4413 (1) Wimbledon. wim 23 Borough of Wimbledon. Public Health Department ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR ENDED 31st DECEMBER, 1950 Printed by Raynes Park Press, Lambton Road, London, S.W.20. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH 1950 Public Health Department, Town Hall, Wimbledon, S.W.I9. August, 1951. 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 1950. This report is compiled in accordance with the instructions contained in Circular 112/50 of the Ministry of Health. The report is largely statistical in character. These statistics show a number of very satisfactory features. The corrected death rate for the Borough in 1950 was 10.37 per thousand as compared with 11.6 for England and Wales. The infantile mortality rate was 18.13 per thousand live births, the comparative figure for England and Wales being 29.8. It is very satisfactory to note that there were no maternal deaths in 1950 amongst women resident in Wimbledon. No case of diphtheria was notified in Wimbledon in 1950. The number of other infectious diseases notified amounted to 668, approximately 300 fewer than in 1949. The most important notifications were in respect of 12 cases of poliomyelitis. 9 of these 12 cases 1 were associated with paralysis and one of these cases ultimately proved fatal. The patient who died from this disease was not a Wimbledon resident. I should like to take this opportunity of expressing to the Chairman and Members of the Health Committee my appreciation for their consideration and courtesy during the year. I also wish to place on record my appreciation of the cooperation which I received from the members of the staff and from my colleagues in other Departments. I am indebted to Mrs. Dymott, the Chief Clerk, for much of the work in the compilation of the statistical side of this report. I have the honour to be. Your obedient Servant, HAROLD ELLIS, Medical Officer of Health. 2 LIST OF CONTENTS. Page Introduction 1 List of Staff 4 SECTION A: STATISTICS AND SOCIAL CONDITIONS: Statistics, etc. 5-7 Deaths Registered 8-9 Infantile Mortality 9-10 Summary of Statistics 11 SECTION B: GENERAL PROVISION OF HEALTH SERVICES: Nursing Homes 12 National Assistance Act, 1948 13 Mass Radiography 13-14 Adoption of Byelaws 14 Clean Food Campaigns 14 SECTION C: SANITARY CIRCUMSTANCES: Water Supply 15 Sanitary Inspectors' Visits 16 Notices Served 16 Nuisances abated and defects remedied 17 Factories Act, 1937, Part I. 18 Outworkers 19 Bakehouses 19 SECTION D: HOUSING 20 SECTION E: INSPECTION AND SUPERVISION OF FOOD: Milk 21 Ice cream 21-22 Meat and other Foods 22-23 Sampling of Food and Drugs 24 SECTION F : PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES: Diphtheria Immunisation 25 Notifiable Infectious Diseases, etc 25-29 Tuberculosis 30-31 3 STAFF Medical Officer of Health: Harold Ellis, M.B., B.S.(Lond.), M.R.C.S., L.R.C.P., D.P.H. Senior Sanitary Inspector: D. F. S. Flynn, (b), (c). Deputy Senior Sanitary Inspector: H. R. Fry, (a), (c). Sanitary Inspectors'. C. W. Southerby, (a), (c). A. N. Scotter, (a), (c). G. R. Pope, (a). J. Hills, (a), (c). Temporary Assistant Rodent Officer: F. J. Reddington. Chief Clerk: t Mrs. V. Dymott. Clerks: * J. E. Field. * Mrs. V. Waters. J. Burrows. † Miss S. G. Miller. F. R. Brackfield. † Transferred to Surrey County Council under National Health Service Act, 1946. Part-time officer to the Wimbledon Borough Council. * Officer of the Wimbledon Borough Council. In part-time employment of the Surrey County Council. (a) Certificate Royal Sanitary Institute and Sanitary Inspectors Examination Joint Board. (b) Certificate Royal Sanitary Institute for Inspector of Nuisances. (c) Certificate Royal Sanitary Institute for Inspector of Meat and other Foods. 