STE 50 METROPOLITAN BOROUGH OF STEPNEY ANNUAL REPORT for the year 1945 (Abridged) of the MEDICAL OFFICER OF HEALTH & ADMINISTRATIVE TUBERCULOSIS OFFICER f.R. O'SRIEL, L.R.C.P.I. ,L.M. ,D.P.H. Together with a SUMMARY OF THE REPORT of the PUBLIC ANALYST PUBLIC HEALTH DEPARTMENT 43, White Horse Road, STEPNEY, E.1 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney. Your Worship, Ladies and Gentlemen, I have the honour to present my report for the year 1945. The report is again abridged in accordance with the directions of the Ministry of Health. The Registrar General's estimate of the population of the Borough for the raid-year 1945 was 77,610. The population figures from the last pre-war year are as follows:1938, 200,500; 1939, 197,200; 1940, 136,030; 1941, 75,010; 1942, 71,980; 1943, 72,920; 1944, 73,030. The birth rate increased from 17,8 in 1944 to 18.5 in 1945. The death rate was lower than last year, 18.9 compared with 19.5. There were four maternal deaths, giving a maternal mortality of 2.6; and the infantile mortality rate was 56.17 compared with 56.6 last year. I am pleased to be able to report that there were no deaths this year from diphtheria or scarlet fever and that whooping cough immunisation increased from 376 to 891 and diphtheria immunisation, from 762 to 967. Compared with last year there were 456 more cases of infectious disease notified, mainly due to measles, of which there were 725 cases but only one death. The measles epidemic tends to recur biennially in this country and 1945 was a "measles year." It is interesting to record that in spite of the fact that 1945 was a measles year, notifications of pneumonia decreased from 65 to 55. As a rule, pneumonia tends to increase in measles years. Whooping cough decreased from 247 to 96 and there were two deaths. Diphtheria decreased from 47 to 44, and as stated above, there were no deaths. There were no cases of smallpox, one case of typhoid fever and one of typhus fever. An interesting account of the latter case will be found in the body of the report. 201 cases of tuberculosis were notified, 16 more than last year, and there were 110 deaths, 14 more than last year. There appears to have been a decline in the incidents of Scabies in 1945. The formal notifications were 807 compared with 1155 last year- nevertheless the scabies clinic had a busy year and I received much help from Dr. R.M. Orpwood and Dr. Susan Tracey who undertook diagnostic duties during the afternoon and evening sessions. Violent deaths again were high, chiefly because of enemy action in the earlier part of the year. For the last three years the violent deaths were 51 in 1943; 166 in 1944; and 174 in 1945. - 1 - With the ending of the World War on 15 August 1945 on the defeat of Japan, the anxiety of Civil Defence duties no longer troubled us. However, until the defeat of Germany on 8 May 1945 the Civil Defence forces remained manned and were actually in operation dealing with flying bomb and long range rocket raids until 27 March 1945. On that day there fell in Stepney the second last enemy projectile to fall in this country. It was a tragic ending to the long period of bombing suffered by this Borough from August 1940 to March 1945. The rocket fell at 7.20 a.m. on Tuesday 27th March 1945 on a large block of Borough Council Flats at Hughes Mansions, Vallance Road, and killed 130 persons. I here record with the deepest regret that in that last incident we lost three of our Aldermen: Aldermen J and Mrs. E. Pritchard and A. Vollasky. The Casualty Services were finally disbanded on the 1st July 1945 and many of the Sanitary Inspectors, clerical staff and employees were released from their part time Civil Defence Duties. I should like to record my sincere thanks to them and all the other officers who helped me so willingly and so courageously during the very trying and dangerous years of the war. To the Chairman and Members of the various Committees associated with my work and to the Civil Defence Controller, Mr. A. R. Beaumont, I tender my thanks for their support and guidance, not only during