WANS 12 AC 4411(1) WANSTEAD WOODFORD BOROUGH OF WANSTEAD AND WOODFORD Annual Report of the MEDICAL OFFICER OF HEALTH For the Year Ending 31st December, 1947. public health committee Alderman F. G. Booth „ A. H. Southam (Vice-Chairman) „ C. Turner Councillor N. E. Britton „ A. G. Burness „ Mrs. J. Davey „ j. W. C. Lynch „ C. H. Moss „ V. E. Stevens (Chairman) maternity and child welfare committee Alderman A. H. Southam Councillor A. G. Burness „ E. H. Day „ Mrs. J. Davey (Vice-Chairman) „ R. Drew „ E. j. Dutton „ Mrs. E. F. M. Hollis (Chairman) „ V. E. Stevens „ P. F. N. Warner Co-opted Members Mrs. R. Drew „ A. R. Page „ F. G. Geeson „ A. Smith „ T. Smith 1 STAFF OF PUBLIC HEALTH DEPARTMENT Medical Officer of Health: F. G. Brown, M.B., B.Ch., D.P.I I. Senior Sanitary Inspector: M. G. Crook, M.S.I.A. (a) (b) (c) (d) Deputy Senior Sanitary Inspector: J. T. S. Templeman, M.R.San.I., M.S.I.A. (a) (b) (from 31.3.47) Sanitary Inspectors: A. J. Storer, M.S.I.A. (a) H. L. Hughes, A.R.San.I., M.S.I.A. (a) (b) Health Visitors: Miss C. Court, S.R.N., S.C.M. (e) Miss S. Butterly, S.R.N., S.C.M. (e) Miss R. Harrington, S.R.N., S.C.M. (e) Miss E. Brooks, S.R.N., S.C.M. (e) Miss M. Graham, S.R.N., S.C.M. (e) (from 15.9.47) Municipal Midwives: Miss S. A. Jones, S.C.M. Mrs. M. Marlow, S.C.M. Miss I. Turner, S.C.M. Miss N. M. Tomlinson, S.R.N., S.C.M. Mrs. I. J. Campe, S.C.M. Clerks: Miss A. E. Harrison Miss D. Howlett Miss M. S. Cryer (from 19.5.47) (a) Royal Sanitary Institute and Sanitary Inspector's Examination Joint Board Certificate. (b) Royal Sanitary Institute Certificate of Meat and other Foods. (c) First Class Certificate in Laboratory Technique of Meat Inspection of Smithfield Technical Institute. (d) Diploma of the Royal Institute of Public Health and Hygiene. (e) Royal Sanitary Institute Certificate for Health Visitor. 2 WANSTEAD AND WOODFORD BOROUGH COUNCIL. To the mayor, the aldermen and councillors, borough of wanstead and woodford Mr. Mayor, Ladies and Gentlemen, I have the honour to submit my Annual Report as Medical Officer of Health for the year 1947. Two events of major importance affecting the work of the Public Health Apartment took place during the year. The first of these was the flooding of the reservoirs at the Lea Bridge Waterworks in March with consequent pollution of water in the mains, With the result that main water supply was completely cut off in all parts of the Borough for 10-14 days. On receipt of information from the Metropolitan Water Board regarding the occurrence, pamphlets warning Householders that all water for drinking or other domestic purposes should be boiled prior to use were printed and delivered to all houses in the Borough Within 24 hours. Advice was also given as regards improvised sanitation and a supply of disinfectant obtained and held at the Public Health Dopartment for collection by householders. An emergency water Supply delivered by tanks on lorries was brought into action by the Metropolitan Water Board with whom the Sanitary Staff of the Department co-operated closely. During the period of emergency frequent visits were made to schools, cinemas, etc., to supervise sanitary measures. Most fortunately no cases of epidemic infectious disease occurred as the result of this crisis. In common with the remainder of the country, the Borough was affected by the outbreak of Poliomyelitis which occurred during the late summer and early autumn. This disease is commonly known as "Infantile Paralysis" a misnomer as it affects all age groups in the first half of life. There Were ten cases among residents in the Borough ranging from the age of six months to 38 years. Two infants under one year were affected, two children of school age and the remainder of ages, varying from eighteen upwards. Luckily none of these cases proved fatal. Children and young persons becoming sick during the period of the outbreak were regarded as “suspect"; they were kept under close observation, some being admitted to the Waltham Joint Isolation Hospital for expert supervision. A close check was made on the contacts of proved and suspect cases. One of the most difficult tasks which had to be coped with by the Health Visitors and Sanitary Inspectors was dealing with the very natural apprehension prevalent among so many parents regarding this most dreaded disease. Our task was greatly simplified by the co-operation which was maintained between General Practitioners and the staff of the Isolation Hospital with the Public Health Department. Apart from the outbreak referred to above, and except for measles, the incidence of infectious disease remained low, and compared favourably with Previous years. Only one case of Diphtheria occurred, this being a mild one in a member of the Staff of Dr. Barnardo's Homes who had 3 recently come to the Borough. Scarlet fever showed a decrease over 1946, 59 cases as compared with 72, all being of mild type. The Diphtheria Immunisation campaign continued, a total of 813 children receiving inoculation. Only a very small minority of parents are actually opposed to Immunisation, but some parents are inclined to postpone it for trivial reasons and it is here that energetic measures of persuasion on the part of the Health Visitors are called for. It is also evident that not all children reaching the age of five are receiving the boosting dose and a concentrated effort is now being made to increase the number of protected children in this age group. Vital statistics are shown on the Table on page five. The Birth Rate per 1,000 of the estimated population