SOUG 27 BOROUGH OF SOUTHGATE ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR WM. CLUNIE HARVEY, M.D.,D.P.H. Medical Officer of Health and Medical Superintondent, Isolation Hospital. To the MAYOR, ALDERMEN and COUNCILLORS of the BOROUGH of SOUTHGATE. Mr. Mayor, Ladies and Gentlemen, I beg to present to you the Annual Report of the Medical Officer of Health for the year 1942 As Dr. Harvey did not join the Forces until early in January 1943, the work recorded in this report was done under his administration, and my only connection with it is to submit the Report. The Report is a short one, in accordance with the instructions of the Ministry of Health, and gives little more than a bare record of the activities of the Council's Medical Services and some statistics of the results achieved. The record is a "satisfactory one, and the chief vital statistics show improvement on the corresponding figures for the previous year. The Birth Rate is higher and the Death Rate, Infantile Mortality Rate and Maternal Mortality Rate all lower. The incidence of infectious disease was considerably lower than in the previous year, and there was no serious epidemic at any period of the year. Good use appears to have been made by the community of the health services provided by the Council, and there is to my mind no evidence in the Report of any deterioration in the general health such as one might naturally expect after three years of war . I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, M. MANSON. Acting Medical Officer of Health. Southgate Town Hall, October, N. 13. 1943. PUBLIC HEALTH COMMITTEE at December 31st, 1942. Alderman G. Peverett (Chairman) His Worship the Mayor (Councillor C. William Skinner, J.P. Alderman V.J. Westlake (Vice Chairman) Councillor W.A. Clarke Councillor Victor Dover Councillor Mrs. E.L. Mason Councillor J. Owers Councillor Mrs. C.M.A. Vandy MATERNITY AND CHILD WELFARE COMMITTEE at December 31st, 1942, Councillor Mrs. C.M.A. Vandy (Chairman) His Worship the Mayor (Councillor C.William Skinner,J.P) Alderman G. Peverett Councillor Mrs. D.M. Gipp (Vice Chairman) Councillor A.S. Gray Councillor J.W. Kimber Councillor A.E. Lauder Councillor Mrs. E.L. Mason . Councillor W. Saxon CO-OPTED MEMBERS. Miss H.M. Corry Mrs. E. Forward Mrs. G. Pheasey Dr. L. Westlake -2- HOSPITAL JOINT MANAGEMENT COMMITTEE at December 31st, 1942. SOUTHGATE REPRESENTATIVES Alderman G. Peverett (Chairman) Councillor W.A. Clarke Councillor J. Owers Councillor Mrs. C.M.A. Vandy TOTTENHAM REPRESENTATIVES His Worship the Mayor (Alderman R.H. Warren,J.P.) Alderman A.R. Turner Councillor C.J. Hurd Councillor Mrs. G.E. Morrison PUBLIC HEALTH STAFF ØMedical Officer of Health and Medical Superintendent, Isolation Hospital: W.C. Harvey., M.D.,Ch.B.,D.P.H. (Full time) Ø Assistant Medical Officer' of. Health: Marjorie K. Hall, M.B.B.S. (Lond),D.P.H. (Lond) (Full time) Ø Senior Sanitary Inspector (No. 1 District): L.Skeeles, Cert,R.San. I.,M.S. I.A.,Cert.R.San.I,Meat. Inspect., on. Ø Sanitary Inspector (No.2 District): H.Hill,M.R.San.I. A.M.Inst.S.E., M.S.I.A., Cert.R.San.I.Meat Inspection. Ø Sanitary Inspector (No.3 District); A.E.Gooday,Cert.R. San. I. ,M.S. I.A., Cert.R.San. I.Meat Inspection, A ,R. P.S. Chief .Clerk:P.E. Barber Clerk: Miss M. Munch Clerk: Miss K. Stoten Health Visitors: Ø Miss E.M.Hart ,S.R.N.,S.C.M.,H.V. (Maternity & ft Miss M.Maddock,S.R.N.,S.C.M.,H.V. Child Welfare) Ø Miss A. Joy, S .R ,N.,,S. C .M;,R.F.N. ,H.V. Ø Miss B.M.Finnegan,S.R.N.,S.C.M.,H.V. (Appointed 31.8.42) Health Visit or; Miss B.E.Wellman,S.R.N.,S.C.M.,H.V. (Public Health A.R.San.I. and General) -3- Pull-time Assistant (Maternity