Journal Rebind Co. Ltd. Unit 4, Pier Wharf. Grays, Essex. Ac 4411CD BOROUGH OF ROMFORD ROM 29 HEALTH DEPARTMENT ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the year 1954 JAMES B. SAMSON, M.D.. D.P.H., Medical Officer of Health 67971 BOROUGH OF ROMFORD HEALTH DEPARTMENT ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the year 1954 JAMES B. SAMSON, M.D., D.P.H., Medical Officer of Health 3 BOROUGH OF ROMFORD MEMBERS OF THE COUNCIL (as at 31st December, 1954) His Worship the Mayor : Alderman A. McGonagle, J.P. Deputy Mayor : Alderman Mrs. L. A. Irons, J.P. Aldermen: Alderman C. H. Barney, A.S.A.A. Alderman G. Roberts, J.P. Alderman H. A. Beck Alderman L. S. Webb Alderman T. W. Bradley Alderman R. Yeal, M.B.E. Alderman S. V. Ellmore, J.P. Councillors : Councillor T. C. Bell Councillor P. F. Broadhead, D.S.C. Councillor S. C. Brown Councillor A. M. Cannon Councillor F. G. Carrick Councillor C. Charlton Councillor Mrs. M. Clark-Lewis Councillor E. T. Clough Councillor F. J. Coffin Councillor L. F. P. Eley Councillor F. A. Fisher Councillor W. S. Gardner Councillor W. J. Hawkins, B.A. (Com.) Councillor E. H. Jarvis Councillor A. C. Latham Councillor W. F. Long Councillor W. R. Pike Councillor D. Raper Councillor P. D. Ridley, M.A. (Cantab.) Councillor M. J. Riordan Councillor G. A. Roberts Councillor Mrs. O. M. J. Roberts, J.P. Councillor M. Sharp Councillor P. J. Smyth Councillor H. W. Talbot Councillor W. A. White Councillor F. W. Wright 4 BOROUGH OF ROMFORD PUBLIC. BUILDINGS AND HEALTH COMMITTEE His Worship the Mayor : Alderman A. McGonagle, J.P. (ex-officio member) Chairman : Councillor W. S. Gardner Vice-Chairman : Councillor W. R. Pike Alderman S. V. Ellmore, J.P. Councillor D. Raper Alderman L. S. Webb Councillor P. J. Smyth Councillor Mrs. M. Clark-Lewis Councillor F. W. Wright 5 HEALTH DEPARTMENT Public Health Department (As at 31st December, 1954) Medical Officer of Health J. B. Samson, M.D., Ch.B., D.P.H. Assistant Medical Officers (a) Mrs. F. M. E. Buchanan, B.A., M.B., B.Ch., B.A.O. (Commenced duties 26th July.) (b) J. J. Duffy, M.B., B.Ch., B.A.O., D.P.H. (c) R. C. Greenberg, M.B., B.S., C.P.H. (d) Mrs. E. M. Haga, M.B., B.S., L.R.C.P., D.P.H. Dental Officers (a) Miss M. L. Ell, L.D.S., R.C.S. (Eng.). (Commenced duties 1st June.) (b) Mrs. D. Shirlaw, L.D.S., R.C.S. (Edin.). (c) S. F. Mitchell, L.D.S. (Part-time). Sanitary Inspectors (a) H. C. Boswell (A.B.). (Senior Sanitary Inspector). (b) M. J. Dove (A.B.). (c) G. D. John (A.B.). (Commenced duties 1st October). (d) T. E. R. Jones (A.B.). (e) G. F. Hobson (A.B.). (f) W. Hodson (A.B.). A. Sanitary Inspector's Certificate of the Royal Sanitary Institute, and Sanitary Inspectors' Joint Examination Board. B. Certificate of the Royal Sanitary Institute for Inspectors of Meat and Other Foods. Shops Inspector S. F. Titterton, Dip. Shops' Acts Admin. (Commenced duties 15th February.) Health Visitors Superintendent: Miss F. K. Wells (A.B.D.). (a) Miss B. C. Blackley (A.B.D.E.G.). (b) Miss O. Clements (A.B.D.F.G.). (c) Miss P. F. Cullis (A.B.D.G.). (Commenced duties 1st ember). (d) Mrs. G. E. Engall (A.B.D.F.G.). (e) Mrs. E. M. H. Geary (A.C.D.G.). (f) Miss D. I. A. Hall (A.B.D.G.). 6 (g) Miss M. Hill (A.B.D.G.). (h) Miss F. Lambert (A.C.D.G.). (i) Mrs. P. O. McMillan (A.C.D.F.G.). (Commenced duties 22nd February). (j) Mrs. M. K. Pressey (A.B.D.G.). (Commenced duties 22nd November). (k) Mrs. L. Thompson (A.B.D.G.). (Commenced duties 8th November). (1) Miss A. M. Tidd (A.C.D.F.G.). (m) Mrs. G. Wallach (A.C.D.E.G.). Tuberculosis Visitor (a) Mrs. B. Alder (A.B.). (b) Miss D. N. Chilton (A.C.E.). Commenced duties 22nd March). Domiciliary Midwives (a) Miss I. A. Bassett (B). (b) Mrs. J. Dennis (A.B.). (c) Miss E. E. Jeenes (A.B.). (d) Miss C. M. Kerr (A.B.). (e) Miss M. Kitson (A.B.). (f) Miss F. L. Law (A.B.). (g) Mrs. M. Mylward (B.). (h) Mrs. E. A. Rooks (B). (i) Mrs. G. E. Sexton (A.B.). (j) Mrs. M. B. Woodhouse (A.B.). Home Nurse/Midwives (a) Mrs. E. D. Carrington (A.B.), Queen's Certificate of District Nursing. (Commenced duties 9th February.) (b) Miss D. D. K. Martin (A.B.). (c) Mrs. A. H. Menzies (A.B.). (d) Mrs. I. Mobbs (A.B.). Home Nurses (a) Mrs. E. M. Broome (A.). (b) Mrs. B. Casey (A.C.). (c) Mrs. C. Cook (A.). (d) Miss J. Macaulay (A.B.), Queen's Certificate of District Nursing. (e) Mrs. A. C. Silcock (A.B.). (f) Miss J. D. Silcock (A.B.). (g) Mrs. D. I. Towell (A.). (h) Mrs. S. A. Wotherspoon (A.). A. State Registered Nurse. B. State Certified Midwife. C. Part 1 S.C.M. D. Health Visitor's Certificate. E. Certificate of Tuberculosis Nursing. F. Registered Fever Nurse. G. Also holds the appointment of School Nurse. 7 Domestic Help Organiser Mrs. L. Canham. Day Nurseries—Matrons "St. Moritz" Mrs. I. C. Bowyer. Collier Row Mrs. D. Eveling. Rush Green Mrs. R. M. O'Halloran. Domiciliary Occupational Therapist Miss J. van der Lande. Dual Dip. Ass. of Occup. Theraps. (Parttime). (Commenced duties 3rd May). Dental Attendants (a) Mrs. P. D. Goodwin. (Part-time.) (b) Mrs. G. E. Taylor. (Commenced duties 19th June.) (c) Mrs. M. Warder. Clerical Assistants (a) E. W. Gowers, Chief Administrative Assistant. (b) C. G. Humberston, Senior Administrative Assistant. (c) S. J. Adams, Administrative Assistant. (d) W. Norris, Administrative Assistant. (e) Miss M. E. Firmin. (f) Mrs. B. Mather. (g) Mrs. M. Barnard. (h) Mrs. K. E. Blome. (i) Mrs. F. Butt. (Commenced duties 15th November.) (j) Mrs. D. E. Cast. (Commenced duties 14th January.) (k) Mrs. S. Corner. (i) Mrs. I. M. Gray. (m) Miss R. Harvey. (n) Mrs. M. E. Riley. (o) Miss J. V. Saggers. (p) Miss V. C. Warren. Harold Hill Health Centre Nursing Staff Miss S. Barlow, S.R.N. (Commenced duties 16th July.) Miss P. E. Cutts, S.R.N. (Commenced duties 16th July.) Clerical Assistants Miss M. O. Little. (Commenced duties 1st July.) Miss R. Markram. (Commenced duties 19th July.) Miss J. Harrison. (Commenced duties 16th July.) 8 BOROUGH OF ROMFORD To His Worship The Mayor, Aldermen, and Councillors of the Borough of Romford. Mr. Mayor, Ladies and Gentlemen, I have the honour, herewith, to present to you, this, my Annual Report on the Health of the District for the year 1954. This is the Twenty-first 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, and with Circular No. 28/54 of the Ministry of Health, dated 15th December, 1954. The position I hold is that of Medical Officer of Health for the Borough, and Area Medical Officer for the Romford Area of the Essex County Council. So far as this Report is concerned, it deals with my duties in both capacities. 