BOROUGH 0F W1MBLEDON. PUBLIC HEALTH DEPARTMENT. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR ENDED 31st DECEMBER, 1944. STAFF. Whole - time. Medical Officer of Health; Schoo1 Medica1 Officer; Medical Superintendent of the Infectious Diseases Hospital; Maternity and child Welfare Officer: HAROLD EIJTS, 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. DCODY, M.B. , B.Ch.,. D.P.H. Temporary Assistant Medical Officer; I 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, E. WOODROFF, (b), (c), (g). • MISS P. N. NASH, (a), (b), (d). MRS. E, S. G. BELL, (a), (b), (d), (h). MISS G. K. JEFFREYS, (a), (b), (d), (h). Matron of Infectious Diseases Hospital. MISS I. MUIHERN. 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, ø 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. LBS LI 3 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. 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. J. M. LEVER, M.B., Ch.B., 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. -2 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH. 1944. 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, 1944. The Report for 3.944 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 Population (mid-1944) 44,800 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:- £811,200 Sum represented by a penny rate:- £3,140. Extracts from Vital Statistics of the Year 1944. (Registrar-General's Figures); Total M. F. Live Births Legitimate 655 343 312 Illegitimate 45 25 20 Total 700 368 332 Birth Rate per 1,000 of the estimated 15,62 Total M. F. Stillbirths Legitimate 24 11 13 Illegitimate - - - Total 24 11 13 Rate per 1,000 total (live and still) births 33.14 Total M. F. Deaths 705 342 363 Death rate per 1,000 of the estimated resident population 13.21 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 and post-abortive sepsis 2 2.76 No. 30 Other maternal causes – – Total 2 2.76 -3- Death Rate of Infants under one year of age:- All Infants per 1,000 live births 37.14 Legitimate Infants per 1,000 legitimate live births 35.11 Illegitimate Infants per 1,000 illegitimate live births 65.66 Deaths from Cancer (all ages) 114 " " Measles (all ages) - " " Whooping Cough (all ages) 1 " " Diarrhoea (under 2 years of age) 6 Birth Rates, Civilian Death Rates, Analysis of Mortality Maternal Death Rates, and Case Rates for certain Infectious Diseases in the Year 1944. (Provisional figures based on weekly and quarterly returns) Wimble don England & Wales 126 C.B's & Great Towns including London 148 Smaller towns (resident population 25,000 50,000 at 1931 London Administrative County (1) (2) (3) (4) Census (5) (6) Rates per 1,000 Civilian Population Live Births 15.62 17.6 20.3 20.9 15.0 Sti11 Births 0.53 0.50 0.64 0.61 0.42 Deaths:- All Causes 13,21 11.6 13.7 12.4 15.7 Typhoid & Paratyphoid 0.00 0.00 0.00 0.00 0.00 Small-pox — 0.00 - - — Measles 0.00 0.02 0.01 0.01 0.00 Scarlet Fever 0.00 0.00 0.00 0.00 0.00 Whooping Cough 0.02 0.03 0.03 0.02 0.04 Diphtheria 0.00 0.02 0.03 0.03 0.01 Influenza 0.13 0.12 0.10 0.11 0.08 Violence 1.65 x x x x Notifications:- Small-pox — 0.00 0.00 0.00 0.00 Scarlet Fever 1.72 2.40 2.41 2.67 1.57 Diphtheria 0.53 0.58 0.67 0.69 0.31 Typhoid Fever – 0.01 0.01 0.01 0.01 Paratyphoid Fever – 0.01 0.00 0.01 0.01 Cerebro-spinal Fever 0.06 0.05 0.06 0.04 0.06 Measles 1.27 4.16 4.51 3.94 2.98 Whooping Cough 2.61 2.49 2.49 2.29 2.90 Erysipelas 0.24 0.29 0.32 0.28 0.37 Pneumonia 0.56 0.97 1.13 0.32 0.93 Rates per 1,000 Live Births Infant Mortality:- Deaths under 1 yr.of age 37 46 52 44 61 Deaths from Diarrhoea & Enteritis (under 2 yrs. of age) 8.57 4.8 7.3 4.4 10.1 * A dash (-) signifies that there were no deaths, x. Information not available. -4- Rates per 1,000 Total Births(i.e., Live and Still). (1) (2) (3) (4) (5) (6) (a) Notification:- Puerperal Fever ) 10.34 10.34 13.13 9.25 ( 3.61 Puerperal Pyrexia ) (14.14 No. 140 Abortion with sepsis No.141 Abortion without sepsis No.147 puerperal Infections Nos,142-146 and 148-150. Other maternal causes (b) Maternal Mortality WIMBLEDON 0.00 0.00 2.76 0.00 England & Wales 0.31 0.09 0.28 1.25 Abortion:- Mortality per