increased to 19.8 as compared with 19.2 in 1946, while the Death Rate, calculated similarly, fell from 11.1 to 10.9. The Infantile Mortality Rate, i.e., the death of infants under one year per 1,000 live births fell from 31.3 to 30.8 as compared with a rate of 41 for the whole of England and Wales. Particulars of the Maternity and Child Welfare Service will be found in the appropriate Section. In conjunction with the Essex County Council two additional Health Visitors were engaged during the year, each of these devoting 50 per cent. of her time to Maternity and Child Welfare and 50 per cent. to school medical work under the Essex County Council. thus combining the post of Health Visitor and School Nurse, continued supervision of the family by the same person is ensured. The twenty-ben Maternity Wing at the Essex County Hospital, Wanstead, opened in December, 1946 continued to prove of great benefit to expectant mothers, a total of 234 women being admitted for confinement during 1947. Close liaison has been maintained between the Borough ante-natal clinics and the Maternity department of the hospital. Attendances at Infant Welfare Centres totalled 24,434, an increase of 7,400 over the previous year. During the year, work was commenced on the construction of the Day Nursery in Spratt Hall Road, Wanstead. The need for Day Nursery facilities has been continually evident not only for those mothers desirous of entering industry, but also for those wishing to obtain employment as nurses or teachers. Many applications have also been received from War widows, unmarried mothers and wives separated from their husbands for whom work is essential on economic grounds and who, in the absence of nursery facilities would be compelled to separate from their children. Further, there is need for nursery accommodation of a temporary nature when sudden illness occurs in a home, or where a mother is being confined. It is gratifying to be able to state that the Nursery was officially opened in June, 1948. I am indebted to the Chairman and Members of the Public Health and Maternity and Child Welfare Committees for the support they have given me in dealing with the problems which have arisen during the year. I also thank the staff of the Public Health and other departments for their co-operation. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, 27th September, 1948. F. G. BROWN, M.B., B.Ch., D.P.H. 4 Section A. Statistics and Social Conditions of the Area Area (in acres) 3,824 Population—Registrar-General's estimate mid-year 1947 60,280 Registrar-General's estimate mid-year 1946 57,570 Rateable value £594,027 represented by penny rate (1947-48) £2,392 Extracts from Vital Statistics of the Year Live Births: Legitimate Males 605 Females 562 Total 1,167 Illegitimate Males 19 Females 13 Total 32 Total Males 624 Females 575 Total 1,199 Birth-rate per 1,000 of the estimated resident population—19.8 Stillbirths. Legitimate Males 14 Females 14 Total 28 Illegitimate Males — Females 1 Total 1 Total Males 14 Females 15 Total 29 Rate per 1,000 total (live and still) births—23.6 Deaths: Males — 321. Females — 339. Total — 660. Death-rate per 1,000 of the estimated resident population— 10.9 Deaths from puerperal causes:— Puerperal and post-abortion sepsis Nil Other maternal causes 1 Total 1 Rate per 1,000 total (live and still) births 0.8 Deaths of Infants under one year of age:— All infants per 1,000 live births 30.8 Legitimate infants per 1,000 legitimate live births 29.9 Illegitimate infants per 1,000 illegitimate live births 62.5 1947 1946 deaths from Cancer 125 124 „ „ Measles Nil 1 „ „ Whooping Cough 2 Nil „ „ Diarrhoea (under 2 years of age) 2 4 „ „ Road Traffic Accidents 6 8 „ „ Suicide 7 7 „ „ Other violent causes 16 8 5 Birth-rates, Civilian Death-rates, Analysis of Mortality, Maternal Mortality, and Case-rates for certain Infectious Diseases in the year 1947. 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 Births: ‡(Rates per 1,000 Civilian Population) Live 20.5* 23.3 22.2 22.7 19.8 Still 0.50* 0.62 0.54 0.49 0.46 Deaths: All Causes 12.0* 13.0 11.9 12.8 10.9 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 - Scarlet Fever 0.00 0.00 0.00 0.00 - Whooping Cough 0.02 0.03 0.02 0.02 0.03 Diphtheria 0.01 0.01 0.01 0.01 — Influenza 0.09 0.09 0.08 0.08 0.16 Smallpox 0.00 0.00 0.00 — — Measles 0.01 0.02 0.02 0.01 — All causes under (Rates per 1,000 Live Births) 1 year of age 41.0† 47.0 36.0 37.0 30.0 Diarrhoea and Enteritis under 2 years of age 5.8 8.0 3.7 4.8 1.6 ‡A dash (—) signifies that there were no deaths *Rates per 1,000 Total Population †Per 1,000 related births Notifications: (Rates per 1,000 Civilian Population) Typhoid 0.01 0.01 0.00 0.01 0.00 Paratyphoid 0.01 0.02 0.01 0.03 0.04 Cerebro Spinal Fever 0.05 0.06 0.05 0.05 0.09 Scarlet Fever 1.38 1.54 1.37 1.37 0.97 Whooping Cough 2.22 2.41 2.02 2.02 3.94 Diphtheria 0.13 0.15 0.14 0.14 0.01 Erysipelas 0.19 0.21 0.18 0.18 0.13 Smallpox 0.00 0.00 0.01 0.01 0.00 Measles 9.41 9.13 9.58 9.58 15.64 Pneumonia 0.79 0.89 0.68 0.68 1.26 (Rates per 1,000 Total Births [Live and Still]) Puerperal Pyrexia 7.16 8.99** 6.27 1.21 7.32 Puerperal Fever 6.94 **Includes Puerperal Fever 6 Section B. General Provision of Health Services in the Area. 1. (i) Public Health Officers of the Authority:— See page 2. (ii) (a) Laboratory Facilities:— All pathological and bacteriological services are provided at the Emergency Medical Services Pathological Laboratory, St. Margaret's Hospital, Epping. 