this year, but throughout the war years. I have the honour to. be, Your Worship, Ladies and Gentelmen, Your obedient servant, F. R. O'SHIEL Medical Officer of Health - 2 - METROPOLITAN BOROUGH OF STEPNEY ANNUAL REPORT (abridged) of the Medical Officer of Health for the year 1945. I. STATISTICS AREA OF BOROUGH (in acres) 1,902,766 POPULATION The Registrar-General' s Estimate for the mid-year 1945 77,610 LIVE BIRTHS Total M F Birth rate per 1,000 estimated population 18.5 Legitimate 1,270 6l7 653 Illegitimate 172 84 88 Total live births 1,442 701 741 STILL BIRTHS 53 24 29 Rate per 1,000 (live and still births) 35.4 Total live and still births 1,495 725 770 DEATHS 1,469 811 658 Death rate per 1,000 estimated population DEATHS FROM PUERPERAL CAUSES Puerperal sepsis 2 Other puerperal causes 2 Rate per 1,000 total (live and still births) 2.6 DEATH RATE OF INFANTS UNDER ONE YEAR OF AGE All Infants per 1,000 live births 56.1 Legitimate infants per 1,000 legitimate live births 53.5 Illegitimate infants per 1,000 illegitimate live births 75.5 DEATHS from cancer (all ages) 201 Meales „ „ 1 Whooping-cough(all ages) 2 Diarrhoea (under 2 years of age) 15 COMPARATIVE RATES England & Wales London Stepney Live births 16.1 15.7 18.5 Deaths 11.4 13.8 18.9 Infantile Mortality 46.0 53.0 56.1 Puerperal causes (death rate) 1.79 Not available 2.6 II. PROVISION OF HEALTH SERVICES IN THE BOROUGH NURSING IN THE HOME The Council's arrangements with the East London Nusing Society were extended during the year to various other illnesses. The Council now pay a block grant of £150 per annum, irrespective of the number of visits. LABORATORY FACILITIES The number of Bacteriological examinations carried out was as follows:- Positive Nagative For Diphtheria bacilli 6 411 For Dysentery 6 8 INSULIN for persons suffering from Diabetes was provided free of cost to 21 patients of which 8 were new cases, under authority of Circular 2734 of the Ministry of Health. AGED AND INFIRM PERSONS One person was removed on Magistrates Orders to institutions during the year under Section 224 of the Public Health (London) Act, 1936. - 3 - tuberculosis 201 notifications wore received-190 pulmonary and 11 non-pulmonary. 110 deaths occurred-103 respiratory and 7 other forms. TUBERCULOSIS DISPENSARIES No. of attendances at the. Dispensary 4520 „ „ consultations with the medical practitioners: Personal 238 Other 637 „ „ visits by Tuberculosis Officers to homes 432 „ „ specimens of sputum examined (100 positive) 562 „ „ X-Ray examinations (films 1338, screening 432) 1772 „ „ children boarded out 8 „ „ visits by Tuberculosis Visitors to homes 4740 Artificial pneumo-thorax treatment was given by the Tuberculosis Officer to 29 patients, necessitating 419 refills. Artificial pneumo-thorax treatment was given by hospitals to 4 patients necessitating 71 refills. Finsen or Sunray Light treatment was given to 3 patients necessitating 381 attendances. No, of patients recommended for Sanatorium treatment 254 No. of contacts examined 686 EXTRA NOURISHMENT to tuberculous patients: 521 grants were made to 102 patients, each grant being for a period of 28 days. TUBERCULOSIS FINANCIAL ALLWANCES Total Cases considered during the year 673 (Of the above, 93 were new cases) Total Cases accepted during the year 548 No. of patients in receipt of allowances at the end of the year 75 MASS RADIOGRAPHY The results of Mass Radiography of the staff of certain factories' and business establishments in Stepney, including some members of the Council's staff:- Women % Men % Total % No. of persons examined 881 - 1340 - 2221 - No. referred for large X-Ray 33 3.7 64 4.8 97 4.3 No. did not re-attend 5 .5 4 .3 9 .4 No abnornality found 7 .7 6 .4 13 .5 Calcified & Other Lesions 5 .5 26 1.9 31 1.3 (no further action) Referred to (Calcified Lesions - - - - - - doctor for (Probably T.B. 11 1.2 16 1.2 27 1.2 further inves- (Probably non-TB - - 3 .2 3 .1 tigation and/or (Cardio-vascular 5 .5 1 .07 6 .2 treatment Total referred for further investigation 16 1.8 20 1.4 36 1.6 The examinations were, in every case, voluntary and