4 SECTION A. — STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres—Census, 1951) 3,212 Population (Census, 1951) 58,158 Home Population (mid-1950) 58,650 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 :— £815,054. Sum represented by penny rate :— £3,303 0s. 0d. Extracts from Vital Statistics of the Year 1950. (Registrar-General's Figures.) Live Births Total M. F. Legitimate 742 381 361 Illegitimate 30 20 10 Total 772 401 371 Total M. F. Stillbirths Legitimate 14 9 5 Illegitimate — — — Total 14 9 5 Birth Rate per 1,000 of the estimated home population 13.40 Corrected birth rate per 1,000 of the estimated home population 12.46 Still-birth Rate per 1,000 total (live and still) births 17.81 Total M. F. Deaths 742 321 451 Crude Death Rate per 1,000 of the estimated home population 2.65 Corrected Death Rate per 1,000 of the estimated home population 10.37 Deaths from puerperal causes— Rate per i.ooo total (live and Deaths. still) births. Puerperal and post-abortive sepsis — — Other maternal causes — — Total — — Death Rate of infants under one year of age:— All infants per 1,000 live births 18.13 Legitimate infants per 1,000 legitimate live births 16.17 Illegitimate infants per 1,000 illegitimate live births 66.67 Deaths from cancer 135 diphtheria 0 „ poliomyelitis 1 „ „ measles 0 whooping cough 0 5 Birth Rates, Death Rates, Analysis of Mortality, Maternal Mortality, and Case Rates for certain Infectious Diseases in the Year 1950. (Provisional Figures based on 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 Rates per 1,000 Home Population Births: — Live Births 12.46 15.8 17.6 16.7 17.8 Still Birth9 0.24 0.37 0.45 0.38 0.36 Deaths:— All Causes 10.37 11.6 12.3 11.6 11.8 Typhoid and Paratyphoid 0.00 0 00 000 0.00 Whooping Cough — 0.01 0.01 0.01 0.01 Diphtheria — 0.00 0.00 0.00 0.00 Tuberculosis 0.27 0.36 0.42 0.33 0.39 Influenza 0.10 0.10 0.09 0.10 0.07 Smallpox — — — — — Acute Poliomyelitis (including Polioencephalitis) 0.02 0.02 0.02 0.02 0.01 Pneumonia 0.43 0.46 0.49 0.45 0.48 Notifications (corrected): — Typhoid Fever 0.00 0.00 0.00 0.01 Paratyphoid Fever 0.05 0.01 0.01 0.01 0.00 Meningococcal Infection 0.05 0.03 003 0.02 0.03 Scarlet Fever 1.16 1.50 1.56 1.61 1 23 Whooping Cough 3.09 3.60 3.97 3.15 3.21 Diphtheria — 0.02 0.03 0.02 0 03 Erysipelas 0.02 0 17 0.19 0.16 0.17 SmallDox — 0.00 0.00 — Measles 6.20 8.39 8.76 8.36 6.57 Pneumonia 0.34 0.70 0.77 0.61 0.50 Acute Poliomyelitis (including Polioencephalitis)— Paralytic 0.15 0.13 0.12 0.11 0.08 Non-paralytic 0.05 0.05 0.05 0.06 0.05 Food Poisoning 0.12 0.17 0.16 0.14 0.25 Rates per 1,000 Live Births Deaths:— All causes under 1 year of age 18 29.8 § 33.8 29.4 26.3 Diarrhoea and Enteritis (under 2 years of age) — 1.9 2.2 1.6 1.0 5 Per 1,000 related live births. 6 Notifications (corrected): — Puerperal Fever and Pyrexia Rates per 1,000 Total Births (i.e., Live and Still) 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 1.27 5.81 7.43 4.33 6.03 Maternal Mortality: — Rates per 1,000 Total Births (i.e., Live and Still) Abortion with sepsis Other abortion Complication of pregnancy and delivery Sepsis of childbirth and the puerperium Other complications of the puerperium WIMBLEDON — — — — — England and Wales 0.09 0.05 0.54 0.03 0.15 England and Wales Rates per Million Women aged 15-44 years Abortion with sepsis Other abortion 7 4 BIRTHS. The statistics supplied by the Registrar-General show that during 1950 the total number of registered live births belonging to Wimbledon was 772. In addition 14 stillbirths were registered. This gives a birth-rate of 13.40 per thousand of the population compared with a rate of 15.38 per thousand for the previous year. A comparability factor has been supplied by the RegistrarGeneral which enables the birth-rate for Wimbledon to be compared with that for England and Wales. The corrected birth-rate for Wimbledon for 1950 is 12.46 per thousand of the population, whilst the rate for England and Wales is 15.8. Of the 14 stillbirths registered, 13 occurred in hospitals or nursing homes, and one occurred at home. The birth-rate for Wimbledon reached its peak in 1947, and has since been falling steadily to its present level of 12.46 per thousand of the population. 