TED 6 With Two Tables. Annual Report on the SANITARY CONDITION of the DISTRICT OF TEDDINGTON, DURING THE YEAR 1894. teddington: Printed by William Hatcher, Church Road. With Two Tables. Annual Report on the SANITARY CONDITION of the DISTRICT OF TEDDINGTON, DURING THE YEAR 1894. teddington: Printed by William Hatcher, Chukch Road. 1895. The Urban District Council of Teddington. Gentlemen, I beg to present to you my Annual Report of the Mortality, Health and Sanitary Condition of the District during the year 1894. The total number of deaths which occurred and were registered was 140 and included— 1 from Scarlatina 1 „ Diphtheria 1 „ Membranous Croup 5 „ Measles 3 „ Whooping Cough 5 „ Influenza 1 „ Diarrhoea 14 „ Phthisis 14 „ Bronchitis, Pneumonia and Pleurisy 12 „ Diseases of the Heart 21 „ Diseases of the Nervous System 10 „ Cancer 23 „ Premature Birth and Debility from Birth 7 „ Old Age 4 „ Injuries 18 „ Various Causes 140 68 were males and 72 females. 41 were under 1 year of age and 21 above 65. Of these 140 deaths two were persons, who had no connection with the District (one was found drowned, and the other was killed by a train), Deducting those two cases and taking the estimated population at 11,000, which was according to the census of 1891, 10,025, the mortality from all causes is at the average annual rate of 12.72 for every 1000 persons living, against 14.81 in the year 1893. The number of births was 298 of which 140 were males and 158 females. The birth rate was 27.09 and Infantile mortality 137 per 1000 births, 4 INFECTIOUS DISEASES. I.—Notifiable. Sixty-three notifications were received against 184 in 1893, 1 of Small-pox, 29 of Scarlatina, 12 of Diphtheria, 1 of Membranous Croup, 1 of Enteric Fever, 4 of Erysipelas, and 15 of Diarrhœa. Small-pox.—On December 12th I received a notification that a gardener, residing in Park Lane, was suffering from smallpox. I visited the house without delay and ascertained that the patient was employed in a nursery garden in Twickenham, where he had frequently to unpack plants coming from foreign countries, and he had probably contracted the disease by coming into contact with substances which contained infectious germs. As the patient was willing to go to a Hospital, and as there is no Isolation Hospital in the District, I telegraphed to the Authorities of the nearest Metropolitan Asylum in Fulham, who refused my request, the District being outside their area. On the advice of the Chairman, I applied to the Medical Officer of the Higligate Small-pox Hospital, who returned a favourable reply. The patient was removed in the ambulance the same evening, December 13th, The bed room occupied by the patient was at once disinfected. The inmates of the house, (wife, child and lodger,) were successfully re-vaccinated. The bedding, clothes, etc. were sent to a professional disinfector and some other articles were burned. The walls were stripped of the paper, which was burned and the room re-papered and white-washed. The inmates were prohibited from leaving the house and the lodger was paid a fortnight's wages during his imprisonment. The Inspector of Nuisances took the necessary steps for the supply of the necessaries of life. The patient remained five weeks in the Hospital. Such a case should remind the Urban District Council of the urgent necessity of an Isolation Hospital, as there was difficulty in finding a Hospital for the patient, who had to travel in the night-time about 15 miles. Vaccination.—The Vaccination was satisfactorily carried out in the District, the children were vaccinated within the prescribed time and no difficulty arose in carrying out the law. Scarlatina.—Twenty-nine cases were notified against 148 in 1893, and only one proved fatal. The greater number of cases (21) occurred during the first three months of the year. From April to October 8 isolated cases were reported, and from middle of October to the end of the year the district was free from the disease, which was generally of a mild character. In one instance the disease was accidently seen by the doctor after 5 desquamation had commenced, and if this child had mixed at school with other children it would not have been surprising if a severe Epidemic had broken out. These mild cases are generally the most dangerous for the community, as no medical aid is called in to attend the invalid, who is supposed to suffer from a trivial disorder, but who is in a condition to spread such an infectous disease over a large area. All cases were visited, disinfectants were supplied and after recovery the premises were disinfected, except in cases where families were living in roomy houses and were able to isolate the patient and by the advice of their medical attendant to use proper precautions against the spread of the disease. Diphtheria.