WEM 026 1945 AC(396) WOMBLLY WEM 26 BOROUGH OF WEMBLEY INTERIM REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1945 A. G. MORISON, M.A., M.D., D.P.H. Medical Officer of Health, August, 1946. 68682 BOROUGH OF WEMBLEY INTERIM REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1945 A. G. MORISON, M.A., M.D., D.P.H. Medical Officer of Health. August, 1946. 8 0 330 BOROUGH OF WEMBLEY AN N UAL REPORT of the MEDICAL OFFICER OF HEALTH for the Year 1945 To the Mayor, Aldermen and Councillors of the Borough. Mr. Mayor, Ladies and Gentlemen, In accordance with Ministry of Health Circular No. 28/46, the Annual Report on the Health of the Borough for 1945 is again an interim one, and is submitted in the following seven short paragraphs:— A. VITAL STATISTICS, Pages 3—4, Statistical appendix Pages 12—18. B. GENERAL HEALTH SERVICES, Pages 4—5, Statistical appendix Pages 18—19. C. MATERNITY AND CHILD WELFARE SERVICES ing DAY NURSERIES), Pages 5—6, Statistical appendix Pages 1ft—30. D. SCHOOL HEALTH SERVICES, Pages 6—7, Statistical appendix Pages 31—40. E. INFECTIOUS DISEASES, Pages 81—9, Statistical appendix Pages 41'—48. F. ENVIRONMENTAL HYGIENE— HOUSING, FACTORIES, FOOD (including MILK) AND WATER, Pages 9—10, Statistical appendix Pages 48—56. G. CIVIL DEFENCE, Pages 10—11. A. The estimated population of the Borough at 31st March, .1946, was 128,000. In population, then, Wembley is now the 37th largest town in England (excluding the Metropolitan 3 Boroughs) and there are 50 'County Boroughs with a smaller population. Wembley is the 5th largest County District in population in Middlesex. In 1945, 2,153 births were recorded giving a birth rate of 16.39 per 1,000. There were 1,024 deaths during 1945; 464 (that is, 45.33%) occurred elsewhere than within the Borough boundary, and 466 took place in hospital (that is, 45.50%), giving a crude death rate of 8.68 per 1,000 estimated population. The infantile mortality rate remained at a relatively low level, being 36.75 per 1,000 live births. Of the 69 deaths which occurred in children who never saw their first birthday, 33 (that is, 47.83%) occurred within the first week of life, while 46 (that is, 66.66%) occurred within the first four weeks of life. The principal causes of death were heart disease and other diseases of the circulatory system, cancer, and the respiratory diseases. There were no maternal deaths from sepsis, but 2 deaths were recorded from other puerperal causes. A Table is presented giving details of the infantile mortality which again shows prematurity as the main cause of the deaths of very young infants, congenital defects, most of 'them incompatible with life, being the next greatest cause of infantile mortality. Tables are also given showing the infantile mortality and maternal mortality during the last five years (1941-45). B. In accordance with Ministry of Health Circular No. 70/45, with the disbandment of the Civil Defence services a re-organisation of the Ambulance Service became necessary. While probably ar. economical siting for such a service is at a hospital or Fire Station, or along with a disinfection station, from the circular's reference to a National Health Service it seemed 'that, for the present, the provision of ambulances was to be considered as an immediate expediency likely to be altered again and, accordingly, the Barham Ambulance Station became the main ambulance station, open ithroughout 'the twenty-four hours, the Kingsbury Station being a subsidiary station open from 7 a.m. to 11 p.m. daily. This arrangement worked well and with the co-operation of the National Fire Service the Borough Ambulance Service is now about to be stationed at the Wembley Fire Station, Harrow Road, while in the daytime one ambulance will be available from the Kingsbury Fire Station. The Domestic Help Service (Ministry of Health Circular No. 179/44) continued difficult of administration because of the impossibility of recruiting sufficient personnel either full-time or part-time. This is a service which should be of the greatest value by supplying a real public need but up to the present the supply of personnel falls very far short of the requirements.. 4 Nursing in the home continued to be efficiently provided by the Wembley and Kingsbury District Nursing Associations in which Associations the Council have been very actively interested and have given substantial grants:— £ s. d. To the Wembley District Nursing Association 1,342 3 10 To the Kingsbury District Nursing Association 805 6 3 The Mortuary at St. John's Churchyard has for some time been inadequate and in their post-war planning the Council have in mind a new Mortuary on a site adjacent to the New Burial Ground in Watford Road. C. Many further duties and responsibilities fell upon the Department with the delegation under the Education Act, 1944, and the Maternity and Child Welfare Services and the School Health Services are now co-ordinated throughout, the same officers being responsible for personal health and welfare services at the Ante-Natal Clinics in the Maternity and Child Welfare Service to the health and welfare of children during school life in the School Health Service. Throughout these two services the essential priority is health education. Medical Officers and Health Visitors have attended appropriate refresher courses, Student Health Visitors have received training in the Borough during their course at the Royal College of Nursing, the magazine "Better Health" has been put on sale (price 2d. monthly) at the Clinics. The approval of the Minister of Health was obtained making the provision of dental treatment (apart from artificial dentures), spectacles, orthopaedic appliances and orthopaedic hospital treatment free for Maternity and Child Welfare cases as they became free for school-children under the Education Act, 1944. There are now 17 Health Visitor Areas in the Borough, all Health Visitors acting also as School Nurses and their services are co-ordinated administratively by 'the Superintendent Health Visitor. An experiment in de-centralisation of a number of the Health Visitors from the Public Health Department to the peripheral Clinics is now being tested by 'the Maternity and Child Welfare Committee and so far the re-arrangement is proving most useful, giving the public immediate access to any service required. The appreciation of and value to the public of the various Clinic services continued to be patent, for example, 64% of 'the women attending the Ante-Natal Clinics commenced their attendances by the third month of pregnancy, while the other figures in the appendix prove the same acceptance, 5 Hospital provision for confinement has become quite inadequate to deal with the women seeking a hospital bed because of unsuitable home conditions, while it is true that the women requiring hospitalisation for some medical reason may still be accommodated. This inadequate provision of maternity bed accommodation is a general problem throughout the country at the present time. The Council's scheme to deal with the premature child (Ministry of Health Circular 174/44) was given in full in the report for 1944. 28 infants were recorded as premature (birth weight 5½ pounds or less) and born at home and 32 born in hospital (Willesden cases— born at Willesden Maternity Hospital). Of these born at home 20 were nursed entirely at home, one died during the first twenty-four hours and 17 survived at the end of one month. Of the 32 Willesden cases in Willesden Maternity Hospital 4 died during the first twenty-four hours and 26 survived at the end of one month. The arrangements with the Middlesex County Council continued throughout the year for Unmarried Mothers (Ministry of Health Circular No. 2866), 3 cases being dealt with. The Day Nurseries continue to provide an important service, firstly, of benefit to the children themselves and secondly, releasing the mothers for employment and solving difficulties in illness, or, for example, at the birth of another child. 