7 DEATHS. The total number of Wimbledon residents who died during 1950 was 742, giving a death-rate of 12.65 per thousand of the population as compared with 12.92 per thousand for 1949. The corrected death-rate for 1950 is 10.37 per thousand as compared with a rate of 11.6 per thousand for England and Wales. The number of Wimbledon residents who died outside the Borough was 295, while 237 persons not normally resident in Wimbledon died in institutions, etc., in the Borough. The following diseases were responsible for over three-quarters of the total deaths Percentage of total deaths Diseases of the heart and circulatory system 50% Cancer 19% Diseases of the respiratory system 10% Total 79% There were two deaths from notifiable infectious diseases during the year. One child aged eight months, and another aged four years, died from meningococcal infections shortly after admission to hospital. 8 The following is an analysis of the causes of death :— Cause Males Females Total 1. Respiratory tuberculosis 11 4 15 2. Other tuberculosis — 1 1 3. Syphilitic disease l — 1 4. Diphtheria — — — 5. Whooping cough — — — 6. Meningococcal infections — 2 2 7. Acute poliomyelitis — — — 8. Measles — — — 9. Other infective and parasitic diseases l 2 3 10. Malignant neoplasm, stomach 7 14 21 11. Malignant neoplasm, lung, bronchus 15 4 19 12. Malignant neoplasm, breast — 16 16 13. Malignant neoplasm, uterus — 5 5 14. Other malignant and lymphatic neoplasms 34 40 74 15. Leukaemia, aleukaemia 2 3 5 16. Diabetes — 3 3 17. Vascular lesions of nervous system 34 63 97 18. Coronary disease, angina 65 46 111 19. Hypertension with heart disease 13 6 19 Cause Males Females Total 20. Other heart disease 36 83 119 21. Other circulatory disease 8 21 29 22. Influenza 3 3 6 23. Pneumonia 10 15 25 24. Bronchitis 20 21 41 25. Other diseases of respiratory system 3 1 4 26. Ulcer of stomach and duodenum 6 3 9 27. Gastritis, enteritis and diarrhoea 2 7 9 28. Nephritis and nephrosis 1 9 10 29. Hyperplasia of prostate 4 — 4 30. Pregnancy, childbirth, abortion — — — 31. Congenital malformations 1 — 1 32. Other defined and ill-defined diseases 32 39 71 33. Motor vehicle accidents 3 2 5 34. All other accidents 5 5 10 35. Suicide 4 3 7 36. Homicide and operations of war — — — Totals 321 421 742 INFANTILE MORTALITY. During 1950, there were 14 deaths in infants under one year of age, giving an infantile mortality rate for Wimbledon of 18.13 per thousand live births as compared with a rate of 29.8 for England and Wales. The total number of neo-natal deaths (i.e. occurring during the first four weeks of life) was 8, giving a neo-natal death-rate of 10.36 per thousand live births. All these eight deaths were due to congenital defects, birth injuries, diseases of the newborn, or prematurity. Of the remaining 6 deaths, one was an accidental death, and could be classified as preventable. Two children died from bronchitis, two from gastro-enteritis and one from meningococcal septicaemia. The following table shows the causes of and ages at death, and also the ward distribution. 9 Infantile Mortality during the Year. 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. Congenital defect or birth injury 2 — — — 2 — — — — 2 — 1 1 — — — — — 2 — 2 Diseases of the newborn 1 — — — 1 — — — — 1 — — 1 — — — — 1 1 — 1 Prematurity 5 — — — 5 — — — — 5 — 2 — — 2 — — 1 2 3 5 Infective GastroEnteritis — — — — — 1 1 — 2 1 — 1 — — — — 2 — 2 Bronchitis — — — — — — — 2 — 2 1 — 1 — — — — — 2 — 2 Meningococcal Septicaemia — — — — — — — — — — — — — — — — — — 1 — 1 Accidental death — — — — — — — — — — — — — — — — — 1 — 1 1 Total 8 — — — 8 2 1 3 — 14 2 3 3 2 2 — — 2 10 4 14 10 Summary of Statistics. The following table shows the birth-rates and death-rates for Wimbledon, as compared with England and Wales since 1939. Year Live-Birth Rate Still-birth Rate Death-Rale Maternal Mortality Rate Infantile Mortality Rate Wim. E.