AC 4411 (1) 2. litrary BOROUGH OF ROMFORD ROM 32 Ersea HEALTH DEPARTMENT ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the year 1937 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 1957 JAMES B. SAMSON, M.D., D.P.H., Medical Officer of Health 3 BOROUGH OF ROMFORD MEMBERS OF THE COUNCIL (As at 31st December, 1957) His Worship the Mayor: Councillor W. S. Gardner, J.P. Deputy Mayor: Alderman W. R. Pike Aldermen: Alderman F. C. Bell Alderman P. D. Ridley, Alderman T. W. Bradley M. A., (Cantab.) Alderman Mrs. L. A. Irons, Alderman G. Roberts, J.P. J.P., C.C. Alderman Mrs. O. M. J. Roberts, J. P. Alder an A. McGonagle Councillors: Councilor H. A. Beck Councillor E. H. Jarvis Councilor Mrs. O. N. Boultwood Councillor A. C. Latham Councilor P. F. Broadhead, D.S.C. Councillor R. Lowley Councilor F G Carrick Councillor M. Monk Coun or E. F. Castle, B.Com.A.S.A.A., C.C. Councillor J. Raeburn Councilor Mrs. M. Clark-Lewis Councillor D. Raper Councilor E. T. Clough Councillor V. Rowlands, Councilor G. W. Dockrill A.M.I.E.E. Councilor L. F. P. Eley Councillor W. G. Russell Councilor W. H. England Councillor E. E. Stallard Councilor F. A. Fisher Councillor A. Hawkesworth, B.E.M. Councillor G. E. Waller Councillor W. A. Hawkins, Councillor W. A. White B.A. (Com.) Councillor F. W. Wright 4 BOROUGH OF ROMFORD PUBLIC BUILDINGS AND HEALTH COMMITTEE His Worship the Mayor: W. S. Gardner, J.P. (ex-officio member) Chairman: Councillor D. Raper Vice-Chairman: Councillor E. F. Castle, B.Com.A.S.A.A., C.C. Councillor P. F. Broadhead, D.S.C. Councillor W. J. Hawkins, Councillor E. W. Driscoll B.A. (Com.) Councillor I. Raeburn Councillor L. F. P. Eley 5 HEALTH DEPARTMENT Public Health Staff (As at 31st December, 1957) Medical Officer of Health J. B. Samson, M.D., Ch.B., D.P.H. Assistant Medical Officers (a) N. P. Bhandari, M.B., B.S., M.R.C.S., L.R.C.P., C.P.H. (b) J. J. Duffy, M.B., B.Ch., B.A.O., D.P.H. (c) Mrs. E. M. Haga, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. (d) Miss S. R. Ingold, M.B., B.S., M.R.C.S., L.R.C.P., D. (Obst.). R.C.O.G. Dental Officers (a) Mrs. F. Ell, Registered Dentist. (Part Time). (b) Miss M. L. Ell, L.D.S., R.C.S., (Eng.). (c) D. J. Hearns, B.D.S., N.U.I. (Commenced duties 29th April). (d) Mrs. F. Morris, L.D.S., R.F.P. & S. (Glas.). (Part Time). Public Health Inspectors (a) H. C. Boswell (A.B.) (Chief Public Health Inspector). (b) M. J. Dove (A.B.). (c) P. W. Edwards (A.B.). (Commenced duties 1st January). (d) G. D. John (A.B.). (e) T. E. R. Jones (A.B.). (f) G. F. Hobson (A.B.). (g) W. Hodson (A.B.). (h) M. J. Lee (Pupil). (Commenced duties 1st January). 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. 6 Health Visitors Superintendent: Miss F. K. Wells (A.B.D.). (a) Miss A. D. Batt (A.B.D.G.). (b) Miss B. C. Blackley (A.B.D.E.G.). (c) Miss G. Brocklebank (A.C.D.G.). (Commenced duties 17th June). (d) Mrs. J. A. Child (A.B.D.G.). (e) Miss O. Clements (A.B.D.F.G.). (f) Miss P. F. Cullis (A.B.D.G.). (g) Miss D. I. A. Hall (A.B.D.G.). (h) Mrs. B. Kersey (A.C.D.G.). (i) Miss F. Lambert (A.C.D.G.). (j) Mrs. M. K. Pressey (A.B.D.G.). (k) Mrs. L. Thompson (A.B.D.G.). (l) Miss A. M. Tidd (A.C.D.F.G.). Tuberculosis Visitors (a) Miss E. G. Govan (A.B.E.). (b) Mrs. F. C. Marshall (A.E.F.). (c) Miss B. Mulligan (A.E.). (Commenced duties 14th May). Domiciliary Midwives (a) Miss I. A. Bassett (B). (b) Miss E. E. Jeenes (A.B.). (c) Miss G. Jones (A.B.F.). (Commenced duties 7th April). (d) Miss C. M. Kerr (A.B.). (e) Mrs. A. King (A.B.). (Commenced duties 9th December). (f) Miss F. L. Law (A.B.). (g) Miss D. D. Martin (A.B.). (h) Mrs. A. H. Menzies (A.B.). (i) Mrs. G. Merry (A.B.). (Commenced duties 10th June). (j) Mrs. M. Mylward (B). (k) Mrs. E. A. Rooks (B). (l) Mrs. G. E. Sexton (A.B.). Queen's Certificate of District Nursing. 7 Home Nurses (a) Mrs. E. M. Andrews (A). (Commenced duties 26th August). (b) Mrs. E. M. Broome (A). (c) Mrs. E. D. Carrington (A.B.). Queen's Certificate of District Nursing. (d) Mrs. B. Casey (A.C.). (e) Mrs. C. Cook (A). (f) Mrs. I. Norris (A). Queen's Certificate of District Nursing. (Commenced duties 1st February). (g) Mrs. A. C. Silcock (A.B.). (h) Miss J. D. Silcock (A.B.). (i) Mrs. D. I. Towell (A). (j) 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. Domestic Help Organiser Mrs. I. M. Gray, Diploma in Social Science. Day Nurseries—Matrons "St. Moritz" Mrs. I. C. Bowyer, S.R.N. Collier Row Mrs. D. Eveling, S.R.N. Rush Green Mrs. R. M. O'Halloran, S.R.N., R.F.N. Domiciliary Occupational Therapist Miss N. J. M. Whitelaw, Dual Dip. Ass. of Occup. Theraps. (Parttime). (Commenced duties 8th April). Dental Attendants (a) Miss A. E. Bell. (b) Mrs. K. Goulding (Part-time). (Commenced duties 16th April). (c) Mrs. H. E. Lightfoot. (d) Mrs. J. M. Spencer. (Commenced duties 6th May). (e) Mrs. M. Warder. 8 Clerical Assistants (a) E. W. Gowers, Chief Administrative Assistant. (b) C. G. Humberston, Senior Administrative Assistant. (c) E. Lamb, Administrative Assistant. ( Commenced duties 24th June). (d) A. V. Tibbitt, Administrative Assistant. (Commenced duties 2nd December). (e) S. A. A. Bowers. (Commenced duties 1st January). (f) Miss M. E. Firmin. (g) Mrs. B. Mather. (h) Mrs. M. Barnard. (Part-time). (i) Mrs. F. Butt. (j) Mrs. D. E. Cast. (k) Mrs. S. Corner. (l) Miss R. Harvey. (m) Mrs. L. Holding. (Part-time). (Commenced duties 1st April). (n) Mrs. S. Moss. (Commenced duties 29th July). (o) Mrs. J. Nichols. (Part-time). (Commenced duties 1st April). (p) Miss J. V. Saggers. (q) Miss G. Smith. (r) Miss A. Vale. (s) Miss V. C. Warren. Harold Hill Health Centre Nursing Staff Mrs. W. Clegg, S.R.N. Mrs. P. Hodgson, S.R.N. Clerical Assistants Miss M. O. Little. Miss R. Markram. Miss A. Wright. (Commenced duties 6th May). 9 BOROUGH OF ROMFORD To His Worship The Mayor, Aldermen, and Councillors of the Borough of Romford. Me. Mayor, Ladies and Gentlemen, I have the honour, herewith, to present to you, this, my Annual Report upon the Health of the District for the year 1957. This is the Twenty-fourth 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. 