Ac439(1) TWI 26 JULY, 1959 GOOD HEALTH IN TWICKENHAM The Annual Report of the Medical Officer of Health JOHN MADDISON, M.D., B.S., D.P.H. CONTENTS Page Introduction 2 Public Health committee and Staff 4 Pest Destruction 5 Keeping the Borough Clean 5 Water Supply 6 Industrial Health 6 General Matters 6 Statistical Tables 15 1 Telephone:TEDdington Lock 4521 TEDdington Lock 4411 PUBLIC HEALTH DEPARTMENT, ELMPIELD HOUSE, HIGH STREET, TEDDINGTON. To the Mayor, Aldermen and Councillors of the Borough of Twickenham. LADIES AND GENTLEMEN, I have the honour to submit my Annual Report for 1959 on the health and sanitary conditions of the Borough together with the supplement containing the statistical tables for 1958 as required by the Ministry of Health. The Minister of Health has called for this report as soon as possible after the receipt of the vital statistics from the General Register Office. I thought it best to get the report off with the least delay by presenting it with other required tables but without a lengthy dissertation. For the past nine years I have endeavoured to give you an account of the progress in the medical world and the changes in preventive and social medicine. I hope you will be kind enough to excuse me from this task at present. During the last eighteen months I have been more than fully occupied in starting the new clinic for the elderly, trying to obtain the instruments and equipment for it, putting it on a sound basis, dealing with social, clinical and preventive medical problems, experimenting with the various techniques, and observing progress. The full report on these activities will be written later. In other fields there is plenty of activity; new ideas are coming forward on all sorts of subjects. At Harrogate this year the Royal Society of Health was discussing such subjects as marriage preparation, mothers at work and family guidance; new ideas on hospital planning; the epidemiology of mental illness; air pollution; radiation levels, social sciences; modular or standardised components in building; the changing pattern of infectious diseases; and a lot more besides. In preventive medicine there is never a dull moment; it is wonderfully exciting; there is always some fresh problem to be solved, something new tp be seen just over the horizon; it is a pleasure to be associated with it. Once again it is a pleasure to acknowledge and commend the untiring zeal and devotion to duty of the staff,both those with me in Elmfield House and those outside in all the ramifications of our service. As I have sail before,health is indivisible,and so except on paper,I practically never think whether a person is Borough or County - the important thing is to get the job done and get it done well. I rely heavily on Dr. Cormack who has taken more than his share of the work this year, on Mr. Easter, Mr. Pugh, Miss Francis, and Miss Reeves, who continually keep me right on the rules and regulations when my enthusiasm will tend to lead me to disregard them, and all the other 400 odd members of the staff who carry on 2 so faithfully and well. They work best with a word of encouragement and a pat on the back. I have pleasure in taking this opportunity of giving them both. I beg to acknowledge my indebtedness to the Chairman and Members of the Public Health Committee for their helpfulness and support, which is always of the greatest encouragement. I desire, also to acknowledge with thanks the friendly co-operation and help which I have always received from my colleagues in the other departments of the Corporation and the other members of the Council. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, JOHN MADDISON, Medical Officer of Health. 3 MEMBERS OF THE PUBLIC HEALTH COMMITTEE Ex-officio members: THE MAYOR, ALDERMAN E. BOSTOCK. M. A. , F. C. A. , J. P. THE DEPUTY MAYOR, COUNCILLOR E.P.G. LEWIS Chairman: COUNCILLOR MRS. M. B. DAVIES Vice-chairman: COUNCILLOR L. DEFRIES-PORTER, LL. B., A. M. B. I. M. Alderman J.H.Knaggs J.P. Councillor Mrs. M.E.D.Lever Councillor G.H.Loman Councillor W.J.E.Pett Councillor Mrs. C.C.Cunningham- Councillor N. Sheldon, A. R.C.S., Howie. F.R.I.C. Councillor G.J. Samuel, M.A. Councillor E.A.Wilson Councillor R.F.E.Howard-Hodges. Councillor C. W. Sewell, M. A., M.B.E. F.R. Econ. S. STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health Dr. J. Maddison, M. D., B. S., D.P.H. (Also Area Medical Officer, Twickenham, Feltham, Staines and Sunbury) Deputy Medical Officer of Health Dr.W.Cormack,M.B., Ch.B. .D.P.H. (Also Deputy Area Medical Officer, Twickenham, Feltham, Staines and Sunbury) Chief Public Health Inspector Mr. H. G.Easter Deputy Chief Public Health Inspector Mr. H. D. Smith Specialist Housing Inspector Mr.K.E.Evans Messrs. K. W. Clement (Commenced Public Health Inspectors 15/1/59) B. E. W. Gabb, A. E. G. Walker All the Inspectors hold the Certificate of the Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board, and the Meat Inspectors' Certificate. Chief Clerk Mr.H.J.Pugh (Also Area Chief Clerk, Twickenham, Feltham, Staines and Sunbury) Senior Clerk Mr. R. N.Himson Clerical staff Mrs. J. Hodgson Miss E.A.Smith (Commenced 1/12/58) Miss J. Lovett Senior Rodent Operative Mr. H.T.Jackman Rodent Operative Mr. S.Jackman Disinfector/Drain Tester Mr.E.G.Cooper 4 PEST DESTRUCTION The service provided by the department enables residents in the Borough to have insect pests identified and advice is given on the method of their eradication. Unusual specimens are sent to the British Museum (Natural History section) for identification, and I am most grateful to them for their willing assistance. The normal work of rodent destruction continued during the year. Thirteen premises were treated during the year against bugs and in all cases complete clearance was effected. Due to the increased use of modern poisons such as Warfarin, much less time is spent in prebaiting, and in July 1958 it was decided to try and manage with only two Rodent Operatives. The work is being satisfactorily carried out. The sewers were again treated during the months of March and September. The Ministry of Agriculture, Fisheries and Food is planning to carry out experimental treatments in 1959 to establish the comparative efficiency of two types of poisons against rats in sewers. The Corporation have agreed to co-operate with the Ministry in the experiment and a section of the soil sewer system in the St. Margarets and Twickenham District has been chosen for this purpose. The complete cost of staff, transport and materials will be borne by the Ministry and they will also indemnify the Corporation against any claim for damage that might arise as a result of the experiment. KEEPING THE BOROUGH CLEAN I am obliged to A. S. Knolles, Esq., B. Sc., M. Inst. C.E., M. I. Mun.E., Chartered C.E., the Borough Engineer and Surveyor for the following report of Drainage, sewerage, Public Conveniences and Refuse Disposal: Drainage and Sewerage. The contract for the East Twickenham sewer was let in 1958 and the first section of 3 ft. diameter pipe and some lengths of the 30 inch reinforced concrete pipes, were laid in tunnel by the end of 1958 - commenced from Station Road, through Station Approach, past London Road, into Amyand Park Road. Although over a quarter of a mile