Ik A r->\^ - BOROUGH . OF WIMBLEDON. PUBLIC HEALTH DEPARTMENT ANNUAL REP0RT of the MEDICAL OFFICER OF HEALTH for the YEAR ENDED 51st DECEMBER, 1945, COPY 4i alt/fp. (^v\, • .tHRA^ { 'ibllio- 0-O-O BOROHQH up WTHRjppnw Medical Off! Medical Superlnt' MaTe HAROLD V A I 0 Sir, Town Hall, Wimbledon, 3.W.19. 13th January, I945. patr: Tei m: R. T. AV x x x x * f * f ] Annual Re,,ort . Health. nna for the yenr 1943, J Annual R®P°rt _ , Wimbledon 1,000 ltve read 1.19 forl.18 Per 1,000 total births,read 1.18 for 1.17 I am, 3ir, Your obedient Servant, (Sgd.) H.Ellis. Medical Officer of HeeOfc The Secretary, Ministry of Henlth, Whitehall, 3.W.I. Senior: JV1J.OO v • jlj • MISS P. N. NASH, (aj, (b), (d). MISS E. S. G. DAVIES, (a), (b), (d), (h). MISS G.K. JEFFREYS, (a), (b), (d), (h). Matron of Infectious Diseases Hospital, MISS I. MULHERN. Matrons of Day Nurseries. MISS J. I. HEAD (All Saints) MISS C. I. TREGURTHA (Russell Road). Senior Clerk. A. L. TAYLOR. Clerks: 0 J. E. FIELD 0 J. BURROWS. MRS. 5« M. BEACON (temporary) xx MISS A. SMITH (temporary) xx MISS E. CARROLL (temporary) W« G. CLEMENT (temporary) Clerk to the Maternity and Child Welfare Department: A. L. TAYLOR. -1- S T A RT Whole-tine. Medical Off tear of Health; School Medical Officer; Medical Superintendent of"'the. Infectious Diseases Hospital; Maternity and Chlid 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; ‡ Ø PATRICK J. DOODY, M.B., B.Ch., D.P.H. Temporary Assistant Medical Officer; † EMILY M. FRAZER, M.B., B.S.(Lond.). 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). * J. F. SMITH, (e), (f. * J. G. PLANT, (e), (f). * Ø A. A. REID, (e) , (f). * Ø H. R. FRY, (e) . Health Visitors - School Nurses; Senior; MISS J, C. MOFFAT, (a), (b), (d), (h). MISS V. B. WOODROFF. (b) , (c) , (g) . MISS P. N. NASH, (a), (b), (d) . MISS E. S. G. DAVIES, (a), (b) , (d) , (h) . MISS G.K. JEFFREYS, (a), (b), (d), (h). Matron of Infectious Diseases Hospital. MISS I. MULHERN. Matrons of Day Nurseries. MISS J. I. HEAD (All Saints) MISS C. I. TREGURTHA (Russell Road). Senior Clerk. A. L. TAYLOR. Clerks; Ø J.E. FIELD 0 J. BURROWS. MRS. B. M. BEACON (temporary) xx MISS A. SMITH (temporary) xx MISS E.CARROLL (temporary) W. G.CLEMENT (temporary) Clerk to the Maternity and Child Welfare Department; A.L.TAYLOR. -1- Part-time. LESLIE H.W. WILLIAMS, F.R.C.S., F.C.O.G., Obstotric 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. F. DURBIN, F.R.C.S,, Orthopaedic Surgeon. R, J. CANN, M.S., Surgeon to Aural Clinic. Col. E. MIDDLETON PERRY, C.B.E., F.R.C.V.S., Veterinary Inspector. F, DEAS, M.R.C.S., L.R.C.P., 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, Ø Serving with H. M. Forces. xx Civil Defence. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH 1945. 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, 1943. The Report for 1943 is an ordinary report compiled in accordance with the instructions contained in Circular 2773 of the Ministry of Health. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres - Census, 1931) 3,221 Population (Census, 1931) 59,524 Number of inhabited houses:- 1921 (Census) 11,926 1931 (Census) 13,325 Number of families or separate occupiers 1921 (Census) 13,998 1931 (Census) 15,443 Rateable Value £811,330. Sum represented by a penny rate:- £2,817. Extracts from Vital Statistics of tho Year 1943. (ftegistrar-General's Figures). Live Births Total M. f. (Legitimate 790 414 376 (Illegitimate 47 21 26 (Total 837 435 402 Birth Rate per 1,000 of the estimated resident population 17.69 Total M. F. Stillbirths (Legitimate 13 5 8 (Illegitimate — ■R — (Total 13 5 8 Rate per 1,000 total (live and still) births 15.29 Total Deaths 680 301 379 Death rate per 1,000 of the estimated resident population 14.37 Deaths from puerperal causes (Headings 29 and 30 of the Registrar-General's Short List) Rate per 1,000 total Deaths.