AC 4388 ask 5/8/50 gm WAN 92 Metropolitan Borough of wandsworth ANNUAL REPORT of the Medical Officer v. Health of for the Year 1955 by J. TUDOR LEWIS, M.D., D.P.H. together with the Report of the Public Analyst REPORT of the Medical Officer of Health for the year 1955 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Wandsworth Mr. Mayor, Ladies and Gentlemen, I have great pleasure in presenting to you the Annual Report on the health and sanitary conditions of the Borough for the year 1955. This is the fourth complete year for which I have had the privilege of supervising the health services in this area and of being responsible for the Council's public health activities. This report follows the general form of previous reports and the statistical tables it contains give hard facts about our work. In this preamble, I draw your attention to one or two, as it seems to me, of the more important parts of the work. In 1954 there was a slight increase in the population as compared with the previous year and this increase was continued in 1955, the population of Wandsworth at the year end being 336,500. This increase is associated with the new housing estates which have arisen and which continue to arise, in the Borough and to which families are transferred from many other parts of London. It is to be expected that this gradual increase of population will continue as the new housing estates approach completion. The birth rate for 1955 was 13.73, a slight increase over the previous year, while the standardized death rate was 13.30, a little above that for 1954. The infant mortality rate, that is to say, the number of infants who died before reaching their first birthday per thousand live births, was 24.4, an increase of five points over the previous year. The figure last year was the lowest ever recorded in Wandsworth and while 2 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 there was a slight regression in 1955, a rate of 24.4 is still below that for England and Wales which in 1955 was 24.9. There were four deaths from causes associated with childbirth. There was a very large increase in the number of cases of infectious disease, namely 7,968. The main cause of this large increase was the fact that 1955 was a "measles" year when we had over 5,000 cases of this disease notified. The number of cases of measles per year in a community tends to fluctuate in cycles; in 1954 for instance, there were only 303 cases in all. Amongst these 5,000 cases of measles, there were two deaths. During the year there was also an increase in the number of cases of poliomyelitis as compared with the previous year, there being in all 49 confirmed cases of this disease; one of these cases died and 22 cases had some form of paralysis. There was an increase in the number of food poisoning cases and further reference is made to this in the body of the report. Tuberculosis, which in recent years has been responding to preventive measures and new methods of treatment was reduced; the total number of cases of tuberculosis coming to our notice was 644 compared with 738 cases in the previous year. The number of deaths from respiratory tuberculosis was 49 compared with 64 in 1954. As I mentioned last year, a number of cases of notified tuberculosis are transferred from other parts of London into this area in connection with the new housing schemes which are in progress. It is a pleasure to report that there were no confirmed cases of diphtheria in Wandsworth in 1955. The standardized death rate, as mentioned above, in Wandsworth in 1955 was 13.30 and there were in all 5,205 deaths, at all ages, in Wandsworth during the year. The table on page 12 gives particulars of the causes of deaths and the ages at which they occurred. The group of diseases which caused the greatest number of deaths was malignant neoplasms (generally referred to as cancer) which caused 1,070 deaths, and diseases of the heart which caused 1,856 deaths. I will say no more here of deaths from cancer since, in general, and with one possible exception, it is not thought that the prevention of cancer is yet amenable to public health methods. Such methods as are available are at the present time mainly educative. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 3 I should, however, like to make a little further reference to deaths from heart disease. It will be noticed that while most of these deaths occurred in people over 65 years of age, quite a proportion occurred in the age group 45/65 which many would consider to be the most important and vital period in the life of the average man or woman. Much attention has been paid in recent years to the so-called "stress" diseases as a public health problem. One does not wish to be technical in a report of this type, but by "stress" diseases is generally meant such conditions as high blood pressure (hypertension) and diseases of the heart blood vessels (coronary arterial disease) which are in some ways thought to be possibly associated with the stresses and strains of modern urban civilization. Certain it is that coronary arterial disease, for instance, has now to be reckoned with as an important cause of death in men and to a lesser extent in women, in the most productive period of life. To throw more light on this as it affects the local inhabitants in Wandsworth, I have prepared table 3a on page 13 which shows the deaths from coronary arterial disease and hypertension in males and females under age groups. Dealing here with coronary arterial disease, it will be seen that between the ages of 15 and 65 in men there were 134 deaths from this condition and of these 124 occurred in the age group 45/65. In women, the deaths were much fewer, there being only 36 deaths from this condition between the ages 45/65. As I have said the age group 45/65 is a most important, probably the most important period, from the economic, the social, and the productive points of view. It is difficult to say immediately how this problem can be tackled from a public health angle or by Public Health Departments as they now exist. The causes of this predominance in men can be little more than a matter for conjecture but it is at least possible that there are social and environmental conditions to account for the considerable preponderance of deaths from this disease in this age group in men. A good deal of thought has been given to the matter and it does seem that if public health departments are to carry out their primary function of safeguarding the health and well-being of 4 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 the public, an attempt should be made to tackle this problem of coronary artery disease. This raises another interesting and important point which possibly is not always recognized. It is that the patterns of public health work and public health problems are not static. They are changing slowly; so slowly, in fact, that to the worker immersed in the daily routine, it is not always apparent when the change has taken place. It is nevertheless hardly possible to doubt that the problems which our public health departments will be called upon to meet in the years to come will be quite different from those which they have tackled so successfully in the years that have gone and one of the problems to which we must certainly bend our efforts is the problem of coronary artery disease. It is but a short step from a consideration of changes in the pattern of public health problems to the staffing of public health departments. Clearly, if in the future different problems are to be met, it may well be necessary to give to public health staff a somewhat altered form of training. It may be that the basis of the training will remain the same but that it will be given a somewhat altered emphasis so that public health staff will