7 Nursery Nurses received the Diploma of the National Society of Children's Nurseries. There was throughout the year considerable difficulty in maintaining sufficient staff for the Nurseries. This was especially so with regard to Wardens and with the present acute shortage of Teachers for the Education Authority it is difficult to foresee the provision of proper Warden personnel for the Nurseries. The Mayor received a gift, of toys from the people of Australia which he shared amongst the Nurseries. This generous gift was very much appreciated. The incidence of the infectious diseases in the Nurseries has again been tabulated so that in due course some answer may be given to the criticism that the Nurseries may have an undue influence in the spread of the infections. That 5 members of the staff contracted infective hepatitis (jaundice) without there being any subsequent case amongst the Nursery children is further evidence that to this disease the young child seems less prone than the school-child. D. The delegation to the Borough in accordance with the Education Act, 1944, of the School Health Services gave an 6 usual opportunity to co-ordinate the Health and Welfare Services provided, and the assumption of such duties was undertaken gradually throughout the year. The major difficulties, of course, have been shortages of professional staff, both medical and nursing. The first step was the amalgamation of the Maternity and Child Welfare Dental Services with the School Dental Services. There are now 4 Dental Clinics working full-time (Stag Lane (Borough), Stag Lane (County), College Road, the fourth Dental Officer working at Wembley Hill and One Tree Hill Clinics). A fifth Dental Officer is about to be appointed whose Dental Clinks will in the main be at Perrin Road. There are in Wembley 21 schools, 18 Primary and Secondary (Modern) schools and 3 Secondary (Grammar) schools. The pupil population of the Primary and Secondary (Modern) schools was approximately 10,000 and of the Secondary (Grammar) schools 1,500. Probably the number of routine inspections annually which should be undertaken at these schools is 6,500. Clinic Sessions were being held once weekly at Wembley Hill, One Tree Hill and Stag Lane (County), one Medical Officer attending once per week. It has now been possible to increase these Clinic Sessions to six per week, and further Sessions will be opened as medical personnel will allow. The School Health Visitors keep themselves aware of the medical condition of the children, including cleanliness and in many respects act as a medium between the Medical Officers and the families of the children, this duty calling for domiciliary visits. The Health Visitors attend the Clinic Sessions with the Medical Officers and accompany them at the routine School Inspections. 2 Health Assistants have now been appointed to deal generally with Cleanliness Inspections and advice, working under the supervision of the Health Visitors. The schools in the Borough have been divided into 5 Medical Officer Areas, but so far it has been necessary for one of the Medical Officers to be responsible for 2 such School Medical Officer Areas. This will be adjusted on the pending appointment of a Deputy Medical Officer of Health. The Special Clinic Services— Ophthalmic and Orthopaedic— are conducted by Specialist part-time officers, again with the assistance of the Health Visitors. With the co-operation of the Borough Education Officer much of the administrative arrangements for the School Medical Inspections are being made by the Borough Education Officer. This prevents a certain amount of duplication in the Public Health Department of records already in the Education Department. With the immediate extension of the Medical and Dental Professional Officers, the recent extension of the Health Visitor personnel and the return from War service of the Senior Clerical and Administrative Officers a smoothly working and efficient School Health Service will soon now be practicable. 7 E. There was no undue incidence of the acute infectious diseases during 1945, except of measles. Towards the end of 1944* the figures showed a slight rise in the number of cases of scarlet fever. This disease, however, for some years has continued generally to be mild and sometimes the convinced diagnosis is impossible without observation over a period. In cases where the patient or a family contact be employed at work in handling food, especially milk, from the public health point of view it is (better administratively to act on suspicion and medical colleagues were asked to inform the Public Health Department of any such suspicious cases of scarlet fever thus allowing the Department, perhaps, to assist in the prevention of possible spread. During the early Summer some cases of typhus fever were imported from the Continent, fortunately not to Wembley. But many possible contacts of this serious disease arrived in Wembley calling for supervision and advice. The Public Health Department is informed of all such typhus and smallpox contacts. The contacts are visited and given appropriate advice and any necessary action is taken. The Local Medical Profession have been kept informed as appropriate. During the year 26 possible smallpox contacts and 38 of typhus were supervised. During August, 4 notifications of anterior poliomyelitis (infantile paralysis) were received. A number of such cases were occurring about that time on the Continent and the possibility of personnel on leave acting as carrier spread was considered. Again the Local Medical Profession were informed and fully co-operated with the Public Health Department. The incidence of infective hepatitis (jaundice) continued to be collated throughout the year. These figures have been submitted periodically to the Secretary of the Medical Research Council Committee on Jaundice. This Committee's investigations have now concluded and it is understood that the Wembley figures are to /be included in its report. The Council have been keenly anxious that the public should accept diphtheria immunisation to the full and no opportunity has been missed to point out the, value of protective inoculation against this serious disease, for diphtheria is a serious disease especially in children, but it can be prevented. The Public Health Committee was gratified to learn of the opportunity taken in The Hyde area, for example, to further the immunisation campaign during their Holidays-at-Home Gala. The last page of this programme was given over to a note to parents to protect their children against diphtheria. Surely there is now no family in the Borough unaware of the Council's scheme, but the 8 number of protected children is still too low. Those children protected against diphtheria by injection treatment when under three years of age should have a reinforcing injection just prior to commencing school life to assure high protection over the next few years. With the co-operation of the Head Teachers of the schools this is now being brought to the notice of parents. Such a reinforcing dose was given to 496 children prior to December, 1945, and during the first six months of 1946 to 313 children. It is hoped that these figures, too, will become much greater. The arrangements for the cleansing of verminous persons and dealing with verminous conditions detailed in previous Reports were taken during 1945 and the figures are given in the appendix. The generalisation remains true that this is scarcely a Public Health problem in Wembley. Only 11 cases had to be referred to Kensington Medicinal Baths for treatment more intensive than could be given by the Health Visitors at the Clinics or in the homes. 