METROPOLITAN BOROUGH OF STEPNEY ANNUAL REPORT (Abridged) for the Year 1947 of the Medical Officer of Health F.R.O'SHIEL, L.R.C.P.I., L.M., D.P.H. Together with a SUMMARY of the REPORT of the PUBLIC ANALYST METRoPOLITAN: BOROUGH 0F STEPNEY With the Medical Officer of Health's Compliments. Public Health Department, 43, White Horse Road, Commercial Road, E.1. Telephone; stepney Green 2484. METROPOLITAN BOROUGH OF STEPNEY PUBLIC HEALTH DEPARTMENT, 43, White Horse Road, Commercial Road, E.l. To The Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney. Your Worship, Ladies & Gentlemen, I have the honour to present my report for the year 1947. The report is again abridged in accordance with the directions of the Ministry of Health. The population of the Borough according to the Registrar-Goneral's estimate shows a considerable increase having risen from 94,800 in the mid-year 1946 to 100,020 in 1947, I anticipate that the rise will continue steadily for some years. The population in the last pre-war year (1938) was 200,500. Births numbered 2246 - again an increase on the previous year which was 2206. Owing to the greater population this increase is not reflected in the birth rate which is 21*8 compared with 22.6 last year. The death rate has fallen from 14.7 to 14.1. The maternal death rate has dropped from 1.8 to 0.8 per 1000 live and still births. It is pleasant to record a considerable drop in the death rate of infants under one year of age, which has fallen from 51.2 in 1946 to 37.5 in the year under review and is the lowest ever recorded in the Borough. Deaths from infectious diseases were again low. There were no deaths from diphtheria of which there were 53 notified cases. There were 545 cases of measles notified and 3 deaths. There was an outbreak of whooping-cough with 374 cases compared with 87 last year. Four deaths occurred from the disease. Poliomyelitis (infantile paralysis) which was prevalent throughout the Country was fortunately not severe in Stepney. There were 32 notified cases of which 20 were confirmed, no deaths: q.nd no case of permanent paralysis. A case of smallpox oocurred in the Borough in a Sailors Home which might have had very serious consequences. However, prompt measures confined the outbreak to two cases. A full account will be found in the body of the report (p.54). -1- 215 cases of tuberculosis were notified compared with. 212 la3t year.There were 99 deaths (81 in 1946). The formal notifications of scabies have dropped from 758 in 1946 to 415 this year. The maternity and child welfare services continued to progress.The Council has established new premises for two infant welfare centres in the Borough— Mary Hughes centre at Underwood Road and a centre in Ashfield Street. The day nursery at Robt.Montefiore School, Vallance Road was also transferred to the new premises at Underwood Road. A special Nursory Creche for the care of infants and children under 5 years of age was opened at 57, white Horse Road. The control of rodent infestation with the exception of sewer baiting was transferred from the Borough Engineer's Department to the Public Health Department during the year, which enables the work to be more closely co-ordinated with that of the District Sanitary Inspectors. The Housing Section has been re-established on pre-war. linos and a Housing Inspector appointed. Dr.J.w.Crawford, Deputy Medical Officer of Health in the service of the Council from October 1937, left to take up. the appointment of Medical Officer of Health at Tonbridge in March 1947, I am grateful for his services which were most valuable to. mo especially during the war years. His place was taken by Dr.J.Kerr Drown who commenced duty as Deputy on tho 6th October; 1947. I would like to express my gratitude to tho Chairmen and Members of tho Committees for their support and intorest throughout the year and to thank all the Staff for their very willing help and co-operation. I have the honour to be, Your Worship, Ladies and Gentlemen, Your obedient Servant F. R. O'SHISL, Medical Officer of Health. -2- STAFF OF THE PUBLIC HEALTH DEPARTMENT on 31st December, 1947. Medical Officer of. Health: F. ROANTREE O'SHIEL, L.R.G.P.I.,K.M.,D.P.H. Duputy Mcdical Officer of Health: J.KERR BROWN, B.Sc. , M.B. , Ch.B., D.P.H. Public Analyst: D. HENVILLE, F.I.C. Deputy Public Analyst: W.M, PAULLEY, B.A,, F.I.C Assistant Administrative Officer: W.F. LELLOW (2) Sanitary Inspectors: District: J. J. COVENEY (3.4) W.E.ANSTEE(1.3) S.FIRSHT(3) J.J.KENIRY(3) W.CUE(1.3) G.D.FREELAND(1.3.4) S.S.LCWTHER(3.4) R.W.G,DAY(3) W, H. HAWORTH(3) E.P.WEBBER( 3.4) Food: A.C.BR0WN(2.4) H.J.GREEN(1.2.4) S,V0GLER(3.4) W.F.SMITH(2.4.10) Disinfestation: E.J.EDWARDS(2.4) (Seconded to War Damage Department) Disinfestation & Female Common Lodging Houses: MISS H. A.WHITTY( 3. 4.5.6 .8 ) Housing: C.F.GUY(2) Rodent Control: J.G.McCARTHY(3 Clerical Staff: D.J.BERRY MISS M.FITZGERALD(M&CW) J.McMULLON MISS G.BOULTON(M&CW) W.E.HART. P.PAYNE MISS G.A.CARTKY(M&cw)MRS.H.HILES(M&CW) M.PLISKIN W.J.DIXON W.P.HOWARD B. REILLY S.EMBLETON MISS M.W. HUNT (M&CW) S.F.ROBERTS Vaccination Officer (Temporary): R.BACH,B.A Medical Officers for Maternity & Child.Welfare (Part-time): NORAH COTTER,M.B.B.Ch.DORQTHY GIBSON,M,B.,B.S. ' SYBIL PRATT,M.R.C.S. ,L.R.C .P. .DORIS .PULLEN,M.B. ,B.C. Health Visitors: MISS M.BAILEY( 5,6.7) MISS E.CLEMENTS(5.6) ' MISS V.RinVFWS(5.6.7) MISS M.F.E. STYLES( 5.6 .7 ) Tuberculosis- Officer: R.M.ORPWOOD,M.R.C.S,,L.R.C.P.,D.P,H. Assistant Tuberculosis Officer (Part-time): DR.GABRIELLE HIGHFIELD JONES,M.B.,B.Ch. -3- Tuberculosis Visitors: MISS E.L3NDSLEY( 7.8) MISS M.F. WEATHERILT(5.6,7.8) Nurse Dispensers: MISS M.COULMAN(5.6.7.8.9) MISS A.E.J0NES(7.8.9) Clerk & Secretary to Care Committee: MISS M.GRANT. Consulting Gynaecologist: R.CHRISTIE BROWN,M.B.,M.S.,F.R.C.S. Duntal Surgeon (Part-time): L.F,PAYNE,L.D.S. Anaesthetist (Part-time): M.J.O'TOOLE,M.B.,B.Ch.,B.A.0. Diphtheria Immunisation: W.W.KING-BROWN,M.B. ,B,S(Lon.), part-time Medical Officer. GUY BOUSFIELD,M.D.,B.S.(Lon.), Hon. Advisory Expert. TEMPORARY STAEE. Health Visitors: MISS B.S.BEARDSON( 5.6.7) MISS H.L.HIRSCH(-5,6.7) MISS L.E. G0DTSCHAILK(5.6.7) MISS M.PYSER( 6) MISS M.T.SMITHS0N(5.6 .7 ) MRS. S. YARNELL( 5 ) Tuberculosis Visitor: MISS J.P. WILS0N(5.6.7.8) Home Helps Organiser: MISS M.HUGH(ll) Clerical Staff: S.S.HARRIS MISS R.LEVEY MISS D.P.NASH(T.B) MISS M.POTTER Day Nurseries: Matrons: MISS M.M.CLULEY( 7 ) MISS D •WOODMAN (6.7.13) MISS A.MURRAY(7) Duputy Matrons: MISS W.D.BLOSS (12) MISS M.0LIVS(7) MRS. D.M/YATES(12) Nursery Creche Matron: MISS G.M. SANDERS(7) Rodent Investigators: S.SMITH T.T.WALKER S.C.LUDLOW 1.Cert.Royal San.Inst. 7.State Registered Nurse. 2. San. In s p. Exam. Bd . 8. Trained 'Nurse. 3. Royal San.Inst.& San'. '9.Cert,'Soc.of Apothecaries. Insp.Exam,Joint Bd. 10.Diploma Social Science. 4. " Meat & Other Foods. 11.Cert,'Social Science. 5.Health Visitors Cert. 12.Certificated Nursery Nurse. 6.State Certif.Midwife. 13.State Reg.Fever Nurse. -4- SUMMARY OF STATISTICS. 1947 Area of Borough (in acres) 1902.766 Population (Registrar-General's estimate) 100.020 Number of inhabited houses (end of 1947) according to Rate Books 25,800 Rateable Value, 1347 £1,242,701 Sum represented by a penny rate £5,178 LIVE BIRTHS. TOTAL M. F. Birth rate per 1000 Legitimate 2038 1072 966 estimated resident Illegitimate 146 73 75 population - 21.8. Total Live Births 2184 1145 1039 STILLBIRTHS. 63 37 25 Rate per 1000 total(live andstill) Total Births 2246 1182 1064 births - 22.4. DEATHS. 1419 805 614 Death rate per 1000 estimated resident population - 14.1. DEATHS FROM PUERPERAL CAUSES. (Headings 29 and 30 of the Registrar-General's short list): Rate per 1000 total Deaths (live 'and still) births No.29 Puerperal sepsis 1 0.4 No.30 Other puerperal causes 1 0.4 2 0.8 DEATH RATE OF INFANTS UNDER ONE YEAR OF AGE. All infants per 1000 live births 37.5 legitimate infants per 1000 legitimate live births 37.3 Illegitimate " " illegitimate " " 41.09 DEATHS FROM:- Cancer (all ages) 229 Measles " " 3 Diarrhoea (under 2 years of age) 5 Tuberculosis of respiratory system 92 Do. Other forms 7 -5- I. STATISTICS AND SOCIAL CONDITIONS OF THE AREA Public Assistance and Unemployment. The Chief Officer of Social Welfare and the Ministry of Labour have kindly supplied me with the following information. (a) Stepney residents in receipt of outdoor relief: 1947. Men VJomen Children Total 4th January - 206 374 215 795 27th December - 207 384 251 842 (b) Number on the Unemployed Register as at 12th January, 1948: Men Boys Women Girls Total 1284 4 213 3 1504 II. GENERAL PROVISION OF HEALTH SERVICES Staff. Numerous changes took place during the year. The undermentioned (a) retired on superannuation: Miss Lacey (Health Visitor) on 12/12/47 Mr.Abson (Food Inspector) 31/1/47 Mr.Dee do. 31/3/47 Mr.Price (Vaccination Officer) 29/3/47 Mr.Robertson do. 29/3/47. (b) left in order to take up a position elsewhere : Mr.Brownlee (Sanitary Inspector) 30/11/47 I.r. Lyons do. 6/9/47 wfcr.Mahoney do. 30/6/47 Mr.Roper do. 26/2/47 Mrs.Reynolds (Health Visitor) 30/4/47 (on marriage) Dr. J.W.Crawford (Deputy M.O.PI.) 31/3/47 (c) entered the Council's service: Miss Griffin (Health Visitor) on 1/9/47 Miss Love do. 10/11/47 Miss Woodfine do. 6/10/47 Mr.Firsht (Sanitary Inspector) 29/12/47 Dr. J.Kerr Brown (Deputy M.O.II.) 6/10/47 Insulin for persons suffering from Diabetes was provided free of cost to 25 patients of which 10 were nev; cases, under authority of Circular 2734 of the Ministry of Health. -6- Nursing in the Home. The arrangement-with the East London Nursing Society to undertake the nursing of children and persons suffering from certain illnesses was continued during the year. The number of visits was as follows:- No.of Cases Revisits To children under 5 years 62 636 To persons over 5 years 795 19,034 Laboratory Facilities. The number of bacteriological examinations carried out at tho Mile End Hospital on behalf of the Public Health Department during the year was 678. These consisted of: Positive Negative Total Swabs (for Diphtheria bacilli) 8 571 579 Faeces 1 7 8 Urine 6 6 Wassermann 2 83 85 HEALTH PROPAGANDA. (a) Diphtheria. In compliance with Circular 128/47 issued by the Ministry of Health, a diphtheria immunisation campaign was organised in the Borough by the Public Health Department. Advertisements were inserted in the Press, cinema slides were shown at five local cinemas, 800 posters were displayed throughout the Borough and 15,000 leaflets were distributed to factories, schools, clubs, shops etc. (b) Venereal Disease. In compliance with the Ministry of Health's Circular dated 13th August, 500 posters and 1,000 leaflets were distributed throughout the various factories in the Borough and departments of the Council. (c) Gonoral. 