be able to understand and to grapple with the newer problems which are likely to arise. This question of training is, in turn, complicated by the fact that in most categories of public health personnel there is a serious shortage. This undoubtedly applies in the case of health visitors and sanitary inspectors, who are key workers in the health department. Health visitors are, at the present time, not the immediate responsibility of metropolitan borough councils and in any case it might be possible by methods of selective visiting to do something to combat shortages of health visitors. I will say no more of the problem of health visitors here. Sanitary inspectors are very much our concern and we in Wandsworth like many other authorities have experienced our full quota of worry and anxiety arising from the shortage of sanitary inspectors. At the time of writing, the department is five inspectors short of establishment, which shortage is accentuated by sickness amongst other members of the staff. Even though the pattern and the problems of public health may change with the years REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 5 and even though the training of inspectorial staff may need to be given a different emphasis, I can see no possibility of there being a diminished demand for qualified sanitary inspectors in the foreseeable future. Indeed, it is likely that quite apart from these newer problems which are presenting themselves, the recent legislation such as the Food Hygiene Regulations would justify an increase in the establishment of sanitary inspectors. This is a problem to which we have given a great deal of attention and we have inaugurated a training scheme so that we can train our own inspectors. This is a long or medium term project which should, however, pay dividends in the years to come, provided always that the right type of candidate is forthcoming to enter the profession of Sanitary Inspector. In the meantime, the problem of how to cope with the existing work, not to mention the demands of new legislation, is one which is causing very considerable anxiety. One may indeed be reluctantly forced to accept a somewhat lower standard of routine work in order to spread the burden as evenly as possible. At a time when health departments ought to be thinking of expanding their activities to include those killing diseases which might be amenable to preventive measures, it is a sombre thought that we should have seriously to think of contracting our services. In the meantime, I would like to pay a tribute to our existing staff of inspectors who are carrying a considerable burden of extra work and duties. I reported last year that Mr. Vickers, Chief Sanitary Inspector, retired during the year. He was succeeded in July by Mr. E. V. Roots, who was promoted from the position of Deputy Chief Sanitary Inspector. To fill the vacancy occasioned by Mr. Roots' promotion, Mr. C. F. Standish was selected to fill the position of Deputy Chief Sanitary Inspector. It is a great pleasure to welcome Mr. Roots and Mr. Standish to the responsible positions which they have undertaken. It is a routine in most Annual Reports to pay a tribute to the help which the Medical Officer of Health receives from many individuals and agencies without whose assistance the work of the health department would be immeasurably more difficult. Because 6 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 this is almost a routine practice, it should not be thought that the thanks I have expressed in these reports have been merely routine. The contrary is very much the case and the thanks and appreciation I have once again to record to members of the Council, my colleagues and my staff are very sincere. Again, I have received every possible help from the Chairman of the Public Health Committee, Councillor T. V. Rowlands, and the various Committees particularly the Health Committee with whose work I am concerned. My fellow Chief Officers of the Council and again Major Jerman, the Town Clerk, have been very helpful to me in the work of the department. Finally, I would like to express my special thanks to the officers and staff of the Health Department, in each and all sections, for their work and support during the year; particularly would I like to thank my colleague, Dr. W. G. Harding, for the efficient and competent way in which he continues to carry out his duties. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, J. TUDOR LEWIS, Medical Officer of Health. June 1956 STAFF The following changes occurred during the year: Retirements In July, Mr. A. E. Vickers, Chief Sanitary Inspector, who had been in the service of the Council for 40 years, retired. Mr. E. V. Roots, Deputy Chief Sanitary Inspector, was promoted to the position of Chief Sanitary Inspector and the resulting vacancy for Deputy Chief Sanitary Inspector was filled by the promotion of Mr. C. F. Standish, who was a district Sanitary Inspector. A further retirement among the inspectorate was that of Mr. H. T. Lambert, who retired in December with a service also of 40 years with the Council. During the same month, Mr. J. T. Lipscombe, Stoker at the Disinfecting Station, who attained the age of 65 earlier in the year, retired after 28 years' service. Resignations In December, Mr. J. E. Higgs, resigned his appointment of Sanitary Inspector which he had held for three years, on obtaining a similar appointment with the Borough of Mitcham. Mrs. A. White, Bathing Attendant at the Disinfecting Station, resigned owing to ill-health. Death The death occurred on 12th April, of Mr. D. Goldsmith, Rodent Operative. The resulting vacancies on the establishment of the department caused by the above-mentioned changes had not been filled at the end of the year. Reference is made in the preamble to this report, of the difficulties experienced in recruiting Sanitary Inspectors and a scheme of recruitment put forward to combat the problem. 7 1 STATISTICS AND SOCIAL CONDITIONS Area 9,107 acres Resident population in 1955 336,500 Wandsworth is the largest of the Metropolitan Boroughs. It has an area of 9,107 acres which includes a number of open spaces, with an approximate combined area of 1,200 acres. The population is a varied one, as the Borough contains residential neighbourhoods which are rapidly being added to by the development of new housing estates by the Borough Council and London County Council. The chief industries carried on are the manufacture of gas, electricity and motor accessories, laundries and general engineering. 8 STATISTICS AND SOCIAL CONDITIONS 9 Extracts from Vital Statistics Number of Live Births: Males Females Total Legitimate 2,199 2,105 4,304 Illegitimate 164 155 319 Total live births 2,363 2,260 4,623 Number of Stillbirths 45 36 81 Number of deaths 2,378 2,827 5,205 Birth-rate . . 13.73 Death-rate—Crude 15.47 Standardized 13.30 Rate per 1,000 {Live and Still) Births Deaths from puerperal causes 4 0-85 Infantile mortality per 1,000 live births: All infants 24 Legitimate infants 23 Illegitimate infants 40 Deaths from Cancer 1,070 „ „ Diphtheria 0 „ „ Scarlet Fever 0 „ „ Measles 2 „ „ Whooping Cough 0 „ „ Tuberculosis 53 Tuberculosis death-rate 0-15 There has been no unusual or excessive mortality during the year. 2 VITAL STATISTICS Population The civilian population at the middle of the year was estimated by the Registrar-General to be 336,500, and all the rates used in this Report are based on this figure. Table I shows the approximate population of each Parliamentary Division, based on the above estimation. TABLE I Population estimated to middle of 1955 Putney 86,852 Central 96,045 Clapham 80,874 Streatham 72,729 Whole Borough 336,500 Births The total number of births belonging to the Borough registered during 1955 was 4,623, consisting of 2,363 males and 2,260 females. The number for 1954 was 4,432. The birth-rate was 13.73 per 1,000 persons living, compared with 13.27 for 1954. Three hundred and nineteen illegitimate births took place in the Borough compared with 265 in 1954. 