WIMI 18 Brough of Wimbledon. Public Health Department ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR ENDED 31st DECEMBER, 1945. Printed by Raynes Park Press, Lambton Road, London, S.W.20 STAFF Whole-Time: Medical Officer of Health; 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: ‡ * Patrick J. Doody, M.B., B.Ch., D.P.H. Temporary Assistant Medical Officer: ‡ Emily M. Frazer, M.B., B.S. (Lond.), (resigned 22.9.45) ‡ H. D. B. North, M.B., Ch.B., D.P.H., M.Sc. (appointed 22.9.45) Senior Sanitary Inspector : † R. T. Avis, M.R. San. I., M.S.I.A., (c), (e), (f). (died 19.12.45) Sanitary Inspectors: † D. F. S. Flynn, (e), (f). † C. W. Southerby, (e), (f). † J. F. Smith, (e), (f). (transferred to permanent staff 3.10.45). † J. G. Plant, (e), (f). (resigned 21.7.45). † * 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). Mrs. E. S. G. Bell, (a), (b), (d), (h). (resigned 28.12.45). 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) (Resigned 7.9.45). Miss E. C. Quarmby (Russell Road) (Appointed 17.9.45). Senior Clerk: A. L. Taylor. Clerks: * J. E. Field. * J. Burrows. Mrs. B. M. Beacon (temporary) (resigned 31.10.45) § Miss A. Smith (temporary) (resigned 21.4.45) § Miss E. Carroll (temporary) (resigned 24.2.45) * W. G. Clement (temporary) (resigned 2.6.45) Miss A. V. Little (temporary) (appointed 24.10.45) Mrs. F. I. Maddison (temporary) (appointed 14.11.45) Miss S. Miller (temporary) (appointed 3.4.45) Clerk to the Maternity and Child Welfare Department: A. L. Taylor 1 Part-Time: Obstetric Consultants: Leslie H. W. Williams, M.D., F.R.C.S., F.R.C.O.G. J. Vincent O'Sullivan, M.D., F.R.C.S., M.R.C.P., F.R.C.O.G. Medical Officer to Ante-Natal Clinics: S. Taylor Harris, M.R.C.S., L.R.C.P. Consultant Paediatrician: G. H. Newns, M.D., M.R.C.P. Medical Officers to Maternity and Child Welfare Centres: Mary M. Tulloch, M.B., B.S., E. A. Evans, M.A., M.B., B.Ch. Deputy Medical Attendant, Infectious Diseases Hospital: W. L. Galvin, M.B., B.Ch. Orthopaedic Surgeon: F. Durbin, F.R.C.S. Surgeon to Aural Clinic: R. J. Cann, M.S. Veterinary Inspector: Col. E. Middleton Perry, C.B.E., F.R.C.V.S. † Salary contribution under Public Health Acts. ‡ Salary contribution bv 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) lations, 1919. (h) Certificate of Fever Training. * Serving with H.M. Forces. § Civil Defence. 2 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, 1945. The Report for 1945 is an ordinary Report compiled in accordance with the instructions contained in Circular 28/46 of the Ministry of Health. 3 STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres—Census, 1931) 3,221 Population (Census, 1931) 59,254 Population (mid-1945) 47,070 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:—£804,544. Sum represented by a penny rate:—£3,094. Extracts from Vital Statistics of the Year 1945. (Registrar-General's Figures.) Total M. F. Live Births Legitimate 731 392 339 Illegitimate 70 45 25 Total 801 437 364 Birth Rate per 1,000 of the estimated resident population 17.01 Total M. F. Stillbirths Legitimate 18 8 10 Illegitimate 2 2 0 Total 20 10 10 Rate per 1,000 total (live and still) births 24.36 Total M. F. Deaths 630 293 337 Death Rate per 1,000 of the estimated resident population 13.38 Deaths from puerperal causes (Headings 29 and 30 of the Registrar-General's Short List):— Deaths. Rate per 1,000 total (live and still) births. No. 29 Puerperal and post-abortive sepsis 1 1.21 No. 30 Other maternal causes l 1.21 Total 2 2.42 Death Rate of Infants under one year of age:— All Infants per 1,000 live births 36.20 Legitimate Infants per 1,000 legitimate live births 39.67 Illegitimate Infants per 1,000 illegitimate live births 0 Deaths from Cancer (all ages) 103 Measles (all ages) 0 Whooping Cough (all ages) 0 „ Diarrhoea (under 2 years of age) 2 4 Birth Rates, Civilian Death Rates, Analysis of Mortality, Maternal Death Rates, and Case Rates for eertain Infectious Diseases in the Year 1945. (Provisional Figures