4 cases were referred to the Department by factory welfare officers, one by a private medical practitioner, one by a hospital, one by a district nurse, while one person made individual application to the Public Health Department for advice. The co-ordination of the Maternity and Child Welfare and School Health Services is having material effect in the reduction of school-children with nits in the hair. This is real preventive medicine, as in the great majority of cases early ascertainment means immediate and entire elimination of the condition, and parents are most appreciative of this service. F. The figures submitted regarding the work of the Sanitary Inspectorial Staff are a record of much accomplished under continuously very difficult conditions. The seriousness of the housing situation requires no emphasis to the Council who have been throughout keenly sensitive about the problem while, in addition, the general man-power situation has rendered even amelioration of urgent conditions sometimes almost impossible. The scarcity of housing accommodation is continually adding to the problem of overcrowding. The minimum standard regarding overcrowding under the Housing Acts is low indeed, but overcrowding has also been increasing in other ways than can be measured by these minimum statutory requirements, so many family units now having to share accommodation primarily intended for only one family. Only 10 cases could be relieved during 1945, and while on the 31st December, the number of houses known to be overcrowded in accordance with the Housing Acts' standard was 197, by April, 1946, this figure had become 267 and now (20th July, 1946) the figure is 340. The physical difficulties, together with the psychological trials of individual families not having their 9 own separate homes, present domestic problems which in many cases have far reaching effects on family health and welfare. Much important action is recorded in the endeavour to protect the food supply and the circumstances under which food is handled and processed. Constant attention has been given to the cleanliness of milk under the Special Designations Orders. In February, 1946, the Ministry of Health drew attention to the need of examining occasional samples of milk for the presence of hypochlorites. The use of hypochlorites has been permitted and controlled by regulation, and sodium hypochlorite, though not harmful in itself, rapidly destroys the Vitamin C in milk, thereby reducing its nutritive value. This special examination need only be made occasionally, and our routine now is always to make the test on the installation of new washing plant and otherwise at regular intervals. Examinations were made in April, 1946, all with negative results. The practice of fortnightly sampling of the public water supplies was continued and the results passed to the respective Water Companies, while also the Water Companies submitted periodically their results. The water supply remained bacteriologically satisfactory and sufficient in quantity. There are no inhabited premises known to be without an internal water supply. An intensive campaign to eradicate rats from the Corporation sewers was commenced on the 7th August and brought to a successful conclusion on the 8th December. The work was performed by 10 Italian co-operators accompanied by 4 men recruited as casual employees, the whole team being directly supervised by Mr. Kluth, Sanitary Inspector. The recommendation of the Ministry of Food was strictly adhered to and the results were very satisfactory. There are 3,320 soil sewer manholes throughout the Borough. Of these it was found impracticable to bait 206 owing to lack of benching, temporary flooding, 'etc. 3,114 manholes therefore received a first treatment revealing the further necessity of poison baiting in 658. The estimated number of rats killed was 4,361. A second treatment after an interval of three weeks was given as circumstances revealed necessary, and a further 713 rats are estimated to have been poisoned. The number of visits to manholes for the purpose of loosening, baiting, inspecting results in the campaign was 23,159. The work of rat destruction throughout the Borough is detailed in the appendix. G. As the Report for 1944 was compiled just at the end of hostilities in Europe opportunity was taken then to refer with 10 some pride to the manner in which the personnel, both full-time and part-time, of the Casualty Services had responded to the exhausting experiences throughout the War years. In 1945, until the 2nd May, one First Aid Post at Imperial College of Science Pavilion, East Lane, a Mobile First Aid Unit stationed at Kingsbury Manor Studio, and 2 Ambulance Depots (one at Barham Park, the other at Kingsbury Manor Studio) remained in action. The personnel attached to these Services were:— Ambulance staff full-time 40, part-time 83, First Aid Post staff full-time 30, parttime 125. By the 25th May both the First Aid Posts (one static, one mobile) had been closed and 'their equipment transferred to the Palace of Arts while the Ambulance Depots ceased as a Civil Defence Unit at 31st May. It can now be recorded that all members of the staff of this Department have returned from their War service with the exception of Mr. D. A. Dowie who is still reported missing after having been taken prisoner in the North African Campaign. The staff has been much strengthened by the return of these officers and the Department looks forward to assisting the Council to carry out their Post-War programme with zeal and, we shall endeavour, with efficiency. I wish personally to thank the Council for the way in which our services have always been appreciated. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, A. G. MORISON, Medical Officer of Health. 14th August, 1946. 11 STATISTICAL APPENDIX. ((A) CERTAIN VITAL STATISTICS, 1945, from figures supplied by Registrar-General. (Some comparative 1944 figures within brackets.) Live Births. Male. Female. Total. Legitimate 953 882 1,835 Live birth rate per 1,000 estimated population 16.39 (18.58) (2,056) Illegitimate 49 48 97 (85) Stillbirths. Legitimate 21 12 33 Rate per 1,000 total (live and still) births 18.28 (24.16) Stillbirth rate per 1,000 estimated population . 0.31 (48) Illegitimate 4 — 4 (5) (0.46) Deaths 533 491 1,024 Death rate per 1,000 estimated population^— Crude rate 8.68 Infantile Mortality. Deaths of infants under one year of age:— Male Female Total. Legitimate 32 27 59 (66) (73) Illegitimate 4 3 7 (3) Death rate of infants under one year of age:— All infants per 1,000 live births 36.75 (35.50) Legitimate infants per 1,000 legitimate live births 32.15 (35.51) Illegitimate infants per 1,000 live illegitimate births 72.16 (35.30) 12 Deaths from: Cancer (all ages) 207 (183) Measles (all ages) — (-) Whooping cough (all ages) 2 (2) Diarrhoea (under 2 years) 4 (5) Maternal Mortality. Deaths from puerperal sepsis — (i) Other puerperal causes 2 (1) Maternal mortality rate per 1,000 live births 1.03 (0.93) Maternal mortality rate per 1,000 total (live and still births) 1.01 (0.91) Per 1,000 population. Pe Per 1,000 Live Births. ;r 1,000 total births (live and still) Birth rate. Still Birth rate. Infantile I Death morrate. tality. Maternal mortality. Maternal mortality. Wembley 16.39 0.31 8.68 36.75 1.03 1.01 England and Wales 16.10 0.46 11.40 46.00 1.79 London 15.70 0.40 13.80 53.00 — — 126 County Boroughs, etc. 19.10 0.58 13.50 54.00 — — 148 Smaller towns, etc. 19.20 0.53 12.30 43.00 - - 13 Causes of Deaths during the Year. 1944. Total, Causes of Death. Male. Female. Total 1,077 All causes 533 491 1,024 — Typhoid and para-typhoid fevers — — — 2 Cerebro-spinal fever 1 — 1 — Scarlet fever — — — 2 Whooping cough — 2 2 1 Diphtheria — — — 52 Tuberculosis of respiratory system 24 18 42 13 Other forms of tuberculosis 2 2 4 9 Syphilitic diseases 6 3 9 5 Influenza 1 — 1 — Measles — — — — Ac: polio-myel: and polio-enceph: — — — 2 Acute infectious enceph: — — — — Cancer of buc: cav: and œsoph:(M) 14 — 14 20 „ uterus (F) — 10 10 29 Cancer of stomach and duodenum 18 13 31 24 Cancer of breast — 22 22 118 Cancer of all other sites 76 54 130 8 Diabetes 1 5 6 87 Intra-cranial vascular lesions 31 69 100 222 Heart disease 114 120 234 66 Other dis: of circ: system 26 33 59 45 Bronchitis 33 20 53 59 Pneumonia 23 20 43 16 Other respiratory diseases 10 6 16 14 Ulcer of stomach or duodenum 17 2 19 5 Diarrhoea under two years 2 2 4 3 Appendicitis 1 5 6 20 Other digestive diseases 20 5 25 20 Nephritis 12 9 21 1 Puerperal and post-abort: sepsis — — — 1 Other maternal causes — 2 2 15 Premature birth 13 9 22 30 Congenital malf: birth injury and infant diseases 11 13 24 12 Suicide 7 6 13 8 Road traffic accidents 9 2 11 87 Other violent causes 13 8 21 81 All other causes 48 31 79 14 The Principal Causes of Death. Disease. Total number of deaths. 