SUTC 19 BOROUGH OF SUTTON AND CHEAM ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the Year 1955 BOROUGH OF SUTTON AND CHEAM ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1955 PUBLIC HEALTH COMMITTEE THE WORSHIPFUL THE MAYOR (Alderman Mrs. D. Sparks. M.B.E.,J.P.) Alderman F. WARREN "D. WEBSTER (Miss) J. P. Councillor R. A. BEUZEVAL „ L B. BLACKLER „ D.M, JOHNSON, M.P. A. W. LETTS „ F. R. MUDDLE Councillor A.N. PERRY „ D.M. PETTINGELL (Mrs.) „ A. G. TAYLOR (Chairman) „ F. E. W. TOZER PUBLIC HEALTH OFFICERS OF THE AUTHORITY Medical Officer of Health ENEAS J MACINTYRE, M. D, D P. H. Chief Sanitary Inspector CHARLES WILLIAM NEWBERY Certlf R S.I Certlf. Meat and Food Certlf. S.I. Exam Board Deputy Chief Sanitary Inspector ARTHUR SYDNEY WILLIAMS Certlf, RSI Certify Meat and Food Additional Sanitary Inspectors KENNETH HUGH HALSTEAD Certlf R. S I. and S.I.E. J. B., Certlf Meat and Food (Resigned on 23rd October, 1955) JOHN ALWYN EVANS JONES Certlf. R.SL and S.I.E.J.B. Certlf Meat and Food Resignedon 31st Decftmber,. 1955. REGINALD WILLIAM NORMAN Certlf.R.s.I. and S.I.EJ.B. Certlf Meat, and Food KEMPTON HUDDLESTONE PRIOR Certlf. R.S.I. and S.I.E.J.B. Certlf. Meat and Food FRANK SUTCLIFFE Certlf, R.S.I. and S.I.B. Certlf. Meat and Food Public Analyst DANIEL D. MOIR Sc. F.R.I.C. Analytical and Consulting Chemist (part-time) 1 TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE BOROUGH OF SUTTON AND CHEAM Mr. Mayor, Ladles and Gentlemen, I have the honour to present to you the Annual Report on the health of the Borough for the year 1955. The general health of the community was good. The estimated population shows a reduction of five hundred and twenty. The birth rate fell from 12,1 to 11.4 per thousand of population. The Infantile mortality rate remained low. There was no maternal death. There was a fall In the mortality rate for Tuberculosis. The Incidence of Infectious diseases was higher. Influenza was prevalent at the beginning of the year. A severe epidemic of Measles occurred In the Spring. There were sixteen cases of Poliomyelitis during the late Summer and Autumn, Scarlet Fever and Dysentery declined in prevalence There was no case of Diphtheria. Fewer new cases of Pulmonary Tuberculosis were notified. A Mass X-Ray Unit visited the Borough In July and again contributed to the early diagnosis and prevention of diseases of the chest. The Council's housing programme made further progress. During the year forty seven flats and houses were occupied and one hundred and five flats and houses were In course of construction. Schemes were In progress for thirty three flats and houses. At the end of the year seven hundred and thirty six families had been accommodated In new houses, flats and prefabricated bungalows since the end of the war. The general work of sanitation, of the prevention of nuisances and of the protection of food was carried out efficiently under the direction of the Chief Sanitary Inspector (Mr. C.W. Newbery). I wish to express my appreciation to him and to the staff of the department. The first stage In the major reconstruction of the Worcester Park, sewage works proceeded successfully and was nearlng completion at the end of the year. The water supply of the district maintained a high standard of chemical and bacteriological purity. Effective control by dally sampling and by chlorlnatlon was continued. I thank the members of the Council for their advice and help during the year and I am grateful to the Officers of the Council for their co-operation. I am, Mr. Mayor, Ladles and Gentlemen, Your obedient Servant, ENEAS J. MACINTYRE Medical Officer of Health, 3 STATISTICS OF THE AREA 1954 1955 Area In acres 4336.15 4338.15 Registrar General's estimate of the Resident Population 79,200 78,680 Number of Inhabited houses (end of year) according to the Rate Book. 23,100 23,1770 Rateable Value and sum represented by a Penny £940,735 £950,420 Rate £3,859 £3,927 EXTRACTS FROM VITAL STATISTICS (Comparative of the years 1954 and 1955) Total 1954 Male Female Total 1955 Male Female England & Wales 1955 Live Births 959 484 475 893 486 407 Legitimate 919 466 453 869 475 394 Illegitimate 40 18 22 24 11 13 Birth Rate per 1000 of the Estimated Resident Population 12.1 11.4 15.0 Still Births 14 6 8 18 9 9 Legitimate 13 5 8 17 9 8 Illegitimate 1 1 - 1 - 1 Rate per 1000 total (live and still births) 14.3 19.7 23.1 Deaths 809 390 419 815 394 421 Death Rate per 1000 of the Estimated Resident Population 10.2 10.4 11.7 Deaths from Sepsis 0 0 Other Maternal Causes 0 0 Death Rate from Maternal Causes per 3.000 total (live and still births) 0.00 0.00 0.64 Deaths of Infants under one year of age All infants per 1000 live births 18.7 19.0 24,9 Legitimate Infants per 1000 legitimate live births 19.5 19.6 Illlgltlmate Infants per 1000 illegitimate live births 0.0 0.0 4  1954 1955 Deaths from Cancer 176 157 „ Measles 0 1 „ Whooping Cough 0 0 „ Diarrhoea 2 2 Percentage of Deaths from certain causes to the total number of deaths 1954 1955 Diseases of the heart and circulation 37.5 40.0 Cancer and malignant disease 21.8 19.2 Diseases of the lungs (non-tuberculous) 9.9 7.5 Tuberculous diseases 1.0 0.5 Vascular lesions of the nervous system 14.4 15.7 Congenital malformations 0.6 1.2 Suicide and violence 2.8 3.2 Diseases of the digestive system 1.6 1.8 Infectious diseases 0.5 1.1 Diseases of the kidney 1.4 0.5 Other defined diseases 8.5 9.3 Maternal Mortality. There was no maternal death. The maternal mortality rate for England and Wales was 0-64 per thousand total births.. Infantile Mortality. The Infantile mortality rate was 19.0 per thousand live births, compared with 18.7 per thousand live births In 1.954 There were seventeen deaths of infants under one year compared with eighteen In 1954, Of the seventeen deaths, thirteen occurred In the neo-natal period within one month of birth as is shown in the following table of causes and age groups. Causes of Death AGE GROUPS Under 1 month 1-3 months 3-12 months Congenital Abnormality 7 1 2 Prematurity 3 - - Cerebral Haemorrhage 1 - - Pneumonia 2 - - Septicaemia - 1 - Totals 13 2 2 5 CAUSES OF DEATH IN THE BOROUGH OF SUTTON AND CHEAM DURING 1955 M. F. Total 1. Tuberculosis, respiratory 2 1 3 2. Tuberculosis, other 1 - 1 3. Syphilitic disease 4 3 7 4. Diphtheria - - 5. Whooping Cough - - - 6. Menlngococcal Infections - - 7 Acute Poliomyelitis - - - 8. Measles 1 - 1 9. Other Infective and parasitic diseases 1 1 2 10. Mall giant neoplasm, stomach 11 11 22 11. Malignant- neoplasm, lung, bronchus 26 6 32 12. Mallgiant neoplasm, breast - 19 19 13. Malignant neoplasm; uterus - 5 5 14. Other malignant and lymphatic neoplasms 31 40 71 15. Leukaemia, aleukaemla 4 4 8 16. Diabetes 4 3 7 17. Vascular lesions of nervous system 57 71 128 18. Coronary diseases, angina 81 57 136 19. Hypertension with heart disease 6 15 21 20. Other heart disease 48 87 135 21. Other circulatory disease 16 16 32 22. Influenza 3 5 8 23. Pneumonia 15 16 31 24. Bronchitis 27 8 35 25. Other diseases of respiratory system 2 3 5 26. Ulcer of stomach and duodenum 5 1 6 27. Gastritis, enteritis and diarrhoea - 2 2 28. Nephritis and nephrosis 2 2 4 29. Hyperplasia of prostate 11 - 11 30. Pregnancy, childbirth, abortion - - - 31. Congenital malformations 5 5 10 32. Other defined and 111-defined diseases 17 28 45 33. Motor vehicle accidents 2 1 3 34. All other accidents 6 7 13 35. Suicide 6 4 10 36. Homicide and operations of war - - - Totals 394 421 815 6 GENERAL PROVISION OF PUBLIC HEALTH SERVICES FOR THE AREA NEW LEGISLATION The Food and Drugs Act, 1955 This Act consolidates the Food and Drugs Act, 1938, the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, and the Food and Drugs Amendment Act, 1954, together with certain Sections of the Slaughterhouses Act, 1954 and the Slaughter of Animals (Amendment) Act, 1954, There Is now only one main Act and this Incorporates many amendments which practice has shown to be necessary. The Food Hygiene Regulations, 1955, made under the 1955 Act, make possible a stricter control over food premises generally, REMOVAL OF PERSONS IN NEED OF CARE AND ATTENTION The national Assistance Act, 1948 - Section 47 There was no necessity for formal action during the year. BURIAL AND CREMATION OF THE DEAD The national Assistance Act, 1948 - Section 50 Six burials were arranged under the powers granted to the Council by this Section. MORTUARY One hundred and thirty eight bodies were received and one hundred and thirty eight post mortem examinations were made. The Mortuary premises, which Include a three body refrigerated chamber, have been well maintained. LABORATORIES Arrangements were continued for the use of the laboratory at Sutton and Cheam Hospital which has provided an essential Public Health service. The use of the Public Health Laboratory at Epsom, to which samples of milk and Ice cream are sent, has Increased but Is limited by the distance from the Borough. CLINICS Details of the clinics available In the district are given at the end of this report, 7 SANITARY CIRCUMSTANCES OF THE AREA Water Supply- The water supply is mainly derived from the deep wells in the chalk of the Sutton District Water Company situated at Sutton, Cheam and Woodmansterne, A small area in the North Ward is