1/58 of the Ministry of Health, dated 13th January, 1958. As explained in previous reports, my position 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 the Part iii duties of the National Health Service Act, 1946 are concerned. For convenience, the functions of this dual appointment are commented upon in this one Report. My best thanks, and appreciation, are again tendered to the members of the Borough Council, and to those of the Health Area Sub-Committee; to the members of my staff; and to my fellow officials for their kind assistance throughout the year, and for their ever keen interest in all matte pertaining to the health of the district. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, JAMES B. SAMSON, Medical Officer of Health. Public Health Department, Town Tall, Romford, May, 1958, 10 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the Year 1957 Statistics and Social Conditions of the Area Area (in acres) 9,342 Population: Census (1951), 88,002; Mid. 1957 (Estd.) 111,800 Number of Inhabited Houses (end of 1957) 31,763 Rateable Value (end of 1957) £1,442,502 Product of Penny Rate (end of 1957) £5,500 Extracts from Vital Statistics for the Year Total M. F. Live Births: Legitimate 1,919 960 959 Illegitimate 58 22 36 Birth Rate: 14.9 per 1,000 of estimated resident population. Still Births: Legitimate 35 16 19 Illegitimate 4 2 2 Rate per 1,000 total (live and still births): 19.3. Deaths 709 407 302 Death Rate: 9.8 per 1,000 estimated resident population. Rate per 1,000 total (live and still) births Deaths from Puerperal causes 0.50 Death Rate of Infants under one year of age:— All Infants per 1,000 live births 18.2 Legitimate Infants per 1,000 legitimate live births 14.9 Illegitimate Infants per 1,000 illegitimate live births 0.0 Deaths from Cancer (all ages) 148 Deaths from Measles (all ages) — Deaths from Whooping Cough (all ages) — Deaths from Diarrhoea (under 2 years of age) - TABLE 1 BIRTH-RATES, DEATHS-RATES, ANALYSIS OF MORTALITY, MATERNAL MORTALITY, and CASE-RATES for certain Infectious England and Wales, and Romford. Diseases in the year 1957. (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 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 16.1 0.37 11.5 0.00 0.00 0.00 0.11 0.16 0.00 0.01 0.56 *** 23.0 ROMFORD 14.9 0.35 9.8 0.00 0.00 0.00 0.08 0.04 0.00 0.00 0.38 0.00 18.2 The Maternal Mortality Rate for Romford is as follows: Per 1,000 Total Live and Still Births — 0.50 The Maternal Mortality Rate for England & Wales is as follows: Per 1,000 Total Live and Still Births — 0.17 ***Not available. 11 12 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 2534 3544 4554 5564 6574 754 upward 1. Tuberculosis, respiratory 2 7 9 .. .. .. .. .. 2 4 1 2 .. .. 2. Tuberculosis, other 1 .. 1 .. .. .. .. .. .. .. .. .. .. 1 3. Syphilitic disease 3 1 4 .. .. .. .. .. .. .. 1 2 .. 1 4 Diphtheria .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5. Whooping Cough .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6 Meningococcal infections .. .. .. .. .. .. .. .. .. .. .. .. .. .. 7. Acute poliomyelitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. 9. Other infective and parasitic diseases 1 2 3 .. .. .. 1 .. .. .. 1 .. .. 1 10. Malignant neoplasm, stomach 12 3 15 .. .. .. .. .. .. .. 1 6 5 3 11. Malignant neoplasm, lung, bronchus . . 38 6 44 .. .. .. .. .. .. 1 14 14 12 3 12. Malignant neoplasm, breast .. 13 13 .. .. .. .. .. .. 1 4 5 3 .. 13. Malignant neoplasm, uterus .. 5 5 .. .. .. .. .. .. 1 .. 1 3 .. 14. Other malignant and lymphaticneoplasms 40 31 71 .. .. .. .. 1 .. 6 5 16 23 20 15. Leukaemia, aleukaemia 3 2 5 .. .. 1 .. .. .. .. 2 1 1 .. 16. Diabetes .. 2 2 .. .. .. .. .. .. .. .. 1 .. 1 17. Vascular lesions of nervous system 37 54 91 .. .. .. .. .. .. 3 13 17 25 33 18. Coronary disease, angina 66 37 103 .. .. .. .. .. 1 4 14 16 38 30 19. Hypertension with heart disease 1 4 5 .. .. .. .. .. .. .. .. 2 2 1 20. Other heart disease 50 51 101 1 .. .. .. .. .. 7 15 10 15 53 21. Other circulatory disease 13 8 21 .. .. .. .. .. .. 1 1 2 7 10 22. Influenza 3 1 4 .. .. .. .. .. .. .. 2 1 1 .. 23. Pneumonia 25 17 42 6 .. .. 1 .. .. .. 3 6 11 15 24. Bronchitis 38 5 43 1 .. .. .. .. .. 3 4 11 12 12 25. Other diseases of respiratory system 4 2 6 .. .. .. 1 .. .. .. 1 2 2 .. 26. Ulcer of stomach and duodenum 3 .. 3 .. .. .. .. .. .. .. .. .. 1 2 27. Gastritis, enteritis, and diarrhoea 1 4 5 .. .. .. .. .. 1 .. .. 1 1 2 28. Nephritis and nephrosis 6 2 8 .. .. .. .. .. .. 2 1 2 1 2 29. Hyperplasia of prostrate 5 .. 5 .. .. .. .. .. .. .. .. .. .. 5 30. Pregnancy, childbirth, abortion .. 1 1 .. .. .. .. .. 1 .. .. .. .. .. 31. Congenital malformations 6 3 9 5 .. 1 .. 1 2 .. .. .. .. .. 32. Other defined and ill-defined diseases 33 35 68 22 .. .. 3 2 3 4 5 5 9 15 33. Motor vehicle accidents 5 1 6 .. .. .. 2 2 .. 1 1 .. .. .. 34. All other accidents 10 3 13 1 .. .. .. .. .. 2 3 2 2 3 35. Suicide 1 2 3 .. .. .. .. .. .. 1 1 1 .. .. 36. Homicide and operations of war .. .. .. .. .. .. .. .. .. .. .. .. .. .. Total 407 302 709 36 .. 2 8 6 10 41 93 126 174 213 13 This year the Registrar-General has given his estimate of the midyear population of Romford as 111,800, which compares with 110,100 for last year, an increase of 1,700. During 1957, the total number of live births registered was 1,977, and the total number of deaths registered was 709. The difference of 1,268 gives the natural increase in the population. As this number falls short of the Registrar-General's estimated increase of 1,700, it again follows that the balance of 433 is made up of Immigration over Emigration. For 1957, we estimate the Birth Rate to be 14.9 per 1,000 of the estimated resident population. This figure is obtained by multiplying the Crude Birth Rate of 17.7 by the Comparability Factor of 0.84. For last year the Rate was 14.5. The Rate for England and Wales for 1957 is given as 16.1. The Death Rate for Romford is estimated at 9.8 per 1,000 of the estimated resident population. This figure is obtained by multiplying the Crude Death Rate of 6.3 by the Comparability Factor of 1.56. For last year the Rate was 10.3. The comparable Rate for England and Wales is 11.5. 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. 