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 Service:— Municipal. The Council's ambulance service consists of three vehicles. Two are modern vehicles, fully equipped with up-to-date appliances; they were purchased in 1938. The third ambulance was purchased for Civil Defence in 1945 and is used as a reserve ambulance. Each ambulance can carry two stretchers or six sitting cases. The ambulance station is located at the Squash Courts, Cambridge Park, Wanstead, and the ambulances are easily accessible to all parts of the Borough. The staff consists of 10, all of whom are in possession of the British Red Cross and St. John certificate and three possess the St. John Medallion. All staff have passed a special test in recent first-aid work and have been congratulated on the high standard attained. They have also undergone a special life -saving examination organised by the Life-saving Society. Ambulance calls: 1947 1946 Accident 366 274 Maternity 287 267 Private 971 914 Other calls 65 49 Old Age Pensioners 75 — Total 1,764 1,504 Britis Red Cross Society. An ambulance of the B.R.C.S. is located at the Eagle Lane Depot and has carried out 84 calls during the year. (c) Nursing in the Home:— Arrangements for a Home Nursing Service exist with two voluntary organisations, the Woodford District Nursing Association, and the Wanstead District Nursing Association. The number of whole-time nurses employed in domiciliary Nursing is four (two Queens Nurses employed by each of the above-mentioned Association). Supervision is carried out by representives of the Essex County Nursing Association, to which the two voluntary organisations are affiliated. The Chairman of the Woodford nursing Association and the Secretary of the Wanstead Nursing Association also exercise supervision. 7 (d) Clinics and Treatment Centres:— Maternity and Child Welfare. There are six infant welfare centres in the Borough. Sessions are held as under:— Baptist Church Hall, Aldersbrook, E.12. Monday, 2.30 - 4 p.m. Ashton Playing Fields Pavilion, Woodford Bridge. Tuesday, 2.30 - 4 p.m. St. Barnabas Church Hall, Snakes Lane, Woodford Green. Wednesday, 2.30 - 4 p.m. Fullers Road Sunday School, South Woodford, E.18. Wednesday, 2.30 - 4 p.m. Cromwell Hall, Nightingale Lane, Wanstead, E.ll. Thursday, 2.30 - 4 p.m. Holy Trinity Church Hall, Hermon Hill, South Woodford, E.l8. Friday, 2.30 - 4 p.m. Ante-natal Clinic. The ante-natal clinic is situated at 118 Hermon Hill, South Woodford, E.18. Sessions are held on Mondays from 2.30 to 4.30, and on Tuesdays and Thursdays from 2 to 4.30 p.m. School Clinics. The minor ailment clinics are under the control of the Essex County Council and are held as under:— 93 High Road, South Woodford, E.18. Fridays, 9 a.m. Wanstead Church of England School. 2nd, 3rd and 5th Tuesdays at 2 p.m. Orthopœdic Centre. The orthopaedic centre is open at 93 High Road, South Woodford, E.18, on Tuesday, Wednesday and Thursday, and is run conjointly by the Essex County Council and the British Red Cross Society. Tuberculosis Dispensary. The Tuberculosis Dispensary administered by the Essex County Council is held at 93 High Road, South Woodford E.18, on Thursdays at 5 p.m. and Fridays at 9.30 a.m. (e) Hospitals:— Municipal Essex County Hospital, Hermon Hill, Wanstead, E.ll. 206 beds. Voluntary Jubilee Hospital, Woodford Green. 54 beds. 8 Maternity and Child Welfare 1947 1946 1. Notification of live births (corrected) 1,199 1,117 Notification of still births (corrected) 29 22 2. Ante-Natal Clinic Attendances: New cases registered 541 571 Total attendances—ante-natal 2,764 2,502 Total attendances—post-natal 92 132 Cases Attended by Municipal Midwives As midwives 297 282 As maternity nurses 61 29 Total 358 311 4. Institutional Provision for Maternity Cases By kind arrangement with the County Medical Officer, Essex County Council, cases were admitted to hospital for confinement as shown below:— St. John's Hospital, Chelmsford 9 Essex County Hospital, Wanstead 234 Cases were also admitted to Queen Mary's Hospital, Stratford (5), Forest Gate Maternity Hospital (4), and the Mothers' Hospital, Clapton (1). 5. Private Nursing Homes 759 infants were born in Private Nursing Homes situated in the Borough; the majority of these cases belong to areas outside the Borough. 6. Home Help Scheme Difficulty has been experienced in finding suitable women to act as Home Helps for persons being confined at home. Four Home Helps were employed, a total of 24 cases being attended. 7. Infant Welfare Centres The following attendances were recorded:— 1947 1946 Children under 1 year of age. 19,073 13,142 Children between 1 and 5 years 4,361 3,918 23,434 17,060 8. Daily Guardians The scheme previously operated in conjunction with the Ministry of Labour terminated on 31st March, 1946. Since the termination of hostilities it has become increasingly difficult to obtain suitable Daily Guardians. During the year two Daily Guardians looked after three children. 9 9. Premature Infants During the year 50 premature infants were born to mothers belonging to the Borough. 11 of these births took place at home, and 39 in hospital or nursing home. 41 of these (82 per cent.) were alive at the end of one month. 