soug 19 library borough of southgate ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1944 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 1944. The Report is again a short one, in accordance with the instructions of the Minister of Health and gives little more than a brief record of the Health Department's activities during the year. The year has been a good one from the health standpoint, and the incidence of infectious disease very much lower than in 1943. The vital statistics show little change from the previous year, except in the Infantile Mortality-Rate, which at 38 per 1,000 live births compares unfavourably with that for the previous year, which was 33. The Birth-Rate of 17.07 is very slightly higher than that for 1943 and the highest recorded since 1920. The Death-Rate was 12.5 as compared with 12.2 in 1943. By the death in April, a few days after his retirement on account of ill-health, the Council lost the services of Mr. L. Skeeles, the Senior Sanitary Inspector, who had served the community faithfully for 32 years, very quietly but very efficiently. To fill the vacancy caused by Mr. Skeeles's retirement, Mr. R. L. Burkill was appointed and commenced duty in February. I wish to express to the Chairmen and Members of the Public Health and Maternity and Child Welfare Committees my appreciation of the support and consideration they have given, as always, to the work -1- of the Health Department, and to the members of the staff of the Department for their willing service throughout the year. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, M. MANSON. Acting Medical Officer of Health. Southgate Town Hall, N. 13. October, 1945. -2- PUBLIC HEALTH COMMITTEE at December 31st, 1944. Alderman G. Peverett (Chairman) His Worship the Mayor (Councillor A.E.Lauder,J.P.) Councillor W. A. Clarke (Vice Chairman) Councillor A. C. Crane Councillor Victor Dover Covincillor Mrs. E. L. Mason Councillor J. Owers Councillor Mrs. C. M. A. Vandy MATERNITY AND CHILD WELFARE COMMITTEE at December 31st, 1944. Councillor Mrs. C. M. A. Vandy (Chairman) His Worship the Mayor (Councillor A.E.Lauder,J.P.) The Deputy Mayor (Alderman V.J.Westlake,J.P.) Alderman J. T. Barber, J.P. Alderman G. Peverett Councillor Mrs. D. M. Gipp (Vice Chairman) Councillor J. W. Kimber Councillor Mrs. E. L. Mason Councillor W. Saxon CO-OPTED MEMBERS. Mrs. E. Forward Mrs. M. Piggott Mrs. G. Pheasey Dr. L. Westlake HOSPITAL JOINT MANAGEMENT COMMITTEE at December 31st, 1944. SOUTHGATE REPRESENTATIVES Alderman G. Peverett (Chairman) Councillor W. A. Clarke Councillor J. Owers Councillor Mrs. C. M. A. Vandy TOTTENHAl. REPRESENTATPTES Alderman A. R. Turner Alderman R. H. Warren Councillor C. J. Hurd Councillor Mrs. G. E. Morrison -3- PUBLIC HEALTH STAFF. Medical Officer of .Health and Medical Superintendent, Isolation Hospital: W. C. Harvey, M. D., Ch.E. ,D. P. H. (serving.in H.M.Forces) Acting'Medical Officer of Health: M. Manson,M.C.,G.M., M.A.,M.D.,D.P.H. (Part time) Acting Medical Superintendent, Isolation Hospital: G. G. Macdonald,M.A.,M.D. (Part time) Assistant Medical Officer of Health: Marjorie K. Hall, M.B.,B.S.(Lond),D.P.H.(Lond) (Full time) Senior Sanitary Inspector (Ho.1 District)-: L.Skeeles, Cert .R .San. I. ,M.S. I.A., Cert .R .San. I.Meat Inspection. (Superannuated 51.3.44, died 7.4.44) A.E.Gooday, Cert .R. San. I, M-. S. I .A, ^ Cert .R.San. I. Meat Inspection (appointed Senior Sanitary Inspector as from 1..4.44) Sanitary Inspector (Ho.2 District): J. D. Dant, Cert .R.San.I.,M.S.I.A. ,Cert .R.San.I.Meat Inspection. Sanitary Inspector (No.3 District): R. L. Bur kill, A.R. San .1.,M.S. I.A., Cert. .R.San. I .Meat Inspection. (commenced'14.2.44) Chief Clerk: P. E. Barber. Clerk: Miss M. Munch. Clerk: Miss K. Stoten. Health Visitors: Miss E.M.Hart,S^-R.N. ,S.C.M. ,H.V. (Maternity & Child Welfare)Miss M.Maddock,S.R.lIv,S.C.M. ,H.V. Miss A.Joy,S.R.N.,R.F.N. ,S.C.M. ,H.V. Miss" B.M. Finn