10 VITAL STATISTICS II Deaths The number of registered deaths which took place in the Borough during the year was 3,682 but 350 of these did not belong to the Borough, while 1,873 Borough residents died outside the Borough. The corrected number of deaths for the Borough, after allowing for these factors, was 5,205 of whom 2,378 were males and 2,827 females. The crude death-rate for the year was 15.47, compared with 14.63 for 1954, but after taking into account the area comparability factor supplied by the Registrar General, the adjusted rate works out at 13.30. Table II shows the total number of registered deaths and the death-rates for each division based on the approximate population in each division. TABLE II Corrected Deaths Death Rate Males Females Total Putney 531 613 1,144 13.17 Central 841 986 1,827 19.02 Clapham 604 739 1,343 16.61 Streatham 402 489 891 12.25 Whole Borough 2,378 2,827 5,205 15.47 12 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 Table III is the general mortality Table for the whole Borough and shows the number of deaths from each cause divided into sexes, age-groups and sub-districts TABLE III. causes of, and ages at death, during the year 1955 causes of death deaths in or belonging to whole district at subjoined ages deaths in or belonging to localities (all ages) AH Ages Males Females Under 1 year 1 and under 5 5 and under 15 15 and under 45 45 and under 65 65 and upwards Putney Central Clapham Streatham Tuberculosis, Respiratory 49 37 12 – – 5 22 22 13 16 11 9 Tuberculosis, Other 4 3 1 – – – 3 1 — 1 1 1 1 Syphilitic Disease 12 6 6 – – — 1 11 4 2 3 3 Diphtheria – – – – – – – – – – – – – Whooping Cough – – – – – – – – – – – – – Meningococcal Infections – – – – – – – – – – – – – Acute Poliomyelitis 1 1 – – – 1 – – 1 – – – Measles 2 1 1 1 – 1 — — — 1 1 — — Other Infective and Parasitic Diseases 9 4 5 – – – 2 4 3 3 2 3 1 Malignant Neoplasms 1,070 525 545 – 1 – 60 404 605 203 218 478 171 Leukaemia, Aleukaemia 23 10 13 – 1 2 3 4 13 6 8 4 5 Diabetes 30 12 18 – – 2 3 — 25 8 12 6 4 Vascular Lesions of Nervous System 535 183 352 – – — 7 86 442 124 171 129 111 Diseases of Heart 1,856 792 1,064 – – 1 21 237 1,597 379 922 301 254 Other Circulatory Disease 268 112 156 – – 1 7 22 238 61 82 62 63 Influenza 30 8 22 – – — 1 7 22 7 10 7 6 Pneumonia 251 99 152 18 9 6 10 30 178 57 90 59 45 Bronchitis 289 186 103 1 2 — 3 61 222 62 98 74 55 Other Diseases of Respiratory System 50 29 21 1 — — 2 13 34 11 17 12 10 Ulcer of Stomach and Duodenum 62 35 27 — — — 1 9 52 14 17 17 14 Gastritis, Enteritis, Diarrhoea 32 17 15 2 — 3 11 16 9 8 8 7 Nephritis and Nephrosis 26 17 9 — — — 3 3 20 7 5 8 6 Hyperplasia of Prostate 41 41 – – – – – 5 36 11 13 10 7 Pregnancy, Childbirth, Abortion 4 — 4 — — — 4 — — — 1 3 — Congenital Malformations 33 17 16 18 2 1 7 3 2 7 5 16 5 Other Defined and Ill-defined Disease 362 158 204 70 5 6 31 77 172 104 86 93 79 Motor Vehicle Accidents 25 17 8 — — 4 6 3 12 9 5 8 3 All other Accidents 98 43 55 1 — 2 8 16 71 28 30 21 19 Suicide 39 22 17 — — — 11 16 12 12 5 9 13 Homicide and Operations of War 4 3 1 1 — — 2 1 — 2 2 — — All Causes 5,205 2,378 2,827 113 21 26 204 1,036 3,805 1,144 1,827 1,343 891 VITAL STATISTICS 13 TABLE III (a). DEATHS FROM HEART DISEASE, 1955 Males in age groups 1-5 Females in age group Total M. & F. Total 1-5 5-15 1545 4565 65 up Total 5-15 1545 4565 65 up Coronary Disease, Angina, etc. – – 10 124 192 326 – – 1 36 202 239 565 Hypertension with Heart Disease – – – 6 22 28 – – – 6 56 62 90 Other Heart Disease — — 4 27 407 438 — 1 6 38 718 763 1,201 — – 14 157 621 792 – 1 7 80 976 1,064 1,856 Infantile Mortality The number of deaths under one year was 113, the infantile mortality-rate being 24.4 per 1,000 births. This compares with a rate of 19 for 1954, and 23 for 1953. For the ten years ended 1945 the average infantile mortality rate was 46 while for the ten years ended 1955 the average rate was 25. Maternal Mortality Four deaths occurred from accidents and diseases of pregnancy or child-birth. This is equivalent to a rate of 0.85 for 1,000 live and still births, compared with 0.44 in 1954. 3 INFECTIVE DISEASES The number of deaths from all notifiable infectious diseases was 113. This included 53 from all forms of tuberculosis and 57 from the notifiable forms of pneumonia. There was one death from poliomyelitis and two deaths from measles. From all notifiable infective diseases the death-rate was 0.33 per 1,000. Table IV shows the number of cases of the notifiable diseases reported, arranged in age groups, and Table V shows the same figures arranged in the sub-district in which they occurred. Smallpox No case occurred in the Borough during the year. Notification is frequently received from Port and Local Authorities of persons coming into the Borough who may have been in contact with Smallpox. Observation for the necessary period is kept on these persons by members of the Public Health Department. Diphtheria There were no confirmed cases. Scarlet Fever Two hundred and eighty nine cases of scarlet fever were notified, compared with 345 in 1954, and 336 in 1953. The diagnosis was not confirmed in five cases. No deaths occurred. I referred in my 1954 report to the concentration of cases which occurred towards the end of that year, on one of the new estates and suggested as a probable cause the large number of children coming together and playing together on the new estate. Cases continued to be reported from this area during the first two months of 1955, but during the following month the incidence steadily declined. Whooping Cough Five hundred and forty-seven cases were notified during the year. There were no deaths. Measles The number of cases notified during the year was 5,206 compared with 303 in 1954, 2,850 in 1953 and 2,290 in 1952. 14 INFECTIVE DISEASES 15 TABLE IV notifiable diseases no. of cases of infective diseases grouped in age-period Total Under 1 1-2 3-4 5-9 10-14 15-24 25-44 45-64 65 and upwards Smallpox – – – – – – – – – – Diphtheria — — — — — — — — — – Scarlet Fever 284 7 28 45 148 40 12 4 – Measles 5,206 86 880 990 3,148 57 21 24 – – Whooping Cough 547 21 111 136 255 14 10 – – – Enteric Fever and Paratyphoid Fever 7 — 1 — 2 1 1 1 – 1 Malaria 1 — — – — 1 – – – – Dysentery 89 1 9 12 20 10 16 10 10 1 Erysipelas 52 — — — — 2 5 8 26 11 Scabies 33 — — — 5 2 11 13 2 – Puerperal Pyrexia 101 — — — — — 50 51 — – Ophthalmia Neonatorum 5 5 — — — — — — — Meningococcal Infection 6 1 2 — 2 1 — – — – Acute Poliomyelitis 49 — 4 6 17 8 5 6 2 1 Acute Encephalitis — — — — — — — – – – Anthrax — — – – — – – – – – Pneumonia: Acute Influenzal 121 – 1 2 1 4 4 21 51 37 Acute Primary 200 2 4 10 15 16 16 39 62 36 Tuberculosis—All forms 644 1 2 8 19 16 152 310 107 29 Food Poisoning 623 5 67 92 137 156 58 49 34 25 Total 7,968 129 1,109 1,301 3,769 328 361 536 294 141 16 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 TABLE V NOTIFIABLE DISEASES TOTAL CASES OF INFECTIVE DISEASES OCCURRING IN EACH WARD Whole Borough Deaths PUTNEY CENTRAL CLAPHAM STREATHAM Putney Thamesfield Fairfield West Hill Southfield Earlsfield Springfield Tooting Graveney Bedford Larkhall Clapham North Clapham Park Thornton Balham Streatham Hill St. Leonards Streatham Common Streatham South Furzedown Smallpox – – – – – – – – – – – – – – – – – – – – – – Diphtheria — — — — — — — — — — — — —- — — — — — — — – Scarlet Fever 18 8 11 83 6 33 12 17 18 9 8 7 9 3 14 7 7 6 3 5 284 – Measles 315 171 315 351 245 361 300 423 286 736 343 778 734 746 185 185 164 188 195 715 5,206 7 Whooping Cough 28 25 28 56 28 24 21 61 34 19 45 21 29 30 23 10 13 14 17 21 547 – Enteric Fever and Paratyphoid Fever 1 – 1 – – – – – 1 – 1 – 3 – – – – – – – 7 – Malaria 1 – – 1 – – – – – – – – – – – – – – – – 2 – Dysentery 5 2 7 5 4 6 4 18 2 3 7 1 4 – 3 3 7 3 10 5 89 – Erysipelas 2 1 3 4 4 4 6 10 2 – – 1 2 – – – 4 7. – 4 52 – Scabies 1 3 4 — — 5 — 4 2 — 2 — 5 — 1 1 1 2 1 1 33 — Puerperal Pyrexia 2 — 1 3 1 7 1 6 — 4 2 11 15 19 16 4 2 3 1 3 101 — Ophthalmia Neonatorum – – – 2 – – – – – 1 – – – – 1 – – – – 1 5 – Meningococcal Infection 1 — 1 — – – – 1 – – – 1 – – – – – 1 – 1 6 – Acute Poliomyelitis 7 — 2 10 1 4 3 – – 3 – 2 7 4 1 – 3 2 – – 49 1 Acute Encephalitis – – – – – – – – – – – – – – – – – – – – – – Anthrax – – – – – – – – – – – – – – – – – – – – – – Pneumonia:—– – – – – – – – – – – – – – – – – – – – – – – Acute Influenzal 7 4 4 3 4 7 3 12 7 34 ? 