WANS 14 BOROUGH OF WANSTEAD AND WOODFORD Annual Report of the MEDICAL OFFICER OF HEALTH For the Year Ending 31st December, 1949. PUBLIC HEALTH COMMITTEE Alderman A. H. Southam (Vice-Chairman) „ C. Turner Councillor N. E. Britton „ A. G. Burness „ R. A. Dalton „ Mrs. J. Davey „ J. W. Lynch „ C. H. Moss „ V. E. Stevens (Chairman) REPRESENTATIVES ON FOREST HEALTH AREA SUB-COMMITTEE Councillor R. A. Dalton „ E. H. Day „ R. Drew ,, A. R. Page 1 STAFF OF PUBLIC HEALTH DEPARTMENT Medical Officer of Health: F. G. Brown, M.B., B.Ch., D.P.H. Senior Sanitary Inspector: M. G. Crook, M.S.I.A. (a) (b) (c) (J) Deputy Senior Sanitary Inspector: J. T. S. Templeman, M.R.San.I., M.S.I.A. (a) (b) Sanitary Inspectors: A. J. Storer, M.S.I.A. (a) H. L. Hughes, A.R.San.I., M.S.I.A., D.P.A. (a) (b) (e) F. M. Flack, M.S.I.A. (a) (b) (from 3.8.48) Clerks: Miss D. Howlett Miss M. S. Cryer (а) 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 Smith field Technical Institute. (d) Diploma of the Royal Institute of Public Health and Hygiene. (e) Diploma in Public Administration. 2 WANSTEAD AND WOODFORD BOROUGH COUNCIL. To THE MAYOR, THE ALDERMEN AND COUNCILLORS, BOROUGH OF WAN STEAD AND WOODFORD. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit my Annual Report on the Health Services in the Borough for the year 1949. Included in the report are some details of the personal health services under Part III of the National Health Service administered by the Essex County Council and decentralised to the Forest Health Area. In my capacity as Area Medical Officer of the Forest health Area I am in the fortunate position of being in control of both Personal and environmental health services as they affect the Borough. Infectious Disease During the year the incidence of infectious disease remained low. Mention must be made of the outbreak of poliomyelitis (infantile paralysis) which was prevalent throughout the country during the latter half of the year. The number of cases in the Borough was nine, comparing favourably with the incidence of this disease in adjacent areas. Luckily no case proved fastal; at the end of the year all cases were either symptom free or progressing satisfactorily. It is gratifying to note that, for the first time on record, case of diphtheria occurred during the year, a tribute to the success of our immunisation campaign. There were fifty-one cases of scarlet fever compared with fifty during the previous year; all were of a mild type. here was an increase in the number of cases of measles notified, 800 as compared with 451 in 1948. 167 cases of whooping cough were notified as compared with 242 during the previous year. VITAL Statistics The Birth Rate per thousand of the estimated population showed a decrease to 13.5 as compared with 16.0 in 1948. The Death Rate, similarly PART III Health Services Midwifery: — The number of domiciliary cases attended by Municipal Midwives was 253 of which 205 received gas and air analgesia. All midwives working in the Borough are trained in the use of this form of anaesthesia Possess the necessary apparatus. Child Welfare Services: — The six welfare centres in the Borough continued to be well attended. 6,150 visits were made to homes by Health Visitors in respect of children under the age of five years. Domestic Help Service:— This very popular service continued to expand. Help was provided in 181 cases, a total of 19,365 hours being 3 given. Particulars of cases served will be found under the appropriate section. Difficulty was experienced in recruiting Home Helps suitable and willing to attend cases of Tuberculosis. Clean Food Campaign Experience has shown that the best means of conducting a clean food campaign is by individual approach to those concerned with handling of food in shops, restaurants and cafes. Public meetings, with exhibits and film shows, to which much time and energy are given, are poorly attended and are not a successful means of making contact with the type of foodhandler most likely to spread infection. The District Sanitary Inspector is able to visit these persons while they are actually working and, where the standard of hygiene is unsatisfactory, to make follow-up visits. Housing The number of families on the Council's list for re-housing at the beginning of the year was 2,575. 257 families were re-housed during year, leaving 2,273 families still waiting to be housed at the end of the year. This is a disturbing factor, and one affecting the nation generally,which reflects most adversely on the mental health and well-being of very persons. Functional nervous disorders in both adults and children can be traced back to a common cause, i.e., inadequate or unsatisfactory housing Many couples who have been married as long as five years have not yet, been able to secure a home of their own and are still living with 'in-laws'. The children of these people are frequently referred for child guidance Further, many persons, anxious to have children, are unwilling to do owing to lack of a suitable home. Another aspect of the problem is the disturbance caused to elderly persons who want to live quietly but cannot do so owing to having to share their homes with children and gran children. Tuberculosis In conclusion I would mention the problem of the tuberculous. to lack of accommodation in hospitals and sanatoria, the average time for awaiting admission is six months for females and nine months for males During the waiting period there is opportunity for spread of the disease this being especially accentuated when housing conditions are unsatisfactory Closure of sanatorium beds owing to shortage of nursing staff and the that modern methods of treatment render it necessary for the patient's in an institution to be a prolonged one, are contributory factors. It is .extra beds may be made available. I am much indebted to the Chairman, Vice-Chairman and members of the Public Health Committee for the support and co-operation which they have given me in my work throughout the year. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, F. G. BROWN, M.B., B.Ch., D.P.H 29th August, 1950 4 Section A. Statistics and Social Conditions of the Area Area (in acres) 3,824 Population—Registrar-General's estimate mid-year 1949 62,010 Registrar-General's estimate mid-year 1948 61,150 Rateable value £611,378 Sum represented by penny rate £2,426 Extracts from Vital Statistics of the Year Live Births: Legitimate Males 425 Females 390 Total 815 Illegitimate Males 12 Females 12 Total 24 Total Males 437 Females 402 Total 839 Birth-rate per 1.000 of the estimated resident population—13.5 Stillbirths. Legitimate Males 6 Females 14 Total 20 Illegitimate Males 1 Females 1 Total 2 Total Males 7 Females 15 Total 22 Rate oer 1.000 total (live and still") births—25.5 deaths: Males — 324. Females — 363. Total — 687. Death-rate per 1,000 of the estimated resident population—11.0 Deaths from puerperal causes:— Puerperal and post-abortion sepsis 1 Other maternal causes - Total 1 Rate per 1,000 total (live and still) births 1.2 Deaths of Infants under one year of age:— All infants per 1,000 live births 36.9 Legitimate infants per 1,000 legitimate live births 34.3 Illegitimate infants per 1,000 illegitimate live births 125 1949 1948 Deaths from Cancer 119 111 „ „ Measles 1 1 „ „ Whooping Cough Nil 2 „ „ Diarrhoea (under 2 years of age) 2 3 „ „ Road Traffic Accidents 5 4 „ „ Suicide 5 4 „ „ Other violent causes 6 11 5 Birth-rates, Civilian Death-rates, Analysis of Mortality, Maternal Mortality, and Case-rates for certain Infectious Diseases in the year 1949. 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 \ WAN STEM) and W'OODTORD Births: ‡(Rates per 1,000 Civilian Population) Live 16.7* 18.7 18.0 18.5 13.5* Still 0.39* 0.47 0.40 0.37 0.35* Deaths: : J. All Causes 11.7* 12.5 11.6 12.2 11.1 * Typhoid and Paratyphoid - - - - 0.34 Tuberculosis 0.45 0.52 0.42 0.52 - Whooping Cough 0.01 0.02 0.01 0.01 - Diphtheria 0.00 0.00 0.00 0.01 - Influenza 0.15 0.15 0.14 0.11 0.09 Smallpox 0.00 0.00 — — — Acute Poliomyelitis and Polioencephalitis 0.01 0.02 0.02 0.01 - Pneumonia 0.80 0.91 0.65 0.55 0.43 All causes under 1 year of age 32.0† Rates per 1,000 Live Births) 37.0 30.0 29.0 36,9 Diarrhoea and Enteritis under 3.0 3.8 2.4 1.7 2.4 j 2 years of age ‡ A dash (—) signifies that there were no deal'1 * Rates per 1,000 Total Population †Per 1,000 related births Notifications: (Rates per 1,000 Civilian Population) Typhoid 0.01 0.01 0.01 0.01 - Paratyphoid 0.01 0.02 0.01 0.01 - Cerebro Spinal Fever 0.02 0.03 0.02 0.02 - Scarlet Fever 1.63 1.72 1.83 1.46 0.82 Whooping Cough 2.39 2.44 2.39 1.70 2.69 Diphtheria 0.04 0.05 0.04 0.07 - Erysipelas 0.19 0.20 0.19 0.17 0.19 Smallpox 0.00 0.00 0.00 0.00 - Measles 8.95 8.91 9.18 8.54 12.9 Pneumonia 0.80 0.91 0-65 0.55 0.6 Acute Poliomyelitis 0.13 0.13 0.12 0.18 0.10 Acute Polioencephalitis 0.01 0.01 0.02 0.01 0.05 (Rates per 1,000 Total Births [Live and Still]) Puerperal Pyrexia and Fever 6.31 8.14 5.30 6.82 3.48 6 Section B. General Provision of Health Services in the Area 1.(a) Public Health Officers of the Authority:— See page 2. (b) Laboratory Facilities. All pathological and bacteriological services are provided at the 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. Part III. Health Services. (a) Care of Mothers and Children. The care of mothers and children has followed along the lines of the County Council's proposals under the National Health Service Act. (i) Infant Welfare Centres. There are six infant welfare centres in the Borough, sessions being 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.18. Friday, 2.30 - 4 p.m. The following attendances were recorded during 1949, in comparison Vv'th those for the year 1948: — 1949 1948 Children under 1 year of age 15,691 17,508 Children between 1 and 5 years 6,092 6,089 21,783 23,597 (ii) Premature Infants. During the year 37 premature infants were born to mothers belonging to the Borough. 8 of these births took place at home, and 29 in hospital or nursing homes. All those born either at home or in private nursing homes werew alive at the end of one month. (iii) Daily Guardians. The scheme operating in the Borough whereby certain suitable persons were registered as Daily Guardians has been continued throughout the year. the end of the year there were four guardians registered with accomodation for eleven children. 7 (iv) Dental Treatment. This work has been seriously hampered by the difficulty in obtaining Dental Surgeons. I am setting out below some statistical information on the work carried out during the year:— Numbers provided with dental care. Examined Needing treatment Treated Made dentally Expectant Mothers 17 17 16 24 Nursing Mothers 2 2 4 6 Children under 5 yrs. 51 51 50 50 Forms of Dental Treatment provided. Extractions Anaesthetics Fillings Scalings, etc. Silver Nitrate Treatment Dressings Dentures provided Local General Complete Partial Expectant Mothers 41 14 6 36 8 Nil 19 1 21 Nursing Mothers 5 Nil 3 8 Nil Nil 2 Nil 7 Children under 5 46 29 Nil 20 Nil 77 11 Nil Nil (b) Midwifery and Home Nursing Service. The number of domiciliary cases in the Borough attended by Municipal Midwives was 253—186 in their capacity as midwife and 67 as maternity nurse. Of the 186 cases attended as midwives, 157 received gas and air analgesia or 84.4 per cent. 48 of the 67 cases attended as maternity nurse received analgesia, a percentage of 71.8. Ante-natal Clinic. The ante-natal clinic is situated at 118 Hermon Hill, South Woodford, E.18. Sessions are held on Tuesdays and Thursdays from 2-4 p.m. and 1,887 attendances were made by patients during the year. The post-natal clinic is held at the same address and 680 attendances were made. On the home nursing side the following visits were carried out in the Borough: —• Number of New Cases Pre-school cases 35 School children ` 10 Adults 469 8 Number of Visits to Pre-school cases 174 School children 44 Adults 8,755 Last Offices performed 29 Advisory or Casual Visits Pre-school cases 2 School children Nil Adults 36 (c) Health Visiting. The total number of visits paid by Health Visitors to expectant mothers and children under 5 years of age in the Borough during the year was 6,546. To Expectant Mothers 396 To Children under 1 year of age 2,549 To Children between 1 and 5 years 3,601 five years of age the Health Visitors were also concerned with the family as a Whole and undertook visits to the aged and infirm. (d) Vaccination and Immunisation against Diphtheria. The scheme for vaccination, and immunisation against diphtheria, has been carried out largely by means of the medical practitioner service. The response in this Borough has been good and statistical details will be found Under Section F of this report dealing with the prevalence of, and control over, infectious and other diseases. (e) Domestic Help Service, This service has continued to expand throughout the area, the demands 1949 to 181 patients within the Borough and details of the types of cases assisted are set out below: — Number of Hours help patients given Maternity cases 78 7,626 Acute sick 82 5,325 Chronic sick 18 5,263 Tuberculous cases 3 1,151 At the end of the year help was still being provided for 