1. Heart disease and other diseases of circulatory system 293 Intra-cranial vascular lesions 100 393 2. Cancer 207 3. Respiratory diseases:— (a) Bronchitis 53 (b) Pneumonia 43 (c) Other respiratory diseases 16 112 4 Digestive Diseases:— (a) Appendicitis 6 (b) Other digestive diseases 25 (c) Ulcer 19 50 5. Tuberculosis:— (a) Respiratory system 42 (b) Other forms 4 46 6. Premature births 22 Congenital malf: birth injury and infant diseases 24 46 7. Violent deaths:— (a) Suicide 13 (b) Road traffic 11 (c) Other violent causes 21 45 15  Percentage of total deaths under 1 year. Percentage of total deaths under 50 years. Percentage of deaths taking place in hospitals. 1941 6.45 30.14 43.00 1942 6.40 26.55 48.71 1943 7.61 25.59 52.17 1944 7.06 29.18 45.87 1945 6.44 22.26 45.50 SOME OTHER ESSENTIAL LOCAL STATISTICS. Birth Notifications. Notified by. At home. In Hospital. In Nursing Home. Totals. Doctors 65 820 272 1,157 Midwives 476 245 27 748 Parents 1 3 — 4 Totals 542 1,068 299 1,909 Percentages 28.4 56.0 15.6 100 Live births — 1,869. Still births — 40. .16 Infantile Mortality. Deaths from stated causes at various ages under one year. Cause of death (extracted from weekly returns of local Registrars, and from inward transfers of RegistrarGeneral). Under 1 week 1 — 2 weeks 2 — 3 weeks 3 — 4 weeks Total under one month 1 — 3 months 3 — 6 months 6 — 9 months 9 — 12 months Total deaths under 1 year Prematurity 20 1 — 1 22 2 — — — 24 Congenital defects* 5 1 3 1 10 1 1 — — 12 Pneumonia — 1 — 2 3 1 2 — 4 10 Gastro-enteritis — — — 3 3 2 1 1 — 7 Hæmorrhage of newly born 2 — — — 2 — — — — 2 Whooping cough — — — — — — 1 — 1 2 Atelectasis 2 — — — 2 — — — — 2 Erythroblastosis foetalis 2 — — — 2 — — — - 2 Suprarenal hæn: 1 — — — 1 — — — — 1 Staphylococcal abscess — — — — — 1 — — — 1 Septicaemia — — — — — 1 — — — 1 Tubercle of mesenteric glands - - - - - - - - 1 1 Asphyxia neonatorum 1 — — — 1 — — — — 1 Bronchitis — — — — — 1 — — — 1 Otitis media - - - - - - - 1 — 1 Violent death — — — — — 1 - — — 1 33 3 3 7 46 10 5 10 6 69 * Included in congenital defects are meningocele (1), spina bifida (1), congenital heart (4), idiocy (Mongolian) (1), imperforate anus and hypoplasis of kidney (1), anencephalitic malformation (1), imperforate anus (1), anuria and urethral obstruction from congenital valve (1), diaphragmatic hernia (1). 17 Infantile Mortality, 1941-1945. Year. Wembley. En; gland & Wales. 1941 42.32 59 1942 34.16 49 1943 37.17 49 1944 35.50 46 1945 36.75 46 Infantile mortality during last five years (9,445 live births, 354 deaths under one year): 37.48. Maternal Mortality. Rate per 1,000 total births (live and still), 1941-1945. Year. Wembley. England & Wales. 1941 4.30 2.23 1942 2.43 2.01 1943 2.35 2.29 1944 0.91 1.93 1945 1.08 1.79 Maternal mortality during last five years (9,705 total births— 21 maternal deaths): 2.16. (B) GENERAL HEALTH SERVICES. Ambulance Service. Accident removals 703 Sick removals 3,543 Maternity removals 366 Total 4,612 Domestic Help Scheme— Ministry of Health Circular No. 179/44. No. of families to whom service given. Assessment re recovery of cost. Full. 100% 75% 50% 25% Free. Period 19/2/45 - 31/12/45 92 80 — 2 4 4 2 Full time. Part-time. No. of domestic helps on Council's Panel on 31/12/45 2 1 18 Provision of Insulin. Number of persons who received free insulin in accordance with the Council's scheme;— 29. Total cost of insulin provided £122 4s. Od. Nursing in the Home— Wembley and Kingsbury District Nursing Associations. The Associations have supplied the following figures relating to their work during the year:— (C) MATERNITY AND CHILD WELFARE SERVICES. Health Clinics. (Some comparative 1944 figures within brackets.) Total number of children who first attended at the Clinics during the year, and who on the date of their first attendance were under one year of age 1,872 (1,894) 19 Total number of children who first attended at the Clinics during the year, and who on the date of their first attendance were between the ages of 1— 5 years 192 (104) Total number of children under five years of age who attended at the Clinics during the year, and who at the end of the year were: (1) Under one year of age 1,620 (2) Over one year of age 4,449 6,069 .(5,773) Number of attendances by children under one year of age 33,536(33,226) Number of attendances at all the Health Clinics by children between the ages of 1—5 years 12,344(14,437) The percentage of notified live births represented by the number of children who first attended at the Clinics during the year and who on the first attendance were under one year of age in 1945 86.8 (95.9) (This number is exclusive of those children who are known previously to have attended a centre in another district prior to coming to reside in Wembley.) Number of attendances at the ante-natal Clinics 9,784(10,488) Total number of women who attended for the first time 1,513 (1,562) Percentage of total notified births (live and still) represented by the total number of women who attended the Clinics for the first time during the year 79.3 (77.4) 20 Attendances at the various Health Clinics. Children under one year of age. Clinic. Total Average attendances. per attendance session. Stag Lane 8,813 64 Slough Lane 6,702 68 College Road 5,572 38 Ealing Road 3,581 31 Perrin Road 5,276 35 Monks Park 4,436 45 One Tree Hill 4,728 48 Children between the ages 1— 5 years. Clinic. Total Average attendances. per s attendance session. Stag Lane 1,968 14 Slough Lane 2,453 25 College Road — — Ealing Road 1,703 17 Perrin Road 2,446 16 Monks Park 2,127 21 One Tree Hill 1,647 17 Domiciliary Nursing. Children referred for treatment to the Wembley and Kingsbury District Nursing Associations. Children under one year 5 Children over one year 19 Treatments given— Seven or fewer attendances 21 Over seven attendances 3 Specialist Clinic Services. Eye Clinics (Wembley Hill and Stag Lane (County) Clinics). 51 children referred. Orthopaedic Clinic (Stag Lane (County) Clinic). 121 children referred. 12 appliances supplied. 21 Clinic at Metropolitan Ear, Nose and Throat Hospital for Children showing Deafness, Defective Speech and Allergic Asthma Conditions. Number of cases referred 3. Child Guidance Clinic. 6 cases referred to Middlesex County Council Clinic, Harrow. Dental Clinic. See page 28. Artificial Sunlight and Massage Treatment. Number referred by Medical Officers: 107 (under one year, 16; over one year, 91). Reasons for treatment:— Rickets 18 Debility, anaemia, etc. 41 Delayed dentition 6 Recurrent colds 22 Chronic bronchitis 3 Bowed legs 14 Knock knees 3 Total 107 Ante-Natal Clinics. The months of pregnancy at which women attended for the first time:— 1st 2nd 3rd 4th 5 th 6th 7 th 8th 9th 12 369 618 283 146 74 33 15 3 Attendances of Expectant Mothers:— Clinic. Total attendances Average attendance per session. Stag Lane 2,531 18 Slough Lane 1,001 20 College Road 853 18 Ealing Road 772 16 Perrin Road 1,494 15 Monks Park 1,399 14 One Tree Hill 1,783 18 22 Special Blood Tests at Redhill Hospital. 369 examinations. X-Ray Ante-Natal Examinations. Number of women referred: 64. Supply of Sheets for Expectant Mothers: Ministry of Health Circular No. 154/44. Number of dockets issued: 729. Hospital Confinements. 