Cout 10 BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1942 M. A. GLASS, Medical Officer of Health. King & Hutchings, Ltd., Printers, Southall. BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1942 M. A. GLASS, Medical Officer of Health. THE COUNCIL OF THE BOROUGH OF SOUTHALL, 1942. Members of the Public Health Committee (which also functions as a Maternity and Child Welfare Committee) are denoted by an asterisk. THE WORSHIPFUL THE MAYOR * ALDERMAN Mrs. F. S. AMOS, J.P. (Chairman of the Public Health Committee). Deputy Mayor : *Alderman F. G. Smith, J.P. Aldermen : Gardner, F. E. Hamblin, E. B. *Neighbour, D. C. *Pargiter, G. A. Councillors : Bill, H. R. Hopkins, W. H. Braine, E. W. H. *Hutchings, C. Cox, E. W. *Lowe, J. Dane, A. T. Luckett, F. H. Davies, R. L. Lye, A. E. *Douglas, H. C. *Marks, F. J. Eldridge, J. T. *Knott, Mrs. A. Harris, G. Saxon, J. A. *Hill, J. *Sturgeon, J. M. To the Mayor, Aldermen and Councillors of the Borough of Southall. YOUR WORSHIP, LADIES AND GENTLEMEN, I have the honour to present the forty-sixth Annual Report on the health and sanitary circumstances of the district. Certain vital statistics have been excluded from the Report on the instructions of the Ministry of Health for security reasons. The health of the population continued to be good. There were no considerable outbreaks of infectious disease. The birth rate was higher than in 1941, and the death rate was lower compared with the previous year. The infant mortality rate was considerably lower than in 1941, 56 9 as compared with 69 3. There was an increase in the number of attendances at the Cleansing Station for the treatment of scabies and verminous conditions. The first War-time Day Nursery in Southall was opened at 22, Villiers Road, on the 9th March, 1942. Large numbers of children were placed on the waiting list for entry into further day nurseries when these were constructed. Clinic attendances were satisfactory, and the Health Visitors did good work in home visiting, and advising expectant and nursing mothers of children under five years. It will be noted that there has been an increase in the total clinic attendances, health visiting and other Public Health work during the year. It is satisfactory to note the increase in the number of births, the decrease in the number of deaths, and the reduction of 10 per 1,000 in the Infant Mortality rate, following a reduction in the previous year of 3 per 1,000, is very good, though there is still room for improvement. I am, your Worship, Ladies and Gentlemen, Your obedient Servant, M. A. GLASS, Medical Officer of Health. 3 HEALTH DEPARTMENT STAFF for the year 1942. Medical Officer of Health : Ernest Grundy, M.D., B.S.(Lond.), M.R.C.S., L.R.C.P., D.P.H.(Eng.). * Deputy Medical Officer of Health : C. W. Seccombe, M.R.C.S.(Eng.), L.R.C.P.(Lond.). Assistant Medical Officers : Margaret A. Glass, B.Sc., M.B., Ch.B., D.P.H. Joan McMichael, M.B., Ch.B. Sanitary Inspection Staff : Senior Sanitary Inspector : R. W. McDonald, Cert. S.I.B., Cert. M. & F., M.S.I.A. Sanitary Inspectors : L. Mair, Cert. S.I.B., Cert. M. & F., M.S.I.A. F. C. Hills, S.I.B., Cert. M. & F. (In H.M. Forces until 2.5.42). R. W. Bashford, S.I.B., M.S.I.A., A.R.S.I. Health Visiting Staff: Miss E. L. Perrett, S.R.N. (Retired 11.6.42). Miss B. M. Stanbridge, S.R.N., H.V., Cert. R.S.I. Miss G. M. Leverett, S.R.N., S.C.M., H.V., Cert. R.S.I. Miss M. Williams, S.R.N., S.C.M., H.V., Cert. R.S.I. Mrs. M. D. Cattle, S.R.N., S.C.M., H.V., Cert. R.S.I. (Resigned 1.5.42). Miss F. Keynes. (Appointed 15.6.42). Midwives : Miss V. Robinson, S.R.N., S.C.M. Miss G. Robinson, S.C.M. Mrs. Delahaye, S.R.N., S.C.M. Miss Sandell, S.C.M. Miss Johnson, S.R.N., S.C.M. Clerical Staff: Chief Clerk : J. W. Cronk, Cert. R.S.I. Clerks, Shorthand- Typists : Miss P. Ashton. Miss D. Mash. Miss J. D. Winterburn. Miss V. Fuggle. G. Woodrow. Miss H. Heatlie. f Consulting Obstetrician : J. W. Rait Bell, Esq., F.R.C.S. Matron of the Isolation Hospital: Miss E. James, S.R.N., R.F.N. *Part time. †Part time, Maternity and Child Welfare. 4 STATISTICS AND SOCIAL CONDITIONS OF THE BOROUGH. Area (acres) : Land, 2,554-5. Water, 50. Total, 2,604.5. Population—Registrar-General's estimate — Number of inhabited houses according to Rate Book — Rateable value £419,320 Sum produced by a penny rate The Council control the following parks and open spaces :— Southall Park 26 acres. Recreation Groun 18 acres. Manor House Grounds 2 acres. Norwood Green 7.25 acres. Frogmore Green 35 acre. Wolf Green 18 acre. Wolf Fields 3.33 acres Southall Municipal Sports Ground 20 acres. Jubilee Park 11.13 acres. Durdans Park 29.5 acres. Viaduct Field 4.22 acres. Dairy Meadow 6.21 acres. Swimming Bath Site 10.5 acres. West Middlesex Golf Course 136.16 acres. I am indebted to Mr. J. B. Thomson, the Engineer and Surveyor, for the above information. For general administrative purposes and for the main statistical purposes of this report the district is divided into six Wards with boundaries as detailed in previous annual reports. The majority of the houses in the district are occupied by good class working people, chiefly engaged in the local factories and workshops. These include food, jam, and chemical works, engineering, hosiery, paint, dye and wood works, laundries, etc. There are no trades carried on which are at present scheduled as offensive trades. DEATHS AND DEATH RATE Whole District. Total deaths, 444. (Males, 223 ; Females, 221). Crude Death Rate,— For extracts from vital statistics and causes of death see Appendix Tables I and II. From these it will be noted that the deaths are lower in 1942 than in 1941. The deaths from infectious disease are lower, but those from cancer are 1 higher. Deaths from tuberculosis and other respiratory diseases are higher than in 1941. The total number of deaths registered of persons belonging to the district and dying within the district at all ages and from all causes was 178 (males 84 and females 94). For statistical purposes it is necessary to add to this figure the deaths of persons ordinarily resident in the district who died in various London Hospitals, the Hillingdon County Hospital, other Middlesex County Hospitals and elsewhere outside the district. These " outside " deaths were 266 in number (males 139 and females 127). The total number of deaths therefore belonging to the district is 444. The deaths of non-Southall residents in the St. Bernard's Hospital (not included in the above figures) numbered 257 (males 116 and females 141). For the distribution of deaths in the various Wards see Appendix Table III, and for the comparison of general birth and death rates and rates of maternal mortality, see Appendix Table IV. 5 Births and Birth Rate (figures for 1941 are given in brackets). The total number of births notified to the Health Department under the Public Health Act, 1936, was 921 (769). The total number of registered births in the district (under the Births and Deaths Registration Act—included in the notified births above) was 498 (445). The total number of live births belonging to the district whether occurring within or outside the district was 826 (713). The illegitimate live births were 38 (30). There were 23 stillbirths (14), and these were legitimate, with two exceptions. The number of expectant mothers who wish to have their