confidential, the abnormalities found being transmitted to the doctor concerned only with the volunteer's permission. This was not withheld in any of the cases. It can be seen from the table that the results showed no difference between the sexes. - 4 - It is also interesting to note that no material difference between the various trades represented could be found,as the following table show:- Total number examined No. of abnormals found % Makers of food drinks and tobacco 345 6 1.7 Makers of textile goods and articles of dress 221 5 2.2 Commercial occupations 1012 14 1.3 Workers in precious metals 92 1 1.08 Public administration and utilities 450 8 1.7 Others and undefined workers 101 2 1.9 The total percentage of persons needing further investigation (1.6) compares favourably with previous experience with Mass Radiography in other places, e.g. No. of persons examined Abnormals requiring investigation % Factory A 4,720 115 2.5 Factory B 5,657 150 2.7 Office C 10,903 229 2.1 (Medical Research Council's special report Series 251) Mass Radiographic Survey of 166,598 ratings in Royal Navy showed an abnormality percentage of 1.14 (Dr. W. A. W. Brooks Proceedings of Royal Society of Medicine). The low figure is accounted for by the fact that the men were almost all young and had already passed a preliminary medical examination. Mass Radiographic examination was, however, for them compulsory. It must be borne in mind that as the examination of this civilian population is entirely voluntary, it is likely that persons suspicious as to the real state of their health may avoid participating for fear of any abnormality being found. It is, therefore, reasonable to assume all civilian examinations, including those in Stepney, show an abnormality percentage that errs on the low side. The response to the appeal for volunteers in Stepney has been gratifying and many more would have availed themselves but for the limiting quota allocated to the district by the London County Council, owing to lack of plant, equipment and time. The generous co-operation of employers and workers has contributed to make the scheme a success. When more X-Ray sets are available and no limit is placed on the number of volunteers the response is likely to be greater and the value of the scheme to the health of the individual enhanced. The Stepney Survey has only been possible on an experimental scale but the propaganda value of teaching positive health methods to the people far exceeds the actual importance of finding the comparatively few fresh cases of tuberculosis and other chest diseases. Mass Radiography of Borough Council Staff and Employees: No. of Council employees examined 450 No. needing further investigation and/or treatment 8 Abnormality percentage 1.7 The Abnormality Percentage for all Stepney examinations was 1.6. The Mass Radiography Scheme in Stepney was carried out by the Mass Radiography Unit in co-operation with Dr. orpwood the Borough Council's Tuberculosis Officer. TUBERCULOSIS CARE COMMITTEE 212 cases were considered by the Tuberculosis Care Committer - 5 - at their meetings during 1945. Of those 82 needed assistance of some kind, which in many cases was able to be supplied through the Committee's Voluntary Fund. The Government's Tuberculosis Allowances Scheme has undoubtedly made it easier for many patients to accept sanatorium treatment without the financial worry they had in nearly all cases before the Scheme was inaugurated, although the amount of the allowances does not cover certain special needs of some patients, and is supplemented by the Care Committee Unfortunately the Scheme still only applies to those pulmonary cases who are expected to be able to return to work within a reasonable time after discharge from sanatorium, and does not help the chronic or very ill patients or any cases of non-pulmonary tuberculosis. It will, therefore, be seen that the Care Committee still plays a very useful and necessary part in assisting many patients Who do not benefit at all by the Scheme. The help given from the Committee's Voluntary Fund still