500 large posters were billposted in market areas with regard to the covering of food. Also, 1,000 leaflets regarding infantile paralysis were distributed throughout tho various infant welfare centres, etc. In addition thousands of leaflets have been distributed on behalf of various Government departments, -7- TUBERCULOSIS Tilbareulosis Dispensary. All sessions are held at the main Dispensary, Steels Lane, Devonport street, and the present time-table is as follows:- M0N. TUES. WED. THUR. FRI. SAT. Morning Men'x Special cases Men x School Children Afternoon Women & Children Women & Children Women & Children Evening Workers x x Double sessions. In addition, new patients are seen daily at 10 a.m., except Thursday, when they attend afc 6 p.m. Patients are also seen at times other than the above by special appointment. Tuberculosis Officer's Olinic at the Mile End Hospital. No. of patients under treatment 51 " " artificial pneumothorax refills given 850 " " pneumoperitoneum refills given 170 Total attendances at the Clinic 1021 Special Treatment at other Hospitals. No.of No. of pat- attend ients -ances Pneumothorax refills at Brompton Hospital 4 116 " " " London Chest " 2 42 " " " Grove Park " 1 47 " " " Royal Chest " 1 21 Finsen and Sunray treatment at London " 4 107 Supply of Extra Nourishment. Grants to Tuberculous patients were made on the recommendation of the Tuberculosis Officers for periods of 28 days in the first instance. The grant consists of one-and-a-half pints of pasteurised milk per day and one pound of Ovaltine per month. During the year 641 grants were made to 156 persons. -8- Return showing the work cf the Dispensary during 1947. Diagnosis Recpiratory Non-Recpiratory TOTAL Grand Total Sex AdultS Children Adults Children Adults Children I.No.of definite cases of Tuberculosis on Dispensary Register at beginning of year M 533 77 56 65 589 142 1161 F 284 64 49 33 333 97 Transfers from Authoritis of areas outside that of Council during year M 23 2 - - 23 2 35 F 7 1 2 - 9 1 Lost sight of cases returned during year M - - - - - - - F - - - - - - II.No,of New'Cases diagnosed as tuberculous during the year 1. Class T.B. ninus M 27 13 — - 27 13 78 F 22 16 - - 22 16 2. Class T.B. plus M 48 - - - 48 - 80 F 32 - - - 32 - 3. Non-pUlnonary M - - 4 4 4 4 18 F - - 6 4 6 4 III.No,of cases included in I and II written off Dispensary Register during year as:- 1, Recovered M 6 4 2 2 8 6 32 F 10 5 2 1 12 6 2. Dead (all causes.) M 49 2 1 2 50 4 78 F 21 2 1 - 22 2 3, Removed to other Areas M 33 3 2 3 35 6 69 F 21 6 - 1 21 7 4. For other reasons M 13 - 2 2 15 2 25 F 4 3 1 - 5 3 IV.No.of definite cases of Tuberculosis on Dispensary Register at ond of year M 530 83 53 60 583 143 1168 F 289 65 53 35 342 100 -9- No.of attendances at Dispensary (incl. contacts) 6399 " " consultations with Medical Practitioners:- (a) Personal 332 (b) Other 589 " " visits by Tuberculosis Officers (including personal consultations) 525 " " " " Tuberculosis Visitors for Dispensary purposes 4300 " " contact examinations made 1050 " " contacts boarded out 12 " " patients recommended for Sanatorium 206 " " specimens of sputum examined: Negative 771 Positive 130 Total 901 " " x-ray examinations; Films 1986 Screening 854 Total 2840 " " New Cases examined during the year 528 Tuberculosis Allowances. Treatment allowances are paid to certain'patients• undergoing treatment for Pulmonary Tuberculosis. Payments are made weekly either at the Dispensary or at the Hospital or sanatorium whore the patient is being treated. The payments are made by the 3orough Treasurer and the expenditure is reimbursed by the Exchequer through the London County Council under Ministry of Health Memo.266/7. No. of cases considered during 1947 622 " " " acccptod " " 498 New cases considered " " 83 No. of patients in receipt of allowances on 31/12/47 72 Boarded-out Contacts. Twelve children who were contacts of infectious cases of pulmonary tuberculosis were boarded out during the year. -10- Care Committee. The Care Committee's work has been carried along the same lines as in former years. 195 cases wore considered, and of those 65 needed assistance through the Committee's voluntary fund. This would not have been available without the support givon to the Christmas Seal Sale appeal, which has now bocomo well known and is the chief source of the Committoc's fund. The 1947 appeal met with the greatest response yet, and £S36 was roccivcd from the sale of the greetings scals. Pocket money whilst at sanatorium, roplacoments of warm clothing, and faros for relatives to visit patients away at sanatorium for long periods continue to make the greatest demand on tho Committoo's fund;, but during the year assistance has also been given in several other ways, help being granted towards the cost of holidays, removal expenses paid for patients obtaining badly needed improved housing accommodation, and grants towards the cost of floor coverings for now homes otc. Four patients doing handicraft work at home have been helped with the cost of materials. The Welfare Department of the British Red Cross Society have helped all those pensioners and ex-servicemen referred to them, and the Invalid Kitchens have continued to supply dinners to several patients. The Committee's work is likely to increase when the now Health Act comes into force, as the Government Tuberculosis maintenance allowance scheme will then come to an end, and although the scales of sickness bonofit will be increased, many of our patients will be less well provided for than they arc under the presont arrangement, which includes a rent allowance for married patients. -11- Public Health (Prevention of Tuborculosis) Regulations, 1925. These regulations provide that persons suffering from tuberculosis of the respiratory tract shall not bo employed in the handling of milk or milk receptacles. Power is given to the Council to cause such persons to discontinue their employment. It was not found necessary to teko action under the regulations during the year. DENTii CLINIC. Summary of work carried out during the year at the Council's Clinic: Maternity Tuberculosis Ch. F. Total M. F. Ch. Total No. of attendances 58 645 703 6 42 1 49 Fillings: Simple - 2 2 - - - -- Root - - - - - - - " Scalings - 78 78 - 1 - 1 Extraction Cases: •Without anaesthetic - - - - - - • - Local administration. - 2 2 - - - - Gas administration 36 150 186 2 3 1 6 No. of teeth extracted. 103 631 734 14 17 3 34 Dentures: Upper - 45 45 - 2 - 2 Lower - 38 38 - 2 - 2 Re-models - - - - - - - Repairs - 18 18 - 3 - 3 No, of dressings 1 82 83 - 1 - 1 No, for advice 34 86 120 - 5 1 6 Denture visits - 312 312 4 34 - 38 No, of new patients 34 86 120 - 5 1 6 Sessions: Gas - — 23 - - - 11 Ord inary - — 24 — — — 11 -22- (Fom MCW.96) MAT3RHITY AND CHILD WELFAR3 Arrangements made for maternity and child welfare by the Council and by Voluntary Associations providing maternity and child welfare services in respect of which the Council pay contributions under Section 101 of the Local Government Act, 1929, or otherwise; and giving particulars of the work done during the year 1947. i-» No. of births notified in the area, as adjusted by any transferred notifications:- LIVE BIRTHS STILLBIRTHS TOTAL 2288 53 2341 2* Health Visiting. No, of Health Visitors employed at the end of the year: - By the Council 14 Voluntary Association 1 (and 1 part-time) . No. of visits paid by all the Health Visitors:- First Total visits visits To expectant mothers 1143 1931 children under 1 year 2235 10063 " children between ages 1 and 5 - 14690 3. Infant v"olfarc Centres. No. of Centres provided and maintained by the Council 7 Voluntary Associations 1 No. of children under 5 years who first attended the Centres during the year and who, on the date of their first attendance, were:- Under 1 year of age . 1968 Over 1 " ' 316 No. of children under 5 years who attended the Centres during the year and who, at the end of the year, were:- Under 1 year of ago .. 1777 Over 1 2883 -13- 4, Ante-Natal and Post Natal Clinics. No. of Clinics opon at 31 Dec.1947 provided r.nd maintained by - Ante-Natal Post Natal tho Council 2 2 Voluntary Associations 2 1 No. of women who attended at tho Clinics during the year 1241 372 5. Day Nurseries. No.of No,of children approvod on register at Nurseries maintained places . end of year. by - No. 0-2 2-5 0-2 2-5 thi Council 3 76 94 77 94 Voluntary Asscns 2 45 - 56 Municipal Nursery Creche 1 15 15 99 136 8. Home Helps & Domestic Helps. Employed 42 (Part time). No. of cases where helps were provided was 215 including 6 Home Helps in confinement cases. 9. Institutions provided by Voluntary Associations and subsidised by the Council. The Council make a grant of £200 per annum for one bed. No. of women admitted from the Council's area: 24 (2 a month) 10. Maternal Deaths. No. of women who died from sepsis 2 " " " " " other causes 1 (ffldied at home and 1 in an institution.) 11. Illegitimate Children. The Health Visitors work in close co-operation with the local Moral Welfare worker. -14- 12. Care of Premature Infants, (Circular 20/44). No. of premature babies notified during 1947 whose mother is normally resident in the Council's area - 209. Total No. of premature babies notified who were born at home 16 in Hospital or Nursing Home 195 -(3 of which were untraced) No. of those born at home who were nursed entirely at home 16 — (1 died after 24 hours) who died during the first 24 hours 1 who survived at end of one month 14 No. of those born in hospital or nursing home who died during tho first 24 hours 15-0-3 died after 24 hours but before end of 1 month) who survived at end of one month 162 13. Infectious Disease, Ophthalmia Puerperal Neonatorum Pyrexia. Institutional Institutional No. of Cases. Confinements. Confinements. Notified during the year 6 16 Visited by officers of the Council 6 16 Removed to hospital 6 16 In all cases of Ophthalmia Neonatorum the vision was unimpaired. 