million women aged 15-45 yrs. No.140.With sepsis No.141. Without sepsis England & Wales 25 7 Including Puerperal Fever. Births: - The statistics supplied by the Registrar-General show that during 1944 the total number of registered live births belonging to Wimbledon amounted to seven hundred (three hundred and sixty-eight males and three hundred and thirty-two females). This gives a birth rate equal to 15.62 per thousand of the population, compared with 17.69 per thousand for the previous year. Forty-five of the births were illegitimate. Of this number twenty-five were males and twenty females. In addition, twenty-four stillbirths (eleven males and thirteen females) were registered. Public Health Act, 1956 - Notification of Births, During the year seven hundred and fifty-two births were notified by the following persons:- Parents 1 Midwives 166 Doctors 25 Other persons 560 Total 752 Nineteen of these notifications were in respect of stillbirths. Of the seven hundred and fifty-two notifications, three hundred and eighty-eight 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-eight confinements occurred in Wimbledon amongst women whose homes were situated in other districts. The net number of notified births belonging to Wimbledon is, therefore, six hundred and sixty-four. Deaths:- The total number of deaths registered in the district was six hundred and seven (two hundred and forty-three males and three hundred and sixty-four females), equal to a death rate of 13.54 per thousand of the population. The deaths occurring outside the district, of persons belonging to this Borough, were three hundred and nineteen. The deaths occurring within the district, of persons not belonging thereto, were two hundred and twenty-one. Taking these figures into consideration, the total number of deaths properly belonging to Wimbledon is seven hundred and five, and the crude death rate 15.73 per thousand of the population. The death rate shows a slight increase on the figure for the previous year. -5- The crude death rate 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 which it is available, the adjusted death rate for Wimbledon would be 13.21 per thousand of the population as compared with a figure of 11.6 per thousand for England and Wales. causes of death. Males Females Total I. Typhoid ana paratyphoid fevers - - - 2. Cerebro-spinal fever - - - 3. Scarlet Fever - - - 4. Whooping Cough - 1 1 5. Diphtheria - - - 6. Tuberculosis of respiratory system 12 14 26 7. Other forms of tuberculosis 2 2 4 8. Syphilitic diseases 1 1 2 9. Influenza - 6 6 10. Measles - - - 11. Acute poliomyelitis and polioencephalitis - - - 12. Acute infectious encephalitis - - - 13. M.Cancer of buccal cavity and oesophagus (males only) 5 - 5 13. F.Cancer of uterus - 2 2 14. Cancer of stomach and duodenum 10 9 19 15. Cancer of breast - 13 13 16. cancer of all other sites 36 39 75 17. Diabetes 1 2 3 18. Intra-cranial vascular lesions 30 36 66 19. Heart disease 92 100 192 20. Other diseases of the circulatory system 12 10 22 21. Bronchitis 22 9 31 22. Pneumonia 16 13 29 23. Other respiratory diseases 9 2 11 24. Ulcer of the stomach or duodenum 6 3 9 25. Diarrhoea (under 2 years of age) 3 3 6 26. Appendicitis 1 - 1 27. Other digestive diseases 7 8 15 28. Nephritis 5 6 11 29. Puerperal and post-abortive sepsis - 2 2 30. Other maternal causes - - - 31. Premature birth 4 2 6 32. Congenital malformations, birth injury, infantile diseases 7 4 11 33. Suicide 4 1 5 34. Road traffic accidents 6 1 7 35. Other violent causes 20 42 62 36. All other causes 31 32 63 Totals 342 363 705 Over half the total deaths which occurred amongst Wimbledon residents in 1944 were again due to cancer, diseases of the heart and circulation, and diseases of the respiratory system. Infant Mortality. There were twenty-six. infant deaths (including transferable deaths) giving an Infantile Mortality Rate of 37.14 per thousand live births, compared with a figure of 50.17 per thousand in the previous year. During 1944 the Infantile Mortality Rate for England and Wales was fortysix. The following table shows the causes of, and ages