Romr 11 Romford Rural District Council. ANNUAL REPORT OF THE Medical Officer of health, 1 9 O 9. 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, 1909. 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. Wilson and Whitworth Ltd., Printers, Romford. 2 Summary of Action taken during the year for preventing the spread of disease. No. Date. Locality. Disease. Source of Disease. Action Taken. Result. 1 Jan. 1 North Hornchurch Scarlet Fever One case. Removed No other case 2 „ 2 Rainham Scarlet Fever One case. Removed No other case 3 „ 5 Wennington Diphtheria One case. Foul local sanitary condition. Remedied No other case 4 „ 5 Beacontree Heath Diphtheria Ditto No other case 5 „ 9 North Hornchurch Diphtheria Ditto No other case 6 „ 10 North Hornchurch Scarlet Fever One case. Removed No other case 7 „ 11 Dagenham Diphtheria Ditto No other case 8 „ 13 North Hornchurch Diphtheria Ditto. Dubious case 9 „ 17 North Hornchurch Scarlet Fever One case See No. 12 10 „ 17 Chadwell Heath Scarlet Fever Ditto Isolated at home 11 „ 19 North Hornchurch Diphtheria One case 12 „ 20 North Hornchurch Scarlet Fever One case. Infected by No. 9 13 „ 21 Chadwell Heath Scarlet Fever One case. Removed Imported See No. 15 14 „ 30 Havering Diphtheria One case. Bad sanitary condition. Remedied. Removed No further case 3 15 Jan. 27 Chadwell Heath Scarlet Fever One case. Removed. Infected by No 13 16 ,, 27 South Hornchurch Scarlet Fever One case. An unremoved case next daor a month ago. Removed No further case 17 „ 29 Rainham Scarlet Fever A convalescent case. now peeling. Removed See No. 25 18 „ 30 Chadwell Heath Scarlet Fever One case. Infected by No. 13. Removed No other case 19 „ 31 Dagenham Scarlet Fever One case. Removed No other case 20 Feb. 1 & 2 North Hornchurch Diphtheria Three cases. Drain insanitary. Removed No other case 21 „ 2 Havering Diphtheria One case. Ditto No other case 22 „ 13 Wennington Scarlet Fever Two cases, infected at school. Removed No other case 23 „ 15 and 18 South Hornchurch Diphtheria Two cases. Drains bad. Remedied. Removed No other case 24 „ 17 Beacontree Heath Scarlet Fever One case. Infection imported. Removed No other case 25 „ 18 Rainham Scarlet Fever One case, infected by No. 17. Removed No other case 26 „ 22 23 and 24 Dagenham, South Hornchurch Diphtheria Three notified cases, not confirmed by bacteriological examination 27 Mar. 1 Beacontree Heath Scarlet Fever One ease, Infection supposed to have occurred at school from children of a family where scarlet fever had occurred. Children not removed. Removed No other case 4 No. Date. Locality. Disease. Source of Disease. Action taken. Result. 28 March 1 Beacontree Heath Scarlet Fever One case same as No. 27 No other case 29 „ 1 Beacontree Heath Scarlet Fever Ditto No other case 30 ,, 3 North Hornchurch Scarlet Fever Three cases in one family. Removed No other case 31 „ 10 North Hornchurch Scarlet Fever Two cases. Removed 32 ,, 12 to 20 North Hornchurch Scarlet Fever Six cases in different families all attending Park Lane School. Children at school examined hut found to be clear. All cases removed No other case 33 ., 9 Hornchurch Village Scarlet Fever One case. Presumably infected at a "Band of Hope" meeting where children from North Hornchurch were present. Removed 34 „ 15 Dagenham Diphtheria One case. Removed. Bad drains. Remedied. No other case 35 „ 12 Hornchurch Scarlet Fever One case. Removed. A playmate of No. 33. Ditto 36 „ 21 Dagenham Scarlet Fever One case. Removed. Ditto 37 „ 25 Chadwell Heath Scarlet Fever Ditto. A case previously in this house. Not removed. Ditto 38 „ 26 South Hornchurch Diphtheria One case. Removed Ditto 5 39 March 27 Dagenham Scarlet Fever One case. Now peeling. Removed No other case 40 „ 27 Dagenham Scarlet Fever Ditto. Infected by previous case Ditto 41 „ 31 Rainham Scarlet Fever Three cases, Presumably infected by an unrecognised case. Removed Ditto 42 April 7 Cottage Homes Scarlet Fever One case. Removed to Homerton Hospital 43 „ 6 Rainham Diphtheria One case. Faulty drain. Removed Ditto 44 „ 7 Rainham Scarlet Fever One case. Infected by a previous case not removed. Removed Ditto 45 „ 10 Dagenham Scarlet Fever One case. Attending the Beacontree Heath School where several cases had occurred. Removed Ditto 46 „ 24 Rainham Diphtheria A dubious case 47 May 5 Beacontree Heath Diphtheria One case not removed as Measles was in the house See No. 53 48 „ 5 Dagenham Scarlet Fever One case. Source of infection obscure. Removed No other case 49 „ 11 Great Warley Scarlet Fever One case. Contracted in Brentwood. Removed. Ditto 50 „ 14 Squirrels Heath Scarlet Fever Ditto Ditto 51 „ 14 Beacontree Heath Diphtheria One case. Foul ditch at back of house. Removed. Ditto 6 No. Date. Locality. Disease. Source of Disease. Action Taken. Result. 62 May 14 Hornchurch Scarlet Fever A return case 53 „ 15 and 16 Beacontree Heath Scarlet Fever Three cases. Not removed owing to measles in the house. See No. 47 54 June 8 Rainham Scarlet Fever One case. Imported from Wanstead. Removed No other case 55 „ 18 Great Warley Scarlet Fever A dubious case 56 „ 33 Rainham Scarlet Fever One case 57 „ 24 Dagenham Diphtheria Two cases in adjacent house Foul ditch 58 „ 25 Rainham Scarlet Fever One case 59 May 12 Great Warley Scarlet Fever Ditto. Contracted in Brentwood. Removed Ditto June 30 Dagenham Diphtheria Another case near No. 57. Removed. 61 „ 30 Beacontree Heath Scarlet Fever Two cases in adjoining houses. Infection by No* 52. Removed Ditto 62 July 1 North Hornchurch Diphtheria One case. Faulty drain. Removed Ditto 63 , 3 North Hornchurch Diphtheria Ditto Ditto 64 „ 10 Rainham Scarlet Fever One case. Infected by a previous case not removed 7 65 July 10 Beacontree Heath. Diphtheria One case. Foul ditch. Removed No other case 66 „ 11 Havering Scarlet Fever One case. Imported. Removed Ditto 67 „ 11 Dagenham Scarlet Fever Ditto Ditto 68 „ 11 Dagenham Diphtheria Two cases. Bad sanitary condition. Removed See No. 70 69 ,, 15 Isolation Hospital Scarlet Fever A nurse 70 „ 15 Dagenham Diphtheria One case in same house as No. 68. Removed No other case 71 „ 15 Rainham Scarlet Fever One case. Infected by a previous case not removed 72 „ 15 Ardleigh Green Scarlet Fever One case. Source of infection obscure. Removed No other case 73 „ 15 North Hornchurch Diphtheria One case. Faulty drain. Removed No other case 74 „ 27 Dagenham Diphtheria One case. Removed to Eastern Fever Hospital No other case 75 „ 31 Dngenham Diphtheria Three cases. Foul ditch at back of house 76 Aug. 2 Dagenham Diphtheria One case. Fatal. Not removed 77 „ 6&7 Upminster Scarlet Fever Two cases in same family. Source of infection obscure. Removed. No other case 78 „ 24 North Hornchurch Scarlet Fever One case. Removed No other case 79 „ 25 Havering Scarlet Fever One case. Imported. Removed No other case 80 Sept. 5 North Hornchurch Scarlet Fever One case. Source of infection obscure 8 No. Date. Locality. Disease. Source of Disease. Action taken. Result. 