14. Child Life Protection. Individual Foster Mothers receiving (1 is children under nine for reward apart (guaranteed from their parents at tho end of tho (payment by year 8 (the Council No. of children under nine received during the year 4 No. of children under nine at the end of the year 10 No. of Child Protection Visitors at the end of the year:- Health Visitors 15 Othor 1 Female, -15- 15, Adoption of Children (Section 7 of the Adoption of Children (Regulation) Act, 1939). No. of persons who gave notice under Sec,7(3) 10 Total number of children.in respect of whom notice was given under Soc,7(3) 10 No., of children notified under Sec,7(3) under supervision at the end of the year 10 DAY NURSERIES. Particulars as to attendances at the Council's three Nurseries and the two Voluntary Nurseries are given below. Old church Road. Mary Hughes Queen ELizabeth Beaumont Hall (Vol.) St. Paul's (Vol.) Accommodation: 0-2 yrs. 30 30 - 16 — - 2-5 " 30 30 34 20 25 No, of children on Register at 31 Dec, 0-2 yrs. 29 27 21 - 1 2-5 " 31 36 27 24 32 60 63 48 24 33 No, of mothers whose children were on the Register at 31 Dec, (i) in Employment: (a) whole time 55 58 48 20 32 (b) part-time 5 1 - 2 - (ii) Not in employment - - — 2 1 Average attendance per day: 0-2 yrs. 26 22 13 - - 2-5 " 30 33 30 23 30 Highest attendance in any one day:0-2 yrs. 27 27 25 - - 2-5 " 33 36 30 25 21 -16- NURSERY CRECHE. 57 White Horse Road, E.l. This Creche was taken over by the Council from the Anglo-American Relief Fund for London Children & Mothers, Ltd. on the 21st August, 1947. Babies and children under 5 years are looked after by a trained staff and it is open for Stepney residents daily from 9 a.m. to 6 p.m. except Saturdays and Sundays. The purpose of the Creche is to give mothers a few hours one day a week to attend to their own affairs without having to worry about the welfare of their little ones, and the charge for each child is sixpence per session either from 9 a.m. to 1 p.m. or 2 p.m. to 6 p.m. The number of attendances up to the end of December was 3056. It serves a useful need for the mothers of Stepney and is much appreciated. There is only one other Creche in London, but this is run by a voluntary society. There are 30 approved places, and the number of children on the register at the end of the year was 99 under 2 years and 136 from 2-5 years. MARY HUGHES CENTRE & DAY NURSERY, 22-28 Undorwood Road. These premises were formerly the 3earsted Memorial Hospital (Jewish Maternity Hospital) and comprised a 4-storey building erected and originally constructed as a maternity hospital, the main building being built in 1927. The Bearsted Memorial Hospital now occupies new premises at Lordship Road, Stoke Nowington, and the Borough Council purchased the Underwood Road premises for £32,000. It is proposed to establish here an ante-natal clinic, day nursery, special residential nursery for short-term care of premature infants, a hostel for nursery nurses and a resident caretaker's flat. Facilities are also providod for a school treatment centre for the L.C.C. The first part of the scheme, viz., the infant welfare centre and ante-natal clinic, day nursery, and resident caretaker's flat wore completed this year, and the premises Were formally opened by His Worship the Mayor, Councillor M. Zeital, J.P., on the 5th November, -17- in the proscnee of the Chairman of the Maternity and Child Wolfaro Committee and a largo gathering of visitors and officers of the Council. The works of adaptation and alteration were carried out by the Council under the supervision of the Borough Engineer & Surveyor (Mr. B.W. Stuttle) in accordance with drawings prepared by him in consultation with the Medical Officer of Health. The Nursery accommodates 36 toddlers, 20 tweenies and 8 infants. On the opening of this establishment.the infant welfare centre, formerly hold at Hughes Mansions, Vallancc Road, and the day nursery, temporarily occupying Robt.Mantefioro School, Ve.llance Road, were transforrod to the now promises. It is hoped that the remainder of the scheme, viz./ the residential nursory for premature infants and the school treatment centre, will be completed by.the Borough Council or, if after 5th July 1948, when the National Health Service Act, 1946, comos into operation, by the now health authority, the London County Council. M^YOR OF STEPNEY' S DAY NURSERIES TOY FUND. His Worship the Mayor kindly inaugurated this fund, the purpose of which is the supply to the Nurseries in the borough of toys, playing material and recreational facilities for the children of all the day nurseries. It is hoped that this fund will be well supported as toys and play material are always urgently required in the Nurseries. ASHFIELD STREET INFANT WELFARE CENTRE. In the previous year, to replace the old Infant Welfare Centre at 36 Newark Street which for many years hod been considered most unsatisfactory, a now Infant Welfare Centre at 52/54 Ashfield Street was opened. These premises, consisting of reception, weighing, waiting rooms and kitchcnotto together with doctor's consulting room, pram shed and yard, are shared with the Registrar of Births and Deaths for the district. -18- They are spacious and well lit and are regarded as a great improvement on the old Centre. They were formally opened on the 18th November, 1946, by His Worship the Mayor and Mayoress in the presence of Councillor Mrs.A.P.Bunn, the Chairman, and members of the Maternity and Child Welfare Committee. HOME HELPS SERVICE (Home Helps and Domestic Helps). Forty-two part-time helpers are on theCouncil's panel and they arc paid 2/- an hour. The number of persons receiving such help at the and of the year was 215 (6 of those being confinement cases) and 7088 attendances were made to them during the year. Cases are assessed according to the scale laid down by the Ministry of Health. A full-time paid organiser is engaged and she made 354 visits to thehonos. Tho scheme is very popular end is much appreciated. It is ringing groat headway, so much so that two full-time clerks have been engaged to assist her, more helpers arc on thepanel and much more'Visiting is done. SUNLIGIIT TREATMENT. The arrangement with-the-L.C.C. to provide artificial sunlight treatment at the Milo End Hospital for children attending•the infant wolfare ccntres were continued. Nine children received treatment, the number of treatments being 76. -19- DINNERS are supplied through the Londoners' Meals Service on the grounds of health to expectant and nursing mothers and to children under 5 years who are in necessitous circumstances. The Borough Council pay for such dinners and during the year 528 dinners were supplied to adults and 903 to children. SUPPLY OF MILK AND VITAMINS. Under the National Scheme, Welfare foods have been distributed through the Infant Welfare Centres, etc., as follows: Commodity. Day Nurseries - Instit utions Welfare Centres Food Office W.V.S. Total National Dried Milk-fullcream Pkts 207 1722 209 62 25708 1532 50131 halfcream " 1134 1224 1667 86 4110 Cod Liver Oil Bots 899 294 11243 7280 593 20309 A & D Capsules Pkts 3 — 1418 2294 142 3857 Orange Juice Bots 2368 4197 48511 36858 3600 95534 ILLEGITIMATE BIRTHS. The result of an investigation into 105 cases was as follows:- Died before reaching age of one month " " " " one year 1 Looked after by own mother in own home during first year of life 83 Looked after by an individual foster mother during first year of life 4 Looked after in L.C.C. or other Local Authority Home or Institution 9 Adopted from birth 2 Looked after by relatives 1 Mother of child normally lives outside Stepney 5 -20- -21- INFANT WELFARE CENTRES, NATAL CLINICS, &c. Lime house. mon Lane Mile End St. Georges. Spit- al fids ping Wh chpl. Dane Colet (Vol). TOTAL No.of:- Infant Welfare Sussior.s 99 101 103 155 100 53 105 99 815 Attendances of Infants 5124 • <':■ • 3115 3676 3587 3449 1500 i- 2746 2123 23518 Children 905 1477 1705 1872 1184 915 1435 780 10333 Infants on Register at end of the year 1387 1461 1787 1450 1462 606 1013 939 10105 Children uo. do. 1-123 1504 2040 2069 1577 824 1171 589 11197 Ante-Fatal: - Sessions 51 - - - 52 - - — 103 Nov Crses 220 — - - 90 - - — 310 Subsequent Attendances 501 - - 2 203 - - - 706 Doctor's Consultations 150 101 v." 103 163 152 53 105 99 927 To dlers' Clinic . sessions •. - - - - - - - - 8 1st Attendance - - - 35 - - - - 35 Total - — - 57 - - - - 57 Toddlers with defects - - 42 - - - - 42 No. of defects found - - - 42 - - - - 42 Details of the work at the Infant Welfare Centres etc. are Given in the following table. VISITS BY HEALTHE VISITORS. Tho following table shows during the year. Miss Bolloy Mies Boards on Miss Cloments Mrs. Dickson (Vol.) Miss Godtschailk Mica Griffin (from 1 Sept.) Visits:- Primary 135 172 169 198 154 40 Revisits:- To infants under 1 year 691 748 488 596 610 204 To children 1-5 years. 898 971 943 1734 1110 666 Ante-natal:- Primary 31 67 67 147 84 28 Subsequent 15 52 21 184 21 43 Ophthalmia Neonatorum - - 1 1 - - Puerperal Fever - - - - - - ,, Pyrexia 1 2 1 - 3 - Measles 22 39 51 27 52 1 " Revisits - 6 5 9 3 - Scabies 2 54 16 21 40 3 Miscellaneous 228 528 237 535 498 97 Attempted Visits 172 179 370 205 230 250 Child Life Protection:Visits to homes of foster mothers 2 - - - - - Visits to foster children 12 4 - - 9 6 Other visits - - •. - - 6 Totals 2209 2822 2369 3657 2814 1344 Centres attended 181 106 210 100 135 43 Scabies Clinic attended - - - - - - -22- the number of visits etc. paid by the Health Visitors Miss Hirsch i Miss Lacey (to 12 Doc.) Miss Love (from 10 Nov.) Miss Pysor Miss RubonsJ Miss Smthson Miss Stylos i Miss Wcodfino (from 6 Oct.) Mrs, Yarne11 Mrs. Reynolds to (30 Arr) T 0TALS 168 198 18 148 292 ( 156 170 38 129 50 2235 652 508 119 676 455 565 570 215 565 166 7828 848 1380 197 1172 707 1159 905 280 1300 420 14690 102 106 18 133 57 67 84 14 79 59 1143 26 101 28 36 43 100 3 18 89 8 788 1 1 — — — — 1 1 — — 6 1 — — — — — — — — — 1 1 1 — 2 3 2 — — — — 16 24 88 — 61 126 51 14 1 53 12 622 2 26 — 3 14 67 — — 12 4 151 15 33 1 17 66 19 9 11 21 16 344 297 509 150 150 413 127 42 93 667 170 4741 126 32 131 118 202 466 i • 244 145 431 73 3474 — — — — — — — — — — 2 — — 1 — 9 11 16 — 14 — 82 12 — — — 10 6 — — — — 34 2275 2983 663 2516 2397 2796 2058 816 3360 978 36157 157 131 15 89 130 169 162 38 105 25 1796 — — — — — — — — 1 4 5 -23- III. SANITARY CIRCUMSTANCES OF THE AREA Pharmacy & Poisons Act, 1955. 