confinements in hospital is steadily on the increase. This is partly due to the inability to obtain help in the home and lack of suitable accommodation in the home for confinement purposes. Many expectant mothers are the wives of serving men, and are often living with relatives, and the contingency of pregnancy has apparently not been anticipated. The table below gives the analysis of the places of confinement and monthly registration of births classified in Wards, is given in Appendix Table V. Details of abnormalities in confinements during 1942 are to be found in Appendix Table XI. The following table gives an analysis of the places of confinement. Total Confinements (live births and still births), 849. No. born in Hillingdon County Hospital 234 or 27% No. born in London voluntary hospitals 31 or 4% No. born in nursing homes or other hospitals 211 or 25% No. confined in their homes by midwives or doctors 373 or 44% Infant Mortality. The total number of deaths under one year of age was 47. The rate per 1,000 births was 55. The corresponding rate for England and Wales was 49, for London 60, and for the 148 smaller towns 46 per 1,000. The infant mortality rate shows a satisfactory decrease on that of the previous year, which can be attributed to the provision of special nourishment for expectant mothers, and the increase of Ante-Natal care. For details of cases of deaths of infants in the year see Appendix Table VII. Maternal Morbidity and Mortality. During the year four cases of puerperal pyrexia were notified. There were two maternal deaths during the year in connection with childbirth ; one occurred in Hillingdon County Hospital. GENERAL PROVISION OF HEALTH SERVICES IN THE BOROUGH. Nursing in the Home. General Nursing. The local District Nursing Association provides three nurses in the district for the home nursing of cases or ordinary sickness and accidents. During 1942 the total number of visits made by the nurses was 7,820. A certain number of these patients were referred to the Nursing Association from the Maternity and Child Welfare Clinics. The Council makes a monetary grant towards the service generally, and a specific grant per visit to toddlers treated under the Maternity and Child Welfare scheme. Infectious Disease (Measles). The Health Visitors act if need be as nurses in the case of Measles outbreaks. No call was made on their services during the year. 6 Clinics and Treatment Centres. The services provided in the district are shown in Appendix Table VI. A report on the work in the diphtheria prevention clinic is given on page 13. The Council affords facilities to all medical men practising in the district for the examination of pathological specimens. This work is carried out by the Ministry of Health Emergency Laboratory, Ealing. The following table shows the work done during the year 1942 (exclusive of work done for the Isolation Hospital (which is shown separately). Table A. Emer. Lab. Swabs for diphtheria 430 Sputa for tubercle 118 Wasserman reaction 7 Faeces and urine 28 Miscellaneous 9 Total 592 Scabies Clinic. The total number who attended the clinic for treatment of scabies and other skin conditions during 1942 was 1,789. Details of the cases were as follows:— Scabies First Visits 460, Reattendances 503, Total 963 Other skin conditions „ „ 140, „ 442, ,, 582 Verminous heads „ „ 87, „ 157, „ 244 While these figures show an increase on the previous year, this does not necessarily mean an increase in the amount of scabies and verminous conditions, as the Cleansing Station, being newly opened in 1941, would not be known to the public generally for some time after that, and although many cases are referred from private practitioners and the clinics, a considerable number attend on their own initiative. Ambulance Facilities. Two motor ambulances under the control of this department are provided by the Council for the use of residents to remove non-infectious and accident cases to hospital, and for other ambulance work. The vehicles are stationed at the Salisbury Road Civil Defence Depot, and are manned by the members of the Casualty Service. Heavy demands are made on this service, and it functions successfully. Details of the work of this service are as follows :— Table B. Ordinary cases removed to hospital 1,831 Accidents 224 Persons taken ill in the street 64 Out of district cases 8 Total 2,127 Miles travelled in the period 17682 Poor Law Medical Relief. The Relieving Officer issued 366 Medical Orders during 1942. Some of these cases also received outdoor relief or institutional treatment. 7 MATERNITY AND CHILD WELFARE. Health Visiting. The district is divided into five health visitor's areas, in which each officer does all health visiting work, including infectious diseases, home-visiting, and visiting schools in connection with infectious disease, but excluding child life protection visiting which, as heretofore, is done by one of the health visitors, who is also Child Protection Visitor. See Appendix Table VIII for summary of visits during 1942. While the number of visits wasted because of no access is considerable, it compares very favourably with other districts. In some areas this figure is very much higher. Child Life Protection. The general arrangements as outlined in the report for 1934 remain unaltered. The Council has decided that the register of foster mothers and children should be reviewed annually. This expedites the removal from the register of foster mothers who do not wish to take in further foster children, and so keeps the register in a live condition. See Appendix Table IX for statistics of this work. Consultant Aid in Difficult Labour. The arrangements outlined in the report for 1934 remain unaltered. During the year the consultant was not called in. An economic circumstance scale is in force and includes the payment of fees in these cases. Institutional Provision for Unmarried Mothers, Illegitimate Infants and Homeless Children in the District. None. Ultra-Violet Light Clinic. This treatment clinic is held at the Manor House twice a week, from October until May. The general types of patients recommended for treatment are children suffering from malnutrition, general debility, chronic bronchitis, and rickets, and expectant mothers who are not in a satisfactory condition. Cases of infantile eczema and other conditions are also occasionally treated. The ultra-violet light has produced some very good results, and there is constantly a considerable number on the waiting list for treatment. Table C. Number of sessions held : 30. Number of attendances :— First Visits. Re-visits. Mothers 83 810 Infants 151 1,401 Post-Natal and Birth Control Clinic. Table D. Number of Sessions held : 22. Number of attendances :— Post-Natal. Birth Control. First Visits 137 34 Re-attendances 106 113 8 Ante-Natal Clinics. The number of new patients seen at the ante-natal clinics during the year was 642, and the total number of attendances was 3,554 (1,885 at the Manor House and 1,669 at the Branch Centre). 