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 0.50. The Infant Mortality Rate, or the Death Rate of Infants under one year age per 1,000 live births, is 18.2, a decrease of 4.1 compared with the previous year. The corresponding figure for England and Wales is 23.0. 14 1.—GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA (i) Staff The particulars are again given at the beginning of this report. The Assistant Medical Officers, Dental Staff, Nursing Staff, Domestic Help Organiser, and also the majority of the Clerical Staff come under the jurisdiction of the Essex County Council, and are members of that section of the department of which I am Area Medical Officer. At the beginning of the year, an additional Public Health Inspector was appointed, and, also, a Pupil Inspector under the Council's arrangement for paid pupillage. (ii) Laboratory Facilities These facilities remain as before, and meet all requirements for the department, and for the General Practitioners. (iii) Nursing in the Home (a) General. At the end of the year 10 Home Nurses were serving the a ea. These were employed in general domiciliary nursing. Sick-room equipment has again been available on loan, free of charge, as sanctioned by Section 28 of the National Health Service. Act. Table 3 sets out the work of the Home Nursing service during the year. TABLE 3 (1) Number of visits paid 20,934 (2) Number of cases attended 1,010 (b) Domiciliary Midwives. At the end of the year 12 Domiciliary Midwives were employed. The following gives a summary of the cases attended by the Domiciliary Midwives, as Midwives, and as Maternity Nurses. TABLE 4 As Midwives 822 As Maternity Nurses 69 Table 5 gives a summary of the "Medical Aid" notices rec 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 1 (2) Others 47 15 (iv) Ante-natal, and Post-natal Clinics Three Ante-natal sessions are held each week, and two Post-natal sessions are held per month. When necessary, patients are referred to the Consultative Clinic at Old church Hospital. During the year 265 individual expectant mothers attended the Antenatal Clinics, or which 154 sessions were held. The total number of attendances of the Ante-natal mothers was 1,665, giving an average of 6.3 attendances per patient. The average number attending at each session was 10.8. Twenty-one Post-natal sessions were held, and 96 attendances were recorded. The average number attending at each session was 4.6. (v) Child Welfare Clinics Twelve Child Welfare sessions are held each week. Altogether, there were 594 sessions, and the following table gives a summary of the attendances. TABLE 6 Individual children attending 3,285 Children under one year of age attending for the first time 1,355 Medical consultations 6,655 Attendances of children under one year of age 19,863 Attendances of children between the ages of one and five years 5,787 Average attendance per session 43.3 (vi) Health Visitors A the end of the year, there were 12 Health Visitors. All of these also acted as School Nurses. Table 7 relates to Home Visits paid by the Health Visitors in connection with their duties under Maternal and Child Welfare. TABLE 7 (a) To Expectant Mothers:— First visits 207 Total visits 281 (b) To Children under one year of age:— First visits 1,871 Total visits 6,157 (c) To Children between the ages of one and five years:— Total visits 8,643 (vii) Inspection of Nursing Homes There are three Nursing Homes registered in the district. These were all inspected, on four occasions during the year, and the conditions, there in were found to be satisfactory. 16 (viii) Domestic Helps The requests for this service remain fairly constant. Throughout 1957, 114 Part-time, and Casual Helps were employed, and they attended 586 individual cases. Once again, tuberculous patients were given domestic assistance from a panel of special volunteers. (ix) Day Nurseries The three Day Nurseries continued on the same lines, as hitherto. The average daily attendances for the year at each Nursery is shown below: TABLE 8 "St. Moritz" Nursery 29 Collier Row Nursery 28 Rush Green Nursery 28 The "St. Moritz" and Collier Row Nurseries are scheduled to take 40 children each, and the Rush Green Nursery 50 children. Works were carried out to the kitchens at each Nursery to meet the requirements of the Food Hygiene Regulations- (x) Dental Service There has again been a very slight improvement in the numbers of Dental Officers during the year. There are now two full-time Dental Officers, and, in addition, we have the services of a part-time Dentist for six sessions per week, and another for three sessions per week. A Consultant Anaesthetist continues to attend one session per week, for the purpose of administering general anaesthetics to the more difficult cases. The following gives particulars of the work done during the year for expectant and nursing mothers, and children under school age. TABLE 9 (a) Numbers provided with Dental care:— Examined Needing Treatment Treated Made Dentally Fit Expectant and Nursing Mothers 77 50 42 41 Children under Five 343 225 155 171 (b) Forms of Dental Treatment provided:— Extractions Anaesthetics Fillings Scalings or Scalings and Gum Teratment Silver Nitrate Treatment Dressings Radiographs Dentures provided Local General Complette Partial Expectant and Nursing Mothers 167 108 11 210 31 4 23 9 18 22 Children under five 216 9 110 499 - 39 15 - — — 17 (xi) Harold Hill Health Centre The work in the Local Authority section has progressed satisfactorily, on the same lines as last year, and this embraces services for Maternal and Child welfare, and the care of the health of the school child. A Dental Officer attends daily for the dental requirements of the school children, and facilities are also available for the other priority groups viz., nursing and expectant mothers, and children under 5 years of age. So far as the dental work for the general service is concerned, a Dental Officer, appointed by the Executive Council, is also in daily attendance. The four suites in the General Practitioner's section are allocated to right practitioners who attend at times mutually arranged by themselves, and they are provided with nursing staff and clerical assistance by the Local Health Authority, and also by the Authority with the necessary equipment for their work. Working under one roof, and in close proximity has brought about an improved liaison between the General Medical and Dental Services, and hose Services provided by the Local Health Authority, and has been an important factor in improving relationships between the practitioners and other staffs. 