Centres) Miss N. Freeman Disinfector A. &. Bates Assistant Disinfector B. Latter. Ø These Officers salaries are repaid to the Council, in part, by the Ministry of Health or the County Council. STATISTICS OF THE AREA Area (in acres) 3,764 Registrar-General's estimate of Resident Civilian Population, 1942 65,790 Number of inhabited houses (end of 1942) according to Rate Books 20,478 Rateable Value (1942) £925,597 Sum represented by a penny rate (1942) £3,787 EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Total Male Female LIVE BIRTHS Legitimate 893 461 432 Illegitimate 32 15 17 Totals 925 476 449 Birth Rate per 1,000 of the estimated population 14.06 STILLBIRTHS Legitimate 19 13 6 Illegitimate 3 – 3 Rate per 1,000 total (live and still) births 23.23 - 4 - DEATHS from all causes Total Male Female and at all ages 702 330 372 Death Rate per 1,000 of the estimated population 10.67 Deaths from puerperal causes:- Rate per 1,000 Deaths. total (live and still) births. From puerperal sepsis 1 1.05 From other puerperal causes 0 0.00 Deaths of Infants under 1 year of age- Total Male Female Legitimate 31 15 16 Illegitimate 3 2 1 Total 34 17 17 Infant Death Rates:- All infants per 1,000 live births 36.75 Legitimate - per 1,000 legitimate live births 34.71 Illegitimate- per 1,000 illegitimate live births 93.75 Deaths- from measles (all ages) 0 " " whooping cough (all ages) 1 " " diarrhoea (under 2 years of age) 3 POPULATION The Registrar General estimated the civilian population of the Borough at. the middle of 1942 to be 65,790. BIRTHS - BIRTH RATE The nett total births accredited to the district was 925., an increase of 278 on the preceding year. Of these, 476 were males and 449 females (15 males and 17 females were illegitimate). - 5 - The birth-rate for the year was 14.06 per 1,000 of the population. The birth-rate for England and Wales for 1942 was 15.8 and for the administrative County of London, 14.0. During 1942, the number of births recorded was 223 greater than the number of deaths, whereas in 1941 there were 124 fewer births than deaths. The total number of births actually registered in the district during the year amounted to 982, of which 9 were unnotified. The percentage of births notified was therefore 99.08 as compared with 98.46% in 1941. Two. hundred and fifty-one births were notified by midwives MORTALITY GENERAL MORTALITY AND DEATH RATE - The nett number of deaths accredited to this district was 702, a decrease of 69 as compared with the previous year. This gives a death-rate of 10.67 per 1,000 of the population, a decrease of 0.61 on the rate for the previous year, which was 11.28. The rate for England and Wales (1942) was 11.6 and for London 13.9. INFANT MORTALITY.- There were 34 (3 illegitimate) deaths of infants under 1 year of age, which gives an infantile death rate of 36.75 per 1,000 births registered, as compared with 25 deaths and a rate of 40.91 in the preceding year. The corresponding rates for England and wales and London were 49 and 60 respectively. - 6 - Of the 34 infant deaths during 1942, 20 or 58.8 occurred within the first week of life, while the total deaths under 1 month numbered 24 or 70.6% Eight of these deaths were due to prematurity, 4 to pneumonia, 3 to enteritis and 1 to pemphigus neonatorum. STILLBIRTHS.- Twenty-two stillbirths, (3 illegitimate) were accredited to the district for 1942. This is equal to a death-rate of 23.23 per 1,000 (live and still) births registered, the corresponding figures for 1941 being 22 stillbirths, with a rate of 34.75. MATERNAL MORTALITY.