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 for all the assistance they have rendered to me, in the compilation of this report, or in dealing with routine matters, and in the launching of new schemes. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, JAMES B. SAMSON, Medical Officer of Health. Public Health Department, Town Hall, Romford. May, 1955. 9 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the Year 1954 Statistics and Social Conditions of the Area Area (in acres) 9,342 Population: Census (1951), 88,002; Mid. 1954 (Estd.) 105,900 Number of Inhabited Houses (end of 1954) 29,282 Rateable Value (end of 1954) £774,444 Product of Penny Rate (end of 1954) £2,956 Extracts from Vital Statistics for the Year Total M. F. Live Births: Legitimate 1,857 984 873 illegitimate 73 30 43 Birth Rate: 153 per 1,000 of estimated resident population. Still Births: Legitimate 39 22 17 Illegitimate — — — Rate per 1,000 total (live and still births): 19 8. Deaths 682 359 323 Death Rate: 91 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 20.7 Legitimate Infants per 1,000 legitimate live births 21.0 Illegitimate Infants per 1,000 illegitimate live births 13.8 Deaths from Cancer (all ages) 145 Deaths from Measles (all ages) - Deaths from Whooping Cough (all ages) — Deaths from Diarrhoea (under 2 years of age) 1 10 TABLE 1 BIRTH-BATES, DEATH-RATES, ANALYSIS OF MORTALITY, England and Wales, London, 160 County Boroughs and MATERNAL MORTALITY, and CASE-RATES for certain Infectious Great Towns, and 160 Smaller Towns. Diseases in the year 1954. (Provisional Figures based on Weekly and Nuarterly Returns) RATE PER 1,000 POPULATION DEATH-RATE PER 1,000 POPULATION RATE PER 1,000 LIVE BIRTHS Live Births Still 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 England and Wales 15.2 0.36 11.3 0.00 0.00 0.00 0.18 0.05 0.00 0.00 0.48 0.8 25.5 160 County Boroughs and Great Towns, including London 16.8 0.44 12.1 0.00 0.00 0.00 0.20 0.04 0.00 0.00 0.50 0.9 29.2 160 Smaller Towns (Resident Populations 25,000 to 50,000 at 1951 Census) 15.4 0.36 11.3 0.00 0.00 0.00 0.17 0.05 0.00 0.01 0.49 0.5 23.8 London 17.7 0.35 11.7 0.00 0.00 0.00 0.19 0.02 0.00 0.00 0.49 0.4 22.1 ROMFORD 15.3 0.37 9.1 0.00 0.00 0.00 0.14 0.00 0.00 0.01 0.24 0.5 20.7 The Maternal Mortality Rate for England and Wales is as follows : Per 1,000 Total Live and Still Births — 0.69 The Maternal Mortality Rate for Romford is as follows : Per 1,000 Total Live and Still 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 15-24 25-34 35-44 45-54 55-64 65-74 75 & upwards 1. Tuberculosis, respiratory 10 5 15 .. .. .. .. 2 2 .. 5 3 1 2 2. Tuberculosis, other .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Syphilitic disease 1 .. 1 .. .. .. .. .. .. .. .. 1 .. .. 4. Diphtheria .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5. Whooping Cough .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6. Meningococcal infections 1 1 2 1 .. .. .. .. .. 1 .. .. .. .. 17. Acute poliomyelitis 1 .. 1 .. .. .. .. 1 .. .. .. .. .. .. 8. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. 9. Other infective and parasitic diseases 1 .. 1 .. .. .. .. .. .. .. 1 .. .. .. 10. Malignant neoplasm, stomach 10 7 17 .. .. .. .. .. 1 .. 4 5 5 5 1 2 11. Malignant neoplasm, lung, bronchus 25 6 31 .. .. .. .. .. .. 2 5 11 8 5 12. Malignant neoplasm, breast .. 21 21 .. .. .. .. .. .. 4 5 6 2 4 13. Malignant neoplasm, uterus .. 5 5 .. .. .. .. .. .. .. 1 1 2 1 14. Other malignant and lymphatic neoplasms 35 36 71 .. .. 1 1 2 1 4 7 20 20 15 15. Leukaemia, aleukaemia 4 3 7 .. .. .. 2 .. .. .. 1 1 .. 3 14. Diabetes 2 5 7 .. .. .. .. .. .. .. 1 .. 3 3 17. Vascular lesions of nervous system 34 49 83 .. .. .. .. .. 1 1 7 17 17 40 18. Coronary disease, angina 58 27 85 .. .. .. .. .. .. 2 12 17 29 25 19. Hypertension with heart disease 7 7 14 .. .. .. .. .. .. .. .. 4 4 6 20. Other heart disease 36 54 90 .. .. .. .. 1 .. 4 6 7 24 48 21. Other circulatory disease 10 15 25 .. .. .. .. 1 .. 1 .. 3 8 12 22. Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. 23. Pneumonia 15 10 25 4 3 .. 1 .. .. .. 1 6 3 7 24. Bronchitis 21 9 30 .. 1 .. .. .. .. .. 3 4 10 12 25. Other diseases of respiratory system 8 1 9 .. .. .. .. .. 1 1 2 4 1 .. 26. Ulcer of stomach and duodenum 6 .. 6 .. .. .. .. .. .. 1 .. 2 3 .. 27. Gastritis, enteritis, and diarrhoea 2 1 3 1 .. .. .. .. .. .. .. .. 1 1 28. Nephritis and nephrosis 8 3 11 .. .. .. 1 .. .. 1 2 2 2 3 29. Hyperplasia of prostrate 3 .. 3 .. .. .. .. .. .. .. .. .. .. 3 30. Pregnancy, childbirth, abortion .. .. .. .. .. .. .. .. .. .. .. .. .. .. 31. Congenital malformations 5 6 11 7 2 .. 1 .. .. 1 .. .. .. .. 32. Other defined and ill-defined diseases 32 40 72 26 .. 1 3 1 4 2 5 11 7 12 33. Motor vehicle accidents 8 2 10 .. 1 .. 3 2 .. .. .. .. 2 2 34 All other accidents 5 8 13 1 1 .. 1 1 .. 3 1 .. 1 4 35. Suicide 9 3 12 .. .. .. .. .. .. 1 4 4 2 1 36. Homicide and operations of war 1 .. 1 .. .. .. .. .. .. .. .. .. 