116 persons are entered in the List of Persons entitled to sell Poisons included in Pert II of the Poisons List. 221 inspections and visits were made by the sanitary inspectors during the year. Rent & Mortgage Interest Restrictions Acts. 162 certificates were issued to tenants as to houses not being in a reasonable state of repair, and 10 applications for such certificates were refused. 21 certificates to landlords were issued as to houses being in a reasonable state of repair and 16 such applications were refused. Rats and Mice. During the year 693 complaints were received as to nuisance from rats or nice. As a consequence 736 drains were tested and in 237 instances were found to be defective. The Borough Engineer & Surveyor has kindly supplied information as to Rat Destruction carried out by the Council's Ratcatchers during the period 1st January to 7th May. from which date rodent control v/as transferred to the Public Health Department : No. of premises visited 598 No, of visits 4,200 No, of rats found dead 35 No. of rats caught in our traps 27* No..of premises cleared of rats as reported by the Occupiers 78 No, of complaints received 86 h these were actually brought into the Depot and destroyed. The poisons used were as follows:- Rodino 765 portions Barium carbonate 5,662 cubes Extract of Souills 1,199 portions (2oz.) Rat Bane (Zinc Phosphide) 7,428 portions. Maintenance Treatments" for destructions of Rats in Sewers In accordance with Local Authority Circular N.S.No.6. dated 29th August, 1944, issued by tho Ministry of Food (infestation Division), 2 treatments for the destruction of rats in sewers were carried out during the year, -24- viz. from 6th January to 18th February 1947 (inclusive) and from 2nd June to 12th July 1947 (inclusive. The systen adopted was that recormended, viz. 2 days prepaiting and 1 day poison baiting. The pre-bait used was danped sausage rusk and the poison zinc phosphide (2½%). Approximately 1100 nanholes were treated on each occasion, at selected points throughout the borough. RODENT CONTROL, with the exception of sewer-baiting, was transferred from the Borough Engineer's Departnent to the Public Health Department on the 8th May 1947 and the Medical Officer of Health was appointed Rodent Control Officer. Mr. J.McCarthy, one of the Council's Sanitary Inspectors, was appointed Assistant Rodent Control Officer and the Rodent Depot was established at Branch Road with a staff consisting of a clerk, 3 rodent investigators and 9 operatives. Following is a review of the work done by the Rodent Section of the Public Health Department,' under the Ministry of Food (Infestation Branch) Comprehensive Scheme, Circular N.S.12, from the commencement of the scheme on the 1st April to 31st December 1947, inclusive. The Scheme operated until the 31st March 1948. The duty of the Rodent Investigators is to make an inspection of all premises in the borough and submit a report of the result of the investigations as to whether rat or nice infested or not. In the case of business promises they record the number of baits necessary to be laid, and the position upon which the charge is made. Dwellinghouses are, of course, treated free of charge. Accounts rendered to business premises for work done for the 9 months total £830:7:0. The duties of the Operatives consist of the laying of unpoisoned and poisoned baits in the infested premises, and the recording of bait "takes" on the work sheet. Since the commencement of the Scheme complete investigation of premises has been carried out in six areas and three areas are in course of investigation. Also a "Block Control" scheme was carried out in Hessel Street Market. In addition, 43 riverside wharves were Investigated but -25- found, generally, to be in good condition. Treatment was carried out in 4 wharves. Business Premises Dwellings No, of visits made by Investigators 2981 6966 No. of infestations found 526 973 No. of treatments undertaken 418 836 No. of visits made by Operatives 4842 7080 No. of prebaits laid 62,811 No. of poisoned baits laid 17,295 Estimated kill of rodents 8,491 No. of bodies recovered 958 Ho. of complaints, received 634 MORTUARY. 16 bodies were deposited in the Council's Mortuary during the year and 13 of those wore removed on the Coroner's order. LODGING HOUSES. There has been a narked "decrease in the number of Common Lodging Houses in the borough as compared with pre war. The number has beon reduced from 17 to 3 accommodating 793 men and 41 couples. 60 inspections were made during the year. There are 6 Seamen's Lodging Houses accomodating 592 men, and 118 inspetions were made during the year necessitating the service of 7 sanitary notices. DRAINAGE. A summary of the drainage work carried out under tho supervision of the Sanitary Inspectors will bo found on page 32-3. 1,570 drains were tested, of which 449 wore found to be defective. AGED AND INFIRM PERSONS. Many requests were made to me during the year to take action to secure the compulsory removal of diseased or infirm persons to hospitals or institutions. Such persons are usually persuaded to enter an institution, but in 6 cases it became necessary for me to apply to a Magistrate for an Order to have them removed under Section 224 of the Public Health (London) Act, 1936. -26- POST WAR TRAINING OF SANITARY INSPECTORS. Tho Council agreed to participate in the special scheme prepared by the Ministry of Health by Which selected students discharged from H.M.Services would be given an opportunity of practical training as sanitary inspectors with the sanitary inspectors of the various metropolitan boroughs co-operating. Two students were given the training and they successfully passed the Sanitary Inspectors Examination. During the coming year I anticipate an increase in the number of s'tudents. LEGAL PROCEEDINGS - Summary of No. of Summonses Fines Costs £. s. d. £ s. d. Public Health (London) Act,1936 80 32. 7. 0. 171. 5. o. Food & Drugs Act, 1938. 36 l10. 2. 0. 57. o. o. Factories Act, 1937 1 - 2. 8. 0. L.C.C. Drainage Byelaws 1 - 1. 0. 0. Total: 118 £142. 9. 0. £231. 13. 0. -27- -28- Summary of works carried out Sanitary Inspectors V.E. ANSTEE J•J• C0VENEY J.H. BR0VNLEE (to 30 Nov.) w. CUE R.W. G.DAY G.D. FREELAND S. FIRSHT (from 29 Dec.) H.J. GREEN (to 1 Apr.) Animals kept so as to constitute a nuisance removed — — — — — 1 — 1 Bakehouses - No, of cleansings of — — — 1 2 — — — Cisterns cleansed, covered and repaired 13 2 1 — — — — — Dampness in premises remedied 156 201 187 188 157 153 3 11 Drains cleansed or repaired 82 41 58 31 127 114 1 1 Drains - Constructed or reconstructed 47 31 121 73 9 — — — Dust receptacles provided 5 11 5 69 98 43 1 2 No, of dwelling rooms cleansed 211 375 221 531 545 267 4 24 Houses ventilated beneath lower floor — — — — — — — — Improved light and ventilation provided to rooms — 1 — — 3 — — — Manure receptacles provided or reconstructed — — — — — — — — Offensive accumulations removed 20 4 8 7 11 41 — 4 No,of gutters and rainwater pipes fixed or repaired 64 33 37 165 131 61 5 3 No,of repairs to roofs 50 198 113 271 274 259 5 2 under the supervision of the District during the year. C.F. GUY (to 12 Mnr. ) W.H.. HAWORTH J. J. KENIRY S. Lowther J.G. LYONS (to 6 Sept.) R.MAHONEY (to 30 June ) J.G. McCARTHY ( to. 31 Mar.) R.ROPER (to 20 Feb•) W. F. SMITH (to 12 MNR. E.P. WEBBER TOTAL - - 2 - - - - 1 - 2 7 - - - 2 - - 4 - - 6 15 - 4 1 - - - - 2 - - 23 29 61 48 214 93 51 71 24 54 189 1890 7 67 43 42 85 23 15 8 24 87 867 6 56 187 61 - - 5 - 5 79 680 4 9 11 91 11 9 51 4 13 102 539 39 138 130 591 103 47 189 31 68 564 4078 - - - - - - - - 6 - 6 - - - 4 - 1 - 1 - 2 12 1 23 4 19 7 7 8 11 3 8 184 7 63 13 109 15 25 21 10 21 98 881 34 64 83 205 79 32 31 8 38 213 1959 -29-(contd) Summary of works carried out Sanitary Inspectors W.E. ANSTEE J. J. COVHNEY J.H. BROWNIEE (to 30 Nov.) W.CUE R.W. G.DAY G.D. FREELAND S. FIRSHT. (from. 29 Dec. ) H.J. GREEN . (to 1 Apr.) Sink, bath and lavatory pipes fixed or repaired 58 27 37 157 173 50 1 1 Smoke nuisance abated Underground rooms - - 3 - - 1 - - - legal occupation discontinued - - - - - - - 1 Urinals fixed or repaired - 1 - 13 9 - - - Verminous rooms cleansed 57 42 43 23 31 7 - 1 Waterclosets - Cleansed or repaired 53 41 63 123 143 85 - 7 Waterclosets- Licht and ventilation provided - - - - - 2 - - Waterclosets - Pans and traps fixed 57 76 69 204 71 87 1 1 Waterclosets - Provision or repair of flushing apparatus 73 28 27 78 49 91 - 5 Water supply to houses reinstated or repaired Yards, areas and 62 35 3 12 23 24 - 2 courts cleansed, paved or paving repaired 33 26 7 37 79 97 - - Floors, windows, staircases, fireplaces and coppers repaired 101 209 187 308 405 322 3 20 Miscellaneous 23 33 2 31 287 233 - 11 -30- under supervision of the District during the year (Continued). C.F.GUY (to 12 Mnr. ) W.H. HAWORTH J.J. KENIRY S.LOWTHER J.G. LYONS (to 6 SePt.) R. LMAHONEY , (to 30 June) J.G. McCARTHY (to 31 Mar.) R.ROPER (to 20 Feb.) W.F. SMITH (to 12 Mar.) E.P. WEBBER TOTAL 5 5 23 101 28 6 11 9 19 162 963 - 1 " " - - - - 1 2 8 - - - - - - - - - - 1 - 2 2 17 - - - - - 10 54 5 13 2 42 29 - - 5 13 - 313 1 38 36 133 62 53 25 7 9 215 1094 8 - 1 - - - - - 3 6 14 16 39 31 87 31 23 9 12 12 89 925 9 46 31 91 25 22 20 13 10 99 717 10 26 16 15 14 8 5 - 6 17 278 1 7 6 84 20 6 9 3 9 76 500 47 128 128 409 77 50 121 31 61 387 2994 8 96 130 240 34 27 40 8 57 401 1671 -31- Summary of Inspections, etc. Sanitary