AC 439 (1) TWI 27 DECEMBER, I960 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 New Legislation 5 Pest Destruction 6 Keeping the Borough Clean 6 Water Supply 7 Industrial Health 8 General Matters 8 Statistical Tables 13 1 Telephone: TEDington Lock 4521 TEDington Lock 4411-5 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 1960 on the health and sanitary conditions of the Borough together with the supplement containing the statistical tables for 1959 as required by the Ministry of Health. I apologise for this report being so late; it has awaited my return to duty after my illness; I am very grateful for the indulgence and sympathy you have shown to me. The infant death rate continues to be low at 16.78 deaths per 1,000 live births, which shows good care is taken of the infants by their parents. Mothers attend the clinics in enormous numbers; they must therefore feel they get good service, good advice, help and comfort from going there or they would not come. We get our reward in healthy babies given a good start in life. The population of the Borough has remained steady this last 3 years at about 103,600. There is little difference in the number of deaths from cancer each year which remains at about 230. Diseases of the circulatory system, such as atherosclerosis, coronary thrombosis, and stroke, continue to be the most serious menace to people grow ing older. There were 669 deaths in this group. There is good reason for believing that atherosclerosis may have as a contributory cause the deficiency in the consumption of linoleic acid which is contained in the vegetable fats such as maize oil. In the experimental clinic for older people at Teddington we have been observing the effects of the part substitution of vegetable fat for animal fat and have been encouraged to observe that the progress of atherosclerosis seems at least to be halted if not reversed under this regime. The day may come when the full cause will be completely known and we may then be in a position of controlling and preventing this disease as we have been in the case of so many others. An important advance has been putting into effect the provisions of the Clean Air Act which enables us to get rid of smoke in the whole of the Borough. The Health Committee went to considerable pains to find out the extent of the problem, and what would be needed and the probable cost. A special survey was done on a 10% sample of all types of houses in the Borough which showed that the estimated total number of grate conversions required was over 20,000. The total estimated cost was nearly £300,000.and the cost to the Corporation was estimated at approximately £96.000. The Corporation have faced this problem boldly and have decided to try to clear the whole Borough within 10 years which is a formidable and costly undertaking. They are to be congratulated on this wise health promoting measure. Once again it is a pleasure to acknowledge and commend the untiring zeal and devotion to duty of the staff, both those with me 2 in Elmfield House and those outside in all the branches of the service. Owing to my illness this year I am more than ever indebted to Dr. Cormack, Dr. Wilkinson, Mr. Easter, Mr. Pugh, Miss Francis, Miss Greeno and Miss Reeves. It says much for the smooth running of the administrative and technical activities of the health department that they have gone on so smoothly during my absence and I am deeply appreciative of the devotion to duty of these officers and all the many others outside who have carried on so faithfully and so well. 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 tp 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 H.S.FUTTER THE DEPUTY MAYOR, COUNCILLOR E.A.TAPSELL Chairman: COUNCILLOR MRS.M.B.DAVIES Vice-chairman: COUNCILLOR L. DEFRIES-PORTER, LL. B.,A..M.B. I. M. . Alderman F.J.Edwards J.P. Councillor Mrs.M.E.D.Lever Alderman J.H.Knaggs J.P. Councillor R.H.Mitchison Councillor Mrs.G.E.Brightmore Councillor W.J.E.Pett Councillor Mrs.C.C.Cunningham- Councillor N.Sheldon,A.R.C.S., Howie. P.R. I.C. Councillor A. C. Lasseter Councillor C. W. Sewell,M. A.,, 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, T. C. Coleman, Public Health Inspectors T. A. Dawkins, 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 Miss,D.Wheeler Senior Rodent Operative Mr.H.T.Jackman Rodent Operative Mr.s.Jackman Disinfector/Drain Tester Mr.E.G.Cooper 4 NEW LEGISLATION 1. The Slaughterhouses (Hygiene) Regulations, 1958 and the Slaughter of Animals (Prevention of Cruelty) Regulations, 1958 came into force on the 1st January, 1959. These regulations deal with the hygienic construction, layout and equipment of slaughterhouses and the practices to be observed therein. 2. The Milk and Dairies (General) Regulations, 1959, came into force on the 8th March, 1959 and re-enact, with amendments, the Milk and Dairies Regulations, 1949 54. Amongst the principal changes are (a) the registration of distributors is now required to be effected only with the local authority in whose area the premises from which the milk is distributed are situated; (b) provision is made for the local authority to pay compensation to a person who sustains damage or loss through being debarred from certain employment connected with cows or with milk because he is suffering, or has been in contact with a person suffering, from a disease liable to cause infection of milk; (c) there are new provisions as to personal cleanliness, precautions against contamination or infection of milk, and the provision of first aid equipment. 3. The Ice-Cream (Heat Treatment etc.) Regulations, 1959, came into force on the 27th April 1959. These regulations consolidate and amend the previous regulations made between 1947 and 1952. They require that ingredients used in the manufacture of icecream are to be pasteurised by one or other of three specified methods or sterilized and thereafter kept at a low temperature until the freezing process is begun. The regulations make it an offence to sell ice cream which has not been so treated but they exempt from the requirement the pasteurisation or sterilization of certain types of water ice and ice lollies which are sufficiently acid to make such treatment unnecessary. 