LIBRARY BOROUGH OF WANSTEAD AND WOODFORD Annual Report OF THE MEDICAL OFFICER OF HEALTH For the Year Ending 3st December, 1940. WANS 55 BOROUGH OF WANSTEAD AND WOODFORD Annual Report OF THE MEDICAL OFFICER OF HEALTH For the Year Ending 31st December, 1940. PUBLIC HEALTH STAFF. Medical Officer of Health (part time), R.F. Vere Hodge, M.D., Cantab. Senior Sanitary Inspector, H.C. Howard, M.R.San.I., M.S.I.A. (a) (c). Deputy Senior Sanitary Inspector, E. Jackson, M.R.San.T., M.S.I.A. (b) (c) (d). Sanitary Inspector, A. J. Storer, M.S.I.A. (b). (Joined R.A.M.C., 28th May, 1940.) Sanitary Inspector and Senior Clerk, L. G. Howard, M.S.I.A. (b) (c). Health Visitors, Miss H. Hird, S.C.M. (e). Miss J. E. Rhodes, S.R.N., S.C.M. (e) (from 26th February, 1940). Midwives, Miss E. Dixon, S.R.N., S.C.M. (resigned 31st January, 1940). Miss S. A. Jones, S.C.M. Mrs. M. Marlow, S.C.M. (from 18th January, 1940). Miss I. Turner, S.C.M. (from 1st February, 1940). Clerks, F.E. Farrington. (Joined R.A.D.C., 2nd May, 1940.) S. C. Hearson. (a) Royal Sanitary Institute Certificate for Sanitary Inspector. (b) Royal Sanitary Institute and Sanitary Inspector's Examination Joint Board Certificate. (c) Royal Sanitary Institute Certificate of Meat and other Foods. (d) Royal Sanitary Institute Certificate for Sanitary Science as applied to Buildings and Public Works. (e) Royal Sanitary Institute Certificate for Health Visitor. WANSTEAD AND WOODFORD BOROUGH COUNCIL. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the Year Ending 31st December, 1940. In the year under review the public health in this district remained satisfactory and the incidence of infectious disease very low. Whilst at the beginning of the war, a number of people left the district, there has been since then a considerable influx of people from inner London. At the same time, the further call-up both of men and women has resulted in a loss of some of our pre-war inhabitants, and on balance our population decreased. The Registrar-General's estimate population at the middle of 1939 was 55,880, whilst in 1940 the figure given bv him was 48,620. It will be noticed that the birth rate has fallen and the death rate has increased. This increase in death rate is accounted for by deaths due to enemy action. The deaths of infants under one year of age have fallen from 37.8 per cent. to 31.8 per cent. as calculated per 1,000 live births. There was also a fall in the proportion of stillbirths. The latter is remarkable in view of war conditions. Section A. Statistics and Social Conditions of the Area. Area (in acres) 3,824 Registrar-General's estimate of resident population, 1940 48,620 Number of inhabited houses (end of 1940) according to Rate Books 16,400 Rateable value (end of 1940) £578,771 Sum represented by a penny rate (1940-41) £2,216 Extracts from Vital Statistics of the Year. Live Births. (a) for calculating birth rates. Legitimate Males 324 Females 270 Total 594 Illegitimate Males 7 Females 10 Total 17 Total Males 331 Females 280 Total 611 4 (b) for calculating infantile and maternal mortalities. Legitimate Males 299 Females 251 Total 550 Illegitimate Males 6 Females 10 Total 16 Total Males 305 Females 261 Total 566 Birth rate per 1,000 of the estimated resident population—12.6. Stillbirths. (a) for calculating birth rates. Legitimate Males 9 Females 12 Total 21 Illegitimate Males 1 Females 0 Total 1 Total Males 10 Females 12 Total 22 (b) for calculating infantile and maternal mortalities. Legitimate Males 8 Females 12 Total 20 Illegitimate Males 1 Females 0 Total 1 Total Males 9 Females 12 Total 21 Rate per 1,000 total (live and still) births—34.75. Deaths. Males—315. Females—338. Total—653. Crude Death rate per 1,000 of the estimated resident population—13.4. Adjusted Death Rate—13.1. Deaths from puerperal causes: — Puerperal and post-abortion sepsis Nil Other maternal causes Nil Total Nil Rate per 1,000 total (live and still) births nil Death Rate of Infants under one year of age:— All infants per 1,000 live births 31.8 Legitimate infants per 1,000 legitimate live births 32.7 Illegitimate infants per 1,000 illegitimate live births Nil Deaths from Cancer (all ages) 101 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) Nil Deaths from Diarrhoea (under 2 years of age) Nil s Birth-rates. Civilian Death-rates, Analysis of Mortality, Maternal Mortality, and