1 .. Total 358 324 682 40 8 2 13 11 10 29 73 129 156 211 12 This year the Registrar-General has given his estimate of the midyear population of Romford as 105,900, which compares with 104,100 for last year, an increase of 1,800. During 1954, the total number of live births registered was 1930, and the total number of deaths registered was 682. The difference of 1,248 gives the natural increase in the population. As this number falls short of the Registrar-General's estimated increase of 1,800, it follows that the balance of 552 is made up of excess of Immigration over Emigration. For 1954, we estimate the Birth Rate to be 15.3 per 1,000 of the estimated resident population. This figure is obtained by multiplying the Crude Birth Rate of 18.2 by the Comparability Factor of 0.84. For last year, the Rate was 15.8. The Rate for England and Wales for 1954 is given at 15.2, and for the 160 County Boroughs and Great Towns with populations exceeding 50,000 at the 1951 Census, the Rate is 16.8. The Death Rate for Romford is estimated at 9.1 per 1,000 of the estimated resident population. This figure is obtained by multiplying the Crude Death Rate of 6.4 by the Comparability Factor of 1.42. For last year the Rate for 10.5. The comparable Rate for England and Wales, and for the 160 Great Towns, referred to above are 11.3 and 12.1 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. Other conditions, comparatively speaking, take a minor position. As there were no maternal deaths the Maternal Mortality Rate, which is the number of Maternal Deaths, due to conditions associated with pregnancy or confinement, per 1,000 total (live and still) births is 0.0. The corresponding Rate for England and Wales is 0. 69. The Infant Mortality Rate, or the Death Rate of Infants under 1 year of age per 1,000 live births is 20.7, a decrease of 10.9 and, incidentally, this is the second lowest recorded rate for the district. The corresponding figures for England and Wales, and the 160 Great Towns are 25.5 and 29.2 respectively. 13 1.—GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA (i) Staff The particulars are set out at the beginning of this report. The Assistant Medical Officers, Dental Staff, Nursing Staff, the Domestic Help Organiser, and also the majority of the Clerical Staff come under the jurisdiction of the Essex County Council, in their capacity as Local Health Authority. By reason of the establishment of the Health Centre at Harold Hill additions were made to the staff. (ii) Laboratory Facilities For the purpose of the Food and Drugs Act, Dr. J. H. Hamence, F.R.I.C., of the Analytical Laboratory at 20, Eastcheap, London, was appointed Public Analyst for the Borough. The other laboratory facilities are, as before, and meet requirements. (iii) Nursing in the Home (a) General Nursing. At the end of the year 8 Home Nurses, and 4 Home Nurse/Midvvives were serving in the area. These were employed in general domiciliary nursing, but, in addition, the Home Nurse/Midwives also combined this work with midwifery duties. Under the provision of Section 28 of the National Health Service Act, arrangements continued for the loan of sick-room equipment, for which no charge is made. Table 3 sets out the work of the Home Nursing section during the year. TABLE 3 (1) Number of Visits paid 23,561 (2) Number of Cases attended 1,483 (b) Domiciliary Mid wives. At the end of the year 10 Domiciliary Midwives were employed, and also the 4 Home Nurse/Midwives referred to above. The following gives a summary of the cases attended by the Domiciliary Midwives, as Midwives, and as Maternity Nurses. TABLE 4 As Midwives 893 As Maternity Nurses 84 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 7 (2) Others 95 14 (iv) Ante-natal, and Post-natal Clinics Five Ante-natal sessions have been held each week, and 3 Postnatal sessions are held per month. As, and when necessary, mothers have been referred to the Consultative Clinic at Oldchurch Hospital. During the year, 492 individual expectant mothers attended the ante-natal clinics. In all, 255 ante-natal sessions were held. The total number of attendances of the 492 ante-natal mothers, mentioned above, was 2,664, giving an average of 5 4 attendances per patient. The average number attending at each session was 10 4. Twenty-four post-natal sessions were held, and 244 attendances were recorded. The average number attending at each session was 101. (v) Child Welfare Clinics Twelve child welfare sessions have been held each week. Altogether, there were 601 sessions, and the following table gives a summary of the attendances. TABLE 6 Individual children attending 3,916 Children attending for the first time 1,381 Medical consultations 5,182 Attendances of children under one year of age 16,638 Attendances of children between the ages of one and five years 6,263 Average attendances per session 38.1 (vi) Health Visitors At the end of the year there were 13 Health Visitors on the staff. Table 7 relates to Home Visits paid by the Health Visitors during the year. TABLE 7 (a) To Expectant Mothers:— First visits 205 Total visits 241 (b) To Children under one year of age: — First visits 2,114 Total visits 7,750 (c) To Children between the ages of one and five years: — Total visits 12,098 (vii) The Care of Premature Infants The same facilities exist, and have proved satisfactory. (viii) Inspection of Nursing Homes The number of Nursing Homes remains the same, viz., four. These were inspected quarterly, on behalf of the County Council and, on each occasion, were found to be satisfactory. 