4. Housing (Underground Rooms) Act, 1959. Since the passing of the Housing Act, 1935, conditions in underground rooms have been governed mainly by Regulations prescribed by the Local Authority and defining adequate standards of light, ventilation and protection against dampness and effluvia. In a case heard in 1957 a Court of Appeal expressed the view that, by virtue of the wording of the Housing Repairs and Rent Act, 1954, the Regulations were no longer operative and that conditions in underground rooms were instead governed by general standards pertaining to all dwellings and now found in the Housing Act, 1957. The above new Act has restored the position and Regulations made by the Local Authority are once more operative. Existing Regulations are under consideration by the Minister of Housing and Local Government for revision and it is expected that 5 certain amendments to them will be advocated to the Local Authority for their adoption. 5.Public Health Officers Regulations, 1959. These regulations came into force on 15th June, 1959 and are substantially the same as the former regulations as to qualifications, duties and tenure of office of medical officers of health and public health inspectors. Under the former regulations, however, compliance with certain provisions was a condition of the right of councils of county districts arid metropolitan boroughs to receive from county councils payments towards the salaries of medical officers of health and public health inspectors. These payments were abolished by Section 57 of the Local Government Act, 1958. In addition to the qualifications prescribed for public health inspectors, the regulations now provide that a public health inspector appointed by a local authority employing only one public health inspector should have had at least two years previous experience. PEST DESTRUCTION The service provided by the department enables residents in the Borough to have insect pests identified and advice is given as to 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. Many complaints were received during the summer months of wasps nests being built in air vents, lofts, etc., due no doubt to the unusually hot summer and during the year 186 nests were destroyed. 25 premises were treated against bugs and in all cases complete clearance was effected. The normal work of rodent destruction continued during the year. The annual 10% test-baiting of the soil system of sewers was carried out in February, and infested manholes were subsequently treated in March and October. Part of the system was treated by the Ministry of Agriculture, Fisheries and Food in carrying out experimental work with a new type of poison. The whole cost of the experiment was borne by the Ministry. The area selected was in the St.Margarets and Twickenham district. The system comprised 203 manholes. The first treatment was carried out in July and poison takes were recorded in eighty manholes. The treatment was repeated in October when it was found that the number of infested manholes had been reduced to thirty four. A final census of the system in November revealed that there were minor infestations in eleven manholes only. 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 Contractor for the East Twickenham sewer has continued the 6 work chiefly in tunnel along Amyand Park Road, and some 1140 yards of reinforced concrete pipes 36" and 30" in diameter have now been laid. It is anticipated that this work will be completed in 1960. The diversion of foul and surface water sewers in the vicinity of London Road has been completed so as to permit of the con struction of the railway bridge. The widening of that road and the construction of the new bridge is now awaited. Public Conveniences Work on the construction of new conveniences in Water Lane is well advanced and it is anticipated that these Conveniences will be in use early in 1960, when the Conveniences at the junction of York Street and London Road will be removed for the improvement of that junction. Free washing facilities complete with hot water, towels and soap have been provided at the conveniences behind the cinema in the High Street, Whitton and similar facilities will be available at Water Lane when the new convenience is completed. Refuse Disposal Operation of the Charlton Plant continues satisfactorily and during the year there was an improvement in the price of certain salvageable materials and improved income for the year is therefore envisaged. 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 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. 7 INDUSTRIAL HEALTH Factories There are in the borough as many as 309 factories. Most of them are engaged in light industries such as the manufacture of electrical components,piston rings, 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. All factory premises are periodically inspected 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. In 1959 the Inspector's paid 348 visits to factories and in 6 cases the attention of the management had to be drawn to contraventions of the regulations. GENERAL MATTERS Housing Further progress was made during the year in dealing with unfit houses. Two Clearance Orders involving 14 houses were confirmed by the Minister, a compulsory purchase order made involving 25 houses and in addition 1 Demolition Order was made on an individual unfit house. Works of repair and improvement to three houses were carried out enabling the Corporation to determine three Closing Orders. Rent Act, 1957 During the year 20 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, 1959 PART I - Applications for Certificates of Disrepair. (1) Number of applications for certificates 20 (2) Number of decisions not to issue certificates 1 (3) Number of decisions to issue certificates 19 (a) in respect of some but not all defects 17 (b) in respect of all defects 2 (4) Number of undertakings given by landlords under paragraph 5 