WIM 13 BOROUGH OF WIMBLEDON Public Health Department. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR ENDED 31st DECEMBER, 1940. STAFF. Whole-time. Medical Officer of Health; School Medical Officer; Medical Superintendent of the Infectious Diseases Hospital; Maternity and Child Welfare Officer: HAROLD ELLIS, M.B., B.S.(Lond.), M.R.C.S., L.R.C.P., D.P.H. Deputy Medical Officer of Health, assistant School Medical Officer: PATRICK J. DOODY, M.B., B.Ch., D.P.H. Senior Sanitary Inspector; R. T. AVIS, M.R.San.I., M.S.I.A., (c), (e), (f). Sanitary Inspectors: D. F. S. FLYNN, (e), (f). C. W. SOUTHERBY, (e), (f). A. A. REID, (e), (f). H. R. FRY, (e) . Health Visitors - School Nurses: MISS V. B. WOODROFF, (b), (c), (g). MISS P.N. NASH, (a), (b), (d). MISS J. C. MOFFAT, (a), (b), (d), (h). MISS E.S.G. DAVIES,(a), (b), (d), (h). MRS. E. A. JONES, (a), (b), (d). Matron of Infectious Diseases Hospital: MISS L. McCRORY. Matron of Day Nursery: MISS I. CUTLER. Senior Clerk: A. L. TAYLOR. Clerks: J. E. FIELD. J. BURROWS. Clerk to the Maternity and Child Welfare Department: A. L. TAYLOR. Part-time. LESLIE H. W. WILLIAMS, F.R.C.S., F.C.O.G., Obstetric Consultant. S. TAYLOR HARRIS, M.R.C.S., L.R.C.P., Medical Officer to Ante-natal Clinic. MARY M. TULLOCH, M.B., B.S., Medical Officer to Maternity and Child Welfare Centres. W. L. GALVIN, M.B., B.Ch., Deputy Medical Attendant Infectious Diseases Hospital. R. J. FURLONG, F.R.C.S., Orthopaedic Surgeon. R. J. CANN, M.S., Surgeon to Aural Clinic. A. MCALLISTER, F.R.C.S., Consulting Obstetrician under Public Health (Notification of Puerperal Fever and Puerperal Pyrexia) Regulations, 1926. Col. E. MIDDLETON PERRY, C.B.E., F.R.C.V.S., Veterinary Inspector. J. H. JOHNSTON, M.Sc., L.S.A., Bacteriologist. Salary contribution under Public Health Acts. " " by Exchequer Grants. a. S.R.N. b. S.C.M. c. Certificate Sanitary Inspectors Examination Board (London). d. New Health Visitor's Certificate, Royal Sanitary Institute. e. Certificate Royal Sanitary Institute for Inspector of Nuisances. f. Certificate Royal Sanitary Institute for Inspector of Meat and Other Foods. g. Diploma Board of Education (Health Visitors' Training) Regulations, 1919. h. Certificate of Fever Training. 0 Serving with H.M. Forces. ANNUAL REPORT of the Medical Officer of Health 1 9 4 0. To the Mayor, Aldermen and Councillors of the Borough of Wimbledon. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit the Annual Report on the work of the Public Health Department for the year ended 31st December, 1940. The Report for 1940 is an ordinary report compiled in accordance with the instructions contained in Circular 2314 of the Ministry of Health. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres - Census, 1931) 3,221 Population (Census, 1931) 59,524 Resident Population (Estimated Mid-1940 R.G. ) For calculation of birth rates) 49,910 " " " death rates) Number of inhabited houses:- 1921 (Census) 11,926 1931 (Census) 13,325 Number of families or separate occupiers:- 1921 (Census) 13,998 1931 (Census) 15,883 Rateable Value:- £829,430 Sum represented by a penny rate:- £3,456. Extracts from Vital Statistics of the Year 1940. (Registrar-General's Figures) For Calculation of Infantile Mortality, etc. Birth Rate Total M. F. Total M. F. Live Births (Legitimate 552 279 273 585 300 285 (Illegitimate 24 15 9 24 15 9 (Total 576 294 282 609 315 294 Birth Rate per 1,000 of the estimated resident population 12.20 Total M. F. Stillbirths (Legitimate 19 6 13 (Illegitimate 2 1 1 (Total 21 7 14 Rate per 1,000 total (live and still) births 33.33 Total M. F. Deaths 828 406 422 Death rate per 1,000 of the estimated resident population 13.92 2. * Deaths from puerperal causes (Headings 29 and 30 of the Registrar-General's Short List) Deaths Rate per 1,000 total (live & still) births No. 29 Puerperal & post- abortive sepsis 1 1.67 No. 30 Other maternal causes - — Total 1 1.67 Death Rate of Infants under one year of age:- All infants per 1,000 live births 43.40 Legitimate infants per 1,000 legitimate live births 36.23 Illegitimate infants per 1,000 illegitimate