10. Infantile Mortality Rate The infantile mortality rate for the year was 30.8 per 1,000; deaths in infants under 1 year totalled 37, 18 of these occurring within four weeks of birth. Causes were as follows:— Lung conditions 20 Gastro enteritis 2 Congenital 8 Prematurity 6 Other causes 1 11. Health Visiting Number of visits paid during the year by Health Visitors:— To children under 1 year of age—First visits 1,183 Total visits 2,827 To children between one and five years of age 1,758 12. Child Life Protection The Health Visitors are appointed Child Life Protection Visitors under Part VII of the Public Health Act, 1936. Ten Foster Mothers and twelve Foster Children were on the register at the end of the year. A total of 181 visits was paid. Section C. Sanitary Circumstances of the Area. 1. Water Supply. The Water Service throughout the Borough is supplied by the Metropolitan Water Board. Routine tests carried out by the Board reveal that the supply has been satisfactory in quality and quantity. 2. Drainage and Sewerage I am indebted to the Borough Engineer and Surveyor for the following information:— (a) Eastern Sewage Disposal Works. These Works continue to function satisfactorily and effluents of the standards required by the Essex County Council have been obtained. (b) Southern Sewage Disposal Works. Despite the fact that these Works are scheduled for extension quite reasonable effluents have been obtained throughout the year. (c) Western Sewage Disposal Works. These Works are obsolete and it is only by constant supervision that normal standards of discharge are 10 obtained. The Council have served notice on the Chingford Corporation their intention to divert the flow into their system. The actual date of the change over is dependent upon negotiations now proceeding. Refuse and Salvage Collection (a) Refuse Collection. This was the first full year in which the Council operated their own fleet of modern vehicles and the collection service has proceeded without serious complaints of any sort and in fact is a distinct improvement over previous years. The disposal of refuse is by control tipping and complaints were overcome during the very hot summer by frequent dustings of "Gammexane" which proved quite effective in preventing flies and other vermin. (b) Salvage Collection. The collection of salvage has proceeded throughout the year and is collected at the same time as the house refuse. The lncome from this source has proved quite remarkably steady. Sanitary Inspection of the Area The Senior Sanitary Inspector reports as follows:— The beginning of the New Year (1947) threw much work above the normal on the Department on account of the abnormal weather. The extreme cold caused many defects in the water supply systems and the inspectors were busy arranging for plumbers to repair many burst pipes in requisitioned houses. Many complaints were received in connection with other dwellings. Following on the trouble with burst pipes, came complaints of falling ceilings in houses where the supply in the roof space became frozen and pipes showed defects on thawing. The strain on the piping apparently caused by frost seems to have shown itself during the remainder of the year, when many pipes again burst during the periods of fine weather. The department was further engaged on additional duties during the period when the water supply from the mains was discontinued and was maintained by the Metropolitan Water Board by an emergency service, during which water was carted to the inhabitants in tanks on lorries. Visits were made to schools and cinemas to ensure that the sanitary arrangements for the use of the scholars and patrons were maintained. By acting as liaison officers, the Sanitary Inspectors were able to make satisfactory arrangements between these establishments and the Metropolitan Water Board, whereby sufficient water was supplied and stored. Near the end of the long spell of bad weather the Department was called in to survey damage to dwellings which had been flooded where the River Roding overflowed its bank after the thaw. It was reported that in 1946 much work and time was devoted to the repair of requisitioned property, and it must be noted that in 1947 this work continued. During the year the presence of dry rot seems to have become more evident. The work involved in removing affected timber, etc., and making good was in some cases considerable and costly. It was 11 interesting to note the damage which could be caused and the considerable area over which the fungus could spread. Once again we are indebted to builders for the co-operation given during the year in repairing requisitioned property, and particularly during the period of extreme cold when they responded quickly to our requests. In the annual report for 1946, reference was made to application to the Local Authority for permission to take legal action or carry out work in default of the owner. During 1947, the Local Authority authorised proceedings to be taken in connection with Section 93 of the Public Health Act, 1936, in respect of a defective roof. The case was heard by the magistrates who made the necessary nuisance order, fined the defendant and awarded costs to the Council. Referring to works executed in default for non-compliance with notices served in 1946, two houses were repaired and five dustbins provided during the year 1947. In all cases a charge was made against the owners for the costs incurred. In addition to the above-mentioned works, 26 houses were repaired and six dustbins provided during 1947. Against notices served during 1947, a charge was made for the work done in each case. During the year it was found necessary to serve more statutory notices and a considerable increase in the number served during 1947 will be noted when compared with the number served during 1946. (i57 in 1947 compared with 97 in 1946). The following are details of notices served during 1947:— Informal Notices Under Public Health Act 302 Under Housing Act 180 Under