&W. Wim. E.&W. Wim. E.&W. Wim. E.&W. Wim. E.&W. 1939 10.86 15.0 0.37 0.59 10.53 12.1 1.57 2.82 29.41 50 1940 12.20 14.6 0.42 0.55 13.92* 14.3 1.67 2.16 43.40 55 1941 12.82 14.2 0.29 0.51 11.92* 12.9 — 2.23 41.15 59 1942 15.46 15.8 0.47 0.54 12.44* 11.6 — 2.01 41.95. 49 1943 17.69 16.5 0.27 0.51 14.37* 12.1 1.18 2.29 50.17 49 1944 15.62 17.6 0.53 0.50 13.21* 11.6 2.76 1.93 37.14 46 1945 17.01 16.1 0.42 0.46 13.38* 11.4 2.42 1.79 36.20 46 1946 18.90 19.1 0.64 0.53 13.51* 11.5 — 1.43 23.14 43 1947 19.39 20.5 0.42 0.50 13.64* 12.0 0.88 1.17 18.03 41 1948 16.33 17.9 0.26 0.42 11.56* 10.8 1.04 1.02 19.03 34 1949 14.99 16.7 0.39 0.39 10.72 11.7 — 0.98 25.14 32 1950 12.46 15.8 0.24 0.37 10.37 11.6 — 0.86 18.13 29.8 * From 1940 to 1948 it was not possible to correct the local death-rate as the publication of an area comparability factor was suspended. Consequently it is not strictly possible to compare the death-rate for Wimbledon with that for England and Wales for those years. 11 SECTION B. - GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. PUBLIC HEALTH ACT, 1936, PART VI. — NURSING HOMES. The Wimbledon Borough Council is responsible for the supervision of nursing homes in the Borough. Sixteen visits of inspection were made during 1950. Two nursing homes closed during the year and one new home was registered for the reception of medical and chronic cases. Application for re-registration was made in respect of one nursing home which was taken over by a new proprietor. At the end of the year re-registration had not been granted pending compliance with precautions against fire. In the case of one establishment which had been exempted on an annual basis from registration under the Public Health Act, 1936, renewal of this exemption was deferred pending compliance with certain requirements in connection with precautions against fire. These requirements had been previously communicated to the proprietors but had not been put in hand pending extensive alterations and additions to the premises. The position at the end of 1950 was as follows :— Number of homes on the register : Maternity Nil. Others 8 No. of beds provided 105 Registration or exemption under consideration 2 12 NATIONAL ASSISTANCE ACT, 1948. Under Section 47 of this Act, power is given to the Councils of County Boroughs and County Districts to apply to a Court of Summary Jurisdiction for an Order for removal and detention, in a suitable hospital or other place, of persons who (a) are suffering from grave chronic disease, or, being aged, infirm or physically incapacitated, are living in insanitary conditions; and (b) are unable to devote to themselves, and are not receiving from other persons, proper care and attention. During 1950 eight cases were brought to the attention of the Public Health Department where it was thought that action under Section 47 might be necessary. In one of these cases there was found to be no justification for such action. In another case the patient died. In the remaining six cases beds were obtained in suitable hospitals or homes, and all the patients ultimately agreed to removal. At the beginning of 1950 there was one patient already in hospital as the result of an Order made by the local Court under Section 47 of the Act in 1948. This Order, which had been extended during 1949, was further extended during 1950, and the patient was still in hospital at the end of the year. MASS RADIOGRAPHY. By arrangement with the South-West Metropolitan Regional Hospital Board, the Mass Radiography Unit was stationed in Wimbledon from 9th October to 17th November, 1950. This x-ray unit offers facilities for the free x-ray of the chest of all persons over the age of 14 years. During the visit to Wimbledon special appointments were available for business houses, associations, schools, etc., and