live births 208.33 Deaths from Cancer (all ages) 106 " " Measles (all ages) - " " Whooping Cough (all ages) - " " Diarrhoea (under 2 years of age) 5 Birth Rates, Civilian Death Rates, Analysis of Mortality, Maternal Death Rates, and Case Rates for certain Infectious" Diseases in the Year, 1940. (Provisional figures based on weekly and quarterly returns) Wimble don. England & Wales 126 C.B's & Great Towns including London 148 Smaller towns (Resident pop.25,000 50,000 at 1931 Census) London Administrative County Rates per 1,000 Civilian Population Live Births 12.20 14.6 16.0 15.7 13.7 Still Births 0.42 0.55 0.64 0.55 0.44 Deaths:- All Causes 13.92 14.3 15.8 12.8 17.8 Typhoid & Paratyphoid 0.00 0.00 0.00 0. 00 0.00 Small-pox - - - _ - Measles 0.00 0.02 0.02 0. 02 0.01 Scarlet Fever 0.02 0.00 0.00 0. 00 0.00 Whooping Cough 0.00 0. 02 0. 02 0. 02 0.00 Diphtheria 0.02 0.06 0.07 0. 05 0. 01 Influenza 0.20 0.32 0.29 0.30 0.18 Violence 2.70 Notifications:- Small-pox - 0.00 - - - Scarlet Fever 0.30 1.63 1.53 1.57 0.82 Diphtheria 0.18 1.16 1.29 1.21 0.61 Enteric Fever 0.38 0.07 0.06 0.10 0.06 Erysipelas 0.22 0.33 0.36 0.30 0.35 Pneumonia 0.46 1.20 1.37 1.00 0.87 Rates per 1,000 Live Births Infant Mortality:- Deaths under 1 yr.of age 43 55 61 54 50 Deaths from Diarrhoea & Enteritis (under two years of age) 8.68 4.6 5.9 4.4 5.8 Maternal Mortality (Excluding Abortion) Puerperal infection 1.75) Others 0.00) Total 1.73) 3. Rates per 1,000 Total Births (i.e.,, Live and Still) Maternal Mortality (Excluding Abortion):- Puerperal Infection 1.67 0.52) ??? ??? ??? Others 0.00 1.64) Total 1.67 2.16) Notifications:Puerperal Fever 10.05 11.96 13.90 9.73 -3.34 " Pyrexia 13.40 * Not available. Births.- The statistics supplied by the Registrar-General show that during 1940 the total number of registered live births belonging to Wimbledon amounted to six hundred and nine, (three hundred and fifteen males and two hundred and ninety-four females). This gives a birth rate equal to 12.20 per thousand of the population. Twenty-four of the births were illegitimate. Of this number fifteen were males and nine females. In addition, twentyone stillbirths (seven males and fourteen females) were registered. Public Health Act, 1956 - Notification of Births. During the year, five hundred and eight-eight births were notified by the following persons:- Parents 3 Midwives 182 Doctors 12 Other persons 391 Total 588 Twelve of these notifications were in respect of stillbirths. Of the five hundred and eighty-eight notifications, two hundred and eighty-six were received from Medical Officers of Health of outside areas, and related to births which had occurred to Wimbledon residents confined outside the Borough. Similarly, forty-seven confinements occurred in Wimbledon amongst women whose homes were situated in other districts. The net number of notified births belonging to Wimbledon is therefore five hundred and forty-one. Deaths.- The total number of deaths registered in the district was six hundred and seventy-three (three hundred and twelve males and three hundred and sixty-one females), equal to a death rate of 13.48 per thousand of the population. The deaths occurring outside the district, of persons belonging to this Borough were three hundred and three. The deaths occurring within the district, of persons not belonging thereto were one hundred and forty-eight. Taking these figures into consideration, the total number of deaths properly belonging to Wimbledon is eight hundred and twentyeight and the crude death rate 16.58 per thousand of the population. The death rate shows an increase on the figure for the previous year. 4. The crude death rate is, strictly speaking, not comparable with the figure for England and Vales. In order to provide for this the Registrar-General has introduced an areal comparability factor. This factor, for Wimbledon is 0.84. factor. This factor, for Wimbledon is 0.84. The adjusted death rate for Wimbledon for 1940 is consequently 13.92 per thousand of the population as compared with a figure of 14.3 per thousand for England and Wales. CAUSES