at, death, together with the Ward distribution. -6- -7- Infant Mortality during the Year 1944. Cause of Death Under One wk. 1-2 wks 2-3 wks 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 Ntn. W'dor Sth, W'don Total St. Mary's St. John's Cott. Park Wtion Park Durd Trini ty Sth. park Haydon Park Whooping Cough — — — — — — — — 1 1 — — — — — 1 — — — 1 1 Pneumonia — — — — — 1 — — — 1 — — — — — 1 — — — 1 1 Broncho-pneumonia — 1 1 —- 2 1 — — — 3 1 — 1 — — — 1 — 2 1 3 Gastro-enteritis — — — 1 1 1 3 — — 5 1 1 — — 1 1 1 — 2 3 5 Prematurity 3 1 — — 4 2 — — — 6 — — — 2 — 2 — 2 2 4 6 Marasmus — — — — — — — 1 — 1 — — — — 1 — — — — 1 1 Atelectasis 2 — 1 — 3 — — — — 3 — — — 1 — — 2 — 1 2 3 Congenital defects 1 — — — 1 1 — — — 2 1 1 — — — — — — 2 — 2 Other causes 3 1 — — 4 — — — — 4 1 1 — — — 1 — 1 2 2 4 Total 9 3 2 1 15 6 3 1 1 26 4 3 1 3 2 6 4 3 11 15 26 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 Epsom 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 1944 amounted to 8,839, the figure for the previous year being 9,363. Details of the homo visits carried out are given below:- Number of Infants visited - first visits 709 revisits 1,434 Number of Toddlers visited 2,128 Ante-natal - first visits 450 " - revisits 140 Visits re Infant deaths 14 " " Stillbirths 11 " " Ophthalmia Neonatorum 5 " " Puerperal Pyrexia 3 " " Non-notifiable Infectious Diseases 2 " " Milk applications 20 " " Foster Children 345 " " Midwives 7 Miscellaneous 881 Total welfare visits 6,159 Visits - School Medical Service 1,298 Tuberculosis - Home visits 45 Visits to Nursing Home 20 Other visits 78 Ineffectual visits 1,239 2, 680 Total visits 8,839 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 50.32, and at the Friday sessions 50.11. At the Cottenham Park Centre the average weekly attendance was 43.18„ The average attendance at the Wandle Park Centre was 36,10. The Centre at Wimbledon Park, which was opened in 1943, showed an average weekly attendance of 54.84. The premises used by the Council as a Welfare Centre at Cottenham Park were destroyed by enemy action in July. Temporary accommodation was made available in a part of the Civil Defence Ambulance Station which was situated nearby, and it is probable that these premises will continue to be used when the Civil Defence Service is disbanded. -8- Ante-natal Clinic. The Pelham Road Ante-natal Clinic continued to be held on Monday and Saturday each week, the average attendances being 15.75, and 10.05 respectively. The Ante-natal Clinic at Wandle Park was held every other Thursday, The average attendance was 9.59. Midwifery and Maternity Services - Midwives Act, 1956. A service of whole-time domiciliary midwives is provided by the Wimbledon District Nursing and Midwifery Association under an agreement with the Councils Midwives Act, 1902 - 1936. The Council is the Local Supervising Authority for the Midwives Acts in Wimbledon. There were six practising midwives in Wimbledon at the end of 1944, one of whom was resident outside the Borough, One hundred and forty-one confinements were attended by midwives and twenty-two by maternity nurses. Medical Aid forms were received in eighty-four instances. The total fees paid to doctors by the Corporation daring the year under Section 14 (1) of the Midwives Act, 1918, amounted to £115,2.6d. The amount recovered from the patients' relatives was £67.18.l1d. Public Health Act, 1936 (Child. Life Protection); Children and Young Persons Act, 1932: children Act, 1908 (Part 171). The following figures relate to the administration of the above Acts in Wimbledon during 1944. (i) Number of foster-mothers on the Register - (a) At the beginning of the year 12 (b) At the end of the year 11 (ii) Number of children on the Register- (a) At the beginning of the year 93 (b) At the end of the year 17 (c) Who died during the year - (d) On whom inquests were held during the year - Every foster-child was visited regularly. In all, three hundred and forty-five visits were made to the homes of foster-mothers. Treatment Eacilities, - 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 nine cases of ophthalmia neonatorum