81 Sept. 20 North Hornchurch Diphtheria One case. Contracted away from home 82 „ 11 Upminster Scarlet Fever One case. Source of infection obscure. Removed No other case 83 „ 21 Dagenham Diphtheria Three cases (mild), in one house. Faulty drain 84 Oct. 3 Havering Diphtheria One case. Faulty drain. Removed No other case 85 „ 1 Rainham Scarlet Fever One case. Evidently infected by an unrecognised case next door. Removed No other case 86 „ 4 Rainham Scarlet Fever One case. Contracted at Barking 87 „ 2 Harold Wood Scarlet Fever One case. A boy employed at the Scarlet Fever Convalescent Home (West Ham). Removed to West Ham Hospital 88 „ 8 Winkletye Lane Diphtheria One case. Bad sanitary condition. Removed No other case 89 „ 14 North Hornchurch Scarlet Fever One case. Not removed 90 ,, 21 North Hornchurch Scarlet Fever One case. Infected by No. 89. Removed No other case 9 91 „ 21 Great Warley Scarlet Fever One case. Contracted in Brentwood. Removed subsequently on the mother becoming infected No other case 92 ,, 24 Chadwell Heath Scarlet Fever One case. Removed No other case 93 „ 24 Dageuham Diphtheria One case. Removed. Bad drains Ditto 94 Nov. 1 North Hornchurch Scarlet Fever One case. Removed No other case 95 „ 5 Great Warley Scarlet Fever One case. Infected by No. 91. Removed No other case 96 „ 4 North Hornchurch Scarlet Fever One case. Removed No other case 97 „ 7 North Hornchurch Scarlet Fever One case. Removed No other case 98 „ 7 Upminster Scarlet Fever One case. Source of infection obscure. Removed No other case 99 9 Bennetts Castle Lane Scarlet Fever One case. Attended the Goodmayes School, where there have been several cases. Removed No other case 100 „ 9 Chadwell Heath Scarlet Fever One case. Attended school where a child was found to be in attendance desquamating after Scarlet Fever 101 „ 12 and 14 Upminster Scarlet Fever Two cases in one house. Source of infection obscure. Removed No other case 102 ,, 17 Chadwell Heath Scarlet Fever One case. See No. 99. Removed No other case 103 „ 22 Upminster Scarlet Fever One case. A return case B 10 No. Date. Locality. Disease. Source of Disease. Action taken. Result. 104 Nov. 28 Upminster Scarlet Fever One case. Source of infection obscure 105 „ 29 Dagenham Diphtheria One case. Removed. No other case 106 „ 26 Upminster Scarlet Fever Another case from same family as No. 103. Removed 107 „ 29 Upminster Scarlet Fever Another case from same family as No. 103. Removed 108 Dec. 1 Chadwell Heath Diphtheria One case. Dubious case. Removed 109 „ 4 Chadwell Heath Scarlet Fever One case. Removed No other case 110 „ 8 Upminster Scarlet Fever Another case from same family as No. 103. Removed 111 „ 13 Upminster Scarlet Fever Another case from same family as No. 103. Removed 112 „ 13 Upminster Scarlet Fever Another case from same family as No. 103. Removed 113 „ 14 Harold Wood Scarlet Fever A child, probably infected by a brother who works at the West Ham Scarlet Fever Convalescent Home. Removed No other case 114 „ '7 Upminster Scarlet Fever Another case from same family as No. 103. Removed No other case 115 „ 24 Five Elms Scarlet Fever One case. A return case. Remove d No other case 11 During the year, 155 cases of infectious disease were notified, the number for the past three years being as follows 1907 406 cases 1908 289 cases 1909 155 cases thus showing a considerable diminution during the past year. The different diseases are thus tabulated :— Scarlet Fever 96 Diphtheria 42 Erysipilas 14 Purpureal Fever 3 155 104 of these cases were removed to the Isolation Hospital. The following is a succinct account of the different infectious diseases requiring action by your sanitary officials during the year. In accordance with your instructions I have, since the time of receiving such instructions, visited every one notified for removal to the Isolation Hospital, before such removal, with the exception of a few instances of extreme urgency, where speedy removal was essential to the welfare of the patient, permission for such exceptions) being granted by you, at my discretion. I think this practice has been a judicious one as it has enabled me to correct the diagnosis of some erroneously notified, and to obviate the removal of others which could be safely isolated at home, thus saving to a considerable extent the hospital expenses. In all cases of infectious disease the rooms occupied by the patient, the bedding, etc., are disinfected by the Sanitary Inspectors after removal or recovery of the patient. In cases that have been treated at home, the bedding is removed after the patient's recovery, to the Hospital for disinfection, but in cases removed to the 'Hospital in the early stage of the disease, it is considered sufficient !to remove the clothing actually worn by the patient, and to disinfect the bedding, etc., at home. 12 Small Pox.—No case of this disease was notified during the year. Scarlet Fever.—96 cases were notified. This disease unusually prevalent in the neighbourhood of London during the past few years, has been much less so in this district than in the previous two years, the degree in which it has occurred in the various parishes of the district being as under :— Dagenham 36 Hornchurch 30 Havering 1 Upminster, Cranham, and Corbets Tey 11 Great Warley 4 Rainham and Wennington 14 Total 96 N.B.—The number of cases in the parish of Hornchurch comprises those occurring in the North-West part of the parish, forming practically part of the town of Romford. Hornchurch itself and the immediate neighbourhood being unusually free from this disease. Enteric Fever.—No case of this disease occurred in the district during the year. Diphtheria.—42 cases were notified, in the different parishes as under :— Dagenham 24 Hornchurch 13 Havering 2 Rainham and Wennington Total 42 The same remarks as to the comparative immunity of Hornchurch from this disease during the year apply as in the case of Scarlet Fever. Infantile Diarrhœa. was, as in the previous year, unusually absent during 1909. 13 The subjoined table shows the degree in which infectious disease prevailed in the various parishes of the district. Phthisis.—This disease, which was recently made a notifiable one, in the case of paupers, is not very prevalent in this District. The practice is, in those cases which are brought under official notice, to disinfect houses where patients suffering from this disease The following table shows the distribution of infectious diseases in the several parishes of the district. Dagenham, Beacontree and Chadwell lieaths Havering. ' Hornchurch. Upminster, Cranham, and Corbets Tey. Great Warley. Rainham and Wennington. Scarlet Fever 36 1 30 11 4 14 Diphtheria 24 2 13 ... ... 3 Enteric Fever ... ... ... ... ... ... Puerperal Fever 1 ... 1 ... ... 1 Erysipelas 6 ... 5 ... 1 2 67 3 49 11 5 20 II.—An Account of the Sanitary Condition of the district at the end of 1909. In complying with this section of the Local Government Board's instructions to Medical Officers of Health, 1 proceed to give, as in former years, a short account of the sanitary state of the district, under the same heads of localities as are given in the statistical table. Dagenham, Beacontree 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 London Clay, some (part of Dagenham Village and immediate neighbourhood) on alluvium. Population estimated 7,550. Mainly agricultural, some 14 (Dagenham Village) employed in a large telephone factory, and some on river-side labour. At Chadwell Heath an increasing number of residents employed in London. Water supply mainly from South Essex Water Company. The system of sewerage for these localities is now completed, and the house connections are being made. I anticipate a great improvement in the sanitary condition here in the immediate future, now that this system has been at length successfully completed, after much anxious action on the part of the Council for a long time past. Scavenging is done by the Council's Contractors, and pail-closets will be abolished and w.c.'s substituted, as the house connections are being made. Birth Rate, 34.1. Death Rate, 11.9. Death Rate from Zymotic Disease, 0.6. hornchurch.