15 (ix) Domestic Helps. The service of domestic helps has continued to meet the needs of the area. During the year 147 part-time and casual helps were employed, and these gave assistance in 639 individual cases. Tuberculous patients have been helped by those who volunteer for this service. These latter have a special medical examination, prior to taking up duties, and they receive detailed instructions on precautionary measures. (x) Day Nurseries The average daily attendance for the year at each Nursery was as follows: — TABLE 8 "St. Moritz" Nursery 32 Collier Row Nursery 21 Rush Green Nursery 16 The "St. Moritz" Nursery and the Collier Row Nursery are scheduled to take 40 children each, and the Rush Green Nursery 50. (xi) Dental Service During the year, we were able to acquire the services of another full-time Dental Officer, and Dental Attendant. Although appointed primarily for duties in connection with the School Health Service, nevertheless, one session per week is devoted to expectant and nursing mothers, and children under school age. The following gives particulars of the service:— TABLE 9 (a) Numbers provided with Dental care: — Examined Needing Treatment Treated Made Dentally Fit Expectant and Nursing Mothers 65 64 56 21 Children under Five 223 205 173 120 (b) Forms of Dental Treatment provided:— Extractions Anaesthetics Fillings. Scalings or Scalings and Gum Treatment Silver Nitrate Treatment Dressings Radiographs Dentures provided Local General Complete Partial Expectant and Nursing Mothers 52 22 16 155 28 3 40 - - - Children under five 130 5 95 182 - 77 80 - - - (xii) Welfare Foods When the local Food Office closed at the end of June, the Ministry of Health transferred the responsibility for the distribution of Welfare Foods to the Local Health Authorities, and arrangements were accordingly made in the district for the continuance of this service. This 16 necessitated the provision of extra storage accommodation, and arrangements for redistribution. This service is progressing satisfactorily. (xiii) Harold Hill Health Centre The building of this Health Centre was completed at the beginning of July, and commenced to function about the middle of that month. This Health Centre, the first of its type in Essex, and, indeed, amongst the first few in the Country, consists of two sections, one for the use of the Local Authority for Health Services purposes, and one for the use of General Medical and Dental services. The first of the sections mentioned above has accommodation for Ante-natal and Child Welfare work, and a Minor Ailments Room for work in connection with the School Health Service. Facilities are also available for School Dentistry, Physiotherapy, Ophthalmic examinations, and Speech therapy. The other section has four consultation rooms for the use of nine General Practitioners, who occupy these according to a pre-arranged scheme. There is also a room for minor operations, and upstairs a surgery for general Dentistry. The remainder of the building is given up to Waiting Rooms, Staff Rooms, Office accommodation, Food Storage, and Caretaker's Flat. The section devoted to the General Practitioners is rented by them, and this includes furniture, and equipment, also the services of Nurses and Secretarial Staff. Although each of the two sections mentioned above functions in its own way, the two services, preventive and curative have an admirable opportunity of intermingling, and it is hoped thereby that this will strengthen the link, and provide something of great advantage to the ultimate benefit of the public. 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 1954, other than for the supply to permanent housing sites. (b) Lengths of mains laid, in yards: — 3" 4" 6" L.C.C. Harold Hill Estate ... 61 — 159 Romford Area 1,230 3,091 555 Total 1,291 3,091 714 (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 17 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 various parts of the Company's district all proved to be satisfactory. A total of over 3,800 Chemical, Bacteriological, and Biological examinations have been made. (e) The waters are not liable to plumbo-solvent action. (f) No contamination has arisen, therefore no action has been necessary." In addition to the analyses carried out by the Waterworks Company, samples have also been taken from consumers' taps by the Sanitary Inspectors and sent for Bacteriological analyses once per month, and Chemical analyses one per six months, and the results have confirmed the findings of the Company. (ii) Sanitary Inspection of the Area The Senior Sanitary Inspector has given me the undermentioned report, as required by Article 27 (18) of the Sanitary Officers' (Outside London) Regulations, 1935, and also the particulars which follow: — During the year, 1,624 complaints were received, and investigated. TABLE 10 Nature and Number of Inspections During the Year Accumulations and Refuse Deposits 47 Bakehouses 24 Butchers' Shops and Stalls, etc. 169 Cesspools 119 Common Lodging Houses 20 Cowsheds, Dairies and Milkshops 78 Drains, relaid or altered 131 Drainage—obstructed or defective 791 Drains Tested 94 Disinfections and disinfestationsi 20 Dustbins 91 Establishments for Massage and Special treatment 17 Factories Act (Mechanical Power) 137 Factories Act (Non-mechanical) 68 Factories Act (Outworkers Premises) 205 Food Preparing Premises 353 Food Hawkers 47 Food Inspection 418 Food Sampling—Formal 81 Food Sampling—Informal 156 Food Shops 188 Housing Acts 2,336 Ice Cream 192 Heating Appliances (Fireguards) Act 1952 52 Infectious Disease 1,218 Insects and Pests 10 Keeping of Animate 14 18 Milk Sampling 152 Miscellaneous 103 Markets 140 Nuisances, Public Health Act 1,867 Old Metal Dealers 24 Pet Animals Act 1951 21 Piggeries 33 Prevention of Damage by Pests Act 1949 2,841 Public Baths 15 Public Conveniences 50 Rag Flock Act 8 Sale of Horseflesh 14 Schools 20 Shops Act 2,495 Slaughterhouses 712 Smoke Observations 28 Streams and Ponds 79 Tents, vans and sheds 161 Verminous premises 61 Water closets 14 Water Supplies 31 Informal Notices (number served) 870 Statutory Notices (number served) 129 As a result of the service of Notices, the necessary works were completed by the owners or occupiers in all cases except 91, the worksi for which were still in hand at the end of the year. (iii) Factories Act, 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 Section 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 14 68 10 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 246 137 4 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding OutWorkers premises) 41 53 1 - Total 301 258 15 — 19 2. Cases in which Defects were Found Particulars m 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 Cleanli- linessi 2 2 - - - Overcrowding - - - - - Unreasonable Temperature - - - - - Inadequate Ventilation 1 1 - - - Ineffect. drain, of floors Sanitary — — — — — ences— (a) Insufficient 2 2 - - - (b) Unsuitable or defective 10 10 - 1 - (c) Not separate for Sexes - - - - - Other Offences — — — — — Total 15 15 — 1 — 3. Outwork. e of Work No. of OutWorkers in August List 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. 