were notified In no case did any impairment of vision occur. The services of a consultant are available where necessary, CASES Vision Unimpaired Vision impaired Total Blindness Deaths Notified Treated At Home Hospital 9 5 4 9 - - - -9 Maternal Mortality. There were two maternal deaths amongst Wimbledon mothers in 1944. One of these occurred in the patient's own home and the other in an Institution outside the Borough. One maternal death occurred in 1943. During 1941 and 1942 there were no maternal deaths in Wimbledon, The following table gives the maternal mortality rates for Wimbledon and also for England and Wales:- 1944 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 2.85 0.00 Per 1,000 total births 0.00 0.00 2.76 0.00 England & Wales: Per 1,000 total births 0.31 0.09 0.28 1.25 Hospital Treatment for Complicated Obstetric Cases - During 1944 eleven patients received treatment under this' Scheme. The cost of maintenance and treatment of these patients amounted to £59.10.0d., of which £16. 5.6d. was recovered from the relatives. Supply of Milk to Expectant and Nursing Mothers and Infants. In addition to the National Milk Scheme administered by the Ministry of Food, 127 lbs. of dried milk were supplied under the Maternity and Child 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. Tne evacuated nursery remained at Hindhead as a residential nursery. It is administered by the 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 1944. There were fifty-six. children on the register at the end of the year* A second War-time Nursery was provided on a site in Russell 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 fifty-two. Nursing Homes Registration Act, 1927. Public Health Act, 1956 -Part VI. 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-two visits of inspection were made. -10- Care of Premature Infants, In June, 1944, the Council appointed Dr. G.H. Newns as Consultant Paediatrician. His services are available to all local practitioners in respect of any infant up to the age of twelve months. In addition, the necessary special equipment suggested in Ministry of Health Circular No. 20/1944 was obtained, and is available on application to the Wimbledon District Nursing and Midwifery Association, 28, King's Road, Wimbledon. Infestation by Head Lice - Circular No. 2831. The examination of the heads of children under the age of 5 years has been carried oat as part of the Health Visitors' normal duties both at the times of their visits to the homes and also in the M tornity and Child Welfare Clinics. The standard of cleanliness of children under 5 in Wimbledon has always been high. It has been the practice of the Health Visitors, who also combine the duties of School Nurses, to pay particular attention to the homes of school children whose heads have been found to be dirty, and where there are children under the age of 5 years in such homos their condition of cleanliness is closely supervised in so far as the co-operation of the parents can be obtained. In most cases the Health Visitors arc successful in obtaining the good will and assistance of the parents. A supply of steel fine-tooth combs is kept at the Health Centre and these are available for sale or on loan. A number of parents have taken advantage of these facilities. Whore it has been considered advisable Lethane hair oil (384 - "Special") has been used and a supply of this preparation is always kept at the Health Centre, The supervision of the hair of adolescent girls residing in a house where children have been found with dirty heads is a much more difficult problem. The need for advising these adolescent girls is constantly kept in mind by the Health Visitors, and where the mother and girls were receptive every assistance has been given. SANITARY CIRCUMSTANCES OF THE AREA. Sanitary Inspection of District. - The following is a statement shewing the number and nature of inspections made for the year 1944:- -11- Reason of Visit No. Infectious Diseases 712 House Inspections 3,194 Inspections under Housing Acts, 1935 28 House to House Inspections 721 Rent Act Inspections 12 Houses