supplied by the Metropolitan Water Board. The water from all. wells of the Sutton District Water Company is softened to nine degreos of hardness. Chlorine is applied in the form of chloramlne as a protective measure. Samples of the raw and treated waters are examined dally by the laboratory at the Sutton Works, Samples are also examined at monthly intervals by the Company's Consultant. Analyst, and month: v samples are examined'n rotation by the District Councils In the area of supply. The supply from all sources has been satisfactory in quality and quantity All the dwelling houses have a direct supply from the public mains. Below is the average of monthly analyses. Chemical Results in Parts per Million Average Total Solids 195,38 Armonia, free 0.12 Ammonia. Albuminoid 0 Nitrogen in Nitrates 7.89 Nitrogen in Nitrites 0 Oxygen Absorbed 0.06 Chlorine in Chlorides 19.15 Hardness total (grains per gallon) 8.15 Bacteriological Results No. of Bacteria, growing on Agar per ml. for 3 days at 20° C 0 No. of Bacteria growing on Agar per ml, for 1 day at 37° C 0 Presence of Bacillus Coll in 100 ml. 0 Swimming Baths. Satisfactory control over residual chlorine and pH has been maintained in the two swimming baths Two samples taken at peak periods of attendance gave satisfactory chemical and bacteriological results Drainage and Sewerage. During the year work has proceeded on the reconstruction of Worcester Park Sewage Works, the first stage of which will be completed during the early months of 1956. As a result of the new tanks etc. being brought into operation a greatly Improved effluent is now being discharged to the Beverley Brook. preparations for succeeding stages of reconstruction are now in hand and it is anticipated that work will commence during 1956 on the construction of a new sludge digestion tank. 8 Refuse Collection and Scavenging. The collection and disposal of house refuse and salvage together with the scavenging of public highways is carried out under supervision of the Borough Engineer and Surveyor The work has been executed in a satisfactory manner. Rivers and Streams. The streams within the Borough have been maintained in a satisfactory condition. Closet Accommodation. There are four premises with cesspools in use. Some four pall closets and one chemical closet are in use. In the past twenty seven years one hundred and sixty one premises originally with cesspool drainage have been connected to sewers. 9 SANITARY INSPECTION OF THE AREA Report of the Chief Sanitary Inspector under Article 27 of the Sanitary Officers (Outside London) Regulations 1935/1951 (Pages 10 to 31) RECORDOF INSPECTIONS MADE AND NOTICES SERVED Visits Special inspections. Interviews and advisory visits 1,437 Relnspectlon visits 3y 117 Visits to works in progress 551 " Factorles/Workplaces 467 " Bakehouses 30 " Outworkers premises 124 " Butchers/Grocers/Greengrocers/Flshmongers etc. 702 " Dairies/Milk Purveyors 61 " Ice Cream Premises (Manufacture and sale of) 216 " Stables/Passages/Piggeries and Ditches 43 " Restaurant/Cafe Kitchens, Dining Rooms etc 104 " School/Indus trial Canteen Kitchens 38 " Premises in connection with rodent control 6,338 " Tents/Vans/Sheds 10 " Clnemas/Theatres/Halls 19 " Hairdressers and Barbers Premises 69 " School and Public Conveniences 63 " Verminous Premises 9 " Slops under the Shops Act 491 " Licenced Public Houses 24 " Hospitals - spraying of kitchens 9 Visits re Infectious Diseases 133 " Fbod Poisoning Enquiries 9 " " Ccmplaints (request inspections) 134 " Overcrowding and permitted numbers 188 " Food and Drugs Act sampling 366 " Sampling of milk and water (bacteriological) 109 " " " ice cream (bacteriological) 310 " Merchandise Marks Act 356 " Rag Flock Act 8 " Pet Animals Act 4 " Heating Appliances (Flregiard) Regulations 15 " Atmospheric Pollution Gauges/anoke observations 68 Miscellaneous visits 1,641 Total 17,263 Number of complaints received and Investigated 534 Premises at Which defects or nuisances were discovered lt 173 Dwelllng-houses surveyed for housing defects under the Public Health or Housing Acts 196 Number of defects or nuisances discovered 1,801 " " " remedied 1,498 " " "in hand 127 " " " outstanding 176 Number of Informal notices served 770 10 STATUTORY NOTICES WERE SERVED AS UNDER Housing Act 1936 Sections 9 and 10 (as amended by the Housing Act 1949) 21 Public Health Act 1936, Section 24 12 " " " 39 3 " " " 45 3 " " " 75 9 Sutton and Gheam Corporation Act, Section 42 1 Ttotal 49 SUMMARY OF REMEDIAL WORKS AND SANITARY IMPROVEMENTS CARRIED OUT Drainage and Sanitary Fittings Number of houses and other premises redralned 15 Number of houses and other premises connected to soil and surface water sewers 1 Repairs and amendments to existing drains 33 Drains or gullies unstopped or cleansed (Involving 824 premises) 298 Sanitary fittings repaired/renewed provided or cleansed 288 Water service plpes/cistems/repalred/renewed or cleansed 4 water, smoke and chemical tests applied 79 Co Apartments W, C. Apartments provided 14 " llgited and/or ventilated 2 provided with ventilated lobbies 1 " cleansed 35 Separate W. C. accommodation provided for the sexes 1 Structural Repairs or Improvements Carried Out: Number of roofs repaired or renewed 98 " guttering and rainwater pipes provided/repaired, etc. 50 " damp walls remedied 59 " brick walls repolnted/repalred or re-rendered 48 " chimney stacks repaired or rebuilt 13 " yards paved or repaired 16 " floors relald or repaired 46 " wlndows/cllls/sashcords repaired or renewed 224 " doors/thresholds provided or repaired 37 " staircases/handrails provided or repaired 7 " ranges/stoves/coppers renewed or repaired 35 " Flood cupboards provided/ventilated 5 CIeansing: Number of rooms/passages/larders cleansed and/or repaired 158 " trade premises cleansed 54 " verminous premises dlsinfested for bugs/fleas 14 " premises sprayed for cockroaches/crickets/wood beetles etc. 34 " premises disinfected after various diseases 119 " School Canteens/Kitchens sprayed for flies and ants 10 " Hospital kitchens sprayed 7 Various Number of dustbins provided 40 " accumulations of refuse and manure removed 26 " offensive ponds and ditches cleared 1 " wasp nests destroyed 126 " miscellaneous items 20 11 HOUSING Inspection of Dwelling-Houses during the Year; (1) (a) Total number of dwelling-houses inspected under the Public Health or Housing Acts 196 (b) Number of inspections made for the purpose 379 (2, Number of dwelling houses found not to be in all respects reasonably fit for human habitation 54 2 Remedy of Defects during the year without service of Formal Notices Number of defective dwelling-houses rendered fit in consequence of Informal action by the Local Authority or their officers 75 (including 29 for 1954) 3 Action under Statutory Powers during the Year (A) Proceedings under Sections 9. 10 and 16 of the Housing Acts 1936-1949:- (1) Number of dwelling-houses in respect of which notices were served requiring repairs 21 (2) Number of dwelling-houses which were rendered fit after service of formal notices:- (a) By Owners 10 (b) By Local Authority in default of owners 2 (B) Proceedings under the public Health Acts:- (1) Number of dwelling-houses in respect of which Notices were served requiring defects to be remedied 6 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:- (a) By Owners 5 (b) By Local Authority in default of owners 1 (C) Proceedings under Sections 11 and 13 of the Housing Act 1936:- (1) Number of houses demolished as the result of formal action by the Local Authority 1 HOUSING REPAIRS AND RENTS ACT. 1954 Four Certificates of Disrepair were issued during 1955 and two were revoked. 12 INSPECTION OF FACTORIES AND OTHER PREMISES Factories Act 1937-1948 1. Inspections made by sanitary inspectors for the purpose of provisions as to health:- Type of Premises Number on Register Number of Inspections Notices, written and/or oral (1) Factories without mechanical power 55 60 12 (2) Factories with mechanical power 322 348 44 (3) Other premises (excluding outworkers premises) 46 59 13 Total 423 467 69 2 Defects found in Factories and Other Premises under the Act:- Particulars Number of cases in which defects were found Referred Found Remedied To h.m. Inspector by h.m. Inspector Want of cleanliness 33 30 - 11 Overcrowding - - - - Unreasonable Temperature - - - - Inadequate Ventilation 1 1 - - Ineffective drainage of floor 1 1 - - Sanitary Conveniences (a) insufficient 8 7 - 1 (b) unsuitable or defective 10 8 - 1 (c) Not separate for the sexeis 2 2 - 2 Other offences against the Act (not Including offences relating to outwork) 16 13 - 1 Total 71 62 - 16 WORKPLACES - Public Health Act, 1936 Inspections Number of Written and Verbal Notices Occupiers prosecuted 59 13 Nil SMOKE ABATEMENT The grit deposit gauges have been maintained in the North end of the Borough. The Sutton Works of the South Eastern Gas Board ceased to make gas on the 30th September 1955. It is yet too early to determine the resultant effect on grit deposit in the vicinity of the Works. No instances of black smoke from the few industrial chlmnles have been observed. 