38 - - - - - Box Making 14 l l - — — Total 52 l l — — — During the year 205 inspections were made of Outworkers' premises. iv) Caravan Sites. There are 6 licensed caravan sites, one of which is controlled by lie Council. Altogether, there are 231 caravans on thozie sites. The sites are naintained in a satisfactory condition. (v) Prevention of Damage by Pests Act, 1949. During the year the Sanitary Inspectors and Rodent Operative irried out 2,841 inspections, or re-inspections to premises infested by its and mice. Further maintenance treatment, in respect of rat disinfestation to wers was undertaken on two occasions, and a total of 302 manholes ere treated. 20 (vi) Infestation. The facilities for disinfestation, and the destruction, when necessary, of clothing and bedding remain as before. (vii) Pet Animals Act, 1951. Fourteen persons are licensed to keep Pet Shops. Frequent inspections continue to be carried out. 3.—INSPECTION AND SUPERVISION OF FOOD (i) Milk Supply. At the end of the year, 45 persons were registered as Retailers or Distributors. Of these 13 were licensed to retail Tuberculin-Tested Milk, 18 were licensed to retail Pasteurised Milk, and 40 were licensed to retail Sterilised Milk. Two of the Retailers have their own Pasteurising plants, which are kept under the supervision of the department. During the year, 152 samples of milk were taken, and only 2 failed to pass the prescribed test. (ii) Ice Cream. All Traders and Manufacturers have to be registered. There were at the end of the year 4 manufacturers, and 199 vendors on the register. During the year, 79 samples were taken for Bacteriological examination. Only 2 proved unsatisfactory. Twenty-five samples of ice-lollies were taken, and only 1 proved unsatisfactory. (iii) Meat. At the end of July the Ministry of Food de-requisitioned the Regional Slaughterhouse in Oldchurch Road. There are now 3 licensed slaughterhouses in the Borough, and one of them is also licensed for the slaughter of horses. Altogether, 26,923 animals were slaughtered for human consumption. In addition, 157 horses were slaughtered for human consumption. The Sanitary Inspectors have again paid the usual visits to Slaughterhouses, Meat Depots, Butchers' Shops, Stalls, etc. Table 12 sets out the particulars of the carcases inspected, and condemned. to h-« TABLE 12 CARCASES INSPECTED AND CONDEMNED 1954 Cattle except Cows Cows Calves Sheep and Lambs Pigs Horses TOTAL Number killed (if known) 3,170 1,310 1,233 12,455 8,755 157 27,080 Number inspected 3,170 1,310 1,233 12,455 8,755 157 27,080 All diseases except Tuberculosis. Whole carcases condemned 7 7 15 6 15 9 59 Carcases of which some part or organ was condemned 870 543 3 952 1,309 2 3,679 Percentage of the number inspected affected with diseases other than tuberculosis 27% 42% 1.5% 7% 15% 7% 13.8% Tuberculosis only. Whole carases condenmed 12 10 1 — o — 25 Carcases of which some part or organ was condemned 165 310 1 — 134 — 610 Percentage of the number inspected affected with tuberculosis 1.5% 24% .16% — 1.5% — 2.3% 22 (iv) Food Products in General. In addition to the premises used for Milk, Ice Cream, and Meat, referred to above, the following food premises are registered under the Romford Urban District Council Act, 1931, and are subject to the Clean Food Byelaws. Bakers 32 Cafesi 60 Confectioners 61 Fishmongers 30 Greengrocers 45 Grocers 116 Miscellaneous 11 Hawkers 29 There are also 45 food stalls situated in the Market Place on three days of the week. All the above are subject to regular inspections. During the year, 873 such inspections were made. The majority of the food shops now have constant hot water provided. (v) Unsound Food. During the year, 418 visits were made to food premises, mainly on request, for the purpose of dealing with unsound food, and a total quantity of 6 tons, 13 cwts. 76 lbs. of food was surrendered as unfit for human consumption. Where possible all unsound food is disposed of for animal feeding; if this is not possible it is dealt with by the Cleansing Department. (vi) The Food and Drugs Acts. 1938-1954 The Romford Borough Council became its own " Food and Drugs " Authority on 1st April. Since the 1st April 179 samples were submitted for analysis, comprising 46 Formal and 133 Informal samples. Table 13 sets out the types of food examined. Of the 46 formal samples taken, 7 proved to be not genuine and the Council authorised legal proceedings to be taken against the vendors. One sample of sausages taken formally was found to be slightly deficient in meat content, but the deficiency was not sufficient to warrant prosecution. Of the informal samples taken the following articles were reported upon adversely:— A sample of dried milk taken on request from an ice cream manufacturer was found to have a very high acid content and on being informed of the analyst's findings, the manufacturer surrendered the remainder of the consignment, 192 lbs., which was disposed of for animal feeding. One ice lolly was found to contain an excess of