of the First Schedule 18 (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule 1 (6) Number of Certificates issued 11 PART II - Applications for Cancellation of Certificates (7) Applications by Landlords to Local Authority for cancellation of certificates 8 8 (8) Objections by tenants to cancellation of certificates 8 (9) Decisions by Local Authority to cancel in spite of tenant's objection 4 (10) Certificates cancelled by Local Authority 4 CLEAN AIR ACT 1956 Section 3. Smoke from Furnaces This section deals with the installation of new furnaces and the requirement that new furnaces shall be so far as practicable smokeless. Subsection (1) makes it an offence to instal a furnace unless it is capable of being operated without emitting smoke. Subsection (2) provides that where plans and specifications are submitted and approved the furnace shall be deemed to comply with subsection (1), and subsection (3) provides that notice must be given to the Corporation of a proposal to instal a furnace. This notice is quite separate from an application submitted for approval under subsection (2). During the year three applications under subsection (2) were submitted and approved and notice given in two cases of intention to instal a furnace. Section 11. Smoke Control Areas The special survey on smoke control areas is referred to on page 2. The normal work of the department on the control of the emission of dark smoke from chimneys etc. was continued. Readings are taken every month from the instruments set up at Beveree, Hampton and York House, Twickenham and daily from Elmfield House, Teddington. These readings are compared with readings from instruments set up by neighbouring authorities. 9 Shops Act, 1950 Section 38 of this Act deals with provisions for the health and comfort of the staff. Shops must be properly ventilated, adequately warmed and sufficiently lighted, must have toilet and washing facilities and, if the staff take meals on the premises, must have proper arrangements made for them. Sometimes it is 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 22 exemption certificates in force. Schools Inspections of the sanitary arrangements and canteens at the schools within the jurisdiction of the Divisional Executive were carried out by Public Health Inspectors during the year. The table on page 29 gives details of the work carried out under the Pood Hygiene Regulations, 1955 and the general standard of the canteens remains good. It was not necessary to close any schools on account of infectious disease amongst the children. Complaints During 1959 the number of complaints received by the department was 1,632. Food and Drugs Act, 1955 Food Hygiene Regulations, 1955 The table on page 29 gives details of the work carried out under these regulations. 26 complaints were received about unsound food purchased from retailers in the Borough. 2 cases were reported to the Public Health Committee and in both cases a warning letter was sent to the offender. 3438 visits were made to food premises under these Regulations. Petroleum Installations Regular inspections are made of all premises where petroleum or petroleum mixtures are stored and in the year 823 visits were made to the 105 premises licensed. 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 12 persons were registered and 65 visits were made by Inspectors. 10 Rag Flock and Other Filling Materials Act, 1951. It is unlawful in the course of a business to use filling materials in the manufacture of bedding, toys, baby carriages and other articles of upholstery except in premises registered by the Local Authority. Where rag flock is manufactured or stored for distribution to registered premises it is also necessary to be licensed. There are no premises in the Borough where rag flock is manufactured so therefore there are no premises licensed but three premises are registered. Pet Animals Act, 1951 No person is allowed to keep a pet shop except under the authority of a licence granted in accordance with the provisions of this Act. There are 11 licences in force in the Borough and 63 visits were made for the purpose of securing compliance with the licensing conditions. Following the receipt of a letter from a resident who had purchased from a pet shop in the Borough a kitten which was found to be suffering from an infectious disease, it was decided in November, 1959, to appoint a veterinary surgeon, in accordance with Section 4 of the Act, to advise, and if necessary, carry out clinical examinations of animals suspected of suffering from any such disease. It was not necessary for Mr. M. A. P. Simons, M. R.C.V. S. , the Veterinary Surgeon appointed, to visit any pet shops during 1959. It was not necessary to ask the R. S. P. C. A. Inspector for any assistance. Establishment for Massage, Chiropody, Electrical and Special Treatment 9 licences in respect of establishments for these purposes were issued during the year 1959. 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 62 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. Twickenham Bath, the most modern and also the largest, has a capacity of 280,000 gallons, Teddington Bath 180,000 gallons and Hampton Bath 110,000 gallons. Water is supplied by the Metropolitan Water Board's main and purified by means of continuous sand filters with marginal 11 tion. The Teddington and Hampton Baths have venturi-induced aeration and the Twickenham Bath has cascade aeration. The whole of the bath water is completely turned over every 6½ hours at each bath. During the season 53 samples were taken for bacteriological examination. 