Case-rates for certain Infectious Diseases in the year 1940. England and Wales, London, 126 Great Towns and 148 Smaller Towns. (Provisional Figures based on Weekly and Quarterly Returns) England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns (Resident populations 25,000 to 50,000 at 1931 Census) London Administrative County Borough of WANSTEAD and WOODFORD Rates per 1,000 Civilian Population Births: Live 14.6 16.0 15.7 13.7 12.6 Still 0.55 0.64 0.55 0.44 0.45 Deaths: All Causes 14.3 15.8 12.3 17.8 13.4 Section B. General Provisions of Health Services for the Area. 1. (1) Public Health Officers of the Authority:— Particulars are given on page 2, at the beginning of this report. (2) (a) Laboratory facilities:— All pathological and bacteriological facilities are provided by the Essex County Council, the work being done at the Essex Public Health Laboratory, 91, Queen Victoria Street, London, E.C.4. The analysis of water, milk and food is carried out by Dr. Bernard Dyer and Mr. George Taylor, Public Analysts for the Borough. (b) Ambulance facilities:— (i) For infectious diseases. All cases requiring removal to hospital are conveyed by the ambulances attached to the hospitals. (ii) For non-infectious and accident cases. Cases of this class are taken to hospital by either of the two ambulances belonging to the Borough Council. A satisfactory service is maintained throughout the district. (c) Nursing in the home:— Home nursing is carried out:— (i) By private nurses; (ii) By district nurses working under a Committee and supported by voluntary contributions and receipts from patients. 6 (d) Clinics and Treatment Centres:— Child Welfare Centres. There are five centres in the district:— (i) St. Barnabas Church Hall, Snakes Lane. (ii) Fuller's Road Sunday School. (iii) Baptist Church Hall, Aldersbrook. (iv) Ashton Playing Fields Pavilion, Chigwell Road. These are supported and directed by the Borough Council. (v) Holy Trinity Church Hall, Hermon Hill. This is under the direction of a voluntary committee, but is subsidised by the Council. The following treatment centres in the district are under the control of the County Council: — (i) The Tuberculosis Dispensary. (ii) The School Clinic. (iii) The Orthopaedic Clinic. (Conjointly with the British Red Cross Society). (iv) The Mental Treatment Clinic. These all find accommodation at The Shrubberies, High Road, South Woodford. (e) Hospitals. Public and Voluntary:— Maternity.—There are no maternity hospitals in the district. Our arrangements for the reception of maternity cases which we had before the war with Queen Mary's Hospital, Stratford, are no longer in operation. We are still able to send cases of Puerperal Pyrexia to the Waltham Joint Hospital, but for other cases where the condition of the mother or home conditions require that the mother should be removed, we have been making arrangements to evacuate the patients to hospitals outside the district. Children.—There is a children's ward of five beds at the Woodford Jubilee Hospital. Infectious Diseases.—Cases of infectious diseases in Wanstead and Woodford, which required removal, were taken to the Waltham Joint Hospital, under the control of the Waltham Joint Hospital Board. Since November, 1936, the Waltham Joint Hospital Board have been willing to admit, in addition to Scarlet Fever and Diphtheria, cases of the following diseases: — Complicated cases of Measles, Whooping Cough, Influenza and Pneumonia; The acute infectious diseases of the nervous system, Meningitis, Poliomyelitis and Encephalitis; Typhoid and Paratyphoid Fevers; Dysentery, Erysipelas and Ophthalmia Neonatorum; Puerperal Pyrexia. 7 Smallpox.—The London County Council are prepared to receive cases of Smallpox from this area into the London Smallpox Hospital so long as they have sufficient accommodation available. 2. Maternity and Child Welfare:— (1) Midwifery and Maternity Services.—Nurse Dixon and Nurse Straw have resigned their appointments and Nurse Marlow and Nurse Turner have been appointed to take their place. We have three Municipal Midwives working in the district. Except for ante-natal visiting they devote the whole of their time to midwifery. The number of cases attended by them was as follows:— (a) As Midwives 158 (b) As Maternity Nurses 39 Number of visits paid by these Midwives:— (a) Number of cases 197 (b) Ante-natal visits 1,297 (c) Nursing visits 2,981 Ante-natal Supervision.