- The maternal mortality rate i.e. the number of mothers dying as the result of childbirth per 1,000 total (live and still) birthswas 1.05 for 1942, representing a total of 1 death. In 1941 there were 2 deaths, with a corresponding rate of 3.16. MORTALITY OP "TODDLERS".-Six deaths occurred amongst children of the age group 1-5 years during 1942. This represents a death-rate of 0.09 per 1,000 of the population, and 0.85 per cent of the total deaths for the year, at all ages. In 1941 there were eight deaths giving a death rate of 0.12 and a percentage of 1.04. MORTALITY OP PERSONS OVER THE AGE OP 65. 397 or 56.55% of the total deaths during the year were persons over the age of 65. Of these, 124 died at ages between 80 and 90 years, while a further 17 were over that age, (9 males, the eldest being 91 and 8 females, the eldest being 99). ZYMOTIC MORTALITY (including deaths from the seven principal zymotic diseases, viz; smallpox, scarlet fever, diphtheria, typhoid fever, measles, whooping cough and diarrhoea (in children under 2 years of age). There were 5 deaths in this category; 1 from diphtheria, 1 from whooping cough and 3 from infantile diarrhoea. The zymotic death-rate for the year was therefore 0.07 per 1,000 of the population. There were no deaths attributable to these diseases during 1941. - 7 - CAUSES OP DEATH DURING THE YEAR 1942. Causes of Death Male Female Total All Causes (Civilians only) 330 372 702 Typhoid & Paratyphoid fevers - – – Cerebro-spinal fever - 1 1 Scarlet Fever - - – Whooping Cough – 1 1 Diphtheria 1 - 1 Tuberculosis, Respiratory system 13 12 25 „ Other forms 1 1 2 Syphilitic diseases 2 2 4 Influenza 3 6 9 Measles – – – Ac. Poliomyelitis & polioencephalitis – 1 1 Ac. Inf. Encephalitis 1 - 1 Cancer, oesoph.(M) uterus (F) 4 10 14 „ stomach & duodenum 11 8 19 „ breast - 24 24 „ other sites 55 28 83 Diabetes 2 3 5 Intra-cran: vasc.lesions 30 54 84 Heart Disease 87 95 182 Other Circulatory diseases 10 22 32 Bronchitis 15 8 23 Pneumonia 13 16 29 Other Respiratory diseases 2 4 6 Ulcer, stomach or duodenum 4 1 5 Diarrhoea under 2 years 3 - 3 Appendicitis 1 1 2 Other Digestive diseases 4 13 17 Nephritis 11 12 23 Puerperal sepsis - 1 1 Other Maternal causes - – – Premature birth 3 5 8 Con: Malformations,Birth injuries,etc. 13 6 19 Suicide 2 2 4 Road Traffic Accidents 1 2 3 Other violent causes 3 8 11 All other causes 35 25 60 -8- GENERAL PROVISION OP HEALTH SERVICES. HOSPITALS.- General Hospitals - The arrangements set out in the Annual Reports for 1930 and 1938 relating to the provision of general and special hospital accommodation, together with the provision of maternity beds for the inhabitants of Southgate, remain unaltered. They still appear satisfactory, having due regard to present circumstances. ISOLATI0N HOSPITAL.- As stated in previous Annual Reports, every effort "has been made to maintain the hospital in a state of efficiency, and no essentials have, been neglected. CLINICS and TREATMENT CENTRES MATERNITY AND CHILD WELFARE (Southgate; Council) . At 31st December, 1942. Infant Welfare:- Methodist Church, The Bourne, Southgate. Monday 2-4 Methodist Church, Palmerston Road, Bowes Park. Tuesday 2-4 Combined Clinic, Bowes Road, New Southgate. Wednesday 2-4 Methodist Church Green Lanes, Winchmore Hill. Thursday 2-4 De Bohun School Clinic, Green Road, Southgate. Friday 2-4 Toddler Clinics:- Methodist Church, Green Lanes, Winchmore Hill. Tuesday 2-4 Methodist Church, Palmerston Road, Bowes Park. Thursday 2-4 - 9 - Pre-Natal Combined Clinic, Bowes Road, New Southgate. Wednesday 10-12 Methodist Church, Palmerston Road, Bowes Park. Thursday 10-12 Post-Natal. Combined Clinic, Bowes Road, First Tuesday in New Southgate. each month, 10-12 IMMUNISATION (against diphtheria) CLINIC - (Southgate Council) Town Hall, Palmers Green. Thursday 2-4 The Tuberculosis, Venereal Disease and School Clinics (Middlesex County Council) continue as set out in the Report for 1938. INSTITUTIONAL PROVISION for unmarried mothers, illegitimate infants and homeless children. No change from the arrangements in the Report for 1930. AMBULANCE FACILITIES.