STPAN 99 METROPOLITAN BOROUGH OF SAINT PANCRAS ABRIDGED INTERIM REPORT of the MEDICAL OFFICER OF HEALTH for the year 1941 MAITLAND RADFORD, M.D., B.S.. D.P.H. -2- To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Saint Pateras. Sir, Ladies & Gentlemen, This report is the 85th Annual Report that has been submitted and the eighth that I have had the honour to prepare. In accordance with Instructions received from the Ministry of Health it is an abridged report from which everything except essential statistical information has been excluded. Large and rapid changes in the estimated population have the effect of making rates expressed as so much per 1,000 of the estimated raid-year population of less value for purposes of comparison than in normal times. With this reservation however, it is to be noted that both the birth rate and the death,rate are higher than in 1940. My thanks are due to the Public Health Group Representatives, the members of the Council, and to the staff of the Public Health Department for their assistance and support during the year. I wish again to acknowledge the very great assistance received from the Local Medical War Committee of the British Medical Association through those co-operation the services of a very large number of medical practitioners of the Borough have been made available in connection with various aspects of A.R.P. work. I an, Sir, Ladies & Gentlemen, Your obedient Servant, MAITLAND RADFORD Medical Officer of Health. 17 JUN 1942 10th July,1942 -3- METROPOLITAN BOROUGH OF SAINT PANCRAS ANNUAL (ABRIDGED INTERIM) REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1941. POPULATION The estimated mid-year population is less than in 1940, but in accordance with instructions no exact figure is quoted. LIVE BIRTHS Total M F Legitimate 1,275 629 646 Illegitimate 159 81 78 1,434 710 724 STILL BIRTHS Legitimate 27 17 10 Illegitimate 7 4 3 34 21 13 DEATHS 2,055 1,110 945 DEATHS FROM PUERPERAL CAUSES Deaths Rate per 1,000 total (live and still) births Puerperal and post abortive sepsis 1 0.68 Other maternal causes 3 2.04 Total 4 2.72 DEATH RATE OF INFANTS UNDER ONE YEAR OF AGE All infants per 1,000 live births 51 Legitimate infants per 1,000 legitimate live births 52 Illegitimate infants per 1,000 illegitimate live births 44 NOTIFICATION OF BIRTHS The total number of notified births, including stillbirths, from all sources was 997• Of this number 962 were notified by midwives. CLASSIFICATION OF DEATHS, WITH AGE DISTRIBUTION AGES - BOTH SEXES CAUSES OF DEATH Under 1 year 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards SEX. TOTALS M F All causes 74 23 24 64 264 569 1037 1110 945 1. Typhoid and Paratyphoid — — — — — — — — — 2. Cerebro Spinal Fever — 2 — — — — — 1 1 3. Scarlet Fever — — — — — — — — — 4. Whooping Cough 8 — — — — — — 2 6 5. Diphtheria — 4 2 1 — — — 5 2 6. Tuberc. of Resp. Syst. — 1 1 9 45 33 24 82 31 7. Other Tuberculosis — 1 1 1 4 2 1 4 6 8. Syphilitic Diseases — — — — 4 12 10 14 12 9. Influenza 1 — — — 2 8 7 10 8 10. Measles 1 — 1 — — — — 2 — 11. Ac. Poliomyelitis and Polioencephalitis — — — — — — — — — 12. Ac. Infectious Encephalitis (Lethargic) — — — — 1 — — 1 — 13. Cancer, Buccal Cavity and Oesphagus (M) — — — 3 13 16 22 10 Uterus (F) 14. Cancer, Stomach and Duodenum — — — — 3 15 20 17 21 15. Cancer, Breast — — — — 1 14 7 1 21 l6. Cancer, All other sites — — 1 — 12 67 88 105 63 17. Diabetes — — — 1 2 2 4 5 4 18. Intracranial Vascular Lesions — — — — 1 32 68 43 58 19. Heart Diseases - - - 4 13 76 321 200 214 20. Other circulatory Diseases - - ' - 5 18 37 27 33 21. Bronchitis 1 1 1 2 5 37 82 84 22. Pneumonia 9 1 1 3 8 36 95 85 68 23. Other Respiratory Diseases — — — — 1 8 13 12 10 24. Ulcer, Stomach & Duodenum — — — — 6 19 11 28 8 25. Diarrhoea (under 2 years) 9 2 — — — — — 5 6 26. Appendicitis — — — — 5 2 3 3 7 27. Other Digestive Diseases 1 — — 1 2 15 30 30 19 28. Nephritis — — — 1 6 17 24 24 24 29. Puerperal and Post Abortive Sepsis — — — 1 — — — 1 30. Other