based on Weekly and Quarterly Returns). Wimbledon England and Wales 126 C.B's and Great Towns including London 148 Smaller towns (resident population 25.000 -50,000 at 1931 Census London Administrative County (i) (2) (3) (4) (5) (6) † Rates per 1,000 Civilian Population Live Births 17.01 16.1 ‡ 19.1 19.2 15.7 Still Births 0.42 0.46‡ 0.58 0.53 0.40 Deaths:— All Causes 13.38 11.4‡ 13.5 12.3 13.8 Typhoid and 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 0.00 0.00 0.00 0.00 0.00 Whooping Cough 0.00 0.02 0.02 0.01 0.02 Diphtheria 0.02 0.02 0.02 0.02 0.01 Influenza 0.08 0.08 0.07 0.07 0.07 Violence 0.30 * * * * Notifications:— Small-pox – 0.00 0.00 – 0.00 Scarlet Fever 0.98 1.89 2.02 2.03 1.57 Diphtheria 0.25 0.46 0.52 0.56 0.31 Typhoid Fever — 0.01 0.01 0.01 0.01 Paratyphoid Fever — 0.01 0.00 0.01 0.00 Cerebro-Spinal Fever 0.13 0.05 0.05 0.05 0.06 Measles 12.45 11.67 10.89 11.19 9.03 Whooping Cough 1.15 1.64 1.65 1.47 1.25 Erysipelas 0.23 0.25 0.28 0.24 0.31 Pneumonia 0.57 0.87 1.03 0.72 0.78 Rates per 1,000 Live Births Infant Mortality:— Deaths under 1 year of age 36 46 § 54 43 53 Deaths from Diarrhoea and Enteritis (under 2 years of age) 2.5 5.6 7.8 4.5 7.6 † A dash (—) signifies that there were no deaths. * Information not available. ‡ Rates per 1,000 Total population. § Per 1,000 related Births. 5 (1) Rates per 1,000 Total Births (i.e., Live and Still) (2) (3) (4) (5) (6) (a) Notifications:— Puerperal Fever 9.74 9.93 12.65 8.81 3.60 Puerperal Pyrexia 15.87 (b) Maternal Mortality:— No. 140 Abortion with sepsis No. 141 Abortion without sepsis No. 147 Puerperal Infections Nos. 142-146 and 148-150. Other maternal causes WIMBLEDON 0.00 0.00 1.21 1.21 England and Wales 0.25 0.08 0.24 1.22 Mortality per Million Women aged 15-45 years No. 140 with Sepsis No. 141 without sepsis England and Wales 18 6 ‡ Including Puerperal Fever. Births.—The statistics supplied by the Registrar-General show that during 1945 the total number of registered live births belonging to Wimbledon amounted to eight hundred and one. (Four hundred and thirty seven males and three hundred and sixty four females). This gives a birth rate equal to 17.01 per thousand of the population, compared with 15.62 per thousand for the previous year. Seventy of the births were illegitimate. Of this number forty five were males and twenty five females. In addition twenty still-births (ten females and ten males, two of which were illegitimate) were registered. Public Health Act, 1936.—Notification of Births. During the year eight hundred and fifty six births were notified by the following persons:— Parents Midwives 166 Doctors 7 Other persons 683 Total 856 Fifteen of these notifications were in respect of still-births. 6 Of the eight hundred and fifty six notifications, four hundred and seventy two 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 ninety four confinements occurred in Wimbledon amongst women whose homes were situated in other districts. The net number of notified births belonging to Wimbledon is, therefore, seven hundred and sixty two. Deaths:—The total number of deaths registered in the district was six hundred and seventeen (two hundred and seventy four males and three hundred and fifty seven females), equal to a death rate of 13.11 per thousand of the population. The deaths occurring outside the district of persons belonging to the Borough were two hundred and fifty nine. The deaths occurring within the district of persons not belonging thereto were two hundred and forty six. Taking these figures into consideration the total number of deaths properly belonging to Wimbledon is six hundred and thirty, and the crude death rate 13.38 per thousand of the population. The death rate shows a slight decrease on the figure for the previous year. Comparability Factor. The variety and magnitude of local population movements, and the uneven incidence of civilian war deaths, have together combined to frustrate the attempt to secure comparability between local