7 ? 5 14 ? 4 – 1 1 121 16 Acute Primary 11 5 22 12 8 26 11 12 7 12 10 8 6 5 17 3 4 5 6 10 200 41 Tuberculosis—All forms 92 15 35 56 22 38 22 35 22 21 25 36 30 29 35 34 36 22 16 23 644 53 Food Poisoning 19 2 25 24 2 49 23 412 20 8 2 2 3 1 2 1 2 11 5 10 623 — Total 530 236 459 610 325 564 406 1,011 401 350 442 320 349 342 312 250 242 262 258 300 7,969 113 INFECTIVE DISEASES 17 Acute Poliomyelitis One hundred and four cases of this disease were notified or reported during the year, of which 55 were subsequently not confirmed. Of the remaining 49 confirmed cases, 22 were of the paralytic type and 27 non-paralytic. There was one death. In 1954, seven cases were confirmed with no deaths. Acute Encephalitis Of two cases investigated, neither was confirmed. Meningococcal Infection Six confirmed cases were notified, none of which proved fatal. Twenty-four other cases were investigated, but were subsequently not confirmed. In 1954, there were eight cases with three deaths. Typhoid and Paratyphoid Fever Of 13 cases reported during the year, two were subsequently confirmed as typhoid and five as paratyphoid. Diagnosis was not confirmed in the remaining six cases. Puerperal Pyrexia During the year 101 cases were notified, of which 96 occurred in hospital and 5 at home. Thirty-three of the hospital notifications referred to patients whose home addresses were outside the borough. Information was also received of 57 cases, referring to Wandsworth residents whose confinements took place in hospitals located in other Metropolitan boroughs. Sonne Dysentery Systematic follow-up of all cases of Dysentery continued throughout the year and where it was considered necessary, stool specimens were obtained from family contacts for bacteriological examination. In addition to the cases for which formal notifications were received and which, in the main, were single unrelated cases, a number of other cases were discovered by investigation of diarrhoea outbreaks which occurred at Day Nurseries and Schools. Influenza The number of deaths from Influenza was 30 compared with 23 in 1954, 64 in 1953 and 26 in 1952. 18 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 Influenzal Pneumonia and Acute Primary Pneumonia These are the notifiable forms of pneumonia. One hundred and twenty-one cases of acute influenzal pneumonia and 200 cases of acute primary pneumonia were notified. Sixteen of the former, and 41 of the latter died. The total number of deaths credited to all forms of pneumonia during the year was 251, compared with 192 in 1954. Malaria Two cases were reported. Both were in children of families recently arrived in this country from Pakistan. Erysipelas Fifty-two cases were notified. Other Infective Diseases Twelve deaths occurred from syphilis. Scabies Thirty-three cases were notified. Thirty-eight men were treated at the Council's Disinfecting Station during the year. On the resignation of service of the female bathing attendant early in the year and pending a decision on the question of replacement, arrangements were made with Battersea Borough Council for women and children (under school age) requiring treatment for Scabies to be dealt with at the Battersea Cleansing Station. This arrangement was still in force at the close of the year. Food Poisoning One hundred and seventy-nine formal notifications were received during the year. One hundred and thirteen were unrelated cases and 22 were minor outbreaks involving two or more persons. The majority of the single cases were only slightly affected and where bacteriological investigation was carried out, organisms likely to have caused the illness were discovered in only 6 cases. The organism was Salmonella typhimurium. In 19 of the minor outbreaks it was not possible to identify the causative agent and in the remaining three, the organism Clostridium welchii was isolated. In addition to the above cases, there were four other outbreaks reported. Three occured in two hospitals in the borough and the fourth in the canteen of a Public Utility Regional office. INFECTIVE DISEASES 19 These outbreaks involved a total of 444 persons, 369 of whom constituted one of the hospital outbreaks. The remaining three involved respectively 38, 18 and 19 persons. From bacteriological investigation of a number of those affected, it appeared that the major and two of the minor outbreaks were due to heat resistant Clostridium welchii and the remaining one to Salmonella typhimurium. Full reports on the major outbreaks were submitted to the Ministry of Health in accordance with Circ. 46/49 and revised Memo. 188/Med. Diseases Reported from Schools A total of 3,366 infective diseases was reported from schools in the Borough throughout the year. The numbers of each disease were: Scarlet Fever 152 Chicken Pox 853 Diphtheria — Whooping Cough 210 Measles 1,833 Mumps 169 German Measles 34 Dysentery 17 Poliomyelitis 20 Other Diseases 77 Disinfection During the year 772 rooms were disinfected after infectious and other disease and 522 rooms disinfected for vermin. Bacteriological Examinations All bacteriological examinations are carried out at the Public Health Laboratory at County Hall under its Director, Dr. A. J. H. Tomlinson. The following is a summary of examinations made during the year: Nose and throat swabs 880 Faeces for the typhoid and dysentery groups 1,076 Miscellaneous specimens 34 Total 1,990 NON-INFECTIVE DISEASES The total number of deaths from cancer and malignant disease was 1,070, the number of males being 525 and females 545. The death-rate was 3.18 per 1,000. The number of deaths in 1955 was 40 less than in 1954. Deaths from disease of the heart and circulatory system were 2,124 compared with 1,986 in 1954. Of these deaths 1,835 were of persons of 65 years of age and above. There were 590 deaths from diseases of the respiratory system compared with 443 in 1954. The number of deaths from bronchitis was 289 compared with 231 in 1954, and from pneumonia (all forms), 251 compared with 192 in 1954. Further particulars relative to pneumonia are given on page 18. One hundred and sixty-six deaths were due to violence, 25 of them being due to motor accidents, 39 to suicide and 102 to other forms of violence. CERTIFICATES OF VACCINATION AND INOCULATION One thousand, two hundred and thirty-four requests were received from residents in the Borough for a certificate of vaccination or inoculation to be authenticated for the purpose of travel abroad. The signature of the person issuing the certificate was verified in each case as that of a registered medical practitioner practising in Wandsworth and the certificate was endorsed accordingly. STAFF MEDICAL EXAMINATIONS At the request of the Committees and Chief Officers concerned, arrangements were made during the year for five members of the Council's staff to undergo special medical examinations. In the majority of cases the purpose of the examination was to determine the employee's future fitness for his occupation, following serious illness, and in two cases it was found necessary to recommend superannuation. Forty-five shorter reports on members of the staff who were sick were obtained from doctors and hospitals at the request of the departments concerned. 