49 of these proved satisfactory and 4 unsatisfactory. The unsatisfactory samples were taken from Twickenham and Teddington Baths during the very hot weather when attendances were exceptionally high. The staff were running the plants at their maximum efficiency and it was impossible to increase the residual chlorine content as this was already maintained as high as was possible. The baths were not designed to deal with such high numbers of bathers and the only solution with the existing plant was to limit the numbers during the continuous hot weather. Laboratory Work The usual arrangements continued during the year and worked satisfactorily. Type of Sample or Specimen No. Taken Result Ice Cream (including Ice Lollies) 118 115 Grade I - Satisfactory 2 Grade II- Satisfactory 1 Grade IV- Unsatisfactory Water 75 57 - Satisfactory 18 - Unsatisfactory Faeces 305 Miscellaneous 3 National Assistance Act, 1948. Section 47 National Assistance (Amendment) Act, 1951 It was necessary during 1959, to remove to suitahle premises two persons who were in need of care and attention. Health Education Continued use was made of various health education methods, including propaganda by posters, leaflets and lectures illustrated by films and film strips. The Corporation made a contribution of thirteen guineas to the Central Council for Health Education during the year. Mortuary The number of bodies-659-admitted to the Mortuary during 1959 was the highest ever recorded. 12 TABLES FOR STATISTICAL YEAR 19 5 9 13 STATISTICAL TABLES for the Year 1959 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) 103,600 Number of inhabited houses 31,221 Rateable value £1,914,343 Sum represented by a penny rate £7,237.6.5 Total M. F. Live Births-Legitimate 1319 696 623 Illegitimate 52 26 26 Total 1371 722 649 Live Birth rate per 1,000 of estimated Civilian Population 13.23 Adjusted Live Birth rate ... ... ... ... ... 13.63 Total M. F. Still Births-Legitimate 21 11 10 Illegitimate 1 - 1 Total 22 11 11 Still Birth rate per 1,000 live and still births 15.79 Total Live and Still Births 1,393 Infant Deaths (under 1 year of age) Total M. F. Legitimate 22 13 9 Illegitimate 1 1 - Total 23 14 9 Infant mortality rate per 1,000 live births 16.78 Legitimate Infant mortality rate per 1,000 legitimate live births 16.68 Illegitimate Infant mortality rate per 1,000 illegitimate live births 19.23 Neo-Natal deaths Under 4 weeks of age Under 1 week of age Total M. F. Total il/„ F. Legitimate 16 10 6 14 9 5 Illegitimate 1 1 - 1 1 - Total 17 11 6 15 10 5 Neo-Natal mortality rate per 1,000 live births 12.40 Early Neo-mortality rate (deaths under 1 week per 1,000 total live births) 10.94 Perinatal mortality rate (stillbirths and deaths under 1 week combined per 1,000 total still and live births) 26.56 Illegitimate live births per cent of total live births 3.79 Maternal deaths Nil Maternal mortality rate per 1.000 live and still births Nil Deaths M. F. 1,256 624 632 Crude death rate per 1,000 of estimated civilian population 12.12 Adjusted death rate 11.51 14 Population 1942/1959 Table 2. Year Population Population trend Migration excess Total increase or decrease Percentage proportion Natural increase or decrease Inward Outward 1942 92,460 + 640 + 0.70% + 450 190 - 1943 92,780 - 320 + 0.35% + 502 - 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 - l.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 1959 103,600 + 100 + 0.10% + 115 - 15 Table 3. Causes of Death. Registrar-General's Official Returns. Causes of Death Males females Total All causes 624 632 1256 1. Tuberculosis, respiratory 6 2 8 2. Tuberculosis, other - - - 3. syphilitic disease 1 1 2 4. Diphtheria - - - 5. Whooping cough - - - 6. Meningococcal infections - - - 7. Acute poliomyelitis - - - 8. Measles - - - 9. other infective and parasitic diseases - 2 2 10. Malignant neoplasm, stomach 16 7 23 11. Malignant neoplasm, lung, bronchus 45 8 53 12. Malignant neoplasm, breast - 25 25 13. Malignant neoplasm, uterus - 13 13 14. Other malignant and lymphatic neoplasms 56 59 115 15. Leukaemia, aleukaemia 3 3 6 16. Diabetes 1 - 1 17. Vascular lesions of nervous system 75 98 173 18. Coronary disease, angina 149 88 237 19. Hypertension with heart disease 22 24 46 20. Other heart disease 49 108 157 21. Other circulatory diseases 28 28 56 22. Influenza 12 11 23 23. Pneumonia 38 40 78 24. Bronchitis 37 14 51 25. Other diseases of respiratory system 6 5 11 26. Ulcer of stomach and duodenum 4 2 6 27. Gastritis enteritis and diarrhoea 1 2 3 28. Nephritis and nephrosis 3 4 7 29. Hyperplasia of prostate 6 - 6 30. Pregnancy, Childbirth, abortion - - - 31. Congenital malformations 4 6 10 32. Other defined and ill-defined diseases 36 56 92 33. Motor vehicle accidents 10 3 13 34. All other accidents 9 18 27 35. Suicide 6 5 11 36. Homicide and operations of war 1 - 1 15 Table 4. Main Causes of Death An analysis of the death returns reveals the following main causes of death: Disease Percent age of total deaths Death rate per 1,000 of the population Diseases of heart and circulatory system 39.49 4.79 Intra-cranial vascular lesions 13.77 1.67 Bronchitis, Pneumonia, and other respiratory diseases 12.98 1.57 Cancer 18.71 2.27 Violence 4.14 0.50 Tuberculosis 0.64 0.08 16 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 and under 6mths. 6 months and under 9mths 9 months and under 12mths total deaths under 1 year All Causes: Certified 15 _ 2 _ 17 3 2 1 - 23 Uncertified - - - - - - - - - - Smallpox - - - - - - - - - - Chicken-pox - - - - - - - - - - Measles - - - - - - - - - - Scarlet Fever - - - - - - - - - - Diphtheria and Croup - - - - - - - - - - Whooping Cough - - - - - - - - - - Influenza - - - - - - - - - - Enteritis - - - - - - - - - - Tuberculous Meningitis - - - - - - - - - - Abdominal Tuberculosis - - - - - - - - - - Other Tuberculous Diseases - - - - - - - - - - Congenital Malformations 1 - - - 1 1 1 - - 3 Premature Birth 5 - - - 5 - - - - 5 Atrophy, Debility and Marasmus - - - - - - - - - - Atelectasis 8 - 1 - 9 - - - - 9 Injury at Birth - - - - - - - - - - Erysipelas - - - - - - - - - - Syphilis - - - - - - - - - - Rickets - - - - - - - - - - Meningitis (not Tuberculous) - - - - - - - - - - Convulsions - - - - - - - - - - Gastritis - - - - - - - - - - Laryngitis - - - - - - - - - - Bronchitis - - - - - - - - - - Pneumonia (all forms) - - - - - 2 1 1 - 4 Suffocation (overlying) - - - - - - - - - - Other causes 1 - 1 - 2 - - - - 2 Totals 15 - 2 - 17 3 2 1 - 23 (b) An analysis of the mortality reveals that neo-natal deaths were responsible for 73.91 per cent. of the total infant deaths. Under 24 hours 1 to 7 days 1 to 4 weeks Total under 4 weeks Percentage total infant deaths 8 7 n 17 73. 