chiefly fills the same needs as before, e.g. the payment of fares for relatives to visit patients in sanatorium, the provision of pocket money for destitute patients in sanatorium, and assistance with the purchase of warm clothing. The Committee have also helped with removal expenses, the costs of beds and bedding, and holidays for two mothers who had.nursed patients through very long and trying illnesses. The Christmas Seal Sale was again held, and realised the total of £220, the highest amount yet obtained. Practically all the money for the Committee's Voluntary Fund is now raised by,this method. A printed Annual Report is sent to each subscriber, and the Committee's work must now be known to a considerable number of local sympathisers, who respond very generously to the appeal. The Committee would like to express their appreciation to those members who have very generously helped with clothes and bedding for cases mentioned at the meetings. Mattresses, pillows, sheets and blankets were also given by the Council from surplus A.R.P. Stores, and have been received with great gratitude by patients, as many of them cannot easily replenish their bedding in these days. DENTAL CLINIC Tuberculosis Maternity & Child Welfare. Total attendances 41 582 No. of new patients 3 85 No. of dentures supplied 8 56 MATERNITY & CHILD WELFARE No. of Health .Visitors employed: Municipal 10. Voluntary 6. No. of all Health Visitors' visits to expectarit mothers: „ „ „ „ „ „ First visits 1132. Total 2141 to children under 1 year. „ „ „ „ „ „ First visits 1354.Total 10415 to children between 1 & 5 years: Total 19181 No. of Infant Welfare Centres on 31st December: Municipal 7. Voluntary 3. Total 10. No. of children at first attendance: Under 1 year old 1357 Between 1 and 5 years 329 - 6 - No. of children attending at the end of the year: Under 1 year 1134. Over 1 year old 2327. Total 3461 Total number of visits made during the year for all purposes by the Health. Visitors: Municipal 25,307. Voluntary 19,129 ANTE & POST NATAL CLINICS No. of Clinics: Municipal 2. Voluntary 3. Total number of women who attended 1143 CONVALESCENT TREATMENT During the year a bed was pernanently reserved at St. Christopher's Nursery Training College, Tonbridge Wells for children under the age of 5. As more Convalescent Homes are releases further provision will be made for convalescent treatment. SUPPLY OF MILK AND VITAMINS. Under the National Scheme, the following Welfare Foods were distributed: FOOD Infant Welfare Centres Day Nurseries institutions Food Office Total Milk, full cream 16239 pkts 120 pkts 1382 pkts 5890 pts 23631 „ half „ 1273 „ 3 „ 354 „ 523 „ 2153 Orange Juice 52364 bots 1594 bots 1848 bots 7101 bots 62917 Cod Liver Oil 4830 „ 320 „ 168 „ 679 „ 5997 A & D Capsules 1036 - - 204 „ 124 THE CARE OF PRIEMATURE INFANTS (Circ 20/44) Information of all premature and underweight infants (5| lbs and under at birth) is supplied to the Medical Officer of Health on the birth, notification cards. The-number of babies notified during 1945 who weighed 5½ lbs or less at birth was 124, Of these 12 were born at home and 112 were born in hospital. Of those born at home: 12 were nursed entirely at heme 3 died during the first 24 hrs 9 survived at the end of one month. Of those born in hospital: '21 died during the first 24 hrs. 06 survived at the end of one month NOTE: The apparent increase in prematures and illegitimates this year is probably a statistical increase only as this has been the first complete year in which particular attention has been given to the compilation of these items following directions in recent circulars. Special equipment for premature infants born at home is supplied" by the London County Council to their domiciliary midwives and to the District Midwives of the end on Hospital and East London Nursing Association who undertake domiciliary midwifery for the L.C.C. The services of a paediatrician are available at the London Hospital and the L.C.C. hospitals in the Borough. Following up of the infant after discharge from hospital, or, in the case of those