7 acute sick 11 chronic sick cases. Other Clinics and Treatment Centres. (a) School Clinics. The Minor Ailment Clinic, under the control of the Essex County Council, is held at 93 High Road, South Woodford, E.18, Fridays at 9 a.m. (b) Orthopædic Centre. The orthopaedic centre is open at 93 High ac*i South Woodford, E.18, on Tuesday, Wednesday and Thursday, and 9 is run conjointly by the Essex County Council and the British Red Cross Society. (c) Chest Clinic. The Chest Clinic, previously held at 93 High Road South Woodford, E.18, has now been transferred to Harts Hospital, Woodford Green and 180 High Road, Leyton, E.10. Patients living south of the Southend Road attend the clinic at Leyton on Mondays, 9.30-11 a.m., and SECTION C. SANITARY CIRCUMSTANCES OF THE AREA 1. Water Supply. The water supplied throughout the Borough by the Metropolitan Water Board was satisfactory both in regard to quality and quantity. Regular monthly bacteriological examinations are carried out by Metropolitan Water Board, the examinations being of raw and treated water. The results obtained from treated water were satisfactory. Copies of these reports are received regularly from the Board. The number of houses supplied with a piped supply in the Borough is 18,015, which covers the whole of the population of 62,010. 2. Refuse and Salvage Collection. (a) Refuse Collection. A fleet of modern vehicles is operated collection, and disposal is by controlled tipping. A certain amount of trouble was experienced during the hot weather owing to the presence of crickets on the tip, but this was overcome by treatment of the tip surface. (b) Salvage Collection. Salvage collection has proceeded throughout the year but owing to the serious decrease in the price of waste paper it is likely to prove uneconomical and the Council is considering the question of (c) Kitchen Waste Collection. The original system of collection by means of communal bins placed in the streets has many drawbacks; wilful. removal of lids and overturning of bins caused a serious nuisance, and the prolific breeding of flies in the hot weather was a potential danger to publm health. . Three experimental areas in the Borough were set up wherein the collection of waste by means of individual containers was put into operation and in view of the satisfactory results it was decided .to apply the system the whole Borough. 3. Drainage and Sewerage. (a) Eastern Sewage Disposal Works. There are indications that the flow into these works is approaching the maximum capacity for which the works were designed. Nevertheless a good standard of effluent is maintained (b) Southern Sewage Disposal Works. A scheme for the extension of these works is in course of preparation but owing to general conditions it is not possible to state when the work will be carried out. Despite the 10 that these works are heavily loaded a good standard of effluent is obtained by means of careful maintenance and supervision. (c) Western Sewage Disposal Works. Negotiations are still proceeding with a view to the disposal of these obsolete works and for the diversion of the sewage from the western area into the Chingford system. Fortunately the sewage from this area is mild in character and this, together with constant supervision, has enabled a satisfactory standard of discharge to be Maintained. Sanitary Inspection of the Area The Senior Sanitary Inspector reports as follows:— The year 1949 provided us with no great event of outstanding importance. Nevertheless, much work was put in by the staff of Sanitary Inspectors. Again it must be reported that a considerable proportion of the Sanitary Inspectors' duties was occupied with the general maintenance of requisitioned Properties. In addition to internal and external works of repair, attention was given to the redecoration of these properties. Previous reports made mention of the fact that dry rot was the cause much expenditure on house maintenance. One can only confirm that the menace is still with us, and the recurrence of such rot emphasises the difficulty that exists in completely eradicating it. once again say "thank you" to the local builders who have continued to give every co-operation in connection with work on requisitioned property. Referring to the requirements of the Housing Act, it must be recorded that repairs were carried out to five houses because of default on the part of the owner(s). Clark's Cottages, Woodford Bridge, which were the subject of a Clearance Order in 1948, were demolished early in 1949 and the site cleared. Originally built as eight dwellings, and later converted into four, of the back-to-back type, built in a small court. The dwellings housed four families, totalling seven adults and thirteen children. These dwellings were demolished by the Council because of the default of the owners. Four other properties were demolished during the year and were also Referred to in the 1948 Report of the Medical Officer of Health. Here were housed seven adults and three small children. The properties in this case were demolished by the owners. The Council issued a Demolition Order on two further dwellings beause of the bad condition of the structure and their unfitness for human habitation These premises were of the old cottage type found in the locality constructed of weatherboard and lined with laths and plaster. As is often the case these days, one cottage housed two families, the parents' and married daughter's family. In considering work under the Public Health Act, 1936, the Council found it necessary to take proceedings against an owner for not complying a statutory notice to abate a nuisance. This case was deferred by the 11 Magistrates on various occasions, who eventually made an order for the work to be executed. This work was finally undertaken by the Council the cost to be ultimately recovered by the Local Authority taking the rent of the premises. This particular case again accentuated the difficulties that Local Authorities and their officers are up against, because of the very low rents still being paid in many cases, particularly when compared with the large increase in the cost of repair works, due to higher wages and cost of materials. The low rents being paid in so many cases reflects on the general standard of repair of property, owners in such cases find that to keep their houses in proper repair they have to expend, say, a year's rent and often more, allowing nothing in the way of interest or reserves for insurances, etc. Works carried out on the instructions of the Council are given below- Under Housing Act—repairs