Rom 26 BOROUGH OF ROMFORD HEALTH DEPARTMENT ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the year 1951 JAMES B. SAMSON m.d., d.p.h. Medical Officer of Health. BOROUGH OF ROMFORD HEALTH DEPARTMENT ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the year 1951 JAMES B. SAMSON m.d., d.p.h. Medical Officer of Health. 3 BOROUGH OF ROMFORD MEMBERS OF THE COUNCIL (as at 31st December, 1951) His Worship The Mayor: Councillor A. E. Blane, J.P. Deputy Mayor: Councillor J. R. Poel Aldermen: Alderman C. H. Barney Alderman C. E. Smart Alderman G. F. Chaplin, C.C. Alderman L. S. Webb Alderman A. J. Dyer, O.B.E. Alderman R. Yeal Alderman R. A. Forge, J.P. Councillors: Councillor P. J. Bartaby Councillor H. A. Beck Councillor F. C. Bell Councillor T. W. Bradley Councillor P. F. Broadhead, D.S.C. Councillor S. C. Brown Councillor E. F. Castle Councillor C. Charlton Councillor Mrs. M. Clark-Lewis Councillor G. Coulson Councillor O. J. Hammond Councillor A. McGonagle Councillor W. A. Reeder Councillor P. D. Ridley Councillor M. J. Riordan Councillor G. Roberts, J.P. Councillor S. E. C. Stevens Councillor A. G. Western 4 BOROUGH OF ROMFORD PUBLIC HEALTH COMMITTEE His Worship The Mayor: Councillor A. E. Blane, J.P. (ex-officio member) Chairman: Councillor S. C. Brown Vice-Chairman: Councillor 0. J. Hammond Alderman R. A. Forge, J.P. Alderman L. S. Webb Councillor P. J. Bartaby Councillor H. A. Beck Councillor F. C. Bell Councillor P. F. Broadhead, D.S.C. Councillor Mrs. M. Clark-Lewis Councillor A. McGonagle Councillor P. D. Ridley Councillor M. J. Riordan Councillor S. E. C. Stevens 5 HEALTH DEPARTMENT Staff Medical Officer of Health J. B. Samson, M.D., Ch.B., D.P.H. Assistant Medical Officers (a) A. P. Diaper, M.C., M.A., M.D., B.Ch., B.A.O. (b) Mrs. E. M. Haga, M.B., B.S., L.R.C.P., D.P.H. (c) Mrs. G. A. Kolibabka, M.A., M.B., Ch.B. (Commenced duties 6th November, 1951). (d) Mrs. H. Symonds, M.D., M.R.C.S., L.R.C.P. (Resigned 14th November, 1951). Sanitary Inspectors (a) W. S. Gent, Senior Sanitary Inspector, Certificate of the Royal Sanitary Institute; Certificate of the Liverpool University School of Hygiene for Meat and Other Foods. (Left on Superannuation 31st October, 1951). (b) H. C. Boswell, Certificate of the Royal Sanitary Institute ; Certificate of the Royal Sanitary Institute for Meat and Other Foods. (Commenced duties as Senior Sanitary Inspector, 1st November, 1951). (c) M. J. Dove, Certificate of the Royal Sanitary Institute; Certificate of the Royal Sanitary Institute for Meat and Other Foods. (Commenced duties 25th June, 1951). (d) T. E. R. Jones, Certificate of the Royal Sanitary Institute. (e) H. H. Seddon, Certificate of the Royal Sanitary Institute; Certificate of the Royal Sanitary Institute for Meat and Other Foods. (f) J. F. Stables, Certificate of the Royal Sanitary Association, Scotland; Certificate of the Royal Sanitary Association, Scotland, for Meat and Other Foods. (Resigned, 26th January, 1951). Health Visitors. Superintendent Health Visitor: Miss F. K. Wells, State Registered Nurse; State Certified Midwife; Health Visitors' Certificate. (a) Miss M. K. Bays, State Registered Nurse; State Certified Midwife; Health Visitors' Certificate. (Also holds the appointment of School Nurse). (b) Miss O. Clements, State Registered Nurse; Registered Fever Nurse; State Certified Midwife; Health Visitors' Certificate. 6 (c) Miss M. A. Cowles, State Registered Nurse; State Certified Midwife; Queen's Certificate of District Nursing; Health Visitors' Certificate. (Also holds the appointment of School Nurse). (Resigned, 1st September, 1951). (d) Miss D. I. A. Hall, State Registered Nurse; State Certified Midwife; Health Visitors' Certificate; Queen's Certificate of District Nursing. (Also holds the appointment of School Nurse). (Commenced duties, 14th August, 1951). (e) Miss M. Hill, State Registered Nurse; State Certified Midwife ; Health Visitors' Certificate. (Also holds appointment, of School Nurse). (f) Miss H. E. S. Holmes, State Registered Nurse; State Certified Midwife; Health Visitors' Certificate. (Also holds the appointment of School Nurse.) (g) Miss M. A. Mander, State Registered Nurse; Part 1. S.C.M.; Health Visitors' Certificate. (Also holds the appointment of School Nurse.) (h) Mrs. S. Pratt, State Registered Nurse; Registered Fever Nurse; Part 1 S.C.M.; Health Visitors' Certificate. (Also holds the appointment of School Nurse). (Commenced duties, 14th August, 1951). (i) Mrs. G. Wallach, State Registered Nurse; Part 1 S.C.M.; Health Visitors' Certificate; Certificate of British Tuberculosis Association; Certificate of Brompton Hospital. (Also holds the appointment of School Nurse). (Commenced duties, 1st March, 1951). Tuberculosis Visitors. (a) Mrs. B. Alder, State Registered Nurse; State Certified Midwife. (b) Miss I. M. Baldwin, State Registered Nurse; Certificate for Tuberculosis. (Part-time). Domiciliary Mid wives. Non-Medical Supervisor of Midwives and Home Nurses: Miss M. B. Worby, State Registered Nurse; State Certified Midwife ; Midwifery Teaching Diploma. (a) Miss I. A- Bassett, State Certified Midwife. (b) Miss C. M. Kerr, State Registered Nurse; State Certified Midwife. (c) Miss M. Kitson, State Registered Nurse; State Certified Midwife. (d) Mrs. M. Mylward, State Certified Midwife. (e) Mrs. E. A. Rooks, State Certified Midwife. (f) Mrs. G. E. Sexton, State Registered Nurse; State Certified Midwife; Queen's Certificate of District Nursing. (g) Mrs. J. Thompson, State Registered Nurse; State Certified Midwife. 