- This is given to all women attended by the Municipal Midwives and in every case one or more examinations are made and if necessary treatment is given by a doctor of the patient's choice. In necessitous cases the fees for the medical services are paid by the Council. In 1940 payments were made to medical practitioners in 21 cases. Consultant.—This appointment is now vacant. (2) Institutional Provision for Mothers or Children.—Over fifty per cent.—306 out of 545—births in Wanstead and Woodford occurred in private nursing homes. 3. Health Visitors.—Miss Rhodes began her duties as Health Visitor on 26th February in succession to Miss Smith. The following particulars of the work done by the Health Visitors are taken from Form M.C.W.96 (Revised), which was sent to the Ministry of Health in advance of this report. Number of visits paid during the year by the Health Visitors:— (a) To children under one year of age:— First visits 507 Total visits 2208 (b) To children between the ages of one and five years:— Total visits 2663 Infant Welfare Centres.—In the year under review, enemy action has interfered considerably with our normal routine at our welfare centres. We have kept our centres open for medical consultation and for the supply of infant foods, but in view of the frequent raid warnings we have not encouraged mothers to linger at the centres. These conditions have also interfered with the accurate keeping of records. The following attendances 8 were recorded at the five Centres serving the Wanstead and Woodford residents:— (a) Children under one year of age 7167 (b) Children between the ages of one and five years 4385 4. Child Life Protection.—The Health Visitors are appointed Child Life Protection Visitors under Part VII of the Public Health Act, 1936 There were eight foster-mothers and ten foster-children on the Register at the end of the year. A total of one hundred and seventeen visits were paid by the Visitors. 5. (a) Arrangements for Dental Cases.—Arrangements were made with the local dentists in 1937 to undertake the dental treatment of expectant and nursing mothers and children under school age. Their charges are on an agreed scale and the fees payable by the patients are assessed according to their means, on a scale similar to that of the Essex County Council. During the year 1940, ten mothers and seven children were treated under this Scheme. (b) Arrangements for Orthopaedic cases.—There is an orthopaedic clinic at the Shrubberies, High Road, South Woodford, directed conjointly by the British Red Cross Society and the Essex County Council. In suitable cases the Wanstead and Woodford Borough Council have paid the fees for the admission of orthopaedic cases to Brookfield Ortho. paedic Hospital. Section C. Sanitary Circumstances of the Area. 1. (1) Water Supply.—The water service throughout the district is supplied by the Metropolitan Water Board. (2) Drainage and Sewerage- There have been no important extensions of sewerage or improvements made in the arrangements for drainage, sewerage and sewage disposal. 2. Rivers and Streams.—The results of the analyses of samples of effluent from the three sewage works were satisfactory, with the exception of the Western Sewage Works when the samples taken in April, June and October, 1940, proved to be unsatisfactory. 3. (1) Closet Accommodation.—With the exception of four isolated dwellings, house drainage throughout the district is conducted on the water carriage system. (2) Public Cleansing.—The collection and disposal of house refuse has continued to be carried out under contract requiring the maintenance of a weekly collection throughout the district and the disposal of the refuse under controlled tipping conditions. The present contract dating from March, 1938, is for a period of three years, the contractor providing mechanised transport only. Council owned land in the Borough is used for the tipping of the refuse. 9 (3) Sanitary Inspection of the Area.—The Report of the Senior Sanitary Inspector is included at the end of this Section. (4) Shops and Offices.