eg an, 3 .R.N. ,S.C.M. ,H.V. Health Visitor: Miss B.E.Wellman,S.R.11., S.C.M., H.V., (Public Health Gert .R .San.I. and General) Full-time Assistant (Maternity Centres): Miss N. Freeman, Part-time Assistant (Maternity Centres): Mrs, M. Edwards. Disinfector: A. G. Bates. Assistant Disinfector: B. Latter. Rodent Operator: W. Dowsett. (commenced 15.5.44) These Officers' salaries are repaid to the Council, in part, by the Ministry of Health or the County Council. -4- STATISTICS OF THE AREA. Area (in acres) 3,764 Registrar General's estimate of Resident Civilian Population, 1944 64 190 Number of inhabited houses (end of 1944) according to Rate Books 20,430 Rateable Value (1944) £926,394 Sum represented by a penny rate (1944) £ 3,740 EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Total Male Female LIVE (Legitimate 1,056 557 499 BIRTHS (Illegitimate 40 16 24 Totals 1,096 573 523 BIRTH RATE per 1,000 of the estimated population 17.07 STILLBIRTHS (Legitimate 25 14 11 (Illegitimate 11 0 RATE per 1,000 total (live and still) births 23.17 DEATHS from all causes and at all ages 803 411 392 DEaTH RATE per 1,000 of the estimated population 12.51 Deaths from PUERPERAL CAUSES:- Rate per 1,000 Deaths. total (live and still) births. From puerperal sepsis 0 0.000 From other puerperal causes 1 0.891 Deaths of INFANTS under 1 year of age:- Total Male Female Legitimate 40 25 15 Illegitimate 2 2 0 Total 42 27 15 INFANT DEATH RATES:- All infants per 1,000 live births 38.32 Legitimate-per 1,000 legitimate live births 37.87 Illegitimate-per 1,000 illegitimate live births 50.00 -5- Deaths from MEASLES (all ages) 1 " 11 WHOOPING COUGH (all ages) 2 " " DIARRHOEA (under 2 years of age) 3 POPULATION. The Registrar General estimated the civilian population of the Borough at the middle of 1944 to be 64,190, a decrease of 1,530 as compared with 1943. BIRTHS - BIRTH RATE. The nett total of births accredited to the district was 1,096, an increase of 8 on the preceding year. Of these, 573 were males and 523 females (16 males and 24 females being illegitimate). The birth-rate for the year was 17.07 per 1,000 of the population. The birth-rate for England and Wales for 1944 was 17.6 and for the administrative County of London, 15.0 The births and birth-rates for the past 5 years were as follows: No. of Births Birth Rates. Southgate. England & Wales. London. 1940 707 10.62 14.6 13.7 1941 647 9.97 14.2 8.9 1942 925 14.06 15.8 14.0 1943 1088 16.55 16.5 15.8 1944 1096 17.07 17.6 15.0 During 1944, the number of births recorded was 293 greater than the number of deaths, as compared with 286 in 1943. The total number of births actually registered in the district during the year amounted to 1064, of which 10 were unnotified. The percentage of births notified was therefore 99.06 as compared with 99.46 in 1943. -6- MORTALITY. GENERAL MORTALITY AND DEATH RATE.- The nett number of deaths accredited to this district was 803, 1 more than in 1943. This gives a death-rate of 12.51 per 1,000 of the population, an increase of 0,31 on the rate for the previous year, which was 12.20. The rate for England and Wales (1944) was 11.6 and for London 15.V. The deaths and death-rates for the past 5 years were as follows: No. of Deaths Death Rates. Southgate. England & Wales. London. 1940 769 10.97 14.3 17.8 1941 771 11.28 12.9 16.3 1942 702 10.67 11.6 13 i 9 1943 802 12.20 12.1 15.0 1944 803 12.51 11.6 15.7 INFANT MORTALITY.- There were 42 (2 illegitimate) deaths of infants under 1 year of age, which gives an infantile death-rate of 38.32 per 1,000 births, as compared with 36 deaths and a rate of 33.08 in the preceding year. The corresponding rates for England and Wales and London were 46 and 61 respectively. The infant deaths and rates for the past 5 years were as follows: No. of Deaths Infantile Death Hates. Southgate. England & Wales. London. 