- The details set out in the Annual Report for 193-5, as amended by the alterations referred to in the Reports for 1936 and 1939 still obtain. MORTUARY.- During 1942, 49 bodies were deposited in the Council's mortuary situated at the rear of the Town Hall. Forty-nine post-mortem examinations were held. LABORATORY FACILITIES.- The following table's set" out the work carried out at the Council's laboratory, and at -other laboratories to which material was sent during 1942. -10- Work carried out at the Council's laboratory HOSPITAL BOROUGH Positive Positive Negative Negative Swabs for Diphtheria bacilli 204 2244 6 196 Swabs for Haemolytic Streptococci – 3 – 5 Sputa for Tubercle bacilli 1 4 7 119 Total 2,789 (1941, 2,389) Specimens sent to Clinical Research Association. Faeces for Typhoid Negative 6 „ „ Dysentery Positive 4 Negative 9 „ „ Food Poisoning Negative 1 Blood „ Typhoid Negative 3 Positive 2 Nasopharyngeal swabs Negative 5 Specimens sent to laboratory at Prince of Wales's Hospital. Cerebro-spinal fluid Negative 3 Nasopharyngeal swabs Negative 2 Faeces for Typhoid Negative 1 Swabs for virulence tost Negative 7 Positive 11 Negative swabs 25 Swabs for haemolytic streptococci Negative 4 Urine 1 Pleural fluid 1 --11- MATERNITY AND CHILD WELFARE SERVICES. STATISTICS OF ATTENDANCES AND WORK DONE AT THE WELFARE CENTRES DURING 1942. Number on Resisters:- Under 1 year Over 1 year Totals 1942 1941 January 1st, 1942- 448 960 1408 1085 December 31st, 1942- 1279 1365 2644 2320 New cases during 1942- 831 405 1236 1235 99 of the new cases under 1 year were "removals" into the district. The remaining 732 represent 79.13 per cent of the total births credited to the district. ATTENDANCES AT CENTRES. 1942. Under 1 year. Over 1 year totals Sessions The Bourne 2204 1804 4008 48 Bowes Park 3233 2071 5304 51 Combined Clinic 2349 1334 3683 50 Winchmore Hill 3221 1669 4890 52 De Bohun 1917 1572 3489 50 Totals 1942 12924 8450 21374 251 1941 9266 8977 18243 251 Average 1942 51.49 33.66 85.15 1941 36.92 35.76 72.68 TODDLER CLINICS. 1942. Winchmore Hill 208 Average 17.33. 12 Bowes Park 287 „ 22.07. 13 -12- STATISTICS OP ATTENDANCE AND WORK DONE AT PRE-NATAL CENTRES. Number on Register 1941. 1942. January 1st 82 110 December 31st 110 159 New cases during the year 428 472 Number of Sessions held 106 117 Total attendances 2508 2872 Average per session 23.66 24.55 POST NATAL CLINIC. The Post Natal Clinic referred to in the last Annual Report was continued throughout the year. The following figures give details of the attendances. Attendances 152 Sessions 12 Average 12.66 -13- TABLE OF VISITS MADE BY THE HEALTH VISITORS UNDER THE NOTIFICATION OF BIRTHS, MATERNITY AND CHILD WELFARE, AND PUBLIC HEALTH ACTS. Children. 1942. 1941 First visits 547 426 Under 1 year of age 953(In addition) 890 Over 1 year of age 3183(to 1st Visits) 3162 Visits re Deaths under 5 years of age 4 10 Stillbirths 7 4 Ophthalmia Neonatorum - — Dental cases - - Pre-Natal visits 347 422 Clinics attended 831 763 Special visits (test feeds, following up special cases seen by M.O. at Centres, failing lactation, etc.) 388 513 Totals 6260 6190 CHILD LIFE PROJECTION - The following is a summary of the work carried out in this connection during 1942. Number of registered Poster Mothers 29 Number of Foster children on register during the year 45 Number of Foster children at end of year 30 Number of visits paid by Health Visitors 189 No unsatisfactory conditions were met with throughout the year. - 14 - DENTAL TREATMENT. Number of “Council” patients attending type Eastman Dental Clinic, 1942 Children 6 Mothers 15 Cost of such cases £36 HOME HELP SCHEME.