—Twelve cases were notified and those occurred in 5 houses in the early part of the year. As only one case proved fatal this dangerous disease was of a very mild type, and judging from the unusually small mortality probably even suspicious cases were included in the notifications, which was certainly evidence of caution on the right side. As it is very often impossible to distinguish the diphtheritic character of a sore throat from true diphtheria, it is safer therefore to isolate all such mild doubtful cases and prevent them from mixing with other children. In every case attention was directed to the milk supply and in no case was the outbreak traced to this source. The houses were all visited and the necessary steps taken to prevent the spread of the disease Membranous Croup.—One case was notified and this proved fatal. Puerperal Fever.—No case. Enteric Fever.—Only one case occurred and that was of a man who showed symptoms of illness and was taken into the Cottage Hospital,. After a time it was found that he was suffering from Enteric fever. I visited the house, but could not trace any cause for the outbreak. Diarrhoea.—This disease was much less prevalent than in former years. When the circular letter from the Local Government Board was received suggesting that Diarrhoea should be made a notifiable disease, the Sanitary Authority passed a resolution, that the Infectious Diseases Notification Act, 1889, should apply to all cases of diarrhoea occurring within the district other than those of children under two years of age and the order to terminate on November 30th 1894. The number of cases notified during that period was 15, and most of those were of a mild type. Only one death occurred during the year and this was of an infant 5 months old. 6 II.—Not Notifiable. Influenza.—Five deaths occurred in the early part of the year. The disease never assumed an epidemic character as in former years. Measles.—Two deaths occurred in the beginning and 3 at the end of the year. They were isolated cases and in different parts of the District. Whooping Cough.—Three deaths were registered, all were infants under two months old. INSPECTIONS AND OTHER SANITARY WORK. A systematic inspection of the District was made between October 12th and 26th. The usual sanitary defects were found although the number was smaller than in former years. Some cottages had either no roof-guttering or it was in a defective condition causing dampness of walls and yards. Owing to the wet season many cess-pools were overflowing. Some of the cisterns were found without covers and some with covers defective. The attention of the inhabitants was directed to keep the cisterns clean. Domestic animals such as fowls, ducks, rabbits are very often kept in too confined spaces without proper shelter and cause offensive smells, especially in wet weather. Wherever such conditions existed, verbal warnings were given, and in about 16 cases the usual notices were served. Accumulations of manure and house refuse were frequently found. Special attention was given to the water-supply of the closets connected with the main sewers, and it was found that 150 were without water, 21 had an insufficient flush and in 24 cases the flushing apparatus was defective. Notices were served on the owners to remedy these defects. Great supervision will be necessary to ensure that that water-waste preventing cisterns which deliver a small quantity of water for flushing purposes are kept in order and that the quantity of discharge is not less than two gallons at a time. Apart from the annual inspection, special inspections were made at various times of different localities in connexion with infectious diseases, nuisances or complaints received. Several complaints were made with reference to bad smells in Broom Road, which were frequently brought under your notice. On March 22nd an inhabitant complained of bad smells arising from the grassland connected with the Sewage works. I inspected the locality and found that the effluent was partly discharged on the land, and the ground being not even and having a slope towards the adjoining owners land, stagnant pools were formed which caused offensive smells. As soon as the cause was ascertained, steps were taken to prevent a recurrence. In May complaints were made about very offensive smells 7 coming from the Broom Hall Estate, where the river has been let in by means of a cutting. I inspected the premises and found that a barge load of burned corn coming from Rotherhithe was deposited on the land. As soon as fermentation of the corn set in a very offensive odour was emitted. The owner of the land received notice to remove it and such order was complied with. In June complaints were received about bad smells in the same road, arising from the premises of Normansfield. I inspected the premises and found that the soap-water used in the laundry was collected in