Shops Act 1 Total 483 Statutory Notices Public Health Act Section 24 3 Section 39 11 Section 45 15 Section 75 13 Section 93 29 Housing Act Section 9 59 Section 11(1) 9 Section 11(4) 13 Section 155 7 Food and Drugs Act Section 13 1 Total 160 12 Complaints recorded during the year totalled 1,395 Complaints received from the Housing Manager in connection with requisitioned houses and included in the above, amount to 996 Orders given to building contractors to execute repairs to requisitioned houses numbered 1,127 Rats and Mice Destruction The Council maintained their free treatment for infestations in surface Property and the good work has been maintained by the Council's rodent operator. Details of the work carried out are given below. At meetings during the year the Public Health Committee discussed the advisability of treating the sewers for rodent infestation and on 8th December, 1947, work of rodent destruction in sewers commenced and was continued into 1948. Some difficulty existed in getting suitable staff for this work and it was found necessary to operate with one gang of three men instead of with two gangs, as originally arranged. The work involved was divided into three separate operations:— (1) A survey was made of the entire Borough and the number of manholes to be used was accurately ascertained and recorded. The figure of 700 obtained from the sewer maps and upon which the estimate for work was based was found to be inaccurate and altogether some 1,300 manholes were recorded. (2) Men from the Borough Surveyor's Department were engaged for some weeks in freeing manholes and marking the same. (3) The first treatment was made with sausage rusk used as a prebait and rusk and zinc phosphide as a poison. A fourth operation was to follow, with the use of bread mash as a pre-bait and bread mash and arsenic as a poison. The treatment will not be completed until the end of March, 1948. The Ministry of Food (now Ministry of Agriculture and Fisheries), co-operated by supplying trays, depositors, etc., and the method used was that prescribed by that Ministry. Every assistance has been rendered by the Ministry through their Divisional Rodent Officer (Mr. Marley) and the Ministry's Inspector, Mr. Harris, and we are indebted to these officers for that assistance. Rodent record Number of inspections made by Sanitary Inspectors 26 Complaints received 139 Number of baits laid (baiting points) 599 Number of baits laid 2,995 Number of baits taken 1,320 Estimated kill 1,172 Number of bodies found Number of premises on which gas pump was used 17 Total number of visits made by rat catcher 2,242 13 Ponds. Various ponds were treated with paraffin as a precaution against mosquito breeding. Petroleum (Regulation) Acts, 1928 and 1936 49 licences were renewed at the beginning of the year. Game Licences Four licences to deal in game were renewed and three new licences were granted. Shops Act, 1934 Under this Act, 14 visits were made. In one case a notice was served for the want of a sanitary convenience for the staff and was complied with. With reference to closing hours, no offences were noted or reported, in fact it can be stated that shops in the Borough are very prompt in closing. Eradication of Bed Bugs Again it is pleasing to report the small degree of infestation in the Borough from this pest. It has been necessary to carry out fumigation in 49 cases, which must be considered a low figure for a population of 60,280. The use of the usual insecticides containing D.D.T. is continuing. It has not been necessary to use hydrogen cyanide for eradicating the bugs. The work of disinfestation is performed by the Council's disinfector, and as reported previously, a charge is made for carrying out the treatment. Schools It is pleasing to report again the satisfactory condition of the schools in the locality. War Damaged Drains The Public Health Department continued until 31st October, 1947 to execute repairs and reconstructions to drainage systems damaged by enemy action. At the end of October the Council closed down the War Damage Department, and in keeping with the Council's policy in war damage, the Public Health Department discontinued executing such works and frorn that date, although the Sanitary Inspectors continued the supervision of all such drainage works, all repairs and works of reconstruction were carried out under licence. Essex County Council Act, 1933 Visits were made to premises where massage and special treatment were conducted and in all cases the businesses were conducted under satisfactory conditions. No infringements of the regulations were reported. During the year nine such visits were made. Training Scheme for Sanitary Inspectors. Special Scheme Early in the year the Council received a letter from Mr. Taylor, liaison officer at Battersea Polytechnic asking if they would co-operate the training scheme adopted by the Ministries of Health, Labour Education, in connection with the Sanitary Inspectors' Association. The 14 Scheme was devised in order to assist ex-service personnel in training for the Post of Sanitary Inspector and whose opportunity of studying for the Joint Board Examination was interrupted by being "called up" for service with the armed forces. The Council agreed to accept a maximum of two pupils at a time into the Public Health Department and up to the end of the year two had received training in the Sanitary Inspectors' section of the Public health Department, although more had been allocated. The number was reduced owing to the acceptance by the Joint Board of some candidates