773 women referred to various hospitals:— (i) Medical reasons for reference to hospital:— (a) Regarding current pregnancy— Abnormality of maternal pelvis 51 Elderly primipara 60 Maternal ill-health 19 Cardiac abnormality 11 Toxaemia 3 Tuberculosis 3 Threatened miscarriage 10 Miscellaneous 10 167 (b) Regarding previous pregnancies— Abnormal obstetric history 98 Abnormal medical history 15 113 280 (ii) Home conditions unsuitable 376 (iii) Mothers desired hospital accommodation 117 Total 773 Wembley births taking place in hospital, (a) Middlesex County Council Hospitals:— Redhill 352 Central Middlesex 264 Maternity Hospital, Bushey 177 West Middlesex 4 Chiswick Hospital (Annexe of West Middlesex) 1 798 23 (b) London Hospitals:— Queen Mary's 75 Queen Charlotte's 59 St. Mary's 40 City of London 18 University College 12 Middlesex Hospital 11 Charing Cross 8 Elizabeth Garrett Anderson 8 Royal Northern 5 Westminster Hospital 5 Paddington 3 Royal Free 3 Mothers' 2 London Hospital 1 St. Bartholomew's 1 St. James' 1 252 (c) Other Hospitals:— Bearstead Memorial 6 Wembley 4 Willesden Maternity 2 One at each of the following hospitals:— Sussex Maternity, Oxford Maternity, Shrodells, North Herts, and South Beds., Cambridge Emergency,*Kingston County 6 18 Total 1,068 24 Five-Year Review. Year. Total No. of births notified. No. of births at home. No. of births in hospital No. of births in M.C.C. hosPitals (inc. preceding column) Births in private nursing homes and at private addresses outside Wembley 1941 1,539 529 781 608 229 34.4% 50.7% 39.5% 14.9% 1942 1,942 612 1,051 795 279 31.5% 54.1% 40.9% 14.3% 1943 2,037 657 1,034 740 346 32.2% 50.8% 36.3% 17.0% 1944 2,018 601 1,080 816 337 29.8% 53.5% 40.4% 16.7% 1945 1,909 542 1,068 798 299 28.4% 55.9% 41.8% 15.7% Puerperal Pyrexia. Number of notifications received: 25 (excluding 11 Willesden Maternity Hospital cases— Willesden residents). Number of women removed to hospital: 6. Obstetric Consultant Service. Consultant called in by private medical practitioners: 8. Stillbirths. 37 cases of stillbirths allotted to Wembley by RegistrarGeneral. Detailed investigation made in 34 cases. Multipara 12 Primipara ,22 34 Ante-natal supervision given by— Hospital and/or Clinic 26 Private medical attendant 7 Information incomplete 1 34 25 Attendant circumstances — Instrumental delivery 4 Long labour 5 Prematurity 5 Breech delivery 4 Twin pregnancy 1 Ante-partum hæmorrhage 3 Foetal abnormality incompatible with separate existence 4 No abnormal cause or circumstance elicited 8 34 Post-Natal Clinics. Clinic. First attendances. Re- attendances. Aver. att'dancc per session. Stag Lane 94 27 6 Perrin Road 54 39 4 One Tree Hill 65 19 4 Totals 213 85 — Test feeding scales issued on loan to 217 mothers. Special Milk Grants. Liquid milk: Nil supplied. Grants of dried milk and other accessory foods amounting to £24 Is. 9½. made during the year. Maternity Outfits. Number of maternity outfits supplied: 501. 26 Gynaecology Clinics. Clinic. at First tendances. Reattendances Aver. att' dance ;. per session. Stag Lane 37 24 3 Perrin Road 20 5 2 One Tree Hill 30 18 3 Totals 87 —t— 47 — Birth Control Sessions. Clinic. First attendances. Reattendances Aver, att' dance per session. Stag Lane 78 128 19 Perrin Road 71 104 14 Totals 149 i 232 — Home Helps. Number of Families Attended. By full-time personnel. By personnel on approved panel. Economic circumstances scale of families. Fulltime. Parttime. Fulltime. Parttime. Free 25% 50% 75% 100% Full cost , (£3 per week). of £2 per week. 49 1 51 1 13 31 21 13 9 15 50 52 102 Domiciliary Nursing. Mothers referred for treatment to the Wembley and Kingsbury District Nursing Association: 4. 27 Dental Services— Women and Children. Expectant mothers. Nursing mothers, Children under 5 years. Numbers referred for treatment 386 61 317 Numbers who received treatment 235 45 209 Numbers made dentally fit 207 30 195 Numbers of treatments:— (a) Fillings:— (i) in temporary teeth — — 446 (ii) in permanent teeth 866 90 — (b) Number of teeth extracted 675 130 218 (c) Number of administrations of general anaesthesia (nitrous oxide) 145 31 91 (d) Number of persons supplied with dentures 42 11 - (e) Number of dentures supplied 74 20 - Total attendances at Dental Clinics last five yearsr— Children. Mothers. 1941 972 1,709 1942 869 1,870 1943 643 1,303 1944 451 882 1945 621 1,547 Domiciliary Visits by Health Visitors. Home Visits. (a) To children under one year 1,938 First visits 5,667 Revisits (lb) To children between the ages of 1—5 Total visits years 8,606 (c) To expectant mothers 1,094 First visits 1,708 Revisits (d) To nursing mothers 842 First visits 533 Revisits (e) Other special visits 2,678 28 Analysis of special visits included in (e) above:— Diphtheria immunisation 19 Infectious diseases:— Measles 949 Whooping cough 213 Mumps 1 Tuberculosis 16 Ophthalmia neonatorum (35) others (14) 49 Puerperal pyrexia 11 Dysentery 2 Epidemic diarrhœa 3 Scabies 264 Re Day Nursery children 648 Home Help supervision 123 Daily minders 2 lie stillbirths 33 lie verminous conditions 50 Impetigo, etc. 23 Be adoption of children 21 Evacuation 53 Defaulting re treatment advised 67 General'—e.g., infantile deaths, premature babies, home conditions, negligent care 131 Child Life Protection. Visits by Health Visitors:— To foster children 392 To foster parents 327 At the end of the year on register:— Foster children 27 Foster parents 23 Adoption of Children (Regulation) Act, 1939. Number of notifications received under Section 7 (3) 15 Number of visits to children proposed for adoption 352 Number of children received for proposed adoption 10 29 DAY NURSERIES. The daily cost (pence) per child-in-attendance of all foods (as purchased uncooked) provided at the nurseries (all food provided for staff reckoned as part of cost of feeding the children):— Period 22nd September— 21st December. Ealing Road Nursery 13.45d. Neeld Crescent Nursery 12.28d. Princes Avenue Nursery 10.03d. Carlyon Road Nursery ll.lOd. Old Kenton Lane Nursery 12.45d. Harrowdene Road Nursery 13.42d. Woodstock Road Nursery 11.45d. District Road Nursery 13.59d. Infectious Diseases— Day Nurseries, 1045. Disease. January February March April May June July August September October November December Total. (a) Children:— Scarlet fever — 2 1 1 — 2 — — 1 1 — 2 10 Dysentery— B.Sonne — 1 1 1 — — — — — — — 3 B.Morgan No. 1 - - 1 - 1 - 1 - - 2 - - 5 Chicken-pox — 2 - 1 1 — — 1 2 — 6 1 14 Mumps — 4 1 2 1 5 1 - - - - - 14 German measles — — - 1 1 1 - - - - - - 3 Measles 11 22 45 10 7 1 — 1 2 — — — 99 Whooping cough — — — — 2 — 1 1 1 6 2 1 14 Infective hepatitis (jaundice) - - - - - - - - - - - - Nil (b) Staff:— German measles — 1 - - - - - - - - - - 1 Infective hepatitis (jaundice) - - - - - - - - - - - - 5 30 (D) SCHOOL HEALTH SERVICES. ELEMENTARY SCHOOLS. Return of Medical Inspections during the Year. (a) Routine Medical Inspections. Number of code inspections:— Entrants 1,270 Age 7 172 Age 10 135 Leavers 545 Total 2,122 Number of other routine inspections 318 Grand Total 2,440 (b) Other Inspections. Number of special inspections 975 Number of re-inspections 481 Total 1,456 (c) Pupils found to Require Treatment. Number of individual pupils found at routine medical inspection to require treatment (excluding uncleanliness and dental diseases). r defective Vision. Excluding squint). For all other conditions recorded in next Table. Total. Prescribed groups:— Entrants 6 103 109 Age 7 8 21 29 Age 10 7 15 22 Leavers 32 19 51 Total 53 158 211 Other routine inspections 21 22 43 Grand Total 74 180 254 Note,—(Pupils requiring treatment for defective vision and for other conditions appear once only in the column headed "Total." 