—Large village and scattered groups of houses extending over a large parochial area. Part of the parish adjoining and actually forming part of the town of Romford. Stands mostly on gravel, partly on clay, and some small part, running down 'to 'the river Thames on alluvium. Population (estimated) 8,500. Principally agricultural. Foundry and brewery in the village, and an increasing number of residents having their occupation in London. Birth-rate, 24.5. Death-rate, 9.8. Death-rate from zymotic disease, nil. Diphtheria and Scarlet Fever prevailed to a considerable extent but mainly in the North-West part of the parish, which actually forms part of the town of Romford. Scarlet Fever was mainly caused by personal infection from neighbours, the part of Romford near being similarly affected. Thanks to the help of our Isolation Hospital, the disease did not assume an epidemic character. Diphtheria, too, was prevalent to a considerable extent, and i fear that the prevalence of this disease must, to a large extent, be connected with faulty house drains. In my last year's report I mentioned that the (Council had instructed the Sanitary Inspector to test all the drains in thickly-populated parts of the parish, but, unfortunately, this was stopped by a magisterial decision given against the Council in a case where an owner was proceeded against for refusing his drains to 'be tested, so that this can only now be done where a nuisance is suspected to exist, or where infectious disease has occurred. In such cases is has almost invariably been found that the sewerage arrangements were faulty. 15 Upminster, Cranham, and Corbets Tey.—Adjoining villages standing oh high ground. Mostly brick earth, some gravel. Population 2,410. Birte-rate, 15.4. Death-rate, 7.9. Death-rate from zymotic disease, Nil. A large estate for good-class residences being now developed, many houses having been erected during the last two or three years. Water supply mainly from South Essex Co. Some outlying parts formerly badly supplied by private wells and ponds have recently been supplied by an extension of the South Essex Co.'s mains. great Warley stands high on London clay. The most thickly populated part of the plarish forms part of the town of Brentwood, the large and less populated area having scattered houses and groups of houses. Population, 2,380. Agricultural. Water supply mainly from South Essex Water Company. Birth-rate, 23.5. Death-rate, 7 5. Death-rate from zymotic disease, Nil. Rainham and Wennington lie low on gravel and alluvium at the edge of the Thames. Marshy. Villages of 2,520 inhabitants, employed in agriculture, factory, and riverside work. Tidal stream runs through Rainham to the Thames, about a mile distant. Birthrate, 281. Death-rate, 16.5. Death-rate from zymotic disease, 0.3. Rainham, in years past. has borne an unenviable reputation for infectious disease, notably Diphtheria. There has been a marked improvement the last few years in this respect, and the village has been much improved by the Council making several incompleted roads into roads of the first order. NOAK hill stands high on London clay. Population, 264. Agricultural. Water supply indifferent, the water area being very difficult to tap. Several boring attempts in recent years having failed to obtain supplies. Birth-rate 7.5. Death-rate, 7.5. Death-rate from zymotic disease, Nil. HAVERING stands high on pebble sand, bounded by London clay. Population 440. Agricultural and good-class residents. Birth-rate, 184, Death-rate, 18.4 Death-rate from zymotic diseases, Nil. Water supply much improved by the extension of the South Essex Co.,s mains to this district. N.B.—The death-rate in such sparsely populated localities is no index of the salubrity of such locality. 16 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 Inspectors, 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, Beacontree and Chadwell heaths. Jan. 5th.—Dagenham, Station Road.—Six dilapidated houses.— Notice. Repaired. Jan. 5th.—Dagenham.—Seven houses in bad sanitary condition. Notice. Remedied. Jan. 8th.—Dagenham Village.—Collection of manure, causing a nuisance. Notice. Removed. Jan. 11th.—Ditto.—Filthy premises. Notice. Remedied. Jan. 11th.—Ditto.—Cesspool overflowing into watercourse. Notice. Remedied. Jan. 13th.—Ditto.—Foul ditch. Notice. Cleansed. Jan. 15th.—Chigwell Road.—Cesspool close to houses, not ventilated, and causing a nuisance. Inspection chamber faulty, and defective w.c. Notice. Remedied. Jan. 18th.—Dagenham Village.—Damp premises owing to defective gutters. Notice. Remedied. Jan. 20th.—Ditto.—Swine kept so as to be a nuisance, and accumulation of manure. Notice. Remedied. Jan. 20th.—Ditto.—Van used as a dwelling, with no sanitary accommodation. Notice. Removed. Jan. 21st.—Ditto.—Four houses not drained. Notice. Remedied. 17 Jan. 23rd.—Dagenham Village—Escape of sewer gas into house. Notice. Remedied. Jan. 27th.—Ditto.—Foul ditch. Notice. Cleansed. Jan. 29th.—Ditto.—Bad water supply to house. Notice. Remedied. Jan. 29th.—Ditto.—Blocked drain. Notice. Remedied. Feb. 1st.—Ditto.—Swine kept so as to be a nuisance. Notice. Removed. Feb. 2nd.—Ditto.—A house with defective sanitary arrangements. Notice. Remedied. Feb. 2nd.—Beacontree Heath.—Foul ditch. Notice. Cleansed. Feb. 3rd.—Dagenham Village.—Eight houses in bad sanitary condition. Notice. Remedied. Feb. 3rd.—Ditto.—Accumulation of manure. Notice. Removed. Feb. 4th.—Ditto.—Foul ditch. Notice. Cleansed. Feb. 4th.—Ditto.—Foul ditch. Notice. Cleansed. Feb. 11th.—Station Road, Dagenham.—Eight houses damp, yards unpaved and dirty. Notice. Remedied. Feb. 11th.—Ditto.—Six ditto do. do. Feb. 15th.—Dagenham Village.—Eight houses with defective sanitary accommodation. Notice. Remedied. Feb. 15th.—Ditto.—Four ditto do. do. Feb. 24th.—Beacontree Heath.—Foul ditch. Notice. Cleansed. Feb. 24th.—Ditto.—Foul ditch. Notice. Cleansed. C 18 Mar. 5th.—Dagenham Village.—Insanitary premises. Notice. Cleansed. Mar. 11th.—Ditto.—Foul ditch. Notice. Cleansed. Mar. 15th.—Ditto.—Six damp and dilapidated houses. Notice. Remedied. Mar. 15th.—Ditto—Accumulation of manure. Notice. Removed. Mar. 17th.—Ditto.—Foul ditch. Notice. Cleansed. Mar. 25th.—Beacontree Heath.—Accumulation of refuse. Notice. Removed. Mar. 25th.—Ditto.—Foul ditch. Notice. Cleansed. Mar. 29th.—Dagenham Village.—Blocked drain. Notice. Cleansed. Mar. 29th.—Beacontree Heath.—Three foul ditches. Notice. Cleansed. Mar. 31st.—Dagenham Village.—Defective Cesspool. Notice. Cleansed. April 6th.—Ditto.—Two houses with had sanitary arrangements and defective water supply. Notice. Remedied. April 17th.—Chigwell Road.—Cesspool close to house and bad sanitary arrangements. Notice. Remedied. April 14th.—Chadwell Heath.—Blocked drain. Notice. Remedied. April 17th.—Dagenham.—Four foul ditches. Notice. Remedied. April 19th.—Beacontree Heath.—Foul ditch. Notice. Remedied. April 19th.—Ditto.—Swine kept so as to be a nuisance. Notice. Remedied. April 20th.—Five Elms.—Foul ditch. Notice. Remedied. 19 April 121st.—Dagenham Village.—Damp premises owing to defective gutter. Notice. Remedied. April 21st.—Ditto.—Ditto do. do. April 21st.—Ditto.—Ditto do. do. April 23rd.—Ditto.—Defective cesspool. Notice. Remedied. April 23rd.—Ditto.—Foul ditch. Notice. Remedied. May 3rd.—Beam Bridge.—Shed occupied as a dwelling, no sanitary arrangements. Notice. Remedied. May 3rd.