wide publicity was given beforehand I am indebted to the Secretary of the Mass Radiography Unit for the following particulars of the persons who attended for examination. The facilities were available to all, whether they resided in the Borough or not. The statistics given hereunder do not, therefore, necessarily relate onlv to Dersons residing in Wimbledon. Number of persons examined: Males 2055 Females 2537 4592 A bnormalities discovered: (i) Active pulmonary tuberculosis : Males 6 Females 9 15 (ii) Inactive pulmonary tuberculosis: Males 75 Females 69 144 13 (iii) Non-tuberculous conditions : Males 62 Females 80 142 (iv) Awaiting final diagnosis : 1 The number or persons found to be suffering from active pulmonary tuberculosis was equivalent to 3.3 per thousand persons examined, as compared with a rate of 3.1 per thousand for the whole of Surrey. When the Mass Radiography Unit was stationed in Wimbledon during 1949 the number of persons found to be suffering from active pulmonary tuberculosis was 5.5 per thousand persons examined. ADOPTION OF BYELAWS. During 1950 the Wimbledon Borough Council adopted the Model Byelaws of the Ministry of Food relating to "the observance of Sanitary and Cleanly Conditions and Practices in connection with the Handling, Wrapping and Delivery of Food and Sale of Food in the Open Air". These Byelaws came into force on the 19th June, 1950. Copies were sent to the owners or managers of all food premises in the Borough. CLEAN FOOD CAMPAIGNS. At the beginning of 1950 the Health Committee already had under consideration Ministry of Food Circular 12/49, issued in 1949, relating to the need for bringing home to the public, and to food traders, the importance of clean handling of food. Informal meetings were held early in the year with representatives of the various food trade organisations in Wimbledon, to discuss the best methods of implementing the Ministry's circular. The local food trade representatives then obtained the views of the members of their organisations, and later met the members of the Health Committee. His Worship the Mayor attended this meeting and the Chairman of the Health Committee took the chair. As a result of this meeting it was unanimously decided that a Clean Food Advisory Committee should be formed consisting of the members of the Health Committee and appropriate representatives of food manufacturers, retailers and others interested in the handling or distribution of food, with power to co-opt. It was agreed that the aim of the Committee should be to advise the Council from time to time and to formulate reasonable codes of practice to be observed by those connected with the handling of food. It was felt that if the imagination and interest of the public could be stimulated by suitable propaganda, and by the publication of codes of practice as to cleanliness of premises and hygiene of personnel in food establishments, in course of time a certain accepted standard would be expected by the public, and adopted by all those concerned with the retail food industry. At the end of 1950 codes of practice were being drafted in the Health Department for submission to the Clean Food Advisory Committee for consideration and approval. 14 SECTION C. — SANITARY CIRCUMSTANCES OF THE AREA. Water Supply. The Metropolitan Water Board is responsible for the supply of water to the Borough and regular periodical examinations are made by them. With three exceptions all the dwelling houses in Wimbledon are supplied from public water mains direct to the houses. During 1950 one sample of water was sent for bacteriological examination from The Lodge, Warren Farm. The result of this examination was satisfactory. Swimming Baths. During the year four samples of water were sent for bacteriological examination from the Wimbledon Corporation Swimming Baths. All four samples were reported upon as satisfactory. Disposal of Sewage and Refuse. There were no important alterations to the main sewage disposal works or refuse disposal works in Wimbledon during 1950. 