borh at home, after the midwife leaves the house, is undertaken by the Heclth Visitor of the district concerned. - 7 - Home helps are available if necessary. ILLEGITIMATE INFANTS (Circular 174/44 and 2866 (revised) 172 illegitimate infants were born during the year, 84 males and 88 females. The death rate of these infants was 75.5 per 1,000 illegitimate live births. Each borough contributes a block grant to the voluntary moral welfare societies operating in its area, according to the rateable value of the borough. On this basis Stepney Borough Council contributes £143, which is distributed on an agreed basis to the moral welfare societies concerned, through the Metropolitan Boroughs Standing Joint Committee. The Health Visitors and the,officer of the local moral welfare societies co-operate in all cases. CHILD LIFE PROTECTION Number of persons who were receiving children for reward at the end of the year 5 Number of children at end of the year 6 Number of Child Protection Visitors: Health Visitors 15 „ „ „ „ „ : Others 1 Visits made by above to Homes of foste mothers 36 „ „ „ „ „ „ „ „ children 45 Proceedings taken during the year under Part XIII of the Public Health (London) Act 1936, Section 239 (a) 1 WAR TIME DAY NURSERIES There are three war-time Day Nurseries for the children of paid working mothers and one voluntary Day Nursery. Queen Elizabeth Hospital (Shadwe11) Old Church Road Vallance Rd. (Robert Montifiore School) Beaumont Grove Girls Club (Voluntary) Accommodation: 0-2 years 16 (incl. 6 infants) 30(incl 10 infants) 30 (incl 10 infants) 2-5 34 30 30 20 Total 50 60 60 20 Average Attendances per day: 0-2 years 20 20 21 - 2-5 " 16 25 25 18 Total 36 45 46 18 Highest attendances in any one day: 0-2 years 29 28 31 - 2-5 " 29 31 33 - Total 58 59 64 - Great difficulty has been experienced in obtaining staff for the nurseries. In this respect probably the eastend boroughs in London suffer more than those in residential areas. The remuneration does not encourage parents to allow - 8 - their daughters to undertake work of this kind in districts where it is difficult to obtain lodgings. The .Council has a small hostel for nurses with accomodation for 6. Hostels for'Nursery Nurses. 35 Stepney Green. Total accommodation 6. III. SANITARY CIRCUMSTANCES0F ARE SANITARY inspection The following is a summary of the inspections carried out by the nine District Sanitary Inspectors:- To houses and other premises (relating to Complaints, Nuisances, Infectious Diseases, Restaurants, Lodging houses, etc. 9,386 Miscellaneous Inspections 9,759 To factories, Workshops and Outworkers premises 1,275 Number of Revisits 5,377 Number of Intimations served 2,308 „ „ Statutory Notices 445 „ „ Summonses taken out - „ „ visits to air-raid shelters 158 „ „ visits to Rest and Feeding Centres 6 „ „ visits to Canteens 85 Note: Eight of the Council's Sanitary Inspectors are still seconded to War Damage and are not avilable to the Public Health Department. A summary of sanitary work carried out as a result of notices served is as follows:- Repairs to roofs, gutters and rain-water pipes 848 Cleansing or repairs to drains, water-closets, sinks, baths and lavatory wastes 2,837 Miscellaneous repairs 3,021 Dampness in premises remedied and rooms cleansed 2,246 Drains tested 329, of which 21 were defective. RAT CONTROL The District Sanitary Inspectors continued to co-operate with the Council's Rodent Officer and Rat-catchers in the Borough Engineer's Department on the control of Rat Infestation. During the year 630 complaints were received as to nuisances for rats and mice. Drains were tested where necessary and 431 complaints were forwarded to the Borough Engineer and Surveyor so that the Council's Rat-catchers could call and assist the tenant's concerned. IV HOUSING INSPECTION Number of houses inspected for housing defects 7,572 " " inspections made for such purposes 9,643 " " houses not reasonably fit 2,648 „ „ houses rundered fit informally 2,202 " " houses in respect of which notices were served. 