—Ditto.—Privy pit defective. Notice. Remedied. May 5th.—Dagenham.—Insanitary cowshed. Notice. Remedied. May 5th.—Dagenham.—Insanitary cowshed. Notice. Remedied. May 7th.—Beacontree Heath.—Foul ditch. Notice. Remedied. May 10th.—Dagenham Village.—House unfit for occupation. Notice. Remedied. May 17th.—Ditto.—Ditto do. do. May 17th.—Ditto.—Foul ditch. Notice. Remedied. May '24th.—Beacontree Heath.—Filthy premises, defective drain and foul ditch. Notice. Remedied. May 26th.—Chadwell Heath.—Blocked drain. Notice. Remedied. May 28th.—Beacontree Heath.—Foul ditch. Notice. Remedied. May 29th.—Dagenham.—Foul ditch. Notice. Remedied. June 2nd.—Ditto.—Six houses unfit for occupation. Notice. Remedied. Juno 12nd.—Ditto.—Foul ditch. Notice. Remedied. June 2nd.—Beacontree Heath.—Foul ditch. Notice. Remedied. 20 June 15th.—Dagenham.—Undrained stables., animals kept so as to be a nuisance. Notice. Remedied. June 21st.—Beacontree Heath.—Two houses insanitary. Notice. Remedied. June 21st.—Ditto.—Foul ditch. Notice. Remedied. June 25th.—Chadwell Heath.—Accumulation of manure. Notice. Remedied. June 28th.—Dagenham.—Blocked drain. Notice. Remedied. June 30th.—Dagenham, Chequers Lane.—Overflowing cesspool into the marsh dyke. Diphtheria. Notice. Remedied. July 5th.—Dagenham.—House with insufficient sanitary accommodation. Notice. Remedied. July 8th.—Ditto.—Defective water cistern. Notice. Remedied. July 8th,—Chadwell Heath.—House with insufficient sanitary accommodation. Notice. Remedied. July 8th.—Dagenham.—Foul ditch. Notice. Remedied. July 13th.—Ditto.—Houses with bad sanitary arrangements. Notice. Remedied. July 14th.—Beacontree Heath.—Foul drain. Diphtheria. Notice. Remedied. July 16th.—Ditto.—Defective drain. Notice. Remedied. July 21st.—Dagenham.—Defective drain. Notice. Remedied. July 27th.—Chadwell Heath.—Defective drain. Notice. Remedied. July 30th.—Dagenham Village.—Four houses with defective pail closets. Notice. Remedied. July 31st.—Ditto.—Damp and defective yard paving. Notice. Remedied. 21 Aug. 4th.—Dagenham Village.—Insufficent accommodation. Notice. Remedied. Aug. 5th.—Ditto.—Defective water supply to house. Notice. S.E. Co.'s water laid on. Aug. 9th.—Ditto.—Foul ditch. Notice. Remedied. Aug. 9th.—Ditto.—Ditto do. do. Aug. 11th.—Chadwell Heath.—Animals kept so as to be a nuisance. Notice. Removed. Aug. 16th.—Beacontree Heath.—Foul ditch. Notice. Cleansed. Aug. 18th.—Chadwell Heath.—Accumulation of fish refuse. Notice. Removed. Aug. 22nd.—Ditto.—Swine kept so as to be a nuisance. Notice. Removed. Aug. 23rd.—Dagenham.—Insanitary privies. Notice. Remedied. Aug. 24th.—Chadwell Heath.—Four houses dilapidated. Notice. Remedied. Aug. 28th.—Ditto.—Animals kept so as to be a nuisance. Notice. Remedied. Aug. 28th.—Ditto.—Ditto do. do. Aug. 28th.—Ditto.—Ditto do. do. Aug. 27th.—Dagenham.—Dilapidated premises. Notice. Remedied. Aug. 27th.—Ditto.—Ditto d.o do. Aug. 27th.—Chadwell Heath—Swine kept so as to be a nuisance. Notice. Removed. 22 Sept. 4th.—Dagenham.—Three houses insanitary. Notice. Closed. Sept. 8th.—Ditto.—Twe stables undrained. Notice. Remedied. Sept. 11th.—Accumulation of refuse. Notice. Remedied. Sept. 20th.—Ditto.—Filthy premises. Notice. Remedied. Sept. 2lst.—Ditto.—Ditto do. do. Sept. 21st.—Ditto.—Ditto do. do. Sept. 21st.—Five Elms.—Foul ditch. Notice. Cleansed. Sept. 29th .—Dagenham.—Three houses damp, roofing bad. Notice. Repaired. Sept. 29th.—Ditto.—Ditto do. do. Nov. 3rd.—Chadwell Heath.—Damp premises and insufficient sanitary accommodation. Notice. Remedied. Nov. 3rd.—Dagenham.—Undrained stable, fowls kept so as to be a nuisance. Notice. Remedied. Nov. 11th.—Ditto.—Blocked drain. Notice. Remedied. Nov. 11th.—Ditto.—Ditto do. do. Nov. 15th.—Ditto.—House with bad sanitary accommodation. Notice. Remedied. Nov. 18th.—Ditto.—Four houses unfit for occupation. Notice. Work now being done (Feb., 1910). Nov. 22nd.—Ditto.—Foul ditch. Notice. Cleansed. Nov. 24th.—Chadwell Heath.—Fowls kept so as to be a nuisance. Notice. Removed. Nov. 29th.—Dagenham Village, Rookery Farm.—Cowshed clean and well ventilated, but drainage bad. Notice now under consideration of West Ham Corporation, the occupiers. 23 Dec. 1st.—Dagenham.—Undrained stable. Notice. Remedied. Dec. 20th.—Ditto.—Two houses insanitary. Notice. Remedied. Dec. 20th.—Beacontree Heath .—Animals kept so as to be a nuisance. Notice. Removed. Dec. 24th.—Marks Gate.—Foul ditches. Notice. Cleansed. hornchurch. Jan. 12th.—Douglas Road. Faulty drains. Notice. Remedied. Jan. 22nd.—Harold Wood.—Ditto do. do. Jan. 26th.—Squirrels Heath.—Ditto do. do. Jan. 29th.—Park Lane.—Ditto do. do. Feb. 4th.—Craigdale Road.—Ditto do. do. Feb. 4th.—Douglas Road.—Ditto do. do. Feb. 5th.—Harold Wood.—House damp. Notice. Remedied. Feb. 11th.—Clydesdale Road.—Defective sanitary arrangements. Notice. Remedied. Feb. 20th.—Douglas Road.—Defective drains. Notice. Remedied. Feb. 22nd.—Butts Green.—Ditto. Notice. Remedied. Feb. 22nd.—Hornchurch.—Ditto. Notice. Remedied. Feb. 26th.—South Hornchurch.—Ditto. Notice. Remedied. Mar. 8th.—Douglas Road.—Accumulation of manure, &c. Notice. Removed. Mar. 8th.—Park Lane.—Slaughter House dirty. Notice. Cleansed. Mar. 16th.—Harold Wood.—Blocked drain. Notice. Cleansed. Mar. 19th.—Craigdale . Road.—Defective w.c. Notice. Cleansed. Mar. 19th.—Clydesdale Road.—Faulty drains. Notice. Remedied. Mar. 19th.—Longfield Estate.—Ditto do. do. April 3rd.—Ardleigh Green.—Dirty premises and bakehouse. Notice Remedied. 24 April 6th.—Allandale Road.—Blocked drain. Notice. Remedied. April 8th.—Clifton Road.—Ditto do. do. April 8th.—Clifton Road.—Ditto do. do. April 8th.—Clifton Road.—No dustbin to house. Provided. April 14th.—Hornchurch.—Overcrowded cottage. Notice. Remedied. April 16th.—Douglas Road.—Defective sanitary arrangements. Notice. Remedied. April 19th.—Allandale Road.—Defective W.C., &c. Notice. Remedied. April 19th.—Ditto.—Ditto do. do. April 19th.—Craigdale Road.—Blocked drain. Notice. Remedied. April 19th.—Ditto.—Blocked drain. Notice. Remedied. April 19th.—Douglas Road.—Blocked drain. Notice. Remedied. April 19th.—Wheatsheaf Road.—No dustbin to house. Notice. Remedied. April 21st.—Hornchurch Old School House.—Defective and foul pail closets. Notice. Remedied. April 23rd.—South Hornchurch.—Special report to Council (on instructions) on the riverside dust-shoots and factories. April 24th.—Harold Wood.—Defective sanitary arrangements and water supply. Notice. Remedied. April 26th.—Squirrels Heath.—Overflowing cesspool. Notice. Remedied. May 4th.—Harold Wood.—Dirty cowshed. Notice. Remedied. May 4th.—Hornchurch Brewery.—Visited owing to complaint made by neighbours of noise from exhaust pipe of engine. Advised the Council that it was a matter for mutual arrangement. May 18th.—Marsh Green.—Cowshed dirty. Notice. Remedied. May 18th.—South Hornchurch.—Blocked drain and foul ditch. Notice. Remedied. 25 May 21st.—South Hornchurch.—Second visit to riverside factories. May 26th.—Hornchurch.—Defective drain. Notice. Remedied. May 27th.—Harold Wood.—Swine kept improperly. Notice. Remedied. May 28th.—Hornchurch.—Accumulation of manure. Notice. Remedied. May 29th.—Lower Richmond Street.—Overcrowding. Notice. Remedied. June 2nd.—Wood Lane.—Water supply to cottages impure. Several analyses and visits. Report to Council. Well cleaned. Water still contaminated, and now under notice. June 7th.—South Hornchurch.—Another visit to riverside dust-shoo &c. June 12th.—Hornchurch.—Defective drains. June 19th.