91 17 Table 6. Review of the Comparative Vital and Mortality Statistics for the Borough of Twickenham, together with those for England and Wales for years 1942-1959 inclusive Year Birth Rate DeathRate Infantile Mortality Rate Twickenham England and Wales Twickenham England and Wales Twickenham England and Wales 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 (bj 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 (bj 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 1959 (a) 13.23 16.5 (a) 12.12 11.6 16.78 22.0 (b) 13.63 (b) 11.51 (a) Crude (b) Adjusted 18 19 Table 7 AVERAGE RESULTS OP THE CHEMICAL AND BACTERIOLOGICAL EXAMINATION OF THE WATER SUPPLY TO THE BOROUGH OF TWICKENHAM FOR 1959 Milligrammes per litre (unless otherwise stated) (a) Chemical Description of the Sample No. of Samples Ammonia Nitrogen Albuminoid Nitrogen Oxidised Nitrogen (Nitrate) Chlorides as Cl. Oxygen abs. from Permanganate 4 hrs. at 27ºC Turbidity in terms of Silica Colour, mm. brown 2ft. tube Burgess's Tintometer Hardness (Total) Hardness (Non-carbonate) pH Value Phosphate as PO4 Silicate as SiO2 Sulphate as SO4 Fluoride as F Magnesium as Mg Electrical Conductivity (gemmhos) Hampton 52 .022 .075 3.8 28 1.08 0.4 10 250 56 7.7 0.95 9 54 0.2 4.0 525 (b) Bacteriological Description of the Sample No. of Samples Agar Plate count per millilitre Coliform count Percentage samples negative in 100 ml. 37°C 20-24 hrs. 3 days at 22°C Coliform E.Coli Hampton 976 6.7 — 100.0 100.0 Table 8 Analysis of Complaints Received Nature of Complaint Number Received Housing defects 241 Choked and defective drains 210 Accumulations of offensive matter 50 Unsound Pood 118 Verminous and other Infested premises (a) Bugs 27 (b) Wasps 303 (c) Rats and Mice 512 (d) Other 31 Keeping of Animals 3 Unsatisfactory milk supplies 3 Miscellaneous 134 Total 1632 20 Table 9 Summary of Visits, Inspections, etc. Housing Acts Number Clearance Areas 235 Individual Unfit Houses 209 Underground Rooms 57 Overcrowding 55 Housing Applications 203 Rent Act Certificates 254 Public Health Act: Drain Testing 105 Provision and maintenance of drainage systems 592 Public Sewers 753 Provision of Dustbins 36 Dirty/verminous premises and articles 205 Verminous persons and clothing 18 Wasps, Plies and Insects 528 Sanitary accommodation at Licensed Premises 49 Statutory nuisances relating to Premises 3684 " " " " Animals 128 " " " " Accumulations 215 " " " " Dust and Effluvia 141 " " " " Workplaces 6 Infectious Disease 1061 Tents, Vans, Sheds 12 Outside Interviews 456 Miscellaneous matters 570 Factories Acts: Factories with mechanical power 343 Factories without mechanical power 5 Rodent Control 224 Clean Air Act 747 Shops Acts 13 Water Act 39 Pet Animals Act 63 Petroleum Regulations 823 Milk and Dairies Regulations 14 21 Table 9 - continued Supervision of Food Supplies Inspection of Meat 43 Inspection of other Foods 133 Manufacturing and Wholesale Premises 88 Bakehouses 133 Butchers Shops 379 Grocers Shops 670 Fishmongers Shops 81 Fried Fish Shops 42 Sweet Shops 143 Bakers Shops 58 Greengrocers Shops 334 Restaurants 712 Licensed Premises 168 Factory and School Canteens 198 Ice-Cream Premises 229 Preserved Meat and Fish preparation premises 27 Sampling: Ice-Cream 21 Domestic water supplies 21 Swimming bath water 30 Middlesex County Council Act: Places of Public Entertainment , 66 Hawkers. Vehicles and Premises 65 Hairdressing Establishments 62 Noise Nuisances 119 Total number of visits and inspections 15,665 22 Table 10 Sanitary Improvements Effected Number Offensive accumulations removed 4 Chimney flues repaired 2 Chimney stacks repaired 5 Dampness to walls 133 Downspouts repaired 4 Drains repaired 21 Drains unstopped 22 Dustbins provided 5 Eavesgutters repaired 34 Filthy condition of premises remedied 1 Fireplaces repaired 8 Floors repaired 23 Gullies repaired 6 Plaster to walls and ceilings repaired 95 Roofs repaired 78 Sashframes and sashcords repaired 28 Sinks provided and repaired 2 Sink Waste Pipes repaired 10 Soil Pipes repaired 6 Stairs repaired 7 Walls (external) repaired 7 Water closets repaired 10 Water Closet cistern and fittings provided 23 Water closet accommodation provided 2 Other works carried out 104 23 Table 11 Housing Statistics HOUSES IN CLEARANCE AREAS AND UNFIT HOUSES ELSEWHERE Return for the Year ended 31st December, 1959 A. HOUSES DEMOLISHED In Clearance Areas: Houses Demolished. Displaced during Year Persons Families (1) Houses unfit for human habitation 3 23 8 (2) Houses included by reason of bad arrangement, etc. - - - (3) Houses on land acquired under Section 43 (2) Housing Act, 1957 - - - Not in Clearance Areas: (4) As a result of formal or informal procedure under Section 17(1) Housing Act, 1957 5 4 2 (5) Local Authority owned houses certified unfit by the M.O.H. 1 7 2 (6) Houses unfit for human habitation where action has been taken under local Acts - - - (7) Unfit houses included in unfitness Orders. - - - B. UNFIT HOUSES CLOSED Number (8) Under Sections 16(4),17(1) and 35(1) Housing Act, 1957 - - - (9) Under Sections 17(3) and 26, Housing Act 1957 - - - (10) Parts of Buildings closed under Section 18, Housing Act, 1957 - - - C. UNFIT HOUSES MADE FIT AND HOUSES IN WHICH DEFECTS WERE REMEDIED. By Owner By Local Authority (11) After informal action by local authority 258 - (12) After formal notice under (a) Public Health Acts. 26 - (b) Section 9 and 16 Housing Act, 1957 3 - (13) Under Section 24, Housing Act, 1957. - - D. UNFIT HOUSES IN TEMPORARY USE (Housing Act,1957) Position at the end of year Number of house (1 Number of separate dwe11ings contained in column (1) (2) (14) Retained for temporary accommodation (a) under Section 48 - - - - (b) under Section 17(2) - - (c) under Section 46 - - (15) Licensed for temporary occupation under Sections 34 or 53 - - 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 - - 24 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 236 114 Number of Informal Notices complied with 258 136 Number of