Maternal Causes — — — 1 2 — — — 3 31. Premature Birth 19 — — — — — — 9 10 32. Congenital Malformations, Birth Injury, Infantile Diseases 17 — — 5 3 1 17 9 33. Suicide -— — — 1 6 4 — 8 3 34. Road Traffic Accidents — 2 3 1 2 11 ,7 19 7 35. Other Violent Causes 6 6 9 33 104 96 66 163 157 36. All other Causes 2 3 4 5 15 29 102 82 78 Erysipelas (included in 36 above) 1 1 - -5- PROVISION OF HEALTH- SERVICES IN THE BOROUGH. BACTERIOLOGICAL EXAMINATIONS Positive Negative Total For Diphtheria Bacilli 38 347 385 Tubercle Bacilli 17 106 123 Haemolytic Streptococci etc. 3 5 8 58 458 516 NURSING IN THE HOME The following District Nursing Associations undertake the nursing of cases of illness occurring in expectant and nursing mothers and children under 5 years of age. An annual block grant is made to each Association in respect of such nursing of certain specified diseases: Block Grant Cases Hampstead £ 30 56 Metropolitan 250 153 North London 25 19 TREATMENT CENTRES AND CLINICS Centre Expectant Mothers Children Total Consultations Total Attendances Total Consultations Attendances Under 1 1-5 Total St. Pancras School for Mothers Ampthill Square 11 84 144 1517 847 2364 Camden Town 52 561 259 2468 2695 5163 Kentish Town 71 756 173 2245 1716 3961 North St. Pancras School for Mothers Queens Crescent 50 572 173 2660 1840 4500 Somers Town 12 136 135 1769 1390 3159 * South Highgate - - 105 1559 1655 3214 University College Hospital 151 3227 104 308 202 510 Royal Free Hospital 100 359 41 23 37 60 TOTALS 447 5695 1134 12549 10382 22931 Artificial Light treatment - - 84 173 1463 1636 NOTE Less included in South Highgate & figures 30 6l 559 620 above. (Monday attendances) 54 112 904 1016 -b- HEALTH VISITORS The total number of visits made by Health Visitors was : Council's 15 Visitors U. C. H. 2 Visitors Total. To Expectant Mothers 3201 75 3276 Post Natal 254 - 254 Children 18499 652 19151 Child Life Protection 408 16 424 Infectious Diseases etc, . 2694 29 2723 25056 772 25828 DIPHTHERIA IMMUNIZATION This is provided free for children between 1 and 13 years of age, whose parents are not earning more than £4-00 a year. Immunization under the scheme was received during the year as follows:- 1941 1942 Private Practitioners 593 89 Welfare Centres 221 L.C.C. schools 1347 2161 89 GYNAECOLOGICAL CLINIC 53 Sessions were held, 90 women received attention, and there were 260 attendances. INVALID CHILDREN'S AID ASSOCIATION Assistance is rendered towards the cost of convalescence of children under 5 years of age, to a maximum of 5° children at 30/- each for any one year. DENTAL TREATMENT Ampthill Square Camden Town Sessions 24 44 Attendances 93 545 . The Borough Council also made a contribution of £49.1.0d towards the cost (£126.13.0d) of dentures supplied to-nursing or expectant mothers. SUPPLY OF MILK TO MOTHERS AND YOUNG CHILDREN The total quantity of milk supplied free by the Council during the year,(otherwise than under the National Milk Scheme) was 54 pounds, to 13 cases, at a cost of £l8.0,6d. In addition 40 lb. was supplied by the several voluntary committees. SANITARY CIRCUMSTANCES OF THE AREA. During the year 19,342 visits and Inspections (including reinspections) were made by eight of the Council's Inspectorial Staff. Of these, 4,932 were made by the two Food Inspectors, and 5,364 by the two Factory Inspectors. ' -7- Under the general direction of the Housing Inspector, the remaining Sanitary Inspectors have been wholly engaged in the supervision of work in connection with first-aid repairs to war damaged houses in the Borough, with the assistance of eight temporary Housing Assistants. 