15 Sanitary Inspection of District. The following is a statement showing the number and nature of inspections made during 1950 :— Reason for Visit. No. Infectious Diseases, investigations, etc. ... 431 Inspections under Housing Act, 1936, Part IV 246 House to House Inspections (Section 91, Public Health Act, 1936): — (a) number of houses inspected 431 (b) number of revisits 1,342 House Inspections 9,398 Inspections of Factories, Workplaces and Outworkers' premises 558 Inspections of Dairies 51 Inspections of Food, and Food Premises 1,355 Obtaining samples of Food and Drugs 121 Inspections under the Shops Act 1950 626 Inspections under the Petroleum (Regulation) Acts, 1923 and 1936 153 Applications of Tests to Drains 164 Inspections under The Prevention of Damage by Pests Act, 1949 3,407 Smoke Observations 13 Miscellaneous Inspections (including visits to Nursing Homes, Caravans, Piggeries, Stables, Hairdressers' premises and Watercourses) 1,554 Total 19,490 Notices Served. Preliminary notices or intimations 2,730 Statutory Notices 585 Result of Service of Notices. (a) Legal proceedings. As a result of non-compliance with abatement notices legal proceedings were started in nine cases. In five instances, nuisance orders were made, and in three the summonses were withdrawn as the work had been completed. The remaining case was adjourned sine die. In one instance a fine of £1 was imposed, and the costs awarded amounted to £4 2s. 6d. 16 (b) Work carried out in default. Three dustbins were supplied by the Corporation in default of the owners. Nuisances abated and defects remedied. The following table gives a summary of the nuisances abated and the sanitary improvements carried out, together with the defects remedied under the supervision of the sanitary inspectors :— Accumulations removed 38 Cisterns provided - Cisterns repaired, cleansed or covered 1 Drains, new, provided 21 Drains, repaired or altered 56 Drains, stoppages removed 169 Dustbins provided 144 Flushing cisterns, new, provided 3 Flushing cisterns, repaired 81 Manure receptacles provided 1 Rain-water pipes disconnected 3 Roofs repaired 657 Rooms stripped and cleansed 1,297 Verminous rooms cleansed 10 Soilpipes, new, provided •— Soilpipes, repaired or altered 1 Vent pipes, new, provided 3 Vent pipes, repaired or altered 35 Waste pipes, new, provided 6 Waste pipes, repaired, disconnected or trapped 53 Water-closets, new, provided 53 Water-closets, repaired or ventilated 62 Water services restored 5 Water supply direct from main — Yards paved 6 Yards repaired 62 Guttering repaired 192 Floors ventilated 2 Nuisances from damp walls abated 609 Sinks provided 14 Other nuisances remedied 5,901 Rooms disinfected 307 Total 9,792 Work executed by the Borough Surveyor and rechargeable under Section 24 of the Public Health Act, 1936. Twenty-eight sewers vested in the Local Authority by Section 20 of the Public Health Act, 1936, were cleared or repaired. 17 FACTORIES ACT, 1937. PART I. 1. Inspections for Purposes of Provisions as to Health. Premises Number on Register Number of Inspections Written Notices Prosecutions Factories without mechanical power 92 83 8 — Factories with mechanical power 228 333 35 — Other premises under the Act (including works of building and engineering construction but not including outworkers' premises) 4 6 Totals 324 422 43 — 2. Defects Found. Particulars Number of Defects Prosecutions Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector Want of Cleanliness (S.l) 21 20 — — — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) — 1 — — — Sanitary Conveniences (S.7)— Insufficient 8 2 — 3 Unsuitable or Defective 39 37 — 3 — Not Separate for Sexes 1 3 — 2 — Other Offences (Excluding offences relating to outwork) 4 4 — — Totals 73 63 4 8 — 18 PART VIII. OUTWORK — SECTIONS 110 & 