Statutory Notices served 23 - Number of Statutory Notices complied with 26 - 25 Table 13. Prevention of Damage by Pests Act, 1949. TYPE OF PROPERTY Non-Agricultural Agricultural Local Authority Dwelling louses(incl Council Houses) All other (incl. Business Premises) Total of cols 1.2&3 Number of properties in Local Authority's District 113 30,467 4.717 35,297 30 Number of properties inspected as a result of (a) Notification 22 288 89 399 - (b) Survey under the Act 30 2289 449 2768 - (c) Otherwise (e.g., When visited primarily for some other purpose 1 10 4 15 - Total inspections carried out including re-inspections 194 4318 1233 5745 - Number of properties inspected which were found to be infested by (a) Rats 27 229 43 299 - (b) Mice 10 41 6 57 - Number of infested properties treated by L.A. 37 268 47 352 - Total treatments carried out including re-treatments 37 287 50 374 - Number of notices served under Section 4 of the Act (a) Treatment - 2 2 4 (b) Structural work - - - - - Number of cases in which default action was taken following the issue of a notice under Section 4 of the Act - - - - - Legal proceedings - - - - - Number of Block control Schemes carried out 6 NOTE: In accordance with the instructions of the Ministry of Agriculture, Fisheries and Food the above report covers the period 1st April to 31st December, 1959. 25 27 Table 14 Eradication of Insect Pests. D.D.T. and Other Special Treatments Number of Infestations Treated Type of Premises Beetles Bugs Cockroaches Fleas Flies Wasps Woodworm Totals Dwelling-houses 1 25 1 9 - 171 1 208 Workplaces - - - - - 9 - 9 Food Shops - - 4 - 1 . - - 5 Miscellaneous - - - - - 6 - 6 Totals 1 25 5 9 1 186 1 228 Total income for D.D.T. and other special treatments, £140- 15-6 Table 15 Disinfections, etc. Number Premises disinfected after infectious diseases 2 Premises disinfected after other diseases - Articles disinfected after infectious disease 333 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 20 (1) Cases of overcrowding relieved during the year 5 (2) Persons concerned in such cases 16 Table 17 Milk and Dairies (General) Regulations, 1959 Milk (Special Designation) (Raw Milk) Regulations, 1949 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 Itie necessary registration of persons and premises, and the issue of appropriate licences, hes been effected in accordance with the following table: Milk and Dairies (General) Regulations, 1959 Persons registered as distributors ... ... ... 26 Premises registered as dairies (not being dairy farms) 14 Special Designation Dealers' Licences Supplement aryLicences Milk (Special Designation) (Raw Milk) Regulations 1949 Tuberculin tested 18 11 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 Pasteurised 26 11 Sterilised 29 10 28 Table 18 Food and Drugs Act, 1955 Public Health Act, 1936, Section 89 INSANITARY CONDITIONS IN POOD PREMISES Number of premises found with insanitary conditions 114 Number of premises remedied 136 Insanitary conditions found in premises above Number of defects Number of defects remedied Equipment not kept in good order 11 as Food so placed as to involve risk of contamination 12 20 Food placed within eighteen inches of the ground and not adequately protected 2 2 Absence of personal Cleanliness - - Insufficient ventilation to w.C. 11 20 Absence of "Wash your Hands" notices to W. C.s 4 20 Absence of suitable and sufficient wash-hand-basins 5 13 Absence of hot water at a suitably controlled temperature over wash-hand-basins 6 25 Absence of soap, nail brushes, clean towels, etc., near wash-hand-basins 7 10 Absence of first aid materials 9 18 Absence of accommodation for clothing not worn during working hours 4 12 Absence of suitable and sufficient sinks for the washing of food and equipment 5 4 Absence of hot water at a suitably controlled temperature over sinks 1 6 Absence of soap, clean cloths, etc., at sinks 1 1 Absence of suitable and sufficient lighting in food room 3 6 Absence of suitable and sufficient ventilation in food room 0 1 Walls, etc., not kept clean 63 77 Walls, etc., not kept in good order 49 73 Accumulation of refuse, etc. 10 11 Verminous condition of premises - - Miscellaneous 73 107 Total 278 464 29 SCHOOLS } Number of defects Equipment not kept in good order 25 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 - Absence of accommodation for clothing not worn during working hours - Absence of suitable and sufficient sinks for the washing of food and equipment 2 Absence of suitable and sufficient lighting in food room - Absence of suitable and sufficient ventilation in food room 4 Walls, etc., not kept clean 18 Walls, etc., not kept in good order 10 Accumulation of refuse, etc. 1 Miscellaneous 2 Total 63 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 30 Table 20 (a) Meat Diseased and unsound conditions found in meat caused the detention and surrender for destruction of: lbs. Beef 187 Mutton and Lamb 259 Pork 362 Total 808 (b) Other Foodstuffs. The following foodstuffs, other than meat, being unfit for human consumption, were voluntarily surrendered for destruction lbs. Bacon 426 Cheese 111 Coconut 28 Fish 474 Dried Fruit 11 Offal 56 Poultry 723 Sausages 5 Apricot Pulp 672 Jars Pickles, Sauce, etc. 455 Preserves 19 Other 9 Tins Fish 72 Fruit and Fruit Juices 557 Meat 209 Milk 64 Vegetables 144 Soup 17 Other 30 Pkts. Frozen Foods 218 Crisps 727 Dates 19 31 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 1959. Article Total dampLes Procured Unsatisfactory Milk (Various) 93 1 Butter 9 - Cakes 8 1 Cheese 4 - Cream 16 - Drugs 22 - Fish and Fish Products 25 1 Fruit, Fresh and Canned 17 - Ice-Cream 32 - Liver 12 - Margarine 7 - Meat and Meat Products 57 - Preserves 6 - Spirits 9 - Vinegar and Non-Brewed Condiment 30 2 Miscellaneous 23 1 Totals 370 6 32 With regard to the samples listed as being unsatisfactory, the following comments are made. Milk (Various) A glass of cold milk purchased from a milk bar was found deficient in fat. The deficiency was doubtless owing to the milk in the container from which the milk was obtained not being correctly mixed. Other