Sou 56 Ac 4379 METROPOLITAN BOROUGH OF SOUTHWARK ANNUAL (Abridged) REPORT of the MEDICAL OFFICER OF HEALTH. Relative to the work of the Health Services Department during the year 19 4 6 W. Stott, M.B., B.S., D.P.H., Medical Officer of Health. Health Services Department, Walworth Road, S.E.17. Health Servioes Department, Walworth Road, S.E.17. October, 1947. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Southwark. Mr. Mayor, Ladies and Gentlemen, I beg to submit my Annual Report for the year 1946. The year has been one of increasing activity in all branches of the Health Services, but it has been a harrowing year and of much concern to the Council owing to the shortage of staff and the inability to obtain additional staff due to the inevitable shortage consequent upon the War. The most urgent matter with which the Council is faced is undoubtedly the serious lack of housing accommodation and the fact that very many of the houses which remain and are inhabited are unfit for human occupation. Nevertheless, in spite of almost insurmountable difficulties, the Council are doing their uttermost to remedy the position as quickly as possiblo and thus alleviate the serious conditions under which many of our Citizens are compelled to live. In view of the difficult times and conditions, it is not a little surprising to find that the health of the Borough as indicated by the Death rates and incidence of infectious diseases has remained very good. The Birth rate has soared up to 24.3 per 1,000 population 2093 (1107 males and 986 females) births having boen registered during tho yoar; a considerable increase on the previous year, when only 1303 births were registered. It would appear from tho increasing numbers attending tho Maternity & Child Welfaro Centres and tho additional sessions which I havc«been compelled to mako to meet tho demand, that wo can expect an even greater number of births in tho future. These figures compare with those of the pre-war ones when the population was almost double. Other rates and the work undertaken by the various Departments are indicated in the body of this report and do not require enlarging upon. One matter, however, which has caused somo little concorn to tho Health Committee is tho increase in outbreaks of food poisoning. This has boon general throughout the Country and has ariaon as a result of an increase of communal feeding in canteens and restaurants. Our investigations locally havo proved that in many cases the food has been contaminated by those persons handling It , owing to lack of knowledge of personal hygiene and cleanliness. In other cases we have found bad general conditions and inadequate equipment, total absence of proper handwashing sink, soap and towels, the complaint being always the inability to provide owing to restrictions. If these excuses are true, it shows a very serious lack of understanding on the part of those responsible at the Board of Trade. Local Authorities possess certain powers to enforce cleanliness in promises where food is prepared, but these powers are inadequate for present day needs and amplification and unification of procedure is necessary in tho form of a well thought out food hygiene code. Ohoe again, I desire to place on record my appreciation of the good will shown to me by the Chairmen and Members of the Committees on which I serve, and also the willing advice and assistance rendered to me by the Chief Officers of the Council and by every member of my staff. I am, Mr. Mayor, Ladies and Gentlemen, Yours obediently, W. STOTT. Medical Officer of Health. VITAL STATISTICS, 1946. Estimated Civil Population 86,280 Live Births Males Females Total Legitimate 1019 915 1934 Illegitimate 88 71 159 1107 986 2093 Live Birth Rate:- 24.3 per thousand population Still Births Legitimate 33 19 52 Illegitimate 2 1 3 35 20 55 Still 3irth Rate;- 25.6 per thousand total births Deaths Death Rate;- 15,7 per thousand population Rate per thousand Maternal Deaths Live and still births Prom Puerpferal Sepsis - 0.00 Other Puerperal Causes 4 1.86 Infant Deaths (under one year) Death Rate All Infants - per thousand live births 46 Legitimate Infants - per thousand live legitimate births 45 Illegitimate Infants - per thousand live illegitimate births 62 Deaths from: Measles (all ages) 1 Cancer (all ages) 198 Whooping Cough (all ages) 3 Diarrhoea (under 2 yrs of age) 10 Classification of Deaths The causes of death (759 males and 600 females) were as follows:- Cerebro spinal fever 4 Whooping Cough 3 Diphtheria - Tuberculosis of the respiratory system 62 Other Tuberculous diseases 11 Syphilitic diseases 17 Influenza 6 Measles 1 Acute poliomyelitis 1 Cancer 198 Diabetes 3 