—Under the provisions of the Shops Acts, 1934, a total of one hundred and ninety-six shop inspections were recorded! Improvements with regard to ventilation and temperature of shops and to sanitary conveniences were effected upon four premises. Two notices, Section 10, subsection (7), Shops Act, 1934, were served for the provision of sanitary arrangements in shop premises, and the notices were complied with. Shops (Hours of Closing) Act, 1928.—Under the provisions of Defence Regulations, 1939, earlier closing hours operated during the winter months and normal closing hours were resumed between March and November. Seven shopkeepers were warned against minor contraventions. (5) Camping Sites.—There are no camping sites in the district. (6) Smoke Abatement.—One smoke nuisance was abated. (7) Eradication of Bed Bugs.—The means employed for eradication of the bed bug as outlined in previous reports has been continued with satisfactory results. The number of premises disinfested was nineteen, including two Council owned houses. The insecticides used were Pyagra and Deodex preparations. Spraying and steam disinfestation is carried out by the staff of the Public Health Department. 4. Schools.—During the year the Elementary Schools were closed for varying periods, owing to the evacuation of the children. Towards the end of the year the Elementary schools were reopened and the average attendances reached approximately 64 per cent, of the pre-war figure. At the time of the heavy bombing of London, some of the schools were utilised for accommodation for refugees. The Public and Secondary schools did not close during the year, but in the latter school, numbers of the children were evacuated. SANITARY INSPECTION OF THE AREA. Report of the Senior Sanitary Inspector. In accordance with Article 27(18) of the Sanitary Officers (Outside London) Regulations, 1935, I beg to submit the following particulars with regard to the work accomplished by the Sanitary Inspectors during the year 1940. Owing to war time conditions a considerable amount of time was taken up in connection with the following matters:— Food stocks on damaged premises. Arrangements for the treatment and disposal of foodstuffs contaminated by gas. Civilian war deaths. 10 Salvage operations. Underground shelters. Refugee centres. War damaged premises (drains and sanitary arrangements). Summary of the various inspections made by the Sanitary Inspectors: — Dwelling Houses— On complaint and other causes 511 Infectious disease enquiries 71 House-to-house inspections 21 Premises measured for purposes of Part IV of the Housing Act, 1936 (abatement of overcrowding) 57 Number of rooms measured in these premises 247 Rent Restriction Act enquiries 6 Total number of re-inspections for all purposes 1477 Other Premises— Schools 31 Factories 75 Outworkers premises 14 Meat distributing centre 340 Slaughterhouses (January only) 9 Carcases examined (January only) 47 Butchers' shops and provision stores 360 Bakehouses 33 Fishshops 62 Dairies and Milkshops 50 Ice Cream dealers 28 Other Food premises 72 Rat infestation 138 Verminous premises 21 Petroleum installations 103 Shops Act 196 Premises where animals are kept 57 Miscellaneous inspections, including visits due to war circumstances 607 Total number of inspections and re-inspections 4333 Drainage— Renewed or repaired, including war damaged drains 61 Notices served— Informal: — Housing Act, 1936 16 Public Health Acts 219 Statutory:— Public Health Act, 1936, Section 24 4 Public Health Act, 1936, Section 39 2 Public Health Act, 1936, Section 287 1 Shops Act, 1934, Section 10 (subsection 7) 2 Food and Drugs Act, 1938, Section 14 1 11 Factories Act, 1937.—The total number of factories registered at the close of the year was (1) Power factories—72, (2) Non-power factories—38. These included fourteen bakehouses, two being underground bakehouses. Informal notices were served and satisfactory results obtained in respect of six factories with regard to cleanliness of premises, improvement or repair to sanitary arrangements, as well as improved ventilation. Rent and Mortgage Interest Restrictions Acts, 1920 to 1939.—Several enquiries were made by occupiers of premises with regard to their position under the Act, but notices served in respect of the conditions referred to usually had the desired effect. One certificate was granted. Rats and Mice (Destruction) Act, 1919.