445 „ „ houses in which defects were remedied after service of formal notices 445 - 9 - OVERCROPPING (a) Houses in which the rooms were measured and the permitted number ascertained 37 Number of visits to the above 46 " " houses in which the information has been supplied to owners and occupiers 5 (b) Relief of Overcrowding Number of cases investigated 87 „ „ „ found to be overcrowded and referred to L.C.C. 57 (c) Preferential Housing on Grounds of Health Number of cases investigated 28 " " " referred to L.C.C. 24 Prior to the war Stepney's population of approximately 200,000 was accommodated in some.34,000 separately rated housing properties. The Borough was one of the most overcrowded in the country. During the War 7,040 houses were totally destroyed or are fit only for demolition; 3,795 were seriously damaged and uninhabitable but capable of repair by the carrying out of major works of repair; 3,178 were seriously damaged but habitable; and 15,278 were officially classified as slightly damaged. Some houses were damaged as many as five or six times. During 1945-46 500 pre-fabricated hutments were erected by the Council on requisitioned sites as a temporary measure. During 1945 the L.C.C. erected 19 bungalows. Under the Council's requisitioning powers 2,696 houses were recuisitioned for re-housing of the homeless and "families inadequately housed." Under the Council's housing schemes approximately 1,355 dwellings are planned so far, and it is hoped that the first block of 31 flats will be. ready for opening towards the end of 1946 V. INSPECTION SUPERVISION OP FOOD Total number of inspections and re-inspections made by the four Inspectors engaged in the supervision and inspection of food amounted to 9,415. Legal proceedings were taken out in 13 instances. The quantity of foodstuffs dealt with as unfit for human consumption during the year amounted to 42 tons under the Public Health (Imported Food) Regulations, and 465 tons under the Public Health (London) Act, 1936 (see also Analyst's report). 1498 samples of food and drugs and 73 other samples were submitted for analysis, assistance was also rendered by these Inspectors to the Food Control Committee on Food Salvage, new registrations, etc. BASEMENT BAKEHOUSES Of the 69 which were certified in 1903/4 under the Factory and Workshop Act, 1901, only 23 remained. VI. PREVALENCE AND CONTROL OVER INFECTIOUS DISEASE NOTIFICATION OF INFECTIOUS DISEASES (Other than Tuberculosis) 1,222 notifications were received during the year: Scarlet Fever 157; Diphtheria 44; Puerperal Pyrexia 14; Puerperal Fever 2; Erysipelas 33; Cerebrospinal Fever 6; Ophthalmia Neonatorum 6; Polio-Myelitis 1; Malaria 4; Measles 725; Pneumonia 55; whooping Cough 96; Dysentery 76; Food Poisoning 1; Typhus 1; Enteric 1; Smallpox 0. - 10 - Of the above 1,222 notifications, 73 cases removed to hospital were found not to be suffering from the disease notified. These referred to Scarlet Fever 14; Diphtheria 31; Cerebro Spinal Fever 1; Measles 7; WhooDing Cough 7; Dysentery 11; Puerperal Fever 1; Erysipelas 1. DEATHS FROM INFECTIOUS DISEASES There were 68 deaths, i.e. Cerebro-Spinal Fever 3; Pneumonia 62; Whooping Cough 2; Typhoid Fever 1. TYPHUS FEVER A case of Typhus Fever was notified to me on the 4th June 1945. The patient was a medical student residing at the London Hospital, who was one of 95 London medical students who went voluntarily to the Belsen Concentration Camp in Germany at the beginning of May, to help in the relief work at the camp. The London Hospital students returned on the 28th May by air to Croydon and proceeded to the London Hospital and to their own homes. I was notified by the County Borough of Croydon of the arrival of these students, all of whom had been in close contact with Typhus cases in Belsen. These contacts had been closely followed up and thus it was ascertained one student was ill and a bed patient in the London Hospital. On further investigation of this case, typhus was suspected, and I visited the London Hospital on the 4th June. A consultant was obtained, Typhus confirmed, and the patient removed to an Infectious Disease Hospital forthwith. I