- The following table sets out the details of the work carried out under the above-scheme during 1942. 1941 1942 Total cases dealt with 59 48 No. provided free of charge 27 13 " " @1/- per day -.15 6 " " @2/- " " 7 8 " " " @ 3/- " " 4 3 " " @ full charge 6 18 The Home Help, worked for 28 days in 1 case. " " " " " "21 " " 1 case. " " " " " 14 " "40 cases. " "" " "11 1 case. " " 10 " " 2 cases. " " " " " 7. " " 1 case. " " " " " 6 " "1 case. " " " " 4 " "1 case. Total No. of days worked: 832 657 " cost (1942) £102. 2. 0. (1941) £195. 2. 6. Average No. of Home Helps on Council's roll 8 5 -15- MATERNITY OUTFITS.- Sterilized, maternity outfits were supplied to expectant mothers during 1942, as follows. 39 free of charge ) 23 at a charge of l/- ) costing £25. 14. 0. 19 " " " " 2/- 2 " " a " 3/- ) (1941) £20. 10. 8. 30 at cost price ) Total 113 (1941, 87) INSPECTION AND SUPERVISION OP POOD. MILK SUPPLY.- No registration of retailers or producers has had to be refused'under the provisions of the Milk and Dairies (Amendment) Act, 1922 (Milk and Dairies Order, 1926). One additional retailer was registered during the year. Under the Milk (Special Designations) Order, 1936, 29 Dealers' Licences, 21 Supplementary Licences, and 1 Pasteuriser's Licence were granted. MEAT AND OTHER FOODS.- Butchers' shops are visited frequently and the "bakehouses, fish, fruit and grocers' shops are kept under observation. Since the commencement of the war, there has been little or no slaughtering of animals for human consumption at the 4 private slaughterhouses in the Borough which have continued to be licenced for this purpose. The premises at Winchmore Hill which were taken over as a distributing depot of the London Meat Market, continue to be extensively used, and are visited almost daily. _ -16- SANITARY INSPECTIONS 1942, Housing Inspections & Re-inspect ions. 547 Registered premises, including factories, workshops, bakehouses, milk shops and other food shops - Visits & Inspections. 2,592 Infectious Disease - Visits & Inspections. 3,101 Miscellaneous Visits & Inspections, including various complaints, Rats & Mice Destruction Act, ditches and ponds, non-notifiable disease's, etc. 1-3,785 Visits re Verminous premises 189 Visits re nuisances from flies etc. 8,055 28,269 SERVICE OP NOTICES. Total informal sanitary notices served 1,179 Total informal dustbin notices served 368 Total informal notices served 1,547 Total informal notices complied with 1,027 Total statutory notices served 9 Total statutory notices complied with 9 HOUSE-TO-HOUSE INSPECTIONS. - One. hundred and-forty-seven houses were inspected and recorded under the Housing Acts as compared with 161 in 1941. ESTABLISHMENTS FOR MASSAGE OR SPECIAL TREATMENT. Under the bye-laws governing this class of establishment , nine existing licences were renewed during 1942. -17- PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. Seven hundred and ninety-six cases of infectious disease were notified during the year, as against 1,278 in 1941, 591 in 1940 and 147 in 1939. The Infectious Sickness Rate for the district was 12.1, as against 19.69 in 1941, 8.88 in 1940 and 2.17 in 1939. SMALLPOX. No cases of smallpox occurred in the district during 1942. SCARLET FEVER. Ninety-five cases were notified during 1942, as compared with 67 in 1941. DIPHTHERIA. Six cases of diphtheria were notified during 1942, as against 12 in 1941 and 21 in 1940. All the cases were removed to the Isolation Hospital, as were 1 diphtheria "carrier and 6 suspected cases. There was one death. IMMUNISATION: (a) against Diphtheria.