7 (h) Miss M. R. Waddell, State Registered Nurse; State Certified Midwife. (i) Mrs. M. B. Woodhouse, State Registered Nurse; State Certified Midwife; Registered Fever Nurse. Home Nurses. (a) Mrs. E. M. Broome, State Registered Nurse. (b) Miss J. Macaulay, State Registered Nurse; State Certified Midwife; Queen's Certificate of District Nursing. (c) Miss R. E. May, State Certified Midwife; Registered Mental Nurse ; State Enrolled Assistant Nurse. (d) Mrs. K. A. Rushworth, State Registered Nurse; State Certified Midwife; Queen's Certificate of District Nursing. (Resigned, 5th June, 1951). (e) Mrs. A. C. Silcock, State Registered Nurse; State Certified Midwife. (f) Miss J. D. Silcock, State Registered Nurse; State Certified Midwife. (g) Mrs. M. Slavin, State Registered Nurse. (Commenced duties, 25th July, 1951). (h) Mrs. S. A. Wotherspoon, State Registered Nurse. (Commenced duties, 29th January, 1951). Clerks. (a) E. W. Gowers, Chief Clerk. (b) C. G. Humberston, Senior Administrative Assistant. (c) Miss B. Parker. (d) Mrs. S. Corner. (Commenced duties, 6th December, 1951). (e) Miss C. DeBrie. (Resigned, 20th October, 1951). (f) Mrs. I. M. Gray. (Commenced duties, 12th February, 1951). (g) Mrs. G. Y. James. (Commenced duties, 29th January, 1951). (h) Mrs. I. Pugh. (Resigned, 20th October, 1951). (i) J. Rivett. (Resigned, 9th December, 1951). Home Help Organiser. Mrs. L. Canham. Day Nurseries—Matrons. " St. Moritz." Mrs. I. C. Bowyer, State Registered Nurse. Collier Row. Mrs. D. Eveling, State Registered Nurse. Rush Green. Mrs. R. M. O'Halloran, State Registered Nurse; Registered Fever Nurse. 8 BOROUGH OF ROMFORD To His Worship The Mayor, Aldermen, and Councillors of the Borough of Romford. Mr. Mayor, Madam, and Gentlemen, I have the honour, herewith, to present to you, this, my Annual Report on the Health of the District for the year 1951. This is the Eighteenth Report in the series, since I was appointed your Medical Officer of Health, and it is drawn up, in accordance with the requirements of Article 17(5) of the Sanitary Officers' (Outside London) Regulations, 1935, as modified by Circular No. 42/51 of the Ministry of Health, dated 10th December, 1951. This circular states that the Report should be prepared on the lines of that for 1950. Once again the particulars given in the following pages relate, not only to the work carried out by the Romford Borough Council, as the Local Sanitary Authority, but also to the services administered by the Essex County Council, as the Local Authority for duties under Part III of the National Health Service Act, 1946. During the year, the Registrar-General gave the provisional Census figures for the population of Romford as 87, 991. The Estimate of the Population for Mid 1950, given in my Report for that year was 80,240, and I estimated that another 7,537 would be accommodated on the Harold Hill Estate by the date of the Census. I had in mind, therefore, that the Census figure might be in the neighbourhood of 87,777, which proved to be short by only 214. The district still continues to grow in population, but the statistics which are set out show that health conditions are satisfactory. My thanks are again gratefully tendered to all members of the Borough Council, and the Health Area Sub-Committee; to the members of my staff; and to my fellow officials. Each and all have given willing assistance in the compilation of this report, and in the promotion of health in the district. I am, Mr. Mayor, Madam, and Gentlemen, Your obedient servant, JAMES B. SAMSON, Medical Officer of Health. Public Health Department, Town Hall, Romford. May, 1952. 9 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the Year 1951 Statistics and Social Conditions of the Area Area (in acres) 9,342 Population: Census (1931), 35,918; Mid. 1951, (Estd.) 89,340 Number of Inhabited Houses (end of 1951) 25,578 Rateable Value (end of 1951) £677,633 Product of Penny Rate (end of 1951) £2,578 Extracts from Vital Statistics for the Year Total M. F. Live Births : Legitimate 1,662 864 798 Illegitimate 64 32 32 Birth Rate : 17.9 per 1,000 of estimated resident population Still Births : Legitimate 36 25 11 Illegitimate 2 1 1 Rate per 1,000 total (live and still births) : 21.5 Deaths 760 409 351 Death Rate : 10.2 per 1,000 estimated resident population. Rate per 1,000 total (live and still) births Deaths from Puerperal causes 0.0 Death Rate of Infants under one year of age :— All Infants per 1,000 live births 24.3 Legitimate Infants per 1,000 legitimate live births 25.3 Illegitimate Infants per 1,000 illegitimate live births 0.0 Deaths from Cancer (all ages) 135 Deaths from Measles (all ages) 1 Deaths from Whooping Cough (all ages) - Deaths from Diarrhoea (under 2 years of age) 2 10 TABLE 1. BIRTH-RATES, DEATH-RATES, ANALYSIS OF MORTALITY, MATERNAL MORTALITY, and CASE-RATES for certain Infectious Diseases in the year 1951. England and Wales, London, 126 Great Towns, and 148 Smaller Towns. (Provisional Figures based on Weekly and Quarterly Returns) RATE PER 1,000 POPULATION DEATH-RATE PER 1,000 POPULATION RATE PER 1,000 LIVE BIRTHS All Causes Typhoid and Paratyphoid Fevers Whooping Cough Diphtheria Tuberculosis Influenza Small-pox Acute Poliomyelitis and Polioencephalitis Pneumonia Diarrhoea and Enteritis (under 2 years) Total Deaths under 1 year Live Births Still Births England and Wales 15.5 0.36 12.5 0.00 0.01 0.00 0.31 0.38 0.00 0.00 0.61 1.4 29.6 126 County Boroughs and Great Towns, including London 17.3 0.45 13.4 0.00 0.01 0.00 0.37 0.36 0.00 0.01 0.65 1.6 33.4 148 Smaller Towns (Resident Populations 25,000 to 50,000 at 1931 Census) 16.7 0.38 12.5 0.00 0.01 0.00 0.31 0.38 0.00 0.01 0.63 1.0 27.6 London 17.8 0.37 13.1 0.00 0.01 0.00 0.38 0.23 0.00 0.00 0.61 0.7 26.4 ROMFORD 17.9 0.43 10.2 0.00 0.00 0.00 0.35 0.10 0.00 0.01 0.36 1.2 24.3 The Maternal Mortality Rate for England and Wales is as follows: Per 1,000 Total Live Births — 0.79 The Maternal Mortality Bate for Bomford is as follows: Per 1,000 Total Live Births — 0.00 11 TABLE 2. Causes of Death All Ages Deaths at the subjoined ages of Residents, after correction for Inward and Outward transfers M. F Total Under 1 1 2-4 5-14 1524 2534 3544 4554 5564 6574 75 & upwards 1. Tuberculosis, respiratory 17 10 27 ... ... 1 ... 1 6 6 5 2 4 2 2. Tuberculosis, other 2 2 4 ... ... 1 ... ... 1 1 1 ... ... ... 3. Syphilitic disease 1 1 2 ... ... ... ... ... ... ... ... 1 1 ... 4. Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5. Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6. Meningococcal infections ... 1 1 ... 1 ... ... ... ... ... ... ... ... ... 7. Acute poliomyelitis 1 ... 1 ... ... ... ... 1 ... ... ... ... ... ... 8. Measles 1 ... 1 ... 1 ... ... ... ... ... ... ... ... ... 9. Other infective and parasitic diseases ... 1 1 ... ... ... ... ... ... ... ... ... 