—Lea Gardens.—Alleged nuisance from want of sanitary arrangements in pea-pickers encampment. No ground for complaint. July 2nd.—South Hornchurch.—Blocked drain. Notice. Remedied. July 6th.—Globe Road.—Defective drain. Notice. Remedied. July 13th.—Craigdale Road.—Ditto do. do. July 19th.—Squirrels Heath.—Filthy cottage. Notice. Remedied. July 21st.—Emerson Park.—Defective drains. Notice. Remedied. July 22nd.—Brentwood Road.—Ditto do. do. July 26th.—Harold Wood.—Dirty and ill-ventilated cowshed. Notice. Remedied. Aug. 25th.—Brentwood Road.—Defective drains. Notice. Remedied. Aug. 25th.—Park Lane.—Ditto do. 'do. Aug. 26th.—Emerson Park.—Defective drains. Notice. Remedied. D 26 Aug. 27th.—Hornchurch.—Blocked drain. Notice. Remedied. Aug. 27th.—Brentwood Road.—Defective drain. Notice. Remedied Aug. 27th.—Park Lane.—Blocked drain. Notice. Remedied. Aug. 27th .—Emerson Park.—Defective drain. Re-constructed. Aug. 27th.—Hornchurch.—Blocked drain. Notice. Remedied. Sept. 3rd.—Claremont Road.—Ditto. do. do. Sept. 17th.—Squirrels Heath.—Public house and adjoining cottages with bad sanitary arrangements. Notice. Remedied. Sept. 17th.—Harold Wood.—Defective drain. Re-constructed. Sept. 20th.—Harold Wood.—Ditto do. do. Sept. 21st.—Brentwood Road.—Ditto do. do. Sept. 21st.—Walden Road.—Ditto do. do. Oct. 6th.—Harold Wood.—Case of Scarlet Fever. Infected at West Ham Scarlet Fever Convalescent Home. Special report [to Council. Oct. 7th.—Park Lane.—Defective W.C. Notice. Remedied. Oct. 9th.—Lea Garden.—House with bad sanitary arrangements and deficient water supply. Diphtheria. Special report to Council. Notice now being obeyed after much delay on the part of the owner (Feb., 1910. Oct. 16th.—Craigdale Road.—Defective drain. Notice. Remedied. Oct. 20th.—Harold Wood.—Blocked drain. Notice. Remedied. Oct. 26th.—Claremont Road.—Slop water running on to road. Notice. Connection with sewer. Oct. 26th.—Butts Green.—Van dwelling with no water or sanitary arrangements. Notice. Removed. 27 Nov. 6th.—Hornchurch.—Cottages unfit for occupation. Special report to Council. Now closed (February, 1910). Nov. 2nd.—Park Lane.—House with no dustbin. Notice. Remedied. Nov. 5th.—Squirrels Heath.—Cottage with defective drainage. Notice. Nothing done yet (February, 1910). Nov. 5th.—Ditto.—Blocked drain. Notice. Remedied. Nov. 5th.—Hornchurch.—Animals improperly kept. Notice. Remedied. Nov. 6th.—Ardleigh Green.—Dirty Bake-house. Notice. Remedied Dec. 1st.—Harold Wood.—Blocked drain and foul cesspool. Notice. Remedied. Dec. 13th.—Squirrels Heath.—Four cottages with bad sanitary arrangements. Notice. Nothing done yet (February, 1910)). Dec. 22nd.—Lower Richmoind Street.—Four cottages with no dustbins. Notice. Remedied. havering. Feb. 1st.—Accumulation of refuse in yard. Diphtheria. Notice. Removed. Feb. 3rd.—Brickfield.—Dirty premises and dilapidated closets and cesspools. Notice to cleanse and provide pail closets and fill in cesspools. Complied with. Feb. 25th.—Cowshed insanitary. Notice. Remedied. April 1st.—Cottages damp and dilapidated. Notice. Closed. 28 Noak Hill. Feb. 2nd.—Visited dairy where were two tubercular cows. Cautioned owner not to mix the milk from these cows with other milk. Oct. 22nd.—Cowshed insanitary. Notice. Remedied. Upminster, Cranham and Corbets Tey. Jan. 4th.—Cranham Lane.—Blocked drain. Notice. Remedied. Jan. 7th.—Upminster.—Complaint of sewer gas from manhole. Closed. Jan. 13th.—Ditto.—Visited and examined carcass of sheep, run over on railway. Carcass not offered for sale. Feb. 6th.—Ditto.—Dirty cowshed. Notice. Remedied. Feb. 13th.—Upminster Common.—Complaint of cottages dilapidated, and unfit for occupation. Visited and reported that cottages were habitable. Feb. 24th.—Ditto.—Cesspool overflowing. Notice. Cleansed. April 7th.—Corbets Tey.—Defective W.C. Notice. Remedied. May 127th.—Cranham.—Foul ditch close to cottages. Notice. Cleansed. June 2nd.—Ditto.—Defective drain. Notice. Re-constructed. Aug. 24th.—Upminster.—Public urinal in public house premises foul. Notice. Remedied. Sept. 30th.—Cranham Park Estate.—Houses erected and being erected without a proper water supply. Report to Council. Steps now being taken to provide same. 29 GREAT WARLEY. Jan. 25th.—Defective W.C. Notice. Remedied. Feb. 13th.—Visited and reported on proposed slaughter house, to be suitable for its purpose. Feb. 23rd.—Insanitary cowshed. Notice. Remedied. May 15th.—Cesspool overflowing on to road. Notice. Remedied. Sept. 10th.—Dirty bake-house. Notice. Remedied. Sept. 10th.—Cowshed and dairy dirty. Notice. Remedied. RAINHAM AND Wennington. Jan. 4th.—Wennington.—Four W.C.'s defective and insanitary. Notice. Remedied. Jan. 4th.—Ditto.—Foul ditch. Notice. Remedied. Jan. 4th.—Ditto.—Foul ditch and damp premises from defective gutters. Notice. Remedied. Feb. 8th.—Rainham.—Accumulation of refuse and foul dtich. Notice. Remedied. Feb. 10th.—Wennington.—Ten dilapidated cottages. Notice to repair, &c., complied with. Mar. 1st.—Ditto.—Foul water cistern. Notice. Remedied. Mar. 21st.—Rainham.—Cottage dilapidated, &c., and unlit for occupation. Notice. Remedied. April 1st.—Ditto.—Damp premises owing to defective gutter and paving of yard. Notice. Remedied. 30 June 9th.—Ditto.—House with defective drainage, &c. Notice. Remedied. June 21st.—Rainham Ferry.—Foul privy pit and blocked drains. Notice. Remedied. June 28th.—Wennington.—Cottages with defective sanitary arrangements. Notice. Remedied after much delay. « Oct. 11th.—Rainham.—Blocked drain, &c. Notice. Remedied. Nov. 19th.—Ditto.—Nuisance from stagnant surface water. Notice. Remedied. Dec. 17th.—Ditto.—Cottage with blocked drain. Notice. Reme died. The following is a complete list of the Nuisances, &c., reported by 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 341 Filthy houses cleansed 5 Overcrowding abated 2 Houses repaired 26 Houses closed 2 Samples of water analysed 8 Animals improperly kept 14 Cowsheds inspected 46 Privies and W.C.'s repaired, &C 57 Total 501 31 Dec. 13th.-Upminster.—Blocked drain and defective sanitary arrangements. Notice. Remedied. The various bake-houses, dairies, cowsheds and slaughter houses have been periodically visited, and, when insanitary, have been remedied. Sanitary improvements have continued during the year, the Council always responding to complaints from the Sanitary Officials and from private persons, and giving instructions for official action towards remedying sanitary conditions as far as is possible. Much sanitary work has been done during the year by the Sanitary Inspectors under the Council's instructions, amongst which may be enumerated Drainage of Park Lane Schools, Hornchurch. The drains here were found to be very defective by the Sanitary Inspector and myself, and were re-constructed under the supervision of the County Architect. The house to house inspection of drains in the parish of Hornchurch which was commenced in the previous year, was unfortunately stopped by an adverse decision of the Petty Sessions Court, in a case where the Council (summoned an owner for refusing permission to test his drains, so that now this is only done where an actual nuisance is visible, or where infectious disease has occurred. The condition of the Ingrebourne brook has, on several occasions, occupied the attention of the Council. This brook has been for years past polluted by discharge of sewage from the Brentwood and the South Weald sewage works. At these latter, improvements have been made (August, 1909), and the effluent which flows into the Ingrebourne brook has been satisfactory. Improvements in the Brentwood sewage works are in course of being carried out, which, it is assured by 'the Manager, will cause a cessation of the stream's pollution. Gipsies at Harold Wood. -During the past year numbers of Gipsies, with their families and caravans, have encamped on unenclosed land at Harold Wood, causing many complaints from residents near. Many notices were served on them, by the Sanitary Inspector, but the Gipsies left before the expiration of the notices, others 32 taking their places. They were eventuality prevented from access to the land by the cutting of trenches at the entrance to the camping ground. bird Lank, Upminster Common.