Intra-Cranial Vascular Lesions 112 Heart Disease 355 Other Circulatory Diseases 56 Bronchit is 122 Pneumonia 85 Other respiratory diseases 20 Peptic Ulcer 22 Diarrhoea 10 Appendic It is 2 Other digestive diseases 30 Nephritis 35 -1- • Other maternal causes 4 Premature births 15 Congonital malformations and birth injuries 37 Suicide 11 Road Traffic Accidents 12 Other Violent causes 48 All other causes 77 Total deaths at all ages 1,359 AGE GROUPS, Under 1 1 to 4 5 to 14 15 to 44 45 to 64 65 and over Total. Males 57 11 11 50 211 419 759 Females 39 14 7 63 118 359 600 96 25 18 113 329 778 1359 Infant Mortality. The total number of deaths of infants under one year of age was ninety six, the causes of death being as follows Ccrcbro spinal fever 1 Whooping Cough 2 Tuberculosis of the respiratory system 1 Other forms of tuberculosis 1 Syphilitic disease 1 Measles 1 Acute poliomyelitis 1 Bronchitis 2 Pneumonia 13 Other Respiratory Diseases 1 Diarrhoea 9 Other digestive diseases 5 Premature births 15 Congenital naiformations and birth injuries 33 Other violent causes 10 Total deaths under one year of age 96 Maternal. Mortality* The death of four women due to causes other than puerperal sepsis v/aa recorded during the year. -2- maternity and child welfare centres. Showing the Attendance at the Several Centres and visits paid to the homes of Mothers and Children by Health Visitors. TABLE. villa STREET manor PLACE lorrimore Hall lArcom street POCOCK street crOssway lambeth road GUY'S HEALTH SERVICES DEPT. TOTAL Number of Births notified during the year. 448 241 515 260 295 164 200 162 - 2285 Number of individual children attending the Centres during the year. 560 322 695 473 494 317 320 545 - 3726 Number of Sessions held during the year. 109 53 122 68 101 52 91 101 — 697 Number of children 1-5 age group attending during the year. 255 183 391 250 263 197 200 338 - 2077 Number of new cases attending the Centres during the year:(1) Expectant Mothers (Ante Natal Clinics) 869 - - - 460 - 22 747 11 2109 (2) Post Natal Cases (Including Ante Natal Clinics) 376 15 307 240 13 - 30 359 - 1340 (3) Infants under 1 year 370 143 386 274 270 149 125 166 — 1883 (4) Seen by Doctor 370 143 386 274 270 149 125 166 - 1883 (5) Children 1 to 5 years. 47 49 36 60 47 33 28 37 — 337 (6) Seen by Doctor 47 49 36 60 47 33 28 37 - 337 Method of feeding (a) Bottle 73 37 97 39 81 28 19 21 - 395 (b) Breast 281 72 241 213 139 100 97 132 - 1275 (c) Breast and Bottle. 27 9 38 19 33 16 10 19 - 171 (d) Ordinary diet 36 74 46 63 64 38 27 31 - 379 Total number of attendances during the year:- (1) Expectant. Mothers (Ante Natal Clinics) seen by Doctor 2591 — - - 1634 - 55 5451 34 9765 (2) Post Natal Cases (including Ante Natal Clinics) 381 15 314 246 18 - 30 397 - 1401 (3) Infants under 1 year. 4526 1629 4847 2923 2602 1468 1695 1874 - 21564 (4) Children 1 to 5 years 1079 617 1260 720 837 738 837 931 - 7019 Average number of attendances (Infants under 1) 41.5 30.7 39.7 43.0 25.8 28.2 18.6 18.6 - - „ „ „ „ (children 1-5) 9.9 11.7 10.3 10.6 8.3 14.2 9.0 9.2 - - (5) Infants seen by Doctor during the year. 1874 519 928 885 1277 676 583 744 — 7486 (6) Children 1 to 5 seen by Doctor during the year. 428 314 316 220 479 361 352 490 - 2960 (7) Number of weighings recorded (children) 5068 2267 5981 3557 3410 2122 2510 2747 - 27662 Total of first visits paid by Health Visitors to homes (1) Expectant Mothers 337 192 404 163 231 339 351 304 - 2361 (2) Infants under 1 year 448 241 515 260 295 164 200 162 - 2285 Total number of re-visits paid by Health Visitors to homes of (1) Expectant Mothers 26 224 366 90 201 350 140 240 — 1637 (2) Infants under 1 year 2008 809 2245 1508 2722 763 1277 768 - 12100 (3) Children 1 to 5 years 2340 787 2986 1236 2912 2502 1727 2747 - 17237 NOTIFICATION OF BIRTHS . Mothers confined. Live Births. Still Births. Total. BORN AT HOME AND ATTENDED BY: Midwives 835 833 10 843 Private Doctors 3 2 1 3 BORN AT HOSPITALS In the Borough 336 332 12 344 Outside the Borough 1077 1068 27 1095 TOTALS 2251 2235 50 2285 Included above wore the following:Multiple Births - 33. Triplets- 1. HOME NURSING During the year, the nursing of Sick children and home confinemont caae3 and infectious disease was undertaken by the Catholic Nursing Association, Southwark, Newington and Walworth District Nursing Association and Ranyard Nurses. The number of visits made by these associations were as follows:- Catholic Nursing Association 753 Southwark, Newington and Walworth District Nursing Association 1386 Ranyard Nurses 269 Total Visits 2408 PREMATURE INFANTS . The number of premature babies notified during 1946 was as follows:- Born at Home 24 Born in Hospital 40 64 BORN AT