551 cases were completed during the year, and the attendances in respect of these were as follows :— No. of Cases. One attendance 64 Two attendances 52 Three attendances 56 Four attendances 62 Five attendances 80 Six or more attendances 227 No attendance 10 For table of comparison of figures for last eight years, and the proportion of new cases to re-visits, see Appendix Table X. The latter figure has shown a gratifying increase during the year in spite of war conditions, which would seem to tend to make it otherwise, as many expectant mothers manage to attend regularly at the Ante-Natal Clinics, although they are continuing to do work to which they have been directed, or which they require to do because of monetary considerations. Of the total cases seen, 780 (642 new cases and 138 brought forward from 1941), 551 were completed during the year, 15 were non-pregnant, 35 left the district, and 179 were uncompleted at the end of the year. This report, therefore, deals with 551 completed cases, 138 for 1941 and 413 occurring in 1942. Of these cases 415 were normal and 136 showed abnormalities. Table E. Primipara (1st Pregnancy) Multipara (2nd or Subsequent Pregnancy) Delivered at home Admitted to hospital or Nursing Home Primipara Multipara Primipara Multipara Normal cases 173 272 64 208 109 64 Abnormal cases 37 69 10 19 27 5° Of the cases dealt with therefore 210, or 38 per cent., were primiparae (against 44 per cent, in 1941) and of these 136, or 64 per cent. (against 54 per cent. in 1941), were confined in hospital, while 114 cases, or 41 per cent. (against 28 per cent.) of the multiparae were also confined in hospital. Table XI in Appendix gives the chief abnormalities found during the year. Child Welfare Clinics. The attendances at the Child Welfare clinics during 1942 are shown in Table XII in Appendix. The total number of attendances at the Infant Welfare and Toddlers' Clinics during 1942 was 13,346, as compared with 11,109 for 1941. For the proportion of new infant cases attending the clinics to the total five births in the district, see Appendix, Table XIII. 9 Pre-school Medical Inspection (Toddlers' Clinics). Toddlers' Clinics are held fortnightly at each centre. The total attendances at these clinics were 432, 269 at the Manor House and 163 at the Branch Centre. (See Appendix, Tables XIV, XV, XVI, XVII, and XVIII.) The general physical condition of children under five years of age in Southall is on the whole satisfactory as the defects found, although apparently large in number, contain several of a minor degree which are present fortuitously at the time of examination and are quickly relieved. Many children were selected during the year for treatment at the remedial exercise classes where defects of posture and slight deformities are corrected by specially arranged courses of exercise. Beneficial results are achieved in early cases and small defects prevented from having serious debilitating effects in later life. Treatment is arranged by the department for all defects found, and parents are very happy to take advantage of the facilities. Treatment. Cases of acute illness, and of chronic illness where indicated, are referred to their own doctors for treatment. For certain illness the following arrangements have been made with London and local hospitals:— Defect. Hospital. Tonsils and Adenoids King Edward Hospital, Ealing, but during the war, St. Bernard's Hospital treat these defects. Orthopaedic conditions North Road School Clinic. Orthoptic „ Western Ophthalmic Hospital, Marylebone Road. Rheumatic ,, Hospital for Sick Children, Great Ormond Street, W.C. Child guidance West End Hospital for Nervous Diseases, Welbeck Street, W.i. There are disadvantages in this variety of hospitals, but with the geographical position of Southall some disadvantages are unavoidable. Help is given with payment of fares if the family income is below a certain scale. A system of following-up has been instituted whereby the health visitors make enquiries to see if the proper treatment has been carried out and, if not, steps are taken to persuade the parent to obtain the necessary treatment. Remedial Exercises—Recommenced July, 1942. Two afternoon sessions of special Margaret Morris Movement exercises are held each week at the Branch Health Centre. The duration of the session is two hours, the first half being devoted to children and the second to expectant mothers. The attendances from July until the end of the year are tabulated below :— Infants. Mothers. First visits 48 14 Re-attendances 322 60 Voluntary Help at Clinics. The voluntary workers continue to give considerable help in the running of the Infant Welfare clinics. As has been pointed out before, the help given greatly aids the efficient running of the clinics and it also saves considerable expense to the Council, who are deeply appreciative of the work done. 10 Midwives. Arrangements in the Council's Domiciliary Midwifery Service remain unchanged and leaflets are issued describing the services provided. These are available at the Manor House and the Branch Health Centre. Midwives attend regularly at the ante-natal clinics, where in consultation with the doctor any anticipated difficulties can be discussed and a solution found. (See Appendix, Tables XIX and XX for information dealing with notifications relating to Southall received from midwives resident in Southall during the year. This information is based on material kindly supplied by the County Medical Officer of Health.) The monthly bookings for each district are included below, Table F :— Districts No. 1 No. 2 No. 3 No. 4 No. 5 January 5 11 5 7 6 February 8 1 2 5 3 March 7 10 6 6 5 April 9 8 11 13 6 May 5 7 2 7 7 June 5 7 1 9 7 July 4 6 4 8 10 August 3 7 8 11 5 September 3 3 7 8 6 October 4 4 1 5 3 November 2 7 4 9 4 December 5 6 4 9 2 Maternity and Nursing Homes. The Middlesex County Council is the local authority under the Acts relating to the registration of maternity and other nursing homes. There are two private nursing homes in the district. The following information, relating to maternity and nursing homes in Southall, has been kindly supplied by the County Medical Officer :— Table G. Total number of registered nursing homes in Southall 2 Total accommodation (No. of beds) 26 Number of deletions during the year 1942 Nil Number of additional applications re registration during the year 1942 Nil Number so registered Nil Refusals or cancellations of registration Nil Number of applications for exemption of registration Nil Result of such applications Nil Grants of Milk. Milk is supplied free or at a reduced rate to expectant mothers (from the third month of pregnancy), to nursing mothers, and to children under five years of age, according to a scale which has been adopted by the Council. Because of the scheme of the Ministry of Food for supplying dried milk and liquid milk at 2d. per pint, according to income, to children under five years of age and expectant mothers, the number who still require assistance under the Borough Council's scheme is very much reduced. 