—One hundred and thirty-eight visits were paid to premises in connection with complaints received and in the majority of cases the source of rat infestation was definitely traced, the premises being freed of rats with the aid of a Cyanogas foot pump wherever this could be applied safely, or by means of Red Squill baits. Factories and Food Premises were also kept under supervision for rat infestation, and methods for their extermination were adopted in necessary cases. Petroleum (Regulation) Acts, 1928 and 1936.—A total of sixty licences were renewed at the beginning of the year and included one licence for the storage of cellulose, and one for carbide of calcium. No further licences were granted during the year. The total storage capacity under licences amounted to 83,320 gallons for petroleum, 50 gallons cellulose and 10 cwts. carbide of calcium. Game Licences.—The nine licences to deal in game were renewed. Section D. Housing. Number of new houses erected during the year by private enterprise only 82 1. Inspection of Dwelling-houses during the Year:— (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 532 (b) Number of inspections made for the purpose 1477 (2) (a) Number of dwelling-houses (included under subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 21 (b) Number of inspections made for the purpose 147 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 240 i2 2. Remedy of Defects during the Year without Service of formal Notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 235 3. Action under Statutory Powers during the Year:— (a) Proceedings under sections 9, 10 and 16 of the Housing Act, 1936: (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By owners Nil (b) By Local Authority in default of owners Nil (b) Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 6 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By owners 2 (b) By Local authority in default of owners 4 (c) Proceedings under sections 11 and 13 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which Demolition Orders were made Nil (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil 4. Housing Act, 1936.—Part IV.—Overcrowding:— (а) (1) Number of dwellings overcrowded at the end of the year 14 (2) Number of families dwelling therein 14 (3) Number of persons dwelling therein 90 (b) Number of new cases of overcrowding reported during the year Nil (c) (1) Number of cases of overcrowding relieved during the year Nil (2) Number of persons concerned in such cases Nil (d) Particulars of any cases in which dwelling-houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report Nil 13 FACTORY AND WORKSHOP ACT, 1901, AND THE FACTORIES ACT, 1937. 1. Inspections for the purposes of provisions as to health. Including Inspections made by Sanitary Inspectors. Premises Number of Inspections. Written Notices. Occupiers Prosecuted Factories with mechanical power 28 4 ... Factories without mechanical power 39 6 ... Other premises (other than Outworkers' premises) 8 ... ... Total 75 10 ... 2. Defects found. Particulars. Number of Defects. Number of defects in respect of which Prosecutions were instituted. Found. Remedied. Referred to H M. Inspector. Want of Cleanliness 3 3 ... ... Overcrowding ... ... ... ... Unreasonable temperature ... ... ... ... Inadequate Ventilation 3 3 ... ... Ineffective drainage of floors 1 1 ... ... Sanitary Conveniences:— 1. Insufficient 3 3 ... ... 2. Unsuitable or defective 2 2 ... ... 3. Not separate for sexes 3 3 ... ... Other Offences ... ... ... ... Total 15 15 ... ... 14 Section E. Inspection and Supervision of Food. (a) Milk Supply— Milk is not produced within the district for the purpose of sale. The number of persons and premises registered for the sale of milk within the district are as follows:— Premises registered as Dairies and Milkshops 17 Persons registered as retail purveyors of milk in sealed bottles 14 Persons registered as retail purveyors of milk whose premises are situated outside the district 21 Number of inspections 50 The premises concerned were generally well maintained; minor infringements of the Regulations were abated promptly. "Designated" Milk.—The number of licences granted for the sale of designated milk under the Milk (Special Designations) Order, 1936, and the results of samples taken, are as follows:— Designation. Licences Supplementary Licences. Samples. Results. Satisfactory. Unsatisfactory. Tuberculin Tested 1 8 5 ... ... ... Tuberculin Tested (Pasteurised) Accredited 2 ... ... ... Pasteurised 11 6 6 4 2 With regard to the unsatisfactory samples of Pasteurised Milk referred to above, both samples were taken from milk supplied to schools. All necessary action was subsequently taken by the County Council with the producers of the milk in question. 