13 INSPECTION AND SUPERVISION OF FOOD Food and Drugs Acts> 1938 to 1954 Sampling. During the year two hundred and twenty seven samples (comprising fifty eight formal and one hundred and sixty nine informal samples) were submitted to the public Analyst for analysis. Type of Food sampled Number of samples examined Unsatisfactory samples Formal informal Total Formal informal Total Almonds - ground 1 2 3 - - - " - nib - 1 1 - - - Apricot Juice - 1 1 - - - Beans and pork, sausages - 1 1 - - - Bicarbonate of Soda - 2 2 - - - Boraclc Powder - 1 1 - - - Broth - chicken - 1 1 - 1 1 Butter 3 1 4 - - - Cake Mix - 1 1 - - - Camphorated Oil - 1 1 - - - Castor Oil - 1 1 - - - Champagne perry - 1 1 - - - Cheese and Macaroni - 1 1 - 1 1 " Spread - - 3 - 1 1 Chicken Jelly - 1 1 - - - Cochineal - 1 1 - - - Coconut - 1 1 - - - Coffee and Chicory - 1 1 - - - " " " Essence - 1 1 - - - " " " Extract - 1 1 - - - Condensed Milk - 1 1 - - - Confectionery - Sugar - 13 13 - - - Cooking Fat - 1 1 - - - Cordial 2 - 7 - - - Crab - dressed - 1 1 - - - Cream - - 5 - 1 1 " of Tartar - 1 1 - - - Custard Powder - - 2 - - - Flan Sponge Mixture - 1 1 - - - Flavouring - - 3 - - - Frankfurts Cocktail - 1 1 - - - F1our - - 2 - - - Gelatine - 1 1 - - - Ginger - 1 1 - - - Grapefruit Segnents - 1 1 - - - Gravy Powder - 2 2 - - - Honey - 3 3 - - - Ice Cream - 9 9 - 1 1 Jam - 3 3 - - - Jelly Creams - 1 1 - - - Ketchup Tomato - 1 1 - - - Lard 4 2 6 - - - Lemonade Crystals - 2 2 - - ~ Lemon Curd - 1 1 - - - „ Juice - 2 2 - - - Lollle - Ice - 3 3 - - - Luncheon Meat - 2 2 - - - Margarine - 5 5 - - - Marmalade - 1 1 - - - " - diabetic - 1 1 - - - Carried forward 10 101 111 - 5 5 14 Type of Food sampled Number of samples examined Unsatisfactory samples Formal Informal Total Formal. informal. Total Brought forward 10 101 111 - 5 5 Marzipan 1 - 1 - - - Mayonalse - 1 1 - - - Meringue Mixture - 1 1 - - - Milk 33 6 39 - - - " (Channel Island) 6 1 7 - - - " (South Devon) 4 - 4 - - - " Drink - 1 1 - - - Mincemeat 1 1 2 - - - Mint Sauce - - 2 - - - " Concentrate - 1 1 - 1 1 Monosodlum Glutonate - 1 1 - - - Mustard - 1 1 - - - Non Brewed Condiment - 1 1 - - - Nutmeg - 1 1 - - - Olive Oil - 1 1 - - - Onion Salt - 1 1 - - - Orange Drink - 1 1 - - - " Juice - 1 1 - - - Paste - - - - - - Pears in Syrup - 1 1 - - - Peas - processed - 1 1 - - - Pepper - white - - - - - - Pies - steak - 1 1 - - - Plasmal - 1 1 - - - popcorn - 1 1 - - - Pudding - Instant - 1 1 - - - „ Mix - 1 1 - - - „ Powder - 1 1 - - - Rennet - essence of - 1 1 - - - Rhubarb Tincture of - 1 1 - - - Rice ground - 1 1 - - - Salad Cream - 1 1 - - - Sardines - 1 1 - - - Sauce - Tomato - 2 2 - - - Sausage - Beef 1 2 3 - - - „ Pork 2 - 2 1 - 1 „ smoked - 1 1 - - - Savoury Ducks - 1 1 - - - „ Spread - 1 1 - - - Seasoning - - - - 1 1 Soups - - - - - - Steak - pudding - 1 1 - - - Suet - Beef - 1 1 - - - " - Flaked - Beef - 1 1 - 1 1 " - Shredded - Beef - 1 1 - 1 1 " shredded - 1 1 - - - Sultanas - 1 1 - 1 1 Tea - 1 1 - - - Tomato Paste - 1 1 - - - " Salad Dressing - 1 1 - 1 1 Vermicelli - chocolate - 1 1 - - - Vinegar - 1 1 - - - " - white wine - 1 1 - 1 1 Vitamin Tablets - 1 1 - - - Welsh Rarebit - 1 1 - - - TOTALS 58 169 227 1 12 13 15 The following details classify the type of irregularity or infringement, and the action taken in connection with thirteen unsatisfactory samples. Sample no. Article Sampled Infringement Action Taken a909 (Formal) Pork Sausage. This sample was purchased as pork sausage, but analysis revealed it to be a sample of preserved pork sausage. It would appear that the butcher had used a proprietary seasoning as a constituent ingredient in the manufacture of the sausages, but had unwittingly failed to observe a printed slip on the container stating that the seasoning contained preservative. This would account for the verbal declaration made at the time of purchase that the sausages did not contain preservative. The seasoning contained Sulphur Dioxide. (For further particulars see under Sample no. 2101). 1967 (Informal) Flaked Beef Suet. This article contained 81.6% by weight of beef suet, whereas the Food Standards (Suet) Order 1952 requires that shredded or flaked suet shall contain not less than 83% by weight of beef fat. The manufacturers assert that although a quantity of flour is added to give not less than 85% fat, it is always possible for some slight segregation to occur during packing, and every known precaution is being taken by them to minimise the segregation. 1975 (informal) Cheese and Macaroni Labelling Infringement This article was described on the container as cheese and macaroni, whereas the actual ingredients weremacaronl and a compound preparation of cheese containing only 50% of cheese. Upon representation the manufacturers issued instructions for the immediate withdrawal from sale of all the remaining stocks in this area. This desirable action was no doubt influenced by the fact that the firm had recently been involved in a prosecution at a West Country Court for a similar type of offence. 1977 (informal) Shredded Beef Suet This sample contained 81.9% of beef fat instead of not less than 83% as required by the Food Standards (Suet) order 1952 Hie manufacturers explained that the slight deficiency of fat would be due to the difficulty of securing the uniform distribution of the flour among and upon the shreds and further that they increased the fat standard by 2% to allow for this. 16 Sample No. Article Sampled infringement Action Taken 1982 (Informal) Chicken Broth Concentrated The broth prepared according to the printed instructions would only contain 0.6% of protein, whereas canned chicken broth of ordinary commercial quality intended for use without dilution contains not less than 1% of protein. The article was therefore deficient in protein to the extent Of 40% investigation revealed that the broth which was of Danish manufacture had been in stock for over four years. The remainder of the stock which consisted of four tins was immediately withdrawn from sale, 1984 (Informal) White Wine Vinegar This article was underacetlfled with the result that the acetic acid content was low and the alcohol content abnormally high. (Acetic acid 3.5% W/V and Alcohol 6.5% W/V). Wine Vinegar of ordinary commercial quality contains between 5 and e% W/V of acetic acid. A firm of Wine Merchants imported a good quality French Sauterne Wine for bottling The wine fermented and therefore became unsaleable as wine. The liquid was allowed to "mother" and tum naturally into white wine, and bottled in the usual manner through a filter. The Wine Merchants regretted the incident and declared that this was the only occasion over many years of trading in wines that fermented stocks of this kind had been sold by them as White wine Vinegar. The few remaining bottles were withdrawn from sale. 2007 (Informal) Cheese Spread Article contaminated by Mould growth. The chgese was wrapped in metai foil, but mould growths had developed at both ends of the block. it would appear that this was an isolated case as the remainder of the stock was found to be in satisfactory condition. 2019 (Informal) Cornish Clotted Cream. Labelling Infringement, This article had neither the appearance, the taste, nor the texture of genuine clotted cream, It consisted of a thick sterilised cream and had not been prepared by the traditional methods of scalding, cooling and skimming. The sample contained 53.7% milk fat and 3.8% milk solids other than fat. The investigation into this case created lengthy correspondence on account of the many parties involved and varied points at issue. Agreement was eventually reached as to the type and wording to be incorporated in the declaration which would be suitable and acceptable for the new labels to be printed. 17 Sample NO, Article Sampled Infringement Action Taken 2040 (Informalj Mint Concentrate Labelling Infringement. Contravention of the Labelling of Food Order 1953 by not having the ingredients specified in the correct manner on the label. The Manufacturers agreed to have new labels printed which would conform to the requirements of the Labelling of Pood Order 1953. 2067 (Informal) ice Cream The sample contained 4.5% of fat instead of a minimum of 5% The Manufacturer was dulywarned and a repeat sample taken was found to conform to the requirements of the Food Standards (Ice Cream) order 1953. 2072 (Informal) Tomato Salad Dressing. This article was stale, rancid and contaminated with iron dissolved from the metal cap. This product had been in stock for many years and had deteriorated to such an extent that it was no longer fit for human consumption. The nine remaining bottles were withdrawn from sale. 2101 (Informal) Combined Seasoning and Preservative. Labelling Infringement. This article was recommended as a preservative for food and should have been sold labelled in accordance with the Public Health Preservatives in Food Regulations 19251953. This seasoning is the constituent ingredient mentioned in connection with the observations made on Pork Sausage sample No.- A909. The manufacturers disclosed that they were also in correspondence with another Authority in connection with a similar type of infringement. It has been agreed that the firm will endeavour to obtain Ministerial approval to a proposed amended type of label which will satisfy all concerned. 