Inspectors W.E. ANSTEE J.J. COVENEY J. H. BR0WNLEE (to 30 Nov.) W. CUE R.W. G.DAY G.D. FREELAND S.FIRSHT (from 29 Dec. ) H.J.GREEN (to 1 APr.) Bakehouses 41 3 - 7 26 41 - - Complaints 704 1212 518 704 463 1125 26 158 Canteens 26 - 1 13 7 5 - - Drainage 219 248 198 550 242 184 1 1 House-to-House - - - 14 - - - - Houses-let-InLodgings 30 42 19 - 88 56 - 4 Housing Inventigations 50 83 33 87 19 26 - 12 Infectious Disease and Contacts 73 70 44 3870 231 77 - 25 Lodging Houses: Common 30 - - - - 3 - 1 Seamen's - - - 35 1 6 - - Markets (Weekend) 1 5 - 2 1 4 - 1 Offensive Trades 65 25 3 - - 36 - 2 Pharmacy & Poisons Aot,1933 41 19 12 26 13 20 - - Rent Restrictions Act 22 14 14 32 13 10 - 10 Restaurants and Eating Houses 42 7 - 52 38 4 - 1 Shops Act, 1934 Observations re 228 50 34 32 7 25 - - Smoke Nuisance 2 48 - 35 35 1 - - -32. carried out by the District during the year. C.F.GUY (to 12 Mar.) W.H. HAWORTTI J. J. KENIRY S.LOWTHER J.G. LYONS ( to 6 sept. ) R.MAHONEY (to 30 June) J.G. McCarthy (to 31 Mar.) R.ROPER (to 26 Feb.) W.F. SMITH (to 12 Mar.) E.P. WEBBER TOTAL 2 7 31 18 33 - 2 4 •• 5 220 163 633 1227 755 399 324 210 92 281 906 9900 - 17 2 28 5 7 - - 1 4 116 34 499 384 373 145 140 66 65 53 238 3650 - - - 16 6 40 - - - - 76 - 61 115 37 1 32 8 2 35 12 542 31 11 74 51 101 24 26 18 85 21 752 17 38 82 427 76 30 99 5 31 245 5450 - 1 1 - 14 7 - 3 - - 60 - 1 75 - - - - - - - 118 1 3 2 2 2 1 1 1 - 3 30 - - - 4 6 2 5 15 - 4 167 - 2 18 26 14 8 - - 3 19 221 8 2 2 62 11 6 1 - 9 16 232 - 5 37 81 7 6 - - 1 - 281 - - 19 69 23 - - 11 2 34 534 - 9 35 40 - - - - - 5 210 (Contd. ) -33- Summary of Inspection, etc. Sanitary Inspectors W.E. ANSTEE J.J. COVENEY . J.H. BROWNLEE (to 30 Nov.) W. CUE R.W.G. DAY G.D.FREELAND S.FIRSHT. • (from 29 Dce) H.J. GREEN (to 1 Apr.) Surveys re Essentiality Certificates & Licences 173 239 137 164 118 169 1 38 Defence Reg. 68CA Factories: 32 1 8 34 2 13 — 1 Mechanical 272 160 41 94 74 141 — 23 Non-Mochanical 22 17 5 28 16 54 1 7 Outworkers 42 31 1 — 3 26 — 4 Workplaces 26 40 12 13 1 2 — — Miscellaneous 393 210 124 226 490 498 10 159 Rovisits 685 1123 503 389 697 1128 3 250 Prenises recommended for requisitioning for rohousing 5 8 — — — 15 — — Intimation Notices served: To L.C.C. and Council Housing Department 9 43 44 53 30 50 1 6 To Owners 500 494 279 405 369 684 8 91 Statutory Notices served 72 208 66 21 52 22 1 37 Legal Proceedings — 17 1 — 1 — — 8 -34- carried out by the District during the year (Continued)' C.F.GUY (to 12 Mar.) W.H.HAW0RTH J. J. KENIRY S.LOWTHER J.G.LYONS (to 6 Sept.) R.MAH0NEY (to 30 June) J.G. McCARTHY (to 31 Mar.) R.ROPER (to 26 Feb.) W.F.SMITH (to 12 Mar.) E.P. WEBBER TOTAL 32 125 140 172 130 70 11 28 37 168 11952 - 6 25 18 8 2 - 2 7 12 171 24 149 96 118 59 36 3 35 24 71 1420 1 86 28 24 10 6 1 1 3 14 324 - 20 - 39 1 17 - 1 8 17 210 1 6 - 44 3 3 - 3 4 26 183 109 731 212 111 591 189 7 67 87 473 4667 213 872 710 1045 610 575 466 30 191 1434 10924 - 9 - 2 6 - - - - 10 55 18 11 21 78 31 27 18 - 43 125 608 64 331 297 447 322 259 167 34 146 537 5424 24 81 77 138 37 79 32 7 33 192 1179 2 3 4 14 - - 1 - 1 30 82 -35- -36- FACTORIES ACT, 1937 (contd.) The following tables contain a summary of the inspections and defects found and remedied during the year 1947. Inspections. Nunber of:- Premises. Premises on Register. Inspections Written Notice Prosecutions Factories with mechanical power . 1513 1420 123 — Factories without mechanical power 535 324 9 1 Other premises under the Act (including works of building and engineering constructions but not including outworkers premises 38 183 4 — Total: 2086 1927 136 1 2. Defects Found. No. of Defects:- No. Found Defects Remedied Referred Prosecutions To: By: H.M.Inspector Want of cleanliness 71 70 3 - - Overcrowding - - - - - Unreasonable temperature - - - - - Inadequate ventilation 6 6 - - - Ineffective drainage of floors 20 20 - - - Sanitary Conveniences: Insufficient 34 34 - 5 - Unsuitable or defective 79 79 2 23 - Not separate for sexes 23 23 - 9 - Other offences (not including offences relating to Homework) 59 59 - - - 2912 291 5 37 1 Outwork. The net number of outworkers on the Register is 520, the nature of the work is as follows:- Making, cleaning, etc. of wearing apparel 510 Lace,: lace curtains and nets 2 Umbrellas, etc 3 Box making 3 Textile weaving 1 Cosaques 1 The number of inspections made to outworkers' premises was 210. Notifiable diseases occurred in 5 premises. Water Supply. Certificates' of the Local Authority certifying that now dwellings have proper and sufficient supply of water were granted in respect to 86 flats. Wells. There are 13 wells in the Borough. The following 8 are out of use:Name Address. 1. Truman, Hanbury & Brick Lane, E.l. Buxton's Brewery. 2. Old baths. 86, Brick Lane, E.l. 3. Thos. Hubbuck & Sons. The Highway, E.l. 4. The Tower of London. 5. The Royal Mint. 6. Potter & Clarke Ltd. Fairclough St. E.l. 7. John Braydons. 6/8, The Highway, E.l. (Destroyed during the war). 8. Commercial Gas Co. Harford Street, E.l. (sealed off and pump dismantled). The following. 5 are in use:- 9. Free Trade Wharf. The Highway, E.l. (Are only used 10. Co-operative Leman Street, E.l.(for drinking Wholesale Society. (2 wells). (purposes and are (frequently sampled (by the Met. Water (Board. 11. Taylor Walkers Narrow St. E.14. (Used for Brewery, (3 wells) (brewing and are 12. Charringtons Brewery.Mile End Road, E.l. (tested frequently. 13. Mann, Crossman & Raven Row, E.l. (Used only for Paulins Brewery. (beer bottle washing. -37- IV. HOUSING Statistics. I. Inspection of dwelling houses during the year:- (1)(a) Dwelling houses inspected for housing defects (under Public Health or Housing Acts 11,195 (b) Inspections made for the above purpose 18,060 (2) Dwelling houses which were inspected and recorded under the Housing Consolidated Regulations, 1925 218 (4) Dwelling houses found not to be in all respects reasonably fit for human habitation 5,959 II. Remedy of defeets during the year without service of formal Notices:- Defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 4,387 III. Action under Statutory Powers during the year:- (a) Proceedings under Sections 9, 10, 11, 13 and 16 of the Housing Act, 1936:- (1) Dwelling houses in respect of which notices were served requiring repairs (b) Proceedings under Public Health Acts:- (1) Dwelling houses in respect of which notices were served requiring defects to bo remedied 1,162. (2) Dwelling houses in which defects were remedied after service of formal notices:- By owners 1,217 By Local Authority in default of owners (d) Proceedings under Section 12 of the Housing Act, 1936:- Number of separate tenements or underground rooms in respect of which Closing Orders were made 3 -38- Overcrowding (Housing Act, 1936. Part IV). During the year 812 cases of overcrowding were investigated, and of these - 306 were referred to the London County Council for rehousing, and 14 were referred to the Rehousing Department of the Stepney Borough Council. A total of 208 overcrowded families were rehoused by the L.C.C. during the year. Preferential Housing on the Grounds of Health. 364 cases wore investigated. 150 cases were referred to the London County Council for rehousing and 15 to the Stepney Borough Council Rehousing Dept. Underground Rooms. At the beginning of the war there were 5,795 underground rooms which did not comply with the Housing Act and the Regulations made thereunder. During the year 12 underground rooms were inspected with a view to formal closing orders, and such action was taken in 3 oases, In addition, the Rehousing Department of the Borough Council was recommended to terminate the letting of 35 underground rooms which had been requisitioned. On the rehousing of the occupants these underground rooms have ceased to be let. Closing Orders under the Public Health (London) Act, 1936. Upon the application of an owner, closing orders were made through. the Magistrate's Court in the case of 2 dwellings, Nos. 5 and 7, Warton Place. Slum Clearance. ' No slum clearance areas- were reprosented during the year, but much old property was cleared away under the Redevelopment Areas in operation at present, viz. Bancroft Road Area, Limehouse Fields Extension Area and Tarling Street Area. -39- Number of Flats Erected. In the areas mentioned in the previous paragraph and in the London County Council Areas, new dwellings have been completed during the year as follows:- Flats erected by Stepney Borough Council 25 " " " London County Council 43 " rebuilt " " " " 67 Building Licences and Essentiality Certificates. Applications received 1928 Recommended 1420 Recommonded with modifications 329 Not recommended 157 Returned - not dealt with 22 Inspections and Visits made by the Housing Inspector. (1) House-to-house inspections to compile evidence for use in the forthcoming "Sidney Street Redevelopment Area" 218 (2) Inspection of dwellings to ascertain if rehousing justified on grounds of health 364 (3) Inspection of underground rooms with a view to closure 12 (4) Inspection of other underground rooms 35 (5) Inspections for Overcrowding 812 (6) Inspection of dwellings with a view to requisitioning (of which 31 were recommended) 57 (7) Inspections to ascertain Permitted Numbers under the Housing Act, 1936 218 (8) Inspections under Sections 9 and 10 of the Housing Act, 1936 42 (9) Inspections under Section 11 of the Housing Act, 1936 6 (10) Inspections re change of user under Defence Regulation 68 CA 115 (11) Visits with regard to issue of building licences and essentiality certificates 122 (12) Miscellaneous Visits 95 -40- V. INSPECTION AND SUPERVISION OF FOOD Consequent upon the retirement of Mr. H.Abson and Mr,T.W.Dee, Mr.W.F. Smith and Mr. H.J.Green were appointed to specialist food duties. In the middle of the year the section took over complete responsibility for restaurants, cafes and bakehouses in addition to its other duties. During the year, 636 tons of unsound food were condemned, a large proportion of this in small quantities, necessitating the issue of approximately 2,000 condemnation certificates to traders who require them for production to various branches of the Ministry of Food for adjustment of 'points.' Legal proceedings were taken in 36 instances, all under the Food and Drugs Act, 1938, and fines amounting to £110.2.0 and costs £57.0.0 were imposed. 