20 TUBERCULOSIS Notifications The total number of new cases which came to the notice of the Department during 1955 was 644 compared with 738 in 1954. The sources of information regarding the 644 new cases were as follows: Primary notifications on Form A 327 Notifications from H.M. Forces 6 Unnotified at death 3 Transfers from other sanitary authorities 308 Total 644 Deaths The number of deaths certified as due to various forms of tuberculosis was 53. Particulars of the new cases and deaths during the year, classified by sexes and age-groups are given in the following table: TABLE VI Age Periods New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary M. F. M. F. M. F. M. F. Under I year 1 – – – – – – – 1-2 — 1 — 1 — — — — 2-5 4 1 3 – – – – – 5-10 3 12 1 3 — — — — 10-15 7 7 1 1 — — — — 15-25 64 82 2 4 — — — 25-45 149 144 9 8 3 2 3 — 45-65 70 32 3 2 18 4 — 1 65 and upwards 18 10 1 — 16 6 — — Totals 316 289 20 19 37 12 3 1 4 SANITARY INSPECTION OF THE BOROUGH Work of the Sanitary Inspectors A summary of the inspections carried out by the Inspectors is given in Table VII. TABLE VII Inspections ReInspections Total To investigate complaints 7,235 23,254 30,489 Housing Reports 1,426 215 1,641 Notifiable diseases 1,306 426 1,732 Piggeries 2 — 2 Factories, Workplaces, etc. (including Outworkers) 1,836 21 1,857 Sanitary conveniences 39 — 39 Mews and stables 196 — 196 Other inspections 5,911 1,709 7,620 Totals 17,951 25,625 43,576 Smoke observations 253 Legal proceedings, attendances at court 23 Table VIII gives details of the sanitary operations carried out in the Borough during the year. The number of drains which were tested was 426 and 923 were cleansed or repaired. The drains of 39 houses were reconstructed, and 112 drains were partially reconstructed. Damp conditions have been remedied in 1,620 premises, and in 51 of these damp courses were inserted. 22 SANITARY INSPECTION OF THE BOROUGH 23 TABLE VIII Putney Central Clapham Streatham Whole Borough 1. Premises cleansed and repaired 299 452 470 184 1,405 2. Drains tested 123 97 82 124 426 3. Drains cleansed or repaired 278 238 228 179 923 4. Water closets cleansed or repaired 100 149 139 122 510 5. Soil pipes altered or repaired 27 26 32 6 91 6. Waste pipes provided altered or repaired 64 60 91 73 288 7. Rainwater pipes repaired 17 24 67 15 123 8. Roofs and gutters repaired 239 374 413 121 1,147 9. Damp courses inserted 21 14 10 6 51 10. Damp conditions otherwise remedied 186 338 336 153 1,013 11. Yards drained or paved 7 11 9 2 29 12. Dustbins provided 23 38 46 22 129 13. Water cisterns cleansed, covered or repaired 7 6 13 3 29 14. Water supply reinstated 70 13 69 5 157 15. Defective stoves and fireplaces remedied 47 84 111 35 277 16. Defective coppers remedied 1 — — — 1 17. Accumulations of rubbish, etc., removed 6 12 20 8 46 18. Urinals cleansed or repaired 1 1 1 1 4 19. Animals improperly kept — 3 4 1 8 20. Smoke nuisances 9 10 3 — 22 21. Other nuisances 22 22 26 11 81 Total 1,547 1,972 2,170 1,071 6,760 Number of Preliminary Notices served 527 666 656 320 2,169 Number of Preliminary Notices complied with 607 883 894 381 2,765 Number of Nuisance Notices served 135 244 238 104 721 Number of Nuisance Notices complied with 144 288 278 104 814 24 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 Water Supply—Cutting-off Notices During the year notices with respect to 157 premises were received from the Metropolitan Water Board stating that the supply had been withdrawn. In 16 premises the water supply was cut off for non-payment of rates, and in 141 premises because of defects in the service. Dustbin Accommodation—Section 105, Public Health (London) Act, 1936, and Section 12, London County Council (General Powers) Act, 1954 Action was taken under the above-mentioned Acts in respect of 117 premises and during this period 119 dustbins were provided. Dustbins were also provided at 10 premises without the necessity of action under the Acts. Rodent Control One thousand, nine hundred and seven rat and mice complaints were received during the year. Following is a summary of the work of the rodent operatives: Number of operatives' visits to premises .. .. .. 9,461 „ „ premises treated with "Warfarin" .. .. 1,052 „ „ premises "Warfarin" laid and found not troubled 127 „ „ premises investigated and found not troubled 279 „ „ "Warfarin" baits laid 7,654 „ „ drains tested by Sanitary Inspector 284 „ „ drains found defective 135 „ „ rats estimated killed 6,331 At the close of the year, there were five rodent operatives and one clerk engaged on rodent control duties under the supervision of a Sanitary Inspector. SANITARY INSPECTION OF THE BOROUGH 25 Swimming Baths and Bathing Pools There are four public swimming bath establishments and one open air swimming pool belonging to the Council, one open air swimming bath owned by the London County Council, one public swimming pool privately owned, and a number of private bathing pools in the Borough. The Queensmere pond on Wimbledon Common has also for many years past been a recognized bathing pond. In four of the Borough Council's swimming baths, the water is purified by a process of continuous circulation through a filtration plant whereby the whole of the water is dealt with every three to four hours and chlorinated automatically during its circulation from the filtration plant to the bath. In the other bath belonging to the Council, each bath is emptied of water as often as necessary and refilled with fresh water which is continuously circulated and chlorinated automatically the whole time the bath is in use. Disinfection and Fumigation of Clothing and Rags for Export At one factory in the Borough rags are washed and disinfected prior to export, under the supervision of the Council's Inspector, and certificates are issued for which a charge is made. During 1955, 48 certificates were issued and the amount received by this department was £14 8s. Od. Removal to suitable premises of persons in need of care and attention— National Assistance Act, 1948, Section 47 In dealing with the problems of the many aged and infirm persons in the Borough, close liaison has been maintained between the Public Health Staff and those members of the London County Council divisional staff who are concerned with the care of the aged. This co-operation with the County Council has meant that in dealing with the large number of aged persons whose capacity to look after themselves adequately was in question, it was again possible to make satisfactory arrangements for their care and attention without the necessity of having to take action under Section 47 of the National Assistance Act, 1948. 26 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 Eradication of Bed Bugs The methods employed for freeing infested houses include the stripping of all paper from the walls, the removal of wooden mouldings and skirtings and application of a blow lamp to the room surfaces. Candles are often used by house owners and the spraying of rooms by the disinfecting staff of the Council is carried out, proprietary insecticides being used. Infested bedding is removed to the Disinfecting Station and treated by steam. During the year 209 houses were found to be infested with bed bugs and disinfestation was carried out in all cases. Special steps are taken to ensure that the furniture and clothing of families about to be accommodated in the Council's houses or flats are freed from vermin. Hydrogen cyanide gas is used for the disinfestation of the furniture, which is placed in special vans constructed for the purpose, the process being carried out by a contractor. Bedding is not subjected to hydrogen cyanide but is disinfested by steam at the Council's Disinfecting Station. Mortuary and Crematorium The mortuary at Wandsworth was used throughout the year and 336 bodies were received there. Under the Crematorium Regulations, 1930, 1,244 cremations were authorized during 1955 as compared with 1,190 in 1954. Burial of the Dead Under Section 50 of the National Assistance Act, 1948, it is the responsibility of the Council to arrange for the burial of persons who die or are found dead in the Borough, and for whom no suitable burial arrangements are made or are being made. The number of persons buried under the provisions of the Act during 1955 was 23. 