1 ... 10. Malignant neoplasm, stomach 7 13 20 ... ... ... ... ... ... 1 ... 4 11 4 11. Malignant neoplasm, lung, bronchus 16 4 20 ... ... ... ... ... ... 3 3 7 6 1 12. Malignant neoplasm, breast ... 15 15 ... ... ... ... ... ... 5 5 1 2 2 13. Malignant neoplasm, uterus ... 6 6 ... ... ... ... ... ... ... 2 ... 1 3 14. Other malignant and lymphatic neoplasms 37 37 74 ... ... ... ... 2 1 6 8 12 26 19 16. Leukaemia, aleukæmia 4 3 7 ... ... 1 ... 1 ... 4 1 ... ... ... 16. Diabetes 1 2 3 ... ... ... ... ... ... ... ... ... 2 1 17. Vascular lesions of nervous system 43 41 84 ... ... 1 ... ... 2 ... 7 14 25 35 18. Coronary disease, angina 69 20 89 ... ... ... ... 1 ... 1 9 21 27 30 19. Hypertension with heart disease 14 8 22 ... ... ... ... ... ... 3 2 3 6 8 20. Other heart disease 48 70 118 ... ... ... ... ... 3 6 5 4 31 69 21. Other circulatory disease 16 11 27 ... ... ... ... ... 1 ... 1 6 8 11 22. Influenza 8 1 9 ... 1 ... ... ... 1 ... ... 1 2 4 23. Pneumonia 17 16 33 4 1 ... ... ... ... 1 3 1 6 17 24. Bronchitis 25 14 39 ... ... ... ... ... ... ... 2 5 15 17 25. Other diseases of respiratory system 3 4 7 ... ... ... 1 ... ... ... 3 2 ... 1 26. Ulcer of Stomach and duodenum 7 5 12 ... ... ... ... ... ... 1 5 2 ... 4 27. Gastritis, enteritis, and diarrhoea 2 4 6 2 ... ... ... 1 1 ... 1 ... ... 1 28. Nephritis and nephrosis 4 6 10 1 ... ... ... ... 2 2 ... 2 2 1 29. Hyperplasia of prostrate 2 ... 2 ... ... ... ... ... ... ... ... ... 1 1 30. Pregnancy, childbirth, abortion ... ... ... ... ... ... ... ... ... ... ... ... ... ... 31. Congenital malformations 4 6 10 8 ... ... ... ... 1 ... ... ... ... 1 32. Other defined and illdefined diseases 35 37 72 25 2 1 8 1 2 2 5 3 7 16 33. Motor vehicle accidents 7 3 10 ... ... ... 1 3 2 ... 2 ... 1 1 34. All other accidents 15 7 22 2 ... ... 4 2 3 2 2 3 1 3 35. Suicide 2 3 5 ... ... ... ... ... ... ... 2 1 1 1 36. Homicide and operations of war 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... Total 409 351 760 42 6 5 14 13 26 44 75 95 187 253 12 This year the Registrar-General has given his estimate of the mid-year population of Romford as 89,340, which compares with 80,240 for last year, an increase of 9,100. On this occasion the estimate is probably more accurate than it has been for twenty years, in view of the fact that a Census of the population was taken in April. The Census figure is given as 87,991. There are many factors to be taken into consideration in giving an estimate, and it will be appreciated that in a District such as this with a large immigration the work of compiling an estimate is by no means easy. The nearer, however, that a particular year is to a previous Census makes the estimate more accurate. Romford now has the unofficial distinction of being classed as a "Great town", by virtue of its population being larger than 50,000 at the 1951 Census, but for statistical purposes, for the time being, it is still placed in the category of a "Smaller town". During 1951, the total number of live births registered was 1,726, and the total number of deaths registered was 760. The difference of 966 gives the natural increase in the population. As this number falls far short of the Registrar-General's estimated increase of 9,100, it follows that the balance of 8,134 is made up of excess of Immigration over Emigration, and, once more, this is very largely accounted for by the development of the Harold Hill Estate. For 1951, we estimate the Birth Rate to be 17.9 per 1,000 of the estimated resident population. This figure is obtained by multiplying the Crude Birth Rate of 19.3 by the Comparability Factor of 0.93. For last year, the Rate was 16.6. The Rate for England and Wales for 1951 is given as 15.5, and for the 148 smaller towns with populations ranging from 25,000 to 50,000 at the 1931 Census, the Rate is 16.7. The Death Rate for Romford is estimated at 10.2 per 1,000 of the estimated resident population. This figure is obtained by multiplying the Crude Death Rate of 8.5 by the Comparability Factor of 1.20. For last year the Rate was 10.0. The comparable Rates for England and Wales, and for the 148 smaller towns, as referred to above are 12.5 and 12.5 respectively. The chief causes of death in order of frequency were :— (1) Diseases of the Heart and Circulation. (2) Cancer. (3) Bronchitis, Pneumonia and other Respiratory Diseases. (4) All forms of Accident. (5) All forms of Tuberculosis. It will be noted that the category of "All forms of Accident" now takes precedence to that of Tuberculosis, otherwise the order remains the same. The Maternal Mortality Rate, which is the number of Maternal Deaths, due to conditions associated with pregnancy or confinement, 13 per 1,000 total (live and still) births is 0.0. The corresponding Rate for England and Wales is 0.8. The Infant Mortality Rate, or the Death Rate of Infants under 1 year of age for 1,000 live births is 24.3, an increase of 1.2. The corresponding figures for England and Wales, and the 148 smaller towns are 29.6 and 27.6 respectively. 1.—GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA (i) Staff. The particulars of staff are again set out at the beginning of the report. As 1 have mentioned before, the Assistant Medical Officers, Nursing Staff, and Home Help Organiser, as also the majority of the Clerical Staff come under the jurisdiction of the Essex County Council, in their capacity as Local Health Authority. For my own part, I hold the position of Medical Officer of Health for the Borough of Romford, and Acting Area Medical Officer for the Part III duties of the National Health Service Act, 1946. It is with very much regret that I have to report that Mr. W. S. Gent, Senior Sanitary Inspector, had to give up duties, by reason of ill health, and I wish to take this opportunity of recording my appreciation of the conscientious service which he has given to Romford for more than 20 years. (ii) Laboratory Facilities. There has been no change in these facilities, and they continue to meet the requirements of the district. Advantage is taken of the service by the Department, and by the General Practitioners. (iii) Nursing in the Home. (a) General