2116 (Informal) Sultanas Labelling Infringement The label on the container made a general claim as to the presence of vitamins. Sultanas do not contain significant proportions of vitamins. The claim was not only misleading, but the proportions of vitamins (11 any) were not specified quantitatively in the nanner prescribed by the Labelling of Food Drder 1953 This article is a prepacked Turkish product and sold in the same condition as received from the suppliers. The Ministry of Agriculture Fisheries and Pood have requested the Turkish Commercial Counsellor to advise the packers to amend the label for the food in question in order to comply with the labelling laws of this Country, in the meantime the retailers have arranged to sell the sultanas in packets after removal from the original cartons 18 Sampling Observations. It will be seen from the detailed classification that of the two hundred and twenty seven samples taken during the year, 3.52% were found to be other than genuine and other irregularities accounted for a further 2.2% making a total of 5.72%. Ftor comparative purposes the figures for 1954 were 2.89% and l.44% respectively with a total of 4 33%. Having regard to the wide variety of articles sampled it is gratifying to record that in no instance was it necessary to institute proceedings in order to obtain compliance with the requirements of the various relevant Acts, Regulations and Orders. Comments by the Public Analyst.(Food and Drugs Act 1938, and Relevant Regulations and Orders) The year 1955 marks the end of a distinct era in the working of the ftiod and Drugs Acts. World War 11 was upon us before the 1938 Act could be operated normally and much war -time and post-war legislation tended to mask the fundamental virtues of this Act. based as it was on traditional British outlook. The new Act of 1955, which came into force on January 1st, 1956, carries on these traditions, but, at the same time provides for more vigorous control of the numerous chemical substances now being added to food. it also incorporates the best of the war-time regulations. it will be interesting to see how the new Act works by the time these notes are written in a year's time. The samples taken in 1955 have, as usual, covered a wide field and the contraventions of the Act and Regulations are noted in detail elsewhere. The following remarks are based on my general experience although arising from the analysis of some of these samples. Vitamins. The vitamin has become fully established as a panacea for all ills and the number of different preparations on the market have increased considerably during 1955. The standard for the added vitamin content of margarine is now subject to careful control by public analysts up and down the country and margarines of British manufacture are nearly always found to conform to standard. Occasional samples of foreign origin were at first deficient in vltamln, but are now generally satisfactory. Sundry claims as to the presence of vitamins in food are controlled by the Labelling of Food Order, but the making of false claims, either intentional or through ignorance, is not uncommon as, for example, in the case of the pre-packed sultanas (No.2116). Sultanas are an excellent concentrated food, but their vitamin content is negligible. Pre-packed foods of the fancy class are becoming more common and are not an infrequent cause for complaint, This year the outstanding sample in this class was the Cornish Clotted Cream (No.2019) which proved to be Cornish only in origin and not in 19 characteristics, unfortunately this traditional delicacy, as also Devonshire Cream, is fast becoming unrecognisable! Another example of this class was the White Wine Vinegar No. 1984. A number of wine merchants have found that by accumulating wine residues from casks and allowing them to ferment an article is produced which simulates vinegar. it is usually found however that the acetic acid content is low and that there is a high residual alcohol content, neither of which are characteristics of genuine wine vinegar. The standard of quality of pork sausages has been maintained at a satisfactory level although intensive efforts have been made in some parts of the country to undermine the good work of the public analysts. It is to be hoped that a legal standard of adequate quality will be prescribed in 1956. Another common article of food is due for a revised standard. The minimum limit of 5% of fat in ice cream is one which is normally exceeded in practice by nearly 100 per cent. although one sample taken in the Borough this year did fall slightly below the minimum. A minimum of 8 per cent at least would appear to be practicable, but consideration must also be given to re-establishing ice-cream as a genuine dairy product made with milk and cream, or butter, instead of with skimmed milk and vegetable fats as is the common practice to-day. It is understood that the Food Standards Committee of the Ministry of Agriculture, Fisheries and Food are exploring these possibilities. MILK SUPPLY Food and Drugs Acts 1938 to 1954 Milk and Dairies Regulations 1949-1953 The Milk Special Designation) ( RauMilk) Regulations 1949 to 1954 The Milk 'Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949-1953 Routine inspection of milk pasteuriser s and purveyor s premises reveals that the provisions of the various Regulations are generally well observed. The following licences to sell graded milks in the Borough were granted in 1955:- Grade of Milk TYPE OF LICENCE Dealers Supplementary Pasteuriser's Tuberculin Tested 10 11 - " " (Pasteurised) 8 1 - Pasteurised 19 11 1 Sterilised 35 12 - TOTALS 72 35 1 20 Examination of Milk Samples. One hundred and sixteen samples of milk were examined as follows:- Class of Milk Number of samples examined Test applied Results Passed Failed Pasteurised 66 phosphatase 66 - Methylene Blue 66 Sterilised 9 Turbidity 9 - Tuberculin Tested (Pasteurised) 19 Phosphatase 19 - Methylene Blue 19 - Tuberculin Tested (Farm Bottled) 22 Methylene Blue 17 5 Totals 116 111 5 To comply with the Milk (Special Designation) (Raw Milk) Regulations 1949-1954 Tuberculin Tested Milk must not decolourise Methylene Blue within 4½ hours if the sample is taken from 1st May to 31st October, or within 5½ hours if taken from 1st November to 30th April. Of the one hundred and sixteen samples taken for bacteriological examination only five failed to pass the prescribed tests. Three of these samples were taken during the 4½ hours test period and decolourised methylene blue in 3, 3½ and 4½ hours respectively. The other two samples taken during the 5½ hour period failed the test by a narrow margin. In the case of farm bottled milk it is the practice immediately to notify any failures to the dairy company, so that the matter may be taken up with the responsible producers as quickly as possible. CHEMICAL ANALYSIS OF MILK AND CREAM SAMPLES Forty three formal, seven informal milk samples and five informal cream samples were taken for chemical analysis. The milk samples contained satisfactory averages of 3.7 per cent milk fat and 8.8 per cent of milk solids other than fat. These results are above the minimum standard of 3 per cent milk fat and 8.5 per cent milk solids other than fat laid down in the sale of Milk Regulations. Of the five informal cream samples submitted to chemical analysis, four were satisfactory and one (Sample No. 2019) Cornish Clotted Creamy was found not to be prepared by the traditional methods of scalding, cooling and skimming. BIOLOGICAL MILK SAMPLES (FARM BOTTLED MILK) Seven samples of Tuberculin Tested Milk were taken for biological examination with negative results. 21 ICE CREAM Ice Cream (Heat Treatment etc.) Regulations 1947-1952 Registrations. At the end of 1955 a total of one hundred and elgity one premises had been registered for the sale of ice cream in accordance with Section 14 of the Food and Drugs Act 1938 and on five of these premises ice cream could be manufactured. At the present time a small amount is made at two of the premises. During the year ten applications for the registration of premises for the sale of ice cream were received and granted. BACTERIOLOGICAL SAMPLiNG OF ICE CREAM During the year eighty six informal and eighteen repeat samples of ice cream were taken for bacteriological examination and provisional grading. The repeat samples were due to a special investigation of plant which had been giving unsatisfactory results. The following table shows the 1955 percentage results, and for comparative purposes the results obtained in 1954. 1955 Grading of samples 1954 Grading of samples Grade 1-68 samples - 79.06% Grade 1-81 samples - 76.41% " 2-7 " - 8.13% "2-12 " - 11.32% " 3-7 „ - 8 . 13% "3-8 „ - 7.54% " 4-4 " -4.65% "4-5 " - 4.71% The following table shows the average percentages and other details in connection with the samples obtained from individual manufacturers:- Code Number of samples taken Number of samples sold Average Percentage in each Grade Wrapped Loose Grade 1 Grade 2 Grade 3 Grade 4 A X 8 - 8 50.00% 12.5% 12.5% 25.00% B X 1 1 - 100.00% - - - C 13 11 2 100.00% - - - D 18 14 4 88.88% 5.55% 5.55% - E 23 13 10 78.26% 8.69% 8.69% 4.34% F 2 - 2 100.00% - - - G 2 2 - 50.00% 50.00% - - H 4 1 3 75.00% - - 25.00% I 2 2 - 50.00% - 50.00% - J 4 4 - 75.00% - 25.00% - K 1 1 - - 100.00% - - L 5 4 1 ioo,oo% - - - M 2 2 - 50,00% - 50.00% - N 1 - 1 - 100.00% - - TOTALS 86 55 31 79 o06% 8. 