immediately put into operation the special Typhus precautions involving the collection and disinfection of all articles of clothing, bedding, etc. and bathing contacts. Prompt notifications (by telegrams where necessary) were despatched to the Medical Officer of Health of seventeen Local Authorities involved by reason of the fact that the districts had been visited by medical student contacts. The medical student concerned recovered in hospital and no further case of typhus occurred. DIPTHERIA IMMUNISATION The number of attendances at the diphtheria immunisation clinics increased considerably this year. In addition to the diphtheria immunisation clinic every Friday afternoon at 35 Stepney Green, E.I., facilities have now been provided at most of the Infant Welfare Centres for those children who attend them. NUMBER OF SESSIONS HELD: 51 B.C. L.C.C. TOTAL Und. 5 Over 5. Und 5 Over 5 Number of Post Schick Tests 544 - - - 544 Number of Immunisation Certificates given 502 — — - 502 Number of attendances of Children for Schick or immunisation 2569 - - - 2569 Number of children who completed the full course of immunisation ■ 882 - 12 73 967 - 11 - WHOOPING COUGH IMMUNISATION In addition to the Whooping Cough Immunisation Clinic held in conjunction with Diphtheria Immunisation Clinic every Friday afternoon at 35 Stepney Green, facilities have now been provided at most of the Infant Welfare Centres. 891 children,were immunised during the year. The immunising agent used is alum-precipitated (pertussis) vaccine (Glaxo) containing 20,000 million cells per cubic centimetre. Three doses are given of 0.5 c.c. at intervals of 2 weeks. BUG ERADICATION During the year the practice was continued of disinfecting with hydrogen Cyanide the furniture and effects of all families before admission as tenants to the Council's Housing Estates. 2,063 inspections and re-inspections were carried out by the Inspectors on bug eradication. 319 premises were found to be verminous. 529 premises, 1180 rooms and 559 bunks and shelters were sprayed. 94 of the families which were re-housed into Stepney Borough Council flats had their furniture and other household effects treated with H.C.N. this includes those where arrangements were made either by the Housing Department or Civil Defence re-housing scheme. 3 families had their furniture and effects treated with H.C.N. prior to transfer into other accomodation by special request of Civil Defence owing to very bad verminous conditions. 17 loads of furniture, bedding, etc. which had been loaned to bombed out families, were treated with H.C.N. prior to return of these articles to Civil Defence Stores. 2 loads of second hand goods were treated with H.C.N. for private firms. All bedding is separately disinfected with steam. » CLEANSING AND DISINFECTION 542 rooms were disinfected because of infectious disease and 33 because of pulmonary tuberculosis. 64,423 articles of clothing and bedding were steam disinfected. SMALLPOX AND VACCINATION No cases of smallpox were notified. 413 children were successfully vaccinated. 379 statutory declarations were received In addition, 448 children who were registered outside the borough were successfully vaccinated. The total number of children vaccinated was 863. SCABIES (Scabies Order 1941) No. of cases notified: Formally 807. Informally 682. Diagnostic Clinic Men Women Children Total No. of sessions - - - 98 No. of persons who attended 393 979 697 1869 „ „ „ found positive(38%)133 292 300 725 Total number of attendances 450 905 777 2138 Branch Road Treatment Centre Persons bathed and clothing disinfected 127 250 98 475 No. of baths and treatments given 243 461 182 886 London Hospital Treatment Centre Persons bathed and clothing disinfected 253 372 328 953 - 12 - Statutory Action under Scabies Order 1941 No. of Inspection of premises notices served 221 " " Medical Examination notices served 215 " " Medical Treatment notices served - " " Cases in which legal proceedings were taken - VERMINOUS persons Branch Road Cleansing Centre Men Women Children TOTAL No. of persons bathed and clothing