(live & still) births. No. 29 Puerperal and post-abortive sepsis - —- No, 30 Other maternal causes 1 1.18 Total 1 1.18 -3- Death Rate of Infants under one year of age:- All Infants per 1,000 live births 50.17 Legitimate Infants per 1,000 legitimate live births 46.83 Illegitimate Infants per 1,000 illegitimate live births 106.39 Deaths from Cancer (all ages) 113 " " Measles (all ages) " " Whooping Cough (all ages) 2 " " Diarrhoea (under 2 years of age.) 5 Birth Rates, Civilian Death Hates, Analysis of Mortality, Maternal Death Rates, and Case Rates for certain Infectious Diseases in the Year 194b. (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 London Administrative County (1) (2) (3) (4) Census (5) (6) * Rates per 1,000 Civilian Population Live Births 17.69 16.5 18.6 19.4 15.8 Still Births 0,27 0.51 0.63 0.61 0.45 Deaths:- All Causes 14.57 12.1 14,2 12.7 15.0 Typhoid & Paratyphoid 0.00 0.00 0,00 0.00 0.00 Small-pox - — — - Measles 0.00 0.02 0.02 0.02 0.02 Scarlet Fever 0.00 0,00 0.00 0.00 0.00 Whooping Cough 0.04 0,03 0.03 0.03 0.03 Diphtheria 0.00 0.03 0.04 0.04 0.02 Influenza 0.50 0.37 0.36 0.37 0.27 Violence 0.65 X X X X Notifications:- Smallpox - - - - - Scarlet Fever 3.93 3.01 3.29 3.54 3.80 Diphtheria 0.42 0.88 1.12 0.77 0.74 Typhoid Fever - 0.01 0.01 0.02 0.01 Paratyphoid Fever - 0.01 0.01 0.01 0.01 Cerebro-spinal Fever 0.21 0,08 0.10 0.06 0.09 Measles 5.74 9.88 9.23 9.77 9.17 Whooping Cough 2.43 2.54 2.82 2.25 2.68 Erysipelas 0.23 0.31 0.35 0.27 0.42 Pneumonia 0.63 1.34 1.62 1.16 1.27 Rates per 1,000 Live Births Infant Mortality:- Deaths under 1 yr.of age 50 49 58 46 58 Deaths from Diarrhoea & Enteritis (under 2 yrs. of age) 5.97 5.3 7.9 4.4 10.4 * A dash (-) signifies that there were no deaths. x Information not available. -4- (1) Rates psr 1,000 Total Births Live and Still (2) (3) (4) (5) (6) (a) ratifications:Puerperal Fever ) 10.50 11.68 15.11 9.26 ( 3.05 Puerperal Pyrexia ) (15.23 ł (b) Maternal Mortality No.140 Abortion with 3epsis No.141 Abortion without sepsis No.147 Puerperal Infections Nos.142-146 and 148-150. Other maternal causes WIMBLEDON 0.00 0.00 0.00 1.18 England & Wales 0.34 0.11 0.39 1.45 Abortion:- Mortality per million women aged 15-45 yrs. No.140. With sepsis No.141. Without sepsis England & Wales 25 8 ł Including Puerperal Fever. BirthsThe statistics supplied by the Registrar-General show that during 1943 the total number of registered live births belonging to Wimbledon amounted to eight hundred and thirty-seven (four hundred and thirty-five males and four hundred and two females). This gives a birth rate equal to 17.69 per thousand of the population, compared with 15.46 per thousand for the previous year. Forty-seven of the births were illegitimate. Of this number twenty-one were males and twenty-sir females. In addition, thirteen still-births (five males and eight females) were registered. Public Health Act, 1956 - Notification of Births., During tho year eight hundrod and twenty-one births were notified by the following persons:- Parents 2 Midwives 215 Doctors 22 Other persons 582 Total 821 Eleven of these notifications were in respect of stillbirths. Of the eight hundred and twenty-one notifications, four hundred and seventy-one 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, eighty-one confinements occurred in Wimbledon amongst women whoso homes were situated