11 There were 124 applications granted during the year, as follows:— Table H. Cow's milk free Cow's milk at 50% cost Dried milk free Dried milk at 50% cost 1942 2 7 104 18 Dental Treatment. By arrangement between this Council and the County Education Authority, expectant and nursing mothers and children under five years of age attending the Maternity and Child Welfare Centres are enabled to have dental treatment and advice, including if necessary the provisions of dentures. (For statistics of dental treatment see Appendix, Table XXI. The figures show a grand total of 659, compared with 681 for 1941.) PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. The Southall Isolation Hospital continued to take cases during the year, and along with reciprocal arrangements with the Ealing, Brentford and Chiswick Hospital, it was possible to deal with all the cases of infectious disease notified. As the hospital was not very full at any time during the year, it was possible to help the Commanding Officers of various units of the Army and Royal Air Force, by taking cases of infections from neighbouring camps into the hospital, although actually these were not Southall cases. Provision of Antitoxin. The Council provides antitoxin free to local medical practitioners for cases of diphtheria in the district. The Ministry of Health has also sanctioned the supply of tetanus antitoxin by the Council to local practitioners if such is required. Diphtheria and tetanus antitoxin can always be obtained at the Health Department during office hours or at the Isolation Hospital at other times. Vaccination. The total number of successful vaccination certificates received during the year was 294, and the number of certificates of exemption issued were 168. Table XXII in Appendix gives details of the percentage of children successfully vaccinated during the last seven years. Disinfection. In cases of infectious disease, rooms, clothing, etc., are disinfected—rooms by sealing and fumigating with formalin or a formalin preparation ; clothing, bedding, etc., and infected articles which can be removed for steam disinfection, by treatment in the disinfector at the hospital. 12 Table I. List of premises, articles, etc., disinfected during the year:— Rooms 118 Covers 103 Beds 240 Eiderdowns 43 Blankets 476 Pillows 493 Bolsters 97 Sheets 353 Books 56 Miscellaneous 352 Scabies clinic: Bags of clothing 122 Total 2,528 The following articles were destroyed : 5 mattresses, 1 sheet, 1 blanket. Cancer. It will be seen by the table of causes of death (Table II of Appendix) that in 1942, 72 cases (34 males and 38 females) died from cancer. (See Appendix, Tables XXIII and XXIV.) An increase in cancer mortality will be noted. Special Infectious Diseases. Smallpox (Variola). No patients with smallpox or contacts of cases of smallpox were notified to the Department during the year. No work was done under the Public Health (Smallpox prevention) Regulation, 1917. Scarlet Fever (Scarlatina). The number of notifications received during the year was 100 as compared with 59 for the previous year. Of these, 94 were removed to the Isolation Hospital. The cases of scarlet fever were mild in character with few complications. Diphtheria. There were 22 cases of diphtheria notified as compared with 60 in 1941. All the cases were removed to the Isolation Hospital. There was one death from diphtheria of residents during the year. Diphtheria Prevention. The campaign for immunising all school children and pre-school children continued throughout the year. The figures of immunisations performed show an increase over those of 1941, undoubtedly due to local efforts and the Ministry of Health broadcasts. Table J. Number of sessions held 92 Total attendances made 11,621 Average attendance per session 126 Highest attendance at a session 193 Lowest attendance at a session ... ... ... 61 During 1942 the number of new cases was 2,880 During the year the number of sessions for diphtheria immunisation at Council clinics was increased by the commencing of a weekly clinic on Monday afternoons at the Branch Health Centre. Ophthalmia Neonatorum. There were 6 cases of ophthalmia neonatorum notified in 1942. Acute Poliomyelitis. No case was notified in the Borough during the year. 13 Notifiable Diseases during the Year. For the incidence of various infectious diseases, excluding tuberculosis, notified during the year, under age groups, locality, and certain cases occurring among school children, see Appendix, Tables XXV, XXVI, and XXVII. Infectious Disease Visits. During the year, the Health Visitors paid 730 visits with reference to cases of infectious disease. One hundred and ninety-five swabs were taken. The total number of children examined by the Health Visitors in the schools was 505. Uncleanliness and Verminous conditions in Schoolchildren. I am obliged to Dr. H. M. C. Macaulay, the school medical officer, for the information on this subject :— Number of children on roll at 31st December, 1942 6,642 Total number of examinations of children in the schools by the school nurses 15,123 Number of individual children found unclean 461 Number of children cleansed under arrangements made by the Local Education Authority 12 No legal proceedings were taken during the year with regard to uncleanliness or verminous conditions relating to children attending schools in the Borough. Prevention of Blindness. No action has been taken under Section 176 of the Public Health Act, 1936, by this authority for the prevention of blindness or for the treatment of persons suffering from any disease or injury to the eyes. Several persons are, however, receiving assistance from organisations who care for the blind. Tuberculosis. Pulmonary Tuberculosis. The number of new cases notified during the year was 51. Other Forms of Tuberculosis. The number of new cases notified during the year was 13. Of the total notifications 37 were notified from Institutions (Sanatoria 6, County Council Hospitals 15, General Hospitals 16). Deaths from Tuberculosis. Tuberculosis of the respiratory system, 24 ; other forms, 7. For details of new cases notified and deaths in 1942, see Appendix, Table XXVIII, and for the occupations of new cases, see Appendix, Table XXIX. Public Health (Prevention of Tuberculosis) Regulations, 1925. Public Health Act, 1936, Section 172. Action under these powers was not necessary during the year. Venereal Diseases. The Middlesex County Council is the authority under the Public Health (Venereal Disease) Regulations, for the treatment of Venereal Disease in the County. 14 REPORT ON THE BOROUGH ISOLATION HOSPITAL. During the year 146 patients were admitted to the Isolation Hospital as compared with 126 in 1941. Of these, 94 were sent in as scarlatina (56 in 1941) and 24 as diphtheria (59 in 1941), 3 as measles, and 3 as scabies, 2 as rubella, 14 as chickenpox and 6 as mumps. Of the cases sent in as scarlatina, 5 were unconfirmed. Similarly, of the cases sent in as diphtheria or suspected diphtheria, 5 were unconfirmed. For details of cases during the year, and dealt with each month of the year, see Appendix, Tables XXX and XXXI. Scarlatina. Of the 94 cases admitted 90 were finally diagnosed, and the following table shows the incidence in age groups of the 90 cases of scarlatina which were nursed at the hospital:— Table K. Age (years) 0-5 5.15 15.25 25.35 35 + Number 3° 54 5 — 1 Two minor operations were performed, one for abscess of ankle and one for removal of toe-nail. One case of scarlatina was on admission incubating mumps. This gave rise to 2 cases of secondary infection. Complications of the cases of scarlatina were :— Cervical adenitis 1 Septic rashes 2 Rhinitis 3 Septic finger and toes 3 Nephritis 1 Rheumatism 1 Secondary attacks 2 Bronchitis 1 Cellulitis 1 Cardiac irregularity 7 Diphtheria. Twenty-four cases notified as diphtheria were admitted to the hospital. Nineteen of these were confirmed as diphtheria. The following table shows the incidence of the cases in age groups:— Table L. Age (years) 0.5 5.15 15.25 25.35 35 + Number 1 10 7 — i The clinical types in which the diagnosis was substantiated were as follows:— Tonsillor (Faucial) 12 Naso-pharyngeal 4 " Bacteriological" 3 Four of the cases were severe. 