death rates by the use of Areal Comparability Factors, and the preparation and issue of such factors are being suspended by the Registrar-General. CAUSES OF DEATH. Males Females Total 1. Typhoid and Paratyphoid Fevers — – – 2. Cerebro-spinal Fever — – – 3. Scarlet Fever – – – 4. Whooping Cough – – – 5. Diphtheria – 1 1 6. Tuberculosis of Respiratory System 18 7 25 7. Other forms of Tuberculosis 2 4 6 8. Syphilitic Diseases 1 — 1 9. Influenza 1 3 4 10. Measles – – – 11 Acute Poliomyelitis and Polioencephalitis 1 – 1 12. Acute Infectious Encephalitis 1 – 1 13.M.Cancer of Buccal Cavity and Oesophagus (males only) 3 – 3 13. F. Cancer of Uterus — 3 3 14. Cancer of Stomach and Duodenum 9 7 16 15. Cancer of Breast — 15 15 16. Cancer of all other sites 36 30 66 17. Diabetes 1 1 2 18. Intra-Cranial Vascular Lesions 28 54 82 19. Heart Disease 78 108 186 20. Other Diseases of the Circulatory System 5 13 18 7 21. Bronchitis 24 12 36 22. Pneumonia 16 15 31 23. Other Respiratory Diseases 7 4 11 24. Ulcer of the Stomach or Duodenum 3 2 5 25. Diarrhoea (under 2 years of age) — 2 2 26. Appendicitis 4 — 4 27. Other Digestive Diseases 7 5 12 28. Nephritis 2 3 5 29. Puerperal and Post-Abortive Sepsis — 1 1 30. Other Maternal causes — 1 1 31. Premature Birth 2 2 4 32. Congenital Malformations, Birth Injury, Infantile Diseases 6 11 17 33. Suicide 3 3 6 34. Road Traffic Accidents 1 2 3 35. Other violent causes 8 6 14 36. All other causes 26 22 48 Totals 293 337 630 Over half the total deaths which occurred amongst Wimbledon residents in 1945 were again due to cancer, diseases of the heart and circulation, and diseases of the respiratory system. Infant Mortality. There were twenty nine infant deaths (including transferable deaths) giving an Infantile Mortality Rate of 36.20 per thousand live births, compared with a figure of 37.14 per thousand in the previous year. During 1945 the Infantile Mortality Rate for England and Wales was forty six. The following table shows the causes of, and ages at, death, together with the Ward distribution. 8 Infant Mortality during the Year 1945. Cause of Death Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under 4 weeks 1-3 months 3-6 months 6-9 months 9-12 months Total Deaths under 1 year WARD Nth. Wimbledon Sth. Wimbledon Total St. Mary's St. John's Cott. Park W'don Park Dundonald Trinity Sth. Park Haydon Pk. Whooping Cough – – – – – – – – – – – – – – – – – – – – – Pneumonia — – – – – – – – – – – – – – – – – – – – – Broncho Pneumonia 1 1 — 1 3 2 1 — — 6 — 1 — 1 – 3 – 1 2 4 6 Gastro-enteritis — – — — — 1 1 — 1 3 — 1 – – — 1 1 – 1 2 3 Prematurity 4 – — – 4 — — — — 4 — – 1 – 2 1 — – 1 3 4 Marasmus – 1 — — 1 — — — — 1 1 – – – — — — — 1 — 1 Atelectasis 1 — — 1 2 — — — — 2 — — – – 1 1 – – – 2 2 Congenital defects 3 — – — 3 1 1 — — 5 1 1 — 1 — — 2 — 3 2 5 T.B. Meningitis – – – – – – – – – – – – – – – – – – — 1 1 Other Causes 2 1 1 — 4 1 2 – – 7 – – 2 – – 1 2 2 2 5 7 Total 11 3 1 2 17 5 6 — 1 29 2 3 3 2 3 8 5 3 10 19 29 9 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 investigation 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. 10 MATERNITY AND CHILD WELFARE. The total number of visits paid by the Health Visitors during 1945 amounted to 9,427, the figure for the previous year being 8,839. Details of the home visits carried out are given below:— Number of Infants visited—first visits 703 Number of Infants visited—revisits 1,641 Number of Toddlers visited 2,354 Ante-natal—first visits 526 Ante-natal—revisits — 157 Visits re Infant deaths 2 ,, „ Stillbirths 11 ,, „ Ophthalmia Neonatorum 6 ,, „ Puerperal Pyrexia 1 ,, „ Non-notifiable and notifiable Infectious Diseases 104 „ Midwives 4 „ Milk applications 17 „ Foster Children 327 Miscellaneous 635 Total Welfare visits 6,488 Visits—School Health Service 1,703 Tuberculosis—Home visits 58 Visits to Nursing Homes 16 Other visits 73 Ineffectual visits 1,089 2,939 Total visits 9,427 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 61.49, and at the Friday sessions 63.79. At the Cottenham Park Centre the average weekly attendance was 71.21. The average attendance at the Wandle Park Centre was 47.82. The Centre at Wimbledon Park, which was opened in 1943, showed an average weekly attendance of 75.10. Ante-natal Clinic. The Pelham Road Ante-Natal Clinic continued to be held on Monday and Saturday each week, the average attendances being 17.11 and 12.82 respectively. The Ante-natal Clinic at Wandle Park was held every other Thursday. The average attendance was 10.4 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 with the Council. 