1,062 intimation notices (including 114 by the Factory Inspectors), and 334 statutory notices were served during the year. None was served under the Shops Act. 7 prosecutions were undertaken under the Public Health (London) Act, 1936 in respect of general sanitary work, and 20 under the Food and Drugs Act, 1938• Defects found under the Factories Act numbered 171, all of which were remedied. There were no prosecutions. DISINFECTION. During the year disinfections were carried out after infectious diseases, as follows:- Disease No. of cases No. of Houses No. of rooms contents disinfected or destroyed. No. of rooms sprayed and fumigated Scarlet Fever 125 125 1 76 Diphtheria 119 119 1 86 Enteric Fever 3 0 - 2 Puerperal Fever 2 - - - Erysipelas 35 35 - 6 Cerebro-spinal Meningitis 35 35 - 13 Polio-myelitis 1 1 - 1 Measles 10 10 - 1 Pneumonia 2 2 - 1 Dysentery 2. 4 - - Tuberculosis 113 113 3 92 Vermin and Scabies 623 608 7 196 Other Diseases,(not notifiable ) 252. 249 5 26 Air raid shelters 169 - 2 21 TOTALS 1498 1311 19 521 The number of articles disinfected or destroyed on account of verminous conditions is as follows: Destroyed 63 Disinfected 14,618 CLEANSING STATION The total number of attendances in 1940 was 4,593 as compared with 6,149 in 1941, the increase being attributable to the larger number of cases of scabies treated. -8- The number of attendances during the year was : Men Women Children under 15 Total Vermin 878 122 1329 2329 Scabies 883 1006 1931 3820 1761 1128 3250 6149 HOUSING. Work under the Housing Act has been at a standstill owing to the war. INSPECTION AND SUPERVISION OF FOOD (a) Milk Supply Premises on the register at the end of the year: Dairies 155 Itinerant purveyors 73 Sealed containers only 237 774 visits were made. 341 formal samples were taken and submitted for analysis, 7 (2.0 per cent) of which fell below the limits required by the Board of Agriculture Regulations. Milk (Special Designations) Orders. 1936 and 1938 The number of licences granted during 1941 was as follows:- Licences Supplementary Licences Tuberculin tested 13 7 Accredited 2 - Pasteurised 45 14 (b) Meat and Other Foods (I) Public Health (Meat) Regulations. 1924 Periodical visits of inspection were made as follows:- Slaughter houses 10 Meat depot 313 Butchers' Shops and Meat Stalls 1033 Prepared Meat Premises 359 (II) Inspection of other Premises where Food, is prepared or offered for sale The Food Inspectors have kept all such premises under regular and frequent observation, 338 inspections being made for the purpose. -9- (c) Adulteration, etc. 800 samples (38O formal and 420 Informal) were submitted, for analysis by the Public Analyst, of which 14 formal and 12 Informal were found to be adulterated. Prosecutions were undertaken under the Food & Drugs Act, 1938, in 7 cases. INFECTIOUS DISEASE AND OTHER DISEASES Notifications Disease Under 1 1 and over Total Cases Admitted to Hospital Total Deaths Scarlatina or Scarlet Fever 4 132 136 128 — Diphtheria and Membranous Croup 1 117 118 104 7 Erysipelas 1 42 43 31 — Enteric or Typhoid Fever - 12 12 12 — Puerperal Fever — 8 3 8 2 Puerperal Pyrexia — 23 23 15 — Cerebro-spinal Meningitis 2 27 29 29 2 Anterior Poliomyelitis and Polioencephalitis — 3 3 2 — Ophthalmia Neonatorum 18 1 19 14 — Encephalitis Lethargica — — — — — Acute Influenza and Influenzal Pneumonia — 33 33 26 3 Acute Primary Pneumonia 4 99 103 88 2 Malaria — — — —- — Dysentery — 19 19 19 — Food Poisoning — 7 7 5 — Measles 45 571 616 260 2 Whooping Cough 60 282 342 147 8 Continued Fever — — — — — SMALL POX AND VACCINATION Of the 1,463 births registered in Saint Pancras during 1940, 490 (33.5 per .cent) were successfully vaccinated. Figures for 1941 are not yet available. -10- TUBERCULOSIS New Cases Deaths Pulmonary Non- Pulmonary Pulmonary NonPulmonary M F M F Primary ifications 140 73 12 15 Death Reports 24 9 1 3 Transfers 22 11 3 2 Other sources 2 — 2 - 0- _ 1 — — 1- 2 — 1 2 1 — 5- 8 4 5 2 1 2 15— 31 35 2 5 9 1 25- 34 21 5 7 27 4 35- 28 13 1 — 13 — 45- 35 3 2 1 17 2 55- 28 9 1 — 10 — 65 and upwards 22 7 1 3 24 1 Totals 188 93 18 20 113 10 (82 m; 31 F.) (4M. 6 F. ) Notification Register on list December, 1941: Pulmonary 695 Non-Pulmonary 143 Tuberculosis Dispensary Number of definite cases of tuberculosis on the Dispensary registers, at the end of the year: Pulmonary Non-Pulmonary Total Grand