15 The complications recorded were as follows:— Cardiac irregularity 3 Palatal paralysis 1 One case became a convalescent carrier and was in hospital 299 days. Tonsillectomy was performed at Ealing Isolation Hospital. Other Diseases. Ten cases admitted as scarlatina or diphtheria were subsequently diagnosed as suffering from other diseases. These were as follows (one case notified as diphtheria and diagnosed as scarlatina is included in the return of this second disease):— Diseases notified as scarlatina: Tonsilitis, 1. Measles and chickenpox, 1. Dysentery carrier, 1. Measles and mumps, 1. Impetigo, 1. Diseases notified as diphtheria : Laryngitis, 1. Scarlatina, 1. Tonsilitis, 2. Septic quinsy, 1. Stay in Hospital. The average stay in hospital was as follows:— Scarlatina : All cases (90) 38.7 days. Patients remaining over 56 days 80 0 „ Patients remaining under 56 days 34.08 „ Diphtheria : All cases (19) 60.3 „ Patients remaining over 56 days 93.2 „ Patients remaining under 56 days 30.7 ,, Other diseases : All cases (9) 16.8 „ Laboratory Work. The laboratory work for the hospital was done by the Emergency Laboratory, Ealing. During the year the following examinations were performed:— Table M. Emer. Lab. Swabs for diphtheria bacilli 166 Swabs for virulence tests for diphtheria 2 Haemolytic streptococci 1 Bact. test for jaundice 1 Dysentery tests 5 Sick Staff. Table N. Permanent. Temporary. Number of staff off duty for 24 hours or more 1 2 Total number of days off duty 46 66 Casual conditions : Gastro-enteritis and jaundice, scarlet fever 46 — Sub-acute rheumatism — 49 Abscess — 17 16 SANITARY CIRCUMSTANCES OF THE BOROUGH. Water Supply. Water is supplied to nearly the whole of the district by the South West Suburban Water Company. The Metropolitan Water Board supplies a small area in the southern part of the district, and the Rickmansworth and Uxbridge Valley Water Company a small area in the northern part. The supply is satisfactory both in quality and in quantity. Sampling : six samples were taken during the year and found to be satisfactory. Sanitary Inspection of the District. The total number of inspections of premises made during the year in connection with the work of the Sanitary Inspectors was 5,998. Tables XXXII and XXXIII show an analysis of the number and nature of such inspections, and the number of complaints received during the year. Eradication of Bed Bugs. Table 0. Statistics for the year:— (a) Number of Council houses (1) found to be infested 14 Total (1) 32 (2) 32 (2) disinfested during the year 14 (1b) Number of other houses (1) found to be infested 18 (2) disinfested during the year 18 Canal Boats. Visits merged with other duties were paid to the canal and 6 boats were inspected. The condition of both boats and occupants was satisfactory. There were no complaint notices issued by other authorities. Mortuary and Post-mortem Room. The new Mortuary situated in Havelock Road, provides adequate accommodation for the Borough. Petroleum and Carbide. During the year 55 applications for licences to store petroleum were granted and four applications were granted for licences to store carbide of calcium. The licensed premises have been inspected at regular intervals during the year. Celluloid and Cinematograph Films Act, 1922. There is one licence in force for the purpose of stripping and making celluloid solution from cinematograph films, and the premises used were periodically inspected during the year. Housing. For statistics see Table XXXIV in the Appendix. 17 ADMINISTRATION OF THE SHOPS ACTS. The adjustment of hours to meet wartime conditions and the obvious endeavour of shopkeepers generally to co-operate to secure the best result, offset the unavoidable neglect of this work. The routine inspection of food shops which was maintained enabled some control to be exercised on other trades. INSPECTION AND SUPERVISION OF FOOD. Milk. The following licences under the Milk (Special Designations) Order, 1936, were granted during 1942:— for the sale of Tuberculin Tested milk 13 for the sale of Accredited milk — for the sale of Pasteurised milk 20 for Pasteurisation 2 Supplementary Licences 2 a total of 37 licences being in force at the end of the year. Sampling. Ninety-nine samples of milk, designated and undesignated, were sent during the year for bacterial count. The examinations are carried out at the National Institute for Research in Dairying, Reading, or at the Public Health Emergency Laboratory, Ealing. The samples are sent by train to the .Institute or delivered at the Laboratory, and are invariably examined within four to six hours of being taken. Food Sampling. The chemical or bacteriological analyses of four food samples taken during the year by the Sanitary Inspectors were carried out by the Public Analyst. The Food and Drugs (Adulteration) Act is administered by the County Council. The figures for 1942 are not available. Food Inspection. Inspections are made of the carcases of recently slaughtered animals, and of premises where meat, fish and other foods are sold or prepared for sale. There is no registered slaughterhouse or public abattoir in the district, and most of the meat supplied comes from the Ministry of Food Distribution Centre. FOOD INSPECTIONS. Table P. Details: Total Inspected Passed as Sound Destroyed Passed for Human Consumption Passed for Animal Feeding Canned (lbs.) (lbs.) (lbs.) (lbs.) (lbs.) 184,435 73.452 2,128 91,020 15.432 Raw 9.903 4.155 1,981 1,094 4.554 Totals 194.338 77,607 4,109 92,114 19,986 18 APPENDICES EXTRACTS FROM VITAL STATISTICS. Table I. Comparative figures for 1941 Total Male Female Live Births —Legitimate 788 409 379 683 Illegitimate 38 21 17 30 Stillbirths— Legitimate 21 12 9 24 Illegitimate 2 1 i Deaths 444 223 221 509 Birthrate (live and stillbirths) per 1,000 of estimated population — — Stillbirth rate per 1,000 total (live and still) births — — Crude death rate per 1,000 of the estimated population — — Deaths from Puerperal Causes (Headings 29 and 30 of the RegistrarGeneral's Short List): Deaths. Rate per 1,000 total (live and still) births. No. 29. Puerperal sepsis 1 1.17 No. 30. Other puerperal causes 2 2.35 1.3 Total 3 352 Death rate of infants under one year of age:— All infants per 1,000 live births 5690 6931 Legitimate infants per 1,000 legitimate live births 57'11 6352 Illegitimate infants per 1,000 illegitimate live births 5262 2000 Deaths from cancer (all ages) 72 7i Deaths from measles (all ages) — 2 Deaths from whooping cough (all ages) — — Deaths from diarrhoea, etc. (under 2 years of age) 8 20 20 Causes of Deaths, 1942. Table II. Male. Female. Total 1942. Total 1941. 