disinfected 252 58 5 315 " " baths and treatments given 261 71 6 338 HEAD LICE (Ministry of Health Circular 2831) Special attention is being given to this matter by the Council's Health Visitors at the Infant Welfare Centres and when visiting the homes. Nit combs and Lethane Oil are supplied free or at cost price at the Infant Welfare Centres. Leaflets have been widely distributed. - 13 - CAUSES OF ALL DEATHS DURING THE YEAR 1945. Causes of Deaths Total Under 1 year 1-5 5-15 15-45 ' 45-65 65 years & over M. F. M. F. M. F. M. F. M. F. M. F. M. F. Typhoid and paratyphoid fevers - 1 - - - - - - - 1 - - - - Cerebro-spinal fever 1 2 1 - - 1 - - - - - 1 - - Scarlet Fever - - - - - - - - - - - - - - Whooping Cough 1 1 1 1 - - - - - - - - - - Diphtheria - - - - - - - - - - - - - - Tub of Resp System 74 29 - - - 1 - 1 33 18 31 7 10 2 Other forms of T.B. 3 4 - - - 2 - 1 2 - 1 1 - - Syphilitic Disease 12 9 1 1 — - - - 2 1 2 3 7 4 Influenza 1 2 - - - - - - - - - 2 l - Measles 1 - - - 1 - - - - - - - - - Ac polio-myelitis & polioencephelitis - - - - - - - - - - - - - - Ac inf encephelitis 1 1 - - - - - - - - 1 1 - - Cancer of buc cavity & eosophagus 9 - - - - - - - - - - - 9 - Cancer of uterus - 7 - - - - - _ - - 4 - 3 Cancer of stomach and duodenum 31 22 - - - - - - 1 2 13 11 17 9 Cancer of breast - 12 - - - - - - - 2 - 7 i 3 Cancer of all other sites 74 46 - - - - - - 5 3 34 19 35 24 Diabetes 2 10 - - - - - 1 1 - 4 1 5 Intra-cranial vascu lar lesions 38 49 - - - - - - 1 2 12 9 25 38 Heart disease 179 172 - - - - - - 2 4 40 28 137 140 Other diseases of the circ system 32 28 - - - - - - 1 1 12 11 19 16 Bronchitis 74 37 - 2 - - - - 1 - 28 8 45 27 Pneumonia 34 28 5 4 1 1 - - 3 2 8 4 17 17 Other resp diseases 13 3 - - - - - - 3 1 8 - 2 2 Ulcer of the stomach or duodenum 17 5 - - - - - - 4 1 7 2 6 2 Diarrhoea 10 5 10 5 - - - - - - - - - Appendicitis 4 1 - - - - 1 - - 1 3 - - - Other digestive diseases 19 6 2 - - - - - 4 1 7 3 6 2 Nephritis 18 9 - - - - - - 1 3 8 1 9 5 Peurperal and postabortive sepsis - 2 - - - - - - - 1 - 1 - - Other maternal cause - 2 - - - - - - - - - - - - Premature births 6 5 6 5 - - - - - - - - - - Congenital malformations, birth injury infantile disease 15 17 14 14 - 1 - - - 2 1 - - - Suicide 5 2 - - - - - - 1 1 3 1 1 - Road traffic accidents 14 4 - - - 2 2 1 2 1 3 - 7 - Other violent causes 72 102 4 - 7 2 9 8 19 48 21 23 12 21 All other causes 51 35 3 2 - - l 1 8 8 12 9 27 15 811 658 47 34 9 10 13 12 94 07 255 160 393 335 TOTAL 1,469 81 19 25 201 415 728 STEPNEY 22nd ANNUAL REPORT. Summary of Borough Analyst's Quarterly Reports for the Year 1945. 1,422 samples were submitted for analysis. Of these 1,379 samples wore taken under the Foud & Drugs Act. The remaining 43 samples were received from Borough Departments. Sanples taken under the Food & Drugs Act: 622 samples were taken formally. 757 samples were taken informally. Total Samples. Foods (taken under the Act) 1,062 Foods (private samples) 34 Drugs (taken under the Act) 317 Other private samples 9 1,422 Out of 1,096 samples of food, including private samples 37 or 3.4 per cent were adulterated, and out of 317 sanples of drugs 6 or 1.9 per cent were adulterated, making a total of 1,413 food and drugs out of which 43 or 3.0 per cent were adulterated. MILK. 578 sanples were examined. The average composition including 12 adulterated samples was:- Fat, 3.50 per cent and solids-not-fat 8.67 per cent. ADULTERATED SAMPLES (including other offences). Nature. Adulterated, etc. Prosecutions. Cautions. No action. Informal Formal Private Foods. Sausage 1 — - - - - Baking Powder l - - - - - Milk 2 10 — 6 - 4 Buttered Rolls 10 - - - - - Fruit Drinks & Essences 1 2 - - 2 - Fish Paste 1 - - - - - Vinegar 2 1 - 1 — — Private Foods. Figs - - 2 - - -- Black Treacle - - 2 - - - Cocoa Beans - - 2 - - — Drugs. Iodine Ointment 2 1 - - 1 - Tincture of Iodine 1 — - - - - Camphorated Oil 1 1 - 1 - - Poor quality samples. 38 samples (including 23 samples of milk) were reported as being of inferior grade or doubtful quality. Total Fines & Costs. £75.10.0d. DOUGLAS HENVILLE, Public Analyst.