Let in Lodgings Inspections 215 Inspection of Factories, Workshops, Workplaces and Outworkers' premises 180 Dairies and Cowsheds Inspections 40 Inspections under Shops Acts 27 Application of Tests to Drains 76 Inspections under Diseases of Animals' Acts - Obtaining Samples of Foods and Drugs 212 Miscellaneous (including Inspections of Food, slaughterhouses, mews, stables, caravans, Petroleum Acts, water supply, piggeries, mosquitoes, etc.) 6,632 12,049 Notices Served. - One thousand five hundred and twenty-seven preliminary notices or intimations were served during the year. It was found necessary to serve two hundred and fifty-four 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:- Accumalations removed 22 Cisterns provided 2 Cisterns repaired, cleansed or covered 26 Drains, new, Drovided 12 Drainage systems made water-tight by patent process – Drains, repaired or altered 21 Drains, stoppages removed 39 Dustbins provided 133 Flushing cisterns, now, provided 2 Flushing cisterns, repaired 47 Manure receptacles provided 2 Rain-water pipes disconnented 1 Roofs repaired 112 Rooms stripped and cleansed 188 Verminous rooms cleased 36 Soilpipes, new, provided 1 Soilpipes, repaired or altered 7 Vent pipes, new, provided - Vent pipes, repaired or altered 8 Waste pipes, new, provided 3 Waste pipes, repaired, disconnected or trapped 14 Water-closets, new, provided 19 Water-closets,repaired or ventilated 9 Water services restored 17 Water supply direct from main 11 Yards paved 6 Yards repaired 4 Guttering repaired 78 Floors ventilated 3 Nuisances from damp walls abated 74 Sinks provided 6 Other nuisances 1,070 Rooms disinfec6ted 471 To tal 2, 444 12- factories, Workshops and workplaces. 1. Inspections for purposes of provisions as to health. Premises Number of Inspections Written Notices prosecutions Factories with mechanical power 120 7 - Factories without mechanical power 15 - - Other Premises under the Act (including works of building and engineering construction but not including outworkers' Premises) - - - Totals 135 7 - 2. Defects Found, Particulars Number of Defects Prosecutions Found Remedied Referred to H.M. Inspector Want of Cleanliness (S.l) 3 3 - - Overcrowding (S.2) - - - - Unreasonable temperature (S.5) - - - - Inadequate ventilation (S.4) - - - - Ineffective drainage of floors (s.6) - - - - Sanitary Conveniences (S.7) Insufficient 3 3 - - Unsuitable or Defective - - - - Not separate for Sexes 1 1 - - Other Ofiences 2 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 reenacted in the Third Senedule to the Factories Act, 1937) Totals 9 9 - - 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. -13- HOME WORK. Lists received:- Twice in the year - Number of Outworkers - Once in the year - Number of Outworkers - Number of Outworkers' Premises on register 35 Number of addresses received from other Councils 24 Number of addresses forwarded to other Councils 5 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 48 Number of unwholesome premises - Notices served to remedy - OTHER MATTERS. Underground Bakehouses in use at the end of the year 3 letters notified to H.M. Inspector of Factories:- Eailure 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. ; Number of inspections made for the purpose 723 Housing Act, 1936 - Part IV - Overcrowding:- (a) (1) Number of dwellings overcrowded at the end of the year 9 (2) Number of families dwelling therein 17 (3) Number of persons dwelling therein 78 (b) Number of new cases of overcrowding reported during the year - (c) (1) Number of cases of overcrowding relieved during the year 2 (2) Number of persons concerned in such cases 7½ (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 water SUPPLY. The Metropolitan Water Board is responsible for the water supply of the Borough. The supply in 1944 was satisfactory, both in quality and quantity. 