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 1957, other than those for the supply to permanent housing sites. (b) Lengths of mains laid, in yards:— 3" 4" 6" 9" Romford Area 623 365 32 1,108 (c) The water supply of the area, and of its several parts, has en satisfactory both as to quality and quantity. (d) Bacteriological and Chemical examinations are made of raw water, of the water in its various stages of treatment, of 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 3,890 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." 18 In addition to the analyses carried out by the Waterworks Company, samples have also been taken from consumers' taps by the Public Health Inspectors, and sent for Bacteriological analyses once per month, and Chemical analyses once per six months, and the results have confirmed the findings of the Company. (ii) Sanitary Inspection of the Area The Chief Public Health Inspector has given me the undermentioned report, as required by Article 27 (18) of the Sanitary Offic rs' (Outside London) Regulations, 1935, and also the particulars which follow:— During the year, 1,547 complaints were received, and investigated, and 5,415 visits were made for this purpose. TABLE 10 Nature and Number of Inspections During the Year Accumulations and Refuse Deposits 134 Atmospheric Pollution 24 Bakehouses 46 Butchers' Shops and Stalls, etc. 240 Cesspools 117 Common Lodging Houses 4 Cowsheds, Dairies and Milkshops 211 Drains, relaid and altered 291 Drainage—obstructed or defective 429 Drains Tested and inspected 362 Disinfections and Disinfestations 23 Diseases of Animals Act 41 Dustbins 41 Establishments for Massage and Special treatment 21 Factories Act (Mechanical Power) 66 Factories Act (non-mechanical) 11 Factories Act (Outworkers Premises) 595 Food Preparing Premises 271 Food Hawkers 73 Food Hygiene Observations 413 Food Inspections 407 Food Sampling—Formal 34 Food Sampling—Informal 259 Food Shops 567 Housing Acts 711 Heating Appliances (Fireguards) Act 1952 98 Ice Cream 181 Infectious Disease including Food Poisoning 1473 Insects and pests 91 Keeping of Animals 107 Milk Sampling 122 Miscellaneous 897 Markets 156 Nuisances, Public Health Act 2005 Old Metal Dealers 10 19 Pet Animals Act 1951 52 Prevention of Damage by Pests Act 1949 2437 Public Baths 16 Public Conveniences 51 Rag Flock Act 12 Sale of Horseflesh 12 Schools and School Canteens 65 Shops Act—All Sections 4451 Slaughterhouses 966 Smoke Observations 106 Streams, Ponds and Watercourses 200 Tents, Vans and Sheds 271 Verminous premises 76 Water Closets 16 Water Supplies 71 Informal Notices (number served) 584 Statutory Notices (number served) 108 As a result of the service of Notices, the necessary works were completed by the owners or occupiers in all cases except 93, the works for which were still in hand at the end of the year. Notices served under the Shops Act 40 Notices served under the Food & Drugs Act 98 (ii) Factories Acts As 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 16 11 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 275 66 6 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding OutWorkers premises) 48 12 - - Total 339 89 6 — 20 2. Cases in which Defects were Found Particulars No. of Cases in which defects were found No. of Cases in which prosecutions instituted Found Remedied Referred to H.M. Inspector by H.M. Inspector Want of Cleanliness 1 1 - - - Overcrowding — — — — — Unreasonable Temperature - - - - - Inadequate Ventilation 2 2 - - - Ineffect. drain. of floors - - - - - Sanitary Conveniences— (a) Insufficient 1 1 - 1 - (b) Unsuitable or defective 3 3 - 3 - (c) Not separate for Sexes - - - - - Other Offences — — — — - Total 7 7 - 4 - 3. Outwork. Nature 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 tions. Wearing Apparel— Making, etc. 44 - - - - - Box Making 19 - - - - — Total 63 - - - - - During the year 595 inspections were made of Outworkers' premises. (iv) Caravan Sites. There are in the area six licensed caravan sites, one of wh.:h is still controlled by the Council. Altogether, there are 301 caravans on these sites, and, in general they are maintained in a satisfactory condition. In addition to the above, there are seven individual caravans licensed for residential purposes. (v) Prevention of Damage by Pests Act, 1949. During the year the Public Health Inspectors and Rodent Operative carried out 2,437 inspections, or re-inspections to premises, suspected of being infested by rats or mice. Further maintenance treatment, in respect of rat disinfestation to sewers, was undertaken during the year. 21 (vi) Pet Animals Act, 1951. Fourteen persons were licensed to keep Pet Shops. Frequent inspections are carried out. 3.—INSPECTION AND SUPERVISION OF FOOD (i) Milk Supply. At the end of the year, 50 firms were registered as Retailers, or Distributors. Of these 19 were licensed to retail Tuberculin Tested Milk, 28 were licensed to retail Pasteurised Milk, and 46 were licensed to retail Sterilised Milk. The two Pasteurising plants are kept under surveillance by the department. During the year, 111 samples of milk were taken, and all but four passed . the prescribed tests. (ii) Ice Cream. here were at the end of the year one manufacturer, and 219 vendors on the register. During the year, 28 samples were taken for Bacteriological examination and of these, 25 were satisfactory and three unsatisfactory. Twenty samples of ice-lollies were taken, and, of them 13 were satisfactory, and seven unsatisfactory. (iii) Meat. ere are three licensed slaughterhouses in the Borough, one of these , being licensed for the slaughter of horses, as well as livestock. Inspectors attend regularly to ensure that 100% inspection is maintained. During the year under review, 966 such visits were made. Durig this period, a total of 33,547 animals were slaughtered, and a 24 tons, 