of sewer has been laid, there is still nearly a mile of sewer to complete this work. The summer saw the commencement of the diversion of foul and surface water sewers in the vicinity of the London Road Railway Bridge, to permit of the construction of the bridge for the widening of London Road. The crossing of the railway tracks was by means of 27" thrust boring, and of London Road by means of sewer in tunnel. This work should be completed early in 1959. Public Conveniences. Plans and details were worked out for the new Public Convenience at Water Lane, which will, in due course, permit of the underground conveniences at the junction of York Street and London 5 Road, being removed for improvements at this road junction. Refuse Disposal. Operation of the Charlton Plant continues satisfactorily and although there was a recession in the price of paper and steel further reducing the income from salvage, such income is nevertheless still worth while. WATER SUPPLY I am indebted to Dr. E. Windle Taylor, M. A., M. D., D.P. H., M. R. C. S., L.R.C.P. Director of Water Examination, Metropolitan Water Board, for the following report: The source of water is the River Thames abstracted at the Wraysbury, Walton and Laleham intakes and stored in the Thames Valley reservoirs at Staines, Littleton and Walton. After storage the water is treated at the filtration works at Hampton. The water is filtered by means of primary or rapid filtration followed by secondary or slow sand filtration. All water is finally chlorinated before it leaves the works. In order to provide adequate contact to ensure complete action by the chlorine a contact tank is provided at the works. The water is treated by a method of controlled superchlorination by maintaining a fixed residual of free chlorine after a given period of contact. The chlorination process is entirely automatic both in regard to changes in quality as well as changes in quantity of the filtered water. Samples of water are collected at all stages of the purification process at least five times each week and analysed at the Laboratories of the Metropolitan Water Board. The supply is not plumbo-solvent. All new and repaired mains are disinfected with chlorine before being restored to supply and samples of water from them are tested to establish that its quality is up to that normally supplied. INDUSTRIAL HEALTH Factories, There are 309 factories in the Borough most of which are engaged in light industries, such as the manufacture of electrical components, piston rings, aircraft parts, name plates and bakery furniture. The number of persons employed in these factories ranges from 680 in the largest to one or two in the smallest. Periodic inspections of factory premises are made to see that proper sanitary accommodation is provided and those factories which do not use mechanical power are inspected for cleanliness, avoidance of overcrowding, adequate ventilation and proper drainage of floors. During 1958 the inspectors paid 229 visits to factories. GENERAL MATTERS Housing Further progress was made during the year in dealing with 6 unfit houses. Two clearance orders involving 14 houses were made. The first, after a local public enquiry, was confirmed unconditionally by the Minister of Housing and Local Government; the second is awaiting confirmation. In addition demolition or closing orders were made on 16 individual unfit houses. Bent Act, 1957- During the year 120 applications were received for certificates of disrepair and the table below shows how these applications were dealt with: Period covered by return: 1st January to 31st December, 1958. PART I - Applications for Certificates of Disrepair. (1) Number of applications for certificates 120 (2) Number of decisions not to issue certificates 3 (3) Number of decisions to issue certificates 117 (a) in respect of some but not all defects 100 (b) in respect of all defects 17 (4) Number of undertakings given by landlords under paragraph 5 of the First Schedule 64 (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First schedule 1 (6) Number of Certificates issued 47 PART II - Applications for Cancellation of Certificates. (7) Applications by landlords to Local Authority for cancellation of certificates 55 (8) Objections by tenants to cancellation of certificates 17 (9) Decisions by Local Authority to cancel in spite of tenant's objection 6 (10) Certificates cancelled by Local Authority 45 Only one owner has availed himself of his right of appeal to a County Court. This was in respect of three houses in Teddington where undertakings given by the landlord to carry out repairs were rejected because they did not comply with the terms of the Act. The landlord appealed, and at Kingston County Court the Corporation's contention that the landlord's undertakings were insufficient was accepted and the Corporation awarded £2. 2s. Od. costs in each case. Clean Air Act, 1956. Although the major part of the Act was brought into operation 7 with effect from the 31st December, 1956, certain provisions regarding the emission of dark smoke from chimneys, the discharge of grit and dust from furnaces and new powers for dealing with smoke nuisances did not come into operation until 1st June, 1958. These provisions make it the duty of the local authority to enforce the provisions of the Act. In June, 1958 a Sub-Committee was set up to consider and report upon the question of the making of smoke control areas within the borough. In order to secure reliable data, it was decided to purchase three instruments for the measurement of atmospheric pollution and from the information obtained therefrom, to decide, at the end of 12 months, whether to make a Smoke Control Area Order for a part of the borough. In January, 1959, however, the Minister of Housing and Local Government asked that Councils in "black areas" should decide on the smoke control orders that were needed, in what order of priority they should be made, and how many years it would take for completion. Twickenham is scheduled as a "black area". In April, 1959, the Corporation approved in principal the declaring of the whole of the borough to be a smoke control area and that, in the first instance, the Medical Officer of Health should proceed to carry out a pilot survey with a view to submitting an overall scheme providing for priority of areas to be dealt with. Phis pilot survey is of an area consisting of approximately 1,500 houses in the North West corner of the borough, bordered by Hospital Bridge Road, The River crane, Hanworth Road and the Railway line. PUBLIC HEALTH ACT, 1936. SECTION 24. Maintenance of Public Sewers. When a Local Authority has carried out work for the maintenance of a length of a public sewer, they may, but they are not compelled to, recover the expenses incurred by them from the owners of the premises served by that length of sewer. For that purpose they must apportion the expenditure against each owner. The work involved is often of quite a minor nature and when the cost is small and the number of houses concerned is of the order of 4, 6 or more, the cost of recovery is out of all proportion to the amount collected from the owner. In February 1959 the Corporation decided that where the cost involved did not (i) in the case of two houses, exceed £5 (ii) in the case of three or more houses, exceed £2 per house the Corporation would not make any recovery from the owner but would charge the cost to the General Rate. In future it will only be necessary to serve Statutory Notices in those cases where it is impossible to estimate the cost of the work or where it is known that the cost will exceed (i) or (ii) above. 