13% 8. 13% 4.65% X Denotes locally produced. 22 CHEMICAL SAMPLING OF ICE CREAM The Food Standards (Ice Cream) Order 1953 prescribes (with certain exceptions) the following standard for Ice cream:Fat 5%. Sugar 10% and milk solids other than fat 7½%. The following table shows that nine samples were submitted to the public analyst for chemical examination. The results reveal that the average constituent percentages are well above the required standard. Producers Code Number of Samples Constituent Percentages Fat Milk solids other than fat Sucrose Total Sugars A X 2 9.05% 10.7% 10.9% 12.6% B 1 7.6% 7.7% 15.6% 20.0% C 1 8.0% 12.4% 14.7% 18.2% D 1 12.0% 15.0% 15.9% 15.9% E 1 11.2% 9.0% 13.0% 17.0% F 3 5,2% 10.7% 13.5% 14.9% 9 8.05% 10.7% 13.5% 15.7% X Denotes locally produced. ICE LOLLIES BACTERIOLOGICAL AND CHEMICAL EXAMINATION l Bacteriological. The Pood Standards (Ice Cream) Orders do not prescribe a standard for water Ices or Ice lollies sold as such. In view of the absence of a prescribed standard and the Increasing public demand for lollies, It was decided as In former years to submit samples of lollies to a bacteriological test similar to the one applied to Ice cream. Fifteen samples of lollies were examined and all passed the provisional grading test 2. Chemical Three samples were submitted to a chemical test In order to ascertain the effect of the use of certain types of moulds used In the manufacture of lollies. No evidence was found of harmful Impurities arising from the use of the moulds. MEAT AND OTHER FOODS Food Shops- The fifty-five butchers shops (Including two horseflesh shops) within the Borough have been inspected and observation kept upon the vehicles used for the conveyance of meat and offal, In general the provisions of the Public Health (Meat) Regulations have been well observed. 23 Remedial action was taken in twelve cases where the sanitary conditions were not satisfactory, or certain contraventions of and Regulations existed. Forty-eight butchers premises are registered in accordance with Section 14 of the Food and Drugs Act 1938 mainly for the manufacture of sausages. A further ten food premises are registered in connection with the preparation of potted, pressed, pickled or preserved foods. Eighty-five cases of insanitary or defective conditions found to exist in food premises other than butchers shops were remedied. The following table shows the number and type of food premises in the Borough and the number of primary Inspections made. Type of Food Premises Number Primary Inspections Bakehouses 17 35 Butchers (Including two horseflesh shops) 55 119 Canteens, Schools/industrial 24 38 Confectioners (Sugar and flour) 150 171 Dairies and Milk Distributors 36 51 Dining Rooms/Snack Bars/Coffee Stalls 7 14 Fishmongers/Fried Fish 35 43 General shops and multiple stores 31 32 Grocers 131 157 Greengrocers/Stalls 90 175 Ice Cream (Manufacture and Sale of) 181 216 Licenced public houses 36 24 Restaurants/Cafes 65 90 Totals 858 1,165 The following table shows the number and type of food premises registered under the Food and Drugs Act 1936-1954 and relevant Regulations. A. Number of premises registered for the preparation or manufacture of preserved foods. B. Number of premises registered for the heat treatment of milk and/or as distributors of milk. C. Number of premises registered for the manufacture sale and/or storage of ice cream, Premises A B C By Type Preserved Foods Milk Ice Cream Butchers 48 - - Cafes/Dining Rooms etc. - - 39 Confectioners - Sugar and Flour - - 91 Dairies - 1 - Fruiterers and Greengrocers 1 - 5 General shops/multiple stores - 4 10 Grocers 9 27 31 Ice Cream Manufacturers — - 5 Milk Depots - 4 - 58 36 181 24 CIean Food Byelaws Food and Drugs Act, 1938 Section 15 The Byelaws for securing the observance of sanitary and cleanly conditions and practises in connection with the handling, wrapping and delivery of food sold or intended for sale for human consumption and in connection with the sale or exposure for sale in the open air of food intended for human consumption have been in operation since July 1950. It is gratifying to record that only three complaints were received during the year in connection with the handling, wrapping and delivery of food. UNSOUND FOOD The following diseased and/or unsound meat and other foods have been surrendered and destroyed or. where suitable, utilised for pig food. Type of food condemned lbs Tins Bottles or Jars Packets or Numbers Beans/Peas/Baked Beans 14 100 - - Beef (Imported) 357 - - - "/Mutton (Home Killed) 150½ - - - Cheese 54 - - - Confectionery (Caramels) 112 - - - Culinary Mixtures/Custard - 1 - 5 Dried Fruit/Peel 90 2 - - Dripping - 2 - - Fish Paste - 1 11 - " (Tinned) - 96 - - " (Wet and Dry) 221 - - - Flour (Pea) 112 - - - Fruit Juices/Puree - 54 1 4 " /Vegetables - 393 8 - Ham 26* 7 - - Jam/Marmalade/Syrup - 44 3 - Kidneys (Imported) 68 - - - Lamb (Home Killed) 38½ - - - Liver 46 - - - Macaroni/Rice - 2 - - Milk/Cream (Tinned) - 199 - - Pearl Barley 50 - - - Pork (Home Killed) 76 - - - Potatoes 101 - - - Salad Cream/Junket - 8 - - Sausages 13 - - - Soups/Pickles/Sauces - 119 8 - Spaghetti - 5 - - Spreads - 10 6 - Sugar - - - 2 Tinned Meats 38½ 64 - - Tongue 18½ - - - Totals 1,586½ 1,107 37 11 25 SLAUGHTERING OF ANIMALS FOR HUMAN CONSUMPTION No animals were slaughtered within the Borough during the year. SLAUGHTER OF ANIMALS ACT, 1933 One licence to act as slaughterman was granted in 1955. BAKEHOUSES There are seventeen bakehouses in the Borough, all of which are provided with mechanical power. The standard of cleanliness and the sanitary conditions in the majority of cases were found to be satisfactory. Thirty five primary visits of Inspection made during the year resulted in seven infringements being discovered and rectified. SHOPS ACT Four hundred and ninety-one visits were made to various premises under the Shops Act and revealed that the arrangements made for the health and comfort of the shop workers were in the majority of cases satisfactory. SCHOOLS The sanitary conditions and the water supply to the Schools in the area are generally satisfactory. HAIRDRESSERS' AND BARBERS' PREMISES The sixty-six establishments in the Borough were inspected during the year, The general standard prevailing is good, as instanced by the discovery of only eight minor infringements of the Hairdressers and Barbers Byelaws 1947. MERCHANDISE MARKS ACT Three hundred and fifty six visits were made to food premises under this Act. The infringements discovered were principally in connection with the marking of imported apples, tomatoes and imported dead poultry. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 The intention of the Act is to secure the use of clean filling materials in upholstered articles, and other articles which are stuffed or lined. 26 The Act provides for the registration of certain premises by the Local Authority on payment of a registration fee and the licensing of certain other premises on payment of a statutory fee. Two applications for renewal licences to store rag flock, were received and granted in 1955. Eight primary visits of inspection were made during the year to the nine registered premises in the Borough. PET ANIMALS ACT, 1951 This Act came into operation on 1st April 1952 and provides that no person shall keep a pet shop except under the authority of a licence granted by the Local Authority in accordance with the provisions of the Act and on payment of a fee not exceeding ten shillings. Eight licence renewal applications were received and granted during 1955 LICENCED PLACES OF PUBLIC ENTERTAINMENT There are twenty-two licenced places of public entertainment in the Borough. They are used mainly for cinematograph shows, concerts, dancing and social functions. Two minor defects were found and rectified. The general standard of cleanliness was good. LICENCED PUBLIC HOUSES Twenty-four visits of inspection were made to the licenced public houses in the Borough. It is pleasing to record that, originating from the general survey of public houses carried out in 1951, further substantial and varied improvements are being carried out in the form of reconstructional work, the provision of additional sanitary conveniences, baths, washbasins, hot water supply and also the more general use of detergents and sterilising agents for the washing of utensils, glasses, beer pipe lines and pumps. HEATING APPLIANCES (FIREGUARDS/ ACT 1952 The Heating Appliances (Fireguards) Regulations 1953 made under the above Act, came into operation in October 1953. The Regulations apply to any heating appliance - gas fire, electric fire, or oil burner - of a type which is so designed that it is suitable for use in a dwelling house or other residential premises. 