31 Return of Defects found by Medical Inspection in the Year. Defect or Disease. Routine Inspections. Special Inspections. No. of Defects. No. of Defects. Requiring treatment. Requiring to be kept under observation, but not requiring treatment. Requiring treatment. Requiring to be kept under observation, but not requiring treatment. (1) (2) (3) (4) (5) Skin:— Ringworm:— Scalp — — 2 — Body — — 4 — Scabies 5 — 28 1 Impetigo — — 46 1 Other Diseases (non-tuberculous) 2 9 216 3 Eye:— Blepharitis 3 2 9 — Conjunctivitis — — 16 — Keratitis — — — — Corneal opacities — — — — Defective vision (excluding squint) 74 20 79 3 Squint 3 6 4 1 Other conditions 1 1 24 1 Ear:— Defective hearing 2 — — 1 Otitis media 3 2 5 — Other ear diseases 4 10 36 8 Nose and Throat:— Chronic tonsillitis only 6 25 41 3 Adenoids only — 4 7 — Chronic tonsillitis and. adenoids 23 27 15 5 Other conditions 19 26 43 11 Enlarged cervical glands (non-tuberculous) — 4 6 — Defective speech 4 4 — 3 32 Return of Dcfccts found by Medical Inspection during the Year—Contd. Defect or Disease. Routine Inspections. Special Inspections. No. of Defects. No. of Defects. Requiring treatment. Requiring to be kept under observation, but not requiring treatment. Requiring treatment. Requiring to be kept under observation, but not requiring treatment. (1) (2) (3) (4) (5) Heart and circulation:— Heart disease:— Organic - 1 — 5 Functional - 5 - 4 Anaemia 2 5 5 5 Lungs:— Bronchitis 5 14 21 4 Other non-tuberculous diseases 4 12 11 2 Tuberculosis:— Pulmonary:— Definite 1 - 1 - .Suspected — 1 1 2 Non-pulmonarv:— Glands - 1 2 - Bones and joints - — — - Skin - — — - Other forms - — — — Nervous system:— Epilepsy - — 4 3 Chorea 1 — — ____ Other conditions 10 14 14 7 Deformities:— Rickets - - - - Spinal curvature - - — - Other forms 70 34 51 24 Other defects and diseases 12 28 51 80 Totals 254 255 742 177 33 Classification of the Nutrition of Pupils Inspected during the Year in the Routine Age Groups. Age-groups. dumber o: Pupils [nspected £ A. (Excellent). B. (Normal). I C. (Slightly subnormal). D. (Bad). No. % No. % No. % No % Entrants 1,270 319 25.12 861 67.79 90 7.09 —. — Age 7 172 12 6.98 151 87.79 9 5.23 — — Age 10 135 24 17.78 108 80.00 3 2.22 — — Leavers 545 100 18.36 413 75.78 32 5.86 — — Other routine inspections 318 69 21.70 227 71.38 22 6.92 — — Totals 2,440 524 21.47 1,760 72.14 156 6.39 — — Return of Defects Treated during the Year. (a) Minor Ailments (excluding Uncleanliness). Number of Defects treated or under Disease or Defect. treatment during the year. Skin:— Ringworm:'— Scalp:— (i) X-Ray treatment — (ii) Other 2 Body 4 Scabies 30 Impetigo 67 Other skin disease 202 Minor eye defects (External and other, but excluding cases falling in Group II.) 41 Minor ear defects 39 Miscellaneous (e.g., Minor injuries, bruises, sores, chilblains, etc.) 75 Totals 460 34 (b) Defective Vision and Squint (excluding minor eye defects treated as minor ailments). Number of Defects Defect or Disease. dealt with under the Authority's Scheme. Errors of refraction (including squint) 478 Other defect or disease of the eyes (excluding those recorded in Group I.) 34 Total 512 No. of pupils for whom spectacles were:— (a) Prescribed 390 (b) Obtained 352 (c) Treatment of Defects of Nose and Throat. Number of Defects. Received operative treatment under the Authority's scheme in hospital 18 Other forms of treatment 89 Total 107 (d) Orthopaedic and Postural Defects. Number of Pupils Treated. Non-residential treatment at orthopaedic clinics. Under the Authority's scheme 50 Dental Inspection and Treatment. 1) Number of pupils who were inspected by the dental surgeons:— (a) Routine age groups:— 5 417 6 648 7 585 8 684 9 665 10 635 11 668 12 459 13 167 14 380 15 36 Total 5,344 (b) Specials 1,083 (c) Grand Total 6,427 35 (2) Found to require treatment 5,004 (3) Actually treated 3,329 (4) Attendances made by pupils for treatment 9,530 *(5) Half-days devoted to:— Inspection 53 Treatment 1,239 Other work 3 Total 1,295 (6) Fillings:— Permanent teeth 5,384 Temporary teeth 2,055 Total 7,439 (7) Extractions:— Permanent teeth 730 Temporary teeth 4,303 Total 5,033 (8) Administrations of general anaesthetics for extractions 1,391 (9) Other operations:— Permanent teeth 2,241 Temporary teeth 1,448 Total 3,689 * Including Secondary Schools. Uncleanliness and Verminous Conditions. (i) Average number of visits per school made during the year by the school nurses and all other authorised persons 9.8 (ii) Total number of examinations of pupils in the schools by school nurses and all other authorised persons 18,723 (iii) Number of individual pupils found unclean 426 36 SECONDARY SCHOOLS. Return of Defects found by Medical Inspection during the Year. Defect or Disease. Routine Inspections. Special Inspections. No. of Defects. No. of Defects. Requiring treatment. Requiring to be kept under observation, but not requiring treatment. Requiring treatment. Requiring to be kept under observation, but not requiring treatment. (1) (2) (3) (4) (5) Skin:— Ringworm— Scalp - - - - Body- - - - - Scabies - - 1 - Impetigo - - - - Other diseases (non-tuberculous) - - 5 - Eye:-— Blepharitis - - — - Conjunctivitis - —— — - Keratitis - - — - Corneal opacities - - — - Defective vision (excluding squint) - 7 - Squint - - 1 - Other conditions - - - - Ear:- Defective hearing - - 1 - Otitis media - - - - Other ear diseases - - 1 - Nose and Throat:— Chronic tonsillitis only - - — 2 Adenoids only - - — — Chronic tonsillitis and adenoids - - - - Other conditions - - 1 2 Enlarged cervical glands (non-tuberculous) - - — — Defective speech - - — — 37 Return of Defects found by Medical Inspection during the Year—Contd. Defect or Disease. Routine Inspections. Special Inspections. No. of Defects. No. of Defects. Requiring treatment. Requiring to be kept under observation, but not requiring treatment. Requiring treatment. Requiring to be kept under observation, but not requiring treatment. (1) (2) (3) (4) (5) Heart and circulation:— Heart disease:— Organic - - - - Functional - - - - Anaemia - - - - Lungs:— Bronchitis - - - - Other non-tuberculous diseases -— • - - Tuberculosis:— Pulmonary:— Definite - - - - Suspected -— - - - Non-pulmonary:— Glands -— - - - Bones and joints — - - - Skin —- - - — Other forms -— - - -" ' Nervous system:— Epilepsy -— • - — Chorea - - - - Other conditions -— - - -' Deformities:— Rickets — - - - Spinal curvature — - - - Other forms - - 1 Other defects and diseases - - 1 1 Totals -— - 18 6 38 Return of Defects Treated during the year. (a) Minor Ailments (excluding Uncleanliness). Number of Defects treated, or under Disease or Defect. treatment during the year. Minor eye defects (External and other, but excluding cases in next Table) 1 (b) Defective Vision and Squint (excluding Minor Eye Defects treated as Minor Ailments). Number of Defects Defect or Disease. dealt with. Errors of refraction (including squint) 11 Other defect or disease of the eyes 1 Totals 12 No. of pupils for whom spectacles were:— (a) Prescribed 19 (b) Obtained 19 Dental Inspection and Treatment. (1) Number of pupils who were inspected by dental surgeons:— (a) Routine age groups:— 9 -— 10 1 11 56 12 43 13 --—- 14 3 15 4 16 11 17 -— 18 •-— 19 — Total 118 (b) Specials 127 (c) Grand Totals 245 39 (2) Found, to require treatment 219 (3) Actually treated 158 (4) Attendances made by pupils for treatment 789 (5) Fillings:— Permanent teeth 614 Temporary teeth -— Totals 614 (6) Extractions:— Permanent teeth 95 Temporary teeth 20 Totals 115 (7) Administrations of general anaesthetics for extractions 30 (8) Other operations:— Permanent teeth 371 Temporary teeth 5 Totals 376 40 41 (E) INFECTIOUS DISEASES. Cases of infectious diseases notified in Wards and removals to Hospitals. Disease. Total Alperton Central Chalkhill Fryent The Hyde Roe Green Kenton Preston Sudbury Court Sudbury Wembley Park Tokyngton Total removed to hospital Percentage of cases removed to hospital Scarlet fever 180 27 6 10 14 13 28 19 11 3 21 7 21 106 58.89 Diphtheria 4 1 1 — — — — 1 — — — — 1 3 75.00 Pneumonia 134 12 12 10 16 14 17 6 8 8 7 6 18 36 26.82 Erysipelas 29 2 2 1 2 8 4 1 — 4 2 2 1 7 24.14 Ophthalmia neonatorum 5 1 1 - - - - - - 2 1 — — 2 40.00 Cerebro-spinal fever 2 1 - - - - - - - - - 1 — 2 100.00 Dysentery 68 12 3 1 5 2 7 3 8 4 6 5 12 13 19.12 Measles 1,495 235 123 89 101 250 136 90 93 44 97 89 148 38 2.54 Whooping cough 218 15 6 7 14 47 9 7 16 31 20 6 40 9 4.13 Acute poliomyelitis 6 — — 1 — — 1 — — 1 3 — — 6 100.00 Malaria 1 — — — — 1 — - — — — — — — — 42 * Notifications of infectious Diseases according to sex and age. Age group. Scarlet fever. Whooping cough. Diphtheria. Measles. Acute poliomyelitis. Dysentery. Acute pneumonia. Erysipelas. Cerebrospinal fever. Paratyphoid fever. M F M F M F M F M F M F M F M F M • F M F 0 — — 2 13 — — 32 24 — - 0 9 6 17 8 1 — — 1 — — 1 7 6 41 37 — — 192 176 — 1 5 10 10 14 8 1 - - - - - 3 20 22 22 27 — — 191 176 — 1 15 14 14 21 13 4 5 — 1 — — 5 42 46 31 . 