1940 23 32.81 55 50 1941 25 40.91 59 68 1942 34 36.75 49 60 1943 36 33.08 49 58 1944 42 38.32 46 61 Of the 42 infant deaths during 1944, 23 or 54.7% occurred within the first week of life, while the total under 1 month numbered 25 or 59.5%. Eleven of these deaths were due to prematurity, 8 to pneumonia, 3 to bronchitis and 2 to whooping cough. -7- STILLBIRTHS:- Twenty-six stillbirths, (1 illegitimate) were accredited to the district for 1944. This is equal to a death-rate of 23.17 per 1,000 (live and still) births, the corresponding figures for 1945 being 26 stillbirths, with a rate of 23.34. 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) births - was 0.891 for 1944, representing a total of 1 death. In 1943 there were 2 deaths, with a corresponding rate of 1.79. MORTALITY OP "TODDLERS";- Three deaths occurred amongst children of the age group 1-5 years during 1944. This represents a death-rate of 0.04 per 1,000 of the population, and 0.37 per cent of the total deaths for the year at all ages. In 1943 there were 4 deaths giving a death-rate of 0.09 and a percentage of 0.49. MORTALITY OP PERSONS OVER THE AGE OF 65.- 469 or 58.41% of the total deaths during the year were of persons over the age of 65. Of these, 122 died at ages between 80 and 90 years, while a further 24 were over that age, (7 males, the eldest being 99 and 17 females, the eldest being 96). 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)J.- There were 6 deaths in this category; 1 from measles, 2 from whooping cough and 3 from infantile diarrhoea. The zymotic death-rate for the year was, therefore, 0.09 per 1,000 of the population, as compared with 3 deaths and a rate of 0.04 in 1943. -8- CAUSES OF DEATH DURING THE YEAR 1944. Causes of Death. Male Female Total All Causes (Civilians only) 411 392 803 Typhoid & Paratyphoid fevers - - - Cerebro-spinal fever 1 - 1 Scarlet fever - - - Whooping cough 1 1 2 Diphtheria - - - Tuberculosis, Respiratory system 13 8 21 " Other forms 4 3 7 Syphilitic diseases 3 3 6 Influenza 5 2 7 Measles 1 - 1 Ac.Poliomyelitis & Polioencephalitis - - - Ac. Inf .Encephalitis - - - Cancer, oesoph.(M) uterus (P) 5 4 9 " stomach & duodenum 16 6 22 " breast - 23 23 " other sites 56 41 97 Diabetes 2 4 6 Intra-cran: vascular lesions 32 60 92 Heart disease 95 90 185 Other circulatory diseases 11 13 24 Bronchitis 18 13 31 Pneumonia 23 18 41 Other respiratory diseases 3 5 8 Ulcer, stomach or duodenum 7 - 7 Diarrhoea under 2 years 1 2 3 Appendicit is 1 - 1 Other digestive diseases 8 10 18 Nephrit is 13 6 19 Puerperal sepsis - - - Other maternal causes - 1 1 Premature birth 6 5 11 Con. malformation,birth injuries,etc. 10 3 13 Suicide 1 4 5 Road traffic accidents 1 1 2 Other violent causes 29 38 67 All other causes 4-3 28 71 -9- GENERAL PROVISION OF 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. ISOLATION 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, 1944. Infant Welfare.- Methodist Church, The Bourne, Southgate. Monday 2-4 Methodist Church, Palmerston Road, Tuesday & Bowes Park. Thursday 2-4 Combined Clinic, Bowes Road, New Southgate. Wednesday 2-4 Methodist Church, Green Lanes, Tuesday & Winchmore Hill. Thursday 2-4 De Bohun School Clinic, Green Road, Southgate. Friday 2-4 Pre-Natal. Combined Clinic, Bowes Road, Tuesday & 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 -10- War-time Day Nurseries. Alderman House, Aldermans Hill, Palmers Green. Tottenhall Sports Ground, Tottenhall Road, Palmers Green. Hoppers Road, Palmers Green. IMMUNISATION (against diphtheria) CLINIC.- (Southgate Council) Town Hall, Palmer-s Green. Thursday 2-4 The TUBERCULOSIS, VENEREAL DISEASES and SCHOOL CLINICS (Middlesex County Council) continue as set out in the Report for 1933, except that the Tuberculosis Dispensary at Hornsey has been closed. AMBULANCE FACILITIES.- There has been no material change in the Ambulance Facilities as recorded in the Reports for 1935, 1936 and 1939. MORTUARY.