in other districts. The net number of notified births belonging to Wimblodon is, therefore, seven hundred and forty. Deaths:- The total number of deaths registered in the district was six hundred and ten (two hundred and fifty-eight males and three hundred and fifty-two females), equal to a death rate of 12.39 per thousand of the population. The deaths occurring outside the district, of persons belonging to this Borough, were two hundred and eighty-eight. The deaths occurring within the district, of persons not belonging thereto, wore two hundred and eighteen. Taking these figures into consideration, the total number of deaths properly belonging to Wimbledon is six hundred and eighty, and the crude death rate 14.37 per thousand of the population. The death rate shows a slight decrease on the figure for the previous year. -5- The crude death rata is, strictly speaking, not comparable with the figure for England and Wales. In order to provide for this the Registrar-General introduced some years ago an areal comparability factor. This factor, however, is not available this year, but assuming it to be the same as for 1940, the last year for whioh it is available, the adjusted death rate for Wimbledon would bo 13.07 perthousand of the population as compared with a figure of 12.1 perthousand for England ana Wales. CAUSES OF DEATH Males Females Total 1. Typhoid and paratyphoid fevers - - - 2. Cerebro-spinal fever - 1 1 3. Scarlet Fever - - - 4. Whooping Cough 1 1 2 5. Diphtheria - - - 6. Tuberculosis of respiratory system 20 10 30 7. Other forms of tuberculosis 2 2 4 8. Syphilitic diseases 6 2 8 9. Influenza 11 13 24 10. Measles - - - 11. Acute poliomyelitis and polioencephalitis - - - 12. Acute infectious encephalitis - - - 13.M. Cancer of buccal cavity and oesophagus (males only) 1 - 1 13.F.Cancer of uterus - 11 11 14. Cancer of stomach and duodenum 6 7 13 15. Cancer of breast - 17 17 16. Cancer of all other sites 39 32 71 17. Diabetes - 4 4 18. Intra-cranial vascular lesions 25 41 66 19. Heart disease 63 103 166 20, Other diseases of the circulatory system 8 11 19 21. Bronchitis 23 21 44 22. Pneumonia 16 15 31 23. Other respiratory diseases 6 5 11 24. Ulcer of the stomach or duodenum 4 2 6 25. Diarrhoea (under 2 years of age) 3 2 5 26. Appendioitis 2 1 3 27. Other digestive diseases 8 6 14 26. Nephritis 2 10 12 29. Puerperal and post-abortive sepsis - - - 30. Other maternal causes - 1 1 31. Premature birth 5 3 8 32. Congenital malformations, birth injury, infantile disease 7 2 9 33. Suicide 1 1 2 34. Road traffic accidents 3 2 5 35. Other violent causes 10 14 24 36. All other causes 29 39 68 Totals 301 379 680 Over half the total deaths which occurred amongst Wimbledon residents in 1943 were again due to cancer, diseases of the heart and circulation, and diseases of the respiratory system. Infant Mortality. There were forty-two infant deaths (including transferable deaths) giving an Infantile Mortality Rate of 50,17 per thousand live births, compared with a figure 9t forty-one per thousand In the previous year. During 1943 the Infantile Mortality Rate for England and Wales was forty-nine, The following table shows the causes of, end ages at, death, together with the Ward distribution. -6- -7- Infant Mortality during the year 1943. Cause of Death Under One wk, 1-2 wks 2-3 vks 3-4 wks Total under Four wks. 1-3 mths 3-6 mths 6-9 mths 9-12 mths Total Dths. under one year WARD Nth. 