Total Adults Children Adults Children Adults Children M F. M F M F M F M F M 325 168 15 16 41 26 20 20 366 194 35 36 656 Total attendances: 2,825 X-ray examinations 587 A. P. Refills 1,212 Visits by Tuberculosis Visitors 3,639 Sputum examinations 403 Finsen Light Treatments 8 Admissions to Institutions 282 TUBERCULOSIS CARE COMMITTEE. An account of the work of this Committee which is more than ever necessary under war conditions, is omitted owing to lack of space, except for the following details: Income from Seal Sale and other sources £107.2.3. Expenditure on clothing, pocket money, coal, removals etc. for patients £60.14.2. Extra nourishment (provided by Borough Council): Number of patients 54, Cost, £238.2.9. Dental treatment (provided by Council): Number of patients 7, Cost, £16.14.3* Slaughter houses 341 Butchers' Shops and meat Stalls 1,669 Prepared Meat Premises 308 (11) Inspection of other Premises where Food is prepared or offered for sale The Food Inspectors have kept all such premises under regular and frequent observation, 1,949 Inspections being made for the purpose. (c) Adulteration, etc. 800 samples (394 formal and 406 Informal) were submitted for analysis by the Public Analyst, of which 18 formal and 15 informal were found to be adulterated. Prosecutions were undertaken as follows: Food & Drugs (Adulteration) Act, 1928 14 Food 8c Drugs Act, 1938 1 Public Health (preservatives in Food) Regulations, 1925/1939 1 Merchandise Marks Act, 1887 2 Merchandise Marks (Imported Goods) No. 7 Order, 1934 2 INFECTIOUS DISEASE AND OTHER DISEASES Notifications Disease Under 1 1 and over Total Cases Admitted to Hospital Total Deaths Scarlatina or Scarlet Fever 2 251 253 243 - Diphtheria and Membranous Croup 3 154 157 157 2 Erysipelas - 51 51 50 1 Enteric or Typhoid Fever . - 6 6 6 1 Puerperal Fever - 6 6 5 1 Puerperal Pyrexia — 34 34 31 2 Cerebro-spinal Meningitis 2 10 12 13 2 Anterior poliomyelitis and Polioencephalitis 2 2 2 - Ophthalmia Neonatorum 23 — 23 17 1 Encephalitis Lethargica - - - - 2. Acute Influenza and Influenzal Pneumonia - 31 31 22 18 Acute Primary Pneumonia 5 . 163 168 126 2 Malaria - 1 1 1 - Dysentery l 9 10 10 1 Food Poisoning - 4 4 - - Measles 14 71 85 47 — Whooping Cough 64 462 526 307 6 Continued Fever - 1 1 1 - SMALL POX AND VACCINATION Of the 3,843 births registered in Saint Pancras during 1938, 1,689 (43.9 per cent.) were successfully vaccinated Figures for 1939 are not yet available. TUBERCULOSIS New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary M F. M F M F M F. Primary notifications 136 98 17 17 Death Reports 12 4 4 2 Transfers 29 31 3 1 0- - - - - - - - - 1- - 1 2 1 - - 2 - 5- 1 4 3 5 - - 1 - 15- 33 41 3 6 8 9 - - 25- 52 48 6 6 10 11 2 1 35- 29 22 7 - 14 10 2 - 45- 27 10 1 - 15 5 - 1 55- 25 6 1 — 20 2 1 - 65 and upwards 10 1 1 2 13 1 -. 2 Totals 177 133 24 20 80 38 8 4 Death rate from Tuberculosis 0.77 per 1,000 of the average population appropriate to the calculation of death rates. Notification Register on 31st December, 1939: Pulmonary 740 Non-Pulmonary 147. Tuberculosis Dispensary Number of definite cases of Tuberculosis on the Dispensary Registers at the end of the year: Pulmonary Non-Pulmonary Total Grand Total Adults Children Adults Children Adults Children M F M F M F M F M F M F 346 229 19 25 43 32 22 14 389 261 41 39 730 Total attendances: 3321. X-ray examinations 434 A. P. Refills 1,334 Visits by Tuberculosis Visitors 3,493 Sputum examinations 495 Finsen Light Treatments 15 Admissions to Institutions 357 TUBERCULOSIS CARE COMMITTEE An account of the work of this. Committee, which is more than ever necessary under war conditions, is omitted owing to lack of space, except for the following details: Income from Seal Sale and other sources, £147.2.3d. Expenditure on clothing, holidays, etc. for patients, £103.7.4½d. Extra nourishment (provided by Council) Number of patients, 103. Cost, £318.0.l1d. Dental treatment (provided by Council): Number of patients, 11. Cost, £32.15.7d.