5 HOUSING STATISTICS RELATING TO HOUSING Public Health (London) Act, 1936 Number of houses inspected on account of complaints or illness 8,541 Re-inspections 23,680 Number of statutory notices served: Intimation notices 2,169 Nuisance notices 721 Number of houses in which nuisances were abated 2,662 The number of cases referred to the Solicitor for legal action during 1955 was 168 The following is a summary of Police Court proceedings: Number of summonses served 52 „ „ „ withdrawn 19 „ „ „ adjourned 8 „ „ Orders made for abatement of nuisances 25 Costs awarded in respect of two cases £2. 2s. Od HOUSING ACT, 1936 Number of houses inspected—house to house (Housing Consolidated Regulations, 1925) Nil Repair of Houses Number of notices served under Section 9 of the Housing Act 1936 Nil Number of houses made fit for habitation: (a) by owners Nil (b) by Local Authority in default of owners Nil Demolition Orders Number of orders made under Section II of the Housing Act 1936 Nil Number of houses demolished: (a) as the result of such orders Nil (b) voluntarily Nil Closing Orders (other than underground rooms) Number of houses closed (Local Government (Miscellaneous Provisions) Act 1953) Nil Number of such orders determined Nil Number of rooms in respect of which Closing Orders were made under Section 12 of the Housing Act 1936 Nil Number of such orders determined Nil 27 28 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 Closing Orders (underground rooms) Number of rooms found to be unfit for habitation 26 Number closed or modified occupation approved 23 Number of Closing Orders determined 2 Slum Clearance Number of houses included in representations under Section 25 of the Housing Act 1936 77 Number of houses demolished following such action 23 Overcrowding Number of families found to be living in overcrowded conditions 78 Number of overcrowded families who have obtained alternative accommodation 35 New Accommodation Number of dwellings erected by the borough council during the year 408 The Housing Repairs and Rents Act, 1954 During the year 191 applications were received for Certificates of Disrepair and were dealt with as follows: (a) One hundred and sixty-eight Certificates of Disrepair were granted; (b) One Application was withdrawn at the request of the tenant; (c) Twenty-two Applications were not granted as the premises were found to be in good repair and reasonably suitable for occupation; One hundred and seventy Applications were received for revocation of Certificates of Disrepair and these were granted. HOUSING 29 Housing Accommodation—Medical Priority During the year 919 of the applications made to the Council for rehousing were referred to me for consideration of additional points on health grounds in accordance with the Council's Points Scheme. I also made 356 recommendations for transfer on health grounds in respect of applications received from tenants of Council's permanent and requisitioned properties for the provision of more suitable alternative accommodation. UNFIT HOUSES Slum clearance Gay Street, Waterman Street and Felsham Road On the 30th December, 1954, I submitted official representations under Part III of the Housing Act, 1936, upon the condition of the properties, Nos. 1-35 (odd) and 2-42 (even) Gay Street, Nos. 7-31 (cons.) Waterman Street and Nos. 40-64 (even) Felsham Road, and these representations are now being considered by the Council. 1, 2, 3 and 4 Kings Cottages, Streatham High Road These properties were declared a Clearance Area following my representations and a Clearance Order was subsequently confirmed by the Minister of Housing and Local Government. individual unfit houses Closing Orders were made on basement premises at 199 New Park Road, 24 Pendennis Road, 1 Richmond Mansions, Lower Richmond Road, 60 Rossiter Road, 14 Stratford Grove, 85 Drakefield Road, 123 Endlesham Road, 17 Milford Street, 510 and 512 Wandsworth Road and 28 Rossiter Road, comprising, in all, 23 underground rooms. In each case the owners had been invited to submit proposals to render the premises fit for human habitation, but none were received. At the end of the year proposals were still awaited from the owner of 10B Old Town in respect of a proposed Demolition Order. 6 FOOD AND FOOD PREMISES There were four inspectors engaged wholly in the supervision of the food supply. One of them is the Food and Drugs Inspector of the Borough who is occupied in procuring samples of food and drugs for analysis by the Public Analyst and the Public Health Laboratory and the supervision of dairy premises. The other three Inspectors are designated Food Inspectors and supervise other premises where food is sold, stored, manufactured, or prepared for sale. One-third of the Borough is allocated to each Inspector. The three Inspectors also carry out the duties required under the Pharmacy and Poisons Act, 1933, and the Pharmacy and Medicines Act, 1941. The district Sanitary Inspectors who hold the additional certificate of Inspector for Food and Drugs carry out the day-to-day supervision of the catering establishments in their respective areas. With the object of ensuring that all food businesses are supervised systematically, a register of all premises where a food business is carried on has been compiled and is kept up to date. This Register includes not only those premises which are subject to some form of legal control, but also all other premises in which a food business of any description is carried on. The total number of food premises on the register in the Borough is 2,781 and during 1955 they were visited on 42,928 occasions. Table IX has been drawn up to show the number of visits to various food premises in different parts of the Borough. Milk Supply The Milk and Dairies Regulations, 1949—1954 These Regulations came into force on 1st October, 1949, and require local authorities to keep a register of all persons carrying on the trade of distributor in their district and of all premises within their district which are used as dairies, not being dairy farms. During the year 34 applications have been received from persons to be registered as distributors of milk. In each case the certificate of registration was granted. Twenty-five notices of cancellation of registration have been received. At the end of the year there were 229 persons on the register, including 18 persons with premises outside the Borough. There were three dairies on the register at the end of the year. The bulk of the milk sold by retail within the Borough is sent out in bottles filled in properly constructed dairies and its quality is good. 30 TABLE IX SUMMARY OF VISITS TO FOOD PREMISES Putney Thamesfield Fairfield West Hill Southfield Earlsfield Springfield Tooting Graveney Bedford Larkhall Clapham North Clapham Park Thornton Balham Streatham Hill St. Leonards Streatham Common Streatham South Furzedown Whole Borough Dairies and Shops distributing Milk 138 197 123 82 148 125 93 201 145 123 156 156 156 115 168 123 131 169 166 108 2,823 Restaurant Kitchens 119 169 143 124 101 89 75 147 108 43 141 210 42 77 124 100 230 56 38 72 2,208 Ice Cream Premises 103 124 92 62 84 57 30 98 147 