- 1,762 persons attended for immunisation during 1942 at the weekly clinic held at the Town Hall, or at the schools visited during the year. This compares with a total of 2,440 during 1941. It is calculated that at the 31st December, 1942 52.6% of children in Soubhgate below the age of 5 years, have been.-immunised and that 63,1% of children between 5 & 15 years of age have been similarly protected. The total number of persons attending the Clinic for immunisation from the commencement of the scheme in March 1933, until December 31st, 1942, is 7,874. -18- (b) against Colds Inoculation against the common cold has "been offered to members of the Town Hall Staff for several years past. The number of persons inoculated during 1942 was 30. TYPHOID FEVER (including Paratyphoid). One case of typhoid fever was notified during the year, as against 5 in 1941. PUERPERAL PYREXIA. Twenty-four cases of puerperal pyrexia were notified during the year, as against 6 in 1941. In addition to these notified cases, the Registrar General reported one maternal death which occurred in an institution outside the district. The somewhat considerable rise in this type of notification was due to a large number of maternity cases being transferred to a hospital in the district from certain London hospitals. ERYSIPELAS. Twelve cases of erysipelas were notified during the year, compared with 20 in 1941 and 22 in 1940. TUBERCULOSIS. Sixty cases of pulmonary and 12 cases of non-pulmonary tuberculosis were notified during the year, the corresponding figures for 1941 being, pulmonary 57, non-pulmonary 13. In addition to these notified cases, 23 patients (22 pulmonary) were entered in the register, including 4 restored to the register; these cases, with the exception of those restored to the register, being new residents in the district, previously notified elsewhere. SCABIES AND LICE. During 1942, 150 patients were sent to the Hornsey Cleansing Station, 133 for treatment for scabies and 17 for head vermin. While'the arrangements for the treatment of these cases have so far proved satisfactory, the question of the establishment of a treatment centre in the district was dealt With early in 1943. - 19 - DISINFECTION AND DISINFESTATION. The following Is a summary of the work carried out under this heading during the year" Total number of rooms disinfected 160 Total number of articles of bedding etc. disinfected 2,114 Total number of articles destroyed 121 Total number of library books disinfected 276 Number of verminous houses disinfested 97 Number of rooms disinfested 254 In addition to the above, a large number of blankets and pillows used by the Casualty Services and Fire Guard Personnel have been regularly disinfected. - ISOLATION HOSPITAL. The number of patients treated in hospital during 1942 was 475, as against 393 during 1941, and 381 during 1940. (This number comprises all patients admitted during the year, together with those in hospital on 1st January, 1942). The following table sets out the number of patients admitted to the hospital during 1941 & 42 and the area's from which those patients were admittedr: 1941. 