OF DEATH. Males Females Total 1. Typhoid and paratyphoid fevers - - - 2. Cerebro-spinal fever 2 1 3 3. Scarlet fever - 1 1 4. Whooping cough — - - 5. Diphtheria — 1 1 6. Tuberculosis of respiratory system 15 6 21 7. Other forms of tuberculosis 1 1 2 8. Syphilitic diseases 4 - 4 9. Influenza 3 7 10 10. Measles - - -mm 11. Acute poliomyelitis & polio- encephalitis 1 - 1 12. Acute infectious encephalitis 15 - 1 13.M Cancer of buccal cavity and esophagus (males only) 3 - 3 13.F Cancer of uterus — 7 7 14. Cancer of stomach and duodenum 8 6 14 15. Cancer of breast — 10 10 16. Cancer of all other sites 36 36 72 17. Diabetes 3 3 6 18. Intra-cranial vascular lesions 30 32 62 19. Heart disease 96 104 200 20. Other diseases of the circulatory system 9 16 25 21. Bronchitis 22 27 49 22. Pneumonia 20 16 36 23. Other respiratory diseases 8 5 13 24. Ulcer of the stomach or duodenum 14 4 18 25. Diarrhœa (under 2 years of age) 3 2 5 26. Appendicitis 2 - 2 27. Other digestive diseases 10 12 22 28. Nephritis 9 12 21 29. Puerperal and post-abortive sepsis - 1 1 30. Other maternal causes - - — 31. Premature birth 3 2 5 32. Congenital malformations, birth injury, infantile disease 7 2 9 33. Suicide 2 7 9 34. Road traffic accidents 6 1 7 35. Other violent causes 61 58 119 36. All other causes 27 42 69 Totals 406 422 828 Over half the total deaths which occurred amongst Wimbledon residents in 1940 were due to cancer, diseases of the heart and circulation, and diseases of the respiratory system. Infantile Mortality. There were twenty-five infant deaths (including transferable deaths) giving an Infantile Mortality Rate of forty-three per thousand live births. In 1939 the figure was twenty-nine per thousand. During 1940 the Infantile Mortality Rate for England and Wales was fifty-five. 5. general provision of health services for the area. Laboratory Facilities. The Corporation employ a part-time bacteriologist for the examination of pathological specimens. In addition, the laboratory provided at the Health Centre is utilised for the examination of pathological specimens from the Infectious Diseases Hospital. This work is carried out by the staff of the Public Health Department, Maternity and child welfare The total number of visits paid by the Health Visitors during 194 0, amounted to 7,213, the figure for the previous year being 7,179. Details of the home visits carried out are given below:- Number of Infants visited - First visits 530 Number of Infants visited - Re-visits 1,380 Number of Toddlers visited 2,023 Ante-natal - First visits 330 Ante-natal - Revisits 196 Visits re Infant Deaths 15 " " Stillbirths 15 " " Ophthalmia Neonatorum 13 " " Puerperal Pyrexia 4 " " Non-notifiable Infectious Diseases 1 " "Milk Applications 60 " "Foster Children 142 " " Midwives 7 Miscellaneous 322 Total welfare visits 5,038 Visits - School Medical Service 975 Tuberculosis - Home Visits 64 Visits to Nursing Homes 24 Other visits 125 Ineffectual visits 992 2.180 Total visits 7.218 The Maternity and Child Welfare Centres remained open throughout the year. At Pelharn Road Centre two sessions per week were held. The average attendance at the Tuesday sessions was 59.46 and at the Friday sessions 69.57. At the Cottenham Park Centre the average weekly attendance was 28.26. The average attendance at the Wandle Park Centre was 57.24. Ante-natal Clinic. The Pelham Road Ante-natal Clinic was held weekly and the average attendance was 13.46. At the weekly Ante-natal Clinic at Wandle Park, which was re-started in January, 1940, there was an average attendance of 6.95. Midwifery and Maternity Services - Midwives Ace. 1956. A service of whole-time domiciliary midwives is provided by the Wimbledon District Nursing and Midwifery Association under an agreement with the Council. 6. Midwives Acts, 1902-1956. The Council is the Local Supervising Authority for the Midwives Acts in Wimbledon. There were seven practising midwives in Wimbledon at the end of 1940, one of whom was resident outside the Borough. One hundred and sixty-three confinements were attended by midwives and twenty-five by maternity nurses. Medical Aid forms were received in seventy-five instances. The total fees paid to doctors by the Corporation during the year under Section 14- (1) of the Midwives Act, 1913, amounted to £101. lbs. 6d. The amount recovered from the patients' relatives was £44. 