at an earlier examination. It is pleasing to report that the two trainees mentioned were successful in the subsequent examination. Ispections carried out by Sanitary Inspectors. Infectious disease enquiries including enquiries in respect of scabies 82 Visits in connection with contacts, etc. 7 Enquiries in connection with food poisoning 9 General environmental Public Health Drains and public sewers inspected 396 Tests to drains and public sewers 82 Stables and manure pits inspected 2 Ditches and streams inspected 2 Public Conveniences inspected 2 Tents, vans and sheds (including gipsy encampments) 6 Workplaces inspected 1 Requisitioned houses inspected and visited 1,455 Smoke observations (casual) 1 Smoke observations (visits to plants) 1 Visits to Council tip 25 Schools inspected 33 Keeping of animals inspections 8 Shops Act inspections 14 Petrol installations 17 Illegal dog racing tracks 9 Water samples 1 Cinemas 5 Miscellaneous Visits 113 Section D. Housing No. of houses erected during 1946: 72 Council; 45 Private enterprise; Cost of Works (rebuilds). 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) 1,042 (b) Number of inspections made for the purpose 1,439 VISITS (2) (a) Number of dwelling-houses (included under subhead (1) above) which were inspected and recorded 15 under the Housing Consolidated Regulations, 1925 and 1932 Nil (b) Number of inspections made for the purpose Nil (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 16 (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 180 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 37 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 180 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By owners 35 (b) By Local Authority in default of owners 13 (b) Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 302 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By owners 45 (b) By Local Authority in default of owners 1395 (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 11 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 2 4. Housing Act, 1936.—Part IV.— Overcrowding:— No formal action during the year. 72 inspections were made in suspected cases of overcrowding, and two revisits made. 16 Nuisances Abated and Improvements Effected Dwelling-houses Roof repairs 152 External walls and chimney stacks repaired 88 Walls underpinned 29 Gutters and spouts repaired or renewed 100 Damp-proof courses provided 11 Dampness remedied 75 Yards paved or repaired 8 Internal walls and ceilings repaired 233 Doors and frames repaired or renewed 35 Windows repaired or renewed 114 Floors repaired or renewed 94 Sub-floor vent. provided or improved 11 Skirtings repaired 45 Rooms cleansed or redecorated 222 Rooms with improved lighting 2 Staircases repaired and hand-rails provided 25 Fireplaces and flues repaired or renewed 65 Cooking stoves repaired or renewed 15 Wash coppers repaired or renewed 6 Sinks and washbasins provided or renewed 10 Waste pipes repaired or renewed 42 Food stores provided or improved 18 Dustbins provided or renewed 32 Water supply improved or reinstated 32 Water closet cisterns repaired or renewed 25 Water closet pans repaired or renewed 66 Water closet structures repaired or rebuilt 3 Water closet flush pipe joints repaired 12 Water closet lighting and ventilation provided 3 Storage tanks repaired or renewed 3 Chimney cowl provided ... 1 General Environmental Public Health Drains cleansed from obstruction 20 Drains repaired or renewed 23 Inspection chambers repaired 8 Soil pipes and vent shafts repaired 9 Animal nuisances abated 2 Offensive accumulations removed 6 Tents, vans and sheds removed 30 1,575 Disinfection and Disinfestation No. of rooms disinfected 140 Bedding removed from premises for steam disinfection 146 No. of rooms disinfested 49 17 FACTORIES ACT, 1937 1. Inspections for the purposes of provisions as to health (including Inspections made by Sanitary Inspectors). Premises (1) Number of Number on Register Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 58 7 1 - (ii) Factories not included in (i) to which Section 7 applies — — — - (a) Subject to the Local Authorities (Transfer of Enforcement) Order, 1938 116 59 3 (b) Others — — — (iii) Other Premises under the Act (excluding out-workers' premises) — 3 - — Total 174 69 4 - 2. Defects found. Number of Defects Number defects in respect of which Prosecutions were instituted Particulars. Found Remedied Referred to H.M. Inspector Want of Cleanliness 2 1 ... ... Overcrowding ... ... ... ... Unreasonable temperature ... ... ... ... Inadequate Ventilation 2 .... ... ... Ineffective drainage of floors ... ... ... ... Sanitary Conveniences:— ... ... ... ... 1. Insufficient ... ... ... 2. Unsuitable or defective ... 1 ... ... 3. Not separate for sexes ... ... ... ... Other Offences ... ... ... ... Total 4 2 ... ... 