HOME Nursed entirely at home 24 Died during the first 24 hours 4 Survived at end of first month 20 BORN IN HOSPITAL Died during the first 24 hours 9 Survived at end of first month 31 HOME HELPS. There were 6 part-tine Hone Helps on the register, and 58 cases wore helped during the year under review. WOMEN'S COUNTRY HOLIDAY FUND. 25 Mothers and 28 Children were sent for convalescent treatment under this scheme. -4- DAY NURSERIES. There are three Day Nurseries under the control of the Council in the Borough, and the following is a summary of the average daily attendances during the year:- Jan. Feb. Mar. Apl. May. Jun. Jul. Aug. Sep. Oct. Nov. Dec. Bishop's House, 65 75 62 66 70 76 75 74 74 69 76 76 Crossways. 39 39 42 42 43 44 38 41 34 38 34 33 St. Georges. 22 34 40 46 53 51 46 48 49 51 38 35 SOLATIUM - HEALTH SERVICES DEPARTMENT . During the year 571 children under the age of five years received treatment in the Solarium at the request of the Council's Medical Officers. The total number of attendances was 2,390. EXTRA NOURISHMENT. The Invalid Kitchens of London, under arrangements made with the Council, supplied 384 dinners to children, necessitous, expectant and nursing mothers, upon the recommendation of the Council's Medical Officers. DENTAL CLINIC. Expectant Mothers, Nursing Mothers. Pre-School Children. Total. Number of patients. 129 34 122 285 Attendance at Clinics. 599 394 404 1397 Tooth Extracted. 312 83 103 498 Teeth conserved by fillings. 98 - - Patients fitted with partial dentures. 14 - - Patients fitted with full dentures. 12 - - Scalings 37 — — In addition to the operative treatments stated above, a largo number of dressings with Zinc Oxide were also carried out, and all necesary operative treatment was carried out in the clinic with the exception of orthodontic eases which were referred to hospital. In 26 instances patients were radio-graphed for dental purposes in the Council's X-Ray Department. VACCINATION. The total number of certificates and copies of certificates of successful primary vaccinations received during the year was:- Northern Division 605 Southern Division 775 TOTAL 1,380 CHILD LIFE PROTECTION, In 1946 five names were added to the register of Poster Mothers and eleven were removed from it. At the end of the year there were nine Foster Mothers and eight Foster Children. The health of the children was good. except for occasional minor ailments. Three Foster Children were legally adopted by the Foster Parents, Mo Foster Mothers have been paid under the F.M.Scheme, because no suitable Foster Homes were available in the Borough. 187 visits were paid to Foster Homes and to the schools which some of the older children attend. -5- SANITARY CIRCUMSTANCES OF THE AREA. Summary of work Carried out under the Public Health and Factory Acts during the year:- Inspections upon complaints being received 4983 Miscellaneous Inspections 2299 Inspection of War Damaged properties 302 Inspections of Factories 699 Visits to Outworkers 151 Re-housing visits 995 Inspections of Shops 119 Inspections of Common Lodging Houses 47 Re-visits 14824 Intimation Notices served 3284 Statutory Notices served 999 Defects found and remedied 6740 PUBLIC HEALTH ACT, 1936 - SECTION 95. Certificates as to habitability were issued in respcct of 201 newly erected premises. RENT ESTRICTION ACTS. 65 Certificates were issued during the year under the abovementioned Acts. INSPECTION AND SUPERVISION CF FOOD PREMISES. Pood supplies in the Borough have received close attention during the year, and their inspection has been carried out thoroughly and in a systematic manner. Regular inspections have been made of the large quantities of food received at the riverside wharves in the Borough with a view to ascertaining it3 fitness for human consumption. Meat and bacon have been kept under close surveillance, both during landing at the riverside and whilst in Cold Storage to ensure its wholesomeness. Pood premises, including factories, eating houses and dairies were visited during the year, and advice given regarding the importance of cleanliness in handling food, where necessary, 234 tons, 17 cwts and 89 lbs of food were found to be unfit for human consumption as a result of inspections, and instructions given for its disposal. MORTUARY AND CORONER'S COURT. The following is a statement of the work of the Mortuary and Coroners Court during the year 1946:- Post-mortens without inquest 725 " " with " 336 Inquests without Post-nortems elsewhere 59 Bodies brought in for convenience 2 1,122 COMMON LODGING HOUSES. There arc six Common Lodging Houses in the Borough, four being Women's. The beds are always occupied each night and in many instances people havo to be turned away owing to lack of accommodation. In one Women's Common Lodging House a case of infectious disease was notified, but it proved very difficult to get the woman removed because of lack of hospital accommodation. The use of D.D.T preparations has reduced the amount of infestation. Several Notices wcro served, but the defects wcro remedied as soon as the necessary labour and materials could be obtained. 