11 Midwives Acts, 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 1945, one of whom was resident outside the Borough. One hundred and forty three confinements were attended by midwives and twenty by maternity nurses. Medical Aid forms were received in one hundred and nine instances. The total fees paid to doctors by the Corporation during the year under Section 14 (1) of the Midwives Act, 1918, amounted to £128 9s. 6d. The amount recovered from the patients' relatives was £88 17s. 8d. Public Health Act. 1936.—Child Life Protection. The following figures relate to the administration of the above Act in Wimbledon during 1945:— (i) Number of foster-mothers on the Register— (a) At the beginning of the year 11 (b) At the end of the year 18 (ii) Number of children on the Register— (a) At the beginning of the year 17 (b) At the end of the year 56 (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 twenty seven 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 operative treatment of tonsils and adenoids remained available through the usual channels. Ophthalmia Neonatorum.—The following table shows that nine cases of Oohthalmia 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 T recited At Home Hospital 9 4 5 9 – — — 12 Maternal Mortality. There were two maternal deaths amongst Wimbledon mothers in 1945, both of which occurred in Hospitals outside the Borough. The causes of death were as follows:— (i) Eclampsia of Pregnancy. (ii) (a) Pulmonary Embolism. (b) Femoral Thrombo-phlebitis following first pregnancy. There were also two maternal deaths amongst Wimbledon mothers in 1944. The following table gives the maternal mortality rates for Wimbledon and also for England and Wales:— 1945 No. 140 No. 141 No. 147 Other maternal causes A bortion with sepsis A bortion without sepsis Puerperal Infections WIMBLEDON: Per 1,000 live births 0.00 0.00 1.22 1.22 Per 1,000 total births 0.00 0.00 1.21 1.21 England and Wales: Per 1.000 total births 0.25 0.08 0.24 1.22 Hospital Treatment for Complicated Obstetric Cases.—During 1945 sixteen patients received treatment under this scheme. The cost of maintenance and treatment of these patients amounted to £110 10s. 0d, of which £18. 16s. 0d. was recovered from the relatives. Domiciliary Treatment for Complicated Obstetric Cases.—Two consulting Obstetricians, Mr. Leslie Williams and Mr. Vincent O'Sullivan, are available for consultation with medical practitioners for any complicated case at home in connection with pregnancy or childbirth. During 1945 they were called in on five occasions. Supply of Milk to Expectant and Nursing Mothers and Infants.— In addition to the National Milk Scheme administered by the Ministry of Food, 941bs. of dried milk were supplied under the Maternity and Child Welfare Scheme. Emergency Maternity Hostels and Homes.—On and after the 31st August, 1945. the cost of evacuating expectant mothers, whose home conditions were unsuitable for confinements, to emergency hostels and homes in the country, through the L.C.C. scheme, became the financial responsibility of the Corporation, a flat rate charge of 14/- per diem being made. Where, however, the mother was accommodated in a billet during the ante-natal period and provided only with lodging, the Hat rate charge over the whole period was 11/per diem. 13 Eleven mothers were evacuated under this scheme, the total cost amounting to £299 4s. Od. of which £63 12s. 3d. was recovered. Denial 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 Hindhead as a residential Nursery. It was administered by the Surrey County Council on behalf of the Wimbledon Borough Council. Nine children were admitted from Wimbledon during 1945. The War-time Nurseries in the nursery premises at All Saints Road and Russell Road, continued to be well used during 1945. There were sixty one and fifty seven children on the registers respectively at the end of the year. Public Health Act, 1936—Part VI.