5s. 9d. Public Health -Act, 1956 (Child Life Protection); Children and Young Persons Act, .1932; Children Act, 1908 (Part 1).The following figures relate" to the administration of the above Acts in Wimbledon during 1940. (i) Number of foster-mothers on the Register - (a) At the beginning of the year 24 (b) At the end of the year 21 (ii) Number of children on the Register - (a) At the beginning of the year 56 (b) At the end of the year 40 (c) Who died during the year - (d) On whom inquests were held during the year - Every foster-child was visited regularly. In all, one hundred and forty-two visits were made to the homes of foster-mothers. Treatment Facilities.- The Minor Ailment, Ophthalmic, Orthopaedic and Aural Clinics remained open throughout the year. Facilities for the operative treatment of tonsils and adenoids remained available through the usual channels. Ophthalmia Neonatorum.- The following table shows that three cases of ophthalmia neonatorum were notified. In no case did any impairment of vision occur. CASES Vision Unimpaired. Vision Impaired Total Blindness Deaths Notified Treated At Home Hospital 3 3 - 3 - - - Maternal Mortality. There was one maternal death amongst Wimbledon mothers in 1940. This occurred in a hospital outside the district and was due to general peritonitis and septic abortion. During 1939 one maternal death occurred. 7. The following table gives the maternal mortality rates for Wimbledon and also for England and Wales:- 1 9 400 Puerperal Infection. Others Total Wimbledon: Per 1000 Live Births 1.73 0.00 1.73 Per 1000 Total Births 1.67 0.00 1.67 England & Wales: Per 1000 Total Births 0.52 1.64 2.16 Hospital Treatment for Complicated Obstetric Cases.During 1940 twenty-two patients received treatment under this Scheme. The cost of maintenance and treatment of these patients amounted to £182. 0. 0d. of which £39. 0s. 0d. was recovered from the relatives. Supply of Milk to Expectant and Nursing Mothers and Infants.During 1940,4,140¼ gallons of fresh milk and 896 lbs. of dried milk, cod liver oil and malt etc., were supplied under the Maternity and Child Welfare Scheme. The National Milk Scheme came into operation at the end of July, and this is administered through the Ministry of Food. Dental Treatment. Dental treatment is available for children under school age, and for nursing and expectant mothers. This Clinic continued without interruption throughout the year. Municipal Day Nursery.- On the outbreak of war the Nursery was evacuated to Arundel. In September 1940 the Nursery was transferred to Hinhead, and is now administered by the Surrey County Council on behalf of the Wimbledon Council. Visits were paid to the Nursery by the Chairman of the Wimbledon Maternity & Child Welfare Committee and the Medical Officer of Health as circumstances permitted. Nursing Homes Registration Act, 1927. Public Health Act, 1936 Part VI. The Wimbledon Borough Council is responsible for the supervision of nursing homes in Wimbledon. At the end of the year there were eleven registered nursing homes. Twenty-three visits of inspection were made, SANITARY CIRCUMSTANCES OF THE AREA. Sanitary Inspection of District.- The following is a statement showing the number and nature of inspections made for the year 1940, 8. ]Reason of Visit. No. Infectious Diseases 586 House Inspections 4336 Inspections under Housing Acts 1936 229 House to House Inspections 598 Rent Act Inspections 6 Houses Let in Lodgings Inspections - Inspection of Factories, Workshops, Workplaces and Outworkers' premises 120 Dairies and Cowsheds Inspections 78 Inspections under Shops Acts 131 Application of Tests to Drains 56 Inspections under Diseases of Animals' Acts 7 Obtaining Samples of Foods and Drugs 121 Miscellaneous (including Inspections of Food, Slaughterhouses, mews, stables, caravans, Petroleum Acts, water supply, piggeries, mosquitoes, etc.) 1590 Total 7642 Notices Served.