lead, which was introduced from the soldered joints of the moulds. This has been remedied. Two samples of sausages were found to contain preservatives which were not declared at the time of purchase. As the amount of preservative came within the prescribed standard, the matter of failing to indicate that the sausages contained preservatives was taken up with the vendors, and a satisfactory explanation was given. Two samples of "buttered" sweets were reported as not being genuine, in that they did not contain at least 4% butter. Upon 23 investigation, it was found that the manufacturers had been warned by another Authority and they had altered the labels on the sweet containers so asi to read " Butter Flavoured " in order to comply with the Regulations. LEGAL PROCEEDINGS The following cases under the Food and Drugs Act were taken before the Magistrates Court during the year. Offence Section Result (1) Sausage containing piece of metal 9 Fined £2 (2) Selling "buttered" rolls containing not butter but margarine 3 Fined £2 plus £2.2.0 cost. (3) Selling "buttered" bread the fat consisting of a mixture of butter and margarine 3 Fined £2 plus £2.2.0 cost. (4) Selling "buttered" bread the fat consisting of a mixture of butter and margarine 3 Fined £2 plus £2.2.0 cost. (5) Selling "buttered" milk rolls the fat being not butter but margarine 3 Fined £2 plus £2.2.0 cost. (6) Selling " buttered ' scones the fat consisting of a mixture of butter and margarine 3 Fined £2 plus £2.2.0 cost. (7) Selling "buttered" buns the fat being not butter but margarine 3 Fined £2 plus £2.2.0 cost. Cases taken under the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950 Offence Section Result (1) Using a special designation without being the holder of a licence 13 (2) Case dismissed. (2) Adding water to milk 9 (a) Fined £5 plus £2.2.0 cost. The defendant in this case lodged an appeal to the County Quarter Sessions. 24 TABLE 13 SUMMARY OF SAMPLES TAKEN FOR ANALYSIS DURING THE YEAR 1954 Article Number examined Result of Analysis Formal Informal Total Genuine Not Genuine Almond Essence - 1 1 1 - Almonds (ground) - 1 1 1 — Butter — 4 4 4 — Buttered Confectionery 3 4 7 5 2 Buttered Rolls & Bread 7 — 7 1 6 Cake Mixtures — 2 2 2 — Chicklettes — 1 1 1 — Chocolate (drinking) — 1 1 1 — Christmas Pudding - 1 1 1 — Cochineal — 1 1 1 — Cocoa — 1 1 1 — Coffee — 1 1 1 — Coffee & Chicory Essence — 2 2 2 — Cooking Fat — 1 1 1 — Cordials — 1 1 1 — Corn Flour — 1 1 1 — Currants — 1 1 1 — Curry Powder — 1 1 1 — Custard Powder — 2 2 2 — Dripping (Beef) — 1 1 1 — Fat Emulsifier — 1 1 1 — Fish Cakes — 2 2 2 — Fruit Juice — 2 2 2 — Fruit Pectin — 1 1 1 — Ginger (ground) — 2 2 2 — Horseradish Sauce — 1 1 1 — Ice Cream 3 — 3 3 — Ice Lollies — 9 9 8 1 Ice Lolly Bags — 1 1 1 — Jams — 2 2 2 — Jellies — 2 2 2 — Lard — 1 1 1 — Lobster Paste — 1 1 1 — Luncheon Meat — 1 1 1 — Margarine — 7 7 7 — Meat Paste — 2 2 2 — Milk 15 1 16 15 1 Milk Powder — 1 1 — 1 Mint — 1 1 1 — Mustard — 1 1 1 — Nutmeg (ground) — 1 1 1 — Oranges 3 — 3 3 — Pepper — 3 3 3 — Pudding Mixture — 1 1 1 — Raisins — 2 2 2 — Rennet Essence — 1 1 1 — Rum 4 — 4 4 — Salad Cream — 1 1 1 — Sauces — 3 3 3 — Sausages (beef) 7 23 30 28 2 Sausages (pork) 1 17 18 17 1 Self Raising Flour — 2 2 2 — Soup Powder — 1 1 1 — Soups (prepared) — 3 3 3 — Stewed Steak — 1 1 1 — Suet, Shredded & Flaked — 2 2 2 — Tapioca — 1 1 1 — Tea Cakes — 1 1 1 — Tomato Ketchup — 2 2 2 — Vinegar — 1 1 1 — Whiskey 3 — 3 3 — Totals 46 133 179 165 14 25 (vii) Shops Act, 1950. (a) In February of this year the Council appointed a full-time Shops Inspector to work under the supervision of the Senior Sanitary Inspector. Up to date 558 shops have been inspected, and recorded on the Register. Altogether, 2,495 inspections and observations have been made for various purposes under the Act. During these inspections the following contraventions were noted: — Failure to exhibit prescribed Notices 844 Failure to keep records 115 Conditions of employment 95 Sanitary accommodation 73 Washing facilities 10 Other matters 22 In order to draw the attention of the occupiers to these contraventions 311 informal notices were served, and 203 verbal cautions were given, as a result, the majority of the contraventions were rectified by the end of the year, and others were receiving attention. (b) Exemption Certificates. On being satisfied that alternative arrangements were reasonably available and satisfactory, the Council have issued three Certificates, under Section 38 (6) of the Act, exempting the occupiers of certain shops from providing additional sanitary accommodation and washing facilities. (c) Orders—Early Closing. (i) At the request of the majority of Hairdressers within the district the Romford, Hornchurch and Upminster (Hairdressers) Order 1923 was revoked, as far as it applied to Romford, and the local hairdressers may now select their own early closing day. (ii) On being satisfied that the majority of the Motor Traders in the district requested an exemption, the Council made an Order under Section 1 (4) of the Act exempting: the sale of Motors and Motor Cycles from the provisions of Section 1 of the Act relating to early closing days. (d) Legal Proceedings. The Council authorised the following cases to be taken before the Magistrates' Court in respect of contraventions under the Shops Act, 1950. Offence Section Result (1) Sunday Trading 47 Fined £1 (2) Sunday Trading 47 Fined £1 (3) Sunday Trading 47 Absolute Discharge on payment of 4/- costs. (4) Failing to give assistant half-holiday 17 Fined £1 (5) Failing to give assistant half-holiday 17 Fined £1 (6) Failing to keep records of Sunday employment 22 (3) Fined £2 (7) Failing to keep records of hours worked by Young Persons 32 (1) Fined £2 (8) Failing to allow a Young Person proper intervals of rest 31 Fined £1 26 4.