1942. Southgate 119 116 Tottenham 223 284 Middlesex County Council 1 15 - Military Authorities 13 20 356 435 20 - The diseases for which the 435 patients were admitted during 1942 were as follows: Scarlet fever 198 Scarlet fever & Diphtheria 1 Scarlet fever & Chicken pox 1 Scarlet fever & Mumps 1 Scarlet fever & ? Mastoid 1 Diphtheria 74 Diphtheria "Carriers" 19 Diphtheria & Mumps 1 Diphtheria & Chicken pox 1 Erysipelas 3 Poliomyelitis 3 Encephalitis Lethargica 1 Cerebro-spinal Meningitis 4 Cerebro-spinal Meningitis Carrier 1 Dysentery 4 Puerperal Pyrexia 8 Baby with Mother 4 Pneumonia 3 Measles 32 Measles & Bronchitis 3 Measles & Pneumonia 11 Measles & Mastoid 1 Whooping cough 4 Whooping cough & Pneumonia 4 Whooping cough & Bronchitis 1 Chicken pox 7 Mumps 16 Others 5 Observation cases 23 DEATHS. Eight deaths took place during the year, as compared with 16 in 1941. These 8 deaths occurred from the following diseases: Diphtheria 3 (Tottenham patient, aged 4) (Tottenham patient, aged 4) (Southgate patient, aged 34) - 21 - Pneumonia 1 (Southgate patient, aged 50) Cerebro-spinal meningitis 1 (Southgate patient, aged 3) Pneumococcal meningitis 2 (Tottenham patient, aged 11) (Tottenham patient, aged 71) Puerperal Fever 1 (East Barnet patient, aged 26) (Admitted from Southgate) These 8 fatal cases give a mortality rate of 1.68% of the total cases treated. OPERATIONS. Five operations for the removal of tonsils and adenoids were performed at the Isolation Hospital during 1942. NUMBERS IN HOSPITAL. The daily average of patients treated in hospital during each month of 1942 was as follows: January 27.45 July 3-5, 84 February 32.17 August 29,51 March 34.12 September 28.03 April 27.3 October 35.03 May 25.35 November 43.63 June 25.56 December 50.35 Daily average for the year 1942 32.92 " " " " " 1941 26.69 The highest and lowest numbers of patients in hospital on any one day during 1942 were as follows Highest (December 7th) 59 Lowest (Several dates in May,June-& Sept) 21 -22- Notified Oases of Infectious Diseases, 1942. Diseases. Totals Jan. Feb. Mar. Apr. May June July Aug. Sep. Oct Nov. Dec. D’ths Dinlitheria 6 - — - — - 2 1 - - - 2 1 1 Scarlet fever 95 6 11 6 I 4 7 3 5 2 21 16 13 - Typhoid fever 1 - - - - - - - - - 1 — - - Dysentery - - - - - - - - - - — — - - Malaria 1 - - - 1 - - - - - — - - - Puerperal Pyrexia 24 2 1 1 3 3 2 6 - 2 1 2 1 1 Erysipelas Ophthalmia 12 2 3 2 - - 3 - - - 1 - 1 - Neonatorurn . - - - - - - - — - - - — - - Measles 371 4 1 9 27 7 6 35 50 46 34 28 124 - Who oping Cough 156 31 28 32 9 18 13 11 10 1 2 1 - 1 Acute Poliomyelitis 2 1 - - 1 - - - - - - - - 1 Cerebro-spinal meningit is 2 - 1 1 — - — - - - - - - 1 Encephalitis Lethargica - - - - - - _ - - - - - - - Pneumonia 54 11 6 15 6 2 1 - 3 1 4 1 4 29 Tuberculosis Pulmonary 60 1 6 7 6 3 6 5 3 6 5 4 8 25 "N on-Pulmonary 12 - 1 - 2 2 1 1 2 1 1 2 - 2 Totals 796 58 58 73 56 39 41 62 73 58 70 56 152 61 Including all forms of pneumonia, notifiable & non-notifiablo. 23- REGISTER OF TUBERCULOSIS CASES. Pulmonary NonPulmonary Totals M F M F Cases on Register 1. 1. 42 139 119 32 32 322 Cases Notified for first time,1942 35 25 7 5 72 Cases Restored to Register 4 - - - 4 Other cases added 10 8 - 1 19 Cases Removed from Register 30 28 5 4 67 Remaining on Register,31.12.42 158 124 34 34 350 - 24 - TUBERCULOSIS, 1942. Age Periods New Gases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary M F M F M F K F Under 1 yr - - - - - - - 1 1 - 5 yrs 1 - 1 1 - - - - 5 -10 " - 1 - 2 - - - - 10-15 " 2 1 1 - - 1 - - 15-20 " 4 5 2 1 - 1 - - 20-25 " 6 6 - - 1 1 1 - 25-35 " 15 10 - - 4 3 - - 35-45 " 8 3 1 2 1 2 - - 45-55 " 8 4 1 - 3 1 - - 55-65 " 5 3 1 - 3 2 - - 65 & over - - — - 1 1 - - Totals 49 33 7 6 13 12 1 1 These figures include all cases previously notified elsewhere and noted by the Tuberculosis Officer and others as having removed into the district. 25 '