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 9 Accredited Milk - Pasteurised Milk 12 Supplementary Licences 12 Bacteriological Examination. - Twenty-nine samples of milk were taken for bacteriological examination under the Milk (Special Designations) Order. -14- Food and Drugs Act, 1958. The Council became the Local Authority under this Act on 1st October, 1959,, One hundred and eight samples were talcen up to the end of the year. prevalence OF and CONTROL OVER infectious OTHER diseases. During 1944 four hundred and ninety-six cases of infectious disease were notified. These were two hundred and thirty-four fewer than in 1945. This decrease is almost entirely due to the fewer cases of scarlet fever and measles. For several years the incidence of notifiable infectious diseases in Wimbledon has been low. Scarlet Fever. - Seventy-seven cases of scarlet fever were notified, one "hundred and nine less than in 1945. The attack rate was 1.72 per thousand of the population. Fifty-five, or 71.45 per cent of the cases were treated in hospital. There was no death from this disease. Diphtheria. - Twenty-four cases of diphtheria were notified in 1944, as compared with twenty in the previous year. The attack rate was 0.55 per thousand of the population. All the patients received hospital treatment. There was no death. Diphtheria Immunisation. - Two sessions of the Diphtheria Immunisation Clinic were held every week at the Health Centre. Six children were Schick tested. Three were found to be positive and then immunised. Eighteen attendances were made. The total number of children immunised was three hundred and thirty-two In all six. hundred and twenty-six attendances were made for this purpose. Ninety-eight children attended for a subsequent Schick test. In seventeen casus they were found to be Schick positive and were re-immunised. Two hundred and two attendances were made. The total number cf attendances at the Immunisation Clinics in 1944 was therefore eight hundred and forty-six. paratyphoid Fever. - No cases of paratyphoid fever were notified to the Department. Food Poisoning. - This became a notifiable disease on 5rd October, 1909, No notifications were received during the year, Cerebro-spinal Fever.- Three cases of this disease were notified. All the patients were treated in hospital," There was no death. Erysipelas. - Notifications were received in respect of eleven cases or erysipelas. One patient was treated in hospital. Puerperal Pyrexia. - Six. cases of puerperal pyrexia were notified. Two of these pa tents were removed to hospital. There was no death from puerperal sepsis amongst the patients notified under the Regulations, Measles. - Fifty-seven cases of measles were notified. Thirteen of these were removed to hospital. There were no deaths. Whooping Cough. - There were one hundred and seventeen cases of this disease notified in 1944, Eleven cases were treated in hospital. There was one death. -15. -16- TABLE A. - NOTIFIABLE DISEASES DURING 1944. 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 1 1 12 27 21 4 6 2 1 - 77 55 Diphtheria (including Membranous Croup) - - - - 1 9 9 3 - - 2 - 24 24 Enteric Fever (including Paratyphoid) - - - - - - - - - - - - - Food Poisoning - - - - - - - - - - - - - - Puerperal Pyrexia - - - - - - - - 6 - - - 6 2 Measles 1 6 3 10 7 23 3 1 2 1 - - 57 13 Whooping Cough 17 19 16 8 12 44 - - - 1 - - 117 11 Acute Primary Pneumonia - - 1 - - 1 - - 1 1 7 8 19 - Acute Influenzal Pneumonia - 1 - - - - - - - - 3 2 6 - Cerebro-spinal Fever 1 - - 1 - - - - 1 - - - 3 3 Acute Poliomyelitis - - - - - - 1 - - - - - 1 1 Acute Polio-encephalitis - - - - - - - - - - - - - - Encephalitis lethargica - - - - - - - - - - - - - - Dysentery 2 2 7 5 6 18 12 3 28 3 2 1 89 14 Malaria - - - - - - - 1 - - - - 1 — Ophthalmia Neonatorum 9 - - - - - - - - - - •• 9 4 Erysipelas - - - - - 1 - - 2 3 5 11 1 Tuberculosis (all forms) " - - 1 1 3 3 9 33 18 8 1 76 51 TOTALS 31 29 28 26 39 126 49 21 77 28 26 16 496 179 TUBERCULOSIS - 1944. AGE GROUPS NEW CASES Primary Notifications (Form A) New cases discovered otherwise than by notification Total new cases DEATHS Pulmonary NonPulmonary Pulmonary NonPulmonary Pulmonary NcnPulmonary Pulmonary NonPulmonary Males Females Males Females Males Females Males Females Males Females Males Females Males Females Males Females Under 1 year — — — — — — — — — — — — — — — — 1-5 