27 The Regulations require that every appliance shall be fitted with a guard which is robustly made and of such construction and fitting that it satisfies the prescribed tests. Fifteen visits were made during the year to premises which sold heating appliances. This involved the carrying out of numerous tests on the many types and designs of heaters offered for sale. No infringement of the Act was discovered. DISINFECTION AND DISINFESTATION Council Private Other Houses Houses Premises Number of houses treated with insecticide for bugs and fleas 3 11 5 Ten school canteen kitchens and seven hospital kitchens were sprayed for files, ants, moths and cockroaches. The insecticides used were pybuthrin, Dieldrex, D. D. T., Municipal Spray and Gammaxane Liquid Spray. RODENT CONTROL The Prevention of Damage by Pest Act. 1919 A - Surface Treatment (1) Five thousand six hundred and twenty three visits were made during the year by the Rodent Operators and seven hundred and fifteen by the Sanitary inspectors to premises infested or possibly harbouring rats or mice. Five hundred and fourteen premises were cleared of rats or mice, and no major infestations were recorded. (2) The work for the year is generally summarised as under;- Complaints received or cases discovered and investigated 527 Number of premises found to be infested 488 " " " where no evidence of rodents found 39 " " " cleared of rats or mice (including 97 previous year's cases) 514 " " " still being treated at the year end 72 28 (3/ The cause or site of Infestation at the four hundred and eighty eight Infested premises was:- Keeping of poultry 41 Inside premises (under floors etc.) - rats 20 " " " " " mice 56 Buries, scrapes etc. in gardens, land etc. 201 Under or inside sheds 174 Defective drains 3 Accumulations of refuse etc. 1 Source untraced 1 Total 497 (4)Type of premises found to be infested:- With Rats With Mice Total Council property 13 2 15 Dwelllinghouses 389 11 400 Business premises etc. 25 30 55 Schools, Hospitals, Canteens etc. 4 11 15 Land 3 - 3 Total 434 54 488 (5) Summary of the type of premises and methods employed In clearing premises of rats and mice:- Type of Premises cleared Dwellinghouses (mainly in gardens) 434 Food shops and food premises 37 Non-food shops 9 Waste land 4 Hospitals and Schools 4 Factories and Workplaces 8 Council Premises 12 Miscellaneous 6 Total 514 (6) Methods employed in clearing five hundred and fourteen premises of rats and mice- Warfarin and poison Baits 511 Trapping 4 Gassing 14 Rat and Mouse Proofing 3 Drains repaired 3 Total 535 29 B - Sewer Treatments (1) Treatment No^ 18 - Second Maintenance Treatment (1954-1955) The second maintenance treatment of soil sewer-manholes in areas known to be infested from the previous treatment and those sections found to be infested during the annual 10% test baiting (1954-55; was completed on the 23rd March, 1955. Prebaiting with damped sausage rusks was carried out on two consecutive days and the same bait base with 2½% Zinc Phosphide added was laid on the third day with the following results: - SECTIONS Total A B C D E Number of Manholes prebaited 46 Not baited 49 65 42 202 Complete prebait takes - 5 6 1 12 Partial prebait takes 5 8 12 3 28 Percentage of takes (C . and P.) 10.8 26.5 27.7 9.5 19.8 Number of manholes poison baited 6 23 27 7 63 The number of prebait takes show a slight decrease of 4.4% on the previous maintenance treatment. (2) Test Baiting (1935-561 The Borough was divided into five sections, as in previous tests, and a test baiting of 10% of the soil-sewer manholes in areas previously cleared or thought not to be infested was carried out during the month of August. The following is a tabulated summary of the results:- SECTIONS Total A B C D E Number of manholes baited 16 23 52 61 48 200 Complete bait takes 9 - 5 1 9 24 Partial bait takes - - - - 1 1 Baits not taken 7 23 47 60 38 175 Treatment No. 19 - First Maintenance Treatment 1955-56) This treatment was confined to the areas known to have been infested during the previous maintenance treatment together with sections proved to be infested by the annual 10% Test, and operations were completed on the 1st October, 1955. Prebaiting with damped sausage-rusks was carried out on two consecutive days and the same bait base with 2½% Zinc Phosphide added was laid on the third day. 30 (4) The following is a tabulated summary of the results achieved:- SECTIONS Total A B C D E Number of Manholes prebaited 68 79 105 88 340 Complete prebait takes 7 11 11 7 36 Partial prebalt takes 16 30 16 8 60 Percentage of takes (C. and P.) 33.8 39.2 25.7 17.0 28.2 Number of manholes poison baited 35 42 44 25 146 The number of pre-bait takes shew an increase of 8,4% on the previous maintenance treatment. N. B, It was not necessary to bait Section B since there were no prebait take during the 10% Test Baiting Treatment (5) KEY TO SECTIONS Section "A" - Sutton - All roads south of the Sutton Station and east of Brighton Road. Section "B" - Sutton and Cheam - All roads south of Mulgrave Road and Upper Mulgrave Road and west of Brighton Road. Section "C" - Sutton - All roads east of the Railway and north from Sutton Station. Section "D" - Cheam - All roads between London Road/Stonecot Hill and west of the Railway. Section "E" - Worcester Park. 31 INCIDENCE OF AND CONTROL OVER INFECTIOUS DISEASES One thousand two hundred and eighty eight cases of infectious diseases were notified during 1955-, an increase of eight hundred and sixty three cases. This increase is mainly due to a severe epidemic of Measles. The incidence of Poliomyelitis was high and Whooping Cough was more prevalent. There was a decrease in Scarlet Fever and Dysentery. Scarlet Fever Fifty nine cases were notified, a decrease of twenty three cases. The case rate was 0.75 per thousand of population, compared with 0.73 per thousand of population for England and Wales. The illness was generally mild. There was no death Diphtheria- No case was notified. The continuance of freedom from this serious Infection is dependent on a high standard of Immunisation being attained Diphtheria Antitoxin. It must not be forgotten that Diphtheria Antitoxin is life saving in cases of DiphtheriaAntitoxin should be given on suspicion of infection. Otherwise the suspected case should be admitted to hospital at once for observation and treatment. Penicillin will kill the Diphtheria bacillus but will not counteract toxin. Swabs for diagnosis must be taken before any antibiotic is given. Diphtheria Immunisation, It Is important that the public should not become preoccupied with immunisation against prevalent diseases and forget the need for protection against Diphtheria The local absence of cases can induce apathy. If we allow the immunity of the child population to decline Diphtheria can return as a serious menace Diphtheria Immunisation has had spectacular success in the reduction of incidence and mortality as is shown by the following figures for England and Wales, Year Cases Deaths 1948 3,575 156 1955 161 11 The greatest danger of mortality is in babies and in Infants under five years. All babies should be immunised at the fourth month of age. Infants should be reinforced before they enter nursery school or day school. School children should be reinforced at the age of eight years. A complete cooperative effort could eliminate the residue of cases and deaths. Immunisation is available to every child, free of charge, either through the family doctor or at the nearest Child Welfare Clinic. 32 During 1955 seven hundred and ninety three children were immunised and their ages at the date of immunisation were as follows:- Age Under 1 1 2 3 4 5-9 10-14 Over 15 Total Number 428 239 37 14 11 62 - 2 793 A survey at the end of 1955 of the state of immunisation of nine hundred and fifty nine babies born in 1954 showed that five hundred and forty six, representing 57 per cent, had been immunised. Of the children under five years of age, two thousand five hundred and ninety seven, representing 57 per cent. had been immunised. Of the school children of five to fourteen years of age, six thousand eight hundred and twenty eight, representing 61 per cent. had been immunised and sufficiently reinforced and two thousand three hundred and sixty three, representing 21 per cent, previously immunised required further reinforcement. During 1955 five hundred and eighty two reinforcing injections were given. Measles One thousand and thirty nine cases were notified. This compares with one hundred and seventy cases in 1954, The case rate was 13,21 per thousand of population, compared with 15.61 per thousand of population for England and Wales. There was one death of a weakly child aged seven years. The monthly incidence of cases is shown in the following table. January 24 July 78 February 99 August 16 March 211 September 3 April 298 October 3 May 115 November 7 June 161 December 24 After a period of quiescence for eight months, Measles increased in prevalence in January, rose to epidemic proportions in March and April and declined slowly during the Summer. The epidemic was severe and widespread. Four hundred and sixty four infants, including twenty babies under one year were affected. Measles is a debilitating illness and opens the way for secondary infection. Two children died of Broncho-Pneumonia subsequent to Measles. Occasionally a child may not react adequately to the virus infection. The young baby and the weakly child should be protected from acquiring infection in so far as this is possible. Gamma Globulin will prevent or modify the illness if injected early in the incubation period. A limited quantity of Gamma Globulin is available to medical practitioners for cases where there is special risk. Careful nursing and careful convalescence are essential. 