samples from this source were found to be genuine. Cakes A firm of manufacturing pastrycooks were written to and warned for using incorrectly designated cartons for sponge sandwiches. Fish and Fish Products. The importers of a pack of tinned smoked saithe were officially cautioned for selling this product containing a preservative. The tinned fish was permitted to contain a preservative in the country from which it was exported, but there is an absolute prohibition in this country. Vinegar and Non-Brewed Condiment Two samples of malt vinegar obtained from a retailer were found to be slightly deficient in acidity. Malt vinegar should contain at least 4% of acetic acid to be genuine. The cause of the deficiency was deterioration in the barrel through being kept in stock rather longer than is normal. An official caution was issued. Miscellaneous A packet of dried soup mix should, when made up according to the directions given, make a soup of similar consistency to that made by a tinned liquid soup of the same character. A packet of soup mix labelled "Cream of Champignon" failed to conform to this agreed standard in that the percentage of fat was less than desirable. The manufacturers were officially cautioned, and they changed the description to "Mushroom soup". 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 in the case of a compounded food, with the names of the ingredients in descending order of proportion by weight. Furthermore it controls the manner in which the presence of vitamins and minerals is disclosed and prescribes specific labelling of certain foods. A total of 489 articles of pre-packed food was examined at 123 different premises to verify compliance with these Regulations. Only minor infringements of the Order were discovered, although as to false or misleading labelling, see later under that heading. Merchandise Marks Acts, 1887-1953 The majority of the inspection work carried out under the provisions of the above Acts is to ensure compliance with the requirements of the various Marking Orders made under the provisions of the Act of 1926. These Orders apply to the marking of the country of origin on imported foodstuffs, principally meat, apples, tomatoes, dried fruits,bacon,ham,poultry,butter and honey, upon sale and exposure for sale. inspections were maae at 272 premises of 821 displays of these foodstuffs, and minor infringements detected were dealt with by verbal cautions. Fruit A greengrocer was fined £1 with £l costsfor failing to mark displays of imported apples with the appropriate country of origin. He was further officially cautioned for marking Guernsey tomatoes as "English". Meat A company of butchers was prosecuted for failing to mark displays of meat with the country of origin, and the butchers' manager was cross-summored by the company as the person responsible. He was fined £1 on each of seven summonses. The same company was lurther officially cautioned for failing to indicate the country of origin on a delivery of imported meat made to a children's home, and for applying a false trade description of weight. False and Misleading Descriptions Food advertisements and labels have been scrutinised for false and misleading statements and descriptions. Corrective action taken within the whole area of the County has equal affect within each County district, 33 and work under this heading is combined with inspections made under the terms of the Merchandise Marks Act and the Labelling of Food Order A large confectionery manufacturer advertised one of its products in a manner suggesting considerably increased weight. The actual increase was small, and the advertisement was immediately withdrawn upon the issue of an official caution. Examples where corrective action was sought are set out as follows The percentage fat content marking on Continental Cheeses when set out as a percentage "I.D.M.", changed to a comprehensible statement of "Fat on the dry matter". A Continental biscuit marked as "Cheese Filled", which contained a filling only 20 per cent cheese such descriptions of Continental soft cheeses as " Super-Creme", "Triple-Creme" and "Cream" etc. amended to indicate the true nature of the product, i.e. whole-milk cheese, cheese spread etc. Rice puddings marked as "Creamed Rice", fruit "syrups" labelled as fruit "juices", a "Seedless Fig Bar" which was found to contain crushed seeds, and cheese spreads described as "processed cheese". Slimming claims in respect of lemon juice drinks were challenged, and the claim that a particular breakfast cereal had twice as much honey as any other cereal was also challenged Some extravagant claims in respect of medical remedies were challenged and the advertisements withdrawn. Special Designated Milk During the year under review six samples of designated milk were taken in your area, all of which were certified as being satisfactory. 34 Table 22 Factories Acts, 1937 and 1948. Part I of the Act. 1. INSPECTIONS FOR PURPOSES OP PROVISIONS AS TO HEALTH Premises Number on Register Number- of Inspections Written Notices Occupiers prosecuted (i) Factories in which Sections 1,2, 3,4, and 6 are to be enforced by Local Authorities 25 - - - (ii) Factories not included in (1) in which section 7 is enforced by the Local Authority 284 - 6 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) - - - - Totals 309 - 6 - 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. Inspect tor By H.M. Inspector Want of cleanliness (S.1) 4 4 - - - Overcrowding (S.2) - - - - - Unreasonable temperature (S. 3) - - - - - Inadequate ventilation (S.4) - 1 - - - Ineffective drainage of floors (S 6) - - - - - Sanitary Conveniences (S. 7) (a) Insufficient - 1 - 1 - (b) Unsuitable or defective - 8 - - - (c) Not separate for sexes Other offences against the Act - 3 - - - (not including offences relatins to outwork} 11 3 - - - Totals 15 20 - 1 - Part VIII of the Act, Outwork Nature of the Work Lampshades bearing apparel Electric Fuse Makers Umbrellas. board boxes Section 110 Number of outworkers in August list required by Section 110 (1) (c) 8 39 50 1 1 Number of cases of default in sending lists to Council - - - - - Number of prosecutions for Section 111 Number of instances of work in unwholesome premises - - - - - Notices served - - - - - Prosecutions - - - - - 35 Table 23. Infectious Diseases. Incidence and Mortality DIPHTHERIA, SCARLET FEVER AND ENTERIC FEVER 1942-1959 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. 