to 5 dwellings. Under Public Health Act—drainage and public sewers reconstructed repairs—25 properties. Under Public Health Act—repairs—1 dwelling. Under Public Health Act—provision of dustbins—11 bins provided Referring to a case heard before the local magistrates and referred to in the report of the Medical Officer of Health for 1948, it can be reported that the Council gave instructions for negotiations to be made with a view purchasing the house and grounds, together with the adjoining property with the intention of using both sites for building municipally-owned dwellings. By the end of the year these negotiations were well in hand. Food Hygiene. It was necessary in last year's Report to record disappointment at the poor attendance at a public lecture and film show arranged by the Council the Ministry of Agriculture and Fisheries. This year one has to record a further disappointment at the attendance at a similar meeting. Although about invitations were sent to traders and their staffs, the number of persons attending the lecture and show was down to 25. It can be stated that in addition to the invitations sent out by the Department, visits to shops' proprietors and managers were made by the Sanitary Inspectors. In March the Council arranged a civic exhibition in connection with a local celebration and in it the Public Health Department set up a stand, a portion of which was concerned with food hygiene, some exhibits being kindly loaned by the Public Health Laboratories at Edgware. This stand created great interest and was well worth while arranging. Thanks are due to the kindness the Edgware Laboratories and the Chief Meat Inspector of Smithfield Meat Market for the loan of some very interesting exhibits. In spite of the amount of work being undertaken by the Sanitary Inspectors in connection with the work at requisitioned premises, the inspection of food premises has been stepped up, the number of visits cafes and restaurants being doubled. 12 Lectures to food management and staff at the food premises as Carried out in many boroughs is not practicable in this Borough because all such Premises are of the smaller type, and better propaganda can be put over by the Inspectors during their visits. Rodent Control. The year's work in connection with this branch of the Department's Work can be divided into two sections (1) sewer treatment, and (2) surface treatment. Sewer Treatment. Two maintenance treatments were carried out under the supervision of the Deputy Senior Sanitary Inspector. The first treatment shows that out of 953 manholes baited, the total number of 'Takes' was 615, or 64.5 per cent. Of the 615 'takes' 409 were recorded as "complete". With the second treatment 1,294 manholes were baited, the number of 'takes' being 301, or 24.7 per cent.; 158 'takes' out of the 301 were complete". The following tables are a copy of the record for the first and second treatments. First Treatment 1 2 3 4 5 6 7 8 Section No. of Manholes No. not baited No. baited Average Pre-bait Takes Complete Partial Total takes N.T. 1 68 34 34 13 5 18 16 2 70 23 47 18 15 33 14 3 74 72 2 1 1 2 —. 4 77 28 49 14 10 24 25 5 77 19 58 26 13 39 19 6 82 25 57 22 10 32 25 7 84 39 45 21 12 33 12 8 67 28 39 15 11 26 13 9 82 28 54 23 16 39 15 10 77 20 57 22 17 39 18 11 76 32 44 22 8 30 14 12 70 14 56 20 15 35 21 13 70 28 42 20 11 31 11 14 79 22 57 26 14 40 17 15 74 28 46 23 11 34 12 16 72 6 66 31 18 49 17 17 67 12 55 24 13 37 18 18 77 4 73 35 19 54 19 19 72 — 72 33 23 56 16 1415 462 953 409 242 651 302 13 Second Treatment 1 2 3 4 5 6 7 8 Section No. of Manholes No. not baited No. baited Average Pre-bait Takes N.T. Complete Partial Total takes 1 68 1 67 13 10 23 44 2 70 1 69 19 6 25 44 3 74 70 4 - - - 4 4 77 — 77 5 9 14 63 5 77 — 77 2 2 4 73 6 82 3 79 9 14 23 56 7 84 5 79 12 8 20 59 8 67 5 62 4 17 21 41 9 82 3 79 5 10 15 64 10 77 5 72 8 13 21 51 11 76 8 68 13 10 23 45 12 70 1 69 3 8 11 58 13 70 5 65 9 4 13 52 14 79 1 78 17 11 28 50 15 76 1 75 2 7 9 65 16 72 2 70 14 1 15 55 17 67 1 66 12 5 17 49 18 77 4 73 11 8 19 54 19 72 7 65 — — — 65 1417 123 1294 158 143 301 993 Surface Treatment The following table shows the result of the year's work. Rodent reco-rd Number of inspections made by Sanitary Inspectors 224 Complaints received 287 Number of baits laid (baiting points) 572 B Rats found dead 341 Estimated kill 481 822 Total number of visits made bv rat catcher 380 The amount of "rechargeable" work is small. One factory area was treated on the "block" basis. The result was very encouraging, and after the treatment, test baits were laid, showing that the area was well cleared of the rodents. As recorded in former years, it is pleasing to note that cordial relations exist between the local authority's staff and the staff at the Ministry Agriculture and Fisheries, particular mention being made of Mr. Marley, Divisional Rodent Officer, and Mrs. Windsor, his deputy, and Mr. Harris 14 the Divisional Inspector. Mr. Marley was very helpful at Workable Area Meetings during the year, when much discussion took place on the "Prevention of Damage by Pests" Bill. Petroleum (Regulation) Acts, 1928 and 1936. Fifty-two licences were renewed at the beginning of the year and five new licences were granted. Game Licences. Eleven licences to deal in game were renewed, and one new licence wasgranted. SHops Act, 1934. Ninety-five visits were made under this Act, and no notices were served. Essex County Council Act, 1933— Passage and Special Treatment Establishments. As previously, the Sanitary Inspectors have carried out inspections to these premises, and all have been found to be quite satisfactory. Thirty-five list, bringing the total premises to twelve. TRAINING Scheme for Sanitary Inspectors. The training scheme for ex-service personnel, approved by the Ministers of Health, Education and Labour, came to an end during the year, the Scheme having served the purpose for which it was designed. Inspections carried out by Sanitary Inspectors. Infectious disease enquiries, including enquiries in respect of scabies 37 Visits in connection with contacts, etc. 60 Enquiries in connection with food poisoning 19 GENERAL Environmental Public Health. Drains and public sewers inspected 774 Tests to drains and public sewers 81 Stables and Manure Pits inspected 23 Tents, vans and sheds (including gipsy encampments) 29 Requisitioned houses inspected and visited 1,897 Smoke observations 6 Visits to Council tip 2 Schools inspected . Shops Act inspections 97 Petrol installations 32 Cinemas 6 factories (Mechanical) factories (Non-Mechanical) 23 Miscellaneous visits 127 15 