—HOUSING STATISTICS FOR THE YEAR, 1954. TABLE 14 Number of houses erected during the year:— (1) By Local Authority 309 (2) By Private Enterprise 560 1. Inspection of Dwelling Houses during the Year. (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts 3,255 (b) Number of inspections made for the purpose 5,584 (2) (a) Number of dwelling houses (included under head (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 dangerousi or injurious to health as to be unfit for human habitation 219 (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects fit for human habitation 870 2. Remedy of Defects during the Year without service of Formal Notices Number of dwelling houses rendered fit in consequence quence of Informal action by the local authority or their officers 779 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 3 (2) Number of dwelling houses which were rendered fit after service of Formal Notices:— (a) By owners 2 (b) By local authority in default of owners 1 (b) Proceedings under the Public Health Acts:— (1) Number of dwelling houses in respect of which Notices were served requiring defects to be remedied 125 (2) Number of dwelling houses in which defects were remedied after service of Formal Notices:— (a) By owners 92 (b) By local authority in default of owners 28 27 (c) Proceedings under Section 11 and 13 of the Housing Act, 1936: (1) Number of dwelling houses in respect of which demolition orders were made 3 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 5 (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 Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been made fit 1 4. Housing Act, 1936. Part IV—Overcrowding (a) (1) Number of dwellings overcrowded at end of year 73 (2) Number of families dwelling therein 142 (3) Number of persons dwelling therein 565 (b) Number of new cases of Overcrowding reported during the year 18 (c) (1) Number of new cases of overcrowding relieved during the year 7 (2) Number of persons concerned in such cases 26 (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 5. PREVALENCE OF AND CONTROL OVER. INFECTIOUS AND OTHER DISEASES (i) Notifiable Diseases As in the past, I have not recorded those notifications, where, after lvestigation, or further observation, the diagnosis has been changed, ^here, however, the altered diagnosis has proved to be another type of otifiable infection, this has been appropriately recorded. The necessary mendments have been forwarded at the end of each quarter to the egistrar-General, in accordance with instructions. (a) Acute Anterior Poliomyelitis This year has been a quiet one, so far as Poliomyelitis has been conerned. Why this has been so, we do not know. It has been suggested hat the low incidence throughout the Country generally may have been ue to the lack of real " Summer weather," but I feel that this is not the hole explanation, as very severe spidemics have occurred in America, ven during the Winter. We can at present but be thankful that we have een so free this year. There were in all only 3 patients. Of these, 1 had paralysis of the "spiratory system and, unfortunately, died. The other 2 were nonparalytic. 28 (b) Acute Infective Hepatitis. This condition is still a notifiable one throughout the Eastern Region. Altogether, 62 notifications were received. (c) Diphtheria. Once more, there were no cases of Diphtheria during the year. The following statistics relate to the state of Immunisation at the 31st December, 1954. In addition to the initial series of injections', " booster " doses have also been given. TABLE 15 Under 5 years 5-15 years Number of children who had completed a full course of Immunisation at any time up to 31st December, 1954, and who were born between 31st December, 1939, and 31st December, 1954 7,506 12,327 (d) Dysentery. One hundred and twenty-one cases of Dysentery were notified. One hundred and one were due to Shigella Sonnei, and 20 were unclasified. (e) Food Poisoning. During the year 7 cases were notified, which proved to be suffering from food poisoning. In additaion another 47 proved indefinite. The following table sets out the details, as required by the Ministry of Health. TABLE 16 (a) Total Number of Outbreaks Nil (b) Total Number of Cases included in (a) — (c) Number of Single Cases 54 (d) Number of Deaths Nil (e) (l) Organisms responsible Salmonella Typi-Murium Unknown (ii) Outbreaks attributable to (i) Nil Nil (iii) Single cases attributable to i (i) 7 47 (f) (i) Foods involved Unknown (ii) Outbreaks attributable to (i) Nil (iii) Single cases attributable to (i) 54 (f) Measles. After the large epidemic of last year, there were comparatively few cases in 1954, only 206 being notified. For the most part these occurred in December. (g) Scarlet Fever. The notifications numbered 156, and the type was again mild. (h) Smallpox. Two passengers, who had arrived by air from abroad, were kept under surveillance for the requisite period, as there were several cases of Smallpox in the area where they had embarked. 