47 visits were paid. -6- PUBLIC HEALTH (LONDON) ACT, 1936 - LEGAL PROCEEDINGS. DEPENDANT OFFENCE. RESULT OF PROCEEDINGS. Mrs. Rebecca Benabo, 3, St. Stephen's Parade, S.W.I., trading as Charles Benabo & Son. Nuisances at 39, Chapter Road and 34, Westcott Road. Summons withdrawn works completed. Payment of £1.1.0 costs in each case. Mr.G.P.Farren, trading as G. Farren & Son, 2A, Edridge Road, Croydon, Surrey. Nuisance at 14, Madron Street. Summons withdrawn works completed. Mr.S.G.Powell, 64, Surrey Square, S.E.17. Nuisance at 57, Alpha Square. Summons withdrawn -works completed. Mr. R.E .Palmer , 131, Kennington park Road, S.E.ll. Nuisance at 62, Alberta Street. Summons withdrawn - works completed. Mr Arthur Benabo, 114, Ibex House, Minories, E.C.3. Nuisance at 41C, The Cut. Summons withdrawn on payment of £1.1.0 costs - works completed. Mrs. Rebecca Benabo, trading as Charles Benabo & Son. Nuisance at 35, Chapter Road. Summons withdrawn on payment of £1.1.0 costs - works completed. Mr. J. Davies, "Kildare", 64, Marlborough Road, Wealdstone. Nuisance at 115, London Road Abatement Order to execute the necessary work within 28 days made against the Defendant, who was ordered to pay £5.5.0 costs. Mr.E.Honig, 27, Alleyn. Park, West DulWich, S.E.21. Nuisance at 200, Olney Road. Abatement Order to execute the necessary work within 28 day3 was made against the Defendant, who was ordered to pay £1.1,0 costs. Mrs. Rebecca Benabo trading as Charles Benabo & Son, 3, St. Stephen's Parade, S.W.1. Nuisance3. at 33 & 39, Chapter Road. Abatement Orders to execute the necessary works within 21 days and 14 days,respectively, made against the Defendant, who was ordered to pay £1,1.0 costs on the first summons and £2.2.0 on the second summons. DEPENDANT. OFFENCE. T OF PROCEEDINGS. Mrs. Rebecca Benabo trading as Charles Benabo & Son, 3, St. Stephen's parade, S.W.I. Nuisance at 34, Westoctt Road. Summons withdrawn on payment of £1.1.0 costs - works completed. Liessrs. Briant & Son, 10, Kennington lark place, S.E.ll. Nuisanco at 15, Sharstod Street. Hearing adjourned. Mr, E. Honig, 27, Alleyn park, Dulwich, S.E.21. Nuisance at 208, Olney Road. Summoned for noncompliance with an Abatement Order. Defendant fined £9 and ordered to pay £1.1.0 costs. Mrs. A. Painter 388, Mile Oak Road, portslade, Sussex. Nuisanco at 70, Mann Street. Abatement order to exocute the necessary work within 28 days made against the Defendant, who was ordered to pay £1.1,0 costs. Messrs.R.Cawley & Son, Ltd,, 15, Carew Street, S.E. .5. Nuisance at 99, Inville Road. Summons withdrawn works completed. Mrs. R. Benabo trading as Charles Benabo & Son, 3, St. Stephen's larade, S. W. 1. Nuisances at 11, Royal Terrace, 33, Chapter Road and 37, Chapter Road. Summons in respect of 11 Royal Terrace withdrawn - works completed. Abatement order to execute the necessary work at 33 and 37, Chapter Road within 21 da.y3 - ordered to pay £2.2.0 costs. FACTORIES ACT. 1957. The number of factories on the Register kept by the Council has increased during this year. Several firms have returned from evacuation and some industries have been started in the Borough. Less women are now employed in the heavy engineering industries, but female labour is still extensively employed in the majority of other factories. With very few exceptions, mechanical power is used in all factories. Regular inspections were made under the Factories Act. The standard was good, and as a general rule the factory managers were eager to co-operate for the welfare of their employees. In some cases, it was observed that conditions did not comply with the Factories Act. In minor details, verbal notice was given, but where major alterations were necessary written notice was served and licences issued. OUTWORKERS. 151 visits wore paid to the homes of outworkers, and where inspections wore made, conditions wore found to be fairly satisfactory. Many women go out to work all day and do out-work in the evenings. In these cases, it is difficult to inspect the promises during the day. Several people were known to bo doing out-work, who had not been notified to the Local Authority by their employers, and it is possible that many more were doing work in unsuitable conditions unknown to the Inspector. REDENT CONTROL. Report for twelve months from January 13th. 1946, to January 4th. 1947. Domestic, Business. Visits: Rodent Officer 283 310 Investigators 4,864 1,427 Operatives 4,583 1,286 Drains Tested-. 