8 Shops Act, 1950 Section 38 of this Act deals with provisions for the health and comfort of the staff. Shops must have proper ventilation, be adequately warmed, be sufficiently lighted and must have toilet and washing facilities. If the staff take meals on the premises proper arrangements must be made for them. It is sometimes impossible for the occupier to provide a separate toilet on the premises, but provided alternative arrangements are made to use a nearby toilet, a certificate of exemption can be granted from the requirements of the Act. There are 21 exemption certificates at present in force. Schools The table on page 30 gives details of the work carried out under the Pood Hygiene Regulations, 1955 and provision has been made in the 1959/60 estimates for further improvements to be carried out. The general standard of the canteens remains good. It was not necessary to close any schools on account of infectious disease amongst the children. Slaughterhouses Act, 1958. This Act received Royal Assent on 1st August, 1958 and came into immediate operation. The Act amends the Slaughter of Animals Acts 1933 and 1954, certain provisions of the Food and Drugs Act, 1955 and Section 151 (1) of the Factories Act, 1937. The arrangements for licensing slaughterhouses are substantially amended, but there are no slaughterhouses in the borough, and after obtaining the views of its local members, the Committee of the London Retail Meat Traders Association (Division 9) decided that Slaughterhouse facilities are not needed in Twickenham. Complaints. During 1958 the number of complaints received by the department was 1276. Food and Drugs Act, 1955 Food Hygiene Regulations, 1955 During the year 2,317 visits were made to food premises under these regulations and at 151 premises contraventions were found. As a result of action taken, 212 contraventions were remedied, and the table on page 30 gives details of this work. Eleven complaints were received about unsound food bought from retailers in the borough, details of which are given below:- 1. Bottle top in bottle of milk 2. Foreign body in milk 9 3. Metal cap in bun 4. Dirty milk bottle 5. Dirty milk 6. Bacon and ham infested with blowfly and maggots 7. Foreign body in bread 8. Foreign body in bread 9. Foreign body in chocolate 10. Snail in tin of peas 11. Insect in bread Two cases were reported to the Public Health Committee, and in each case a warning letter was sent to the offender. It was not found necessary to institute legal proceedings Petroleum Installations. The Corporation, in March 1958, approved new conditions of licence and principles of construction for premises where petroleum is stored. In August 1958, the Home Office suggested new conditions in respect of electrical equipment associated with petro 1 service pumps. A survey of all electrically operated pumps installed in the Borough was carried out and it was found that over 75% already complied with the Home Office recommendations. Owners of installations not complying with the new Conditions are required to do so by 1st July, 1960. The Public Health Inspectors paid 587 visits to premises where petroleum or petroleum mixtures are stored and the number of licences issued during the year was 103. Registration of Hawkers of Food and their Premises. A strict watch is kept on all street traders selling food. Both the person and the storage premises have to be registered,and if conditions are unsatisfactory registration can be refused. During the year 8 persons were registered and 57 visits were made by Inspectors. Rag Flock and Other Filling Materials Act, 1951. Three premises are registered under the above Act. There is no manufacture or storage of rag flock in the Borough so therefore no premises require to be licensed. Pet Animals Act. 1951. No person is allowed to keep a pet shop except under authority of a licence granted in accordance with the provisions of this Act. These provisions require: 10 (a) that animals be kept in accommodation suitable as respects size, temperature, lighting, ventilation and cleanliness; (b) that animals be adequately supplied with suitable food and drink and should (so far as necessary) be visited at suitable intervals; (c) that animals, being mammals, should not be sold at too early an age; (d) that all reasonable precautions be taken to prevent the spread of infectious disease amongst the animals; (e) that appropriate steps be taken in case of fire and other emergency. There are 10 licences in force in the Borough and 14 visits were made for the purposes of securing compliance with the licensing conditions. In one case it was decided not to recommend the renewal of the licence. A further inspection of the premises was carried out however, and it was found that there had been considerable improvement in the conditions, and the provisions of the Act were being complied with; accordingly the licence was renewed. It was not necessary to ask the Royal Society for the Prevention of Cruelty to Animals Inspector for any assistance. Establishments for Massage, Chiropody, Electrical and Special Treatment. Ten licences in respect of establishments for these purposes were issued during the year 1958. The premises are inspected regularly and all are well run. Hairdressing Establishments. The Corporation have made Byelaws under the Middlesex County Council Act for "the purpose of securing the cleanliness of any premises used for the purpose of carrying on the business of a hairdresser or barber and of the instruments, towels, equipment and materials used in such premises". During the year 23 inspections were made of these premises. It was not found necessary to take any action for contraventions. Swimming Baths. Excellent facilities are provided for swimming at the Corporation's three open-air baths. Water is supplied by the Metropolitan water Board's main and 38 samples for bacteriological examination were taken throughout the season. 