Section D. Housing No. of houses erected during 1949: 186 Council; 10 Private enterprise; 49 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) 1,145 (b)Number of inspections made for the purpose 3,412 VISITS (2) (a) Number of dwelling-houses (included under head (1)above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 Nil and 1932 Nil (b) Number of inspections made for the purpose (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 2 (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 512 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 501 3. Action under Statutory Powers during the Year:— (а) 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 32 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By owners 27 (b) By Local Authority in default of owners 5 (b) Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 75 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By owners 74 (b) By Local Authority in default of owners 1 16 Illustrations of Clark's Cottages, Woodford Bridge, now demolished, (see page 11. (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 1 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 8 1 Housing Act, 1936.—Part IV.—Overcrowding:— No formed action during the year. 46 inspections were made in suspected cases of overcrowding. Nuisances Abated and Improvements Effected Dwelling-houses Roof repairs 111 External walls and chimney stacks repaired 94 Walls underpinned ... ... ... 3 Gutters and spouts repaired or renewed 83 Damp-proof courses provided 17 Dampness remedied ... 74 Yards paved or repaired 3 Internal walls and ceilings repaired 291 Doors and frames repaired or renewed 85 Windows repaired or renewed 160 Floors repaired or renewed 51 Sub-floor vent, provided or improved 10 Rooms cleansed or redecorated 283 Rooms with improved lighting 1 Staircases repaired and hand-rails provided 10 Fireplaces and flues repaired or renewed 39 Cooking stoves repaired or renewed 25 Wash coppers repaired or renewed ... 8 Sinks and washbasins provided or renewed 8 Waste pipes repaired or renewed 17 Food stores provided or improved 4 Dustbins provided or renewed 5 Water supply improved or reinstated 17 Water closet cisterns repaired or renewed 21 Water closet pans repaired or renewed 19 Water closet structures repaired or rebuilt ... 9 Water closet flush pipe joints repaired 5 Water closet lighting and ventilation improved 1 Nrral Environmental Public Health. Drains cleansed from obstruction 53 Drains repaired or renewed 28 Inspection chambers repaired 19 Soil pipes and vent shafts repaired 9 17 Disinfection and Disinfestation. No. of rooms disinfected 80 Bedding removed from premises for steam disinfection 135 No. of rooms disinfested 13 FACTORIES ACT, 1937 1. Inspections for the purposes of provisions as to health (including Inspections made by Sanitary Inspectors). Premises (1) Number on Register Number of Occupiers prosecuted Inspections Written notices (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 49 23 6 - (ii) Factories not included in (i) to which Section 7 applies — — — —— (a) Subject to the Local Authorities (Transfer of Enforcement) Order, 1938 250 103 - - (b) Others — - — — (iii) Other Premises under the Act (excluding out-workers' premises) — — — — Total 299 126 6 — 18 2. Defects found. Particulars. Number of Defects Number of defects in respect of which proseccutions were instituted Found Remedied Referred to H.M. Inspector Want of Cleanliness 2 2 ... ... Overcrowding ... ... ... ... Unreasonable temperature ... ... ... ... Inadequate Ventilation ... ... ... ... Ineffective drainage of floors ... ... ... ... Sanitary Conveniences:— 1. Insufficient ... ... ... ... 2. Unsuitable or defective 4 4 ... ... 3. Not separate for sexes Other Offences Total 6 6 3. Outwork Number of out-workers in August list required by Sect. 110 (1) (c):— Wearing apparel—Making, etc. 48 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 6 Household linens and furnishings 3 Total 57 Inspection of Foods, etc. .Meat Shops 85 Bakehouses 35 Fishmongers 135 Grocers 133 Restaurants and Cafes 109 Dairies and Milk Shops 7 Greengrocers 10 Fish Fryers 5 Ice Cream Premises 110 Hotels and Boarding Houses 12 Total 641 Section E. Food and Drugs Act, 1938 One hundred and thirty samples of food were submitted to the Public Analyst. It is again pleasing to record that adulterations were low, there being only one case of note. A sample of sausages purchased from one of the smaller multiple stores showed a deficiency of meat to the extent of 20 per cent. This sample being an informal one, a second and formal one was obtained, which showed a deficiency of 10 per cent. This latter sample was purchased in December and the Certificate of the Public Analyst was received too late for the Committee to deal with in 1949. The following is a list of the food samples analysed during the year, together with the number of samples of each kind obtained:— Sausages 3 Bacon 9 Butter 9 Cheese 9 Margarine 9 Tinned Grapes 1 poking Fat 9 Pearl Barley 1 Sogar 10 Oatmeal 1 Rice 4 Meat Pie 1 Jam 8 Suet 1 Saccharin 1 Salad Cream 1 Tea 8 Ice Cream 20 19 Flour 3 2 Vinegar 4 2 Olive Oil 1 Lemonade Crystals 2 Ground Ginger 1 Pastry Mix 1 Coffee 1 Crawfish 1 Bun Flour 1 Tomato Ketchup 1 1 Salmon and Shrimp Paste 1 Jelly 2 1 Surrendered Foods Fish {Fresh) Milk (Tinned) Haddock 28 stone Condensed 39 tins. Sprats 5 stone Evaporated 281 tins. Whiting 39 stone Dried 197 lbs. Dogfish 12 stone Fruit (Tinned) Skate 67 stone Spragg 6 stone Cod 34 stone Apple 7 tins Plaice 11 stone Fruit Salad 19 tins Catfish 13 stone Fruit Juice 9 tins Hake 8 stone Plums 21 tins Witches 5 stone Tomatoes 9 tins Golden Cutlets 8 stone Plums 2 tins Kippers 16 stone Gooseberries 3 tins Halibut Rhubarb 1 tins Herrings 6 stone Pineapple 4 tins Ray 5 stone Grapefruit 4 tins Brill 2 stone Grapes 4 tins Conger 6 stone Peaches 2 tins Fish (Tinned) Oranges 7 tins Sardines 6 tins Apple & Blackcurrant 3 tins "Snoek" 1 tin Blackberries 1 tins Brisling 3 tins Prunes 1 tins Barracuta 3 tins Meat (Tinned) Fish Paste 15 tins Herrings 6 tins Steak 1 tins Herring roes 1 tins Luncheon Meat 54 tins Brisling 1 tins Brisket 1 tins Sild 3 tins Danish Pork 1 tins Anchovies 8 tins Ox Tongue 3 tins Mussels 1 tins Meat and Vegetable 3 tins Crab paste 1 tin Chicken 1 tins Cray Fish 6 tins Brawn 4 tins Salmon 4 tins Steak and Kidney 1 tins Silver Hake 1 tins Meat Loaf 11 tins Pilchards 15 tins Rabbit 1 tins 20 Corned Beef 309 lbs. Marmalade 27 tins Corned Mutton 84 lbs. Pickled Onions 3 jars Potted Meat 2 tins Sauce 22 bottles Meat (Fresh) Honey 2 jars Sugar 1 lb. Pork