18 3. Outwork Number of out-workers in August list required by Sect. 110 (1) (c): — Christmas Crackers 3 Wearing apparel—Making, etc. 48 Artificial flowers 1 The making of boxes or other receptacles or parts there of made wholly or partially of paper 1 Brush making 2 Household linens and furnishings 4 Total 59 Inspection of Foods, etc. Meat shops (including visits to Ministry of Food Depot) 102 Dairies 6 Bakehouses and Bakers Shops 22 Ice Cream premises 36 Fishmongers and poulterers 21 Greengrocers and fruiterers 5 Grocers and wholesale grocers 121 Restaurants, cafes, etc. 56 Fishfryers 3 Other premises 17 FOOD AND DRUG SAMPLING It is pleasing to be able to report an improvement in the number of samples of food submitted to the Public Analyst for examination during year. 110 samples were obtained which is approximately a number recommended by the Ministry of Health at the rate of two samples per 1,000 population. It is also pleasing to note that with one exception only, all samples were reported as being genuine. The following list gives the name of the food sampled, together with the number of samples of each kind obtained:— Butter 11 Bacon 6 Barley Pudding Mixture 1 Bun Kernel 1 Bun Flour 1 Cheese 10 Coffee 2 Cake Mixture 3 Flour (Plain) 1 Flour (Self-Raising) 1 Fish Cakes 1 Fish Paste 1 Gelatine 1 Jelies 4 Jam (Strawberry & Gooseberry) 1 Lard 6 Lard Compo 5 Lemonade Powder 1 Lemon Flavouring Powder 1 Margarine 11 Milk (machine-skimmed) 1 Milk 9 Meat (Sausage) 2 Meat (Luncheon) 1 Oats (Porridge) 1 Peas (Split) 1 Pudding Mixture 2 Saccharin 1 Sugar (Granulated) 8 Sponge Mixture 2 Spaghetti 1 Soya Flour 1 Semolina 1 Sausage (Breakfast) 1 Tea 8 Wheat (Shredded) 1 Total 110 19 With reference to the one defective sample, I have to state that a sample of sausage meat was found to contain preservative—sulphurdioxide — to the extent of 280 parts per million. This amount is well below the amount allowed, unfortunately no indication of the presence of preservative was given in the vendor's shop. Milk Samples During the year, twelve samples of milk were obtained and submitted to the Counties Public Health Laboratories for testing by the Methylene Blue and Phosphatose tests, as prescribed by the Ministry of Health. All pasteurised milk sold in the Borough is processed in the area of other Local Authorities. Of the twelve samples taken, nine satisfied the Methylene Blue test, and the remaining three were reported to adjoining Authorities with a request for investigation. It is pleasing to report that subsequent samples showed a satisfactory result. All the samples satisfied the Phosphatase Test. Surrendered Foods Bread Barley Biscuits Chicken (tinned) Chickens Dates Egg (dried) Fish (fresh) Witch Sole Cod Herrings Herring Roes Skate (tinned) Brisling Anchovies Cray Fish Pilchards Salmon Mackerel Silver Hake Whiting Herring Tidbits Norwegian Tidbits Prawns Sardines Herrings Kipper Snacks Cod Liver Roe Fish Paste Fish Cakes 20 200 x ½ qtn. loaves 1 pkt. 1½ lb. 2 tins 129 280 lb. l0 pkts. 2½ stone 22 stone 7½ stone 6 stone 150 lb. 2 tins 1 tin 2 tins 36 tins 52 tins 5 tins 1 tin 1 tin 2,872 tins 63 tins 14 tins 7 tins 5 tins 1 tin 1 tin 9 tins 2 tins Fruit (fresh) Apples Tomatoes (dried) Prunes Bananas (tinned) Damsons Fruit Cocktail Plums Fruit Salad Apple Puree Pears Peaches Apricots Grapefruit Tomatoes Flour Gherkins Hazelnut Kernels Jam and Marmalade Jelly Crystals Liver Sausage Margarine Malt Flakes Macaroni Cheese Milk (Evaporated) (Dried) (Condensed) Meat (fresh) Beef Beef (roast) Lamb Bacon Liver (tinned) Steak & Kidney Corned Beef Corned Mutton Tongue Bacon Beef Loaf Potted Meat Irish Stew Luncheon Meat Steak Brisket Meat and Vegetable potatoes Pickle Sauce, Worcester Soup Spaghetti Suet (shredded) Shredded Wheat 114 1b. 41 lb. 375 lb. 27 lb. 1 tin 2 tins 16 tins 2 tins 1 tin 5 tins 9 tins 9 tins 32 tins 16 tins 480 lb. 2 bottles 158 lb. 60 tins 2 pkts. 10 1b. 6 ozs. 50 lb. 1 pkt. 1 tin 922 tins 2 x 21 lb. tins 31 tins 36 lb. 5¾ lb. 28¼ lb. 29½ lb. 42 lb. 2 tins 767½ lb. 169 lb. 1 tin 3 tins 1 tin 1 tin 2 tins 16 tins 48 tins 4 tins 42 tins 1 cwt. 75 jars 1 bottle 28 tins 4 tins 9 1b. 1 pkt. 21 Syrup 12 jars Semolina 4 pkts. Scone and Pudding Mixture 146 pkts. Sugar 227 lb. Sweets 27½ lb. Sausages 21 tins Turkey 1 tin Puddings (tinned) Apple 1 tin Rhubarb 2 tins Sweet 1 tin Steak and Kidney 2 tins Vegetables (tinned) Beans 87 tins Carrots 30 tins Beetroot 5 tins Peas 58 tins Potatoes 6 tins Mix 4 tins ICE CREAM See Table appended opposite. Sample No. 1 was referred to the local authority in whose area was situated the supplier. The supplier, it was ascertained, was himself a dealer. The source of supply was eventually checked with a satisfactory result. Sample No. 2 was taken up with the responsible authority and investgated. On a further check being made in the Borough it was ascertains'' that as the local vendor was greatly concerned with the result of the examination he had changed his supplier, with a big improvement, as indicated for Sample No. 5. Sample No. 6 was obtained from a local maker, who was greatly concerned at the adverse report. He was advised as to the possible causes of the unsatisfactory sample. He took further precautions, and it will noted that the following subsequent samples showed a big improvement. Sample No. 9—12,000 colonies per millilitre. Sample No. 14—1,200 colonies per millilitre. Sample No. 17—9,000 colonies per millilitre. Sample No. 21—800 colonies per millilitre. Sample No. 10 was again a local product and the manufacturer and his premises were visited and necessary advice given. A subsequent safflp^' No. 11 — 1,400 count — showed a great improvement, but sample No. 18 — 650,000 count — produced another bad result. A visit was made to thr premises by the Medical Officer of Health and the Senior Sanitary Inspector and it is pleasing to note that sample No. 19 — 7,000 count — again showed another improvement. Samples Nos. 16 and 25 were the product from outside the Borough and were referred to an adjoining Borough. The reports received indicated that the factory was very satisfactory. 