Nursing. There are at present 7 Home Nurses in this area. These are employed whole-time in general domiciliary nursing, but one also combines this work with midwifery duties. Under the provision of Section 28 of the National Health Service Act, arrangements are made for the loan of sick-room equipment, and no charge is now made for this service. Table 3 sets out the work of the Home Nurses during the year. table 3 (1) Number of Visits paid 18,213 (2) Number of Cases attended 1,718 (b) Domiciliary Midwives. At the end of the year 9 Domiciliary Midwives were employed. All these have had the necessary tuition in the administration of Gas and Air Analgesia, and all have the necessary approved 14 apparatus. This apparatus is serviced regularly by an arrangement with the British Oxygen Company. Furthermore, all the Midwives have been approved to administer Pethedine, and this is given, as required. The following gives a summary of the cases attended by the Domiciliary Midwives, as Midwives, and as Maternity Nurses. TABLE 4 As Midwives 522 As Maternity Nurses 158 Table 5 gives a summary of the "Medical Aid" notices received during the year. TABLE 5 (1) Where the medical practitioner had arranged to provide the patient with maternity services, under the National Health Service 19 (2) Others 174 (iv) Ante-natal, and Post-natal Clinics. There are now 6 Ante-natal sessions held each week, an additional session having been commenced at Briar Road on 5th December. Two Post-natal sessions are held per month. When necessary, mothers have continued to be referred to the Consultative Clinic at Oldchurch Hospital. During the year, 1,316 individual expectant mothers attended the Ante-natal Clinics. In addition 42 mothers attended for Postnatal advice. In all, 248 Ante-natal sessions were held. The total number of attendances of the 1,316 Ante-natal mothers mentioned above was 4,163, giving an average of 3.2 attendances, per patient. The average number attending at each session was 16.8. Twenty-two Post-natal sessions were held, and 339 attendances were recorded. The average number attending at each session was 15.4. (v) Child Welfare Clinics. There are now 11 Child Welfare Clinics held each week; this is an addition of 1, compared to last year, and has been necessitated by the immigration to the Harold Hill Estate. This extra session is held in a Social Hut, which has been erected about the centre of of the Estate. Although this latter accommodation is, in many ways, unsatisfactory, it is solving a need, until such time as a Health Centre is erected in the vicinity, and for which negotiations are proceeding. 15 Altogether, 507 Sessions were held, and the following table gives a summary of the attendances. Table 6 Individual children attending 4,411 Children attending for the first time 1,916 Medical Consultations 6,458 Attendances of children under one year 18,943 Attendances of Children between the ages of one and five years 9,675 Average attendance per session 56.4 (vi) Health Visitors. At the end of the year we were 7 short of Establishment. The majority of the Health Visitors also act in the capacity of School Nurses. Those working in the Harold Hill area, also attend the Brentwood Chest Clinic, which serves the Harold Hill Estate. Table 7 relates to Home Visits paid by the Health Visitors during the year. TABLE 7 (a) To Expectant Mothers— First visits 178 Total visits 233 (b) To Children under one year of age— First visits 2,215 Total visits 5,528 (c) To Children between the ages of one and five years— Total visits 8,064 (vii) Care of Premature Infants. The arrangements are the same as hitherto. For those born at home, special draught-proof cots are available, and are issued on the request of a General Practitioner, or Midwives. Special arrangements are made for those born in Hospitals. (viii) Inspection of Nursing Homes. There were at the end of the year 4 Nursing Homes on the Register, viz. :— No. 72 Heath Park Road, registered for 12 Medical or Chronic Patients. No. 68 Heath Park Road, registered for 2 Maternity Patients. Nos. 5 and 7 Heath Park Road, registered for 16 Medical, Surgical or Infirm Patients. No. 21 Gilbert Road, registered for 10 Medical or Chronic Patients. All these were regularly inspected once per quarter, on behalf of the County Council, and were found to be satisfactory. 16 (ix) Domestic Helps. There have again been many requests for this service, and these have been dealt with as quickly as possible. During the year approximately 170 Part-time Helps were employed, and, during the course of the year, the Helps gave assistance in 549 individual cases. A limited number of Helps has again been available for duties in households where there have been cases of Tuberculosis, although, in those particular cases, it has sometimes been impossible to supply immediate assistance. Helps undertaking this work are specially selected and medically examined, and are provided with protective clothing. They are also given detailed instructions on precautionary measures to be adopted. (x) Day Nurseries. Once again, the three Day Nurseries have been working to full capacity, and a waiting list for admissions has been maintained. A system of priorities for those admissions has been continued, as before. It is expected that the alterations to the "St. Moritz" Nursery for the improvement of the sanitary accommodation will be commenced about April, 1952. The average attendance for the year at each Nursery was as follows :— TABLE 8 "St. Moritz" Nursery 32 Collier Row Nursery 35 Rush Green Nursery 37 The "St. Moritz" Nursery, and the Collier Row Nursery are each scheduled to take 40 children, and the Rush Green Nursery 50 children. (xi) Dental Service. There is no new information to give in respect of this service, and we still have the use of 1 Dentist only, instead of 5 for the combined Maternity and Child Welfare and School Health functions. The salary scale for these Dentists has now been improved, but I am afraid that it will be a considerable time before new recruits are forthcoming. In the meantime, we must carry on to the best of our available resources. The following gives particulars of the work done during the year :— TABLE 9 (a) Numbers provided with Dental care :— Examined. Needing Treatment. Treated. Made Dentally Fit. Expectant and Nursing Mothers 34 34 22 3 Children under five 73 66 49 49 17 (b) Forms of Dental Treatment provided:— Extractions. Anaesthetics. Scalings or Scaling and Gum Treatment. Silver Nitrate Treatment. Dressings. Radiographs Dentures provided. Local. Fillings. General. Complete. Partial Expectant and Nursing Mothers 5 - 2 41 22 - - - - - Children under five 86 - 47 9 4 2 - - - - 2.