33 whooping Cough One hundred and sixteen cases were notified in 1955, compared with eighty one cases in 1954. The case rate was 1.47 per thousand of population, compared with 1.78 per thousand of population for England and Wales, There was no death. The monthly incidence of notified cases is shown in the following table; January 10 July 20 February 16 August 3 March 13 September 6 April 13 October 2 May 15 November 4 June 14 December - Infection was prevalent from January to July and was widely distributed, Forty nine of the cases were infants. Ten were babies under one year. Whooping Cough is a serious infection in infancy. The risk of mortality is highest in the first three months of life and diminishes with age Every effort should be made to prevent babies from acquiring infection, Immunisation is protective to a majority of children and can be commenced at the age of four months. Infants should be immunised or reinforced before they enter nursery school or day school. In some children the illness is so modified by immunisation that recognition of infection is difficult. The whoop may be infrequent or absent. If there is any suspicion it is wise to isolate the child until the cough disappears. Immunisation Against Whooping Cough, Immunisation against Whooping Cough is available free of charge for children under five years of age, either through the family doctor or at Child Welfare Clinics. In 1955 six hundred and eighty six children received immunising injections The material used was H. Pertussis suspended vaccine (20.000 million bacilli per c.c.). Three injections of 1 c,c. are given at monthly intervals. The injections are given subcutaneously. Small Pox. No case was notified. Vaccination Against Small Pox. Small Pox appears suddenly and strikes quickly. The danger of the introduction of infection into this country has been increased by the speed of travel. There is no specific cure for the illness. We must be prepared to meet this danger Vaccination is the only effective protective measure Vaccination in infancy provides a basic immunity and reduces the risk of severe reaction to re-vaccination in later years. The safe period for the vaccination of babies is between three and six months of age. A service is available, free of charge, through medical practitioners and Child Welfare Clinics. 34 In 1955 four hundred and seventy eight babies under the age of one year were vaccinated.. The percentage of 53.5 compares with 54.3 in 1954 and 53.3 in 1953. The following table shows the number of vaccinations during 1955. Age Number Vaccinated Number Re-Vaccinated Under 1 478 - 1 34 2 2 7 2 3 4 2 4 1 4 5-9 10 9 10-14 15 9 Over 15 39 132 Totals 588 160 Puerperal Pyrexia Nineteen cases were notified in 1955, compared with fifteen in 1954. The revised definition of Puerperal Pyrexia in the Puerperal Pyrexia Regulations, 1951, made notifiable "any febrile condition occurring in a woman, in whom a temperature of 100.4° Fahrenheit (38° Centigrade) or more has occurred within fourteen days after child birth or miscarriage." The early notification of Puerperal Pyrexia is of primary importance in the prevention of maternal mortality. Medical practitioners should make the fullest use of the consultant, bacteriological and hospital services and ensure the effective isolation of any case of suspected infection occurring in a maternity or nursing home. Dysentery. Five cases were notified in 1955, compared with twenty four cases in 1954 The small number of notified cases is satisfactory but Sonne Dysentery is endemic and is very liable to become epidemic. The routine bacteriological examination of cases of obscure diarrhoea helps to reveal sources of infection and to establish control over infectious patients and contacts, some of whom may be involved in the handling of food. Dysentery spreads quickly from contamination of the hands. Objects are soiled by touch, Infection is passed from hand to hand. Food may be infected. Prevention lies in the washing of hands after' use of the W. C. Typhoid and Paratyphoid Fever, No case was notified, A woman, aged forty one years, a cook, was found to be a chronic carrier of Salmonella Paratyphosus B Type I, and was required by notice under the Public Health (Infectious Diseases) Regulations, 1953. to refrain from engaging in any occupation connected with the preparation and handling of food or drink for human consumption. An attempt to clear the infection by intensive treatment with penicillin and Benemid failed. The infection persists Compensation is being paid in accordance with the Regulations. 35 Food Poisoning Seven cases were notified in 1955, compared with ten cases in 1954. All were single cases. Three contracted infection outside the Borough. Five were due to Salmonella Typhi-murium, one to Staphylococcus and one to Clostridium Welchil. No. of Cases No. of Deaths Organism or Agent Food Involved 1 - C. Welchil Cold tongue. 1 - S. Typhi-murium Cold roast beef. 1 - Staphylococcus Cold ham. 1 - S. Typhi-murium Not ascertained 1 - " " " " 1 - " " " " 1 - " " Sausage roll Bacterial food poisoning is a constant menace. Meat foods are the most commonly involved because they form an excellent medium for bacterial growth when temperature conditions approximate to body heat (98.4c F.). To protect a cooked or partly cooked food from bacterial growth it must be kept sufficiently hot or sufficiently cold to inhibit reproduction. In terms of the Food Hygiene Regulations, 1955, the temperature should be either not less than 145° F. or below 50° F. Between lies the risk of bacterial growth. If cooked food is intended to be eaten cold quick cooling through this range of temperature is essential for safety. Mice are the original source of Salmonella Typhi-murium. They should be eliminated from every house. Some people are too complacent regarding their presence. Ducks eggs are a frequent source of Salmonella Typhimurium. It is dangerous to use them to prepare lightly cooked foods such as mayonnaise, custards, custard fillings and meringues. The degree of heat will not only fall to kill the organisms but will stimulate their growth. Ducks' eggs should be boiled for fifteen minutes. Cleanliness in the handling and preparation of food is our only sure protection against the human carrier, and of all the preventive measures, the washing of hands after the use of the W. C. is the most important. The requirements of the Food Hygiene Regulations, 1955, should be carefully studied by all who are responsible for the handling and preparation of food for sale to the public. These must be implemented and observed. Meningococcal Infections One case of Cerebro Spinal Meningitis was notified The patient, a woman aged 64 years, recovered. Cerebro Spinal Meningitis is a very serious illness. Early diagnosis and early treatment with Sulphonamide are necessary for the prevention of mortality. 36 Poliomyelitis Sixteen cases were notified In 1955, compared with two cases in 1954. Twelve were paralytic and four non-paralytic. Two cases occurred in an institution. Twelve were females and four were males. Of the twelve paralytic cases, five were severe, four were of moderate severity and three were relatively mild, A woman aged forty years and a boy aged nine years have residual paralysis affecting arms and legs. A man, aged forty-one years, who recovered from paralysis of the muscles of respiration after treatment in an iron lung, has paralysis of the left arm and weakness of the right. He has resumed light work. Three girls aged one, three and eighteen years, who had paralysis affecting both legs, are likely to become ambulant. Four girls aged one, three, four and six years have residual weakness of one leg. A girl of nine years, who is a spastic, and a boy aged one year have weakness of one arm. The distribution of the cases in age groups was as follows Age: 1 3 4 5 6 9 14 18 40 41 No. Of Cases: 321122 1 2 1 1 Of the cases, six were infants, six were school children and four were adults. Three of the school children attended different schools within the Borough. No secondary cases occurred in the schools. There was no evidence of direct contact between cases but some localisation occurred within wards. The ward distribution of cases was as follows; - Ward; N. N.W. N.E. W. C. E.C. E. S.W. S. E. S. No. of Cases,: 13 - 3 2-1 42 The residual disability which so often follows Paralytic Poliomyelitis Justifies the urgent efforts being made to produce and to apply a safe protective vaccine. Until a vaccine Is generally available it is necessary for people to recognise the possible significance of minor Indisposition during the season of prevalence of the Infection It Is known that varying degrees of reaction to infection occur. In one family three children recovered from mild febrile Illness and a fourth with similar symptoms developed paralysis of one leg... Rest in bed from the onset of symptoms can be protective. Over exertion and emotional fatigue predispose to paralysis, Pneumonia, Of thirty one deaths from Pneumonia, none was notified before death The total number of notified cases was twenty nine,, compared with thirty nine In 1954 Influenza was prevalent during January and February. Five cases of Influenzal Pneumonia were notified Eight deaths were due to Influenza. 