9 of the summonses were in respect of unsatisfactory samples, 5 of which were adulterated milk samples. Two summonses were issued - one for selling milk to the prejudice of the purchaser and one for selling milk which was unfit for human consumption. The remaining 25 summonses were in respect of. unsatisfactory conditions existing in various food premises. The Food Inspectors have continued to give assistance to the Local Food Control Committee and the liaison between the Public Health Department and the latter Committee has been extended with mutual advantage. -41- Summary of inspections, etc. by the special inspectors engaged in the supervision and inspection of food. H. ABSON (to 31 Jan.) A.C. BROWN T.W. DEE (to 31 Mar. ) H.J.GREEN (from 2 Apr.) W. F. SMITH (from 13 Mar.) S.V0GLER TOTAL Bakehouses - 7 — 79 61 5 XX152 Butcher and bacon shops 31 201 - - - 146 378 Butcher and bacon stalls 15 35 - - - - 50 Butter & Margarine premises - 14 - 13 17 1 45 Complaints - 15 2 7 29 15 68 Cowsheds - 17 - 3 8 6 34 Fish shops and stalls - 166 - 59 79 61 365 Grocery & Provision shops - 42 - 113 116 27 298 Greengrocers & Fruiterers shops and stalls - 241 31 7 - 366 645 Ice Cream premises . 29 - 242 106 21 398 London Fruit Exchange - 22 70 - - 168 260 Markets (Daily) 26 431 24 92 117 223 913 Markets (Week-end) - 3 - 3 2 3 OO11 Milkshops - 128 - 222 79 73 502 Poultry Shops 56 210 - - - 418 684 Poultry stalls 44 384 - - - 388 1016 Prepared Food premises 13 226ø - 79 41 90X 449 Railway Depots - 120 85o - - 95 300 Restaurants and Cafes - 60 265 115 34 474 Spitalfields Market - 53 54 - - 158 265 Wharves 43 480 262 - - 168 953 Wholesale Grocers - 48 - 82 130 29 289 Miscellaneous Visits 7 74 23 96 302 86 588 Samples taken: Food & Drugs - 253 - 591 535 139 1518 Others - 9 - 16 61 9 95 Revisits 17 188 11 76 111 564 967 No.of summonses taken out - 3 — 14 6 13 36 0 includes 54 special night or early morning inspections at Bishopsgate Goods Station. e ti 3 " " " " " " it gg tt « »i ti t» t? xx 280 inspections were also made by the District Sanitary Inspectors. ©© 30 » " " " " * " " J 281 " " " " " " " -42- Milk Supply. No. of No.of No on Inspec- Notices Register tions Served Dairy premises 74 ) 12 Purveyors' bottled milk 176 ) 502 33 Itinerant Vendors 44 - - Cowsheds 9 34 - 29 samples of milk were taken in course of delivery to various schools in the borourgh 24 of the samples were submitted for chemical analyses and 5 for bacteriological examination. Two of the latter proved to be unsatisfactory (see table below). The remainder of tho samples were satisfactory. Legal proceedings were taken against a wholesaler for supplying to a school a bottle of milk which contained foreign matter. 26 samples of milk were taken in course of delivery to hospitals and institutions in the borough. 25 wore submitted for chemical analyses and 1 for bacteriological examination. 1 sample submitted for chemical analysis was found to be deficient in fat and the vendor was cautioned. The remainder of the samples were satisfactory. In addition, as a result of a complaint that milk supplied to a hospital was of inferior quality, 9 samples were taken at intervals at the hospital and the results of the analyses showed that the complaint was not justified. 2 samples were taken at Day Nurseries and 1 at a Meal Centre in the borough. The samples were submitted for chemical analyses and were found to be genuine. The following samples were submitted for bacteriological examination :- -43- Nature of Sample No. of samples No. unsatisfactory and action taken. Milk (Pastourised) 11 2 - Taken in course of delivery to a school in the borough. The LCC., Area Milk Officer of the Ministry of Food, and the M.O.H. of the borough where the milk was produced were notified. Milk (Heat Treated) 29 3 - Takon from the same vendor. Area Milk Officer informed. Adjustments wore made to the H.T. plant and subsequent samples taken were satisfactory. Milk (Sterilized) 6 - Milk (T.T. Pasteurised) 1 1 - M.O.H, of borough where milk was produced was notified. Milk (T.T.) 1 - Asserted canned foods 4 - Brisket of Beef 1 1 - Action taken to ensure clean preparation and handling of food. Beef Sausage Meat 1 - Salt Beef 1 - Cough Tablets 1 - Ice Cream 42 (See special report on icecream. ) 39 licences wore issued under the Milk (Special Designations) Regulations, 1936-1946, as follows:- Dealer's Licences Supplementary Licences "Pasteurised" 16 5 "Tuberculin Tested" 8 5 "Accredited" 1 - -44- Ice Cream. There are 176 premises of which 54 are registered for the manufacture of ice cream. 398 inspections were made and 22 notices served. On May 1st the Ice Cream (Heat Treatment, &c.) Regulations, 1947, came into force and there is no doubt that, as a result of these Regulations, Local Authorities have greater control over the manufacture, storage and sale of ice cream. The Regulations provide that all the ingredients of ice cream must be heat treated to ensure that the product is bacteriologically pure. The manufacturer has the alternative of buying his ingredients already heat treated to which he adds only pure water and freezes, or he can, after making his ice cream, subject it to the required temperature for the prescribed time, rapidly cool and freeze. This is a decided step forward though the results will not be seen for some time owing to the shortage of the required plant. During the year, the Food Inspectors have been endeavouring to educate the ice cream vendors and advising them on their future procedure. The Ministry of Health suggested the use of the Methylene Blue test for the bacteriological examination of ice cream, grading the results into four categories. This test has the advantage of quickness and has proved satisfactory for milk testing but, for several reasons, is not so definite for ice cream which contains varying proportions of milk fats. This is indicated in the low grading of most of the samples taken. The sampling record for the year is as follows:- No. of samples submitted for bacteriological examination 42. Results: Grade 1(Good) Nil Grade 2 (Fair - good) 9 Grade 3 (Poor - fair) 5 Grade 4 (Poor) 28 Eleven samples were submitted for chemical analyses and the fat content of these ranged from 0.13% to 11.52%. The average composition of the samples was : Fat Milk solids-not-fat Starch $ Sugar 3.28 °/o 6.08% 14.50 % -45- Butchers' Shops & Stalls. 428 inspections were made during the year and 38 notices served. Butter & Margarine Dealers. No. on Regi- ster No. of Inspections No.of Notices served Butter & Margarine Factories 4 ) 45 1 Wholesale Dealers in Margarine 41 ) Prepared Food Premises. Preserved Fish premises 73 ) 449 26 Preserved Meat premises 122 ) 51 Cawhouses. There are 9 licensed cowhouses in the borough. 34 inspections were made and no notices served. Only one cowhouse was in occupation during tho year. Restaurants & Eating Houses. 474 inspections were made and 96 notices. served. Greengrocers & Fruiterers Shops & Stalls. 645 inspections were made and 115 notices served. Bakehouses & Bakers' Shops. 152 inspections were made and 41 notices served. Fish Shops & Stalls. 365 inspections were made and 11 notices served. Poultry Shops & Stalls. 1700 inspections were made and 25 noticos 'served." Whelesale Grecers. etc. 289 inspections were made and 6 notices served. 30 noticos were served in respect of niscellanoous food premises. 650 carcases of mutton were examined for Caseous Lymphadenitis by the cutting of the lymphatic glands. All the carcases were found to be free from the disease. One diseased carcase was found in the previous year. -46- Unsound Food. 953 inspections were made at the various wharves in the borough. The following is a list end quantity of unsound foodstuffs from the wharvos, disposed of during the year under the Public Health (Imported Food) Regulations, 1937:- Tons cwts. qrs . lbs. Asserted canned goods 44 1 2 0 Apricot Kernels 24 Barley Flakes 9 4 0 0 Biscuits 3 3 0 Bitter Orange Pulp 9 0 0 Cabbage 4 6 0 14 Cherries 33 6 2 8 Cherry Plums 13 2 16 Coffee 2 1 23 Cucumbers 12 1 14 Dates 1 0 5 Ice Cream Powder 21 Melons 5 18 0 0 Onions 35 19 2 8 Peaches 1 0 20 Pears 33 7 2 2 Peas 3 8 1 0 Plums 6 8 2 22 Raisins 2 0 Runner Beans 6 0 0 0 Tonatoes 19 0 0 24 Tomato Paste 1 10 0 0 204 14 3 5 The following foodstuffs were disposed of during the year undor tho Public Health (London) Act, 1936:- (a) Spitalfiolds Market & , . London Fruit Exchange.. . Tons cwts. qrs. lbs. Apricots 19 3 0 6 Apricots (Driod) 14 1 13 Cabbage 1 12 0 16 Carrots 6 0 2 0 Celariac 10 0 0 Cherries 12 8 1 5 Chestnuts 1 0 1 4 Cucumbers 12 2 2 4 Currants 5 2 23 47 Spitalfiolds Market & London Fruit Exchange (contd.) Tons cwts. qrs. lbs. Figs 2 0 Fennel 10 2 24 Grapes 6 1 0 Looks 2 10 0 0 Melons 20 18 1 1 Onions 3 15 1 4 Poaches 3 9 1 14 Poaches (Dried) 3 0 Pears 25 14 3 22 Plums 3 0 12 Pineapples 10 2 18 Pomegranates 10 Potatoes 4 3 1 6 Prunes 2 17 2 23 Radishes 18 0 0 Sultanas 1 8 2 27 Tomatoes 2 8 1 0 123 12 3 8 (b) Other Promises. Assorted foodstuffs 7 16 1 26 Assorted canned goods 16 11 0 11 Asparagus 4 8 1 20 Artichokes 5 2 24 Beef 3 10 Barley 3 1 22 Butter Beans 1 2 8 Biscuits 4 0 17 Bread 1 0 0 Black Pudding 1 0 0 Bacon 11 2 20 Butter 2 10 Broccoli 1 1 0 Carrots 13 18 0 0 Capsicums 4 6 0 0 Celery 1 8 0 0 Cheese 3 0 0 Cauliflowers 3 0 0 Cucumbers 3 2 0 Cherry Plums 13 1 24 Cabbage 48 14 1 12 Cooking fats 12 1 19 Confectionery 2 0 2 13 Chestnuts 5 0 0 -48- Othor Promises (Cntd.) Tons cwts. qrs. lbs. Cherries 22 2 3 24 Cereals (Assortod) 14 3 12 Dried Fruits (Assortod) 9 2 23 Dried Milk 21 Fowls 3 11 Flour 9 18 1 21 Fish (Assorted,fresh) 4 0 1 3 Grapefruit 11 Han 8 Horseflesh (cooked) 22 Jan 1 10 1 19 Lettuce 28 6 1 0 Margarine 25 Melons 6 0 18 Oranges 1 3 6 Pears 16 6 0 12 Pain Kernel Oil 2 0 0 Peaches 1 0 2 14 Peas 5 7 2 26 Pineapples 2 0 24 Potatoes 2 5 2 18 Potato Powder 1 1 10 Pork 16 Plums 20 16 2 16 Parsley 8 0 0 Pea Flour 3 3 14 Runner Beans 1 1 8 Rabbits 2 . o Swedes 8 0 0 0 Shell Eggs 27 Sprouts 4 19 0 0 Savoys 4 4 0 0 Swiss Roll 1 10 Salami 1 12 Tomatoes 18 0 1 Tangerines 1 18 0 0 Table Jellies 1 0 0 Turnip Tops 4 3 2 4 Veal 2 7 Whelks 3 0 241 9 0 22 -49- 64 Detention Notices and 60 Release Notices were issued during the year in respect of the undermentioned foodstuffs:- Article Detention Notices Release Notices Quantity No. of Notices Weight Quantity No. of Notices Weight T. c. q. 1bs T. c. q. lb Mutton 13,001 carcases 31 - 13,001 carcases 31 - Canned Cockles 80 cs. & 50 cartens 2 4 13 l 21 80 cases 1 3 10 0 0 Groats 13 bags 1 16 1 0 13 bags 1 16 1 0 Lemenade Powder 3199 tins 1 5 1 2 0 3199 tins 1 5 1 2 0 Walnuts 45 bags 1 2 5 0 0 45 bags 1 2 5 0 0 Sugar Sweepings 81 bags 5 8 11 3 12 92 bags 6 9 13 3 12 Date Sweepings 1 bag 1 2 19 1 bag 1 2 19 Tea 10 chests 1 7 2 9 10 chests 2 7 2 9 Cocoa & Sweepings 1274 bags 20 77 16 0 5 1328 bags 17 81 4 1 9 Cassia Lignia 3 bales 1 3 0 0 - - - 50 Zeebrugge-Harwich Train Ferry. 