372 56 " Found Defective 81 16 " Repaired 67 7 " Opened up for examination 53 9 Other Preventive Works — _ Promises reported infested 680 197 " Cleared 671 201 Additional to the above reports. Business: Pre-Baits Laid 21,839 Poison Baits Laid 5,228 Total Baits Laid 27,067 Bodies Recovered 653 Domestic : Poison Baits Laid 4,201 Bodies Recovered 175 Note; Two Maintenance Treatments of the Sewers were carried out during the months of June and November, in conjunction With the Borough Engineer's Department. The respective result s were as follows Poison Takes: Complete 14 Partial 390 Bodies 45 Estimated „ „ Kill 3,440 " " 77 „ 492 „ 47 Estimated Kill 4,845 Manholes treated numbered 801 and 800 respectively -7- Block Scheme. An area comprising 35 Blocks from Union Street in the north to New Kent Road and St. Georges Road in the south, and bounded to the east by Bermondsey and to the west by Lambeth was investigated and all infestations treated. In the cases where business premises employed Servicing Companies, arrangements were made whereby the Servicing Companies stopped up their treatment, at the same time as we were working in a particular area. Co-operation from these services has been very good. TREATMENT & BATHING STATION. KING JAMES STREET . Annual Return of the work of the Station for the year ending 29th. December, 1946. The year under review shows a slight decrease in the total number of treatments given in the Mens and Womens Bathing Section and a slight increase in the Childrens Section. The total treatments were 12,308 in 1945 and 11,978 in 1946. The routine method of treatment for Scabies has been maintained during the year and all cases have been requested to attend for medical examination after the second bath. The Medical Officer of Health has held 49 medical sessions and examined 1,191 cases, and secondary ailments following scabies have been treated under his direction until discharged. Verminous cases have increased, the principal sources of supply being as follows:- MALES RESIDENT IN SOUTHWARK AND LAMBETH, Rowton Houses 104 Salvation Army Hostel 74 Southwark Casuals 26 Marshalsea Road Common Lodging House 17 Embankment Fellowship 2 Waterloo Shelter 1 Union Jack Club 2 Factories and private residents 176 402 FEMALES RESIDENT IN SOUTHWARK AND LAMBETH. 83, Blackfriars Road Common Lodging House 15 78, Camberwell Road Common Lodging House 19 Cecil House Hostel 5 Elizabeth Baxter Hostel 4 Church Army Hostel 2 Southwark Casuals 2 Factories and Private residents 355 402 INFECTIOUS DISEASE . This section shows some increase, the number of Scarlet Fever cases kept at hone owing to shortage of Hospital Accommodation having risen from 58 in 1945 to 84 in 1946. Most of the home cases were of a very mild form and the Increase in numbers cannot be traced to the spread of infection due to home treatment. 8 There have been a number of Small-pox Contacts from overseas notified, all of which were kept under observation for a period of fourteen days from the last date of contact. In this connection, 324 home visits were made. In addition there have been several Typhus Contacts and a few cases of Malaria all from overseas which have been visited and revisited for varying periods. DISINFESTATION OF PREMISES. D.D.T Insecticide is now used in all cases. With few exceptions we have not had to deal with any heavily infested houses. Much of our work has been done on preventive rather than remedial linos. The absence of continuous hot weather tends to reduce the bug problem and the use of an insecticide which continues lethal over a period of months should favourably improve conditions. In connection with the Pre-Fabs, we have had many cases of infestation by ants, the source being from outside and the surrounding site. The separation of the work relative to Council Housing is difficult as we have to deal with so much property that has been requisitioned by the Council for Re-housing. EDUCATIONAL. Facilities have been given to various Training Centres for Public Health Students and demonstrations relative to the work of the Station given at frequent intervals. 254 Students have attended during the year. It is interesting to record that on the 12th. April, 1946, we received a visit from Dr. Reali Tewfik, Sousha Pasha, representing the Egyptian Government accompanied by a Liaison Officer appointed by the Ministry of Health of the British Government. The Chairmen of the Public Health Committee and the Maternity and Child Welfare Committee with the Medical Officer of Health were also in attendance. GENERAL. It is gratifying to report that many of the patients treated at the Station express their appreciation of the manner in which their case has been handled. TREATMENT OF SCABIES, MEN. WOMEN. TOTAL. Lambeth Cases. 