Offal 771 lbs. Tea ½ lb. Bacon 14 lbs. Sultanas 1 lb. Lamb 321 lbs. Suet 2 lb. Rabbits 50 Vermicelli 26 cartons Hares 2 Bun flour 12 packets Ham 15 lbs. Oat cakes 2 packets Pigeons 2 Beef cubes 144 Partridges 10 Custard Powder 1 pkt. Vegetables (Tinned) Crispbread 44 pkts. Fruit Pudding 1 tins Peas 57 tins Liver paste 4 tins Diced vegetables 22 tins Dates 120 boxes Carrots 12 tins Eggs 150 Beans 21 tins Hors Doeuvers 1 Beetroot 10 tins Red cabbage 17 jars Juices 6 tins Nut meat 1 tins Miscellaneous Salad cream 2 bottles Flour 300 lbs. Pudding mixture 8 pkts. Egg (dried) 7 tins Cheese 28 lbs. Tomato Ketchup 1 jar Semolina 26 lbs. Soup 27 tins Chocolate spread 1 jar Spaghetti 10 tins Coffee Essence 1 bottle Mincemeat 3 tins Sausages 2 tins The following items were surrendered as they were damaged after the Premises were broken into by burglars:— Pickle 1 barrel 1 chest Mint Sauce 10 gallons Salad Cream 15 gallons Chinese fruits 40 gallons Tomato Ketchup 10 gallons Ginger 2 cwt. Olives 20 gallons Tea Seed Oil 12 gallons Papers 1 cask Pickle (sweet) 40 gallons Milk Samples. Five samples of milk were obtained during the year, all of which satisfied the methylene blue and phosphatase tests Ice Cream (Fat Content). Twenty samples of ice-cream were submitted to the Public Analyst for lamination to ascertain the fat content, the results are shown in the table 21 given below. In eight cases the Analyst gave also the percentage of total solids. No. Fat Content % Total Solids % 1 5.4 25.3 2 5.5 26.8 3 11.2 35.6 4 10.5 29.7 5 6.3 30.5 6 5.9 29.0 7 8.3 30.2 8 7.1 32.4 9 11.7 10 10.7 11 12.7 12 9.3 13 5.0 14 7.3 15 4.8 16 5.9 17 13.2 18 11.2 19 9.1 20 10.3 These figures indicate that some ice-creams were containing a good percentage of fat. All these details were forwarded to the Ministry, as requested by that body. Ice Cream Samples (Bacteriological Standard). One hundred and thirty-four samples of ice-cream were purchased and submitted to the Counties Public Health Laboratories for examination, table given below shows the reports of the Laboratories. Of the 134 specimens submitted, 71 were in Grade I, of the Ministry of Health's provisional grading, 29 were in Grade II, 27 were in Grade and 7 in Grade IV. Shown as percentages:— 52.9% (approx.) were in Grade I. 21.8% (approx.) were in Grade II. 20.1% (approx.) were in Grade III. 5.2% (approx.) were in Grade IV. 22 The following table shows the percentage compared with the Years 1947 and 1948:— 1949 1948 1947 Grade I 52.9 34.25 8 Grade II 21.8 32.81 24 Grade III 20.1 20.3 32 Grade IV 5.2 12.5 36 Number 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 After preincubation decolourised in (hours) After preincubation not decolourised in (hours) Ministry's Provisional Grading 1. Outside 32,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. - 4½ I. 2. Outside 500 0 in 3 0 in 3 Excellent standard of bacterial purity. - 4½ I. 3. Outside 1,900 0 in 3 0 in 3 High standard of bacterial purity. - 4½ I. 4. Outside 5,000 0 in 3 0 in 3 High standard of bacterial purity. - 4½ I. 5. Outside 40,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. 3½ - II. 6. Local 16,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. - 4½ I. 7. Outside 300 0 in 3 0 in 3 Excellent standard of bacterial purity. - 4½ I. 8. Outside 400 0 in 3 0 in 3 Excellent standard of bacterial purity. - 4½ I. 9. Outside 500 0 in 3 0 in 3 Excellent standard of bacterial purity. - 4½ I. 10. Outside 1,400 0 in 3 0 in 3 Very satisfactory standard of bacterial puritv. - 4½ I. 11. Outside 11 mill. 3 in 3 0 in 3 Unsatisfactory — contains excessive numbers of bacteria. 1 - III. 12. Outside 4,500 0 in 3 0 in 3 High standard of bacterial purity. - 4½ I. 13. Outside 18,000 3 in 3 0 in 3 Fair standard of bacterial purity. 1½ — III. 14. Outside 600 0 in 3 0 in 3 Excellent standard of bacterial purity. - 4½ I. 15. Local 7,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. - 4½ I. 16. Outside 1,200 0 in 3 0 in 3 Very satisfactory standard of bacterial purity. - 4½ I. 17. Outside 500 0 in 3 0 in 3 Excellent standard of bacterial purity. - 4½ I. 18. Outside 3,000 0 in 3 0 in 3 High standard of bacterial purity. - 4½ I. '9. Outside 135,000 3 in 3 0 in 3 Barely passable standard of bacterial purity— contains more bacteria than is desirable. 0 — IV. 20. Outside 800 0 in 3 0 in 3 Excellent standard of bacterial purity. - 4½ I. 21. Outside 800 0 in 3 0 in 3 Excellent standard of bacterial purity. - 4½ I. 22. Outside 1 mill. 2 in 3 0 in 3 Unsatisfactory — contains excessive numbers of bacteria. 0 - IV. 23. Outside 4,600 0 in 3 0 in 3 Satisfactory standard of bacterial purity. - 4½ I. 24. Local 1 mill. 2 in 3 1 in 3 Very unsatisfactory sample. Contains excessive numbers of bacteria, including small numbers of bacteria of excremental origin. 0 - IV. 25. Outside 70,000 3 in 3 0 in 3 Passable standard of bacterial purity but reduction of content of coliform organisms should be attainable. 1 - III. 26. Outside 13,000 3 in 3 0 in 3 Fair standard of bacterial purity, but reduction of content of coliform organisms should be attainable. 4 - II. 27. Outside 600,000 3 in 3 0 in 3 Sample contains excessive numbers of bacteria and is therefore unsatisfactory. ½ — III. 28. Outside 60,000 3 in 3 0 in 3 Sample is of a passable standard of bacterial purity, but reduction of'the content of coliform organisms should be attainable. 3 - II. 29. Local 500 0 in 3 0 in 3 Excellent standard of bacterial purity. — 4½ 1. 30. Outside 600 0 in 3 0 in 3 Excellent standard of bacterial purity. — 4½ I. 31. Local 900 0 in 3 0 in 3 Excellent standard of bacterial purity. — 4½ I. 32. Local 1,800 0 in 3 0 in 3 Very satisfactory standard of bacterial purity. — 4½ I. 33. Local 100,000 3 in 3 0 in 3 Sample of only passable standard of bacterial purity and much improvement should be attainable. ½ — III. 34. Outside 300,000 3 in 3 0 in 3 Sample contains excessive numbers of bacteria and is therefore unsatisfactory. 1½ - III. 35. Outside 45,000 3 in 3 0 in 3 Fair standard of bacterial purity, but reduction of the- content of coliform organisms should be attainable. 2 - III. .. Outside 23,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. — 4½ I. 37. Outside J mill. 1 in 3 0 in 3 Sample contains e-jessfcxve numbers of bacteria and is ti Kerefore unsatisfactory. 1 — III. 38 Outside 800 0 in 3 0 in 3 Excellent standard of bacterid purity. — 4½ I. y). Outside 900 0 in 3 0 in 3 Excellent standard of ->acteri l purity. — 4½ I. % Outside 8,000 0 in 3 0 in 3 Satisfactory standard < J bacvrial purity. — 4½ I. 4i. Outside 100,000 0 in 3 0 in 3 Passable standard of ac al purity and improvement shouK " attainable. 