—Nursing Homes. The Wimbledon Borough Council is responsible for the supervision of nursing homes in Wimbledon. At the end of the year there were eight registered nursing homes, including two for the reception of maternity cases. Twenty two visits of inspection were made. Care of Premature Infants. In June, 1944, the Council appointed Dr. G. H. Newns as Consulting Paediatrician, and his services are available to all local practitioners in respect of any infant up to the age of twelve months. During 1945 he was called in on six occasions. The necessary special equipment suggested in Ministry of Health Circular No.20/1944 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 out as part of the Health Visitors' normal duties both at the times of their visits to the homes and also in the Maternity 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 homes their condition of cleanliness is closely supervised in so far as the cooperation of the parents can be obtained. In most cases the Health Visitors are successful in obtaining the good will and assistance of the parents. 14 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. Where 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. 15 SANITARY CIRCUSTANCES OF THE AREA. Sanitary Inspection of District.—The following is a statement showing the number and nature of inspections made for the year 1945: — Reason for Visit. No. Infectious Diseases 817 House Inspections 5,695 Inspections under Housing Act, 1936 138 House to House Inspections 1,168 Rent Act Inspections 5 Inspections of Factories, Workshops, Workplaces and Outworkers' premises 173 Dairies and Cowsheds Inspections 55 Inspections under Shops Act 27 Applications of Test to Drains 105 Inspections under Diseases of Animals Act 20 Obtaining samples of Food and Drugs 237 Miscellaneous (including Inspections of Food, slaughter-houses, mews, stables, caravans, Petroleum Acts, water supply, piggeries, etc.) 4,753 Total 13,193 Notices Served.—One thousand four hundred and fourteen preliminary notices or intimations were served during the year. It was found necessary to serve one hundred and forty-two Statutory Notices. Legal proceedings were taken against one owner for failure to comply with an Abatement Notice. An order was made by the Court for the work to be carried out within twenty eight days. 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 24 Cisterns provided 3 Cisterns repaired, cleansed or covered 39 Drains, new, provided 20 Drainage systems made water-tight by patent process Drains, repaired or altered 56 Drains, stoppages removed 83 Dustbins provided 261 Flushing cisterns, new, provided 14 Flushing cisterns, repaired 109 Manure receptacles provided 6 Rain-water pipes disconnected — Roofs repaired 305 Rooms stripped and cleansed 89 Verminous rooms cleansed 30 Soilpipes, new, provided 1 16 Soil pipes, repaired or altered 13 Vent pipes, new, provided 2 Vent pipes, repaired or altered 9 Waste pipes, new, provided 12 Waste pipes, repaired, disconnected or trapped 27 Water-closets, new, provided 52 Water-closets, repaired or ventilated 60 Water services restored 63 Water supply direct from main 24 Yards paved 5 Yards repaired 5 Guttering repaired 132 Floors ventilated 3 Nuisances from damp walls abated 142 Sinks provided 11 Other nuisances remedied 1,552 Rooms disinfected 332 Total 3,484 17 FACTORIES AND WORKPLACES. 