111. Nature of work Section 110 Section 111 • No. of outworkers in Auggust list required by Sec. 110 (1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwhole some premises Notices served Prosecutions Wearing Apparel — Making etc. 8 — — — — — Others — — — — — — Total 8 — — — — — Number of addresses received from other Councils 52 Number of addresses forwarded to other Councils 46 Number of premises where outwork was carried on at the end of 1950 62 Inspections of outworkers' premises 104 Outwork in infected premises (Section 153 Public Health Act. 1936) Nil. OTHER MATTERS. Failure to affix Abstracts of Act notified to H.M. Inspector of Factories 4 Underground bakehouses in use at the end of the year 3 19 SECTION D. — HOUSING. Housing Act, 1936, (Part IV) — Overcrowding. The following table shows the position in Wimbledon at the end of 1950 with regard to overcrowding. (a) (i) Number of dwellings known to the partment to be overcrowded at the end of the year 47 (ii) Number of families dwelling therein 52 (iii) Number of persons dwelling therein 208 (b) Number of new cases of overcrowding ported during the year 34 (c) (i) Number of cases of overcrowding known to have been relieved during the year 34 (ii) Number of persons concerned in such cases 137½ (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 1* *In this case the Local Authority had taken steps to secure the abatement of overcrowding, but the dwelling-house concerned again became overcrowded to the extent of one unit. Details of the case were considered very carefully, and in the light of all the circumstances it was decided to take no action for the time being. Rehousing. I am indebted to the Housing Manager for the following information regarding rehousing in Wimbledon :— No. of houses requisitioned since the beginning of the war, and still held under requisition at the end of 1950 481 No. of prefabricated bungalows provided since the end of the war 71 No. of families rehoused by the Council, or by private owners at the Council's instigation, since the beginning of the war 1,652 No. of live applications on the housing waitinglist 3,243 New houses erected, etc. I am indebted to the Borough Engineer and Surveyor for the following information :— No. of new houses erected in Wimbledon during 1950 9 No. of flats created by building or conversion 44 In addition, 37 war-destroyed houses were rebuilt during the year. 20 SECTION E. — INSPECTION AND SUPERVISION OF FOOD. Milk. Under the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949 and 1950, and the Milk (Special Designation) (Raw Milk) Regulations 1949 and 1950, the following licences were granted to retailers by the Council:— Pasteurisers' Licences Nil Dealers' Licences— Tuberculin Tested Milk 18 Pasteurised Milk 22 Sterilised Milk 21 Supplementary Licences— Tuberculin Tested Milk 9 Pasteurised Milk 10 Sterilised Milk 6 86 During the year 37 samples of designated milk were sent for bacteriological examination. The results were as follows :— Class of Milk. Satisfactory. Unsatisfactory. Pasteurised 14 3 Tuberculin Tested (Pasteurised) 6 — Tuberculin Tested 7 1 Sterilised 6 — Investigations were made in connection with the unsatisfactory samples, and communications were sent to the appropriate authorities in order that investigations could also be carried out at the source of production. In addition to the foregoing, 4 samples of ungraded milk were taken during the year. Experience has shown that all the milk sold in the Borough as ungraded milk has been previously pasteurised. In three of the foregoing samples the milk was found to come up to the standard laid down for pasteurised milk. Two samples of tuberculin tested milk were sent to the Public Health Laboratory for animal inoculation. Both samples were found to be negative for tubercle bacilli. Ice Cream. During the year, 114 samples of ice-cream were taken for bacteriological examination. 