2 — III. / 42' Outside 72,000 3 in 3 0 in 3 Passable standard of b. cerial purity and improvement should be attainable. 3 — II. 43. Local 2,000 0 in 3 0 in 3 Very satisfactory standard of bacterial purity. — 4½ I. 44. Outside 360,000 3 in 3 0 in 3 Sample contains excessive numbers of bacteria and is therefore unsatisfactory. 2 — III. 45. Outside 4,800 0 in 3 0 in 3 High standard of bacterial purity. — 4½ I. 46. Outside 6,800 0 in 3 0 in 3 Satisfactory standard of bacterial purity. — 4½ I. 47. Outside 500 0 in 3 0 in 3 Excellent standard of bacterial purity. — 4½ I. 48. Outside 68,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. 2½ - II. 49. Outside 100,000 3 in 3 2 in 3 Sample contains more bacteria than is desirable, including organisms of faecal origin. It is therefore unsatisfactory. 2½ - II. 50. Outside 12,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. — 4½ I. 51. Outside 9,200 0 in 3 0 in 3 Satisfactory standard of bacterial purity. — 4½ I. 52. Outside 6,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. — 4½ I. 53. Outside 3,200 0 in 3 0 in 3 High standard of bacterial purity. — 4½ I. 54. Outside 5,800 0 in 3 0 in 3 Satisfactory standard of bacterial purity. - 4½ I. 55. Outside 70,000 0 in 3 0 in 3 Fair standard of bacterial purity. — 4½ I. 56. Outside 800 0 in 3 0 in 3 Excellent standard of bacterial purity. — 4½ I. 57. Outside 1,200 1 in 3 0 in 3 Satisfactory standard of bacterial purity. 4 — II. 58. Outside 40,000 3 in 3 0 in 3 Fair standard of bacterial purity, but reduction of the content of coliform organisms is desirable. 1 - III. 59. Outside 50,000 3 in 3 0 in 3 Fair standard of bacterial purity, but reduction of the content of coliform organisms is desirable. - 4½ I. 60. Outside 1,200 0 in 3 0 in 3 Very satisfactory standard of bacterial purity. — 4½ I. . 61. Outside 4,000 0 in 3 0 in 3 High standard of bacterial purity. — 4½ I. 62. Outside 30,000 3 in 3 0 in 3 Passable standard of bacterial purity, but the content of coliform organisms should be less. 3 - II. 63. Outside 120,000 3 in 3 0 in 3 Barely passable standard, and marked improvement should be attained. ½ — III. 64. Outside 3,000 0 in 3 0 in 3 High standard of bacterial purity. 4 — II. 65. Outside 300 0 in 3 0 in 3 Excellent standard of bacterial purity. — 4½ I. 66. Outside 1,200 3 in 3 0 in 3 Passable standard of bacterial purity, but the content of coliform organisms should be less. 3½ - II. 67. Outside 120,000 3 in 3 3 in 3 Sample unsatisfactory as it contains large numbers of bacteria including organisms of excremental origin. 1 - III. 68. Outside 1,100 0 in 3 0 in 3 High standard of bacterial purity. — 4½ I. 69. Outside 22,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. 3½ — II. 70. Outside 200 0 in 3 0 in 3 Excellent standard of bacterial purity. — 4½ I. 71. Outside 700 0 in 3 0 in 3 High standard of bacterial purity. — 4½ I. 72. Outside 150,000 3 in 3 0 in 3 Sample contains more bacteria than desirable and is therefore of a barely passable standard of bacterial purity. 0 - IV. 73. Outside 80,000 3 in 3 0 in 3 Passable standard of bacterial purity, but improvement should be attainable. 1½ - III. 74. Outside 70,000 3 in 3 0 in 3 Fair standard of bacterial purity, but a reduction of the content of coliform organisms is desirable. - 4½ I. 75. Outside 130,000 3 in 3 0 in 3 Passable standard of bacterial purity. 1½ — III. 76. Outside 3,000 1 in 3 0 in 3 Satisfactory standard of bacterial purity. —- 4½ I. 77. Outside 40,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. 3½ — II. 78. Outside 800 1 in 3 0 in 3 Satisfactory standard of bacterial purity. — 4½ I. 79. Outside 11,000 3 in 3 0 in 3 Fair standard of bacterial purity, but the content of coliform organisms should be less. 4 - II. 80. Outside 13,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. — 4½ I. 81. Outside 4,000 0 in 3 0 in 3 High standard of bacterial purity. — 4-½ I. 82. Outside 400 0 in 3 0 in 3 Excellent standard of bacterial purity. — 4½ I. 83. Outside 2,000 0 in 3 0 in 3 High standard of bacterial purity. — 4½ I. 84. Local 20,000 3 in 3 0 in 3 Fair standard of bacterial purity, but the content of coliform organisms should be less. 2 - III. 85. Local i mill. 3 in 3 3 in 3 Very unsatisfactory. Contains excessive numbers of bacteria including organisms of excremental origin in considerable numbers. 0 - IV. 86. Outside 30,000 3 in 3 0 in 3 Fair standard of bacterial purity, but the content of coliform organisms should be less. 4 - II. 87. Outside 23,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. — 4½ I. 88. Outside 38,000 3 in 3 0 in 3 Fair standard of bacterial purity, but the content of coliform organisms should be reduced. - 4½ I. 89. Outside 18,000 0 in 3 0 in 3 Satisfactory-standard of bacterial purity. — 4½ I. 90. Outside 100,000 3 in 3 0 in 3 Sample contains more bacteria than is desirable and is therefore only of a passable standard of bacterial purity. 1 - III. 91. Outside 10,000 3 in 3 0 in 3 Fair standard of bacterial purity. Content of coliform organisms should be less. — 2½ II. 92. Outside 18,000 3 in 3 0 in 3 Fair standard of bacterial purity, but the content of coliform organisms should be less. - 2½ II. 93. Outside 42,000 3 in 3 0 in 3 Fair standard of bacterial purity, but the content of coliform organisms should be less. - 3½ II. 94. Outside 5,800 0 in 3 0 in 3 Satisfactory standard of bacterial purity. - 4½ I. 95. Outside 12,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. - 4½ I. 96. Outside 65,000 3 in 3 0 in 3 Fair standard of bacterial purity, but the content of coliform organisms should be less. - l½ III. 97. Outside 70,000 3 in 3 0 in 3 Fair standard of bacterial purity—improvement should be expected. 2 III. 98. Local 12,000 3 in 3 0 in 3 Fair standard of bacterial purity, the content of coliform organisms should be less . 2½ — II. 99. Local 132,000 3 in 3 0 in 3 Contains more bacteria than is desirable— much improvement should be attained. 0 — IV. 100. Outside 4,000 0 in 3 0 in 3 High standard of bacterial purity. — 4½ I. 101. Outside 8,200 3 in 3 0 in 3 Fair standard of bacterial purity, but content of coliform organisms should be reduced. 3 - II. 102. Outside 700 0 in 3 0 in 3 Excellent standard of bacterial purity. — 4½ I. 103. Outside 200 0 in 3 0 in 3 Excellent standard of bacterial purity. — 4½ I. 104. Outside 48,000 3 in 3 0 in 3 Fair standard of bacterial purity but reduction of coliform organisms is desirable. 