40 2 1 317 314 — 1 45 1 3 28 12 5 9 — — — — 10 8 3 1 2 — — 18 11 1 1 65 and over 1 — 6 6 3 1 — — — — 15 4 11 — — — — 10 26 1 — Unstated — — 1 — — — — — — — 25 and over 3 8 — 2 1 — 4 4 — — All ages ... 84 96 97 121 3 1 764 731 2 4 All ages 35 33 87 47 14 15 — 2 — — Consultations regarding infectious disease, between the Medical Officer of Health and the local Medical Profession: 4. 1 case of suspicion of scarlet fever; diagnosis confirmed. 1 case of suspicion of chicken-pox; diagnosis urticaria papulosa. 1 case of unusual rash—food idiosyncrasy. 1 case of food poisoning (typhi-murium infection). Removal of Infectious Diseases. Ambulance stationed at Acton and Wembley Joint Isolation Hospital. Removals carried out:- Quarters ending 31/3/45. 30/6/45. 30/9/45. 31/12/45. 72 67 60 76 Total — 275 Winter Respiratory Diseases (October—March). Notifications of primary pneumonia and acute influenzal-pneumonia. Death certificates in which respiratory diseases mentioned. 1941-42 101 135 1942-43 92 105 1943-44 151 170 1944-45 93 92 1945-46 93 70 43 Dysentery. Bacteriological examinations made:— 1945 + Sonne + Morgan No.1 + Morgan No. 2 + Typhimurium Others Negative Urine January 4 — — — — 10 — February 16 1 1 — — 17 — March 7 5 — — — 25 — April 10 2 — - — 16 1 May 20 4 — — — 41 — June 4 5 — 1 — 29 1 July 11 6 — — 2 11 5 August 7 1 — — — 13 4 September — 2 — — — - 16 11 October — 2 — — — 9 10 November - - - - - 13 7 December — 2 — 1 — 15 3 79 30 1 2 2 215 42 Non - notifiable Infectious Diseases in School Children. Information obtained from the head teachers:— Disease. January February March April May June July August September October November December Total. Chicken-pox 1 2 1 5 14 29 42 — 5 22 15 6 142 Mumps 50 66 28 12 2 18 4 — 2 4 — 1 187 German measles — — — — 1 1 — — 2 — 2 — 6 Infective jaundice - - - - - - - - - 1 1 — 2 44 Diphtheria Immunisation. Numbers treated (five years period):— Year. 0—5 5—10 10—15 Over 15 Totals. 1941 2,454 2,102 998 32 5,586 1942 987 489 272 10 1,758 1943 1,722 431 254 4 2,411 1944 1,314 61 29 Nil 1,404 1945 1,839 69 17 2 1,927 The percentage of the child population considered immunised on the 31st December:— Children under 5 years 62.71% Children between 5 and 15 years 55.505% Vaccination against Small-pox. Dr. Dyson, Public Vaccinator, continued to attend the Clinics to vaccinate infants.Number of infants vaccinated at Health Clinics: 393. Tuberculosis. No. of Notifications. Pulmonary. Non-pulmonary. Male. Female. Male. Female. Under one year — — — '— 1 to 4 years 4 1 3 2 5 to 14 years 5 — 2 — 15 to 24 years 20 33 4 1 25 to 34 years 22 14 4 2 35 to 44 years 21 11 — 1 45 to 54 years 8 6 3 — 55 to 64 years 3 4 — — 65 and over 4 — 2 1 Totals 87 69 18 7 45 No. admitted to hospitals No. discharged from hospitals or Sanatoria: or Sanatoria: 79 91 During the year 188 cases removed from register. At 31st December 781 names remained on register—689 pulmonary and 92 non-pulmonary. Of 49 deaths from tuberculosis, one not notified during life (2.04%). Bacteriological Service (at Middlesex Hospital). Examinations made. Quarter ending Total for 12 months. 31/3/45. 30/6/45. 30/9/45. 31/12/45. Throat swabs— Diphtheria 56 (of which 4 were positive) 63 77 (of which 3 were positive) 51 247 (of which 7—2.83% were positive) Hemolytic streptococci 52 (of which 21 were positive) 59 (of which 36 were positive) 59 (of which 29 were positive) 41 (of which 27 were positive) 211 (of which 113— 53.55% were Vincents angina 13 (of which 5 were positive) 18 (of which 2 were positive) 20 (of which 4 were positive) 29 (of which 5 were positive) positive) 80 (of which 16 were positive) 46  No. of Deaths. Pulmonary. Non-pulmonary. Male. Female. Male. Female. Under one year — — — - 1 to 4 years 1 — — — 5 to 14 years — — — — 15 to 24 years 5 7 — 1 25 to 34 years 4 3 — — 35 to 44 years 6 7 — — 45 to 54 years 7 1 — — 55 to 64 years — 2 — — 65 and over 4 — — 1 Total 27 20 — 2 Examinations made Quarter ending Total for 12 months 31/3/45. 30/6/45. 30/9/45. 31/12/45. Other swabs 12 16 6 1 35 Nasal swabs — Diphtheria 3 3 9 5 20 Hemolytic streptococci - 3 (of which 1 was positive) 3 5 11 (of which 1—9.09% was positive) Sputum (tubercle bacilli) 21 (of which 1 was positive) 20 (of which 1 was positive) 15 (of which 1 was positive) 35 (of which 5 were positive) 91 (of which 8—8.79% were positive) Fasces and urine 86 134 89 62 371 Blood — 6 4 2 12 Films and swabs for special bacteria - - - 1 1 Other specimens Nil 3 6 1 10 Jaundice (infective hepatitis). Reported Cases in Monthly Periods. January 1 July 1 February 2 August 3 March 2 September 2 April — October 1 May 1 November — June 1 December — Total — 14 Age Incidence. 0— 5 years — 5—10 years 3 10—15 years 5 Over 15 years 5 Age unknown 1 47 Scabies. Treatment sessions at Wembley Hospital. No. of Cases Reported. January 92 July 32 February 68 August 55 March 70 September 124 April 64 October 132 May 51 November 112 June 42 December 72 Total — 914 Numbers affected in Individual Families. 1 person in 178 families. 5 persons in 20 families. 2 persons in 105 families. 6 persons in 7 families. 3 persons in 67 families. 7 persons in 1 family 4 persons in 40 families. 8 persons in 2 families. 61 recurrent cases—1 in 7 families, 2 in 7 families, 3 in 5 families, 4 in 5 families, and 5 in 1 family. (F) ENVIRONMENTAL HYGIENE, HOUSING, FACTORIES, FOOD (INCLUDING MILK) AND WATER. Number of complaints received and investigated 2,202 Visits made by Sanitary Inspectors 25,589 (a)| Dwelling Houses:— Visits under Public Health Acts 6,361 Visits under Housing Acts 8 Visits re overcrowding 220 Visits to bug infested premises 115 Visits re other vermin (excluding rats and mice, see below) 105 Visits re cases of infectious disease 1.985 Visits to cases of food poisoning 3 (b) General Environmental Public Healths:— Drains and sewers inspected 2,862 Drain and Sewer Test applied 91 Cesspools, etc14 Chemical closets35 Urinals and latrines 371 Stables, manure pits, etc 109 Piggeries (number on register at end of year 24) 156 Ditches and streams 236 Open spaces, etc. 127 Yards 2,658 48 Public conveniences 61 Tents, vans and sheds 5 Factories—Mechanical 1,013 Non-mechanical 73 Workplaces 378 Outworkers 110 Smoke observations—half hourly 17 „ „ casual 411 „ „ visits ,to plant 10 Cinemas, Dance Halls, etc 77 Hairdressers (number of establishments on register 81) 130 Schools (number of private schools 18) 35 Markets 48 Rats and mice 2,085 Swimming baths—visits 31 „ „ chlorine tests 28 Civil Defence premises 352 A.R.P. Shelters 85 War damage 394 Static water supplies 86 (c) Food, including milk, meat, watery— Number of dairies registered at end of year 28 Number of purveyors of milk registered, with premises in the Borough selling milk in properly closed and unopened receptacles 48 Number of purveyors of milk registered whose premises are outside the Borough 24 Number of dairies (included above) where milk bottled, etc 5 Inspection visits made to:— Meat shops, stalls, etc. (number on register 78) 431 Slaughterhouses 1 Cowsheds 13 Dairies and milk shops—visits 403 „ „ „ „ milk samples taken 102 Fried fish shops (number on register 14) 100 Bakehouses (number on register 23) 204 Ice cream premises 195 Fishmongers and poulterers 230 Greengrocers and fruiterers (number on register 87) 495 Grocers (number on register 189) 1,036 49 Restaurants, cafes, etc. (number on register 105) 439 Street vendors, hawkers, etc.2 Other food premises91 Water supply—visits 224 „ „ samples taken 60 (d) Other visits and inspections:— Massage establishments, etc.54 Certificates lodged by Members of the Chartered Society of Physiotherapists 