—SANITARY CIRCUMSTANCES OF THE AREA. (i) Water. Mr. H. G. Ramsay, Chief Engineer of the South Essex Waterworks Company, has kindly given me the following report, with regard to the water supply to the district:— "(a) There have been no new extensions of public water supply during the year 1951, other than those for the supply to permanent housing sites. (b) Lengths of mains laid, in yards :— 3" 4" 6" L.C.C. Harold Hill Estate 1,102 8,896 1,369 Romford Area 462 1,004 1,354 Totals 1,564 9,900 2,723 (c) The water supply of the area and of its several parts has been satisfactory, both as to quality and quantity. (d) Bacteriological and chemical examinations are made of the raw water, of the water in its various stages of treatment, of the water supplied from the Company's wells, and of the water going into supply. Analyses are also made of samples obtained from consumers' taps in the various parts of the Company's district; all proved to be satisfactory. A total of over 3,500 chemical, bacteriological, and biological examinations have been made. (e) The waters are not liable to have plumbo-solvent action. (f) No contamination has arisen, therefore no action has been necessary. (g) The following are the average number of dwellings and population supplied during 1951:— Dwellings 24,849 Population 89,340 18 Approximately 0.1 per cent. of the inhabited houses, and 0.1 per cent. of the population of the Borough take their water from standpipes. In addition to the above analyses, independent samples have again been taken, by the Sanitary Inspectors, for Bacteriological analyses once per month, and for Chemical analyses once per 6 months, and the results have confirmed the findings of the Water works Company. (ii) Prevention of Damage by Pests Act, 1949. During the year the Sanitary Inspectors and Rodent Operative paid 2,055 visits or re-visits to premises infested by rats and mice. Further maintenance treatment, in respect of rat disinfestation to sewers, was undertaken during the year. (iii) Infestation. There is no new information to give in connection with the general question of infestation. The same facilities are used, as, and when, necessary. (iv) Sanitary Inspection of the Area. The Senior Sanitary Inspector has given me the following report, as required by Article 27(18) of the Sanitary Officers' (Outside London) Regulations, 1935. TABLE 10 (a) Nature and number of Inspections during the year :— Accumulations and Refuse Deposits 56 Bakehouses 41 Butchers' Shops and Stalls, etc. 128 Common Lodging Houses 14 Dairies and Milkshops 36 Drainage 558 Dustbins 129 Establishments for Massage and Special Treatment 12 Factories (Mechanical Power) 42 Factories (Non-Mechanical) 152 Food Preparing Premises 196 Food Inspection 389 Foodshops 240 Ice Cream 99 Infectious Disease including Food Poisoning 692 19 Keeping of Animals 47 Markets 139 Meat Depots 15 Miscellaneous 30 Prevention of Damage by Pests Act, 1949 2,055 Public Baths 21 Public Conveniences 35 Sale of Horseflesh 20 Shop Acts 10 Slaughterhouses 453 Smoke Observations 1 Stables 4 Streams and Ponds 29 Tents, Vans and Sheds 174 Verminous Premises 79 Water Supplies 15 (b) Informal Notices (Number served) 859 Statutory Notices (Number served) 123 (c) As a result of the service of Notices, the necessary works were completed by the owners or occupiers in all cases except 184, the works for which were still in hand at the end of the year. (v) Factories Acts, 1937 and 1948. A summary of the statistics, as required by the Ministry of Labour and National Service, is given below:— TABLE 11 1. Inspections. Premises. Number on Register. Inspections. Written Notices. Occupiers Prosecuted. (i) Factories in which Sections 1, 2, 3, 4, and 6 are to be enforced by Local Authorities 18 42 10 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 204 152 14 - 20 (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding OutWorkers premises) 14 8 1 - Total 236 202 25 - 2. Cases in which Defects were Found. Particulars. No. of Cases in which defects were found. No. of Cases in which prosecucutions instituted. Found. Remedied. Referred to H.M. Inspector. by H.M. Inspector. Want of Cleanliness 20 17 - - - Overcrowding — — — — — Unreasonable Temperature - - - - - Inadequate Ventilation 2 2 - - - Ineffect. drain. of floors - - - - - Sanitary Conveniences:— (a) Insufficent 1 1 — 1 — (b) Unsuitable or Defective - 1 - 1 - (c) Not Separate for Sexes - - - - - Other Offences — — — — — Total 23 21 — 2 — 3. Outwork. Nature of Work. List of No. of Outworkers in August. No. of Cases of default in sending List. No. of Prosecutions for failure to supply Lists. No. of Instances of Work in Unwhole some Premises. Notices Served. Prosecutions. Wearing Apparel— Making, etc. 23 - - - - - Total 23 - - - - - (vi) Caravan Sites. At the end of the year there were 2 sites in the area which had received Public Health, and Planning consent, subject to certain 21 conditions. The first of these sites, in the neighbourhood of Oldchurch Road is permitted to accommodate 85 caravans, the second in the neighbourhood of Broxhill Road is permitted to accommodate 56 caravans. Another site, adjacent to Site No. 1, received Public Health consent for 60 caravans, and was awaiting Planning consent, when the Borough Council instituted proceedings for a Compulsory Purchase Order. This was upheld by the Minister after a Public Enquiry, but an Appeal against the Minister's decision was lodged by the Owners, and this was still outstanding by the end of the year. During the year, the Borough Council gave consideration to the establishment of a Municipal site, and this is still under review. 