3 cwts. 71 lbs. of meat was found to be unfit for hum, consumption; this was disposed of for animal feeding through the recognised channels. Table 12 sets out the particulars of the carcases inspected, and condemned. There are also three Wholesale Meat Depots, and 72 butchers shops in the Borough, and, during the year, 240 inspections were made of these premises. TABLE 12 CARCASES INSPECTED AND CONDEMNED 1957 Cattle except Cows Cows Calves Sheep and Lambs Pigs Horses TOTAL Number killed (if known) 1,522 1,266 1,229 9,750 19,360 412 33,547 Number inspected 1,522 1,266 1,229 9,750 19,360 412 33,547 All diseases except Tuberculosis. Whole carcases condemned 3 12 5 16 32 4 72 Carcases of which some part or organ was condemned 238 496 3 374 639 31 1,781 Percentage of the number inspected affected with diseases other than tuberculosis 15.83% 40.12% .65% 4% 3.46% 8.49% 5.52% Tuberculosis only. Whole carases condemned 2 17 3 — 2 — 24 Carcases of which some part or organ was condemned 68 222 — — 351 — 641 Percentage of the number inspected affected with tuberculosis 4.59% 18.87% .24% — .01% — 1.98% 22 23 (iv) Food Products in General. In addition to the premises used for Milk, Ice Cream, and Meat, referred to elsewhere, the following are registered under the Romford Urban District Council Act, 1931, and are subject to the Clean Food Regulations. Bakers 33 Cafes 59 Confectioners 63 Fishmongers 32 Greengrocers 51 Grocers 139 Miscellaneous 14 Hawkers 48 There are also 45 food stalls situated in the Market Place on three days of the week. All the above are regularly inspected. During the year, 1,614 such inspections were made. The majority of the food shops now have constant hot water provided for washing purposes. (v) Clean Food Campaign. During the year further efforts have been made to encourage local trad to participate in the Council's Clean Food Campaign. As stated in my previous report, the object of the Campaign is to encourage the occupiers of food premises to obtain a higher standard of food hygiene than that required by the Food Hygiene Regulations, and to adopt improved methods for the storage, handling and preparation of food. Further to encourage the traders to participate in the scheme, the Council decided to issue plastic adhesive window plaques in place of the Printed form of certificate. A number of these plaques have been issue but some of the occupiers of the larger shops, who have been most co-operative, were not keen to exhibit these plaques. Unfortunately, in spite of persistent appeals, the attendance at illustrated lectures on food hygiene have rot been very encouraging, the numbers attending being much lower than last year. However, much good work has been done in this field by the Public Health Inspectors making a personal approach to the traders and food handlers. The raders have been very co-operative and the standard of food hygiene in the majority of the shops has improved. During the year lectures have also been given by the Public Health Inspectors to the staffs employed in the School Canteens. (vi) Unsound Food. During the year, 407 visits were made to food premises, mainly on request, for the purpose of dealing with unsound food, and a total of 7 tons, 15 cwts., 76 lbs. of food was surrendered as unfit for human consumption. Where possible, all unsound food is disposed of for animal feeding, the remainder being dealt with by the Cleansing Department, 24 (vii) The Food and Drugs Act, 1955. During 1957, 293 samples were submitted for analysis, comprising 34 formal, and 259 informal. Table 13 sets out the types of food examined. Of the 34 formal samples taken, six proved to be not genuine. The six unsatisfactory Formal samples were of milk taken during the course of delivery, from six churns comprising one consignment. The Analyst reported that these samples contained added water varying from 11% to 14%. The matter was reported to the Health Committee who resolved to prosecute the producer. This case is included in the list of Legal Proceedings. Of the 259 Informal samples taken, the Public Analyst reported adversely on the following' 12:— Bread— (sliced) This sample was submitted as a result of a complaint that the bread contained blackish foreign bodies. The Analyst confirmed that the foreign bodies were pieces of rodent excreta. The manufacturers of the bread were prosecuted and fined. Bridge Roll A complaint was received that this roll contained a darkish streak. The Analyst reported that the dark streak consisted of dirty dough and slight traces of mineral oil. Investigations were carried out at the bakehouse when a slight leak in one of the greasing nozzles to the mixing bowl was rectified. Silver Shred Marmalade This was the result of a complaint that the marmalade contained a small black object resembling mice excreta. Examination revealed that this was a small fragment of black rubber. The matter was taken up with the manufacturer when it was ascertained that the fragment of rubber had come from the lining of the capping machine. Orange Squash This was submitted following a complaint that consumption of a part of the contents had caused vomiting, and had a peculiar taint. The Analyst was unable to find any foreign matter and stated that the peculiar taint was due to the oxidation of the flavouring oils which could also upset a sensitive stomach. Tinned Pears This tin of pears contained a large number of small fruit flies and vegetable debris and was quite unsatisfactory. The matter was taken up with the importers and shippers. 