37 Infestations, Four cases of Infestation by lice were treated at the clinic. No case of Scabies was treated. The number of attendances at the clinic for treatment was twelve. This compares with eleven cases of Scabies, eight cases with lice and fifty six attendances for treatment In 1954. Non-Notifiable Diseases. School teachers reported two hundred and thirty nine cases of Chicken pox, one hundred and sixteen cases of Mumps and seven cases of German Measles. School notifications are a useful Indication of the prevalence of nonnotlflable diseases and form a basis for consultation with the school medical officer. 38 NOTIFIABLE DISEASES (OTHER THAN TUBERCULOUS) DURING 1955 Disease Age in year TOTALS Removed to Hospital Died * Under 1 1 2 3 4 5 10 15 20 35 45 Over 65 Scarlet Fever - 1 1 7 8 35 5 1 1 - - - 59 19 - Diphtheria - - - - - - - - - - - - - - Smallpox - - - - - - - - - - - - - - Typhoid Fever - - - - - - - - - - - - - - - Paratyphoid Fever - - - - - - - - - - - - - - Puerperal Pyrexia - - - - - - - 1 16 2 - - 19 - - Pneumonia - - - 1 1 3 1 - - 4 11 3 24 7 31 Erysipelas - - - - - - - - - - 4 - 4 1 - Dysentery - - - - - - - - 2 - 1 1 4 1 - Poliomyelitis - 2 - 2 1 5 1 1 - 2 - - 14 14 - Cerebro Spinal Fever - - - - - - - - - - 1 - 1 1 - Measles 20 54 98 100 126 550 10 2 8 3 1 - 972 8 1 Whooping Cough 10 14 7 6 9 60 4 - - 1 2 - 113 5 - London Cases In the Downs Residential Nursery Pneumonia 2 3 - - - - - - - - - - 5 5 - Dysentery - - - 1 - - - - - - - - 1 1 - Poliomyelitis - 1 - - - - - 1 - - - - 2 2 - Measles - 11 28 17 10 1 - - - - - - 67 66 - Whooping Cough - 1 1 - 1 - - - - - - - 3 3 - *Under column "Died", all deaths, whether notified In the district or outside It, or not notified at all, are Included. DISTR1BUTION OF NOT1FIABLE DISEASES IN WARDS (District Cases) DISEASE WARDS Case Rate per 1000 population (Mid-year) Case Rate per 1,000 England and Wales N. N. W. N,E. W.C. E.C. E. S.W. S.E. S. TOTAL Population 9683 8884 11143 12423 7095 7735 7099 5701 8917 78680 Scarlet Fever 12 10 5 13 2 7 3 2 5 59 0.75 0.73 Diphtheria - - - - - - - - - - 0.00 0.00 Smallpox - - - - - - - - - - 0.00 0.00 Typhoid Fever - - - - - - - - - - 0.00 0.00 Paratyphoid Fever - - - - - - - - - - 0.00 0.02 Puerperal Pyrexia - - - - - - - 19 - 19 - - Pneumonia 6 2 3 1 4 1 2 2 3 24 0.30 0.63 Erysipelas - - 1 1 - - - 1 1 4 0.05 0.10 Dysentery - - 2 1 - - - 1 - 4 0.05 - Poliomyelitis 1 3 - 3 2 - 1 4 - 14 0.17 0.14 Cerebro Spinal Fever - - - 1 - - - - - 1 0.01 0.02 Measles 113 64 114 210 85 112 99 84 91 972 12.35 15.61 Whooping Cough 16 7 15 4 11 23 9 16 12 113 1.43 1.78 TOTALS 148 86 140 234 104 143 114 129 112 1210 TUBERCULOSIS On 31st December 1955 there were on the register nine hundred and forty six cases of Tuberculosis, of whom eight hundred and seventeen were Pulmonary cases and one hundred and twenty nine non-Pulmonary cases. The total death rate from Tuberculosis was 0.05 per thousand of population, compared with 0.11 per thousand of population In 1954 The death rate for Pulmonary Tuberculosis was 0.04 and for non-Pulmonary Tuberculosis 0.01 per thousand of population. For England and Wales the rate for Pulmonary Tuberculosis was 0.13 and for non-Pulmonary Tuberculosis 0.02 per thousand of population. The number of new cases of Pulmonary Tuberculosis was fifty, compared with sixty one In 1954. Reduction In Incidence and mortality are welcome signs that the advances In diagnosis and treatment are beginning to control the Infection. Progress depends on the Intensity of the search for hidden sources and on the early diagnosis of new cases. The deepest pool of Infection Is likely to remain among the elderly and the aged. Elderly people with chronic cough should be encouraged to have X-Ray examination of the chest. The most vulnerable to Infection are the Infants and adolescents. All adults who are closely associated with the teaching and training of young people In schools and clubs should avail themselves of the opportunities for Mass X-Ray Progressive Improvement In housing Is essential for the reduction of Infection and for consolidating cure of the disease. Six new cases of non-Pulmonary Tuberculosis were notified, compared with seven cases In 1954. Infections of glands, bones and Joints and serous membranes are due to the bovine or human type of the bacillus. In this Borough all milk Is pasteurised or designated. The scheme for the protection of school children at the age of thirteen years by B.C.G. Vaccine against Tuberculosis has an average response of sixty six per cent. The prevention of disease in the adolescent Is of supreme Importance to parents and to the community The Tuberculosis Care Committee has continued to give advice, comfort and support to many patients and families. There are signs that the number of cases of serious physical and social disablement Is being reduced but the domiciliary treatment of early cases has Increased The need for care and after care remains. Patients are given additional nourishment, clothing bedding and relief from anxieties Grants are made to provide occupational therapy and to prepare patients to enter new occupations. Children, wives and convalescent patients are given holidays. The work Is and will remain an Important part of 41 therapy. The services of members of the Committee are highly appreciated. The Hon Secretary Is County Alderman Mrs. Margaret Walkden. J. P.. 90. All Saints Road. Sutton. The following table shows the new cases and deaths In age groups. AGE PERIODS NEW CASES DEATHS Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M F M F M F M F 0 - - - - - - - - 1 - - 1 - - - - - 5 1 1 - - - - - - 15 8 7 1 1 - - - - 25 6 7 1 - 1 - - - 35 4 2 - 1 - - 1 - 45 5 1 1 - - 1 - - 55 5 1 - - - - - - 65 and above 2 - - - 1 - - - TOTALS 31 19 4 2 2 1 1 - Notification of Tuberculosis Respiratory forms of death - Three out of three cases were notified. Other forms of death - One out of one case was notified. MASS RADIOGRAPHY A Mass Radiography Unit, visited the Borough from 27th June 1955 to 22nd July 1955 and was stationed at the Public Hall. Four thousand eight hundred and seventy seven persons were examined. The results were as follows • Tbtal Examined M. F. T. 2139 2738 4877 No. of cases of active Pulmonary Tuberculosis M. F. No. of cases of Inactive Pulmonary Tuberculosis M. F. 116 95 Non Tuberculous abnormalities M. F. 62 53 The Incidence of active Pulmonary Tuberculosis was 0 25 per thousand persons examined The average Incidence In the County of Surrey In 1955 was 0.98 per thousand persons examined. It Is estimated that sixty per cent of the examinations made were of people who had previously visited Mass Radiography, The Incidence In primary examinations Is at least double that among people previously examined Greater use of the service should be made by those who have not yet accepted the opportunity for examination of the chest. The success of continued and Intensified search 42 by Mass X-Ray for early cases and for hidden foci of Infection depends on the maximum response from the general public. The finding of non-Tuberculous abnormalities Is rewarding and gives an opportunity for early treatment and the prevention of disability. 43 CLINICS AVAILABLE FOR THE DISTRICT SUTTON AND BELMONT The Clinic, No. 1, Robin Hood Lane, Sutton Ante Natal Clinic. Every Wednesday, at 9,30 a.m. Infant Welfare Centre. Every Tuesday and Thursday, at 1-30 p.m. (Including Diphtheria and Whooping Cough Immunisation and Vaccination against Smallpox). Methodist Church Hal!,, Station Road., Belmont Infant Welfare Centre- Every Thursday, at 2.0 p.m. (Including Diphtheria and Whooping Cough immunisation and Vaccination against Smallpox), SUTTON COMMON The Clinic, Stonecot Hill, Sutton Ante Hatal Clinic. Every Tuesday, at 9.30 a.m. Infant Welfare Centre. Every Monday. Wednesday and Friday, at 1,30 p.m- (Including Diphtheria and Whooping Cough Immunisation and Vaccination against Smallpox). CHEAM AND WORCESTER PARK The Parochial Roomsr The Broadway, Cheam Infant Welfare Centre. Every Wednesday, at 1.30 p.m. (Including Diphtheria and Whooping Cough Immunisation and Vaccination against Smallpox), The Clinic, Priory Crescent, Cheam Ante Natal Clinic. Every Monday and Friday, at 9.30 a.m. Infant Welfare Centre. Every Monday and Thursday, at 1,30 p.m. (Including Diphtheria and Whooping Cough Immunisation and Vaccination against Smallpox). Wesley HaU, Ruskin Drive, Worcester Park Infant Welfare Centre. Every Friday, at 2.0 p.m. (Including Diphtheria and Whooping Cough Immunisation and Vaccination against Smallpox). 44 SCABIES CLINIC St. Nicholas Road* Sutton Every Thursday, at 10 a.m. CHEST CLINIC St..HeJter Hospital, Wrythe Lanec Carshalton (By appointment) Every Monday Tuesday and Friday- at 9.30 a.m. Every Wednesday,, at 2 p.m. Every second Wednesday In each month, at 5 p.m. (Old cases only) VENEREAL DISEASES CLINIC St.'Helter Hospital, Wrythe Lane, Carshalton Males ... Every Monday, from 5 p.m. to 7 p.m. Females ... Every Wednesday, from 5 p.m. to 7 p.m. 45