years 1 1 — — — — — — 1 1 — — — — — — 5-10" — — 1 1 — — — 1 — — 1 2 — — 1 — 10 - 15 " — 2 — — 1 — — — 1 2 — — — — — — 15 - 20 " 7 2 — — — — — — 7 2 — — — 2 — — 20 - 25 " 5 6 — 2 2 1 2 — 5 7 2 2 — 3 — — 25 - 35 7 5 — — 2 4 1 — 9 7 1 — 3 3 — 2 55 - 45 " 7 2 — — 5 3 — 1 12 5 — 1 4 4 — — 45 - 55 " 5 — — — — — — — 3 — — — 3 2 — — 55 - 65 " 2 1 — 1 1 — — — 3 1 — 1 1 — 1 — 65 and over — — — — — — — — — — — — 1 — — — 30 17 1 4 11 8 3 2 41 25 4 6 12 14 2 2 4,7 5 19 5 66 10 26 4 52 24 76 30 76 TUBERCULOSIS. Seventy-six. cases of tuberculosis were notified. This figure shows an increase of five on the number for the previous year. There were thirty deaths from tuberculosis in 1944, four less than in the previous year* Twenty-six of these were due to pulmonary tuberculosis. During 1944, fifty-one Wimbledon patients were admitted to sanatoria or hospitals. WIMBLEDON INFECTIOUS DISEASES HOSPITAL. Two hundred and twenty-one cases were admitted to the Infectious Diseases Hospital during 1944; as there were thirty-three cases in hospital at the end of 1943, the total number of cases under treatment during the year amounted to two hundred and fifty-four. One hundred and sixty-eight of these cases were from Wimbledon, sixty from Kingston and twenty-six from other areas, Of the two hundred and fifty-four patients under treatment, one hundred and thirty-two were admitted as scarlet fever, thirty-nine as diphtheria, four as cerebrospinal meningitis, one as paratyphoid fever, twenty-two as dysentery, seventeen as whooping cough, eleven as measles and twenty-eight as other diseases. j Of the thirty-nine cases admitted as diphtheria only twenty-seven were found to be true clinical cases of this disease. In one of these cases tracheotomy was performed. This patient made a satisfactory recovery. In the remaining twelve cases four of the patients gave persistent positive swabs and were found to be "carriers" only. Of the other eight cases one was suffering from nasal diphtheria, one from laryngitis and bronchitis, one from tonsillitis, four from nondiphtheritic infections of the throat and one from scarlet fever. One hundred and thirty-two patients were admitted to the hospital as cases of scarlet fever. Three of these were found after admission to be suffering from German measles. In three of the four patients admitted as cases of cerebrospinal meningitis the diagnosis was not confirmed on bacteriological investigation. One patient was admitted to the hospital as a suspected case of paratyphoid fever. After admission he was found to be suffering from tuberculous meningitis. This case terminated fatally on the seventh day. Two other deaths occurred in the hospital during the year. One of these was due to whooping cough which was complicated by bronchopneumonia, and the other to pyaemia from umbilical sepsis. Sixteen patients remained in hospital at the end of 1944, Four of these were suffering from scarlet fever, nine from diphtheria, one from puerperal pyrexia, one from dysentery and one from Vincent's angina. During July the Hospital was very extensively damaged as the result of enemy action. Happily there were no fatal casualties. Three of the patients and two of the staff received minor injuries from flying glass. I should like to take this opportunity of placing on record my deep appreciation of the excellent manner in which all the members of the staff have carried out their duties during the trying conditions prevailing during the war years. -18- S T A F Fo Early in the year Dr. PPJ„ Doody was recruited for service with H.M. Forces. Dr. Enily M. Eraser was appointed in a temporary capacity and commenced duty on 1st January, 1944. In concluding this report I should like to express my deep appreciation to the Chairmen and members of the Public Health and Maternity and Child Welfare Committees for the consideration and courtesy which they have again shown me during 1944. It is also a pleasure bo draw attention to the help and co-operation which I have received from all members of the staff. I have the horror to be, Your obedient Servant, HAROLD ELLIS, Medical Officer of Health. 19-