4 New Licences granted 3 Licences renewed 15 Noise nuisances 69 Dust nuisances 8 Effluvia nuisances 9 Petroleum stores 268 Miscellaneous 270 Number of verbal notices served 295 Number of verbal notices complied with 240 Number of written notices served 453 Number of written notices complied with 404 Number of statutory notices served 66 Number of statutory notices complied with 43 Includes a number of notices served in 1944 and completed in 1945. Nuisances abated and improvements effected:— (a) Dwelling Houses:— Roofs repaired 76 External walls and chimney stacks repaired 21 Gutters and spouts repaired or renewed25 Damp-proof courses provided 7 Dampness remedied 94 Yards paved or repaired 8 Internal walls and ceilings repaired 46 Doors repaired or renewed 15 Windows repaired or renewed 76 Floors repaired or renewed 30 Sub floor vent, provided or improved 11 Rooms cleansed or redecorated 65 Passages and staircases redecorated 7 Staircases repaired 3 Fireplaces and flues repaired or renewed 13 50 Cooking stoves repaired or renewed 6 Wash coppers repaired or renewed 1 Sinks and washbasins provided or renewed 13 Waste pipes repaired or renewed 45 Dustbins provided or renewed 142 Water supply improved or reinstated 157 W.C. walls, etc., cleansed 5 W.C. pans cleansed 14 W.C. pans repaired or renewed 39 W.C. cisterns repaired or renewed 42 W.C. structure repaired or renewed 1 W.C. lighting and vent, improved 1 W.C. flush pipe joints repaired 11 (b) General Environmental Public Health:— Drains cleansed from obstruction 874 Drains repaired or renewed 60 New drains provided 12 New inspection chambers provided 7 Inspection chambers repaired 49 Soil pipes and vent. shafts repaired 10 W.C's.repaired 11 W.C's. cleansed 7 Cesspools emptied 1 Urinals and latrines cleansed or emptied 6 Stables, manure pits, cleansed 14 „ „ „ repaired or renewed 1 Piggeries cleansed or limewashed 4 Pigsties repaired 2 Animals nuisances abated 3 Offensive accumulations removed 42 Ditches and streams cleansed 10 „ „ „ pollution remedied 2 Yards cleansed or repaired 32 Tents, vans and sheds—nuisances abated 1 Smoke nuisances abated 3 Cinemas, Dance Halls, etc.—contraventions remedied 4 Hairdressers—contraventions remedied 12 Markets—contraventions remedied 2 Schools—sanitary conditions improved 2 „ urinals and W.C's. cleansed or repaired 5 Noise nuisances abated 1 Effluvia nuisances abated 2 Water tanks, etc., emptied or cleansed 10 51 (c) Disinfestation:— Bugs—method applied:— Cyanide gas—Council houses — Other premises 3 Sulpher— Council houses — Other premises 1 Sprays, etc.— Council houses 2 Other premises 37 Other vermin eradicated 29 Verminous articles destroyed 10 (d) Meat and other Food Premises:— Meat shops, stalls, etc.—premises cleansed 15 „ „ „ „ other contraventions remedied 11 Dairies—cleansed and limewashed 9 „ premises repaired 5 „ other contraventions remedied 3 Bakehouses cleansed and limewashed 20 Ice cream premises cleansed and limewashed 2 „ „ „ sanitary conditions improved 4 Fried fish shops cleansed and limewashed 11 „ „ „ sanitary conditions improved 1 „ „ „ other contraventions remedied 4 Fishmongers, etc., contraventions remedied 12 Grocers, etc., contraventions remedied 45 Greengrocers, etc., contraventions remedied 23 Restaurants, cafes, etc., contraventions remedied 16 Other food premises, contraventions remedied 2 2,428 Inspection of dwelling-houses during the year:— (a) (i) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 3,069 (ii) Number of inspections made for the purpose 6,369 (b) Number of dwelling-houses found not to be in all respects reasonably fit for human habitation 1,586 52 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 1,509 Action under statutory powers during the year:— (a) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (i) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (ii) Number of dwelling-houses which were rendered fit after service of formal notices:— Nil (1) by owners (2) by Local Authority in default of i owners (b) Proceedings under Public Health Acts:— (i) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 59 (ii) Number of dwelling-houses in which defects were remedied after service of formal notices v— (1) by owners 19 (2) by Local Authority in default of owners 22 Includes compliance in 1945 with 6 notices served in 1944. overcrowding. (a) Number of dwellings recorded as overcrowded at the end of the year 197 Number of families dwelling therein 215 Number of persons dwelling therein 1,045 (b) Number of new cases of overcrowding reported during the year 78 (c) (i) Number of cases of overcrowding relieved during the year Total 10 (1) by removal of families to other known addresses (not overcrowded) 9 (2) by removal to unknown addresses 1 (3) by removal to County Council houses (included also in (1) 1 53 (4) by removal to requisitioned premises (included also in (1) ) 7 (5) by removal of sub-tenants 1 (ii) Number of persons concerned in such cases 66 (d) Particulars of any cases in which dwellinghouses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil Factories. Number of factory premises — 451. Premises. Number of:— Inspections. Written Notices. Occupiers Prosecuted. Factories with mech. power 1,217 9 — Factories without mech. power 73 — - Other premises — — — Total 1,290 9 — Includes 204 inspections of bakehouses with mech. power. Defects found. Particulars. No. of defects:— Found. Remedied. Referred 1. to H.M. Inspector. Prosecution. Want of cleanliness — 1 — — Overcrowding — — 1 — Unreasonable temperature — — — — Inadequate ventilation — —■ 1 — Ineffective drainage of floors.. — — 1 — Sanitary Convenience:— Insufficient 1 2 — — Unsuitable or defective 18 221 — — Not separate for the sexes 1 1 — — Other offences 18 19 1 - Total 38 45 4 - Includes compliance in 1945 with 1 Notice served in 1944. Includes compliance in 1945 with 12 Notices served in 1944. 54 Outworkers. Number on register 31/12/1945 161 Number of visits during year 110 Disinfection of Premises and Articles. Disinfections for:— Infectious diseases 311 Cancer 18 Vermin (routine protection from) 24 Miscellaneous 100 Articles disinfected or destroyed :— Disinfected. Destroyed. Bedding and bedclothing 2,193 23 Wearing apparel 18 — Carpets, rugs, cushions 87 2 Others 21 — Towels and Gowns from Wembley Hospital re Scabies Scheme 50 lots Rats and Mice (Destruction) Act, 1919 (1st February, 1945—29th January, 1946). (1) Number of premises visited 1,000 (2) Number of visits made iby Sanitary Inspectors 321 (3) Number of visits made by Rodent Control Assistants 4,903 (4) Number of premises found to be infested 548 (5) Number of premises which have received treatment by Rodent Control Assistants 238 (6) Number of premises which have received treatment privately 196 55 Offices. Number on the register — 279. Defects. Found. Remedied. Want of cleanliness — — Want of ventilation — — Overcrowding — — Sanitary accommodation:— Insufficient, unsuitable or defective 1 1 Not separate sexes 1 1 Obnoxious effluvia — — Other nuisances 4 2 Total 6 4 (7) Number of Council - owned or occupied premises included in (5) 43 Estimated number of rats and mice killed during the year 1945 (excluding sewer compaign) 5,037 Estimated number killed in special sewer campaign 5,074 Milk (Special Designations) Orders. Licences issued. Dealers. Supplementary. To Bottle. To Pasteurise. Tuberculin tested 14 8 1 — Accredited 1 — — — Pasteurised 26 10 — 1 Samples of designated milk taken. No. of samples taken. No. not satisfactory. Pasteurised 56 1 Tuberculin tested 10 4 T.T. (Pasteurised) 20 2 Accredited 13 2 99 9 In addition 9 samples of Pasteurised and 2 of T.T. (Pasteurised) failed to satisfy the Phosphatase test. Laboratory Examinations re Food, Milk and Water (at Middlesex Hospital). Examinations made. Quarter ending Total for 12 months 31.3.45 30.6.45 30.9.45 31.12.45 Food 2 — 1 1 4 Milk 23 26 34 16 99 Water 14 16 14 16 60 Chemical tests for chlorine content of Swimming Pool water made by inspectors, 28. 56