1. Typhoid fever, etc _ _ _ — 2. Cerebro-spinal fever - 2 2 1 3. Scarlet fever _ — _ — 4. Whooping cough - - - - 5. Diphtheria 1 - i 4 6. Tuberculosis—Respiratory 11 13 24 34 7. Other tuberculosis 4 3 7 4 8. Syphilitic diseases 3 3 6 3 9. Influenza - — 4 10. Measles — _ — 2 11. Ac. poliomyelitis and polioencephalitis - 1 1 1 12. Ac. inf. encephalitis 1 1 2 1 13/16. Cancer (all forms) 34 38 72 7i 17. Diabetes 2 6 8 3 18. Intra-cran. vase, lesions 18 23 41 37 19. Heart disease 47 35 82 99 20. Other circulatory diseases 4 17 21 22 21. Bronchitis 9 5 14 42 22. Pneumonia (all forms) 19 16 35 45 23. Other respiratory diseases 2 2 4 6 24. Ulcer of stomach or duodenum 7 2 9 4 25. Diarrhoea, etc. (under 2 years) 6 2 8 20 26. Appendicitis - 1 1 - 27. Other digestive diseases 5 7 12 6 28. Nephritis 2 1 3 11 29. Puerperal sepsis - i 1 - 30. Other maternal cause - 2 2 1 31. Premature birth 7 6 13 6 32. Congenital malformations, etc 11 5 16 12 33. Suicide 1 2 3 2 34. Road traffic accidents 2 - 2 5 35. Other violence 9 4 13 16 36. All other causes 18 23 41 47 Total Death 223 221 444 509 Table III. Ward Male Female Total Waxlow Manor 26 26 52 Northcote 29 23 52 Hambrough 41 44 85 Dormers Wells 36 28 64 Glebe 53 57 110 Norwood Green 38 43 81 Total 223 221 444 21 Table IV. Vital Statistics compared with other Areas. BIRTH-RATES, CIVILIAN DEATH-RATES, ANALYSIS OF MORTALITY, MATERNAL DEATH-RATES, AND CASE-RATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR 1942. (England and Wales, London, 126 Great Towns and 148 Smaller Towns.) (Provisional Figures based on Weekly and Quarterly Returns) ( England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns (Resident Populations 25,000 to 50,000 at 1931 Census) London Administrative County Southall Rares per 1,000 civilian Population Births :— Live 158 17.3 184 14.0 Still 0.54 o.66 0.62 0.48 Deaths :— All Causes 11.6 13.3 12.1 13.9 Typhoid & Paratyphoid fevers o.oo o.oo o.oo 0.00 Smallpox — — — — — Measles o.o1 0.02 o.oi o.o1 Scarlet Fever 0.00 o.oo 0 00 o.oo Whooping Cough 0.02 0.03 0.02 0.04 Diphtheria 0.05 0.06 0.04 0.02 Influenza 0.09 0.09 o.io 0.07 Notifications:— Smallpox o.oo o.oo — 0.00 — Scarlet fever 2.19 2.49 2.34 1.86 Diphtheria 1.05 1.35 0.91 0.76 Typhoid fever o.o1 0.01 o.o1 0.02 Erysipelas 0.30 0.36 0.26 0.43 Pneumonia 1.07 1.30 094 0.94 Measles 746 9.27 7.39 8.62 Cerebro.spinal fever 0.14 0.17 0.12 0.15 — Whooping Cough 1.73 1.97 1.58 2.72 Rates per 1,000 Live Births Deaths under 1 year of age Deaths from Diarrhoea and 49 59 46 60 Enteritis under 2 years of age 5.2 7.5 4.8 8.6 Maternal Mortality :—(Excluding Abortion Puerperal Sepsis 0.42 Not available Others 1.59 Total 2.01 Notifications:— Puerperal fever 12.61 15.94 10.8o 3.10 Puerperal pyrexia 17.69 22 Table No. V. Monthly Registration of Births. Waxlow Manor North. cote Hambrough Dormers Wells Glebe Norwood Green Total January 5 8 2 6 12 7 40 February 9 3 3 6 9 8 38 March 7 4 2 5 5 6 29 April 6 9 5 11 13 9 53 May 12 8 6 4 12 8 5° June 5 7 4 1 7 7 31 July 6 5 9 6 13 9 48 August 7 4 6 9 12 7 45 September 6 7 10 4 15 4 46 October 8 9 3 4 15 8 47 November 2 6 5 2 11 9 35 December 6 7 2 7 11 3 36 79 77 57 65 135 85 498 23 Table VI. Clinics and Treatment Centres. Situation Services Provided Day and Time By whom provided M. and C.W. Ante-Natal Clinics Manor House Medical Supervision Tuesday 2 p.m. Thursday 10 a.m. The Council Branch Centre Medical Supervision Tuesday 10 a.m. Friday 10 a.m. *M. and C.W. Mothercraft Manor House Teaching of Mothercraft Tuesday 2.30 p.m. The Council Branch Centre Teaching of Mothercraft Wednesday 2 p.m. M. and C.W. Birth Control Clinic Manor House Birth Control Advice, etc. The second and fourth Mondays at 10 a.m. The Council M. and C.W. Dental Clinic North Road School Dental Inspection and Treatment of Expectant and nursing mothers and children under 5 years Friday 2 p.m. and by appointment The Council M. and C.W. General Clinics Manor House Supervision of mothers and children under five years New Cases : Friday 2 p.m. Re-visits : Monday 2 p.m. Wednesday 2 p.m. The Council Branch Centre ditto New cases : Thursday 10 a.m. Re-visits : Monday 10 a.m. Tuesday 2 p.m. Thursday 2 p.m. M. and C.W. Toddlers' (Special) Clinic Manor House Medical Inspection of pre-school children First and third The Council Wednesday 10 a.m. Branch Centre ditto Second and fourth Wednesday 10 a.m. The Council Remedial Exercise Clinic Branch Centre Remedial exercises for Mothers and Toddlers Wed. and Friday— Mothers 2 p.m. Toddlers 3 p.m. The Council Diphtheria Prevention Manor House Branch Centre Immunisation against diphtheria Thursday 2-3 p.m. Monday 2-3 p.m. The Council School Clinics Featherstone Road School Medical Inspection and Treatment of School Children Daily at 10 a.m. Middlesex Education Authority Venereal Diseases Various County and London Hospitals Examination and Treatment Daily, 7.30 a.m. to 7.30 p.m. Middlesex County Council Tuberculosis Dispensary Uxbridge Chest Clinic, High Street, Uxbridge Dispensary treatment and supervision Mon. and Thurs., 1.30 p.m. Wed. and Fri., 10 a.m. Middlesex County Council Scabies and Verminous Conditions Crosby House, Osterley Park Road Treatment of Scabies, etc., and cleansing of verminous conditions Scabies: Mon. and Thurs., 10 a.m. Verminous conditions: Tues. and Fri., 10 a.m. The Council *Suspended during war. 24 Table VII. Certified Cause of Death. Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under weeks 1-3 months 3-6 months 6-9 months 9-12 months Total deaths under 1 year Bronchitis, Pneumonia, etc. 2 _ 1 _ 3 3 2 _ 1 9 Accidental _ _ _ _ _ 2 _ _ _ 2 Congenital Malformations, etc. 9 _ _ _ 9 _ _ _ _ 9 Gastro-enteritis, Diarrhoea, etc. _ 2 _ 1 3 1 2 1 8 Congenital Heart Disease 3 2 _ _ 5 _ _ _ _ 5 Prematurity 10 _ _ _ 10 1 _ _ _ 11 Miscellaneous 1 _ _ 1 2 _ _ _ 1 3 25 4 1 2 32 7 4 1 3 47 Live Births. Legitimate, 788. Infant Deaths. Legitimate, 45. Illegitimate, 38. Illegitimate, 2. The monthly registration of births classified as to Wards is given following table. Table VIII. Summary of Health Visiting Work for the year 1942. Visits to infants— First visits 735 Re-visits 2,986 Visits to children— First visits 84 Re-visits 4,313 Visits to expectant mothers 707 Visits for infectious disease 730 Visits to schools 43* Child Life Protection visits 189 Miscellaneous visits 322 Removals 210 No access 1,127 Total 11,446 *At these visits a total of 505 children were examined. 25 Table IX. (1) Number of foster parents on register— (a) At the beginning of the year 28 (b) At the end of the year 22 (2) Number of foster parents receiving foster children— (a) At the beginning of the year 17 (b) At the end of the year 22 (3) Number of children on the register— (a) At the beginning of the year 24 (b) At the end of the year 27 (4) Number of children received by foster parents during the year 21 (5) Number of foster children— (a) Reached the age of nine during the year 1 (b) Removed during the year to different foster parents or to children's societies 5 (c) Adopted 1 (d) Returned to parents 10 (e) Removed at the request of the medical officer of health — (f) Evacuated with foster mother — (g) Died during the year 1 (h) On whom inquests were held 1 (6) Total number of visits made during the year 189 (7) Number of cases in which court proceedings were taken Nil All foster children, as soon as reasonably possible after arrival, are subjected to a medical examination by the medical officer of health, or by the medical officers at the infant welfare centres. Table X. First visits Re-visits Average number of re-visits per patient Total number of births in the District Percentage of new cases to total births 1935 265 867 3.27 835 31.7 1936 300 998 3.33 827 36.3 1937 407 1333 3.27 848 47.9 1938 531 2157 4.06 856 62.03 1939 506 2109 4.53 824 61.42 1940 433 2036 5.70 732 59.16 1941 549 2358 4.33 713 76.30 1942 642 2912 4.55 826 77.71 Of the 3,554 total attendances, 1,885 occurred at the Manor House centre and 1,669 at the Branch centre. 