15 Examination of Ordinary Milk.- The following table shows the results of four samples of ordinary milk subjected to bacteriological examination and animal inoculation test for tubercle bacilli:— No. No. of Bacteria per 1 ml. Presence o' Bacillus Coliform in 0.01 ml. Presence of Tubercle Bacilli. Remarks 1 350,000 Present Considered free Unsatisfactory 2 34,000 Present Considered free Unsatisfactory 3 53,000 Present Considered free Unsatisfactory 4 228,000 Present Considered present Unsatisfactory It will be observed from the above table that all samples gave unsatisfactory results. Bacillus Coliform was present in each sample, and excessive bacteria (exceeding 200,000 per millilitre) was present in two samples. With regard to No. 4, the Bacteriologist reported as the result of animal inoculation test “The animal inoculated showed generalised tuberculosis and the milk was therefore considered to have contained viable tubercle bacilli.” Sample No. 4 was taken up with the Ministry of Agriculture and Fishieries by the County Council. (b) Food and Drugs Act, 1938.—Forty-four samples of food, including six samples of ordinary milk, were obtained for analysis, and were reported upon by the Public Analysts as being genuine or satisfactory in every sample. Ice Cream.—The number of premises registered for the purpose of manufacture and sale of ice cream within the district remained at seventyeight, but little, if any, ice cream was on sale at many of these premises during the year. Five samples of ice cream were submitted for bacteriological examination and although no legal standard for bacterial purity in ice cream prevailed, three samples were reported upon adversely. The premises concerned were visited and advice given regarding the cleanliness of utensils and other conditions relating to manufacture and storage. (c) Meat and other Foods: Registration of Food Producing Premises. —In order to control the registration of premises used for— (a) the manufacture or sale or storage of ice cream; (b) the preservation or manufacture of sausages, potted, pressed, pickled or preserved food intended for sale, the Council made application to the Minister of Health (1939) to declare the provisions of Section 14 of the Food and Drugs Act, 1938, to be in force within the Borough. The application was granted and an Order to that effect came into operation in January. Thirty-two premises were registered during the year for the purposes of preservation or manufacture of sausages, potted, pressed, pickled or preserved food intended for sale. 16 Slaughterhouse licences granted previous to the thirty-first of January expired on that date, and applied to nine existing slaughterhouses, four of which were registered, and five other slaughterhouses previously subject to annual licences. Applications for licence under Section 57 of the Food and Drugs Act, 1938, were received from the occupiers of eight slaughterhouses. Four licences were granted and the occupier of the remaining slaughterhouses agreed to execute necessary improvements and repairs. The repairs in question were, however, suspended owing to prohibition of slaughtering in private slaughterhouses for the period of the war. Enemy action has also rendered the condition of three of these premises beyond further repair. Meat distributing centres in various areas had already been established under Government control, including the present depot in Woodford. Three hundred and forty inspections were made at this depot during the year and the total quantity of meat, including offal, condemned as unfit for human consumption amounted to eight tons, thirteen hundredweights, one quarter, twenty pounds. Foods examined upon other premises and surrendered as unfit for human consumption included the following:— 322 Rabbits. 140 lbs. Bacon. 42 lbs. Ham. 35 lbs. Meat trimmings. 18 lbs. Cooked Meats. 4 lbs. Ham Roll. 74 lbs. Butter. 2 lbs. Sausages. 6 lbs. Cod Fillets. 