109 special night and early morning inspections were made by the Food Inspectors. In addition, 10 inspections were made by day. 1,028 trucks containing 8,135 tons 11 cwts. of fruit, vegetables, poultry etc., arriving from the Continent were examined. These consisted of: Italian fruit and vegetables - 583 trucks containing apricots, asparagus, aubergines, artichokes, beans, carrots, cauliflowers, celery, cherries, cherry plums, chestnuts, cucumbers, garlic, grapes, lettuce, peas, pears, narrows, melons, parsley, poaches, plums, pomegranates, strawberries, tomatoes and walnuts. Hungarian fruit, bacon, poultry and game - 353 trucks containing apricots, bacon, ducks, fowls, geese, guinea fowls, hares, pheasants and turkeys. Belgian confectionery, fruit, fish and vegetables92 trucks containing fish, bilberries, beans, cherries, confectionery, cabbage, cucumber, grapes, pears and peas. The following foodstuffs were found to bo unsound and wore destroyed:- Italian fruit and vegetables. 174 packages asparagus, 14 packages artichokes, 18 packages apricots, 100 packages beans, 25 packages carrots, 4654 packages cherries, 72 packages garlic, 88 packages narrows, 1770 packages peas, 1724 packages plums,' 1067 packages strawberries. Bolgian fruit. 8 packages of pears. Total weight - 66 tons, 12 cwts. 3 qrs. 22 lbs. -51- vi. prevalence of, and control over, infectious and other diseases Notifications. 1305 notifications (other than of tuberculoses) were received, or 111 more than in the previous year. Corrected Diagnosis. 81 cases of infectious diseases removed to hospital were found not to be suffering from the disease stated on the certificate. Of these, 8 were cases of Scarlet Fever, 38 of Diphtheria, 14 of Measles, 5 of Whooping Cough, 3 of Cerebro-Spinal Fever, 1 Enteric Fever and 12 Poliomyelitis. Diphtheria Immunisation. In addition to the 51 sessions held at 35 Stepney Green every Friday afternoon, children are also immunised at most of the Infant Welfare Centres: S.B.C. L.C.C. Total Und.5 Over 5 Und. 5 Over 5 Post Schick Tests 661 71 mm - 732 Immunisation Certificates given 588 72 _ - 660 Attendance of Children for Schick or Immunisation 3255 179 - - 3434 Children who completed the full course of immunisation 902 11 48 283 1244 Secondary injections 2 1 - 18 21 Whooping Cough Immunisation. In addition to the Whooping Cough Immunisation Clinic held in conjunction with the Diphtheria Immunisation Clinic every Friday afternoon at 35 Stepney Green, facilities are provided at most of the Infant Welfare Centres. 35 Stepney Green Infant Welfare Centres Total Attendance of children 532 2062 2594 Completed immunisations 156 594 750 -52- Verminous Persons. Branch Road Cleansing Centre M. F. Ch. Total No. of persons bathed and clothing disinfected 163 38 48 249 No. of baths and treatments given 174 45 4 223 Bug Eradication. The following is a summary of the work carried out by the special inspector: No. of inspections 1008 Revisits 721 No. found verminous 638 Miscellaneous visits 667 No. of Council Premises sprayed 481 ,, ,, ,, Rooms ,, 1146 ,, ,, Private Premises ,, 566 ,, ,, ,, Rooms ,, 1117 98 of the families which wore rehoused in Stepney Borough Council flats had their furniture and other household effects treated with H.C.N. 4 loads of verminous furniture were treated with H.C.N.: 3 from private premises and 1 of an aged person whilst in hospital. All bedding was separately treated with steam. Cleansing and Disinfection. 440 rooms were disinfected because of infectious disease and 25 because of pulmonary tuberculosis. 114,048 articles of clothing and bedding were steam disinfected. Scabies (Scabies Order 1941). To. of cases notified: Formally - 415; Informally - 213. Diagnostic Clinic M. F. Ch. Total No. of sessions - - - 96 No. of persons who attended 233 276 246 755 ,, ,, ,, found positive 38 55 51 144 Total number of attendances 261 324 280 865 -53- Branch Road Treatment Centre. M. F. Ch. Total Persons bathed and clothing disinfected 103 78 47 228 No. of baths and treatments given 200 147 76 423 London Hospital Treatment Centre. Persons bathed and clothing disinfected 175 138 129 440 Statutory Action. Inspection of premises notices served ' — - - 169 Medical examination notices served -- - - 152 L.C.C. Pro-school children. (a) Scabies No. of baths and treatments given - - 37 57 No. of children who attended - - 7 7 (b) Vermin No. of children who attended - - 20 20 No. of treatments given - - 20 20 SMALLPOX. Two cases of smallpox occurred in the borough, particulars of which are as follows: Case 1. J. A. aged.66 (vaccinated in infancy) was seen by me for the first tine at the Mile End Hospital on the 9th March. I diagnosed the case as Variola Major and immediately removed him to a snallpox hospital. He was a male resident attendant at the Empire Memorial Hostel for Sailors, Commercial Road. It appears that he fell ill suddenly at the Hostel on the 3rd March with headache, vomiting and pains in the back and was immediately put to bed there in his cubicle, where he remained until he was removed to the Mile End Hospital on the 5th March by his own doctor. He made a successful recovery. It is possible that he had been infected by one of the missing cases from a recent outbreak of smallpox at Grimsby -54- on the 13th or 14th February. One of those missing cases may perhaps' have passed through the Sailors Hostel in Stepney and infected the patient. A large number of contacts at the Mile End Hospital and at the Sailors Hostel were offered vaccination and many hundreds were Vaccinated. The contacts were kept under daily supervision and the Medical Officers of Health of the districts where some of then resided were . fully informed. Case II. H.S. aged 34 (mild onset 16th' March). On the 21st March,, I was called to examine one of the contacts at the hospital and diagnosed him to bo suffering from smallpox. This man who occupied the sane ward as patient No. I had been vaccinated in infancy and again (after the diagnosis of Case No.1) on the 9th March, too late to prevent the development of the disease. He had been infected by the first case and was immediately removed to a smallpox hospital, where he made an uneventful recovery. •' • 1 The Ministry of Health and the London County Council were duly informed of both cases. The Mile End Hospital was for a while closed to further admissions and to visitors. Both these cases, one in a hostel for 300 sailors and the other in a large general hospital, occurred under conditions where a serious spread of the infection might have been expected. That the outbreak was confined to two cases and successfully controlled was due in no small measure to the assistance given me by the Medical Superintendent and staff of the Mile End Hospital and the Warden and staff of the Empire Memorial Hostel. I would like to express my thanks to Dr. Morgan, Medical Officer to the Port Health Authority, and to his inspectors who gave me invaluable assistance in the follow-up of the seamen-contacts of the first case. On the night the disease was first diagnosed over 300 sailors were vaccinated between 11 p.m. and 3 a.m. by the Medical Officers of the Public Health Department and the Public Vaccinators assisted by the Public Health Department staff. Some 600 potential hospital contacts and staff were vaccinated by the Medical Superintendent at Mile End Hospital. -55- NOTIFIABLE DISEASES (OTHER THAM TUBERCULOSIS) DURING THE YEAR 1947. DISEASE Under 1-year Total Cases Notified. In Age Groups 55 and over Total Cases admitted to Hospital Total Deaths 1- 2- 3- 4- 5- 10- 15- 20- 35- 45- Smallpox - — — - — — — — 1 - - 1 2 2 - Searlet Fever. - 5 8 10 23 71 20 2 3 2 — — 162 66 - Diphtheria s 6 2 3 5 12 7 3 10 2 - — 53 53 - Membranous Croup. - - - - - - — — - — — - - - - Enteric Fever. - - - - 1 2 1 1 - 1 — 6 5 - Measles. 44 78 90 66 78 163 17 3 6 - — — 545 85 3 Whooping Cough. 75 49 49 49 43 103 4 1 1 — — — 374 39 4 Puerperal Fever. - - - - - — - - - - — • — — — Puerperal Pyrexia. - - - - - - - 2 12 2 — - 16 16 1 Encephalitis Lethargica. - - - - - - - - - - - •- - - - Erysipelas. - - •- - - - - 1 3 5 5 5 19 3 — Cerebrospinal Fever. 3 1 1 - 1 - - — - - 1 - 7 7 2 Ophthalmia Neonaterum. 6 - - - - - • - — - - - 6 6 — Polionyelitis. - 1 2 2 2 10 5 4 5 1 - - 32 32 - Polio-encephalitis. - - - - - - - - - - - - - - - Dysenter. - 1 2 - - - - - 2 1 1 I 8 6 - Malaria. - - - - - - - - 5 - - — 5 — - Pneumonia. 3 3 2 3 1 3 6 1 11 10 11 7 61 21 92 Food Poisoning. — — — - — 1 - - 3 3 2 — 9 1 — Totals 134 147 156 142 153 364 67 18 63 26 21 14 1305 342 102 -56- PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 19 30. Ministry of Health Form T. 137/1947 1. Summary of Notifications during the period from the 1st January, 1947, to the 31st December, 1947, in the area of the Metropolitan. Borough of STEPNEY. Formal Notifications. No. of Primary Notifications of new cases of Tuberculosis. Age periods:- 0 -1 -5 -10. -15 -20 -25 -35- •45- -55- ■ 65- Total (all ages) Total Notif icat ions Pulmonary Mvles 9 2 2 11 11 16 19 21 13 6 110 121 " Females — 9 2 9 10 23 19 11 2 1 2 88 94 Nnn- " Males 3 1 — 1 - , - 1 1 1 . 