- During 1944, 72 bodies were deposited in the Council's mortuary situated at the rear of the Town Hall. 69 post-mortem examinations were held. LABORATORY FACILITIES.- The following tables set out the work carried out at the Council's laboratory and at the laboratories of the Clinical Research Association to which material was sent during 1944. Work carried out at the Council's laboratory:- HOSPITAL BOROUGH specimens. specimens. Positive. Positive. Negative. Negative. Swabs for Diphtheria bacilli 223 825 4 230 " " Haemolyt ic streptococci- - 6 " " Streptococci - - 1 5 " " Vincents Angina - - 1 4 Sputa for Tubercle bacilli - - 12 88 " " Pneumococci 1 1 Pus for Gonococci - - - 2 " " Staphylococci - - 2 - Total 1405. (1943, 2406) -11- Specimens sent to Clinical Research Association: Faeces for Dysentery Negative 15 " " Typhoid Negative 3 " " Pood poisoning Negative 1 Blood " Typhoid Negative 2 Sputa for Tubercle bacilli Negative 2 Swabs for Diphtheria bacilli Negative 8 " " " " virulence test Positive 3 MATERNITY AND CHILD WELFARE SERVICES. STATISTICS OF ATTENDANCES AND WORK DONE AT THE WELFARE CENTRES DURING 1944. Number on Registers:- Under 1 year Over 1 year Totals 1944 1943 January 1st, 1944 698 991 1689 1579 December 31st, 1944 1707 1417 3124 2992 New cases during 1944 1009 426 1435 1413 35 of the new cases under 1 year were "removals" into the district. The remaining 974 represent 88.86% of the total births credited to the district. ATTENDANCES AT CENTIMES, 1944. Under 1 year. Over 1 year. Totals. Sessions. The Bourne 2270 1558 3828 50 Bowes Park 3969 2166 6135 102 Combined Clinic 2541 1177 3718 51 Winchmore Hill 3949 1958 5907 102 De Bohun 1961 1098 3059 50 Totals, 1944 14690 7957 22647 355 1943 17031 7764 24795 284 Average, 1944 41.38 22.41 63.79 1943 59.96 27.35 87.29 -12- STATISTICS OP ATTENDANCES AT PRE-NATAL CENTRES. Number on Registers: 1944. 1943. January 1st. 195 159 December 31st. 113 195 New cases during the year 407 489 Number of sessions held 138 136 Total attendances 2782 3297 Average per session 20.16 24.24 POST-NATAL CLINIC. The Post-Natal Clinic was continued throughout the year and the following are details of the attendances: Attendances 106. Sessions 12 Average 8.83 CARE OP ILLEGITIMATE CHILDREN (Circular 2866) This matter was considered during the year and the Council agreed to participate in the scheme of the Middlesex County Council. No case requiring assistance occurred during the year. In the Circular mentioned above, The Ministry of Health set out various suggestions in which help and advice may be given to the unmarried mother and her child. These follow generally the lines along which the Health Visitors in Southgate have for many years worked, in co-operation with the Edmonton Diocesan Moral Welfare Worker. CARE OP PREMATURE INFANTS (Circular 20/44) The Council gave consideration to this matter and agreed to purchase two draught-proof cots, together with electric pads, hot water bottles and other equipment for issue on loan to mothers of premature infants nursed at home. No special conveyances were contemplated. The Borough ambulances have been equipped for several years with electrically heated blankets. -13- WAR-TIME DAY 1T0RSERIES. At the 31st December, 1944, there were three War-time Day Nurseries operating in Southgate. One at Alderman House, Aldermans Hill, Palmers Green, one at Tottenhall Sports Ground, Tottenhall Road, Palmers Green and one at Hoppers Road, Palmers Green. All three are prefabricated structures erected to the Ministry of Health pattern, the first two being for 40 children each and the third for 50 children. The following table gives details of attendances at the Nurseries during each month of 1944; Aldermans Hill. Tottenhall Road. Hoppers Road. Attendances . Average. Attendances . Average. Attendances . Average. Jan. 694 33 595 28 618 29 Feb. 591 28 624 30 760 36 Mar. 780 33 662 29 991 43 Apr. 657 36 563 31 749 42 May 735 33 826 38 925 42 June 786 36 786 36 794 36 July 557 27 640 30 630 30 Aug. 603 27 537 24 497 23 Sep. 634 30 614 29 535 25 Oct. 752 34 880 40 899 41 Nov. 724 33 880 40 1053 48 Dec. 562 30 706 37 917 48 TABLE OP VISITS MADE BY THE HEALTH VISITORS UNDER THE NOTIFICATION OF BIRTHS, MATERNITY AND CHILD WELFARE, AND PUBLIC HEALTH ACTS. Children: 1943 1944. First visits 744 744 Under 1 year of age 1138(In addition ) 1278 Over 1 year of age 3650(to 1st.visits) 3238 -14- Visits re: 1943. 