370 1,018 1,388 " Treatments. 784 1,988 2,772 Southwark Cases. 335 792 1,127 " Treatments. 714 1,644 2,358 L.C.C.School Children. 3,534 TREATMENT OF VERMINOUS PERSONS. Lambeth Cases. 35 153 188 " Treatments. 37 164 201 Southwark Cases. 352 230 582 " Treatments. 365 238 603 L.C.C. School Children. 2,510 9 TREATMENT OF VERMINOUS BEDDING AND CLOTHING Beds. Pall. Bolsters. Pillows. Cushions. Blankets. Sheets. Quilts. Pieces. 182 227 32 491 36 660 55 43 62,764 TREATMENT OF VERMINOUS ROOMS. Sulphured and sealed Nil D.D.T. Spray 1,369 Deodex Spray 78 Total Rooms Treated 1,447 VERMINOUS EFFECTS DESTROYED. 1 Ton 8 Cwts. Household Goods. TREATMENT OF INFECTIOUS BEDDING. Bods. Pall. Bolsters. Pillows. Cushions. Blankets. Sheets. Quilts. Pieces. 31 116 32 258 14 284 106 65 273 PUBLIC LIBRARY BOOKS DISINFECTED AND RETURNED - 95 ROOMS DISINFECTED AFTER INFECTIOUS DISEASE - 272 INFECTIOUS DISEASE ENQUIRIES Scarlet Fever 167. Diphtheria 61. Erysipelas 32. Dysentery 18. Enteritis 4. Cerebro-spinal meningitis 13. Total - 295 Notified Cases. NUMBER OF SCARLET FEVER CASES KEPT AT HOME, SPECIAL INVESTIGATIONS AND REPORT - 84 cases. DESTRUCTION OF BEDDING FROM INFECTED OR VERMINOUS PREMISES. Beds. Pall. Beds. Pill. Cush. Blank. Sheets. Quilts. Pieces. 24 26 9 33 10 7 8 2 195 SCABIES ORDER 1941. Visits made. 343 Formal notices served. 54 FOOD & DRUGS ACT, 1938 - ANALYSIS OF SAMPLES. Samples Formal. Examined. Informal. Adulterated. Formal. Informal Milk 232 11 2 - Condensed Milk 3 6 - - Dried Milk 2 - - - Graded Milk - 25 - - Butter 27 8 - - Cheese 4 5 - - Margarine 9 9 - - Lard 14 6 - - Tea 23 5 - - Coffee 10 6 - - Coffee Mixture & Essences 10 10 - - Cocoa 18 13 - - Carried Forward. 352 104 2 - 10  Samples Formal. Examined Informal. Adulterated Formal. Informal. Brought Forward 352 104 2 - Sugar 16 5 - - Meat & Meat Products 41 83 1 7 Canned & Potted Foods 24 87 1 2 Fruit & Vegetables (Canned) etc. 39 71 - - Preserves, Jellies, Jams etc • 75 81 - - Cereals & Cereal prepar at ions 102 192 3 11 Bread, Flour & Confectionery 67 76 1 1 Wines, Spirits & Beverages 14 55 3 1 Condiments, Spices, Sauces etc. 124 170 5 13 Drugs & Med. Preparations 34 60 1 4 Miscellaneous Samples 47 93 2 3 Total 935 1077 19 42 FOOD & DRUGS ACT, 1938 - LEGAL PROCEEDINGS. DEFENDANT. CAUSE OF PROCEEDINGS. RESULT. William Reed, "Duke of York" Public House, 47, Borough Rd. Selling Gin 36,5 degrees under proof. Pined £10 do Refusal to sell to the Council's Inspector a sample of Rum exposed for sale. Fined £5 and £6.6.0 Costs. do Obstruction by wilfully permitting his wife to remove the contents of a bottle of whisky after the Council's Inspector had applied to purchase a quantity of the whisky as a sample. Fined £5 and £6.6.0 Costs. Mrs. Imogen Reed, "Duke of York" Public House, 47, Borough Rd. Obstruction by removing the contents of a bottle of Whisky after the Council's Inspector had applied to purchase a quantity as a sample. Fined £5. J. Gunn & Co .Ltd., 361, Bethnal Green Road. Selling Baking Powder 45 per cent deficient in available carbon dioxide. Withdrawn upon receipt of a letter of undertaking and the payment of £10.10.0 Co3ts. Charles Doorey, 16, Ponton Place. Selling Vinegar 35 per cent deficient in Acetic Acid. Fined £2 and £1,1.0 Costs. 11 Jamos Runcorn, 116, Westmoreland Road. Selling Vinegar 32 per cent deficient in Acetic Acid. Fined, £5 and £1.1.0 Costs. do Selling Vinegar 15 per cent deficient in Acetic Acid. Not separately dealt with. Charles Doorey, 16, Penton Place. Soiling Vinegar 32 per cent deficient in Acetic Acid. Withdrawn. Manufacturer fined. Six cautionary letters were sent in respect of other non-genuine samples, BAKEHOUSES. There are 43 Bakehouses in use in Southwark, of which 16 are Underground Bakehouses. MILK (SPECIAL DESIGNATIONS) REGULAT IONS, 1936 - 1943. Dealers' Licences were granted authorising the use of the special designation "Pasteurised" in 22 cases, and Dealers' Licences authorising the use of the special designation "Tuberculin Tested" Milk were granted in 11 cases. 8 Supplementary Liconce3 in respect of "Pasteurised" Milk and 6 in respect of "Tuberculin Tested" Milk were granted to dealers soiling from premises outside the Borough, the principal licences having been issued by the appropriate Licencing authority in each case. During the year, 25 samples of graded milks were taken and submittod to the Public Analyst for bacteriological examination and chemical analysis. MILKSELLERS. At the close of the year, there were 185 registered retailors and wholesalers in the Borough, whilst the number of retailers and wholesalers purveying milk in the Borough but registered elsewhere was 43. PUBLIC, HEALTH (CONDENSED MILK) REGULATIONS. 