—The South Essex water mains have been extended to this locality, and all cottages there are now supplied. HORNCHURCH.—Sewers have been made in Walden Road, and the road made up and taken over. Sewers have been extended to Slewins Lane, Squirrels Heath, Craigdale Road, Douglas Road (extension), and Osborne Road (extension), have been made up and taken over. UPMINSTER.-Roads have been finished and taken over by the Council in this parish. DAGENHAM.—The house connections with the sewers in this parish are now being effected. Station Road, in the village, long a blot in the sanitary condition of this locality, is now in course of being made up, and will be then taken over by the Council, an improvement long wanted but delayed by the non-completion of the sewerage system. New roads on the Whalebone Estate are also now in course of being made up. A great deal of sanitary work which will undoubtedly be of much benefit, has been done in the parish of Dagenham during the past year and is now being done, i.e., old-standing and recurring nuisances from badly-constructed and overflowing cesspools, foul ditches, &c., which will be obviated by the connection of houses with the new sewer. At the present time (February, 1910), there is considerably less zymotic disease in the district than has been the case for several years, a condition that has existed now for several months past. The Council's attention has been drawn by me to the occurrence of Scarlet Fever on three separate occasions in families residing at Harold Wood, and which has undoubtedly been caused by infection from the West Ham Convalescent Scarlet Fever Home, which has recently been established here. The residents of this locality a???e justly alarmed at the existence of this source of infection in their midst, and correspondence between the Council and the Local Government Board has been carried on respecting this matter. 33 Locality. 1905. 1906. 1907. 1908. 1909 Tables of mortality and sickness compiled according to the requirements of the Local Government Board are included in this report. The birth and death-rates for the several localities for the past five years are shown in the following table. BirthRate. DeathRate. BirthRate. DeathRate. BirthRate. Death Rate.- BirthRate. DeathRate. BirthRate. Rate. Dagenham, Beacontree and Chadwell Heaths 31.5 13.1 29.4 11.4 32.6 13.4 27.9 8.7 34.1 11.9 Havering 21.9 12.1 22.1 11.1 22.1 11.5 20.4 13.6 18.4 18.4 Hornchurch 6.5 10.0 29.5 10.5 24.5 9.5 27.2 12.6 24.5 9.8 Upminster, Cranham, and Corbets Tey 14.1 7.3 19.04 8.5 18.2 7.8 18.1 9.09 15.4 7.9 Great Warley 33.4 12.1 36.01 8.5 31.3 12.8 26.9 9.03 23.5 7.5 Rainham & Wennington 32.4 11.1 34.1 13.7 33.1 11.4 31.07 10.03 28.1 16.5 Diseases of a zymotic character proved fatal in 14 instances. The death-rate for this class of disease for the entire district being 0.5 per 1,000. The following table shows the nature and distribution of fatal zymotic disease on the different localities of the district. E 34  Dagenham. Havering. Upminster. Hornchurch. Rainham. Great Warlcy. Measles 1 ... ... ... 1 ... Diphtheria 2 ... ... ... ... ... Enteric Fever ... ... ... ... ... ... Scarlet Fever 2 ... ... ... ... ... Erysipilas 2 .. ... ... ... ... ISOLATION HOSPITAL. The following cases were admitted into the Isolation Hospital from the Rural District during the year. Scarlet Fever 77 Diphtheria , 25 I have, as i n 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 29,951 Population 24,054 General death-rate 10.9 per 1,000. Infant death-rate (under 1 year) 2.3 per 1,000. I am, Gentlemen, Your obedient Servant, The Lodge, Romford, ALFRED WRIGHT. February 23rd, 1910. 35 ISOLATION HOSPITAL. This Hospital is controlled by the "Joint Hospital Hoard," a body composed of members of the Urban and Rural District Councils, to whom I beg to express my warmest thanks for the readiness with which all suggestions from the matron and myself, for the well-being of the Hospital and its patients are responded to. The hospital continues to work satisfactorily, many grave cases having been successfully treated, which could not possibly have resulted favourably in their own homes, thus saving much human life and suffering. The number of cases admitted during the year was 268. Of these 200 were cases of Scarlet Fever, 66 of Diphtheria, and 2 of Enteric (Typhoid) Fever. Not all these came from the Romford Urban and Rural districts, as 35 were admitted from Brentwood and neighbourhood, the Isolation Hospital for that district being, at that time, full. 15 cases came from the Romford Union Workhouse and its Boarded-out Homes. The cases of Scarlet Fever were, for the most part, of a mild type, but many of the cases of Diphtheria were extremely severe, necessitating the oparation of Tracheotomy in 11 instances. Of the cases of Enteric Fever one was severe and one was mild. 8 deaths were caused by Diphtheria, and 3 by Scarlet Fever. I should like to say a few words here about "Return Cases," i.e., instances where, after the return of a child to its home, another member of the familly has been attacked, apparently infected by the case just returned from hospital. This only applies to Scarlet Fever, no instances of a "Return Case" in Diphtheria having occurred. These occurrences have caused some uneasiness in the public mind, and I have, on several occasions, been called upon to give an explanation of what has been unjustly assumed to be the fault of the hospital staff. I have on these occasions pointed out to the Hospital Board, how impossible it is, in all cases of Scarlet Fever, to say when all infection is over. The 36 greatest precautions are taken not to discharge a patient from hospital until the risk of infection is past. When cases are convalescent and apparently no longer infectious, they are removed to the "discharge" block, and kept there for about a week. A separate nurse attends to them, and there is no communication between this block and the infectious wards. In some cases, however, infection germs lurk in the intricate channels of the "Naso-pharynx" (back of nose and throat), which, supposing the child to take cold and get nasal discharge, at once renders it infectious to others in close contact with it. This is the rationale of "Return Cases," and no amount of care will prevent such cases occasionally occurring. It happens in all Scarlet Fever hospitals, and I am happy !to say that in our hospital, the number of "Return Cases" is less than in most Isolation Hospitals. During the past year the number was about 3 per cent. TABLE I. Vital, Statistics op Whole District during 1909 and Previous Years. ROMFORD RURAL DISTRICT. Year. Population estimated to Middle of each Year. Births. Total. Deaths Registered 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.