1944. Deaths under 5 years of age 8 6 Stillbirths 4 7 Pre-natal visits 373 407 Clinics attended 918 979 Special visits (test feeds, following up special cases seen "by M.O. at Clinics, failing lactation, etc.) 349 286 Totals 7185 6945 CHILD LIFE PROTECTION.- The following is a summary of the work carried out in this connection during 1944: Number of registered Poster Mothers 16 " " Poster Children on register during the year 40 " " Poster Children at end of year 19 " " visits paid by Health Visitors 178 No unsatisfactory conditions were met with throughout the year. DENTAL TREATMENT.- In former years, dental treatment for mothers and children attending the Child Welfare Centres was provided at the Eastman Dental Clinic, but as it was found impossible to continue this arrangement, an agreement was entered into with the Middlesex County Council whereby dental treatment is now provided at the County's Dental Clinics in Southgate. This agreement has been in force since May 1944 and is proving satisfactory. The number of cases recommended for treatment to the end of December, 1944 was 193 (129 mothers and 64 children). HOME HELP SCHEME.- The following table sets out details of the work carried out under the above scheme during 1944. Home Helps were provided for 35 patients confined at home'during the year. 5 were provided free of charge. 13 " " @ 7/- per week. 5 " " " 14/- " " 1 was " " 21/- " " 11 were " " full charse. -15- This service has been severely handicapped byshortage of labour and several cases were denied full assistance on this account. The number of Home Helps available for employment at the end of the year was 2. MATERNITY OUTFITS.- Sterilized maternity outfits were supplied to expectant mothers during 1944, as follows: 18 were supplied free of charge. 29 " " @ 1/- each. 22 " " " 2/- " 8 " " " 3/- " 42 " " cost price. 119(1943, 99) SCABIES AND LICE.- As in 1943, patients needing treatment for scabies or vermin were dealt with at the First Aid Post at Grovelands, no alteration being made in the methods employed. During 1944, 170 patients were treated for scabies, 77 for pediculosis and 4 for impetigo. Although these numbers show an increase as compared with 1943 (123,14 and 14 respectively), the problem of lice infestation cannot be described as a serious one in Southgate. The Health Visitors continue their efforts to discover cases of vermin infestation, for which prompt treatment is arranged, while other cases are reported by the officers of the School Medical Service. Once again I would like to express the thanks of the Council for the valuable work carried out voluntarily by the personnel of the First Aid Post. -16- ESTABLISHMENTS FOR MASSAGE OR SPECIAL-TREATMENT. Under the bye-laws governing this class of establishment, nine existing licences were renewed during 1944. INSPECTION AND SUPERVISION OF FOOD. 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) No additional retailers were registered during the year. Under the Milk (Special Designations) Order, 1936, 29 Dealers' Licences, 1 Pasteuriser's Licence and 18 Supplementary Licences were granted. MEAT AND OTHER FOODS.- Butchers' shops are visited frequently and the bakehouses, fish, fruit and grocers shops are kept under observation SANITARY INSPECTIONS, 1944. Housing Inspections & Re-inspections 1315 Registered premises, including factories, workshops, bakehouses, milk shops and other food shops.