22 As the sale by the local vendor of the product ceased it was not possible to make any further check. Nunber Hot or cold mix Local or outside manufacture No. of colonies per ml. on Agar at 37deg. C. in 48 hrs. Coliform test. Positive in 1/100 ml. in 3 tubes Bact. coli. Present in 1/100 ml. in 3 tubes Remarks by Public Health Laboratories methylene blue reaction Direct Decolourised in hours After preincubation Decolourisec hours Ministry s Provisiona Grading 1 — Outside 300,000 3 in 3 tubes 0 in 3 tubes Unsatisfactory sample containing excess number of bacteria. 3½ 0 VI. 2 — Outside 2 million 3 in 3 tubes 0 in 3 tubes Unsatisfactory sample containing excess number of bacteria. 3½ ½ VI. 3 Hot Outside 3,300 0 in 3 tubes 0 in 3 tubes Very satisfactory standard of bacterial purity. 4½ ½ III. 4 Hot Local 120,000 3 in 3 tubes 0 in 3 tubes Passable standard of bacterial purity. 4½ ½ III. 5 Hot Outside 10,000 3 in 3 tubes 0 in 3 tubes Satisfactory standard of bacterial purity. 4½ 2½ II. 6 Hot Local 250,000 3 in 3 tubes 0 in 3 tubes Unsatisfactory, containing excessive number of organisms. 4½ 0 IV. 7 — Outside 50,000 3 in 3 tubes 0 in 3 tubes Satisfactory standard of bacterial purity. 4½ 4½ I. 8 Hot Outside 150,000 3 in 3 tubes 0 in 3 tubes Passable standard of bacterial purity. 4½ 2½ III. 9 Hot Local 12,000 3 in 3 tubes 0 in 3 tubes Passable standard of bacterial purity. 4½ 3 II. 10 Hot Local 1 million 3 in 3 tubes 3 in 3 tubes Unsatisfactory, contains excessive number of bacteria, including organisms of faecal origin. 4 0 IV. 11 Hot Local 1,400 0 in 3 tubes 0 in 3 tubes Very satisfactory sample of bacterial purity. 4½ 1 III. 12 Hot Outside 47,000 3 in 3 tubes 0 in 3 tubes Satisfactory sample of bacterial purity. 4½ ½ III. 13 Hot Local 15,000 0 in 3 tubes 0 in 3 tubes Passable standard of bacterial purity. 4½ 3½ 11. 14 Hot Local 1,200 0 in 3 tubes 0 in 3 tubes Very satisfactory standard of bacterial purity. 4½ 4½ I. 15 Hot Local 66,000 3 in 3 tubes 0 in 3 tubes Satisfactory standard of bacterial purity. 4½ 3 IT. 16 — Outside 220,000 3 in 3 tubes 0 in 3 tubes Unsatisfactory containing excessive number of bacteria. 4½ 0 IV. 17 Hot Local 9,000 3 in 3 tubes 0 in 3 tubes Satisfactory standard of bacterial purity. 4½ 1½ III. 18 Hot Local 650,000 3 in 3 tubes 0 in 3 tubes Unsatisfactory — excessive number of organisms and organisms of faecal origin in 1/10 ml. 4½ 1 III. 19 Hot Local 7,000 3 in 3 tubes 3 in 3 tubes Unsatisfactory—contains organisms of faecal origin in 1/10 ml. — 0 IV. 20 Hot Local 1 million 3 in 3 tubes 3 in 3 tubes Unsatisfactory — contains excessive bacteria and organisms of faecal origin. — 0 IV. 21 Hot Local 800 0 in 3 tubes 0 in 3 tubes Excellent standard of bacterial purity. — 3 II. 22 Hot Outside 200,000 3 in 3 tubes 0 in 3 tubes Passable standard of bacterial purity. — 4 II 23 Hot Local 280,000 3 in 3 tubes 3 in 3 tubes Excessive bacteria coli. in less than 1/10 ml. indicating faecal contamination. — 1½ III. 24 Hot Local 120,000 3 in 3 tubes 3 in 3 tubes Bact. coli. in less than 1/10 ml. indicating faecal contamination. — 0 IV. 25 Hot Outside 600,000 3 in 3 tubes 0 in 3 tubes Unsatisfactory—excessive bacteria. — 0 IV. Sample No. 20 was produced locally. Investigation was made at the premises and advice giyen with some good result, for sample No. 24— 120,000 count, showed some improvement, but the presence of faecal contamination was not obviated. It was not possible to take further samples as the manufacturer ceased production. Sample No. 23 was unsatisfactory and was the product of a local maker and showed a drop in the standard as indicated in Sample No. 15 -66,000 count. This manufacturer reconsidered his method of production and ceased making until his new plant was finally installed. The registration of premises, manufacturers and vendors is made in connection with the Essex County Council Act of 1933, and the numbers on the register up to the end of the year 1946 were as follows:— Manufacturers 22 Vendors 64 Essex County Council Ice Cream Registrations Number of premises newly registered in 1947 5 Number of Vendors newly registered in 1947 9 Section F. Prevalence of, and control over, Infectious and other diseases. 1. The following table shows the incidence of infectious disease during the year cases admitted to hospital and number of deaths. Disease Total cases notified Cases admitted to hospital Total Deaths Smallpox - - - Scarlet Fever 59 16 — Diptheria 1 1 — Pneurnonia 76 28 30 Cerebro-Spinal Fever 6 4 — Acute Poliomyelitis 10 10 — Acute Polioencephalitis — — — Ecephalitis Lethargica — — — Dysentery 2 2 — Ophthalmia Neonatorum 2 2 — Puerperal Pyrexia 9 8 — Paratyphoid Fever 3 3 — Enteric or Typhoid Fever — — — Erysipelas 8 2 —- Malaria (contracted abroad) — — — Measles 943 12 — Whooping Cough 238 5 — Scabies 37 — — 23 2. Diphtheria Immunisation Completed inoculations made during the year were as follows: — Under 1 year 13 1 year 510 2 years 114 3 years 22 4 years 17 5-9 years 109 10-14 years 28 Total 813 3. Scabies. 13 cases of Scabies were treated at the Walthamstow Clinic. This compares favourably with 62 cases treated during the previous year. 4. Tuberculosis. Particulars of new cases of Tuberculosis and mortality from the disease during 1947:— 39 Pulmonary and 7 non-Pulmonary cases were notified for the first time during the year. 11 cases were transferred into the district. 2 cases were restored to the register. 20 Pulmonary and 1 non-Pulmonary cases died during the year. 3 deaths occurred from non-notified cases of Tuberculosis. 30 other cases were removed from the register. 333 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 institutions for treatment during 1947: Pulmonary Non-Pulmonary Total M. F. M. F. Adults 18 17 4 4 43 Children 2 1 2 2 7 24