36 138 153 115 128 70 62 153 60 42 83 1,837 Butchers' Shops 210 244 204 110 128 201 47 162 383 43 224 204 53 250 185 169 330 28 54 193 3,422 Greengrocers' Shops 89 71 48 74 36 66 42 151 230 67 156 116 46 170 265 40 59 19 69 49 1,863 Fishmongers' Shops 12 79 24 39 19 22 22 60 99 11 72 105 39 118 110 42 157 10 25 19 1,084 Fried Fish Shops 5 23 17 3 15 29 12 12 47 4 139 121 2 18 10 12 3 10 14 33 529 Market Stalls 254 675 271 376 408 169 711 1,430 8,720 — 124 660 67 6,640 536 — 944 — — 150 22,135 Other Premises 302 415 418 269 457 331 130 326 537 139 570 516 229 561 337 270 528 134 196 343 7,008 Slaughterhouses — 7 — — — — — — — — 12 — — — — — — — — — 19 Total Visits 1,232 2,004 1,340 1.139 1,396 1,089 1,162 2,587 10,416 466 1,732 2,241 749 8,077 1,805 818 2,535 486 604 1,050 42,928 FOOD AND FOOD PREMISES 31 32 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 Food and Drugs Act, 1938-1954 Two hundred and forty-three samples of milk were submitted for analysis. Of these 15 were samples of Channel Island and South Devon milks with an average fat content of 4.34 per cent. The remaining 228 samples had an average fat content of 3.53 per cent. One sample failed to comply with the regulations. The Milk (Special Designation) (Raw Milk) Regulations, 1949-1954, and the Milk (Special Designation) (Pasteurized and Sterilized Milk) Regulations, 1949-1954 These regulations, which came into force on 1st October, 1949, provide for the issue of licences to persons who sell milk under any of the following designations: "Pasteurized" "Sterilized" "Tuberculin Tested" The following licences for the sale of milk under these designations were granted during the year: Dealers' Dealers Supplementary Total Pasteurized 213 34 247 Sterilized 267 37 304 Tuberculin Tested 153 33 186 Total 633 104 737 Three dealers' (pasteurizers') licences were granted during the year and are included in the above figures. A person who holds a "Tuberculin Tested" licence and a "Pasteurized" or "Sterilized" licence may use the designations "Tuberculin Tested (Pasteurized)" or "Tuberculin Tested (Sterilized)" as the case may be. FOOD AND FOOD PREMISES 33 Meat There are 215 butchers' shops in the Borough. The majority are registered under Section 14(l)(b) of the Food and Drugs Act, 1938-1954, for the preparation or manufacture of sausages or potted, preserved, pickled or pressed foods. There were 3,422 visits made to these shops during the year. Slaughter of Animals There were three private slaughter-houses in the Borough and they were visited on 19 occasions. The carcase of one cow was inspected after slaughter. Slaughter of Animals Act, 1933-1954 Section 3 of this Act provides that no animal shall be slaughtered or stunned in a slaughterhouse or knacker's yard by any person who is not the holder of a licence granted by a local authority and in force under this section. During the year no applications from persons desirous of acting as slaughtermen were received by the Council. Piggeries There are now three piggeries in this Borough and they were inspected on two occasions. Unsound Food One hundred and forty varieties of foodstuff suspected to be unsound were examined at the request of the owners and afterwards either destroyed or released for animal feeding. The owners were granted a certificate to this effect. 34 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 Pharmacy and Poisons Act, 1933, and Pharmacy and Medicines Act, 1941 These Acts provide for the listing with the Local Authority of all persons dealing in poisons included in Part II of the Poisons List. The number of persons on the Council's list at the end of 1955 was 395, and 775 visits were made to the premises of the listed persons by the Food Inspectors. The principal business conducted on the premises of these applicants is shown in Table X. The majority of the listed sellers are also purveyors of food. TABLE X PART II OF POISONS LIST Principal Business Number of Premises Number of Visits Confectioners 3 7 Domestic stores, ironmongers, etc 104 209 Drug stores 20 35 Grocers 247 471 Hairdressers 15 39 Nurserymen and florists 6 14 Total 395 775 Bakehouses There are 68 bakehouses in the Borough, of which 13 are in basements and subject to the provisions of Section 54 of the Factories Act, 1937. Three hundred and seventy-eight visits were made to these premises by Food Inspectors during the year. FOOD AND FOOD PREMISES 35 Water Supply The bulk of the water supply in the Borough is provided by the Metropolitan Water Board and this has been satisfactory both in quality and quantity. Registration of Premises The Food and Drugs Act, 1938-1954 Section 14 (1) of the above Act provides that no premises shall be used for: (a) the sale, or manufacture for the purpose of sale of ice-cream, or the storage of ice-cream intended for sale; or (b) the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale, unless they are registered under this section for that purpose with a local authority. During the year 33 applications for registration under the provisions of Section 14(l)(a) and 11 applications for registration under the provisions of Section 14(l)(b) were submitted to the Council. In all cases the premises were found to be satisfactory and the registration granted. Public Health (London) Act, Sec. 144 During the year no applications were received for licences under the provisions of Sec. 144, to use premises as slaughterhouses. Bacteriological Examination of Food Five hundred and seventy-six samples of food were examined bacteriologically at the Public Health Laboratory during the year. They were as follows: Milk including Raw Milk Fresh Cream including Tinned Cream Synthetic Cream Artesian Well waters Icecream Others Total for 1955 326 5 21 8 47 169 576 36 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 Milk Of the 326 samples of milk, 144 were submitted to the phosphatase test, 159 to the methylene-blue test, and 23 to the turbidity test. In two cases the atmospheric shade temperature exceeded 65°F., making the methylene-blue test void. In addition 15 samples of raw milk were examined for the presence of Mycobacterium tuberculosis and Brucella abortus. In each case negative results were obtained. Fresh Cream Five samples of fresh cream were examined for the presence of pathogenic organisms. They were all reported sterile. Imitation Cream Twenty-one samples were examined for the presence of pathogenic organisms. All were reported free of contamination, with the exception of one, which had a high bacterial count. Further samples have since proved satisfactory. Artesian Well Water Eight samples were submitted for examination, and were reported satisfactory. Ice-cream During the year 47 samples of ice-cream were tested in accordance with the technique suggested by the Ministry of Health and Public Health Laboratory Service. These samples were examined at the Public Health Laboratory. FOOD AND FOOD PREMISES 37 In addition 11 samples of ice-lollies were submitted for examination. These have all been reported satisfactory. Others One hundred and sixty-nine samples of Crystal Hen Albumen were taken in the Borough. Bacteriological examination revealed the presence of pathogenic organism—Group C Salmonella, in a substantial number of the samples. Analysis of Food and Drugs During the year 1,000 samples of food and drugs were procured for analysis: 243 samples of milk, 684 other foodstuffs and 73 drugs. Of these 219 were submitted as formal samples while 781 were purchased informally. One or 0.3 per cent. of the formal and fourteen or 1.8 per cent. of the informal samples, were found to be adulterated or not up to standard. The total adulterations reported were 15 or 1.5 per cent, of the samples submitted. The 15 samples found to be adulterated were: Three samples of sausages, two samples