- One thousand and six preliminary notices or intimations were served during the year. It was found necessary to serve two hundred and forty Statutory Notices, House Inspection.- The following table gives a summary of the nuisances abated and the sanitary improvements carried out, together with the defects remedied, as a result of house to house inspection under the supervision of the Sanitary Inspectors;- Accumulations removed 23 Cisterns provided 1 Cisterns repaired, cleansed or covered 5 Drains, new, provided 36 Drainage systems made water-tight by patent process Drains, repaired or altered 29 Drains, stoppages removed 60 Dustbins provided 286 Flushing cisterns, new, provided 13 Flushing cisterns repaired 45 Manure receptacles provided 1 Rain-water pipes disconnected 2 Roofs repaired 200 Rooms stripped and cleansed 367 Verminous rooms cleansed 71 Soilpipes, new, provided 6 Soilpipes, repaired or altered 7 Vent pipes, new, provided 6 Vent pipes, repaired or altered 8 Waste pipes, new, provided 25 Waste pipes, repaired, disconnected or trapped 15 Water-closets, new, provided 57 Water-closets, repaired or ventilated 8 Water services restored 77 Yards paved 6 Yards repaired 63 Guttering repaired 81 Floors ventilated 17 Nuisances from damp walls abated 309 Sinks provided 6 Other nuisances 1212 Rooms disinfected 314 Total 3,356 9. FACTORIES, WORKSHOPS AND WORKPLACES. 1. Inspections for purposes of provisions as to health. Premises. Number of Inspections. Written Notices Prosecutions. Factories with mechanical power 81 2 - Factories without mechanical power 8 - - Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises) — — -. Total 89 2 - 2. Defects found. Particulars Number of Defects. Prosecu tions. Found Remedied Referred to H.M. Inspector Want of Cleanliness (S.l) 3 2 - - Overcrowding (S,2) - - - - Unreasonable temperature (S.3) - - — - Inadequate ventilation (S.4) 1 1 - - Ineffective drainage of floors (S.6) - - - - Sanitary Conveniences (S.7) Insufficient - - - - Unsuitable or Defective 2 1 - — Not separate for Sexes 1 1 - - Other Offences 1 2 - - (Excluding offences relating to outwork and offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops) Order, 1921, and re-enacted in the Third Schedule to the Factories Act, 1937) Totals 8 7 - - Outwork in Unwholesome Premises - (Section 108). Nature of work Instances Notices Served. Prosecutions Wearing Apparel - Making, etc. - - - Others - - - Outwork in Infected Premises - Sections 109-110 Nil. 10. HOME WORK. Lists received;- Twice in the year 2 Number of Outworkers 3 Once in the year 10 Number of Outworkers 16 Number of Outworkers' Premises on register 37 Number of addresses received from other Councils 17 Number of addresses forwarded to other Councils 3 Notices served on occupiers as to keeping or sending lists - Prosecutions - failing to keep Outworkers' Lists Prosecutions - failing to furnish lists Inspections of Outworkers' Premises 31 Number of unwholesome premises - Notices served to remedy - OTHER MATTERS. Underground Bakehouses in use at the end of the year 3 Matters notified to H.M. Inspeotor of Factories Failure to affix: Abstracts of Act Nil Action taken in matters referred by H.M. Inspector as remedial under the Public Health Acts. Notified by H.M. Inspector Nil Reports of action taken sent to H.M. Inspector Nil HOUSING. Number of dwelling-houses inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 124 Number of inspections made for the purpose 598 Housing Act, 1936.- Part IV.- Overcrowding:- (a) (1) Number of dwellings overcrowded at the end of the year 22 (2} Number of families dwelling therein 46 (3) Number of persons dwelling therein 246 (b) Number of new cases of overcrowding reported during the year - (c) (1) Number of cases of overcrowding relieved during the year 12 (2) Number of persons concerned in 3uch cases 68½ (d) Particulars of any cases in which dwelling houses have again become overcrowded after the local authority have taken steps for the abatement of overcrowding Nil AIR RAID SHELTERS. Two hundred and seventy visits were paid to air raid shelters in the Borough. One hundred of these were carried out by the Medical Officer of Health or his Deputy, seventy-eight by the Sanitary Inspectors, and eighty-two by the Health Visitors. In seventy-four instances defects due to inadequate lighting or ventilation, dampness, uncleanliness, or sanitary accommodation were reported to the A.R.P. Department for attention. 