3.—INSPECTION AND SUPERVISION OF FOOD. (i) Milk Supply. Samples of Milk have again been taken by the Sanitary Inspectors in the usual way throughout the District, and, as before, one sample has been taken, per supplier per school term for bacteriological examination, and one sample of Pasteurised Milk per supplier per school year for biological examination. At the end of the year, 18 persons or firms were licensed to sell designated milk. Of these, 7 were licensed to retail Tuberculin Tested Milk, 14 were licensed to retail Pasteurised Milk, and 12 were licensed to retail Sterilised Milk. (ii) Ice Cream. All Traders and Manufacturers have to be registered. There were at the end of the year 32 manufacturers, and 185 vendors on the register. Here, also, regular sampling has been carried out. (iii) Meat. The Sanitary Inspectors have again regularly attended at the Regional Slaughterhouse, and, in addition, have paid the usual visits to Meat Depots, Butchers' Shops, Stalls, etc. Altogether, 990 visits have been paid, and at the Slaughterhouse, 20, 682 carcases were examined. Unfortunately, owing to conditions at the Slaughterhouse, many of the inspections have had to be carried out during evenings, and, at the week-ends, and, on an average, about 12 hours per week are given up to inspections during those particular periods. Owing to the incapacity of the Senior Sanitary Inspector, and the fact that there was a prolonged vacancy for an Additional Sanitary Inspector, the remaining Inspectors have had an undue burden placed upon them. The Romford Borough Council, in consequence, took up the matter with the Ministry of Food, and the whole question is now under consideration. Table 12 sets out the particulars of the carcases inspected and condemned, 22 TABLE 12. CARCASES INSPECTED AND CONDEMNED. Cattle except Cows. Cows. Calves. Sheep and Lambs. Pigs. Total. Number killed (if known) 5,280 1,580 1,590 6,638 3,666 20,682 Number inspected 5,280 1,580 1,590 6,638 3,666 20,682 All diseases except Tuberculosis. Whole Carcases condemned 17 16 7 7 16 53 Carcases of which some part or organ was condemned 1,478 707 13 194 1,618 4,010 Percentage of the number inspected affected with diseases other than tuberculosis 28.3 45.7 1.25 3.28 44.5 19.6 Tuberculosis only. Whole carcases condemned 26 27 1 — 4 58 Carcases of which some part or organ was condemned 357 381 — — 71 809 Percentage of the number inspected affected with tuberculosis 7.2 25.8 0.06 — 2.04 — 28 (iv) Food Products in General. Considerable progress has been made in the matter of Food Hygiene. All traders concerned have been made aware of the Byelaws, and their premises have been frequently visited. There is a good spirit of co-operation, and many improvements have been carried out. Following the receipt of Ministry of Food Circular No. 20/51, relative to the question of the exclusion of Dogs from Food Shops, Restaurants, etc., 1 was instructed to obtain the appropriate Notices, and this has been done. 4.—HOUSING STATISTICS FOR THE YEAR 1951 TABLE 13 Number of Houses erected during the year:— (1) By Local Authority 141 (2) By Private Enterprise 54 (3) By L.C.C. at Harold Hill Estate 2,111 1. Inspection of Dwelling-Houses during the Year:— (l)(a) Total number of Dwelling-Houses inspected for Housing Defects (under the Public Health or Housing Acts) 1,333 (b) Number of inspections made for the purpose 3,875 (2) (a) Number of Dwelling-Houses (included under subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 Nil (b) Number of inspections made for the purpose Nil (3) Number of Dwelling-Houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 2 (4) Number of Dwelling-Houses (exclusive of those referred to under the preceding subhead) found not to be in all respects fit for human habitation 859 2. Remedy of Defects during the year without service of Formal Notices:— Number of Dwelling-Houses rendered fit in consequence of Informal action by the Local Authority or their Officers 675 3. Action under Statutory Powers during the year :— (a) Proceedings under Sections 9, 10, and 16 of the Housing Act, 1936— (1) Number of Dwelling-Houses in respect of which notices were served requiring repairs Nil 24 (2) Number of Dwelling-Houses which were rendered fit after service of Formal Notices:— (b) By Owners Nil (b) By Local Authority in default of owners Nil (b) Proceedings under the Public Health Acts— (1) Number of Dwelling-Houses in respect of which notices were served requiring defects to be remedied 123 (2) Number of Dwelling-Houses in which defects were remedied after service of Formal Notices:— (a) By Owners 51 (b) By Local Authority in default of owners Nil (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936:— (l)Number of Dwelling-Houses in respect of which Demolition Orders were made 4 (2)Number of Dwelling-Houses demolished in pursuance of Demolition Orders 3 (d) Proceedings under Section 12 of the Housing Act, 1936:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 1 (2)Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been made fit Nil 4. Housing Act, 1936, Part IV—Overcrowding:— (a) 1. Number of Dwellings overcrowded at end of year 157 2. Number of Families dwelling therein 289 3. Number of Persons dwelling therein 1,124 (b) Number of New Cases of Overcrowding reported during the year 18 (c) 1. Number of New Cases of Overcrowding relieved during the year Nil 2. Number of Persons concerned in such cases Nil (d) Particulars of any cases in which Dwelling-Houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil 25 5.—PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES (i) Notifiable Diseases. As in the past, I here make the comment that 1 have not recorded those notifications, where the diagnosis has been altered after a period of observation, or after investigation. Should, however, the amended diagnosis prove the condition to be one of another type of infection which is notifiable, then the case has been appropriately recorded. (a) Acute Anterior Poliomyelitis. Infantile Paralysis was, fortunately, not in epidemic form, so far as this district was concerned. Altogether, there were 6 cases. Three of these had paralysis of varying degree, and 3 were abortive. One patient, a woman, aged 29 years, unfortunately, died. Two days after coming to Romford on holiday, she complained of headache, and pains in the neck and shoulders. Next day she was removed to Rush Green Hospital, and had extensive paralysis, involving practically every muscle in the body. On making our investigions, we found that she had come from an area where 16 paralytic cases had occurred in a relatively short period of time, and it is a fair assumption that she arrived in Romford, whilst incubating the infection. (b) Acute Infective Hepatitis. This condition is still notifiable throughout the Eastern Region. Altogether, there were 26 notifications, and these were again forwarded to the Regional Medical Officer at Cambridge for his information, for research purposes. (c) Diphtheria. During 1951, no cases occurred in the district. This is the third year in succession in which I have been able to give this favourable report. The following statistics relate to the state of Immunisation at the 31st December, 1951. TABLE 14 Under 5 yrs. 5-15 yrs. Number of children who had completed a full course of Immunisation at any time up to 31st December, 1951, and who were born between 31st December, 1936, and 31st December, 1951 4,237 11,133 Percentage Immunised at 31st December, 1951 44 79 26 This, however, does not give a complete record, as children, as a general rule, do not complete inoculation earlier than their first birthday. By allowing for this, the percentage of children immunised between one and five years of age is raised to 58. Table 15 gives the statistics since the inauguration of the scheme in Romford in 1935, till the end of 1951. TABLE 15 Number of Immunising injections given at the Clinics 35,311 Number of children who have completed the course of Injections, either at the Clinics or by own doctors 19,100 Number of Schick Test Injections given at the Clinics, including Control Injections 22,825 Number who have been Schick Tested 11,432 (d) Dysentery. Eighteen cases were notified as belonging to Romford, and all were due to Shigella Sonnei. (e) Food Poisoning. During the year 29 cases were notified, which proved to be suffering from food poisoning. In addition, 133 notified cases were investigated, but were proved not to be suffering from this condition. The following table sets out the details as required by the Ministry of Health. TABLE 16 (a) Total number of Outbreaks 2 (b) Number of Cases 61 (c) Number of Deaths Nil (d) (i) Organisms or other Agent responsible Salmonella Typhi-Murium Unknown (ii) Outbreaks attributable to above 1 1 (e) (i) Foods involved Unknown (ii) Outbreaks attributable to above 2 One outbreak, which occurred in a school is summarised below : On the 10th January, the Headmaster of School A drew my attention to the absence of a number of children on that day, suffering from abdominal pain, sickness, and diarrhoea. I made 27 ate investigation, and found that, altogether, 24 children were absent, and about 35 children had returned to school, who had had symptoms overnight. In addition, 1 teacher, and 8 canteen workers had been affected, but had recovered, and were on duty. The symptoms, on an average, commenced about 6 to 8 hours after partaking of the mid-day meal on the 9th January. This meal was partaken of by 45 staff at School B, by 44 children, and 6 staff at another School C, by 222 children, and 19 staff at School A, and by 72 children and 7 staff at another portion of School A. All the cases, however, were derived from the main portion of School A, which suggested infection of one portion of the meal only. The meal was served direct from the containers, as delivered, and consisted of stew, peas and potatoes, jam tart and custard. As it is an instruction, in this area, that samples of all foods should be retained for 24 hours, I was able to obtain samples for analysis. Furthermore, bowel samples were obtained from some of the patients, and nose and throat samples from the canteen workers. All proved negative to organisms of the food poisoning group. Owing to the relatively short incubation period, the infection would appear to have been due to a preformed toxin, but the source remained unknown. Bacteriologically, with toxin infection, it is difficult to detect preformed toxin, and the organisms which cause the toxin cannot as a rule be isolated, as they are destroyed in the cooking process. Considering the relatively limited number affected in this outbreak, compared to those at risk, the surmise is that a temporary carrier infected a portion of the food only. There were no further cases after the 10th January. Arising out of the investigations, the question of the sterilisation of the food containers was considered, and whilst it was appreciated that the ideal would be steam sterilisation at all canteens, nevertheless, it was felt that the cost would be prohibitive, and it was decided that where possible the sterilising sinks should be used for containers, otherwise, detergents should be used, and boiling water. (f) Measles. Measles was again in epidemic form during the year. Altogether, 1,290 cases were notified, and there was 1 death reported. Most of the cases occurred in the first 5 months of the year. (g) Scarlet Fever. During the month of October, a small outbreak occurred at an Infants' School, involving 7 children—in each case the type was very mild. It was not possible to ascertain the source of the 28 fection, but it may be that the original case was infected by a healthy carrier inside, or outside, the school, or by contact with an abortive case. The other cases followed within the incubation period. Appropriate advice was given to the Headmistress, and the outbreak terminated. (h) Smallpox. No cases occurred in the district, but a few possible contacts were kept under surveillance for the required period. Table 17 gives the statistcs relative to Vaccination, as recorded by the General Practitioners of the district. TABLE 17 Vaccinated: Under 1 year of age 589 Between the ages of 1 and 2 years 84 Between the ages of 2 and 5 years 159 Between the ages of 5 and 15 years 232 Over 15 years 203 Re-Vaccinated: Under 1 year of age — Between the ages of 1 and 2 years — Between the ages of 2 and 5 years 11 Between the ages of 5 and 15 years 74 Over 15 years 422 (i) Tuberculosis. The increased number of notifications is, in the main, accounted for by immigrants to the Harold Hill Estate, in whose case priority has been given for rehousing. There is, however, no evidence of increased infectivity because of this. The work of the Medical Research Council into the value of the Anti-Tuberculosis Vaccine B.C.G., on which I commented in my last report, was continued during the year. The Research Council will also have to follow up those children who have already participated in the scheme, but who have left school. The Health Visitors are very willing to co-operate, and maintain the enthusiasm of the children, which may be no easy matter. 