a tank where it was mixed with sulphate of iron, and afterwards pumped on the land. No bad smell was detected and nothing injurious to health could be found. In July the complaints were repeated and a second inspection was made with a view to ascertain whether the bad smells arose from the drainage of the house near the Kingston Road. I was accompanied by the Surveyor and Inspector of Nuisances. It was found that the sewage of this large establishment was received in a tank of large dimensions where it was thoroughlv disinfected. A second tank receives the overflow, and from this tank the sewage is pumped on and dispersed over a large area of vegetable garden and orchard, where it is covered with earth. The system, which has been in existence for more than 20 years, is a perfectly sound one and no nuisance can arise, especially as the spot is far removed from neighbouring houses and roads. Another complaint was made by an inhabitant of Broom Road of offensive smells emitted from a deposit of house-refuse from the contents of the dust-carts in a field abutting on the Broom Road. A summons was taken out against the Board and heard before the Bench on November 14th. The magistrates decided that the deposit in question constituted a nuisance and the Board was ordered to prevent a recurrence. Bad smells were also observed in the same road coming from a man-hole. This was sealed up. All these various bad smells did not affect the health of the inhabitants, as during the whole year out of 63 infectious cases notified only one case of very mild diarrhoea was reported from this part of the district, which includes the area between the east side of Kingston Road and the river and in which the large establishment of Normansfield and a boarding school containing about 40 children is situated. In October two inspections were made of Blay's premises in Stanley Road, where pigs and poultry were kept in a dirty condition. Verbal notice was given to cleanse the premises. A sample of well-water was taken from the pump and analysed. It was found largely contaminated with organic matter, and a notice was served to close the well and to lay on the water from the water company's main. This order was complied with. 6 WATER SUPPLY. The water supply from the Grand Junction Water Works was satisfactory. During the floods the water was somewhat discoloured The water of 10 wells was analysed and one was found to be contaminated with organic matter. SLAUGHTER-HOUSES. The various Slaughter-houses in the District were inspected from time to time and generally found to be in a fairly clean condition. On two occasions an accumulation of blood, offal and other matter in a putrid state was found to be deposited in the rear of Wolsey Road. The occupier's attention being drawn to this nuisance, it was at once removed. DAIRIES AND COW-SHEDS. Beyond two cases of lime-washing required, these were found in a satisfactory condition on each of the numerous inspections which were made. BAKE-HOUSES. These were periodically inspected. They all complied with the regulations cf the Bake-houses' Act except one, where flour was stored in a perfectly unsuitable place. A notice was served and the necessary alteration carried out. REMOVAL OF HOUSE REFUSE. The removal of house refuse was, on the whole, satisfactorily performed, and your inspector gave the subject perpetual attention. At the annual inspection places were found where the dustbins were evidently not emptied at the proper time, and on enquiry it was very often ascertained that the progress of emptying the dust-bin caused some inconvenience to the occupiers, or that they did not like the work performed at the particular time the dustman made his call. NUISANCES. About 287 nuisances were reported and dealt with. 122 arose from Overflowing Cess-Pools 6 „ Broken and Defective Closets 13 „ Choked Drains 3 „ Insufficient Ventilation of Drains 9 „ Defective Flushing Aarrangements 11 „ Defective Traps of Drains 21 „ Defective Drains 20 „ Accumulation of Offensive Matter 3 „ Damp Walls 9 9 arose from Want of Covers of Cisterns 21 „ Defective Roof Guttering 7 „ Stagnant Water 1 „ Water in Cellar 1 „ Contaminated Well Water 2 „ Dirty Premises 1 „ Defective Pig Styes 1 „ Uncovered Disused Cess-Pool 7 „ Unsanitary Privies DRAINAGE AND SEWERAGE. The work of collecting and disposing of the sewage of the district is being carried on in a satisfactory manner throughout, and the abolition of cess-pools has greatly improved certain properties. The number of houses connected with the sewers during the year was 363, making a total with previous connections of 1088. When the owners of properties in private roads are permitted to connect their drains with the sewers now being laid in these roads the number of connections will no doubt increase rapidly. Of the 122 nuisances arising from overflowing