1923 and 1927. 6 samples of Condensed Milk were purchased under the above Regulations for analysis. They were all certified by the Public Analyst to comply with the said Regulations. PHARMACY & POISONS ACT, 1933. During the year, 95 visits were paid to the various premises listed by the Council for the sale of Part II Poisons under the above Act. There are 61 names of persons on the Council's List of Sellers of Fart II Poisons. 12 INFECTIOUS DISEASES & TUBERCULOSIS. General. Confirmed diagnosis of Infectious Diseases generally showed a slight decrease from both 1944 and 1945 figures; in particular, Scabies dropped from 495 in 1945 to 405, and Measles from 965 to 775. The only substantial increase was in Whooping Cough, which totalled 232 cases, against only 57 in 1945. Cerebro-spinal Meningitis cases number 8; there was none in 1945. Dysentery decreased from 29 to 8. The following data has boon compiled from these cases:- Cerebro-spinal Meningitis. 4 cases under 3 years of age, 2 in recent contact with military personnel, from whom infection may have been contracted. 2 recently suffering from severe Influenza. 4 cases 25/35 of age, 1, probably 2, in recent contact with Military personnel, from whom infection may have been contracted. 2 recently suffering from severe Influenza. 2 fatal cases occurred in the 25/35 age group. One was in recent contact with her husband, a soldier, just returned from India. The other had recently suffered from severe Influenza. Dysentery. 6 cases under 3 years of age, 1 in recent contact with Military personnel. 1 contracted disease immediately following Cerebro-spinal Meningitis. 1 case 32 years of age. Contracted disease previously in Africa, whilst on military service; recently demobilised. 1 case 63 years of age. Fatal case, no relative observations. Malaria. 7 cases of Malaria were diagnosed early in the year amongst recently returned soldiers; there had been no Malaria cases in 1945. Zymotic Enteritis. There was a slight decrease in Zymotic Enteritis cases from 15 in 1945 to 10 in 1946, during the three summer months for which this disease is at present notifiable in Southwark. According to available information, however, it appears that the incidence of this disease is maintained more or less regularly throughout the whole year. On the grounds that official notification enables the Health Visitors to visit cases and obtain important information, or give useful assistance, in connection with child welfare home conditions, which might not otherwise be possible consideration is being given to the proposal that infantile diarrhoea, which is felt to bo a more suitable description than Zymotic Enteritis, should be notifiable throughout the whole year. 13 Hospital accommodation for infectious oases remained severely restricted, and only those of clinical severity or unsuitable home nursing conditions could be removed to hospitals. There are indications however, that this position is slowly improving. Numerous cases of Service personnel returning home from abroad, who had been contacts of Smallpox or Typhus, were examined, but none was found to be infected with either disease. The numbers of such contacts declined during the year, and none has been reported during the latter part. NOTIFICATIONS OF INFECTIOUS DISEASES. 1,821 notifications of Infectious Diseases were received during the year under review, of which the diagnosis of 1,754 were subsequently confirmed. 324 persons were removed to L.C.C fever hospitals. Unfortunately, 12 deaths from notified cases of notifiable diseases were recorded, against only 1 in 1945, with an additional 16 deaths from diseases which had not been previously notified. These deaths are detailed below, from which it will be soon that of the total of 28, 16 were from Pneumonia, the average age being 60. Deaths - Disease. Age Groups. 0-1 1-5 20-35 35-45 45-55 55-65 65-75 75 & Over. Moasles (notified) 2 - - - - - - - Whooping Cough (Notified) 1 1 - - - - - - -do- (un-notified) 1 - - - - - - - Dysentery (notified) - - - - - 1 - - -do- (un-notified) - - - - 1 - - - Cerebro-spinal Meningitis (notified) - - 2 - - - - - Encephalitis Lethergica (notified) - 1 - - - - - - Pneumonia (notified) - - - - 1 1 - 1 -do- (un-notified) - - 2(x) 2 1 2 2 4 (x) 1 of these was notified as a Tuberculous case) Pood Poisoning (Notifled) - - - - 1 - - - Zymotic Enteritis (un-notified) 1 - - - - - - - (July-Sept. only) NOTIFICATIONS. Disease. Original Notifications. Admitted to Hospital. Confirmed Diagnosis Deaths Notified. Un-notified. 