* N umber. Rate per 1,000 Births' registered. Number. Rate.* Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1899. 16,770 593 35.3 84 141 256 15.2 12 262 159 1900. 17,380 476 27.3 26 54 255 14.6 11 266 15.3 1901. 18,990 569 28.9 90 157 266 14 0 16 7 5 271 14.2 1902. 19,500 585 30.0 62 105 235 22.3 11 0 7 241 12.2 1903. 20,000 623 36.1 68 109 248 12.4 15 6 22 264 13.2 1904. 20,415 551 26.8 96 174 274 13.4 16 2 21 293 143 1905. 21,000 654 31.1 86 130 256 12.1 8 1 23 256 12.9 1906. 21,500 634 29.4 87 137 241 11.1 8 3 24 262 12.1 1907. 22,000 602 27.3 51 84 242 11.0 29 4 11 242 11.11 1908. 23,282 622 26.7 52 87 214 9.1 25 7 30 237 10.1 Averages for years 1899. 1908 20,084 590 29 8 70 112 248 13.5 12 3 16 259 12.10 1909. 24,054 641 26.6 58 112 239 9.9 11 6 30 263 10.9 * 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 At Census of 1901. Number of inhabited houses, 3955 Average number of persons per house, 4.7 I. II. III. 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. Isolation Hospital. Union Infirmary. West Ham Small-pox Hospital Romford Cottage Hospital. Various London Hospitals. TABLE II. Vital Statistics of Separate Localities in 1909 and previous years. ROMFORD RURAL DISTRICT. Names of Localitifs. Dagenham, Beacontree and Chadwell Heaths. Havering. Noak Hill. Hoknchurch. Upminster, Cranham, and Corbets Tey. Great Wakley. Rainham and Wenninoton. 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 year. Population estimated to middle of eacn 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 a. b. c. d. a. b. c. d. a. b c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d 1899 5,200 181 64 23 500 12 1 4,800 166 76 27 2,000 40 24 5 1,830 69 29 3 2,340 42 23 14 1900 5,550 181 90 31 504 5 5 3 5,000 168 70 15 2,020 51 31 4 1,970 30 30 12 2,390 79 25 10 1901 6,000 228 87 41 407 11 1 259 5 2 6,100 165 76 25 1,274 29 20 3 1,900 56 30 11 2,080 65 39 14 1902 6,300 223 69 18 407 7 6 1 259 4 3 6,610 177 83 24 1,900 19 19 5 1,910 59 17 11 2,100 74 36 13 1903 6,500 229 83 35 410 4 260 6 4 6,800 191 58 13 1,900 41 28 4 l,930 59 29 8 2,160 93 33 6 1904 6,700 246 102 38 405 7 2 260 2 1 6,900 164 88 32 1,956 46 28 5 2,000 53 14 6 2,200 54 39 15 1905 6.900 252 91 41 410 9 5 2 260 3 6 7,500 209 75 16 2,000 39 15 6 2,000 51 14 6 2,300 73 S9 11 1906 7,130 241 87 33 418 9 6 2 260 5 4 7,700 210 75 13 2.100 40 12 3 2,100 76 12 4 2,400 73 33 16 1907 7,300 238 98 27 415 4 4 260 3 7,350 103 71 10 2,300 38 23 4 2,150 67 28 9 2,458 57 33 16 1908 7,450 208 65 21 440 9 6 1 262 2 8,000 218 101 16 2,310 44 21 4 2.340 63 19 2,480 78 25 10 Averages of Years 1899 to 1908. 6,498 220 83 30 431 7 3 208 3 2 6,636 186 77 18 1,976 39 22 4 2,013 58 22 6 2,290 68 32 12 1909 7,550 258 91 21 440 8 8 264 2 2 1 8,500 209 84 2,400 37 19 4 2.380 56 18 3 2,520 71 41 9 TABLE III. Cases of Infections Disease notified during the Year 1909, in the Romford Rural District. Notifiable Disease. Cases notified in Whole District. No. op Cases Removed to Hospital from each locality. No. of Cases Removed to Hospital from each Locality. At all Ages. At Ages —Years. Dagenham, Beacontree and Chadwell Heaths Noak Hill. Havering. Hornchurch. Upminster. Cranham, and Corbets Tey. Great Warley. Rainham and Wennington. Dagenham, Beacontree and Chadwell Heaths Havering. Noak Hill. Hornchurch. Upminster, Cranham, and Corbets Tey. Greet Warley. Rainham and Wennington. Total cases removed to Hospital. Under 1. 1 to 5. 6 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 42 ... ... ... ... ... 24 ... 2 13 ... ... 3 13 2 ... 10 ... ... 2 27 Erysipelas 14 ... ... ... ... ... ... 6 ... ... 5 ... 1 2 ... ... ... ... ... ... ... ... Scarlet Fever 96 ... ... ... ... ... ... 36 ... 1 30 11 4 14 25 1 ... 27 11 4 10 77 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Relapsing Fever ... .. ... . ... ... ... ... ... ... ... ... . .. ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... .. ... ... ... ... ... ... ... ... ... ... Puerperal Fever 3 ... ... ... ... ... ... 1 ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... . ... ... ... ... ... ... ... ... ... ... ... ... ... ... * ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 155 ... ... ... ... ... 67 .. 3 49 11 5 20 35 3 ... 37 11 4 12 104 Isolation Hospital—Romford Joint Hospital, Rash Green, Romford. Total available beds 40. Number of Diseases that can be concurrently treated, 3 TABLE IV. Causes or, and Ages at, Death during Year 1909. Romford Rural District. Causes of Death. Deaths at the. subjoined ages of "Residents" whether occurring in or beyond the District Deaths at alt. ages op Residents" belonging to Localities, whether occurring in or beyond the District. 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. 15 and under 25. 25 and under65. 65 and upwards. Dagenham, Beacontree and Chadwell Heaths Hornchurch. Havering. Upminster, Cranham, and Corbets Tey. Great Warley. Rainham and Wennington. Noak Hill. Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 2 ... 2 ... ... ... ... 1 ... ... ... ... ... ... ... Scarlet Fever 2 ... 2 ... ... ... ... 2 ... ... ... ... ... ... 3 Whooping-cough 6 3 3 ... ... ... ... ... 2 ... 2 1 ... ... ... Diphtheria (including Membranous Croup) 2 ... 2 ... ... ... ... 2 ... .. ... ... ... .. 8 Croup ... .. ... ... ... ... ... ... ... ... ... ... ... ... ... Fe rer Typhus .. ... ... ... ... ... ... ... ... .. ... ... ... ... ... Enteric 2 ... ... ... ... ... ... ... ... ... ... ... ... ... Other contin'd ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 1 ... ... ... ... 1 ... ... ... .. 1 ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... .. ... ... ... ... Plague .. ... ... ... ... ... ... ... .. ... ... ... ... ... ... Diarrhœa 6 6 ... ... ... ... ... 3 2 ... 1 ... 4 ... ... Enteritis 3 3 ... ... ... ... ... 1 1 ... ... ... ... ... ... Puerperal Fever ... . ... ... ... ... ... ... ... ... ... ... .. ... ... Erysipelas 2 ... ... ... 1 ... 1 2 ... .. ... ... ... ... ... Phthisis (Pulmonary Tuberculosis) 19 ... ... 2 4 12 1 10 9 ... ... 1 ... ... Other tubercular Diseases 7 5 ... ... 1 1 ... 1 1 ... ... ... 2 ... ... Cancer, Malignant Disease 18 ... ... .. ... 9 9 6 3 3 ... 1 ... ... Bronchitis 14 4 2 ... .. 1 7 8 3 ... ... 1 4 ... ... Pneumonia 12 4 3 1 ... 1 3 6 1 1 ... 1 ... ... ... Pleurisy ... .. ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs .. ... .. ... ... .. .. ... ... ... ... ... ... ... ... Alcoholism Cirrhosis of Liver ... ... ... ... ... .. .. ... ... ... ... ... ... ... Venereal Diseases ... ... ... ... ... ... ... ... ... ... .. ... ... ... ... Premature Birth 12 12 ... ... ... ... ... 3 7 1 ... 1 ... ... ... Diseases and Accidents of Parturition 2 1 .. ... ... 1 20 1 1 ... ... ... ... ... ... Heart Diseases 51 3 1 3 3 21 2 13 17 2 7 4 3 ... ... Accidents 7 ... ... 3 1 1 ... 3 2 ... ... 1 2 ... ... Suicides 3 ... ... ... ... 3 ... ... 2 1 ... ... . ... ... Senile Decay 32 ... ... ... ... ... 32 9 9 1 3 6 2 ... ... All other causes 62 16 4 1 ... 22 19 20 24 ... 5 3 6 2 ... All Causes 263 57 19 10 10 73 95 19 84 8 19 18 41 2 ... TABLE V. INFANTILE MORTALITY DURING THE YEAR, 1909. 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. 3-4 Weeks. Total under 1 month. 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. 11-12 Months. Total Deaths under One Year. All Causes Certified 11 5 3 3 22 5 2 6 5 3 5 2 3 3 1 57 Uncertified Common Infectious Diseases. Small-pox .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Chicken-pox .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Measles .