cesspools about one half of the number occurred on properties in Private Roads and of the remainder a considerable' number of the drains have since been connected with the sewers, and of course no further nuisances will arise from the overflowing cesspools in these cases. All the public schools in the district are now connected with the sewers, and their sanitary arrangements are all very satisfactory, their closets having been in each case re-modelled. The closets at the railway station which in former years gave a considerable amount of trouble, both to the officials of the Company and the Sanitary Authority, have also been re-constructed and connected with the sewers and are now greatly improved. The ventilation of the sewers by means of shafts at South Teddington has been successful in removing the nuisance which arose from bad smells issuing from the gratings in the roads. The gratings in this part of the district have been closed and there is now no opportunity for the smells to escape at the street level. There is, however, a point in connection with the erection of ventilating shafts to which I would draw attention. There is no longer any nuisance observable in the street, but the sewers are not free from gases and smells, which are merely allowed to escape at a higher level. The sewers contain the same kinds of offensive matter that they did before, and require as frequent flushings and periodical inspections. In fact they should, if 10 possible, be kept cleaner, because the ventilating openings are reduced both in size and number, and if foul gases are generated in too great a volume they may possibly find their way into the house drains with prejudicial effects to health. I understand that the contract for the sewering of private roads includes the erection of about 25 ventilating shafts in various parts of the district, and these no doubt will prevent bad smells arising from the sewers. The Sewage Disposal Works have been carried on very satisfactorily, only once during the year was a compliant made of a nuisance, to which I have already referred. In addition I may observe that lime of inferior quality for the purpose of precipitation was used on that occasion causing the effluent water to retain an unpleasant smell. A superior lime is now used, and very good results are obtained. The Thames Conservancy Inspector visited the works on many occasions and reported the effluent to be very good. During the severe floods in November the pumps were stopped for three days it being found useless to continue operations during that period. ISOLATION HOSPITAL. The negotiations with representatives of neighbouring Sanitary Authorities for the formation of a combined district for providing an Isolation Hospital have led to no result, and we have so far made no progress towards the solution of this difficult question. In September your Board considered again the subject and resolved to leave the question for the coming District Council to deal with. The need of such an Institution, and also the difficulty to provide one is acknowledged by every member of the Council, and I need not repeat the remarks I have made on this subject for many years past. I hope the new District Council will take some early steps in the matter, and if it is found impossible to induce the adjoining districts to form a combination, the difficulty may be overcome by appealing to the County Council to constitute a joint Hospital District. I remain, Gentlemen, Your obedient Servant, TH. GÜNTHER. M.D., Medical Officer of Health. January 31st, 1895. 11 Table A of Deaths during 1894. Under one year 41 1 and under 5 16 5 „ 15 8 15 „ 25 4 25 „ 65 50 65 and upwards 21 At all ages 140 Causes of Death. Scarlatina 1 under five years. Diphtheria 1 five years and upwards. Membranous Croup 1 Influenza 5 Measles 3 under five years „ 2 five years and upwards Whooping Cough 3 under five years Diarrhœa 1 „ „ Phthisis 3 „ „ ,, 11 five years and upwards Bronchitis 6 under five years Pneumonia 8 five years and upwards Pleurisy Heart Disease 2 under five years „ „ 10 five years and upwards Injuries 4 All other diseases 12 under five years „ „ 67 five years and upwards Total 31 under five years „ 109 five years and upwards 12 Table B of Population, Births and New Cases of Infectious Sickness. Population Census .1891 10,025 Estimated to middle of 1894 11,000 Registered Births 291 Cases of Infectious Sickness. Small Pox 1 five years and upwards Scarlatina 13 under five years „ 16 five years and upwards Diphtheria 1 under five years „ 11 five years and upwards Membranous Croup 1 under five years Enteric or Typhoid Fever 1 five years and upwards Erysipelas 4 five years and upwards Diarrhœa 15 five years and upwards The Notification of Infectious Disease has been compulsory in the District since February, 1890. There is no Isolation Hospital.