25 Swiss Buns This sample consisted of two swiss buns that contained blackish foreign bodies in the icing. The Analyst confirmed that these foreign bodies were rodent excreta. The baker was prosecuted and fined. Pastry This sample was submitted as a result of a complaint that the pastry had a bitter taste and produced a dry sensation in the mouth. The Analyst reported that the pastry contained an excessive amount of salt. Apple Slices These apple slices were found to be affected with spores and mycella of mould growths and were unfit for human consumption. The vendor was prosecuted and fined. Packet of Currants These currants were sold prepacked bearing a label containing the statement that the contents were "Specially Cleaned and ready for use." The Analyst reported that the currants contained 0.47 per cent of sand, and therefore the label was misleading. The matter was taken up with the packers and further samples taken proved to be satisfactory. Milk This sample was found to contain added water and as a result Formal samples were taken from the producer. These are referred to above Whole Orange Drink This sample was submitted following a complaint that it had an unpleasant taste. It was found to be undergoing fermentation. The matter was taken up with the manufacturers who withdrew any outstanding stock of the same batch from sale. Powdered Arrowroot This was the result of a complaint that the "Powdered Arrowroot" cause milk to curdle. On examination it was found that the powder submitted with the complaint was not arrowroot but boracic acid which would account for the curdling of milk. Further samples of arrowroot taken from the same shop proved to be genuine. On further investigation it was found that there was a similarity in the packets and that a mistake had been made in the first instance. 26 Cream Soda This sample was submitted as a result of a complaint as to its peculiar smell of sulphuretted hydrogen. On examination it was found that there were slight traces of sulphuretted hydrogen present, but these did not exceed 2 parts per million. It appeared that the production of the sulphuretted hydrogen was connected with the vulcanised rubber stopper. This matter was taken up with the manufacturers and the local authority in whose area the factory is situated. LEGAL PROCEEDINGS (i) The following cases were taken under the Food and Drugs Act, 1955. Offence Section Result (1) Rodent excreta in buns 8 Fined £2 Costs £2.10.0. (2) Rodent excreta in bread 8 Fined £5 Costs £2.10.0. (3) Mould growths in apple slices 8 Fined £5 Costs £1.6.0 (4) Milk containing added water 32.(3) Fined £3 Costs £8.8.0 (ii) The following cases were taken under the Food Hygiene Regulations. (5) Failure to exhibit name and address on food stall 26.(1) Fined £1 (6) Transporting meat in an unsatisfactory vehicle 29.(1) Fined £20 (7) Exposing food to contamination 8. (b) Fined £5 (8) Smoking whilst handling open food 9 Fined £2 (9) Smoking whilst handling open food 9 Fined 10/- (10) Smoking whilst handling open food 9 Fined £1 (iii) The following case was taken under the Slaughter of Animals Act 1933/54. (11) Failure to stun an animal with a mechanical instrument before slaughter 1 Fined £5 17 TABLE 13 SUMMARY OF SAMPLES TAKEN FOR ANALYSIS DURING THE YEAR 1957 Article Number examined Result of Analysis Formal Informal Total Genuine Not Genuine Almond Marzipan - 1 1 1 — Anchovy Paste - 1 1 1 — Apple Slice - 1 - - 1 Arrowroot Powder — 3 3 2 1 Aspirin Tablets — 1 1 1 — Ball Gum — 1 1 1 — Beef and Ham Paste — 1 1 1 — Beef Loaf, Minced — 1 1 1 — Beef Stew and Vegetables — 1 1 1 — Blackcurrant Juice Syrup — 1 1 1 — Bread, Sliced — 1 1 — 1 Cake Flour Mix — 1 1 1 — Carrots, Sliced — 1 1 1 — Castor Oil — 1 1 1 — Cheese Spread with Ham — 1 1 1 — Cheese Spread with Ham and Onion - 1 1 1 - Cheese Stick — 1 1 1 - Cheese and Tomato Spread - 1 1 1 - Cherries - in Syrup — 1 1 1 - Chicken, Chopped — 1 1 1 - Chicken Fillets — 1 1 1 - Chicken and Ham Paste — 1 1 1 - Chick, Pie — 1 1 1 - Christmas Pudding — 1 1 1 - Citroze — 1 1 1 - Cochineal - 2 2 2 - Cocktail Cherries — 1 1 1 - Coconut, Desiccated — 1 1 1 - Coffee and Chicory — 1 1 1 - Condiment, Non-brewed — 1 1 1 - Cornflcar - 2 2 2 - Cough Candy — 1 1 1 - Crab Paste - 2 2 2 - Cream - 7 7 7 - Cream Mi1k Block - 1 1 1 - Cream Soda - 1 1 - 1 Curranes 1 1 2 1 1 Custar Powder - 2 2 2 - Dripping - 3 3 3 - Essence of Rennet - 1 1 1 - Essences , Various - 3 3 3 - Extra of Herbs for making Beer - 1 1 1 - Foam Crystals - 2 2 2 - Flour - 7 7 7 - Fruit Cream - 1 1 1 - Fruit Flavoured Milk - 1 1 1 - Fruit Wafers - 1 1 1 - Ginger - 1 1 1 - Gravy Powder - 1 1 1 - Green Beans - 1 1 1 - Gripe Water - 1 1 1 - Herbal Night Tablets - 1 1 1 - Horsera dish Sauce - 2 2 2 - Ice Cream. - 4 4 4 - Ice Lolly - 5 5 5 - Icing - 4 4 4 - Icing Sugar - 1 1 1 - Jam — 2 2 2 - Carried forward 1 93 94 89 5 28 Table 13—continued Article Number examined Result of Analysis Formal Informal Total Genuine Not Genuine Brought forward 1 93 94 89 5 Jelly — 3 3 3 - Lemonade Powder — 2 2 2 - Lemon Flavouring — 1 1 1 - Lemon Juice — 1 1 1 - Lemon Squash — 1 1 1 - Liquid Fruit Pectin — 1 1 1 - Liquid of Life — 1 1 1 - Liver and Vegetables — 1 1 1 - Lollies — 1 1 1 - Macprin (Aspirin Tablets). - 1 1 1 - Mandarin Oranges — 2 2 2 - Margarine — 4 4 4 - Marmalade — 2 2 1 1 Meat Loaf - 1 1 1 - Meat Pudding — 1 1 1 - Meringue Powder — 2 2 2 - Milk 9 20 29 22 7 Milk Condensed — 5 5 5 - Milk Evaporated — 1 1 1 - Mint Sauce — 1 1 1 - Mix-a-Shake — 1 1 1 - Olive Oil - 1 1 1 - Orange Drink — 1 1 1 - Orange Squash — 1 1 - 1 Pancake Mix — 1 1 1 - Pastry — 1 1 - 1 Pea with Smoked Ham Soup - 1 1 1 - Peas, Garden — 1 1 1 - Pears — - - 1 1 Pepper — - - 2 - Persomnia Tablets — 1 1 1 - Pineapple Juice — 1 1 1 - Polony — 1 1 1 - Pork Pie — - - 2 - Pork Roll with Stuffing — 1 1 1 - Port Flavour — Non Alcoholic - 1 1 1 - Potatoes — 1 1 1 - Pudding — 1 1 1 - Puff Cream Biscuits — 1 1 1 - Raisins — 1 1 1 - Roll—Sliced Bridge — 1 1 - 1 Rum 5 - 5 5 - Saccharin Tablets — 1 1 1 - Rummettes (Rum Flavoured Wafers) - 1 1 1 - Salad Cream — 1 1 1 - Salmon, Potted — 1 1 1 — Salmon and Shrimp Paste — 1 1 1 — Salmon Spread — 1 1 1 — Samonaize — 1 1 1 — Sardine and Tomato Paste - 1 1 1 - Sauce — 1 1 1 — Sausage, Breakfast — 1 1 1 — Sausage, Liver — 1 1 1 — Sausage, Meat (Beef) — 2 2 2 — Sausages, Beef — 16 16 16 — Sausages, Pork — 10 10 10 — Carried forward 15 208 223 206 17 29 Table 13—continued Article Number examined Result of Analysis Formal Informal Total Genuine Not Genuine Brought forward 15 208 223 206 17 Sausages (Unclassified) — 1 1 1 — Savora (Savoury Relish) — 1 1 1 — Saveloy — 1 1 1 — Scotch Broth - 1 1 1 — Sea Legs — 1 1 1 — Seasoning — 1 1 1 — Self-Raising Flour — 1 1 1 — Slimming Tablets — 1 1 1 — Soup, Asparagus — 1 1 1 — Steak and Kidney Pudding - 1 1 1 - Suet, Beef - 1 1 1 - Sugar - 1 1 1 — Sugar Fruits - 1 1 1 — Sugared Perles - 1 1 1 - Sunny Spread — 1 1 1 - Sweets and Confectionery - 20 20 20 - Swiss Buns - 1 1 - 1 Tea - 1 1 1 - Tomato Cream - 1 1 1 - Tomato Juice - 1 1 1 - Tomato Juice Cocktail - 1 1 1 - Tonic Phosphates — 1 1 1 - Tunes (Throat Sweets) - 1 1 1 - Turkey (Minced) — 2 2 - - Turkey and Ham Paste - 1 1 1 - Vanilla Essence - 1 1 1 - Vecon - 1 1 1 - Vikelp — 1 1 1 - Vinegar, Malt - 1 1 1 - Whisky 19 - 19 19 - Yeast, Dried - 1 1 1 - Yorkshire Relish — 1 1 1 — Totals 34 259 293 275 18 (viii) Shops Act, 1950. (a) Inspections. 