35 samples proved satisfactory and 3 unsatisfactory. The 3 unsatisfactory samples were taken from Twickenham Baths and immediately it was known an investigation was made into the circumstances causing such results. The samples were taken soon 11 after the bath had been refilled after cleaning. Due partly to heavy rain the level of the water was three inches higher than is normal and the mains water and the chlorinated water from the plant had probably not been thoroughly mixed. A series of samples were taken under varying conditions to find whether there is a period under normal conditions when chlorination might be insufficient to maintain purity of water. The results showed that even during the changing period, chlorination can be sufficient to ensure a proper standard of purity, and every precaution is taken to maintain this standard. Laboratory Work. The usual arrangements continued during the year and worked satisfactorily. Type of Sample or Specimen. No. taken Result Ice cream 100 100 Grade I Satisfactory Water 51 47 - Satisfactory 4 - Unsatisfactory Faeces 173 Fertilisers 19 Bone Meal. Cases of enteric type of infection have been traced to infected fertilisers and during the year 19 samples of fertilisers were obtained from a local factory and from various shops in the borough. Of the 13 samples of bone meal taken, 5 were negative and 8 contained organisms of the food poisoning group. All the positive samples were from the Argentine. Six samples of miscellaneous organic fertilisers such as dried blood and horn parings were found negative, and it is interesting to note that a sample of organic fertiliser from the Mogden sewage Works was also negative. I have forwarded a summary of these results to the Public Health Laboratory Service who have been carrying out investigations on these lines, and it may be that there is a case for the compulsory sterilisation of imported bone meal before admission to this country. Poliovirus Survey In Normal Children During 1957 the Medical Research Council through the Central Public Health Laboratory at Colindale carried out a survey in 25 districts in the country in order to get an indication of the proportion of normal children carrying poliovirus, and to relate the carrier rate to the number of notified cases. The results were not conclusive and a further survey in Middlesex over a period of twelve months was undertaken. All sanitary districts in Middlesex co-operated and since May 1958, 100 specimens were collected each week from selected children in the county. It is hoped that as 12 well as obtaining information regarding the poliovirus, it may also be possible to get information regarding the prevalence of other organisms associated with the gastrointestinal tract. 190 specimens were collected from children in this Borough. Ambulance Facilities. The Middlesex County Council is the responsible authority for the provision of the ambulance service under the National Health Service Act, 1946. National Assistance Act, 1948, Section 47. National Assistance (Amendment) Act, 1951. It was not necessary during 1958 to remove to suitable premises any person who was in need of care and attention. Health Education Continued use is made of various health education methods including propaganda by posters, leaflets and lectures illustrated by films or lantern slides. Mortuary The number of bodies admitted to the mortuary during 1958 was 495. Over half of these came from the areas of neighbouring authorities, but by arrangement, payment is made to the Corporation by the majority of those authorities concerned for each body admitted. The Coroner has an unrestricted right to order the removal of a body to any mortuary within the area of his jurisdiction, and it is the duty of this Corporation to receive all bodies directed by him to Hampton Mortuary. It has become the practice to conduct a post-mortem examination of all bodies admitted, and the working conditions for the pathologists are now greatly improved with better ventilation and separate office facilities. 13 TABLES FOR STATISTICAL YEAR 19 5 8 15 STATISTICAL TABLES for the Year 1958 Table 1 Summary Area in acres 7, 078 Population (preliminary census return figure 1951) 105,645 Civilian population - estimated to mid-year (as supplied by the Registrar-General) 103,500 Number of inhabited houses 30, 883 Rateable value 1,835,158 Sum represented by a penny rate £7,350,4.2 Total M. F. Live Births - Legitimate 1310 659 651 Illegitimate 66 34 32 Total 1376 693 683 Live Birth rate per 1,000 of estimated civilian Population 13.29 Adjusted Live Birth rate 13.69 Total M. F. Still Births - Legitimate 12 5 7 Illegitimate 2 1 1 Total 14 6 8 Still Birth rate per 1,000 live and still births 10.07 Total Live and still Births 1,390 Infant Deaths (under 1 year of age) Total M. F. Legitimate 29 12 17 Illegitimate 4 3 1 Total 33 15 18 Infant, mortality rate per 1,000 live births 23.98 Legitimate Infant mortality rate per 1,000 legitimate live births 22.14 Illegitimate Infant mortality rate per 1,000 illegitimate live births 60.60 Neo-Natal deaths (under 4 weeks of age) Total M. F. Legitimate 20 8 12 Illegitimate 4 3 1 Total 24 11 13 Neo-Natal mortality rate per 1,000 live births 17.44 Illegitimate live births per cent of total live births 4.80 Maternal deaths NIL Maternal mortality rate per 1,000 live and still births NIL Deaths M. F♦ 1, 178 580 598 Crude death rate per 1,000 of estimated civilian population 11.38 Adjusted death rate 10. 81 16 Population 1941-1958 Table 2. Year Population Population trend Migration excess Total increase or decrease Percentage proportion Natural increase or decrease Inward Outward 1941 91,820 - 2,250 - 2.39% + 38 - 2,288 1942 92,460 + 640 + 0.70% + 450 190 - 1943 92,780 + 320 + 0.35% + 50.2 - 182 1944 88,660 - 4,120 - 4.44% + 507 - 4,627 1945 91.920 + 3,260 + 3.68% + 424 2, 836 - 1946 102,850 + 10,930 + 11.89% + 835 10,095 - 1947 105,930 + 3,080 + 2.99% + 918 2.162 - 1948 106.700 + 770 + 0.73% + 621 149 - 1949 106,900 + 200 + 0. 19% + 399 - 199 1950 107,600 + 700 + 0.65% + 246 454 - 1951 106,300 - 1,300 - 1.28% + 91 - 1,391 1952 106,500 + 200 + 0. 19% + 144 56 - 1953 105,300 - 1,200 - 1.13% + 250 - 1,450 1954 104,700 - 600 - 0. 57% + 167 - 767 1955 104,300 - 400 - 0.38% + 105 - 505 1956 104.000 - 300 - 0.29% + 146 - 446 1957 103,600 - 400 - 0.39% + 217 - 617 1958 103,500 - 100 - 0.10% + 198 - 298 Table 3. Causes of Death. Registrar-General's Official Returns. Causes of Death Males Females Total All causes 580 598 1178 1. Tuberculosis, respiratory 12 1 13 2. Tuberculosis, other 2 1 3 3. syphilitic disease 3 1 4 4. Diphtheria - - - 5. Whooping cough - - - 6. Meningococcal infections - - - 7. Acute poliomyelitis - - - 8. Measles - - - 9. Other infective and parasitic diseases 1 2 3 10. Malignant neoplasm, stomach 8 11 19 11. Malignant neoplasm, lung, bronchus 35 8 43 12. Malignant neoplasm, breast - 24 24 13. Malignant neoplasm, uterus - 7 7 14. Other malignant and lymphatic neoplasms 68 61 129 15. Leukaemia, aleukaemia 3 2 5 16. Diabetes 4 6 10 17. Vascular lesions of nervous system 70 88 158 18. coronary disease, angina 126 85 211 19. Hypertension with heart disease 20 17 37 20. Other heart disease 57 92 149 21. Other circulatory disease 24 31 55 22. Influenza 2 2 4 23. Pneumonia 29 42 71 24. Bronchitis 41 31 72 25. Other diseases of respiratory system 4 6 10 26. Ulcer of stomach and duodenum 8 3 11 27. Gastritis enteritis and diarrhoea 2 8 10 28, Nephritis and nephrosis 3 5 8 29. Hyperplasia of prostate 3 - 3 30. Pregnancy, childbirth, abortion - - - 31. congenital malformations 3 5 8 32. Other defined and ill-defined diseases 28 40 68 33. Motor vehicle accidents 8 - 8 34, All other accidents 7 12 19 35. suicide 9 7 16 36. Homicide and operations of war - - - 17 Table 4. Main Causes of Death An analysis of the death returns reveals the following main causes of death: Disease Percentage of total deaths Death rate per 1,000 of the population Diseases of heart and circulatory system 38.37 4.37 Intra- cranial vascular lesions 13.41 1.53 Bronchitis, Pneumonia, and other respiratory diseases 13.33 1.52 Cancer 19.27 2.19 Violence 3.65 0.42 Tuberculosis 1.36 0.15 18 Table 5. Infant Mortality (a) The