'W'don Sth. W'don Total St. St. Johns Cott. Park W tbn Perk Dund. Trini ty Sth. Park don Bark Whooping Cough - - - - - - - 1 - 1 - — - — — _ — 1 - 1 1 Pneumonia - - - - - 1 - - - 1 1 - - - - - - - 1 - 1 Brcncho-pneumonia - - - 1 1 1 1 1 2 6 1 - 2 1 - - - 2 4 2 6 Bronchitis - - - - - 1 1 1 - 3 - 1 - - - 1 1 - 1 2 3 Gastro-enteritis - - - 1 1 3 2 - - 6 - 4 - - - - 2 - 4 2 6 Pyloric stenosis - - - - - 1 - - - 1 - - - — - — 1 — - 1 1 Meningococcal meningitis - - - 1 1 - - 1 - 2 - - - - - 2 - - - 2 2 Prematurity 8 - - - 8 - - - - 8 - 1 - - 2 2 2 1 1 7 8 Atelectasis 3 - - - 3 - - - - 3 - 2 - - 1 - — — 2 1 3 Spina Bifida 2 - - - 2 1 - - - 3 1 - - 1 1 - - — 2 1 3 Congenital defects 1 - - - 1 - - - - 1 - 1 - - — — — - 1 - 1 Other causes 2 1 - - 3 1 2 1 7 1 1 1 1 1 2 3 4 ? Total 16 1 - 3 20 9 6 5 2 42 4 9 3 3 4 6 7 6 19 23 48 GENERAL PROVISION OF HEALTH SERVICES. FOR THE AREA. laboratory Facilities. , The Corporation have an arrangement with the Nelson Hospital for the examination of pathological specimens sent by private medical practitioners in the pathological laboratory attached to the Hospital. Dr. Lever, the Pathologist to the Atkinson Morley E.M.S. Hospital, is the Hon. Pathologist to the Nelson Hospital and undertakes this work. The Corporation have also made arrangements with the Ministry of Health for the examination of pathological specimens at the Emergency Public Health Laboratory at Epson College and a considerable number of specimens requiring special investigations are sent there. 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 1943 amounted to 9,365, the figure for the previous year being 7,334. Details of the home visits carried out arc given below:- Number of Infants visited - first visits 667 " " " " - revisits 1,244 Number of Toddlers visited 1,883 Ante-natal - first visits 389 " - revisits 72 Visits re Infant deaths 6 " "Stillbirths 6 " " Ophthalmia Neonatorum 1 " " Puerperal Pyrexia 4 " " Non-notifiable Infectious Diseases 3 " Milk applications 12 " " Foster Children 1,229 " "Midwives 7 Miscellaneous 1,221 Total welfare visits 6,744 Visits - School Medical Service. 1,437 Tuberculosis - Homo visits 32 Visits to Nursing Homes 21 Other visits 46 Ineffectual visits 1,083 2,619 Total visits 9,363 The Maternity and Child Welfare Centres remained open throughout the year. At Pelham Road Centre two sessions per week were held. The average attendance at the Tuesday sessions was 76.36 and at the Friday sessions 74.18. At the Cottenham Park Centre the average weekly attendance was 52.32. The average attendance at the Wandle Park Centre was 47.52. The attendances at each of the Centres were well maintained and in order to satisfy the needs of the Wimbledon Park area, a Centre was opened at the St. Luke's Church Hall on 9th April, 1943. The average attendance at this Centre, to the end of tho year was 68.60. Ante-natal Clinic. The Pelham Road Ante-natal Clinic continued to be held on Monday and Saturday each week, the average attendances being 19.76 and 11.72 respectively . The Ante-natal Clinic at Wandle Park was held every other Thursday. The average attendance was 7.81, Midwifery and Maternity Services - Midwives Act, 1936. A service of whole-time domiciliary midwives is provided by the Wimbledon District Nursing and Midwifery Association under an agreement -8- with the Council. Midwives Act, 1902 - 1956. The Council is tho Local Supervising Authority for the Midwives Acts in Wimbledon, There wore five practising midwives in Wimblodon at the end of 1943. One hundred and seventy-three confinements were attended by midwives and twenty-four by maternity nurses. Medical Aid foms were received in eighty-two instances. The total fees paid to doctors by the Corporation during the year under Section 14 (1) of the Midwives