1,070 shops have been inspected and recorded on the Register. Altogether 4,351 Inspections and observations have been made for various purposes under the Act during the year. The following contraventions were noted:— Failure to exhibit prescribed notices 214 Failure to keep records 39 Conditions of employment 9 Arrangements for Health and Welfare 34 Other matters 9 NOTE Under the heading of Conditions of employment, four employers were found to be employing persons under the age of 18 years for more than the maximum hours laid down in the Act. It is essential, therefore, that frequent routine visits be made to places where young persons are employed to ensure that records of hours worked are properly kept. 30 (b) Legal Proceedings. The Council authorised the following cases to be taken before the Magistrates' Court. Offence Section Result (1) Sunday employment 22 Case dismissed No costs awarded (2) Sunday trading 47 Fined £2 (3) Evening closing hours 2 Fined £2 (ix) The Heating Appliances (Fireguards) Act, 1952. 98 premises were visited where heating appliances were exposed for sale and as a result of these visits 26 appliances were found not to conform with the standards prescribed. These were withdrawn from sale. I have to report that many of the appliances found not to conform with the Act were passed by the manufacturers as complying' with the Regulations. At my request modifications have now been made to the guards giving greater strength etc., and the manufacturers have given assurances that more attention will be given in their final inspection to ensure there will be no further breaches of the Act. (x) Atmospheric Pollution The Council have agreed to co-operate in the County Council's scheme for recording atmospheric pollution throughout the county; this work is carried out in conjunction with the Fuel Research Station, Greenwich. As far as Romford is concerned, there is a Deposit Gauge ituate on the roof of the Town Hall and a Lead Peroxide Instrument situate at North Road, Havering. The former is used to collect rainwater and to estimate the amount of suspended matter in the air, whilst the latter records the amount of Sulphur Dioxide present in a given quantity of air. For research purposes the measurements are obtained monthly, the following table gives the total recording for the whole year. Estimated rainfall collected in inches 18.23 Insoluble matter—tons per sq. mile 82.73 Soluble matter—tons per sq. mile 109.61 Total Solids—tons per sq. mile 192.34 Sulphur Dioxide—Mg. per 1,200 sq. c.m 15.88 31 4.—HOUSING STATISTICS FOR THE YEAR, 1957. TABLE 14 Number of houses erected during the year:— (1) By Local Authority 400 (2) By Private Enterprise 244 (3) By L.C.C. at Harold Hill Estate 63 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) 2,726 (b) Number of inspections made for the purpose 4,336 (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 7 (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 584 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 471 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 (2) Number of dwelling houses which were rendered fit after service of Formal Notices:— (a) By owners Nil (b) By local authority in default of owners Nil 32 (b) Proceedings under the Public Health Acts:— (1) Number of dwelling houses in respect of which Notices were served requiring defects to be remedied 108 (2) Number of dwelling houses in which defects were remedied after service of Formal Notices:— (a) By owners 70 (b) By local authority in default of owners 47 (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 21 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 22 (3) Number of Demolition Orders Revoked Nil (4) Number of Closing Orders made 1 (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 Nil 4. Housing Act, 1936, Part IV— Overcrowding (a) (1) Number of dwellings overcrowded at end of year 31 (2) Number of families dwelling therein 48 (3) Number of persons dwelling therein 249 (b) Number of new cases of overcrowding reported during the year 4 (c) (1) Number of cases of overcrowding abated during the year 16 (2) Number of new cases of overcrowding relieved during the year 2 (3) Number of persons concerned in such cases 73 (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 33 5. Housing Repairs and Rents Act, 1954. During the year five applications were received for Certificates of Disrepair under the above Act, and four Certificates were issued, making a total of 106 Certificates issued since October 1954. Nine applications were also received for the Revocation of Certificates, and in nine cases the Certificates were revoked when the repairs had been completed satisfactorily. This Act was superseded by the Rent Act 1957, and at the end of the year there were 29 Certificates outstanding. 6. Rent Act, 1957. This Act came into operation on the 6th July 1957. From the date of operation until the end of the year the following matters were dealt with. (1) Applications for Certificates of Disrepair 130 (2) Applications refused 4 (3) Undertakings accepted 74 (4) Certificates of Disrepair issued 34 5. PREVALENCE OF AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES (i) Notifiable Diseases As before, I have not recorded those notifications, where the diagnosis has been altered after a period of observation, or after investigation. Where, however, the amended diagnosis has proved to be another type of infection which is notifiable, the case has been appropriately recorded. These amendments are sent to the RegisterGeneral at the end of each quarter. (a) Acute Anterior Poliomyelitis In view of the fact that Poliomyelitis was rather prevalent in some parts of the Country, and even in Essex, during the year, Romford was rather fortunate in having only six cases. One of these occurred in January, and was of the paralytic type. The others occurred in August to October, and were non-paralytic. There were no deaths. In connection with the scheme for immunisation against Poliomyelitis, 868 children received the first injection, and 4,948 completed both injections. (b) Acute Infective Hepatitis. This condition continues to be notifiable in this region. Altogether, there were 18 notifications. 