following table, compiled from official registrations, gives details of the causes of death at various ages under one year of age: Under 1 week 1 - 2 weeks 2-3 weeks 3 - 4 weeks Total under 4 weeks 4 weeks and under 3 mths. 3 months card under 6 mths. 6 months and under 9 mths. 9 months and under 12 mths Total deaths under 1 year All Causes: certified 23 1 - - 24 4 4 - 1 33 Uncertified - - - - - - - - - - Smallpox - - - - - - - - - - Chicken-pox - - - - - - - - - - Measles - - - - - - - - - - Scarlet Fever - - - - - - - - - - Diphtheria and Croup - - - - - - - - - - Whooping Cough - - - - - - - - - - Influenza - - - - - - - - - - Enteritis - - - - - - - - - - Tuberculous Meningitis - - - - - - - - - - Abdominal Tuberculosis - - - - - - - - - - Other Tuberculous Diseases - - - - - - - - - - Congenital Malformations 3 1 - - 4 - 2 - - 6 Premature Birth 8 - - - 8 - - - - 8 Atrophy, Debility and Marasmus - - - - - - - - - - Atelectasis 7 - - - 7 - - - - 7 Injury at Birth 1 - - - 1 - - - - 1 Erysipelas - - - - - - - - - - Syphilis - - - - - - - - - - Rickets - - - - - - - - - - Meningitis (not Tuberculous) - - - - - - - - - - Convulsions 1 - - - 1 - - - - 1 Gastritis - - - - - - - - - - Laryngitis - - - - - - - - - - Bronchitis - - - - - - 1 - - 1 Pneumonia (all forms) - - - - - 4 1 - - 5 Suffocation (overlying) ... - - - - - - - - - - Other causes 3 - - 3 - - - 1 4 Totals 23 1 - - 24 4 4 - 1 33 (b) An analysis of the mortality reveals that neo-natal deaths were responsible for 72.73 per cent. of the total infant: deaths, viz.:the same as the previous year. Under 24 hours 1 to 7 days 1 to 4 weeks Total under 4 weeks Percentage total infant deaths 13 10 1 24 72.73 19 Table 6. Review of the Comparative Vital and Mortality Statistics for the Borough of Twickenham, together with those for England and Wales for years 1941-1958 inclusive Year Birth Rate Death Rate Infantile Mortality Rate Twickenham England and Wales Twickenham England and Wales Twickenham England and Wales 1941 13.4 14. 2 13.0 12.9 70. 95 59 1942 16.49 15.8 11.6 11.6 53.1 49 1943 17.7 16.5 12.3 12.1 47.99 49 1944 18.5 17.6 12.8 11.6 37.1 46 1945 16.76 16.1 12.15 11.4 48.02 46 1946 19.01 19.1 10.89 11.5 26.09 43 1947 19.72 20.5 11.05 12.0 40.21 41 1948 15.86 17.9 10.04 10.8 20.69 34 1949 14.99 16.7 (a) 11.26 11.7 21. 21 32 (b) 11.03 1950 (a) 13.34 15.8 (a) 11.05 11.6 20. 10 29.8 (b) 12.54 (b) 10.72 1951 (a) 12.82 15.5 (a) 11.97 12.5 24.98 29.6 (b) 12.05 (b) 11.61 1952 (a) 12.54 15.3 (a) 11.18 11.3 20.22 27.6 (b) 11.79 (b) 10.84 1953 (a) 13.26 15.5 (a) 10.88 11.4 20.06 26.8 (b) 13.53 (b) 10.01 1954 (a) 12.73 15.2 (a) 11.14 11.3 14.25 25.5 (b) 12.98 (b) 10.25 1955 (a) 12.13 15.0 (a) 11.12 11.7 22.92 24.9 (b) 12.37 (b) 10.23 1956 (a) 12.77 15.7 (a) 11.37 11.7 10.54 23.8 (b) 13.15 (b) 10.92 1957 (a) 12.86 16.1 (a) 10.76 11.5 16.52 23.0 (b) 13.25 (b) 10.33 1958 (a) 13.29 16.4 (a) 11.38 11.7 17.44 22.5 (b) 13.69 (b) 10.81 (a) Crude (b) Adjusted 20 21 Table 7 AVERAGE RESULTS OF THE CHEMICAL AND BACTERIOLOGICAL EXAMINATION OF THE WATER SUPPLY TO THE BOROUGH OF TWICKENHAM FOR 1958 Milligrammes per litre (unless otherwise stated) (a) chemical Description of the Sample Ammonia Nitrogen Albuminoid Nitrogen Oxidised Nitrogen (Nitrate) Chlorides as Cl. Oxygen abs0 from Permanganate 4 hrs0 at 27 C. Turbidity in terms of Silica Colour, mm. brown 2ft. tube Burgess's Tintometer Hardness (Total) Hardness (Non-carbonate) pH Value Phospate as PO4 Silicate as S1O2 Sulphate as SO4 Fluoride as F Magnesium as Mg Electrical Conductivity (gemmhos) Hampton 0.020 0.079 4.1 26 1.30 0.4 13 272 68 7.7 0.85 9 58 0.15 5 550 (b) Bacteriological after chlorination (water passing into supply) Description of the Sample Plate. count (average per millilitre) Colonies counted on agar Coliform count Percentage samples negative in 100 ml. 37°C 20-24 hrs. Coliform E.Coli Hampton 8.2 99.61 100.0 Table 8. Analysis of Complaints Received Nature of Complaint Number Received Housing defects 205 Choked and defective drains 200 Accumulations of offensive matter 30 Unsound food 121 Verminous premises: (a) Bugs 24 (b) Rats and mice 456 (C) Other 30 Keeping of animals 5 Unsatisfactory milk supplies 5 Miscellaneous 200 Total 1,270 22 Table 9 Summary of Visits, Inspections, etc. Dwelling-houses for housing defects under Public Health Act: Number (a) After complaint 909 (b) Subsequent visits 2267 Dwelling-houses under Housing Act. 599 Dwelling-houses under Rent Act 594 Dwelling-houses: Housing applications, specially investigated 52 Infected dwelling-houses: (a) After notified infectious disease (other than tuberculosis) 511 (b) Contacts 156 (c) Fumigations after infectious disease 12 (d) Tuberculosis enquiries and fumigations 3 School and church halls 10 Swimming baths - Water sampling: (a) Swimming baths 22 (b) Dwelling-houses 9 Business premises - Cinemas, dance halls, billiard halls 37 Offensive trade premises - Stables, piggeries, keeping of animals 66 Houses let in lodgings - Factories Acts, 1937 and 1948: Factories with mechanical power 218 Factories without mechanical power 11 Outworkers' premises - Underground rooms 2 Hairdressing premises 23 Tents., vans and sheds 6 Smoke nuisances 295 Fairgrounds - Drainage: Testing by: (a) Smoke 99 (b) Coloured water 108 (c) Water 24 (d) Breaking down 217 Public sewers 505 Watercourses and ditches 1 Means of escape in case of fire - Land and tips 74 Septic tanks and cesspools - Sanitary conveniences — including public-houses 15 Miscellaneous visits 1748 Visits not inspections 1858 Rodent control 6 Verminous premises: (a) Rats and mice: After complaints or from survey 154 (b) Bug infestations: Number of premises visited 43 (c) Beetles 5 (d) Other vermin 160 (e) Scabies - Inspections for supervision of food: Unfit foodstuffs other than meat 197 Slaughterhouses - 23 Table 9—continued Food and Drugs Act, 1955, Food Hygiene Regulations:- Bakehouses 129 Butchers' shops 368 Fish shops, grocers and greengrocers 1130 Factory and school canteens 151 Restaurant kitchens, etc. 401 Hotel and beerhouse bars and cellars: (a) Day inspections 138 (b) Night inspections - Food and Drugs Act, 1955, Section 16: Ice-cream premises (Heat Treatment Regulations, 1947 to 1951 175 Sausage manufacturers - Preserved meat preparation premises 6 Preserved fish preparation premises 4 Milk and Dairies Regulations, 1949: Milk sampling for bacteriological examination - Contravention of Milk and Dairies Regulations 9 Dairies 5 Shops Act, 1950, section 38 26 Game Licences - Middlesex county council Act, 1950: Hawkers' vehicles 54 Hawkers' premises 3 Noise nuisances 27 Massage and/or special treatment establishments 1 Petroleum (Regulation) Acts,1928 and 1936; Petroleum spirit Regulations, 1929-1950 587 National Assistance Act, 1948, Section 47 2 Rag Flock and other Filling Materials Act, 1951 - Dealers in Old Metal and Marine Stores - Pet Animals Act, 1951 14 Agriculture (safety, Health & welfare) Provisions Act, 1956 11 Total number of visits and inspections 14,255 24 Table 10 Sanitary Improvements Effected Number Offensive accumulations removed - Nuisance from keeping of animals remedied - Chimney flues repaired 2 Chimney stacks repaired 3 Roofs repaired 105 Eavesgutters repaired 26 Downspouts repaired 16 Pointing renewed 13 Ditches requiring cleansing - Drains repaired 6 Drains unstopped 20 Dustbins provided 8 Fireplaces repaired 8 Filthy condition of premises remedied - Floors repaired 31 Gullies repaired 6 Pail closets renewed - Plater to walls and ceilings repaired 161 Window frames and sashcords repaired 18 Public sewers repaired 4 Sinks provided 1 Sink waste pipes repaired 11 Soil pipes repaired 7 Stairs repaired 3 External walls repaired 2 Wash boilers repaired - W.C.s repaired 9 W.C. cisterns and fittings provided 26 W.C. accommodation provided - Yard puving repaired - Unpaved Yards and Passages - Other works carried out 216 25 Table 11 Housing Statistics HOUSES IN CLEARANCE AREAS AND UNFIT HOUSES ELSEWHERE Return for the Year ended 31st December, 1958 A. HOUSES DEMOLISHED In clearance Areas: Houses Demolished. Displaced during Year Persons Families (1) Houses unfit for human habitation 6 Nil Nil (2) Houses included by reason of bad arrangement, etc. Nil Nil Nil (3) Houses on land acquired under section 43 (2) Housing Act, 1957 Nil Nil Nil Not in clearance Areas: (4) As a result of formal or informal procedure under section 17(1) Housing Act,1957 10 25 10 (5) Local Authority owned houses certified unfit by the M.O.H. Nil Nil Nil (6) Houses unfit for human habitation where action has been taken under local Acts Nil Nil Nil (7) Unfit houses included in Unfitness Orders. Nil Nil Nil B. UNFIT HOUSES CLOSED Number (8) Under sections 16(4), 17(1) and 35(1) Housing Act, 1957 2 13 5 (9) Under sections 17(3) and 26, Housing Act 1957 Nil Nil Nil (10) Parts of buildings closed under Section 18, Housing Act, 1957. 1 Nil Nil C. UNFIT HOUSES MADE FIT AND HOUSES IN WHICH DEFECTS WERE REMEDIED. By Owner By Local Authority (11) After informal action by local authority 273 - (12) After formal notice under (a) Public Health Acts. 26 Nil (b) Section 9 and 16 Housing Act, 1957 Nil Nil (13) Under Section 24, Housing Act, 1957. Nil - D. UNFIT HOUSES IN TEMPORARY USE (Housing Act, 1957) Position at the end of year Number of houses (1) Number of separate dwe11ings contained in column (1) (2) (14) Retained for temporary accommodation: (a) under section 48 Nil Nil (b) under section 17(2) Nil Nil (c) under section 46 Nil Nil (15) Licensed for temporary occupation under Sections 34 or 53 Nil - E. PURCHASE OF HOUSES BY AGREEMENT Number of houses (1) Number of occupants of houses in column (1) (2) (16) Houses in clearance Areas other than those included in confirmed clearance Orders or Compulsory Purchase Orders, purchased in the year Nil Nil 26 Table 12. Notices Served Administrative action was taken during the year to secure abatement of nuisances and to enforce the appropriate statutory enactments, as follows: Subject of Notice Public Health Act Food and Drugs Act Number of Informal Notices served 326 151 Number of Informal Notices complied with 299 212 Number of Statutory Notices served 52 - Number of Statutory Notices complied with 47 - 27 Table 13. Prevention of Damage by Pests Act 1949 TYPE OP PROPERTY Non-Agricultural Agricultural Local Authority Dwe11ing Houses(incl Council Houses) All other (incl. Business Premises) Total of cols, 1,2 & 3 Number of properties in Local Authority's District 112 30.172 4,689 34,973 29 Number of properties inspected as a result of (a) Notification 12 341 77 430 Nil (b) survey under the Act 23 2898 429 3350 Nil (c) Otherwise (e.g., when visited primarily for some other purpose - 17 6 23 Nil Total inspections carried out including ions 161 6080 2030 8271 Nil Number of properties inspected which were found to be infested by (a) Rats 2 395 80 477 Nil (b) Mice 3 44 15 62 Nil Number of infested properties treated by L.A. 5 416 87 508 Nil Total treatments carried out including re-treatments 5 450 82 537 Nil Number of notices served under section 4 of the Act (a) Treatment Nil 23 8 31 Nil (b) structural work Nil Nil Nil Nil Nil Number of cases in which default action was taken following the issue of a notice under section 4 of the Act Nil Nil Nil Nil Nil Legal proceedings Nil Nil Nil Nil Nil Number of Block control Schemes carried out 9 28 29 Table 14 Eradication of Insect Pests. D.D.T. and Other Special Treatments Number of Infestations Treated Type of Premises Beetles Bugs Bees Fleas Flies Wasps Woodworm Totals Dwelling-houses - 13 3 9 2 30 1 58 Workplaces 1 - - 1 - - - 2 Food Shops - - - - - - - Nil Miscellaneous - - - - - 1 - 4 Totals 1 13 3 10 2 31 1 61 Total income for D.D.T. and other special treatments, £50. 15s. 0d. Table 15. Disinfections, etc. Number Premises disinfected after infectious diseases 12 Premises disinfected after other diseases - Articles disinfected after infectious disease 124 Persons (children and adults) treated for scabies at cleansing station - Table 16. Housing Act, 1936. Overcrowding Number New cases of overcrowding reported during the year 9 (1) cases of overcrowding relieved during the year 5 (2) Persons concerned in such cases 19 Table 17. Milk and Dairies Regulations, 1949 Milk (Special Designation) (Raw Milk) Regulations, 1949 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 The necessary registration of persons and premises, and the issue of appropriate licences, has been effected in accordance with the following table: Milk and Dairies. Regulations, 1949 Persons registered as distributors 36 Premises registered as dairies (not being dairy farms) 16 Special Designation Dealers' Licences Supplementary Licences Milk (Special Designation) (Raw Milk) Regulations 1949. Tuberculin tested 18 11 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949. Pasteurised 24 11 Sterilised 31 10 30 Table 18 Food and Drugs Act. 1955 Public Health Act. 1936, Section 89 INSANITARY CONDITIONS IN FOOD PREMISES Number of premises found with insanitary conditions 151 Number of premises remedied 212 Insanitary conditions found in premises above Number of defects Number of defects remedied Equipment not kept in good order 30 74 Food so placed as to involve risk of contamination 15 39 Food placed within eighteen inches of the ground and not adequately protected 1 3 Absence of personal cleanliness - 1 Insufficient ventilation to W.C. 14 50 Absence of "Wash your Hands" notices to W.C.s 18 46 Absence of suitable and sufficient wash-hand-basins 12 40 Absence of hot water at a suitably controlled temperature over wash-hand-basins 17 61 Absence of soap, nail brushes, clean towels, etc., near wash-hand-basins. 