Act, 1918, amounted to £129.18,6d. The amount recovered from the patients' relatives was £80.6.0d. Public Health Act, 1056 (Child Life Protection); Children and Young Persons Act, 1952; Children Act,1908 (Part l).The following figures relate to the administration of the above Acts in Wimbledon during 1945, (i) Number of foster-mothers on the Register - (a) At the beginning of the year14 (b) At the end of the year12 (ii) Number of children on the Register - (a) At the beginning of the year 55 (b) At the end of the yea 95 (c) Who died during the year - (d) On whom inquests wore held during the year - Every foster-child was visited regularly. In all, one thousand two hundred and twenty nine visits were made to the hones of fostermothers . Treatment Facilities.- The Minor Ailment, Ophthalmic,0pthopaedic 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 six cases of ophthalmia neonatorum" were notified. In no case did any impairment of vision occur. The services of a consultant arc available whore necessary. CASES Vision Unimpaired Vision impaired Total Blindness Deaths Notified Treated At Home Hospital 6 3 3 6 - - - Maternal Mortality. There was one maternal doath amongst Wimbledon mothers in 1943. This occurred in an Institution outside the Borough. During 1941 and 1942 no maternal death occurred. -9- The following table gives the maternal mortality rates for Wimbledon and also for England and Wales:- 1943 No.140 Abortion with sepsis No.141 Abortion without sepsis No.147 Puerperal Infections Other maternal causes WIMBLEDON: Per 1,000 live births 0.00 0.00 0.00 1.10 Per 1,000 total births 0.00 0.00 0.00 1.17 England & Wales: Per 1,000 total births 0.34 0.11 0.39 1.45 Hospital Treatment for Complicated Obstetric Cases. During 1943 sixteen patients received treatment under this Scheme. The cost of maintenance and treatment of these patients amounted to £90. 13. 0d., of which £42. 5. 6d. was recovered from the relatives. r Supply of Milk to Expectant and Nursing Mothers and Infants. In addition to the National I'ilk Scheme administered "by the Ministry of Food, 152 lbs. of dried milk were supplied under the Maternity and Chil Welfare Scheme, 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. The evacuated nursery remained at Einrlhoad as a residential nurser It is administered by thi Surrey County Council on behalf of the Wimbledon Council. The War-time Nursery in the Nursery premises at All Saints Road, opened in March, 1942, continued to be well used during 1943. There were forty-six children on the register at the end of the year. A second War-time Nursery was provided on a site in Russoll Road. This Nursery, a pre-fabricated concrete building, was opened on 2nd November 1943, and has accommodation for fifty-six children, twenty-one of whom are under two years of age. The number of children on the register at the end of the year was forty. Nursing Homes Registration Act, 1927. Public Health Act, 1936 - Part The Wimbledon Borough Council is responsible for the supervision of nursing homes in Wimbledon. At the end of the year there were ten registered nursing homes. Thirty thre6 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 1943. -10- Reason of Visit No. Infectious Diseases 681 House Inspections 3,505 Inspections under Housing Acts, 1936 136 House to House Inspections 897 Rent Act Inspections 4 Houses Let in Lodgings Inspections — Inspection of Factories, Workshops, Workplaces and Outworkers' premises 107 Dairies and Cowsheds Inspections 77 Inspections under Shops Acts 9 Application of Tests to Drains 113 Inspections under Diseases of