11. INSPECTION AND SUPERVISION OF FOOD. Milk Supply.- Practically all the milk for retail sale is brought into the area from other districts. The number of licences granted under the Milk (Special Designations) Order, 1936, was as follows:- Pasteuriser's Licence 1 Dealers Licences: Tuberculin Tested Milk 4 Accredited Milk - Pasteurised Milk 10 Supplementary Licences 4 Bacteriological Examination.- Eleven samples of milk were taken for bacteriological examination under the Milk (Special Designations) Order. Food and Drugs Act, 1998. The Council became the Local Authority under this Act on 1st October, 1939. Sixty-three samples were taken up to the end of the year. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. During 1940, two hundred and sixty-one cases of infectious disease were notified. These were seventy-four more than in 1939. This increase is almost entirely due to the addition of measles, whopping cough and food poisoning to the list of compulsorily notifiable diseases. For several years the incidence of notifiable infectious "disease in Wimbledon 'Has been low. Scarlet Fever.- Forty oases of scarlet fever were notified, fourteen less than in 1939. The attack rate was 0.80 per thousand of the population. One death from scarlet fever occurred in a Wimbledon resident outside the Borough. Thirty-two, or 80.00 per cent of the cases were treated in hospital. There was one death from this disease. Diphtheria.- The number of cases of diphtheria showed a marked decrease, there being only nine notifications in 1940 as compared with twenty-four in the previous year. The attack rate was 0.18 per thousand of the population. All the patients received hospital treatment. There was one death. Diphtheria Immunisation.- Sessions of the Immunisation Clinic were held every Saturday morning at the Health Centre. Twelve children were Schick tested. Seven were found to be positive and then immunised. The total number of children immunised was thirty-nine. In all, one hundred and eighty-eight attendances were made for this purpose. Nine children attended for a subsequent Schick test. In all cases they were found to be Schick negative. Enteric Fever.- In August, several cases of paratyphoid fever were notified, and notifications continued to be received during September. In all, nineteen cases of paratyphoid fever were notified to the Department. In the investigations which ensued the 12. staff of a large restaurant came under suspicion. A very largo number of samples of blood and excreta were submitted to examination and several carriers were detected and isolated. The assistance of Dr. Bamforth of the Ministry's Emergency Laboratory at Richmond was of great value in dealing with this outbreak. It was quickly brought under control and a detailed report was submitted in due course to the Ministry of Health. One patient, a girl aged eight years, has remained a persistent carrier of paratyphoid bacilli. Food Poisoning.- This became a notifiable disease on 3rd October, 1939. Tour notifications were received during the year. These were all members of one family. Cerebro-Spinal Fever.- Twelve cases of this disease were notified. All the patients were treated in hospital. There wore three deaths. Erysipelas. - Notifications were received in respect of eleven cases of erysipelas. Four patients were treated in Hospital. Puerperal Pyrexia.- Six cases of puerperal pyrexia were notified. Four of these patients were removed to Hospital. There was no death from puerperal sepsis amongst the six patients notified under the Regulations. Measles.