13 37 Absence of first aid materials 34 80 Absence of accommodation for clothing not worn during working hours 20 37 Absence of suitable and sufficient sinks for the washing of food and equipment 5 11 Absence of hot water at a suitably controlled temperature over sinks 4 15 Absence of soap, clean cloths, etc., at sinks 1 1 Absence of suitable and sufficient lighting in food room 5 8 Absence of suitable and sufficient ventilation in food room 2 2 Walls, etc., not kept clean 99 90 Walls, etc., not kept in good order 78 103 Accumulation of refuse, etc. 7 19 Verminous condition: of premises - 1 Miscellaneous 90 134 Total 616 1,064 SCHOOLS Number of defects Equipment not kept in good order 6 Insufficient ventilation to w.C. 1 Absence of suitable and sufficient wash-hand-basins - Absence of hot water at a suitably controlled temperature over wash-hand-basins 1 Absence of accommodation for clothing not worn during working hours 1 Absence of suitable and sufficient sinks for the washing of food and equipment - Absence of suitable and sufficient lighting in food room - Absence of suitable and sufficient ventilation in food room 2 Walls, etc., not kept clean 3 Walls, etc., not kept in good order 7 Accumulation of refuse, etc. - Miscellaneous 6 Total 27 31 Table 19. (a) Meat-Carcases Inspected and Findings at Private Slaughterhouses in the Borough Cattle excl. Cows Cows Calves Sheep and Lambs Pigs Horses Number killed (if known) - - - - - - Number inspected - - - - - - All diseases except Tuberculosis and Cysticerci: Whole carcases condemned - - - - - - Carcases of which some part or organ was condemned - - - - - - Percentage of the number inspected affected with disease other than tuberculosis and cysticerci - - - - - - Tuberculosis only: Whole carcases condemned - - - - - - Carcases of which some part or organ was condemned - - - - - - Percentage of the number inspected affected with tuberculosis - - - - - - Cysticercosis: Carcases of which some part or organ was condemned - - - - - - Carcases submitted to treatment by refrigeration - - - - - - Generalised and totally condemned - - - - - - (b) Other Carcases Inspected NIL 32 Table 20. (a) Meat Diseased and unsound conditions found in meat caused the detention and surrender for destruction of: lbs. Beef 1.172 Mutton and lamb 480 Pork 407 Other meats 192 Total 2,251 (b) Other Foodstuffs The following foodstuffs, other than meat, being unfit for human consumption, were voluntarily surrendered for destruction: lbs Bacon 78 Cheese 295 Fish 441 Fresh Fruit 697 Offal 571 Poultry 149 Sausages 114 Vegetables - fresh 143 Meat Pies 75 jars Pickles, Sause, etc. 38 Preserves 50 tins Cream 5 Fish 90 Fruit & Fruit Juices 754 Meat 407 Milk 142 Puddings 10 Soup 108 Vegetables 389 Other 17 33 Table 21 Sampling The Middlesex County Council is the food and drugs authority for the Borough. The Chief Officer, Public Control Department, has kindly supplied the following information relating to samples taken in the Borough during the year ended 31st December, 1958. Article Total Samples procured Unsatisfactory. Milk (Various) 111 - Butter 14 - Cakes 6 - Cooked Meat 7 - Cream 18 - Drugs 18 - Fish and Fish Products 20 - Fruit, Fresh, canned, Dried 22 - Fruit Juice, etc. 4 - Ice Cream 17 - Jelly 5 - Liver 7 - Meat and Meat Products 8 - Preserves 11 - Sausages, etc. 20 7 Spirits 8 - Sweets 7 - Vinegar 23 - Miscellaneous 37 - Totals 363 7 34 With regard to the samples listed as being unsatisfactory, I add the following comments: Sausages Sausages and sausage meat may contain not more than 450 parts per million of sulphur dioxide as an added preservative provided that the presence of this preservative is disclosed. The 7 samples of sausages which are shown as unsatisfactory all contained this preservative in an amount which would have been permitted had its presence been disclosed. In one case a preliminary sample was unsatisfactory whereas a subsequent sample was genuine and no further action was taken. In a second case a general notice declaring the presence of preservative in sausages was obscured and not in a position where it would have been readily seen by a purchaser; the trader was fully advised as to his responsibility for the future. A third retailer received an official caution in respect of two samples of sausages, each of which contained undeclared preservative. A fourth retailer, from whom three unsatisfactory samples had been obtained, was prosecuted and was fined a total of £3, together with £7. 10s. Od. costs. Merchandise Marks Acts, 1887 - 1953. The majority of the inspection work carried out under the provisions of the above Acts relates to ensuring that the requirements of the various Marking Orders made under the provisions of the Act of 1926, and which relates to the marking with an indication of origin of certain imported foodstuffs when exposed for sale or sold, are complied with. Inspections were made at 246 separate premises of 1,437 displays of meat, apples, tomatoes, poultry and dried fruit. No serious infringements were detected. Labelling of Food Order, 1953. This order requires pre-packed food to be marked with the name and address, or with the registered trade mark, of the packer or labeller. It also requires such food to be labelled with its common or usual name (if any) and with the names of the ingredients of a compounded food. It also controls the manner in which the presence of vitamins and minerals is disclosed and prescribes specific labelling of certain foods. A total of 666 articles of pre-packed food was examined at 171 premises to ascertain whether the above requirements were complied with; no serious infringements of this Order were detected. False or Misleading Descriptions. As in previous years food advertisements and labels have been scrutinised for false or misleading statements and descriptions. Much of this scrutiny of food labels can be combined with inspection work under the Labelling of pood Order. No serious infingements were disclosed. Corrective action was secured in relation to descriptions applied to "milk block", "Double Tea", an imitation cream powder, cakes filled with a mixture of butter and sugar, canned mixed vegetables, raspberry syrup, powdered soup mixes, medium red salmon, gorgonzola cheese spread and cheese spread. Special Designated Milk During the year two samples of designated milk were taken and both were certified to be satisfactory. 35 Table 22 Factories Acts, 1937 and 1948. Part I of the Act. 1. INSPECTIONS FOR PURPOSES OF PROVISIONS AS TO HEALTH: Premises Number on Register Number of Inspections Written Notices Occupiers prosecuted (i) Factories in which section 1,2, 3,4 and 6 are to be enforced by Local Authorities 27 9 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 284 215 9 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) - - - - Total 311 224 9 - 2. CASES IN WHICH DEFECTS WERE FOUND: Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l) 2 4 - 2 - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) 4 6 - 1 - Ineffective drainage of floors (S.6) - - - - - Sanitary conveniences (S.7) (a) Insufficient 1 - - - - (b) Unsuitable or defective 4 2 - 2 - (c) Not separate for sexes 1 1 - - - Other offences against the Act (not including offences relating to outwork) 2 1 - - - Totals 14 14 - 5 - Part VIII of the Act, Outwork Nature of the Work Lampshades (fearing apparel Electric Fuse Makers Umbrellas, Cardboard boxes Section 110: Number of outworkers in August list required by Section 110 (1) (c) 9 52 94 1 1 Number of cases of default in sending lists to council - - - - - Number of prosecutions for failure to supply lists - - - - - Section 111: Number of instances of work in unwholesome premises - - - - - Notices served - - - - - Prosecutions - - - - - 36 Table 23. Infectious Diseases. Incidence and Mortality DIPHTHERIA, SCARLET FEVER AND ENTERIC FEVER 1941-1958 Year Diphtheria Scarlet Fever Enteric Fever No. of Cases Case Rate per 1,000 pop. No. of Deaths Death Rate per 1,000 pop. No. of Cases Case Rate per 1,000 pop. No. of Deaths Death Rate per 1,000 pop. No. of Cases Case Rate per 1,000 pop. No. of Deaths Death Rate per 1,000 pop. 1941 25 0.27 