Animals' Acts - Obtaining Samples of Foods and Drugs 195 Miscellaneous (including Inspections of Feed, slaughterhouses, news, stables, caravans, Petroleum Acts, water supply, piggeries, mosquitoes, etc.) 3,068 Total 8,774 r Notices Served. - One thousand two hundred and thirty one preliminary notices or intimations were served during the year. It was found necessary to serve two hundred and eleven 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 47 Cisterns provided - Cisterns repaired, cleansed or covered 15 Drains, new, provided 54 Drainage systems made water-tight by patent process 27 Drains, repaired or altered 37 Drains, stoppages removed 66 Dustbins provided 181 Flushing cisterns, new, provided 12 Flushing cisterns, repaired 73 Manure receptacles provided 1 Rain-water pipes disconnected 4 Roofs repaired 284 Rooms stripped and cleansed 451 Verminous rooms cleansed 44 Soilpipes, new, provided 4 Soilpipes, repaired or altered 4 Vent pipes, new, provided 8 Vent pipes, repaired or altered 13 Waste pipes, new, provided 17 Waste pipes, repaired, disconnected or trapped 22 Water-closets, new,provided 50 Water-closets, repaired or ventilated 12 Water services restored 26 Water supply direct from main 3 Yards paved 13 Yards repaired 12 Guttering repaired 146 Floors ventilated 5 Nuisances from damp walls abated 203 Sinks provided 8 Other nuisances 1,597 Rooms disinfected 639 Total 4,078 -11- FACTORIES, WORKSHOPS AND W0RKPLACES. 1. Inspections for purposes of provisions as to health. Number of Premises Inspections Written Notices Prosecutions Factories with mechanical power 68 4 - Factories without mechanical power 7 - - Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises) """ ' Total 75 4 - 2. Defects Found. Particulars Number of Defects Prosecutions Found Remedied Refferred to H.M. Inspector Want of Cle nliness (S.1) 1 1 - - Overcrowding (3.2) - _ - - Hnreasonable temperature (S,4) - - - - Inadequate ventilation (S.4) - - - — Ineffective rainage of floors (S.6) - - - - Sanitary Conveniences (S,7) Insufficient 4 4 - - Unsuitable or Defective - - — — Not separate for Sexes "" - - - Other Offences (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 reenacted in the Third Schedule to the Factories Act. 1957) 2 2 - _ Totals 7 7 - - Outwork in Unwholesome Premises - Section 108. Nature of Work Instances Notices served Prosecutions Wearing Apparel - Making, etc. - • - Others "" "" - Outwork in Infeoted Premises - Sections 109 - 110 Nil. -12- HOME WORK. Lists received:- Twice in the year - Number of Outworkers - Once in the year - Number of outworkers - Number of Outworkers' Premises on register 32 Number of addresses received from other Councils17 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 12 Number of unwholesome premises - Notices served to remedy - OTHER METTERS. Underground Bakehouses in use at the end of the year3 Matters notified to K.M.Inspector of Factories:- Failure to affix Abstracts of Act Nil Action taken in matters Notified by H..M referred by H.K. Inspector Inspector Nil as remedial under the Reports of action Public Health Acts taken sent to H.M. Inspector Nil HOUSING. Number of dwelling-houses inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932- Number of inspections made for the purpose 880 Housing Act, 1936 - Part IV - Overcrowding:- (a) (1) Number of dwellings overcrowded at the end of the year 11 (2) Number of families dwelling therein 19 (3) Number of persons dwelling therein 85½ (b) Number of new cases of overcrowding reported during the year 4 (c) (1) Number of cases of overcrowding relieved during the year 7 (2) Number of persons concerned in such cases 47½ (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 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 a3 follows:- Pasteuriser's Licence 1 Dealers Licences: Tuberculin Tested Milk10 Accredited Mil- Pasteurised Milk 15 Supplementary Licences 4 Bacteriologioal Examination. - Twenty-nine samples of milk were taken" for "bacteriological examination under the Milk (Special Designa¬' tions) Order, -13- Food and Drugs Act, 1983. The Council became the Local Authority under this Act on 1st October, 1939. One hundred and eleven samples were taken up to the end of the year. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. During 1943 seven hundred and thirty cases of infectious disease were notified. These were one hundred and thirteen fewer than in 1942. This decease is almost entirely due to the fewer cases of measles. For several years the incidence of notifiable infectious diseases in Wimbledon has been low. Scarlet Fever.- One hundred and eighty-six cases of scarlet fever" were notified, eighty-sir more than in 1942. The attack rats was 3.93 per thousand of the population. One hundred and thirty-one, or 70.43 per cent of the cases were treated in hospital. There was no death from this disease. Diphtheria. - Twenty cases of diphtheria were notified in 1943, as compared with ten in the previous year. The attack rats was 0.42 per thousand of the population. All the patients received hospital treatment. There was no death. Diphtheria. Immunisation. Two sessions of the Immunisation Clinic were held "every week at the Health Centre. Fourteen children were Schick tested. Five were found to be positive and then immunised. The total number of children immunised was nine hundred and eighty-six. In all, one thousand eight hundred and forty attendances were made for this purpose. Thirty-six children attended for a subsequent Schick test. In eight cases they were found to be Schick positive and were re-immunised. Paratyphoid Fever. - No cases of paratyphoid fever were notified to the Department. Food Poisoning. - This became a notifiable disease on 3rd October, 1939. Ho notifications were received during the year. Cerebro-spinal Fever. - Ten cases of this disease were notified. Seven of the patients were treated in hospital. There was one death. Erysipelas.- Notifications were received in respect of eleven cases" of erysipelas. One patient was treated in hospital. Puerperal Pyrexia. - line cases of puerperal pyrexia were notified. Five of these patients were removed to hospital. There was no death from puerperal sepsis amongst the patients, Notified under the Regulations. Measles. - Two hundred and seventy-two cases of measles were notified, "Thirteen of these were removed to hospital. There were no deaths, Whooping Cough.- There were one hundred and fifteen cases of this disease notified in 1943. Eifht cases were treated in hospital. There were two deaths. -14- -15- TABLE A. - NOTIFIABLE DISEASES DURING 1943. DISEASE Number of C a vies Notified in V .rious Afo Groups Total Cares notified. Total Cane' removed to Hospital Under 1 1- 2 3-3 3-4 4 - 5 5-1X3 10-15 15-20 2D -35 35-45 45-65 65 & Oer Smallpox - - - - - - - - - - - - - — . Scarlet Fever 1 4 7 16 19 102 24 3 8 2 — — 186 131 Diphtheria (including Membranous Croup) - - - 1 2 4 1 4 5 1 2 - 20 20 Enteric Fever (including Paratyphoid) - _ - - - - - - - - - - - - Focd Poisoning __ __ - - - - - - - - - - - - Puerperal Pyrexia - - — - _ _ 1 7 1 - - 9 5 Measles 7 25 7 22 28 143 13 9 12 6 - - - 13 Vfiicoping Coufh 7 15 15 14 21 40 1 — 1 1 _ - 115 11 Acuta