29 Table 17 gives the statistics relative to Vaccination, as recorded by the General Practitioners. TABLE 17 Vaccinated: Under 6 months 236 Between the ages of 6 months and 1 year of age 167 Between the ages of 1 and 2 years 53 Between the ages of 2 and 5 years 39 Between the ages of 5 and 15 years 59 Over 15 years 81 Re-Vaccinated: Under 1 year of age — Between the ages of 1 and 2 years — Between the ages of 2 and 5 years 10 Between the ages of 5 and 15 years 49 Over 15 years 111 (i) Tuberculosis. During the year it was considered advisable to reduce the Establishment of Health Visitors by the equivalent of one, and, in lieu to appoint one whole-time Tuberculosis Visitor for duties on the Harold Hill Estate. For the remainder of Romford we have the equivalent of 13 Tuberculosis Visitors. The final results of the Romford Survey by Mass Radiography taken in 1953 are shown below:— Total number of miniature films taken 4332 Total number of large films taken 360 Active Pulmonary Tuberculosis found 8 Inactive Pulmonary Tuberculosis found 107 Conditions other than Pulmonary Tuberculosis found 54 During the latter part of the year, a scheme was initiated by the ssex County Council, whereby B.C.G. Vaccination was offered, with 1 irental consent, to children at the age of 13 years, with the object of ving some protection against Tuberculosis before leaving school, and bi fore entering the age period 15—25 years, which has the highest sceptibility to contraction of this infection. The selection of children this age has the further advantage that an opportunity is provided for i Dservation, before the children leave school. It is known that a slight infection with the germ of Tuberculosis does r t always cause the disease, and that in the majority of cases no signs 0 symptoms are experienced. Following this infection, however, a eater resistance to any subsequent attack of the disease is developed. 3 any people have, without knowing it, already had this infection, and 1 .ve so developed a natural resistance, but some have not. It is possible t distinguish between those who have, and those who have not, by a s nple skin test. For those who have not had the infection, it is possible t induce a similar kind of resistance by the injection of the vaccine, I C.G. This vaccine is not harmful to health, and local reactions which f. llow its use are seldom severe. 30 Regarding notifications, it is interesting to note that the new cases of Respiratory Tuberculosis have diminished by 13, and the Deaths are fewer by 9. After considerable delay, we have at last been able to obtain the services of an Occupational Therapist, whom we share with the Ilford Area. It was felt that many cases of Tuberculosis cofined to their homes tend to become introspective, morbid, and depressed, and, therefore, great benefit would accrue both mentally and physically, if they were engaged in useful work. Hence, the appointment. Equipment and materials are provided, the latter being paid for by the patients, but the patients are at liberty to sell the articles which they make, and retain the proceeds. (j) Whooping Cough. Altogether, 101 cases were notified. For the most part, they occurred in the earlier part of the year. Throughout the year, 1,900 children received immunisation injections. (ii) Non-Notifiable Very few infectious diseases now come under this heading. The prevalence of these is set out below, and the figures are compiled from the school returns. It will be appreciated, however, that being nonnotifiable the number of cases occurring amongst those who are either under or above school age is unknown, and we can only judge from those of school age whether an epidemic exists. TABLE 18 Chickenpox 915 Mumps 658 6.— SUPPLEMENTARY. (i) Section 47, National Assistance Act, 1948. It was not found necessary to take any action under this Section of the National Assistance Act. Several investigations were made, when it was found possible, by other means, to get a satisfactory solution. 31 TABLE 19 MONTHLY NOTIFICATIONS OF INFECTIOUS DISEASES Month Scarlet Fever Diphtheria Paratyphoid Fever Puerperal Pyrexia Pneumonia Dysentery | Erysipelas Measles Meningococcal Infection Ophthalmia Neonatorum Poliomyelitis Paralytic Poliomyelitis NonParalytic Whoopng Cough Infective Hepatitis Food Poisoning Tuberculosis Total Resp. NonResp. January 12 — — 15 2 2 I 2 — — — — 5 7 7 6 I 60 February 8 — — 2 5 45 I - - - - - - 10 8 3 — 82 March 25 — — 2 9 46 2 1 — — — — 1 6 4 7 I 104 April 13 — — 1 3 12 2 2 I — I I 14 5 4 9 — 68 May 17 — I 1 3 6 2 - - - - - 12 2 4 11 I 60 June 11 — — 2 5 3 1 3 I — — — 25 6 4 7 — 68 July 21 — — 1 1 5 — 1 — — — — 12 8 4 7 — 60 August 6 — — — — 2 1 8 — — — — 11 5 5 3 — 41 September 8 — — 1 1 — — 8 — — — — 7 5 6 4 — 40 October 13 — — 1 4 — — 6 — I — — 9 2 1 1 — 38 November 10 — — — 5 — — 59 — — — — 5 3 3 3 2 90 December 12 — — — 14 — 3 116 — — — I — 3 4 7 4 164 Total 156 — I 26 52 121 13 206 2 I I 2 101 62 54 68 9 875 32 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 3 7 15 16 99 10 2 2 1 — — 156 Diphtheria .. .. .. .. .. .. .. .. .. .. .. .. .. Paratyphoid Fever .. .. .. .. .. .. .. .. 1 .. .. .. 1 Puerperal Pyrexia .. .. .. .. .. .. .. 2 21 3 .. .. 26 Pneumonia 2 5 2 4 2 11 3 2 6 4 8 3 52 Dysentery 6 8 17 10 4 42 13 1 13 5 2 .. 121 Erysipelas .. .. .. 1 .. .. .. .. 3 3 3 3 13 Measles 5 33 22 18 14 111 1 .. 2 .. .. .. 206 Meningococcal Infection 1 1 .. .. .. .. .. .. .. .. .. .. 2 Ophthalmia Neonatorum 1 .. .. .. .. .. .. .. .. .. .. .. 1 Poliomyelitis Paralytic .. .. .. .. .. .. .. .. 1 .. .. .. 1 Poliomyelitis Non-Paralytic 1 .. .. .. .. .. .. .. 1 .. .. .. 2 Whooping Cough 7 10 14 17 19 31 .. 1 1 .. 1 .. 101 Infective Hepatitis .. .. .. 1 1 32 12 6 6 2 2 .. 62 Food Poisoning 3 3 4 3 3 13 5 3 9 7 1 .. 54 Total 27 63 66 69 59 339 44 17 66 25 17 6 798 OS OS TABLE 21. NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING YEAR 1954, and HOSPITAL ADMISSIONS Disease Cases Notified Cases Admitted to Hospital Total Dsaths Scarlet Fever 156 9 — Diphtheria — — — Paratyphoid Fever 1 1 — Puerperal Pyrexia 26 4 — Pneumonia 52 41 25 Dysentery 121 3 — Erysipelas 13 1 — Measles 206 5 — Meningococcal Infection 2 2 2 Ophthalmia Neonatorum 1 — — Poliomyelitis Paralytic 1 1 1 Poliomyelitis Non-Paralvtic 2 2 — Whooping Cough 101 14 — Infective Hepatitis 62 3 — Food Poisoning 54 5 — Total 798 91 28 TABLE 22 TUBERCULOSIS : NEW CASES AND MORTALITY DURING 1954 AGE PERIODS NEW CASES DEATHS Respiratory Non-Respiratory Respiratory Non- Respiratory 0 M. F. M. F. M. F. M. F. ~~ ~ ~ 1 4 5 — 1 — — — — 5 4 1 2 1 — — — — 15 11 7 1 1 — 2 — — 25 9 11 — 2 — 2 — — 35 5 2 — — — — — — 45 2 1 — — 5 — — — 55 4 — 1 — 3 — — — 65 and upwards 1 1 — — 2 1 — — Total 40 28 4 5 10 5 — — 32