- Fifty-six cases of measles were notified. Eleven of these were removed to hospital. There were no deaths, Whoeping Cough.- There were only ten cases of this disease notified in 1940. Two cases were treated in hospital. There wore no deaths. 13. 14. TABLE A. - NOTIFIABLE DISEASES DURING 1940. DISEASE Number of Cases Notified in Various Age Groups. Total Cases Notified Total Cases Removed to Hospital Under 1 1-2 2-3 3-4 4-5 5-10 10-15 15-20 20-35 35-45 45-65 65 & over Smallpox - - - - - - - - - - - - - - Scarlet Fever - 1 1 5 1 15 8 3 4 2 - - 40 32 Diphtheria (including Membranous Croup) — — 2 — — 2 2 1 2 - - - 9 9 Enteric Fever (including Paratyphoid) - 1 2 - - 3 1 3 6 - 2 1 19 11 Food Poisoning — - - - - - 1 1 - - 2 - 4 - Puerperal Pyrexia - — - - - - - - 6 - - - 6 4 Measles 3 4 7 5 4 9 5 7 11 1 - - 56 11 Whooping Cough 2 1 - 1 1 4 1 - - - - — 10 2 Acute Primary Pneumonia - - - 1 - 1 - 2 1 2 6 5 18 - Acute Influenzal " - - - - - - - - - 2 2 1 5 - Cerebro-Spinal Fever 1 - 2 - 1 - 2 2 3 - 1 - 12 12 Acute Poliomyelitis - - - - - - - - - - - - - - Acute Polio-encephalitis - 1 - - - - - - - - - - 1 — Encephalitis Lethargica - - - - - - - - - - — - - - Fysentery - - - - - - - - - - - - - - Melaria - - - - - - - - - - - - - - Ophthalmia Neonatorum 3 - - - - - - - - - - - 3 - Erysipelas - - - - - - 1 - 4 - 3 3 11 4 Tuberculosis (all forms) - 1 - - 1 2 2 7 34 6 13 1 67 47 TOTALS 9 9 14 12 8 36 23 26 71 13 29 11 261 132 15. TUBERCULOSIS. Sixty-seven cases of tuberculosis wore notified. This figure shows a decrease of six on the number for the previous year. The deaths from tuberculosis were six fewer than in 1939, the total figure being twenty-six. Twenty-three of these were due to pulmonary tuberculosis. During 1940, forty-seven Wimbledon patients were admitted to sanatoria or hospitals. TUBERCULOSIS - 1940. AGE GROUPS NEW CASES DEATHS Primary Notifications (Form A) New cases discovered otherwise than by Notification Total New Cases Pulmonary NonPulmonary Pulmonary NonPulmonary Pulmonary NonPulmonary Pulmonary NonPulmonary . Males Females Males Females Males 1 Females Males Females Males i Females Males Females Males Females Males Females Under 1 year - - - - - - - - - - - - - - 1 4 1-5 years - - 2 - - - - - - - 2 - — — 1 - 5-10 " - - 2 - - - - - - - 2 - - - - - 10-15 " - - 1 - - - - 1 - - 1 1 - - - - 15-20 3 2 - - 1 1 - - 4 3 - - - - - - 20-25 " - 5 - - 5 4 - 1 5 9 - 1 - 2 - - 25-35 " 3 2 - 1 7 5 1 - 10 7 1 1 3 1 - - 35-45 " 3 - - - 2 1 - - 5 1 - - 3 2 - - 45-55 " 3 1 - - 1 2 - - 4 3 - - 7 2 - - 55-65 " 2 3 - - 1 - - - 3 3 - - 1 - - - 65 and over 1 - - - - - - - 1 - - - 2 - - - 15 13 5 1 17 13 1 2 32 26 6 3 16 7 2 1 Totals 28 6 30 3 58 9 23 3 34 33 67 26 67 WIMBLEDON INFECTIOUS DISEASES HOSPITAL. One hundred and ninety-six cases were admitted to the Infectious Diseases Hospital during 1340. As thorn wore ten cases in hospital at the end of 1939, the total number of cases under treatment during the year amounted to two hundred and six. One hundred and fourteen of these cases were from Wimbledon, and ninetytwo from Kingston, Of the two hundred and six patients under treatment, seventyone were suffering from scarlet fever, twenty-nine from diphtheria and twenty-one from cerebro-spinal meningitis, sixteen from enteric fever, thirty-eight from measles and thirty-one from other diseases. There were seven deaths during the year, one of which was due to diphtheria, five to cerebro-spinal meningitis and one to tuberculous meningitis. Fifteen patients remained in hospital at the end of 1940. Ten of these were suffering from scarlet fever, two from measles, one from whooping cough, one from cerebro-spinal meningitis and one from erysipelas. In concluding this report I should like to express my deep appreciation to the Chairman and members of the Public Health and Maternity and Child Welfare Committees for the consideration and courtesy which they have again shown me during 1940. It is also a pleasure to draw attention to the help and co-operation which I have received from all members of the staff. I have the honour to be Your obedient servant, HAROLD ELLIS. 16 " ' ... . ....