1 box Bloaters. In addition, large stocks of food were examined in shops and premises following damage by enemy action, the remains of food products were often unidentifiable, and considerable quantities of food were rendered unfit for human consumption by the action of fire and water, or from contamination by dust and dirt from fallen debris or the results of broken and splintered glass. A total of one hundred and twenty-eight visits were made in connection with the above shops. Bakehouses.—There are fourteen bakehouses in the district; two of these are underground bakehouses. Thirty-three inspections were made and the provisions of the Bakehouse Regulations were observed satisfactorily. 17 Section F. Prevalence of, and Control over. Infectious and other Diseases. 1. (a) Scarlet Fever.—Twenty-four cases were notified. No deaths occurred. (b) Diphtheria.—Eight cases were notified and one death occurred. One hundred and seventy-six children were inoculated during the year. (c) Puerperal Pyrexia.—Seven cases were notified, five of these occurred in the district, three of which were removed to the Waltham Joint Hospital, and the other two were notified from hospitals in the Metropolitan area. No deaths occurred. (d) Typhoid and Paratyphoid Fevers.—One case of paratyphoid B was notified and removed to hospital. (e) Dysentery.—Three cases were notified. (/) Cerebro-Spinal Fever.—Twelve cases were notified and two deaths occurred. (g) Encephalitis Lethargica.—One case was notified. The Measles and Whooping Cough Regulations, 1939, which require the notification of cases of Measles and Whooping Cough, came into operation on the 3rd November, 1939. Particulars of the incidence of notifiable diseases during 1940 are contained in an accompanying table. 2. (a) Disinfection and Disinfestation.—The disinfection of bedding and similar articles is done by the saturated steam process in a cylindrical horizontal steel " thresh " disinfector; infected premises are sprayed with formalin and fumigated by burning formalin tablets. Number of rooms disinfected 142 Number of verminous rooms disinfested 32 Loads of bedding disinfected 155 Loads of bedding disinfected for Chigwell U.D.C. 9 Number of School classrooms disinfected 14 Bedding, etc., disinfected after use by refugees 982 Number of blankets from various A.R.P. Depots steam disinfected 1385 (b) Laboratory Work.—The following specimens from Wanstead and Woodford were dealt with by the Counties Public Health Laboratories:— Diphtheria 96 Sputa 156 Typhoid 8 Ringworm 1 Milk and Ice Cream 13 Histological 1 Miscellaneous 186 Total 461 18 (c) Tuberculosis.—Public Health (Prevention of Tuberculosis) Regulations, 1925, and the Public Health Act, 1936, section 172. No action was necessary with regard to persons suffering from pulmonary tuberculosis employed in the milk trade. 3. Tuberculosis.—Particulars of new cases of tuberculosis and mortality from the disease during 1940:— 24 Pulmonary and 7 non-Pulmonary cases were notified for the first time during the year. 13 cases were transferred into the district. 22 Pulmonary and 3 non-Pulmonary cases died during the year. 8 deaths occurred from non-notified cases of tuberculosis. 4 cases were restored to the Register. 31 other cases were removed from the Register. 181 cases remained on the Register at the close of the year. County Tuberculosis Scheme.—Dr. W. A. Bullough, Chief Tuberculosis Officer of the Essex County Council, has kindly furnished me with the following particulars of Wanstead and Woodford patients sent to instituions for treatment during 1940:— Pulmonary. Non-Pulmonary. Total. M. F. M. F. Adults 19 15 3 2 39 Children — — 13 4 19 NOTIFICATION OF INFECTIOUS DISEASE. Small Pox Scarlet Fever Diphtheria Typhoid including Paratyphoid Erysipelas Tuberculosis Puerperal Fever Puerperal Pyrexia Ophthalmia Neonatorum Pneumonia Cerebro-spinal Fever Aeute Poliomyelitis Measles Whooping Cough Other diseases Pulmonary Other Form* 1936 0 149 53 3 13 33 12 2 4 0 41 0 2 l 1937 0 96 46 3 15 37 10 0 6 l 64 0 3 4 1938 0 83 35 1 24 37 22 11 4 39 0 2 3 1939 0 52 22 3 10 28 9 8 3 28 •0 0 2 1940 0 24 8 1 13 24 7 7 1 31 12 0 95 4 4 VITAL STATISTICS OF WHOLE DISTRICT DURING PREVIOUS YEARS. Year. Population. Births. Deaths Infantile Mortality. Number. Rate. Number. Rate. Number. Rate per 1000 Births. 1936 52,010 699 13.4 471 9.1 27 38.6 1937 53,850 720 13.4 522 9.7 29 40.3 1938 54,810 744 13.6 521 9.5 23 30.9 1939 55,880 763 13.7 555 10.4 28 37.8 1940 48,620 611 12.6 653 13.4 18 31.8 20