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Scarlet Fever .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Diphtheria: Croup .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 .... 1 1 3 Diarrhœal Diseases. Diarrhœa, all forms .... .... .... .... .... .... .... 1 .... 3 .... .... .... .... .... 4 Enteritis, Mucoenteritis Gastro-enteritis .... .... 1 .... 1 .... .... .... 3 .... 1 .... .... .... .... 5 Gastritis, Gastrointestinal Catarrh .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Wasting Diseases. Premature Birth 5 3 2 1 11 .... .... .... .... .... .... .... .... .... .... 11 Congenital Defects 1 .... .... .... 1 1 .... .... 1 .... .... .... .... .... .... 3 Injury at Birth 1 .... .... .... 1 .... .... .... .... .... .... .... .... .... .... 1 Want of Breast-milk .... .... .... .... .... .... .... .... .... .... .... .... .... .... .. .... Starvation Atrophy, Debility, .... .... .... .... .... 2 1 1 .... .... 1 .... .... .... .... 5 Marasmus Tuberculous Diseases. Tuberculous Meningitis .... .... .... .... .... .... .... .... .... .... .... .... 1 .. .... 1 Tuberculous Peritonitis ; Tabes Mesenterica .... .... .... 1 1 .... .... .... .... .... .... .... .... .... .... 1 Other Tuberculous .... .... .... .... .... 1 .... 1 .... .... .... .... .... 1 .... 3 Diseases Other Causes. Erysipelas .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Syphilis .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Rickets .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Meningitis .... .... .... .... .... .... .... .... .... .... .... .... .... 1 .... 1 (not Tuberculous) Convulsions 2 .... .... 1 3 .... .... .... .... .... .... 1 1 .... .... 5 Bronchitis .... .... .... .... .... .... .... 1 .... .... 1 .... 1 .... .... 3 Laryngitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Pneumonia .... 1 .... .... 1 .... .... 1 1 .... 1 .... .... .... .... 4 Suffocation, .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... overlaying Other Causes 2 1 .... .... 3 1 1 1 .... .... 1 .... .... .... .... 7 Population estimated to middle of 1909, 24,054. Births in the year, legitimate, 629 ; illegitimate, 12. Deaths in the year, legitimate, 57 ; illegitimate, 0. Death from all causes at all ages, 263. ESSEX COUNTY COUNCIL. Parishes of Hornchurch, Upminster, Cranham, Great Warley, Havering, and Noak Hill. No. 1 District. Summary of Work done through the Sanitary Inspector in the Rural Sanitary District of Romford during the year ending December 31st, 1909. (To be sent to the Clerk to the County Council with the Medical Officer of Health's Annual Report. Total Number for year. Notes, Results of Inspection, &c. 1 Complaints received 2 Nuisances detected without complaint 3 Nuisances abated 89 4 Notices served 92 5 Summonses taken out for order to test house drains, Hornchurch 1 Order refused 6 Convictions 7 Cottages inspected All in distriot 8 Lodging-houses inspected None in district 9 Slaughter-houses inspected 10 10 Bakehouses inspected 12 11 Dairies and Milk Shops inspected 7 12 Cowsheds inspected 34 13 Workshops inspected Factories 30 7 14 Filthy houses cleansed, sec. 46 Public Health Act, 1875 Nil. 15 Houses disinfected As required by M.O.H. 16 Overcrowding abated 2 Hornchurch 17 Houses placed in habitable repair 8 Havering 18 Houses closed Nil. 19 Houses erected or re-built for which Water "Certificates" were applied Surveyor's duty SANITARY INSPECTOR'S REPORT—Continued. Total Number for year. Notes, Results of Inspection, &c. 20 "Certificates" granted Surveyor's duty 21 „ deferred „ 22 Wells sunk or improved supplies of Water afforded 1 South Hornchurch 23 Wells cleansed or repaired 2 24 Wells closed Nil. 25 Existing houses connected with sewers Surveyor's duty 26 Existing houses connected with water mains 4 Upminster Common 27 Earth, pail, or improved Privies constructed or 2 Havering, &c. 28 existing Privies altered Privies and W.C.'s repaired; W.C.'s supplied with water 5 29 Cisterns cleansed, repaired, or covered 30 Animals improperly kept, removed 2 Harold Wood and Hornchurch Village 31 Samples of water taken for Analysis 6 82 Compensation paid for destruction of infected bedding Nil. 33 Seizures of unsound Meat, &c. Nil. (Signed) ARTHUR CORNELL, Inspector of Nuisances. COUNTY OF ESSEX. Parishes of Dagenham, Rainham, and Wennington. Summary of Work done through the Sanitary Inspector in the Rural Sanitary District of Romford during the year ending December 31st, 1909. (To be sent to the Clerk to the County Council with the Medical Officer of Health's Annual Report. Total Number for year. Notes, Results of Inspection, &c. 1 Complaints received 35 2 Nuisances detected without complaint 217 3 Nuisances abated 252 4 Notices served to connect houses to sewers 139 & 120 5 Summonses taken out 1 6 Convictions 1 7 Cottages inspected 579 8 Lodging-houses inspected 9 Slaughter-houses inspected 5 10 Bakehouses inspected 6 11 Dairies and Milk Shops inspected 14 12 Cowsheds inspected 12 13 Workshops inspected 14 14 Filthy houses cleansed, sec. 46 Public Health Act, 1875 5 15 Houses disinfected 71 16 Overcrowding abated 17 Houses placed in habitable repair 18 18 Houses closed 2 19 Houses erected or re-built for which Water "Certificates" were applied 20 "Certificates" granted 21 ,, deferred 22 Wells sunk or improved supplies of Water afforded 3 23 Wells cleansed or repaired SANITARY INSPECTORS REPORT— Continued. Total Number for year. Notes, Results of Inspection, &c. 24 Wells closed 25 Houses connected with sewers 53 Plans submitted for 413 houses. In hand 26 Houses connected with water mains 2 279 houses (Dagenham 27 Earth, pail, or improved Privies constructed, or existing Privies altered 28 Privies and W.C.'s repaired; W.C.'s supplied with water 52 29 Cisterns cleansed, repaired, or covered 3 30 Animals improperly kept removed 12 instances 31 Samples of water taken for Analysis 32 Compensation paid for destruction of infected bedding 2 33 Seizures of unsound Meat, &c. (Signed) GEORGE T. CARTER, Sanitary Inspector. Annual Report of the Medical Officer of Health for the year 1909, for the Rural Sanitary District of Romford, on the administration of the Factory and Workshop Act, 1901, in connection with Factories, Workshops, Workplaces. and Homework. 1—Inspection of Factories, Workshops, and Workplaces. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections Written Notices. Prosecutions. Factories (Including Factory Laundries) 16 Nil Nil Workshops (including Workshop Laundries) 36 Nil Nil Workplaces 6 Nil Nil Total 58 2.—DEFECTS FOUND. Particalars. Number of Defects. Number of Prosecutions. Found Remedied Referred to H.M. Inspector Nuisances under the Public Health Acts : Want of Cleanliness 1 I Total 1 1 Nil Nil 3.—HOME WORK. NATURE OF WORK. OUTWORKERS' LISTS. Lists received from Employers twice in the year. Addresses of Outworkers. Inspection of Outworkers' premises Lists. Outworkers. Received from other Councils. Forwarded to other Councils. Contractors. Workmen. Wearing Apparel— Making, &c. Brush Making Total 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. Number. Bakehouses 16 Tailors 5 Bootmakers 3 Harness Makers 1 Farriers 4 Dressmakers 7 Coachbuilder and Wheelwright 3 Laundries 2 Total number of workshops on Register 41 5.—OTHER MATTERS. Class. Number. Matter notified to H. M. Inspector of Factories:— Failure to affix Abstract of the Faotory and Workshop Aot (s 133). ALFRED WRIGHT, March 7th, 1910. Medical Officer of Health.