1. Inspections for Purposes of Provisions as to Health. Premises Number of Inspections Written Notices Prosecutions Factories with mechanical power 150 Factories without mechanical power 17 — — Other Premises under the Act (including works of building and engineering construction but not including outworkers' Premises) — — — Totals 167 — — 2. Defects Found. Particulars Number of Defects Prosecutions Found R emedied Referred to H.M. Inspector Want of Cleanliness (S.l) 2 1 — — Overcrowding (S.2) — — — — Unreasonable temperature (S.3) — — — — Inadequate v e n t i 1 a tion (S.4) 1 — — — Ineffective drainage of floors (S.6) — — — — Sanitary Conveniences (S.l):— Insufficient 3 1 — — Unsuitable or Defective 8 5 — — 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 re-enacted in the Third Schedule to the Factories Act, 1937) 5 3 1 — Totals 19 10 1 — 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. HOME WORK. Lists received:— Twice in the year — Number of Outworkers — Once in the year — Number of Outworkers — Number of Outworkers' Premises on register 36 Number of addresses received from other Councils 2 N umber of addresses forwarded to other Councils — 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 6 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. Inspector of Factories:— Failure to affix Abstracts of Act — Action taken in matters referred by H.M. Inspector as remedial under the Public Health Acts. Notified by H.M. Inspector — Reports of action taken sent to H.M. Inspector — HOUSING. Dwelling-houses inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932: Number of inspections made 1,179 Housing Act, 1936—Part IV—Overcrowding:— (a) (1) Number of dwellings overcrowded at the end of the year 27 (2) Number of families dwelling therein 49 (3) Number of persons dwelling therein 171 (b) Number of new cases of overcrowding reported during the year 39 (c) (1) Number of cases of overcrowding relieved during the year 12 (2) Number of persons concerned in such cases 76 (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 20 The number of houses destroyed during the war as a result of enemy action was five hundred and eighty two. A further thirteen thousand, five hundred and nine were damaged. The number of families re-housed in requisitioned property during 1945 was three hundred and seventy nine. WATER SUPPLY. The Metropolitan Water Board is responsible for the water supply of the Borough, and periodical examinations are made by them. The supply in 1945 was satisfactory, both in quality and quantity. All the dwelling houses of Wimbledon are supplied from public water mains direct to the houses. INSPECTION AND SUPERVISION OF FOOD. Milk Supply.—All the milk for retail sale is brought into the area from other districts. Thirty five licences were granted under the Milk (Special Designations) Order, 1936, as follows:— Pasteuriser's Licence — Dealers' Licences:— Tuberculin Tested Milk 8 Accredited Milk — Pasteurised Milk 12 Supplementary Licences 15 Total 35 21 Bacteriological Examination.—Thirty-four samples of milk were taken for bacteriological examination under the Milk (Special Designations) Order. Legal proceedings were taken against one Dairy for selling milk in a dirty bottle. A tine of £10 with £3 13. Od. costs was imposed on the Dairy by the Court. Food and Drugs Act, 1938. The Council became the Local Authority under this Act on 1st October, 1939. One hundred and six samples were taken up to the end of the year. There was one prosecution for the sale of whisky containing 18% of added water, and the defendant was fined £10 and £3 3s. Od. costs. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. During 1945 seven hundred and eighty seven cases of infectious disease were notified—two hundred and ninety one more than in 1944. This increase was almost entirely due to an outbreak of measles between February and June. Scarlet Fever.—Forty six cases of scarlet fever were notified, thirty one less than in 1944. The attack rate was 0.98 per thousand of the population. Thirty two, or 80.00 per cent of the cases were treated in hospital. There was no death from this disease. Diphtheria.