2 — III. 105. Outside 78,000 3 in 3 1 in 3 Sample cannot be considered satisfactory as organisms of excremental origin are present. ½ - III. 106. Local 68,000 3 in 3 0 in 3 Fair standard of bacterial purity, but content of coliform organisms should be less. 2 — III. 107. Outside 13,000 3 in 3 0 in 3 Fair standard of bacterial purity, but reduction of the content of coliform organisms is desirable. l½ - III. 108. Outside 6,700 0 in 3 0 in 3 Satisfactory standard of bacterial purity. — 41 I. 109. Local 5,000 3 in 3 1 in 3 Unsatisfactory. Contains organisms of excremental origin in small numbers. 4 II. 110. Outside 78,000 3 in 3 0 in 3 Fair standard of bacterial purity, but improvement should be attainable. 3 II. 111. 112. Outside Outside 130,000 700 3 in 3 0 in 3 0 in 3 0 in 3 Passable standard only and much improvement should be attained. Excellent standard of bacterial purity. 0 4½ IV. I. 113. Outside 15,000 3 in 3 0 in 3 Fair standard of bacterial purity, but content of coliform organisms should be reduced. 2 —- III. 114. Outside 8,000 3 in 3 0 in 3 Fairly satisfactory standing of bacterial purity but a reduction in the content of coliform organisms is required. 2½ - II. 115. Outside 28,000 3 in 3 0 in 3 Satisfactory standard of bacterial purity, but a reduction in the content of coliform organisms is required. 3 - II. 116. Local 128,000 3 in 3 1 in 3 Unsatisfactory, in that sample contains small numbers of organisms of excremental origin, indicating faecal contamination. 1½ — III. 117. Outside 19,000 0 in 3 0 in 3 High standard of bacterial purity. — 4½ I. 118. Outside 6,200 2 in 3 0 in 3 Satisfactory standard of bacterial purity, but a reduction in the content of coliform organisms is desired. - 3½ II. 119. Outside 35,000 2 in 3 0 in 3 Satisfactory standard of bacterial purity. 21 — II. 120. Outside 1,200 0 in 3 0 in 3 Excellent standard of bacterial purity. -- 4½ I. 121. Outside 3,600 0 in 3 0 in 3 High standard of bacterial purity. 2½ — III. 122. Outside 200 0 in 3 0 in 3 Excellent standard of bacterial purity. 2 — III. 123. Outside 900 0 in 3 0 in 3 Excellent standard of bacterial purity. 3 — II. 124. Local 23,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. 2½ — II. 125. Outside 220,000 3 in 3 0 in 3 Contains excessive numbers of bacteria and is therefore unsatisfactory. 1 — III. 126. Outside 14,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. - 4½ I. 127. Outside 5,000 0 in 3 0 in 3 High standard of bacterial purity. — 4½ I. 128. Outside 18,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. — 4½ I. 129. Outside 8,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. — 4½ I. 130. Outside 15,000 0 in 3 0 in 3 Satisfactory standard of bacterial purity. — 4½ I. 131. Outside 2,000 0 in 3 0 in 3 High standard of bacterial purity. — 4½ I. 132. Outside 1,500 2 in 3 0 in 3 Fair standard of bacterial purity, but reduction of the content of coliform organisms is desirable. 3½ - II. 133. Outside 8,800 2 in 3 0 in 3 Fair standard of bacterial purity, but reduction of the content of coliform organisms is desirable. 3½ - II. 134. Outside 4,300 0 in 3 0 in 3 High standard of bacterial purity. - 4½ 1. Such comparison indicates an improvement in the right direction. It is to be hoped that (1) the continual sampling, (2) the notification of results to the vendor, and (3) the approach to the manufacturer in cases where the sample is not in Grade I or II, is having a good effect, because it generally appreciated that the greater proportion of the manufacturers of ice-cream are anxious to produce a good article. The need to sterilise servers, etc., is impressed upon the vendors by Sanitary Inspectors, because a good quality ice-cream can give a bad result when examined by the laboratories, simply because of the contamination of the surface of the ice-cream by a server which has not been sterilised thoroughly and so kept as to keep the growth of bacteria at a minimum. The Public Health Committee interviewed two vendors of ice-cream where the Laboratory reports were not in the higher grades. One application for the registration of the applicant and the premises for the sale of ice-cream was refused by the Committee. One further applicant who wished both himself and his premises to be registered was interviewed. The Committee agreed to the registration on being assured that no risk to health would be involved by that registration Nineteen new registrations were granted during 1949. The Council control the registration of vendors and premises by the provision of the Essex County Council Act and not by the provisions of the Food and Drugs Act. 24 Section F. Prevalence of, and control over, Infectious and other diseases. 1. The following table shows the incidence of infectious disease year together with cases admitted to hospital and number of Disease Total cases notified Cases admitted to hospital Total Deaths Smallpox - - - Scarlet Fever 51 9 - Diphtheria - - - Pneurnonia 42 4 27 Cerebro-Spinal Fever 1 - - *cute Poliomyelitis 6 6 - Acute Polioencephalitis 3 3 - Encephalitis Lethargica - - Dysentery 2 — - Puerperal Pyrexia 3 3 - Paratyphoid Fever - - Enteric or Typhoid Fever - - Erysipelas 12 1 - Malaria (contracted abroad) 3 1 - Measles 800 5 1 hooping Cough 167 1 - 2 Diphtheria Immunisation and Vaccination. The number of children who completed a full course of primary immunisation during the year is set out below:— Under 5 years 845 5 to 14 years 129 Total 974 The number of children who received a secondary or re-inforcing Injection was 252. 1949 number of persons vaccinated or re-vaccinated during the year Were:- Under 1 1-4 yrs. 5-14 yrs. 15 or over Total Primary Vaccination 177 262 153 55 647 Re-Vaccination 2 8 13 102 125 I am setting out below information on the total number of children under 15 years of age who have at any time received a course of immunisation 25 against diphtheria in the Borough, as at the 31st December, 1949. Imnnunlsation is normally carried out at 9-12 months and again on the attainment of school age. Year of Birth Number Year of Birth Number 1949 69 1940 634 1948 660 1939 562 1947 709 1938 414 1946 698 1937 338 1945 784 1936 339 1944 533 1935 298 1943 442 Total 7,782 1942 594 1941 708 3. Scabies. Two cases of Scabies were treated at the Walthamstow Clinic. 4. Tuberculosis. Particulars of new cases of Tuberculosis and mortality from the disease during 1949:— 50 Pulmonary and 14 non-Pulmonary cases were notified for first time during the year. 18 cases were transferred into the district. 2 cases were restored to the register. 19 Pulmonary and 2 non-Pulmonary cases died during the year. 20 other cases were removed from the register. 363 cases remained on the register at the close of the year.