 3 3 The Hospital continues to give every satisfaction to the friends of patients admitted. TABLE I. Vital Statistics Of Whole District During 1906 And Previous Years. ROMFORD URBAN DISTRICT. Year. Population estimated to Middle of each Year. Births. Totai. Deaths Registerkd 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 agt- At all Apes. 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 1896. 1897. 1898. 1899. 1900. 12,500 398 28.7 42 105 226 16.7 66 55 171 12.6 1901. 13,050 393 28.9 55 113 232 16.9 96 80 16 152 11.1 1902. 14,000 414 29.5 42 101 251 17.9 88 79 4 172 12.2 1903. 14,400 424 29.4 42 99 241 16.7 99 73 1 168 11.6 1904. 14,700 418 28.4 49 117 203 13.8 104 79 4 148 10.06 1905. 15,000 412 26.1 53 128 296 19.7 114 91 1 187 12.4 Aver, ages for years 18961905 1906. 16,260 371 22.8 53 158 305 18.2 98 82 3 226 13.2 * 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), 5,629. Total population at all ages, 13,656 Number of inhabited houses, 2.805 Average number of persons per house, 4.8 At Census of 1901. Is the Union Workhouse within the District?—Yes. 16 1 2 3 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. Other Institutions, the deaths in which have been distributed among the several localities in the District. Union Workhouse. Isolation Hospital. Romford Cottage Hospital. TABLE II. Vital Statistics of Separate Localities in 1906 and previous years. ROMFORD URBAN DISTRICT. Names or Localities- Urban District. Town "Ward. 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 estimatfd to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each rear. 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. 1896 1897 1898 1899 1900 12,500 398 226 1901 13,050 395 232 1902 14,000 414 251 1903 14,400 424 241 11,200 353 218 37 1,000 31 11 2 1,500 37 12 3 1904 14,700 418 203 1,290 352 209 41 1,610 29 12 4 1,600 41 16 4 1905 15,000 412 187 12,250 321 168 49 1,735 32 4 1 1,700 50 14 0 Averages of Years 1896 to 1905. 1906 16,260 371 207 53 12,600 281 181 53 1,760 31 9 1,900 59 17 18 TABLE 111. Cases or Infectious Disease notified during the Year 1906, in the Romford Urban District. Notifiable Disease. Cases notified in Whole District. Total Cases notified in each Locality. At all Ages. At Ages —Years. Town Ward. Collier Row Ward. Harold Wood Ward. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 31 2 13 12 4 ... ... 29 1 1 ... ... ... ... Membranous Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 22 ... ... ... 7 15 ... 20 ... 2 ... ... ... ... Scarlet Fever 28 1 14 17 2 ... ... 23 3 2 ... ... ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 16 ... 1 ... 2 13 ... 16 ... ... ... ... ... ... ...Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 2 ... ... ... ... 2 ... 1 1 ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 99 3 28 23 15 30 ... 89 5 5 ... ... ... ... Isolation Hospital—Rush Green, Dagenham. TABLE V. INFANTILE MORTALITY DURING THE YEAR, 1906. Deaths from stated Causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months 8-9 Months. 9-10 Months 10-11 Months. Total Deaths under One Year. All Causes Certified 6 2 2 5 4 9 6 3 6 1 2 3 3 52 Uncertified .... .... .... 1 .... .... .... .... .... .... .... .... .... 1 Common Infectious Diseases. Small-pox .... .... .... .... .... .... .... .... .... .... .... .... .... .... Chicken-pox .... .... .... .... .... .... .... .... .... .... .... .... .... .... Measles .... .... .... .... .... .... .... .... .... .... .... .... .... .... Scarlet Fever .... .... .... .... .... .... .... .... .... .... .... .... .... .... Diphtheria: Croup. .... .... .... .... .... .... .... .... 1 .... .... .... .... 1 Whooping Cough .... .... 1 .... .... .... .... .... .... .... .... .... .... 1 Diarrhœal Diseases. Diarrhoea, all forms Enteritis (not Tuberculous) .... 1 .... .... 1 2 .... 