8 10 " " Females - 1 - 2 1 1 1 2 1 - - 9 10 Supplemental Return, II. New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the above-mentioned period, otherwise than by formal notification. Age periods:- 0- 1' -5- -10- •15. -20- 25- 35- 45- 55- -65 - Total Pulmonary Males r 2 1 _ 6- 9 3 4- 5 10 40 18 tf Fomales 1 1 1 1- 3 3 1 w 11 6 Non- " M-les a. Mkp •• — — — — — - — — mm " Females - - - - - 2 - - - - - 2 1 The source or sources from which information as to the above mentioned cases was obtained is stated overleaf:- -57- Source of Information. No. of Cases Pulmonary NonPulnonary Death Returns (from local Registrars 13 - (transferable deaths from Registrar General 5 - Posthumous notifications 3 1 "Transfers" from other areas (other than transferable deaths) 30 1 Other Sources - - Notification Register. No. of cases of Tuberculosis remaining at 31st Dec. 194-7 on the Registers of Notifications kept by the Medical Officer of Health. Pulmonary Non-Pulmonary Total Cases M. F. Total F. Total 752 449 1201 163 151 314 1515 VACCINATION. Report for the year 1947. No, of Births 3761 Successfully vaccinated 1447 Insusceptible to vaccination 3 Had smallpox - Statutory declarations 1091 Died unvaccinated 82 Postponed by medical certificate 12 Removals from Borough 551 Removals and not traced 90 Outstanding 485 -58- VII.- STATISTICS FOR THE YEAR 1947. (Prepared by Registrar-General) Estimated Civilian Population 100,020 LIVE BIRTHS STILLBIRTHS M F M F Total (Legitimate and Illegitimate) 1145 1039 37 25 Illegitimate 73 73 5 5 DEATHS UNDER 1 YEAR M F Legitimate 47 29 Illegitimate 3 3 Birth-rates, Civilian Death-rates, Analysis of Mortality, Maternal Mortality and Case-rates for certain Infectious Diseases in the year 1947. (Provisional Figures based on Weekly and Quarterly Returns) England and Wales 1. 126 C.B.s & Great Towns including London 2. 148 Smaller Towns Resident Pop. 25000-50000 1931 Census 3. London Adm. County 4. Rates per 1000 Civilian Population:- BIRTHS Live 20.5 † 23.3 22.2 22.7 Still 0.50† 0.62 0.54 0.49 DEATHS All causes 12.00† 13.0 11.9 12.8 Typhoid & Paratyphoid 0.00 0.00 0.00 0.00 Scarlet Fever 0.00 0.00 0.00 0.00 Whooping Cough 0.02 0.03 0.02 0.02 Diphtheria 0.01 0.01 0.01 0.01 Influenza 0.09 0.09 0.08 0.08 Smallpox 0.00 0.00 0.00 - Measles 0.01 0.02 0.02 0.01 -59- 1. 2. 3. 4. NOTIFICATIONS Typhoid Fever 0.01 0.01 0.00 0.01 Paratyphoid Fever 0.01 0.01 0.01 0.01 Cerebro Spinal Fever 0.05 0.06 0.05 0.05 Scarlet Fever 1.37 1.54 1.37 1.31 Whooping Cough 2.22 2.41 2.02 2.80 Diphtheria 0.13 0.15 0.14 0.14 Erysipelas 0.19 0.21 0.18 0.22 Smallpox 0.00 0.00 0.01 0.00 Measles 9.41 9.13 9.58 5.29 Pneumonia 0.79 0.89 0.68 0.64 A dash (-) signifies that there were no deaths. † Rates per 1000 total population. Rates per 1000 Live Births:- Deaths All causes under 1 year of age 41ø 47 36 37 Enteritis and Diarrhoea under 2 years of. age 5.8 8.0 3.7 4.8 Rates per 1000 Total (Live and Still) Births:- Notifications puerperal fever 1.21 Puerperal pyrexia 7.16 8.99 6.27 6.96* Maternal Mortality in ENGLAND AND WALES Rates per 1000 Total (Live & Still) Births Rates per million women aged 15-44 140 Abortion with sepsis 0.10 9 141 Abortion without sepsis 0.06 5 147 Puerperal infections 0.16 142-146) 148-150)Other, maternal causes • 0.85 ø Per 1000 related births * Including Puerperal fever -60- TOTAL DEATHS BY CAUSE AND AGE IN THE METROPOLITAN BOROUGH OF STEPNEY - 1947. CAUSES OF DEATH. Sex All ages 0- 1- 5- 15- 45- 65 & over 1. Typhoid and paratyphoid fever. M - - - - - - - F - - - - - - - 2. Cerobro-spinal fever. M 2 2 - - - - - F - - - - - - - 3. Scarlet Fever. M - - - - — - — F - - - - - - - 4. Whooping Cough. M 3 3 - - - - - F 1 1 - - — - - 5. Diphtheria. M - - - - - - - F - - - — - — - 6. Tuberculosis of respiratory system. M 62 - 1 1 20 25 15 F 30 1 — — 21 6 2 7. Other forms of Tuberculosis. M 3 - - 1 - 2 — F 4 - 1 1 l 1 - 8. Syphilitic disease. M 9 - - - l 3 5 F 5 1 — - - 2 2 9. Influenza. M 5 1 — — - 2 2 F 6 1 - - - 3 2 10. Measles. M 1 - 1 — — - - F 2 1 1 - - - - 11. Acute Poliomyelitis and Polioencephelitis. M — — — - - - - F - - - - - - - 12. Acute infectious Encepholitis M - - - - - - - F - - - - - - 13a Cancer of buccal cavity and oesophagus. M 8 - - — — 1 7 13f Cancer of Uterus. F 9 - - - 2 7 14. Cancer of stomach and duodenum. M 23 - - - 2 13 8 F 15 - - - 2 6 7 15. Csncer of breast M - - - - — - - F 14 - - - 3 3 8 16. Cancer of all other sites. M 94 - - - 4 36 54 F 66 — — 2 4 25 35 17. Diabetes. M 4 - - - 1 1 2 F . 8 - - - - 5 3 18. Intra-cranial vascular lesions. M 43 - - - 1 13 29 F 65 - - - 1 15 49 19. Heart disease. M 203 - — — 9 57 137 F 191 - - - 7 35 149 -61- TOTAL DEATHS BY CAUSE AND AGE IN THE METROPOLITAN BOROUGH OF STEPNEY - 19 47 (C ntd. ) CAUSES OF DEATH. Sex All ages 0- 1- 5- 15- 45- 65 & over 20. Other diseases of the circulatory system. M 38 - - - 10 28 F 35 - - - - 8 27 21. Bronchitis. M 73 2 - - 3 29 39 F 33 1 1 — - 5 26 22. Pneumonia. M 62 8 2 - 4 14 34 F 30 4 1 1 4 7 13 23. Other respiratory diseases . M 9 - - - 3 1 5 F 8 - - - 1 3 4 24. Ulceration of stomach or duodenum. M 18 - - - 2 8 8 F 3 — - - 1 - 2 25. Diarrhoea (under 2 yrs) M 3 3 - - - - - F 2 2 - - - - - 26. Appendicitis. M 2 - 1 - - 1 - F 1 - - - - 1 - 27. Other digestive diseases . M 9 - - - - 4 5 F 14 - - - 2 5 7 28. Nephritis. M 19 — - — 4 8 7 F 10 - - - 3 3 4 29. Puorperal and postabortive sepsis. F 1 1 30. Other maternal causes. F 1 - - . - 1 - 31. Premature birth. M 6 6 - - - - - F 8 8 - - - - 32. Congenital malformations, birth injury, infantile disease. M 21 20 l - - mm F 12 9 — — 2 1 - 33. Suicide. M 10 - - - 5 3 2 F 2 — - — 2 - 34. Road Traffic Accidents. M 8 - 1 - - 2 5 F 4 - 1 - - 1 2 35. Other violent causes. M 27 3 1 l 9 5 8 F 16 3 - - 3 2 8 36. All other causes. M 40 2 2 - 4 11 21 F 18 - - - 3 4 11 ALL CAUSES. M 805 50 9 4 72 249 421 F 614 32 5 4 60 145 368 Total 1419 82 14 8 132 394 789 -62- 24th Annual Report, SUMMARY OF BOROUGH ANALYST'S QUARTERLY REPORTS for the Year 1947. During the year, 1577 samples were submitted for analysis. Of these 1509 were taken under the Food and Drugs Act. The remaining 63 samples were received from. Borough Departments, the Food Executive Officer and private purchasers. Samples taken under the Food and Drugs Act 536 samples were taken fomally, 973 samples were taken informally. Total Samples Foods (taken under the Act)1,110 Foods (private samples) 59 Drugs (taken under the Act) 399 Other private samples 9 1,577 Out of 1169 samples of food including private samples 54 or 4.6 per cent. were adulterated and out of 399 samples of drugs 13 or 3.3 per cent. were adulterated, making a total of 1568 food and drugs out of which 67 or 4.3 per cent. were adulterated. Milk. 530 samples were examined. The average composition including 8 adulterated samples was : Fat 3,52 per cent., and solids-not-fat 8.68 per cent. -63- ADULTERATED SAMPLES (including other offences) Nature. Adulterated,etc. : Pros: ecu: tions Cautions Informal Formal Private Foods Meat Paste 1 - - - - Fruit Drinks 3 2 1 1 1 Sausages 2 2 - 1 1 Coffee 1 - - - Fish Paste 2 1 - 1 - Milk . 3 5 - 4 1 Buttered Rolls 6 - - - - Vinegar 2 2 - 2 Jolly Mould 1 1 - 1 - Lemonade Powder 1 - - - Sauce 2 1 1 1 1 Tinned Soup 1 - - - - Egg Substitute Powder 1 - - - - Malted Milk Tablets 1 - - - Private Foods 0atmea1 - - 1 - - Meat - - 1 mm - Lemonade Powder — - 2 - - Milk - 1 - - Pickled Cabbage - - 1 - - Vinegar - - 1 - - Tinned Jam - - 3 - - Tinned Pork & Beans - - 1 - - Condensed Milk - - 1 • - Currants - - 1 - - Drugs Fullers Earth 1 1 - - 1 Saccharin 2 - - - . - Fynnon Salts 1 - - - - Baby powder 1 - - - - Boric Ointment 1 - - - Sulphur Ointment 1 1 - - 1 Cough Tablets 1 - - - - Peppermints 1 - - - - Glauber Salts 1 - - - - Zinc Ointment 1 — - - - Poor Quality Samples. 41 samples (including 20 samples of milk) were reported as being of inferior grade or doubtful quality. Legal Proceedings. Lagal proceedings were taken in 9 cases. The vendors paid a total of £92.16.0 in fees and costs. Douglas Henville, F.R.I.C. Public Analyst. -64- INDEX Page 1. Statistics and Social Conditions of the Area 6 II. General Provision of Health Services 6 III, Sanitary Circumstances of the Area 24 IV. Housing 58 V. Inspection and Supervision of Food 41 VI. Prevalence of, and control over, Infectious and other diseases 52 VII. Statistics provided by the Rwgistrar-General 59 Adoption of Children 16 Aged and Infirm Persons 26 Analyst's Report 63 Ante-Natal and Pest Natal Clinics 14.21 Area of Borough 5 Births 5.13,20 Births Act, Notification of 13 Bug Eradication 53 Care Committee 11 Child Life Protection 15 Cleansing of Persons 53 Day Nurseries 14.16 ,, ,, Toy Fund. 18 Deaths 61 Dental Clinic 12 Diphtheria Immunisation 52 Disinfection 53 Drainage 26 Extra -Nourishment, Supply of 8 Factories Act 56 Fines and -Costs 27 Food Inspection 42 ,, Sampling 63 ,, Unsound 47 ,, Zeebrugge-Harwich Ferry 51 Foster Mothers 15 Health Propaganda 7 Health Visitors, Work of 22 Hone Helps Service 14,19 Housing: Statistics 38 Inspections 40 Ice Cream 45 Illegitimate Births 20 Infant Welfare Centres, Work at 13.21 Do. Ashfield Street 18 Do. Mary Hughes 17 -65- Page Infant Mortality 5 Infectious Disease 52.56 Inhabited Houses 5 Insulin 6 Laboratory Facilities 7 Legal Proceedings 27 Lodging Houses 26 Mary Hughes Centre & Day Nursery 17 Maternal Mortality 14 Maternity & Child Welfare 13 Milk Supply 43 Milk and. Vitamins, Supply of 20 Mortuary. 26 Nursery. Creche 17 Nursing in the Home 7 Outworkers 37 Overcrowding 39 Pharmacy & Poisons Act 24 Population 5 Premature Infants 15 Public Assistance 6 Puerperal Fever and Pyrexia 5 Rateable. Value 5 Rats and Mice. Destruction 24 Rent and Mortgage Interest Restrictions Act 24 Rodent Control 24 Sanitary Inspectors:- Inspections 32 Return of Sanitary Work 28 Post war 27 Scabies 53 Social Conditions 6 Staff 3.6 Smallpox 54 Statistics., Summary of .V 5 Stillbirths 5 Sunlight Treatment 19 Tuberculosis: Dispensaries, Report on 8 Notifications 57 Underground Rooms 39 Unemployment 6 Unsound Food 47 Vaccination 58 Verminous persons and premises 53 Vitamins, Supply of 20 Water Supply 37 Whooping Cough Immunisation 52 Zeebrugge-Harvich train ferry 51 -66-