3 0.03 78 0.85 - - 7 0.07 - - 1942 7 0.08 1 0.01 125 1.35 - - - - 1 0.01 1943 4 0.04 1 0.01 238 2.56 - - - - - - 1944 5 0.06 3 0.03 121 1.37 - - - - - - 1945 4 0.04 1 0.01 97 1.06 - - - - - - 1946 4 0.04 - - 60 0.58 - - - - - - 1947 4 0.04 1 0.01 60 0.58 - - - - - - 1948 1 0.01 - - 99 0.93 - - - - - - 1949 - - - - 128 1.20 - - - - - - 1950 - - - - 115 1.07 - - - - - - 1951 - - - - 64 0.60 - - - - - - 1952 - - - - 135 1.28 - - - - - - 1953 - - - - 100 0.95 - - - - - - 1954 - - - - 64 0.61 - - - - - - 1955 - - - - 97 0.93 - - - - - - 1956 - - - - 51 0.49 - - - - - - 1957 - - - - 17 0.16 - - - - - - 1958 - - - - 38 0.37 - - - - - - 37 Table 24 Ophthalmia Neonatorum, years 1941-1958 The following table shows the number of cases notified and result of treatment: Year Cases notified Cases Treated Vision unimpaired Vision impaired Total blindness Deaths At home In hosp. 1941 5 2 3 5 - - - 1942 4 4 - 4 - - - 1943 6 6 - 6 - - - 1944 8 8 - 8 - - - 1945 2 2 - 2 - - - 1946 3 2 1 3 - - - 1947 5 5 - 5 - - - 1948 4 4 - 4 - - - 1949 - - - - - - - 1950 2 2 - 2 - - - 1951 8 6 2 8 - - - 1952 4 3 1 4 - - - 1953 4 4 - 4 - - - 1954 2 2 - 2 - - - 1955 5 2 3 5 - - - 1956 4 - 4 4 - - - 1957 5 5 - 5 - - - 1958 2 1 1 2 - - - 38 39 Table 25 Cases of Infectious Diseases Notified during the Year 1958 DISEASE CASES NOTIFIED AT VARIOUS AGES (YEARS) Total cases notified. Deaths Under 1 Year 1-2 2-3 3-4 4-5 5-10 10-15 15-20 20-25 25-35 35-45 45-65 Over 65 Age not known Dysentery - 1 4 - 6 9 13 8 3 5 8 8 1 1 67 - Encephalitis - - - - - - - - - - - - - - Nil - Erysipelas - - - - - 1 1 - 2 - 1 3 2 1 11 - Food Poisoning 2 5 4 1 2 6 1 1 4 6 8 2 - 1 43 - Measles 8 32 47 59 48 228 17 5 1 6 - - - 5 456 - Meningococcal Infections - - - - - - - - - - - - - - Nil - Ophthalmia Neonatorum 2 - - - - - - - - - - - - - 2 - Acute Poliomyelitis - - - - - - - - - 1 - - - - 1 - Pneumonia - - - - - 8 3 1 3 6 5 14 22 2 64 71 Puerperal Pyrexia - - - - - - - - 2 1 - - - - 3 - Scarlet Fever - 1 2 3 - 28 4 - - - - - - - 38 - Typhoid & ParaTyphoid - - - - - - 1 - - - 1 - - - 2 - Whooping Cough - 7 3 4 2 11 - - 1 - 1 - - 1 30 - Totals 12 46 60 67 58 291 40 15 16 25 24 27 25 11 717 71 40 Table 26 Monthly Incidence of Infectious Diseases during the Year 1958 DISEASE NUMBER OF CASES TOTAL January Feb. March April May June July August Sept. October Nov. Dec. Dysentery 1 - - 3 4 40 - 4 4 - 6 5 67 Encephalitis - - - - - - - - - - - - Nil Erysipelas - - 2 1 1 1 - 1 - - 5 - 11 pood Poisoning 2 4 3 6 10 7 1 - 2 - 1 7 43 Measles 11 18 6 38 25 16 176 55 14 19 37 41 456 Meningococcal Infections - - - - - - - - - - - - Nil Ophthalmia Neonatorum - 1 1 - - - - - - - - - 2 Acute Poliomyelitis - - - - - - - - - 1 - - 1 para-Typhoid - - - - 2 - - - - - - - 2 Pneumonia 16 7 9 2 2 6 3 2 1 3 7 6 64 Puerperal Pyrexia - - 2 - - - - - - - - 1 3 Scarlet Fever - 3 3 5 - 1 2 2 1 2 7 12 38 Whooping Cough - 7 1 2 3 1 2 1 2 1 5 5 30 Totals 30 40 27 57 47 72 184 65 24 26 68 77 717 41 Table 27 Ward Distribution of Infectious Diseases Notified during the Year 1958 Disease Twickenham Heathfield Whitton Hampton Hampton Hill Teddington Hampton Wick Total East Central South West Upper Lower Dysentery - 3 3 6 - - 2 8 - 3 42 67 Encephalitis - - - - - - - - - - - Nil Erysipelas - 2 - - - - - - 2 1 6 11 pood Poisoning 11 5 2 3 - - 17 1 - - 4 43 Measles 16 15 14 29 17 20 163 56 17 64 45 456 Meningococcal Infections - - - - - - - - - - - Nil Ophthalmia Neonatorum - - - - - - 1 - - - 1 2 Acute Poliomyelitis - - - - - - 1 - - - - 1 Para-Typhoid - - - - - - - - - - 2 2 Pneumonia 1 1 3 4 6 1 8 11 10 4 15 64 Puerperal Pyrexia - - - - - - 2 1 - - - 3 Scarlet Fever 3 1 - - 9 2 5 4 6 4 4 38 Whooping Cough 5 3 1 3 3 2 4 4 - 3 2 30 Totals 36 30 23 45 35 25 203 85 35 79 121 717 Table 28 Tuberculosis The following tables have been compiled from the notifications received: NEW CASES AND MORTALITY Age Periods New Cases Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary Male Female Male Female Male Female Male Female Under l 1 - - - - - - - 1-4 - - - - - - - - 5-9 1 1 - - - - - - 10-14 2 - - - - - - - 15-19 2 3 1 - - - - - 20-24 5 4 - 1 - - - - 25-34 5 6 - - 2 1 - - 35-44 2 1 - 2 - - - - 45-54 5 5 - 2 5 - 2 - 55-64 7 1 1 - - - - - 65 and over 3 - - - 5 - - 1 age unknown - - - - - - - - Totals 33 21 2 5 12 1 2 1 Public Health (Prevention of Tuberculosis) Regulations, 1925. It was not necessary to take any action under the above regulations concerning persons suffering from tuberculosis and employed in the Milk trade. Public Health Act, 1936 (Section 172) No action was taken under this section for the compulsory removal to hospital of persons suffering from tuberculosis. Table 29 PRIMARY NOTIFICATIONS OF TUBERCULOSIS, 1941-1958 INCLUSIVE. 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 Pulmonary 127 112 119 133 118 120 132 117 115 96 107 79 105 88 70 58 57 54 Non- Pulmonary 14 18 18 18 18 19 11 17 5 15 14 20 14 12 11 3 7 7 Totals 141 130 137 151 136 139 143 134 120 111 121 99 119 100 81 61 64 61 42 Table 30 Food Poisoning Food Poisoning Notifications: 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter TOTAL 9 23 3 8 43 OUTBREAKS DUE TO IDENTIFIED AGENTS: Nil Number of cases Nil. Outbreaks due to: Chemical Poisons - Salmonella organisms - Staphylococci (inc. toxin) - Cl. Welchii - OUTBREAKS DUE TO UNDISCOVERED CAUSE Nil Number of cases Nil SINGLE CASES: Due to identified agents: Number of cases 7 Chemical Poisons - Salmonella organisms 1 Staphylococci 6 P. Morgani - Due to undiscovered cause 36 Number of cases 36 Total all cases 43 43 44 Table 31 Premises concerned with Health Services in Area 10 A = Ante-natal and post-natal care of mothers. D = Dental H = Headquarters Personal Health P = Family Planning (provided by voluntary Organisation). B = Baby Welfare E = Eye testing I = Vaccination and Immunisation. C = Chiropody (Old People-provided by Voluntary Organisation). F = Distribution of Welfare Foods. J = Geriatric S = School Health M — Mental Health T = Talking and Speech Therapy G - Child Guidance O = Orthopaedic. V = Environmental Health Enquiries should be made at the appropriate address for particulars as to persons eligible, special conditions as to services and the time the premises are open. Elmfield House, High Street, Teddington H V Council Offices, Bridge Street, Staines. V Grove Crescent, Hanworth A B D E F I ST Church Road, Teddington A B C D F J I O Stanwell Road, Ashford. A B C D E F I O S Imperial Road, Bedfont. A B D F I S T Hospital Bridge Road, Whitton. A B C D F I S The Grange, Gresham Road. Staines. A B D E F G I M O P S T Council Offices, Green Street, Sunbury. V 20 Seymour Road, Hampton Wick. A B D F I P S Village Hall, Stanwell. A B F I Duddingston House, Green Street, Sunbury A B C D F I S Stanley Road, Teddington. C D E I S Village Hall, Laleham. B. F I Chertsey Road, Ashford Common A B C D F I ST 24 Station Road, Hampton. A B D F I S St. Anne's School, Ashford S Laleham Road. Shepperton. A B C D F I S T York House, Richmond Road, Twickenham. A B C D E F IS St. Marys Church Hall, Bridge street, Staines F New Hall. Upper Halliford. A B F I 58 Hampton Road, Twickenham. G T Council Offices, Hanworth Road, Feltham. V Hawke House, Green Street, Sunbury. F Baptist Church Hall, Hounslow Road, Whitton. F Cardinal Road, Peltham. A B D E F ISP