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 - " - - - 1959 - - - - 116 1.11 - - - - - - 36 Table 24 Ophthalmia Neonatorum, years 1942-1959 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. 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 - - 1959 1 1 - 1 - - - 37 38 Table 25 Cases of Infectious Diseases Notified during the year 1959. 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 Diphtheria _ _ _ - - - - - - - - - - - Nil - Dysentery 2 2 4 6 2 4 - 3 2 4 2 2 1 - 34 - Erysipelas 1 - - - - - - - - - - 2 7 - 10 - Food Poisoning 4 2 7 2 - - - 2 1 6 8 8 2 - 42 - Malaria - - - - - - - - - - - - - - Nil - Measles 14 69 109 112 124 501 29 3 2 2 3 - 1 - 969 - Meningococcal Infections - - - - 1 1 - - - - - - - - 2 - Ophthalmia Neonatorum 1 - - - - - - - - - - - - - 1 - Pneumonia 1 1 1 - - 8 5 3 1 4 5 31 20 - 80 78 Poliomyelitis - - - - - - - - - - - - - - Nil - Puerperal Pyrexia - - - - - - - - 3 1 - - - - 4 - Scarlet Fever 1 4 7 5 13 62 20 2 - 2 - - - - 116 - Smallpox - - - - - - - - - - - - - - Nil - Typhoid & Para Typhoid - - - - - - - - - - - - - - Nil - Whooping Cough 1 4 4 5 6 15 2 - - 1 - - - - 38 - Totals 25 82 132 130 146 591 56 13 9 20 18 43 31 - 1296 78 39 Table 26 Monthly Incidence of Infectious Diseases during the Year 1959 DISEASE NUMBER OF CASES TOTAL January Feb. March April May June July August Sept. October Nov. Dec. Diphtheria - - - - - - - - - - - - Nil Dysentery 1 - 1 12 2 4 2 3 2 T 5 2 34 Erysipelas 3 - 1 1 3 1 - - - 1 - - 10 Food Poisoning 4 1 3 5 14 6 1 - 1 4 2 1 42 Malaria - - - - - - - - - - - . - Nil Measles 184 414 150 118 57 31 7 7 1 - - - 969 Meningococcal Infections - - - - 1 1 - - - - - 2 Ophthalmia Neonatorum - - - - - - - 1 - - - - 1 Pneumonia 5 26 25 2 4 3 3 1 1 2 4 4 80 Poliomyelitis - - - - - - - - - - - - Nil Puerperal Pyrexia - 2 - - - 1 - - 1 - - - 4 Scarlet Fever 11 19 20 12 13 14 7 1 1 3 10 5 116 Smallpox - - - - - - - - - - - - Nil Typhoid and Para Typhoid - - - - - - - - - - - - Nil Whooping Cough 1 - - 1 2 7 9 4 - 4 2 1 38 Totals 209 462 200 151 96 68 on 22 9 14 23 13 1296 40 Table 27 Ward Distribution of Infectious Diseases Notified during the Year 1959 Diseases Heathfield Whitton West Twickenham Central Twickenham South Twickenham East Twickenham Hampton Hampton Hill Upper Teddington Lower Teddington Hampton Wick Total Diphtheria - - - - - - - - - - - Nil Dysentery 4 1 1 5 1 2 6 3 5 - 6 34 Erysipelas - - 2 - - - l 2 2 2 2 10 Pood Poisoning - 2 - 2 - 7 23 1 2 3 2 42 Malaria - - - - - - - - - - Nil Measles 88 65 92 59 77 132 107 128 87 49 85 969 Meningococcal Infections - - - - - - - 1 1 - - 2 Ophthalmia Neonatorum - - - - - 1 - - - - - 1 Pneumonia 2 1 3 1 5 5 17 19 8 13 6 80 Acute Poliomyelitis - - - - - - - - - - - Nil Puerperal Pyrexia - - - - - - 4 - - - - 4 Scarlet Fever 5 1 4 6 8 12 25 6 15 17 17 116 Smallpox - - - - - - - - - - - Nil Typhoid and Paratyphoid - - - - - - - - - - - Nil Whooping Cough 5 - - - 1 - - 10 5 7 10 38 Totals 104 70 102 i O 92 159 133 170 125 91 127 1296 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 7em ale Male Female Male Female Under 1 - - - - - - - 1 - 4 2 2 - - - - - - 5 - 9 - - - 1 - - - - 10 - 14 - - 2 - - - - - 15 - 19 1 2 - 1 1 - - - 20 - 24 2 3 - - - - - - 25 - 34 2 2 - - - - - - 35 - 44 3 1 - - - - - - 45 - 54 3 1 - 1 - - - - 55 - 64 4 1 - - 3 1 - - 65 and over 1 1 - - 2 1 - - age unknown - - - - - - - Totals 18 13 2 3 6 2 - - 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, 1942-1959 INCLUSIVE 1945 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 195E 1956 1957 1958 1959 pulmonary 115 119 133 118 120 132 117 115 96 107 79 105 88 70 58 57 54 31 Non- ary 18 18 18 18 19 11 17 5 15 14 20 14 12 11 3 7 7 5 Totals 130 137 151 136 139 143 134 120 111 121 99 119 100 81 61 64 61 36 41 Table 30 Food Poisoning Food Poisoning 1st Quarter Notifications. 2nd Quarter 3rd Quarter 4th Quarter TOTAL 8 25 2 7 42 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 agentsChemical Poisons - Number of cases 6 Salmonella organisms 6 Staphylococci - P. Morgani - Due to undiscovered cause 36 Number of cases 36 Total all cases 42 42 43 Table 31 Premises concerned with Health Services in Area 10 A = Ante-natal and post-natal care of mothers. B = Baby Welfare C = Chiropody (Old People-provided by Voluntary Organisations). D = Dental E = Eye testing F = Distribution of Welfare Foods. G = Child Guidance H = Headquarters Personal Health I = Vaccination and Immunisation. J = Geriatric M = Mental Health 0 = Orthopaedic P = Family Planning (provided by Voluntary Organisation). S = School Health T = Talking and Speech Therapy 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, H V Council Offices, V Grove Crescent, Hanworth A B D E F High Street, Teddington Bridge Street, Staines. I S T Church Road, Teddington A B C D F J Stanwell Road, Ashford A B C D Imperial Road, Bedfont. A B D F I I O E F I O S S T Hospital Bridge Road, A B C D F The Grange, A B D E F Council Offices, V Whitton. I S Gresham Road, Staines. G S I T M O P Green Street, Sunbury. 20 Seymour Road, A B D F I Duddingston House, A B C D F Hampton Wick. P S Village Hall, Stanwell. A B F I Green Street, Sunbury I S Stanley Road, Teddington. C D E I S Village Hall, Laleham. B F I Chertsey Road, A B C D F Ashford Common I S T 24 Station Road, Hampton. A B D F St. Anne's School, Ashford S Laleham Road, A B C D F I I S Shepperton. S T York House, Richmond Road, A B C D E 12 Tilley's Lane, F Twickenham. F I S High Street, Staines New Hall, Upper Halliford. A B F I 58 Hampton Road, Twickenham. G T Council Offices, V 1A Staines Road West, Sunbury. F Hanworth Road, Feltham. Cardinal Road, Feltham. A B D E F I S P In addition to the premises listed above there if a mobile clinic in use in the area.