—Twelve patients were notified as suffering from diphtheria during 1945, of whom eleven were admitted to the Infectious Diseases Hospital. The twelfth was found to be a diphtheria carrier and was treated at home. Of the eleven cases admitted to the Infectious Diseases Hospital, the diagnosis of diphtheria was confirmed in six. Two of these patients were adults, and the remaining four were under the age of fifteen years. Two of these had not been immunised, one had been partially immunised, whilst the fourth had been immunised in 1942. This latter patient made an uneventful recovery and the case was not associated with any complications. The only fatal case which arose was in an unimmunised adult aged 65 years. In addition to the foregoing, a soldier aged 25 years, who had contracted diphtheria abroad immediately before coming home on leave, was admitted to an Infectious Diseases hospital outside the district. The total number of true cases of diphtheria which occurred in Wimbledon during 1945 was therefore eight—i.e. seven civilians and one non-civilian. Diphtheria Immunisation.—Two sessions of the Diphtheria Immunisation Clinic were held every week at the Health Centre. The total number of children immunised was five hundred and twenty seven. In all, one thousand and fifty four attendances were made for this purpose. The total number of children under the age of 15 years immunised in the Borough at 31st December, 1945 (including children privately immunised) was five thousand and twenty three. Paratyphoid Fever.—No cases of paratyphoid fever were notified to the Department. Food Poisoning.—This became a notifiable disease on 3rd October, 1939. One notification was received during the year. 22 Cercbro-Spinal fever.—Six 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 of erysipelas. Five patients were treated in hospital. Puerperal Pyrexia.—Eight cases of puerperal pyrexia were notified, and three of the patients were removed to hospital. Measles.—Five hundred and eighty six cases of measles were notified. Twenty six of these were removed to hospital. There were no deaths. Whooping Cough.—There were fifty four cases of this disease notified in 1945. Two cases were treated in hospital: there was no death. 23 24 Table "A" — Notifiable Diseases during 1945. 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 and over Smallpox — — — — — — — — — — — — — — Scarlet Fever — 2 6 5 4 19 3 3 3 1 — — 46 32 Diphtheria (including Membranous Croup) 1 1 2 1 2 — — 1 8 7 Enteric Fever (including Paratyphoid) — — — — — — — — — — — — — — Food Poisoning — — — — — — — — — — — 1 1 1 Puerperal Pyrexia — — — — — — — — 8 — — — 8 3 Measles 21 52 51 73 72 271 25 5 5 6 2 3 586 26 Whooping Cough 8 3 9 9 8 16 — 1 — — — — 54 2 Acute Primary Pneumonia 1 — — 2 — 4 — — 1 1 7 1 17 — Acute Influenzal Pneumonia 1 1 — — — 2 — — 3 — 2 1 10 — Cerebro-Spinal Fever — — — — — 1 1 2 — 2 — — 6 6 Acute Poliomyelitis — — 1 — — — — — 3 — — — 4 3 Acute Polio-encephalitis — — — — — — — — — — — — — — Encephalitis lethargica — — — — — — — — — — — — — — Dysentery 1 1 1 — 5 9 — — — — 1 — 18 4 Malaria — — — — — — — — — 1 — — 1 1 Ophthalmia Neonatorum 10 — — — — — — — — — — — 10 1 Erysipelas — — — — — — — — 2 1 4 4 11 5 Tuberculosis (all forms) 1 — — — 1 2 4 9 51 15 8 1 92 60 TOTALS 43 59 69 91 91 326 34 21 79 27 24 12 876 156 25 TUBERCULOSIS — 1945 J NEW CASES DEATHS AGE CROUPS 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 Males Females Males Females Males Females Males Females Males Females Under 1 Year — — — — — — — — — — — 1 — — — 1 1 — 5 Years — — — 1 — — — — — — — 1 — — 1 — 5—10 1 1 — — — — — — 1 1 — — — — — 1 10—15 — 3 — — — — 1 — — 3 1 — — — — — 15—20 5 2 1 1 — — — — 5 2 1 1 2 2 — — 20 — 25 6 2 2 1 3 2 — — 9 4 2 1 1 1 — — 25 — 35 12 6 — 1 9 4 2 1 21 10 2 2 1 1 — — 35—45 4 3 2 1 5 — — 9 3 2 1 2 1 1 — 45—55 2 — — — — — — — — — — — 4 1 — 1 55—65 4 1 — — 1 — — — 5 1 — — 5 — — — 65 and Over — — — — — — — — — 1 — 3 1 — 1 34 18 6 6 18 6 3 1 52 24 9 7 18 7 2 4 52 12 24 4 76 16 25 6 64 28 92 31 TUBERCULOSIS. Ninety two cases of tuberculosis were notified. This figure shows an increase of sixteen on the number for the previous year. There were thirty one deaths from tuberculosis in 1945, one more than in the previous year. Twenty five of these were due to pulmonary tuberculosis. During 1945, sixty Wimbledon patients were admitted to sanatoria or hospitals. WIMBLEDON INFECTIOUS DISEASES HOSPITAL. Two hundred and sixteen cases were admitted to the Infectious Diseases Hospital during 1945. As there were seventeen cases in the hospital at the end of 1944, the total number of cases under treatment during the year was two hundred and thirty three. Of these cases one hundred and nine were from Wimbledon, one hundred and eleven from Kingston, and thirteen from other areas. The diseases from which the patients were stated to be suffering on admission were as follows:— Diphtheria 36 Scarlet Fever 65 Cerebro-Spinal Meningitis 13 Acute Anterior Poliomyelitis 2 Dysentery 15 Gastro-Enteritis 6 Puerperal Pyrexia 3 Measles 46 Whooping Cough 6 Erysipelas 5 Ophthalmia Neonatorum 2 Pemphigus Neonatorum 2 Other conditions 15 216 Of the thirty six cases admitted as diphtheria, only twenty two were found to be true clinical cases of the disease. Five others were found to be 'carriers' only, and in two of these cases tonsillectomy was performed. Six of the twenty two cases of diphtheria were from the Wimbledon area. The remaining nine cases were finally diagnosed as follows:— Vincent's Angina 2 Scarlet Fever 1 Measles 1 Tonsillitis 2 Quinsy 1 Acute Sinusitis and Otitis Media 1 Catarrhal Laryngitis 1 9 26 Sixty five patients were admitted to the hospital as cases of scarlet fever, of whom two were found after admission to be suffering from measles, and two from tonsillitis unassociated with a rash. In three of the thirteen patients admitted as cases of cerebrospinal meningitis the diagnosis was not confirmed, while a fourth case was found to be due to tuberculous meningitis and proved fatal three days after admission. Out of the six cases of gastro-enteritis admitted there was one death, a child aged six months, admitted from Maiden. This infant died six days after admission. Eighteen patients remained in the hospital at the end of 1945. twelve of these suffering from scarlet fever, two from diphtheria, une from poliomyelitis, one from whooping cough and convulsions, one from gastro-enteritis and one from dysentery. STAFF. None of the members of the staff serving with H.M. Forces were demobilised during the year. There were many changes in the temporary staff and the work of the Department was carried on under considerable difficulties. Dr. E. M. Frazer, the Temporary Assistant Medical Officer, resigned on the 22nd September and Dr. H. D. B. North was appointed in her place. The Department suffered a very heavy loss when Mr. R. T. Avis, the Senior Sanitary Inspector, died in December. He was a man of outstanding ability who had given many years of most efficient service to the Corporation. He was an excellent colleague and his experience and judgment were of the greatest value in dealing with the day-to-day problems which arose. His passing was deeply mourned by all members of the staff. For many months during 1945 Miss Mulhern, the Matron of the Infectious Diseases Hospital, was seriously ill, having undergone two major operations. It is with the greatest regret that one has to record her death which occurred in February of the following year. The courage with which she carried out her duties at the Hospital during the three occasions on which it was heavily damaged by enemy action was an outstanding example to all members "of the nursing staff. 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 1945. It is also a great 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, Medical Officer of Health. 27