1 2 .... 1 1 .... 9 .... .... .... .... .... 3 3 .... .... 1 .... .... .... 7 Gastritis, Gastrointestinal Catarrh .... .... .... .... 1 .... .... .... .... .... .... 1 .... 5 Wasting Diseases. Premature Birth. 5 1 1 .... .... .... .... .... .... .... .... .... .... 7 Congenital Defects .... .... .... .... .... .... .... .... .... .... .... .... .... .... Injury at Birth .... .... .... .... .... .... .... .... .... .... .... .... .... .... Want of Breast-milk Starvation .... .... .... .... .... .... .... .... .... .... .... .... .... .... Atrophy, Debility, Marasmus .... .... .... .... 1 .... .... 1 .... .... .... .... 1 3 Tuberculous Diseases. Tuberculous Meningitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... Tuberculous Peritonitis: Tabes Mesenterica .... .... .... 1 .... 3 1 .... .... .... .... .... .... 5 Other Tuberculous Diseases .... .... .... .... .... .... .... .... .... .... .... .... .... .... Other Causes. Erysipelas .... .... .... .... .... .... .... .... .... .... .... .... .... .... Svphilis .... .... .... .... 1 .... .... .... .... .... .... .... .... 1 Rickets .... .... .... .... .... .... .... .... .... .... .... .... .... .... Meningitis (not Tuberculous) .... .... .... .... .... .... .... .... .... .... .... .... .... .... Convulsions 1 .... .... 1 .... .... .... .... .... .... .... .... .... .... Bronchitis .... .... .... 1 .... .... 1 1 .... .... .... .... .... 3 Laryngitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... Pneumonia .... .... .... 1 .... .... .... 1 2 .... 1 1 2 8 Suffocation, overlaying .... .... .... .... .... .... .... .... .... .... .... .... .... .... Other Causes .... .... .... 1 .... 1 1 .... 1 .... .... .... .... 4 Total 6 2 2 5 4 9 6 4 6 1 2 3 3 53 TABLE IV. Causes of, and Ages at, Death during Year 1906. Romford Urban District. Causes Death Deaths at the subjoined ages of "Residents" whether occurring in or beyond the district Deaths in or belonging to Localities (at all Ages). Total Deaths whether of "Residents"or 'non-residents' in Public Institutions in the District. All Ages. | Under 1 year. 1 and under 5. 5 and under 15. 15and under 25. 25 and under 65. 65 and up- 1 wards. Town Ward. Collier Row Ward. Harold Wood Ward. Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... Whooping-cough 3 1 2 ... ... ... ... 3 ... ... ... 5 Diphtheria and Membranous Croup 1 ... ... 1 ... ... ... 1 ... ... ... ... Croup ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... Enteric 3 ... ... ... 1 2 ... 3 ... ... ... ... Other contin'd ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 2 ... ... ... ... 2 ... 1 ... 1 ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 18 16 2 ... ... ... ... 14 2 ... ... 1 Enteritis ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 1 ... ... ... ... 1 ... 1 ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... 1 Other septic Diseases ... ... ... ... ... ... ... ... ... ... ... ... Phthisis (Pulmonary Tuberculosis) 9 ... ... ... 2 7 ... 8 ... 1 ... 18 Other tubercular Diseases 13 5 2 2 ... 4 ... 12 ... 1 ... 7 Cancer, Malignant Disease 20 ... ... ... ... 12 8 16 3 1 ... 11 Bronchitis 18 2 1 ... ... 5 10 17 ... 1 ... 1 Pneumonia 20 8 4 1 ... 6 1 16 ... 4 ... 2 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver ... ... ... ... ... ... ... ... ... ... ... ... Venereal Diseases ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 8 8 ... ... ... ... ... 7 1 ... ... ... Diseases and Accidents of Parturition 1 ... ... ... ... 1 ... 1 ... ... ... ... Heart Diseases 22 ... ... ... ... 7 15 20 1 1 ... 17 Accidents 2 ... ... 1 ... ... 1 ... 2 ... ... ... Suicides 1 ... ... ... ... 1 ... 1 ... ... ... ... Senile decay 12 ... ... ... ... ... 12 12 ... ... ... 23 All other causes 53 13 3 4 ... 17 16 46 ... 7 ... 22 All Causes 207 53 14 9 3 65 63 181 9 17 ... 98