26 Table XI. (a) Abnormalities of the foetus— (i) twins 4 (ii) abortions 9 (iii) stillbirths 10 (iv) other conditions 16 (b) Abnormalities of the mother— (i) unsatisfactory measurements 25 (ii) post partum haemorrhag 10 (iii) ante partum haemorrhage 5 (iv) albuminuria 6 (v) high blood pressure (exceeding 140 systolic or 90 diastolic other than on the first attendance) 41 (vi) other conditions 21 Neo-Natal Mortality (before the seventh day) 19 Table XII. Manor House— Seen by medical officer: Infants 2,770 Children at ordinary clinics 827 Children at toddlers' clinics 269 Weighing only: Infants 2,553 Children 375 New cases (included in above): Infants 330 Children 66 Branch Centre— Seen by medical officer : Infants 3,801 Children at ordinary clinics 1,262 Children at toddlers' clinic 163 Weighing only: Infants 1,094 Children 232 New cases (included in above): Infants 275 Children 60 Total attendances 3,346 The total attendances at the clinics during the past six years have been as follows:— 1937 12,502 1940 12,033 1938 14,351 1941 11,109 1939 15,452 1942 13,346 27 Table XIII. (1) (2) (3) New Infant Cases Total live births Percentage of (1) to (2)* 1931 337 657 51 1932 408 745 54 1933 350 705 49 1934 395 759 52 1935 563 809 69 1936 558 797 70 1937 598 814 73 1938 711 825 86 1939 652 805 86 1940 567 717 79 1941 586 713 82 1942 605 826 73 *This percentage is a little in excess of the true percentage of live births subsequently attending the clinics as it includes cases born in and belonging to other districts who have since moved to Southall and attended the clinics here during their first year of life. Table XIV. Number of Inspections in stated Groups : Manor House Branch Centre Total 18 months 94 39 133 2 years 53 49 102 3 years 61 27 88 4 years 58 46 104 Total Routine 266 161 427 Other inspections 3 2 5 Total 269 163 432 Table XV. Number of Individual Children found at Routine Medical Inspection to require Treatment (excluding Dental Disease) : Manor House Branch Centre Total 18 months 24 25 49 2 years 13 21 34 3 years 18 11 29 4 years 13 12 25 Total 68 69 137 28 Table XVI. Number requiring Dental Treatment : Manor House Branch Centre Total 18 months — — — 2 years — 1 1 3 years 4 8 12 4 years 9 10 19 Total 13 19 32 Nutrition is assessed for each age group in four grades (A—excellent, B—good, C—slightly subnormal, and D—bad) according to the recommendations of the Board of Education. Table XVII. Nutrition. Manor House Branch Centre Total A B C D 18 months A 69 23 92 38 3 — B 22 16 C 3 — D — — 2 years A 29 28 57 43 2 — B 22 21 C 2 — D — — 3 years A 31 14 45 40 3 — B 27 13 C 3 — D — 4 years A 32 17 49 55 — — B 26 29 C — — D — — Total 266 161 243 176 8 — 29 Table XVIII shows the individual defects found at medical inspection. It must be remembered that one child may show several defects, and that all defects, however slight, are recorded. Table XVIII. Defects Found. Manor House Branch Centre Total Skin 1. Ringworm — — — 2. Scabies — — — 3. Impetigo — 1 1 4. Other diseases (non-tubercular) — — — Total 1-4 — 1 1 Eye 5. Blepharitis — — — 6. Conjunctivitis 13 1 14 7. Keratitis and opacities — — — 8. Other conditions (excl. defective vision and squint) 5 5 10 Total 5-8 18 6 24 9. Defective vision _ _ — 10. Squint 7 — 7 Ear 11. Defective hearing — — — 12. Otitis media 2 — 2 13. Other ear diseases — 1 1 Nose and Throat 14. Chronic tonsils and/or adenoids 11 20 31 15. Other conditions — — — 16. Enlarged cervical glands (non-tubercular) — — — 17. Defective speech — — — Heart and Circulation 18. Organic heart disease — — — 19. Functional heart disease — — — 20. Anaemia — — — Lungs 21. Bronchitis — — — 22. Other non-tubercular diseases — — — 23. Pulmonary tuberculosis — — — Tuberculosis 24. Glands — — — 25. Bones and joints —- — — Nervous system 26. Chorea — — — 27. Other conditions 1 1 2 Deformities 28. Rickets deformities — — — 29. Genu valgum 18 months — — — 2 years 3 i 4 3 years 2 2 4 4 years — 2 2 30. Other forms — — — 31. Other defects and diseases 24 35 59 32. Dental diseases 18 months — — — 2 years — 1 1 3 years 4 8 12 4 years 9 10 19 30 Table XIX. Medical Help, Mothers and Children 127 Laying out dead body 2 Liability to be a source of infection 8 Death of child 5 Stillbirths 4 Artificial feeding 5 The reasons for sending 127 notifications for medical help were as follows:— Table XX. During pregnancy 6 For miscarriage 8 During labour 72 During puerperium 19 Infant conditions 22 Table XXI. Expectant and Nursing Mothers:— Number sent to the dentist for inspection 113 Number inspected 113 Number for whom treatment was completed 75 Number of completed dentures 51 Number of fillings 108 Number of local anaesthetics 11 Number of general anaesthetics 72 Total number of attendances and re-attendances 535 Children under five years of age:— Number sent for inspection 63 Number inspected 63 Number for whom treatment was completed 57 Number of fillings 9 Number of local anaesthetics — Number of general anaesthetics 55 Total number of attendances and re-attendances to dentist 124 These figures show a total number of 659 attendances compared with 681 in 1941, 724 in 1940 and 813 in 1939. 31 Table XXII. Year Live Births Vaccination Certificates Exemptions Percentage of vaccinations to live births 1935 809 301 286 37 1936 797 312 299 39 1937 814 287 309 35 1938 825 265 298 32 1939 805 278 285 34 1940 717 289 184 40 1941 713 267 173 37 1942 826 294 168 35 Table XXIII. Year Male Female Total Estimated population Rate per 1,000 population 1922 18 18 36 1923 21 14 35 1924 20 18 38 1925 — — 40 1926 12 11 23 1927 13 13 26 1928 18 27 45 1929 12 10 22 1930 17 29 46 1931 20 28 48 1932 22 23 45 1933 23 28 51 1934 22 27 49 1935 30 27 57 1936 22 30 52 1937 42 28 70 1938 27 30 57 1939 33 41 74 1940 28 36 64 1941 34 37 71 1942 34 38 72 The following table shows the age distribution of the cancer deaths:— Table XXIV. Ages at Death in Cancer Cases. Age 0-15 15-30 30-40 40-50 50-60 60-70 70-80 80 + Male — _ 1 1 11 10 10 2 Female — — 3 7 4 7 14 3 Total — — 3 8 15 17 24 5 32 The following table shows the various infectious diseases (other than tuberculosis) notified during the year and also their age incidence :— Table XXV. Notifiable Diseases during the year (other than Tuberculosis). Diseases Ages Total cases notified Cases admitted to hospital Deaths Under 1 year 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 65 65 and over Whooping cough 9 12 12 15 9 36 2 2 — 1 — — 98 — — Scarlet fever 3 4 5 16 8 54 9 5 — 1 — — 105 94 — Diphtheria — — i — 1 6 6 4 1 — — — 19 19 1 Measles 11 26 15 29 36 196 11 7 2 — — — 333 — — Puerperal pyrexia — — — — — — — 2 2 — — — 4 1* — Erysipelas — — — — — — — — — — 4 — 4 4* — Pneumonia 3 i — 2 i 4 3 3 6 6 13 8 50 27 35 Ophthalmia neonatorum 6 — — — — — — — — — — — 6 2 — Cerebro-spinal fever, &c. — — 1 — 2 — — 3 — — — — 6 6* 2 *To London hospitals or institutions outside the district. The number of cases of infectious diseases (including tuberculosis) notified during the year, according to their locality, are shown below:— Table XXVI. Diseases Total Waxlow Manor Northcote Hambrough Dormers Wells Glebe Norwood Green Admitted to Hospital Total deaths Scarlet fever 105 33 14 12 17 19 10 94 — Diphtheria 19 3 2 4 3 4 3 19 1 Puerperal pyrexia 4 1 — 1 1 1 — 1* — Pneumonia 50 15 3 3 18 6 5 27* 35 Ophthalmia neonatorum 6 1 — 1 1 I 1 2* — Tuberculosis (all forms) 64 11 5 17 13 7 11 — 31 Erysipelas 4 1 2 — 1 — — 4* — Measles 333 94 57 45 49 47 41 — — Whooping cough 98 13 17 9 27 21 11 — — Cerebro-spinal fever, &c. 6 1 1 1 — 1 2 6* 2 Totals 689 173 102 93 130 107 84 153 69 *To London hospitals and institutions outside the district. 