29 The final results of the Romford Survey, undertaken on December, 1950, and January, 1951, are given below, and I am indebted to Dr. H. Ramsay, the Medical Director of the Mass Radiography Unit for this information :— Total number of miniature films taken 3,435 Total number of large films taken 138 Active Pulmonary Tuberculosis found 2 Inactive Pulmonary Tuberculosis found 49 Conditions other than Pulmonary Tuberculosis found 21 (j) Whooping Cough. Altogether 520 cases were notified. No death occurred. The cases were fairly evenly dispersed throughout the year. (ii) Non-Notifiable. The prevalence of the non-notifiable diseases is set out below, and as the figures are compiled from the school returns only, they are probably an underestimate. TABLE 18 Chickenpox 434 Mumps 381 Rubella 19 6.—SUPPLEMENTARY (i) Section 47, National Assistance Act, 1948. It was not found necessary to take any action during the year under this Section of the National Assistance Act, 1948. By resolution of the Council, the Medical Officer of Health is now authorised to apply to the Court, under Section 47, in any case where it is considered necessary to secure the removal to hospital of any person, who is unable to look after himself. 30 TABLE 19. MONTHLY NOTIFICATIONS OF INFECTIOUS DISEASES Month Scarlet Fever Diphtheria Enteric Fever Puerperal Pyrexia Pneumonia Dysentery Erysipelas Malaria contracted abroad Measles Meningococcal Infection Ophthalmia Neonatorum Poliomyelitis Paralytic Poliomyelitis NonParalytic Whooping Cough Infective Hepatitis Food Poisoning Tuberculosis Total Resp. Non.Resp. January 10 — — 2 23 5 2 — 76 3 — 1 57 5 3 26 2 215 February 3 — — 2 12 6 2 — 213 2 — 1 — 40 1 1 19 3 305 March 3 — — - 3 19 2 — 374 — — - — 41 — - 15 5 462 April 6 — — 1 3 1 4 — 275 — - - 1 25 2 - 18 3 339 May 7 — — — 4 — — — 237 — — 1 — 37 2 2 24 3 317 June 7 — 1 — 6 — — — 44 1 — — — 55 1 7 18 3 143 July 6 — — — 2 4 1 — 12 1 — — — 67 3 5 17 2 120 August 9 — — 4 3 — - — 5 — — 2 1 76 5 3 23 2 133 September 6 — 2 — 3 - - 1 8 — - — 2 37 2 - 22 4 87 October 18 — - — 4 - 2 — 16 — — 1 — 25 2 2 18 1 89 November 15 - - - 1 1 - - 17 - - 1 1 24 2 2 24 2 90 December 10 - - 2 5 1 1 - 13 - - - - 36 1 4 17 - 90 Total 100 — 3 11 69 37 14 1 1,290 7 — 6 6 520 26 29 241 30 2,390 31 TABLE 20. DISEASES NOTIFIED DURING THE YEAR, DIVIDED INTO AGE GROUPS. Disease Under 1 1-2 2-3 3-4 4-5 5-10 10-15 15-20 20-35 35-45 45-65 Over 65 Total Scarlet Fever 1 2 1 13 18 55 6 1 1 2 — - 100 Diphtheria — — — — — — — - — — — — - Enteric Fever — — — — — 2 — — 1 — — — 3 Puerperal Pyrexia — — — — — — — 2 9 — — — 11 Pneumonia 7 12 6 3 2 7 2 1 5 4 10 10 69 Dysentery 4 4 5 1 1 7 1 2 7 1 2 2 37 Erysipelas — - - - — - - 1 — 1 7 5 14 Malaria contracted abroad — - — - — — — — 1 — — — 1 Measles 36 143 213 207 204 467 15 2 1 2 — — 1,290 Meningococcal Infection 2 — 1 2 — 2 — — - - — — 7 Ophthalmia Neonatorum — — — — — — — — — — — — — Poliomyelitis Paralytic — — 1 — — 1 — 1 3 — — — 6 Poliomyelitis Non-Paralytic — — 2 1 1 - 1 — 1 — — — 6 Whooping Cough 54 61 82 90 81 148 2 — 2 — — — 520 Infective Hepatitis — — — — 3 7 3 1 7 2 3 — 26 Food Poisoning — 2 — 5 1 4 2 — 4 5 6 — 29 Total 104 224 311 322 311 700 32 11 42 17 28 17 2,119 32 TABLE 21 DISEASES NOTIFIED DURING THE YEAR, DIVIDED INTO WARDS. Disease Collier Row & Havering Ward. Gidea Park & Noak Hill Ward. Hare Park Ward. Mawney Ward. South Ward. Town Ward. West Ward. Total. Scarlet Fever 25 35 6 7 20 3 4 100 Diphtheria — — — — — — — — Enteric Fever 1 1 1 - — — — 3 Puerperal Pyrexia 2 1 — 1 7 - — 11 Pneumonia 16 24 5 14 4 3 3 69 Dysentery 12 2 — 1 20 2 — 37 Erysipelas 4 2 1 4 - 2 1 14 Malaria contracted abroad — — — — - 1 — 1 Measles 275 505 148 79 111 113 59 1,290 Meningococcal Infection 3 1 — — 3 — — 7 Ophthalmia Neonatorum — — — — — — — — Poliomyelitis Paralytic 1 — 2 — 3 — — 6 Poliomyelitis Non-Paralytic — 3 — — 2 1 — 6 Whooping Cough 141 170 34 74 51 45 5 520 Infective Hepatitis 12 4 3 4 1 2 — 26 Food Poisoning 27 — — 1 — 1 — 29 Tuberculosis—Respiratory 17 159 13 19 17 6 10 241 Tuberculosis—Non-Respiratory 7 13 3 1 6 — - 30 Total 543 920 216 205 245 179 82 2,390 33 TABLE 22 NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING YEAR 1951, and HOSPITAL ADMISSIONS Disease Cases Notified. Cases Admitted to Hospital Total Deaths Scarlet Fever 100 14 — Diphtheria - — — Enteric Fever 3 1 — Puerperal Pyrexia 11 6 — Pneumonia 69 42 33 Dysentery 37 21 — Erysipelas 14 1 — Malaria contracted abroad 1 1 — Measles 1,290 45 1 Meningococcal Infection 7 3 1 Ophthalmia Neonatorum — — — Poliomyelitis Paralytic 6 6 1 Poliomyelitis Non-Paralytic 6 6 — Whooping Cough 520 23 — Infective Hepatitis 26 3 — Food Poisoning 29 1 — Total 2,119 173 36 34 TABLE 23. TUBERCULOSIS: NEW CASES AND MORTALITY DURING 1951 AGE PERIODS. NEW CASES. DEATHS. Respiratory. Non-Respiratory. Respiratory. Non-Respiratory. M. F. M. F. M. F. M. F. 0 — 2 — — - — — — 1 5 8 — 4 1 — - 1 5 11 8 2 5 — — — — 15 23 34 4 1 - 1 — — 25 46 41 2 6 4 2 — 1 35 19 16 1 2 3 3 1 — 45 13 4 1 — 5 — 1 — 55 8 — — 1 1 1 — — 65 and upwards 3 — 1 — 3 3 — — Total 128 113 11 19 17 10 2 2 35 TABLE 24. OPHTHALMIA NEONATORUM. CASES Vision Unimpaired Vision Impaired Total Blindness Deaths Notified. Treated At Home In Hospital Nil - - — - - — WILSON AND WHIT WORTH LTD., ROMFORD.