- Visits & Inspections 1173 Infectious Disease.- Visits & Inspections 1047 Miscellaneous Visits & Inspections, including various complaints, Rats & Mice Destruction Act, ditches and ponds, non-notifiable diseases, etc. 10515 Visits re verminous premises 169 Visits re nuisances from flies, etc. 4555 18774 SERVICE OF NOTICES. Total informal sanitary notices served 506 Total informal dustbin notices served 387 Total informal notices served 893 Total informal notices complied with 798 Total statutory notices served 85 Total statutory notices complied with 73 -17- RATS AND MICE (DESTRUCTION) ACT, 1919. INFESTATION ORDER, 1943. The work of destruction of rats and mice in the Borough was taken over from the Middlesex County Council in February, 1944. In March, the three Sanitary Inspectors were appointed Authorised Officers under Sec. 5 of the Rats & Mice (Destruction) Act, 1919 and became responsible for the work. For a short time the actual work of baiting, poisoning, trapping, etc. was carried out by Mr. Bates, the Council's Disinfector. In due course, however, the amount of work involved in carrying out the provisions of the Act, made it necessary for the Council to appoint a Rodent Operator. Mr. W. Dowsett was appointed Rodent Operator in May 1944 and under the supervision of the Sanitary Inspectors he carries out the whole of the work of rats and mice destruction. The Act of 1919 and the Infestation Order, 1943 places the responsibility on the occupiers for ridding the premises of rats and mice, and in this connection it was decided by the Council in July to charge occupiers of residential premises a nominal charge of 2/6 per treatment for the services of the Council's Operator, and to charge the occupiers of business premises on a basis of time and material for his services. The total number of premises at which treatment was carried out from 22nd February to 31st December, 1944 was 309. The methods adopted for disinfestation consisted almost entirely of poisoning, trapping being resorted to in very few instances. -18- WATER SUPPLY.- Practically the whole of the water supply in the district is from the mains of the Metropolitan Water Board, the remaining small portion of the area being supplied by the Barnet Gas & Water Co. The supply has been entirely satisfactory throughout the year in both quality and quantity. All the houses in the district are provided with a piped supply direct to the houses, the few remaining wells having been discontinued some years ago. No bacteriological or chemical examinations of drinking water were undertaken during the year. There is no evidence of any plumbo-solvent action of the wator. INFECTIOUS DISEASE, DISINFECTION AND DISINFESTATION.- The following is a summary of the work carried out -under this heading during the year: Total number of rooms disinfected 178 Total number of articles of bedding etc. disinfected 1669 Total number of articles destroyed 75 Total number of library books disinfected 527 Number of verminous houses disinfested 115 Number of verminous rooms therein 193 Number of verminous articles destroyed 171 IMMUNISATION AGAINST DIPHTHERIA.- 558 persons attended for immunisation during 1944 at the weekly clinic held at the Town Hall. This compares with a total of 906 dur ing 1943. It is calculated that at the 31st December, 1944 47.23% of the children in Southgate below the age of 5 have been immunised and that 67.22% of children between 5 and 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, 1944 is 9,338. -19- NOTIFICATIONS OP INFECTIOUS DISEASE - INFECTIOUS SICKNESS RATE.