Primary Pneumonia _ - 1 - - p 2 1 1 2 6 4 21 - Acute Influenzal do - - - - - 1 - 1 - 2 3 2 9 - 'Ceiebro-spinal Fever - 1 - -- - - 3 1 3 — 2 - 10 7 Acute Poliomyelitis - — — - — — — — _ - - _ _ _ Acute Polio-encephalitis - - - - - - — — — - - ~~ - Encephalitis lethargica - - - - - _ - - - - - - - - Dysentery - - - - - - - - - - - - - Ialaria - — — - — - — _ - - - - - - Ophthalmia Neonatorum 6 — — — _ - - - _ _ - - 5 3 Erysipelas l - - — - - — — - 1 7 2 11 1 Tuberculosis (all forms) - - 1 - 2 3 4 9 32 4 14 2 71 53 TOTALS 22 47 31 53 72 295 48 29 69 20 34 10 730 244 -16- TUBERCULOSIS - 1943. AGE GROUPS i 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 Females Hales Females L Males Females Males Females Males Females Males Females Under 1 year - - - - - - - - - - - - - - - - 1-5 years 1 2 - - — - — — 1 2 - - — - 1 1 5-10 „ 1 — 2 — — - - - 1 - 2 - - - - - 10-15 „ — 2 - - 1 - 1 - 1 2 1 - - - - 1 15-20 „ 2 3 - 4 - - - - 2 3 - 4 - 1 1 - 20 - 25 „ 5 5 - 1 — - - - 3 5 - 1 2 1 1 - 25-35 „ 6 5 1 - 4 6 1 - 10 11 2 - 2 2 - - 35 - 45 „ 1 2 - - - 1 - - 1 3 - — 4 1 - - 45 - 55 „ 4 4 - - 1 - - - 5 4 - - 3 3 - - 55 - 65 „ 3 - - 2 - - - - 3 - - 2 6 1 - - 65 and over 1 — — - 1 - - - 2 - - - 3 1 - - 22 23 3 7 7 7 2 - 29 30 5 7 20 10 2 2 45 10 14 2 59 12 30 4 55 16 71 34 TUBERCULOSIS Seventy-one cases of tuberculosis were notified. This figure shows a decrease of nine on the number for the previous year. There were thirty-four deaths from tuberculosis in 1943, two more than in the previous year. Thirty of these were due to pulmonary tuberculosis. During 1943, fift^r-three V/imbledon patients were admitted to sanatoria or hospitals. WIMBLEDON INFECTIOUS DISEASES HOSPITAL. Three hundred and sixty-seven cases were admitted to the Infectious Diseases Hospital during 1943. As there were twenty-five cases in hospital at the end.of 1942, the total number of cases under treatment during the year amounted to three hundred and ninety-two. Two hundred and fifty-seven of these cases were from V/imbledon, and one hundred and twenty-five from Kingston. On the three hundred and ninety-two patients under treatment, two hundred and thirty-five were suffering from scarlet fever, thirty-seven from diphtheria, twelve from cerebro-spinal meningitis, one from enteric fever, sixteen from dysentery, twenty-six from measles, and sixty-five from other diseases. There were six deaths during the year. Two of these were due to whooping cough, one of which was complicated by broncho-pneumonia and the other pneumothorax. Two cases admitted as cerebro-spinal fever teminated fatally, the cause of death in each case being pneumococcal meningitis. One case, admitted as dysente^, died from gastroenteritis . Thirty-three patients remained in hospital at the end of 1943.. Twenty-eight of these were suffering from scarlet fever, two from diphtheria, on6 from puerperal pyrexia, one from whooping cough, and one from chickenpox. STAFF. Towards the end of the year Dr. P.J.Doody was informed that he would be recruited for service with H.M.Forces early in 1944. Dr. Emily M. Frazer was appointed in a temporary capacity and arrangements were made for her to commence duty on 1st January, 1944. In concluding this report I should like to express my deep appreciation to the Chaiiman and members of the Public Health and Maternity and Child Welfare Committees for the consideration and courtesy which they have again shown me during 1943. It is also a pleasure to draw attention to the help and cooperation which I have received from all members of the staff. I have the honour to be Your obedient Servant, HAROLD ELLIS. -17-