each of ice-cream and shredded tapioca, and one sample each of ammoniated tincture of quinine, beer, borax, bread, canned tongue, cream, friars balsam and milk. The following table gives a summary of the results: Methylene-Blue Reduction Test Number of Samples Provisional Grade 33 1 4 2 10 3 Nil 4 Total 47 7 FACTORIES ACT, 1937 Prescribed particulars required by Section 128 PART I (1) INSPECTIONS Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (1) Factories in which Sections 1, 2, 3, 4 and 6 of the Act are to be enforced by Local Authorities 480 210 3 - (2) Factories not included above in which Section 7 of the Act is enforced by the Local Authority 1,089 1,122 11 - (3) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 99 31 - - Total 1,668 1,363 14 — (2) DEFECTS 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 3 3 2 Overcrowding — — — — - Unreasonable temperature — — — — - Inadequate ventilation - - - - - Ineffective drainage of floors — — — - Sanitary Conveniences (a) insufficient 2 1 2 - (6) unsuitable or defective 40 21 — 5 - (c) not separate for sexes 1 — — 1 - Other offences against the Act (not including offences relating to outwork) 8 7 1 5 Total 54 32 1 15 — 38 FACTORIES ACT 1937 39 PART VIII SECTION 110. OUTWORK Nature of work Number of outworkers in August list Number of cases of default in sending lists to the Council Number of prosecutions for failure to supply lists Wearing apparel—making, etc. 460 — cleaning and washing 10 - - Household linen 1 - - Furniture and upholstery 2 - - Umbrellas, etc 1 - - Artificial flowers 1 - - Paper bags 7 - - Boxes or other receptacles made wholly or partially of paper 20 - - Brush making 1 - - Carding etc. of buttons, etc. 1 - - Cosoques, Christmas Crackers, Christmas Stockings, etc. 40 - - Lampshades 113 — - Total 657 — — REPORT OF THE WORK OF THE PUBLIC ANALYST FOR 1955 The Public Analyst, J. E. Woodhead, B.Sc., F.R.I.C., Ph.C. reports as follows. By virtue of the requirements of the Food and Drugs Act, 1938-1954, 1,000 samples were examined during the year ended 31st December, 1955, 927 of these were articles of food, and the remaining 73, drugs. All were submitted by the Council's Food Inspector, 219 having been taken with the formalities required by the Act and 781 informally. Samples of the following substances were analysed: fats (butter, margarine, etc.), 32; beverages (cocoa, coffee, etc.), 19; cereal preparations, 26; cream, 27; fish, canned, 22; fruit (canned and dried), 58; meat products (including sausages), 81; milk, 253; pickles and condiments (including spices), 87; preserves, 35; soup, 24; vegetables, 31; friars balsam, 8; iodine solutions, 5; ointments, 11; seidlitz powders, 8; borax, 8. 40 REPORT OF THE PUBLIC ANALYST FOR 1955 41 Adulterated Samples Particulars of the samples reported as adulterated or not up to standard are given in the following table: Case No. Nature of Sample Nature of Report Formal 667 Milk 2% deficient in fat Informal 532 Pork sausages 14% deficient in meat 724 Ammoniated Tincture of Quinine 20% deficient in ammonia 774 Ice-cream 35 % deficient in fat 775 „ 15% 906 Canned tongue Excessive rancidity 907 Bread Dirt in dough 927 Pork sausages 7.5% deficient in meat 940 Bottled cream Dirty bottle 998 Beer Dirty bottle 1123 Shredded Tapioca 1 Fibres and other vegetable 1165 ,, ,, debris present 1194 Borax BP Arsenic 10 p.p.m. in excess 1195 Friars Balsam Deficient in total solids 1235 Pork sausage Meat content 59 % Adulteration The amount of adulteration detected during the year was: For formal samples 0.3 per cent. For informal samples 1.8 per cent. For all samples 1.5 per cent. 42 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 Complaint Samples Case No. 906. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 907. Canned Tongue. Submitted on the complaint that it was unfit for consumption. The complaint was considered justified. Case No. 940. Bottled Cream. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 983. Butter. Submitted on the complaint that it was margarine. The complaint was considered not justified. Case No. 997. Sweets. Submitted on the complaint that they had caused sickness. The complaint was considered not justified. Case No. 998. Bottled Beer. Submitted on the complaint that it was unfit for consumption. The complaint was considered justified. Case No. 1290. Cocoa. Submitted on the complaint that it had caused sickness. The complaint was considered not justified. REPORT OF THE PUBLIC ANALYST FOR 1955 43 Milk The average composition of the samples of milk submitted during each month of the year and returned as genuine was as under: Month Number Total solids Milk fat Non-fatty solids January 10 % 12.20 % 3.51 % 8.69 February 24 12.36 3.64 8.72 March 11 12.33 3.70 8.63 April 16 11.95 3.35 8.60 May 22 12.17 3.35 8.82 June 35 12.03 3.32 8.71 July — — — — August 20 12.07 3.42 8.65 September 30 12.32 3.62 8.70 October 6 12.31 3.56 8.75 November 28 12.51 3.64 8.87 December 26 12.70 3.89 8.81 The average composition of the 228 samples of milk analysed during the year and returned as genuine was as under: Total milk solids 12.26 per cent. Milk fat 3.53 per cent. Non-fatty solids 8.73 per cent. The average composition of the 15 samples of Channel Island and South Devon milks was as under: Total milk solids 13.43 per cent. Milk fat 4.34 per cent. Non-fatty solids 9-09 per cent. INDEX PAGE Accidents, Deaths from 20 Acute Encephalitis 17 Analyst, Report of 40 Bacteriological Examinations of Milk 35 „ „ of Ice-cream 35 Bathing Pools and Swimming Pools 25 Bed Bugs, Eradication of 26 Births, Birth-rates 10 Butchers' Shops 33 Cancer 20 Childbirth, Deaths from 13 Circulatory Diseases 12 Closing Orders 29 Crematorium 26 Cutting-off Notices—Water Supply 24 Deaths, Causes of 12 Death-rates 11 Death-rate from Infective Diseases 14 Death-rate, Infantile 13 Deaths, Number of 11 Diphtheria 14 Diseased or Infirm Persons, Removal of 25 Disinfection 19 Enteric Fever 17 Erysipelas 18 Factories Act, 1937 38 Factories and Workshops 38 Food and Drugs Act, 1938-1954 32 Food Poisoning 18 Food, Supervision of 30 Food Places, Inspection of 31 Food Places, Number on Register 30 Houses and Premises Inspected 27 Housing Act, 1936 27 Housing Repairs and Rents Act 1954 28 Housing Statistics 27 Hydrogen Cyanide Disinfection 26 Illegitimate Children, Births of 10 Infant Mortality 13 45 46 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 PAGE Infective Diseases 14 Infective Diseases, Cases of 15 Infective Diseases, Death Rate from 14 Infirm or Diseased Persons, Removal of 25 Influenza, Deaths 17 Influenzal Pneumonia and Acute Primary Pneumonia 18 Insanitary Areas 29 Malaria 18 Maternal Mortality 13 Meat 33 Meningococcal Infection 17 Milk Analysis 43 Milk, Bacteriological Examination of 35 Milk Premises, etc., on Register 30 Milk (Special Designations) Regulations, 1949-54 32 Mortuary 26 Non-infective Diseases, Deaths from 20 Notification of Infective Diseases 14 Outworkers 39 Overcrowding 28 Pharmacy and Poisons Act, 1933 34 Pharmacy and Medicines Act, 1941 34 Piggeries 33 Poliomyelitis 17 Population 10 Pregnancy, Deaths from Accident and Diseases of 13 Preserved Meat, etc., Manufacture of 35 Public Analyst, Report 40 Puerperal Pyrexia 17 Pulmonary Tuberculosis, Notification of cases of 21 Ragwashing and Sterilisation, Certificates 25 Rodent Control 24 Samples, Formal and Informal, Number of 25 Sanitary Inspection of Borough 22 Scabies 18 Scarlet Fever 14 Slaughter-houses 33 Slaughter of Animals Acts, 1933-1954 33 Smallpox 14 Statistics for the Borough 8 Suicide, Deaths from 20 INDEX 47 page Swimming Baths and Bathing Pools 25 Syphilis, Deaths from 18 Tuberculosis 21 Unfit Houses 29 Unsound Food 33 Water Supply 35 Water Supply, Cutting-off Notices 24 Whooping Cough 14 Printed by Geo. Gibbons Ltd., Leicester