- 636 cases of infectious disease were notified during the year, as set out in the following tables. This compares with 1,229 notifications in 1943, 796 in 1942, 1278 in 1941 and 591 in 1940. The Infectious Sickness Rate for the district was 9.91 as against 18.77 in 1943, 12.1 in 1942, 19.69 in 1941 and 8.88 in 1940. NOTIFICATIONS OF INFECTIOUS DISEASE, 1944. Jan. Mar. Apr. Jun. Jul. Sep. Oct. Dec. Totals. Diphtheria - 1 - 8 9 Scarlet fever 56 22 14 36 128 Typhoid fever - - - - - Dysentery 3 - 12 - 15 Malaria 1 2 - 2 5 Puerperal Pyrexia 8 7 4 5 24 Erysipelas 11 4 3 3 21 Ophthalmia Neonatorum - 1 1 - 2 Measles 23 30 5 38 96 Whooping cough 51 82 38 8 179 Pneumonia 38 11 6 8 63 Cerebro-spinal fever 2 - 1 - 3 Tuberculosis.- Pulmonary 22 12 19 24 77 Non-Pulmonary 2 5 4 3 14 Totals 217 177 107 135 636 -20- REGISTER OF TUBERCULOSIS CASES. Pulmonary NonPulmonary Totals M F M F Cases on Register 1.1.44 161 138 37 38 374 Cases Notified for first time, 1944 35 42 8 6 91 Cases Restored to Register 2 2 4 Other cases added 7 5 1 3 16 Cases Removed from Register 39 28 7 4 78 Remaining on Register, 31.12.44 166 159 39 43 407 -21- TUBERCULOSIS, 1944. Age Periods New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary M F M F M F M F Under 1 yr. - - - - - - - - 1-5 yrs 2 3 - - - - - - 5-10 " - - - - — - - - 10-15 " 1 1 1 1 - - - 1 15-20 " 4 8 1 3 - 1 1 - 20-25 " 8 12 2 1 1 1 2 2 25-35 " 15 13 1 3 5 2 - - 35-45 " 4 7 3 1 2 1 1 - 45-55 " 5 3 - - 1 1 - - 55-65 " 3 1 1 - 3 1 - - 65 & over 2 1 - - 1 1 - - Totals 44 49 9 9 13 8 4 3 These figures include all cases previously notified elsewhere and noted by the Tuberculosis Officer and others as having removed into the district, as well as those cases restored to the register. -22- ISOLATION HOSPITAL. The number of patients treated in hospital during 1944 was 441, as against 585 during 1943 and 475 during 1942. (This number comprises all patients admitted during the year, together with those in hospital on 1st January, 1944.) The following table sets out the number of patients admitted to the hospital during 1942, 1943 and 1944, and the areas from which those patients were admitted: 1942. 1943. 1944. Southgate 116 178 144 Tottenham 284 346 225 Middlesex County Council 15 5 8 Military Authorities 20 15 11 Priern Barnet -- 1 -- Wood Green -- -- 2 435 545 390 The diseases for which the 390 patients were admitted during 1944 were as follows: Scarlet fever 206 Scarlet fever & Chickenpox 1 Scarlet fever & Diphtheria 1 Diphtheria 64 Dysentery 11 Enteritis 1 Erysipelas 14 Measles 9 Measles & Pneumonia 6 Measles & Otitis media 1 German measles 8 Pneumonia 5 Influenza & Pneumonia 1 Whooping cough 6 Whooping cough & Pneumonia 5 Puerperal pyrexia 10 Baby with mother 13 Cerebro-spinal fever 4 Acute Poliomyelitis 2 Chicken pox 4 -23- Post-encephalitis lethargica 1 Asthma 1 Mumps 2 Vincents angina 1 Observation cases 13 DEATHS.- Ten deaths took place during the year, the same number as during 1943. These 10 deaths occurred from the following causes: Diphtheria 3 (Tottenham patients, aged 3, 4 and 13 years, respectively) Pneumonia 1 (Southgate.patient, aged 8 months) Pneumonia and v/hooping cough 2 (Tottenham patients, aged 15 months and 4 years respectively) Whooping cough 1 (Southgate patient, aged 1 month) Gastro-intestinal catarrh 1 (Tottenham patient, aged 9 months) Myocarditis and scarlet fever 1 (Tottenham patient, aged 2 years) Septicaemia, retained placenta, child-birth 1 (Tottenham patient, aged 38 years) These 10 fatal cases give a mortality rate of 2.26% of the total cases treated. OPERATIONS,- Six operations for the removal of tonsils and adenoids were performed at the Isolation Hospital during 1944. -24- NUMBERS HI HOSPITAL.- The daily average of patients treated in hospital during each month of 1944 was as follows: January 50.96 July 25.48 February 44.15 August 15.12 March 33.94 September 15.26 April 22.46 October 16.22 May 21.09 November 20.63 June 20.00 December 24.29 Daily average for the year 1944 25.8 " " " " " 1943 41.14 " " " " " 1942 32.92 The highest and lowest numbers of patients in hospital on any one day during 1944 were as follows: Highest (January 28) 57 Lowest (June 19) 11 -25-