33 Cases of infectious diseases occurred during the year among schoolchildren as follows:— Table No. XXVII. School Scarlet Fever Diphtheria Beaconsfield Road 7 - Clifton Road 3 - Dormers Wells 3 4 Featherstone Road 3 1 North Road 4 - Tudor Road 7 - Western Road 4 - Lady Margaret Road 7 1 Other Schools 22 3 60 9 Table No. XXVIII. Age Periods New Cases Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary Male Female Male Female Male Female Male Female 0-1 — — — — — — — — 1-5 — — 1 — — — 1 — 5-10 — — 2 1 — — — — 10-15 1 — — — — — — 1 15-25 5 12 1 3 — 5 — — 25-35 8 6 1 — 8 4 — 1 35-45 4 2 1 — — 1 2 — 45-65 6 5 — 1 2 3 — — 65+ 1 1 1 1 1 — 1 1 Totals 25 26 7 6 11 13 4 3 Of the 31 deaths, 25—or 86 per cent.—were of notified cases. The occupations of the new cases were as follows :— Table No. XXIX. Occupations Pulmonary Non-Pulmonary Male Female Male Female Building and decorating trades 4 _ 1 — Schoolchildren — _ _ — Clerical work — 5 — — Domestic duties — 6 — 1 Factory hands 6 — 1 3 No occupation 2 3 4 2 Various 13 7 i — Totals 25 26 7 6 34 Table No. XXX. Remaining on 31.12.41 Admitted during year as Subsequently diagnosed as Discharged recovered Died Mort. per cent. Remaining 31.12.42 Scarlatina 6 94 90 86 — — 10 Diphtheria 6 24 19 24 1 3 — Measles — 3 3 1 — — 2 Scabies 3 3 3 6 — — — Rubella — 2 2 2 — v — Chickenpox — 14 14 4 — — 10 Mumps — 6 6 5 — — l Other diseases 3 9 9 12 — — — Table No. XXXI. Number admitted Final diagnosis Number discharged Deaths Sc. Fv. Diph. Measles Scabies Rubella Mumps ChickenPox Other Sc. Fv. Diph. Measles Scabies Rubella Mumps ChickenPox Other Diph. Others January 3 — — — — — — 1 6 3 — — — — — 3 — — February 4 6 — 3 — — — — 1 3 — 2 — — — 1 — — March 11 4 _ — 1 1 — — 6 2 — — — — — — — — April 8 2 _ _ — 1 _ _ 10 2 — — 1 2 — — — — May 22 1 — — — — — — 8 3 — — — — — — — — June 6 1 — — — — — — 18 2 — — — — — — — — July 3 1 — — 1 — 2 — 8 — — — — — 2 1 — — August 5 1 — — — — — 2 5 3 — — 1 — — 2 — — September 4 3 — — — — — 2 4 1 — — — — — 1 — — October 3 — — — — 2 1 2 6 1 — — — — — 3 — — November 14 — 2 — — 1 — — 1 2 1 — — — 3 1 — — December 7 1 1 — — 1 11 1 13 1 — — — — 1 1 — —- 90 19 3 3 2 6 14 9 86 24 1 6 2 5 4 12 1 - 35 Table XXXII. Houses, Public Health Act, 1936 4,027 Houses, Housing Act, 1936 47 Overcrowding 42 Disinfestation 183 War Damage 65 Shops Act 14 Food Shops 475 Fried Fish 15 Cafes, etc 2 Factories, Mechanical 210 Factories, Non-Mechanical 11 Outworkers 7 Food Factories 421 Smoke 4 Offensive Trades 4 Bakehouses 54 Dairies 134 Water Sampling 17 Milk Sampling 69 Other Foods Sampling 5 School 1 Stables 63 Accumulations 51 Petrol, etc 65 Canal Boats 2 Slaughterhouses 10 Total Inspections 5,998 Table XXXIII. Nuisances caused by the keeping of animals 18 Accumulation of refuse, etc. 16 Offensive smells 16 Vermin 36 Choked drains 153 Dampness 37 Defective roofs, gutters, etc. 60 Defective sanitary fittings 97 Rats and mice 47 Miscellaneous 25 Other defective conditions of houses 109 Overcrowding 35 Air raid shelters 6 War-damaged houses 60 Smoke 2 Food 159 876 36 Table XXXIV. Statistics. HOUSING. 1. Inspection of Dwelling-houses during the year :— (I) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 290 (b) Number of inspections made for the purpose 4074 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 (b) Number of inspections made for the purpose — (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation — (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 2. Remedy of defects during the year without service of formal notices Number of defective dwelling-houses rendered fit in consequence of informal action by the local authority or their officers - 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 ( 2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners 4 (b) By local authority in default of owners (b) Proceedings under Public Health Acts :— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 280 (2) Number of dwelling-houses in which defects were remedied after service of formal notices :— (a) By owners 28 (b) By local authority in default of owners — 37 Table XXXIV.—continued. (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936 :— (1) Number of dwelling-houses in respect of which Demolition Orders were made (2) Number of dwelling-houses demolished in pursuance of Demolition Orders - (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 _ (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement room having been rendered fit 4. Housing Act, 1936—Overcrowding :— (a) (1) Number of dwellings overcrowded at the end of the year * (2) Number of families dwelling therein ♦ (3) Number of persons dwelling therein * (b) Number of new cases of overcrowding reported during the year 26 (c) (1) Number of cases of overcrowding relieved during the year 2 (2) Number of persons concerned in such cases 11 (d) Particulars of any case in which dwelling-houses have again become overcrowded after the local authority have taken steps for the abatement of overcrowding None *Work was commenced on supervision of the worst cases of overcrowding coming to the notice of the Department and abatement secured wherever possible. 38 INDEX. Acute poliomyelitis 13 Ambulance facilities 7 Ante-natal clinics 9, 26 Antitoxin 12 Area of borough 5 Bed bugs 17 Birth Control 8 Births and birth rate.6, 23 Canal boats 17 Cancer 13, 32 Causes of death 21 Celluloid and Cinematograph Film Act 3, 17 Child life protection 8, 26 Clinics7, 24 Consultant aid 8 Deaths and death rates 5 Dental treatment 12, 31 Diphtheria 13, 15 Diphtheria Prevention Clinic 13 Disinfection 12 Food 18 Foster Children 8, 26 Health Services, General provision of 6 Health visiting 8, 25 Houses—Number inhabited 5 Housing I7, 37 Infant mortality 6, 25 Infant welfare clinics 9, 27 Inspection and Supervision of Food 18 Isolation Hospital 15, 35 Laboratory facilities and work 16 Maternal morbidity and mortality. 6 Maternity and Child Welfare 8 Maternity and Child Welfare Committee 3 Maternity and Nursing Homes 11 Meat and other foods 18 Medical relief 7 Midwives 11 Milk supply 18 Milk grantsII, 12 Mortuary 17 Notifiable diseases 14, 33, 34 Nursing in the Home 6 Ophthalmia Neonatorum 13 Petroleum Acts 17 Physical feature of district 5 Poor Law medical relief 7 Population 5 Pre-school medical inspection 10, 28 Public Health Committee 3 Puerperal pyrexia 6 Rateable value 5 Remedial Exercises 10 Sanitary circumstances 17 Sanitary inspection 17, 36 Scabies Clinic 7 Scarlet Fever 13 Shops 18 Social conditions 5 Staff 4 Statistics—General and Vital 5, 6 Stillbirths 20 Tuberculosis 14 Ultra-Violet Light Clinic 8 Unfit houses 37 Vaccination 12, 32 Venereal disease clinics, etc. 14 Verminous persons 14 Vital statistics 20, 22 Voluntary help 10 Water supply l7 39