34 (c) Diphtheria. No cases of Diphtheria were reported. The following statistics relate to the state of immunisation at 31st December, 1957. In addition to the initial series of injections, "booster" doses have 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, 1957, and who were born between 31st December, 1942, and 31st December, 1957 5,282 15,956 (d) Dysentery. Twenty-four cases of Dysentery were notified, as belonging to Romford. Three of these were due to Shigella Sonnei, and twenty-one were unclassified. (e) Food Poisoning. During the year, eight cases were notified, which proved to be suffering from food poisoning. In addition another 20 proved indefinite. The following table sets out details, as required by the Ministry of Health. TABLE 16 (a) Total number of Outbreaks 1 (b) Total number of Cases included in (a) 3 (c) Number of Single Cases 25 (d) Number of Deaths Nil Sal. (e) (i) Organisms responsible Typhi-Murium B.Proteus Unkown (ii) Outbreaks attributable to (i) 1 Nil Nil (iii) Single cases attributable to (i) 4 1 20 (f) Measles. Measles was again present in epidemic form from January until July. Altogether, during the year, 1,880 cases were notified. (g) Scarlet Fever. The notifications numbered 151, and the type was again mild. (h) Smallpox. No cases occurred in the district, and no contacts required to be kept under surveillance. 35 Table 17 gives the statistics relative to Vaccination, as recorded by the General Practitioners. TABLE 17 Vaccinated: Under 6 months 365 Between the ages of 6 months and 1 year of age 255 Between the ages of 1 and 2 years 121 Between the ages of 2 and 5 years 157 Between the ages of 5 and 15 years 293 Over 15 years 181 Re-Vaccinated: Under 1 year of age — Between the ages of 1 and 2 years — Between the ages of 2 and 5 years 36 Between the ages of 5 and 15 years 244 Over 15 years 310 (i) Tuberculosis. The scheme whereby B.C.G. is offered, with parental consent, to children at the age of 13 years was continued on the same lines as last year, with the following results. TABLE 18 Number of pupils tuberculin tested 831 Number found to be positive 81 Number found to be negative 750 Number who received B.C.G. 728 Number post-tested 544 Number found to be positive 539 Number found to be negative 5 (j) Whooping Cough. Altogether, 131 cases were notified. For the most part, these occurred during the first half of the year. During 1957, 1,422 children received immunisation injections. (ii) Non-Notifiable The particulars of these are set out below, and the figures are compiled from the school returns. As they are not notifiable, however, the general prevalence is unknown. TABLE 19 Chickenpox 345 Mumps 268 German Measles 88 TABLE 20 MONTHLY NOTIFICATIONS OF INFECTIOUS DISEASES Month Scarlet Fever Diphtheria Enteric Fever Puerperal Pyrexia Pneumonia Dysentery Encephalitis Acute Infective Erysipelas Malaria contracted abroad Measles Meningococcal Infection Ophthalmia Neonatorum Poliomyelitis Paralytic Poliomyelitis NonParalytic Whooping Cough Infective Hepatitis Food Poisoning Tuberculosis Total Resp. NonResp. January 17 — — — 4 — — — — 140 2 — 1 — 8 3 3 10 - 188 February 13 — — — 3 1 — 2 — 133 — — — — 19 2 2 3 — 178 March 15 — — — 3 15 — 2 — 306 — — — — 27 2 1 2 — 373 April 12 — — — 2 6 — 3 — 462 1 — — — 13 1 2 8 1 511 May 17 — — — 3 2 — 1 — 319 1 — — — 25 4 3 6 1 382 June 5 — — — 2 — — 2 — 348 — — — — 9 2 2 7 1 378 July 12 — — 1 1 — — 1 — 144 1 — — — 14 3 2 9 — 188 August 4 — — 1 — — — — 1 20 — — — 4 6 — 3 1 — 40 September 3 — — 1 1 — — 1 — 4 — — — — 6 1 — 7 — 24 October 9 - - - - - - - - - - - - - - - - 4 1 26 November 23 — — 4 8 - - - - - - - - - 1 — 2 1 1 41 December 21 — — — 8 - - 1 — 1 — — — — 3 — 8 3 — 45 Total 151 - - 7 43 24 — 14 1 1880 5 — 1 5 131 18 28 61 5 2374 36 TABLE 21 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 5 12 8 16 84 18 2 2 2 1 - 151 Diphtheria - - - - - - - - - - - - - Enteric Fever - - - - - - - - - - - - - Puerperal Pyrexia - - - - - - - - 7 - - - 7 Pneumonia 4 3 3 2 2 2 5 — 3 4 13 2 43 Dysentery — 2 2 — 3 15 — — 2 — — — 24 Encephalitis—Acute Infective - - - - - - - - - - - - - Erysipelas - - - - - - 1 — 1 — 6 6 14 Malaria contracted abroad - - - - - - - - 1 - - - 1 Measles 58 185 222 262 265 862 21 2 o 1 — — 1880 Meningococcal Infection 2 1 1 — — 1 — — — — — — 5 Ophthalmia Neonatorum - - - - - - - - - - - - - Poliomyelitis Paralytic - - - - - 1 - - - - - - 1 Poliomyelitis Non-Paralytic — — — — 2 — 2 — 1 — — — 5 Whooping Cough 14 11 23 9 16 54 4 - - - - - 131 Infective Hepatitis — — — — — 3 7 — 2 2 2 2 18 Food Poisoning 1 1 — 1 1 5 5 1 6 1 5 1 28 Total 80 208 263 282 305 1027 63 5 27 10 27 11 2308 37 TABLE 22. NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING YEAR 1957, and HOSPITAL ADMISSIONS Disease Cases Notified Cases Admitted to Hospital Total Deaths Scarlet Fever 151 4 — Diphtheria — — — Enteric Fever — — — Puerperal Pyrexia 7 1 — Pneumonia 43 18 42 Dysentery 24 1 — Encephalitis—Acute Infective — — — Erysipelas 14 — — Malaria contracted abroad 1 — — Measles 1880 19 — Meningococcal Infection 5 3 — Ophthalmia Neonatorum — — — Poliomyelitis Paralytic 1 1 — Poliomyelitis Non-Paralytic 5 5 — Whooping Cough 131 6 — Infective Hepatitis 18 4 — Food Poisoning 28 5 — Total 2308 67 42 38 TABLE 23 TUBERCULOSIS: NEW CASES AND MORTALITY DURING 1957 AGE PERIODS NEW CASES DEATHS Respiratory Non-Respiratory Respiratory Non-Respiratory M. F. M. F. M. F. M. F. 0 — — — — — — — — 1 1 4 - - - - - - 5 3 3 - 1 - - - - 15 5 7 — — — — — — 25 5 6 — 2 1 1 — — 35 3 3 1 — 1 3 — — 45 3 1 — — — 1 — — 55 11 — — — - 2 — — 65 and upwards 5 1 1 — - — 1 — Total 36 25 2 3 2 7 1 — 39