1946 .1945. Scarlet Fever 164 73 156 139 - - Pneumonia 68 - 69 58 3 13 Diphtheria 63 63 27 38 - - Erysipelas 28 11 28 33 - - Dysentery 13 10 8 29 1 1 Ophthalmia Neonatorum 10 10 10 12 - - 14 Puerperal Pyrexia 8 5 8 17 - - Puerperal Fever 6 6 6 3 - - Cerebro-spinal Meningitis 12 6 8 - 2 - Zymotic Enteritis (July-Sept) 9 7 10 15 - 1 Paratyphoid 1 1 1 - - - Malaria 7 - 7 - - - Food Poisoning 10 1 3 1 1 - Encephalitis gica 1 1 1 - 1 - Scabies 405 - 405 495 - - Measles 782 89 775 965 2 - Whooping Cough 234 41 232 57 2 1 Totals 1,821 324 1,754 1,862 12 16 TUBERCUL0SIS. Notifications of Tuberculosis showed a slight increase over 1945 figures, which, however, was almost equally offset by a corresponding decrease in the number of deaths of notified cases. Primary Notifications. Age Groups 0 1 5 10 15 20 25 35 45 55 65 Total Total Including Duplicates Pulmonary Males - 2 4 3 5 8 25 16 14 23 7 107 118 Females - 3 4 1 20 18 19 4 - 1 1 71 78 Totals - 5 8 4 25 26 44 20 14 24 8 178 196 Total 1945 176 198 Non-pulmonary Males 1 1 4 2 1 2 2 1 - - 1 15 15 Females - 3 2 1 1 - 4 - - - - 11 11 Totals 1 4 6 3 2 2 6 1 - - 1 26 26 Total 1945 24 24 New cases, other than by formal notification. Pulmonary Males 1 - 1 - 2 3 7 10 6 4 2 36 - Females - 1 - - 1 8 9 4 1 1 2 27 - Totals 1 1 1 - 3 11 16 14 7 5 4 63 - Total 1945 37 - Non-pulmonary Males - - - 2 - - - - - - - 2 - Females - 1 1 1 - 1 1 - - - - 5 - Totals - 1 1 3 - 1 1 - - - - 7 - Total 1945 5 - Grand Totals 1946 1945 Pulmonary 241 213 Non-pulmonary 33 29 274 242 15 TUBERCULOSIS DEATHS. Ago Groups 0 1 5 10 15 20 25 35 45 55 65 75 Totals Notified T.B Cases from other causes. Notified Cases. M.49 died Actinomycosis. F.22 died Pneumonia, F.25 notified as Non-Pulm T.B. Pulmonary Males - - - - - 1 2 7 9 15 1 2 37 Females - - - - 3 5 6 4 2 1 - - 21 Totals - - - - 3 6 8 11 11 16 1 2 58 Total 1945 85 Non-pulmonary Males 1 - - - - - - 1 - - - - 2 Females - 1 1 - - - 2 - - - - - 4 Totals 1 1 1 - - - 2 1 - - - - 6 Total 1945 7 Un-notified cases. Pulmonary Males 1 - - - - - - 1 2 3 1 2 10 Females - 1 - - 1 1 - - - 1 1 1 6 Totals 1 1 - - 1 1 - 1 2 4 2 3 16 Non-pulmonary Males - - - - - - - - - - - - - Females - 1 - - - - 1 - - - - - 2 Totals - 1 - - - - 1 - - - - - 2 Grand Totals Pulmonary Non-pulmonary Notified(1946) 58 6 Cases. (1945) 85 7 Un-notified Cases. (1946) 16 2 PROPAGANDA. During the year under review, two Diphtheria Immunisation campaigns ware organised in the Borough, in conjunction with the Ministry of Health and Ministry of Information. Cinema slides, press publicity, mobile 'broadcasting' units covering the whole area, a special window display through the courtesy of the Royal Arsenal Co-operative Society, and intensive poster and leaflet propaganda, all contributed to a satisfactory response, and it is gratifying to record that Diphtheria notifications again decreased to 27 confirmed cases. The L.C.C Mass Miniature Radiography scheme was available during the early part of the year to all persons employed in the Borough. As many as possible of the industrial and commercial concerns in Southwark, and a great number of persons were examined by the Unit at the L.C.C South Eastern Hospital, New Cross, the Borough Council providing and arranging full transport facilities. 16 17 RETURN RELATING TO THE WORK OF THE DISPENSARY DURING THE YEAR ENDING 31ST. DECEMBER, 1946. DIAGNOSIS PULMONARY NON-PULMONARY TOTAL GRAND TOTAL Adults Children Adults Children Adults Children A (1) Number of definite cases of Tuberculosis on The Dispensary Register at the beginning of year M. F. M. F. M. F. M. F. M. F. M. F. 292 302 57 54 17 26 3 6 309 328 60 60 757 (2) Transfers from other Authorities during the year 10 9 l - - - - - 10 9 1 - 20 (3) Lost sight of cases returned during the year 1 4 - - - - - - 1 4 - - 5 B Number of New Cases diagnosed as tuberculosis during the year . (1) Class T.B minus 48 34 7 7 - - - - 48 34 7 7 96 (2) Class T.B plus 35 21 - - - - - - 35 21 - - 56 (3) Non-pulmonary - - - - 9 3 6 2 9 3 6 2 20 C Number of cases included in A & B written off the Dispensary Register during the year as:- (1) Recovered 6 11 1 - 2 3 2 1 8 14 3 1 26 (2) Dead (all causes) 37 18 - - 1 - - 1 38 18 - 1 57 (3) Removed to other Areas 15 27 1 4 - 1 - 1 15 28 2 4 49 (4) For other reasons - - - - - - - - - - - - - D Number of definite cases of tuberculosis on the Dispensary Register at the end of the year 328 313 63 57 24 25 7 5 352 333 70 62 822 A.P. Refills - 2,559 X-Ray Exams - 5,866 Total Attendances - 10,857 Home visits by Health Visitors - 3,879