21 The results of these samples were as follows: — Grade 1 55 Grade 2 26 Grade 3 25 Grade 4 8 Total 114 The results of the methylene blue test divide ice-cream into four grades. If ice-cream consistently fails to reach grades 1 and 2 in the test, this is regarded as indicating a defect of manufacture or handling which calls for further investigation. Repeated visits were made to premises from which unsatisfactory results had been received, and communications were sent to the Medical Officers of Health of the areas in which the ice-cream was manufactured. In one case where unsatisfactory results had been obtained for some time, particularly searching investigations were carried out. These investigations included the taking of ten samples over a period of two days, from all stages of the process between the delivery of the mix from the factory and the production of ice-cream in the server ready for sale to the public. In all these ten a Grade 1 standard was attained, indicating that with constant attention to detail satisfactory results were possible in this case. These, and other premises from which unsatisfactory results had been received, were still under careful supervision at the end of the year. Eight applications for registration for the sale of ice-cream were received, and registration was granted in all cases. One application was received for the registration of premises for the manufacture of ice-cream. Registration was deferred pending the carrying out of alterations to the premises,. These alterations had not been completed at the end of the year. One registration for the manufacture of ice-cream was cancelled during the year, the use of the premises for this purpose having been discontinued. In all, 194 visits were paid during 1950 to premises where the manufacture or sale of ice-cream was being carried on. Meat arid Other Foods. The following inspections of food premises etc. were made by the Sanitary Inspectors during 1950:— Inspections of dairies 51 Inspections of food premises 644 Inspections of premises where ice-cream is manufactured or sold 194 Visits to obtain samples of food and drugs 121 Visits to obtain samples of designated milk 64 Visits to obtain samples of ice-cream 111 Inspections of other foods 343 No carcases were inspected or condemned during the year. 22 Unsound Food. The following is a list of the unsound food surrendered during the year :— Bacon 108* lbs. Beans 12 tins Cake 19 lbs. Cake Mixture 1 packet Cereals 163 packets Cheese 13 lbs. Cheese, Gruyere 18½ lbs. Chicken, frozen 6 packets Coffee 1 bottle Confectionery 242½ lbs. Currants 60 lbs. Custard Powder 40 packets Dessicated Coconut 130 lbs. Eggs 1,327 Fisn, Fresh 48 stones Fish 106 tins Fish Paste 29 jars Fruit, Frozen 20 packets Fruit 295 tins Ham 11 lbs. Junket Powder 13 bottles Marmite 1 jar Meat, Fresh 557 lbs. Meat 399 tins Milk 514 tins Mincemeat 5 tins Mixed Pickles 61 jars Olive Oil 1 bottle Ovaltine 4 tins Pears 784 lbs. Preserves 47 jars Preserves 139 tins Prunes 30 lbs. Puddings 30 Rabbits 84½ lbs. Salad Cream 6 jars Sauce 7 jars Sausages 150 lbs. Shrimps, Frozen 14 packets Soups 47 tins Spaghetti 6 tins Tea 1 lb. Tomatoes 94 tins Vegetables 402 tins Under Section 9 of the Food and Drugs Act 1938 there was one prosecution for the sale of food (bread) unfit for human consumption. The firm pleaded guilty and a fine of £5 was imposed. Costs awarded amounted to £5 5s. 0d. 23 Sampling of Food and Drugs. During 1950 samples were taken for analysis as under :— Articles Analysed Inferior or Adulterated Formal Informal Total Formal Informal Total Almonds, ground — 2 2 — — — Aspic jelly powder — 1 1 — — — Aspirin tablets - 3 3 — — — Baker's filling - 1 1 — — — Bicarbonate of Soda - 1 1 — — — Butter 3 — 3 — — — Butter, peanut - 1 1 — — — Cake flour - — 2 — — — Cake mixture, sweetened - 1 1 — — — Camphorated oil - — 2 — — — Cinnamon, ground — 1 1 — — — Cocoa powder — 1 1 — — — Coconut, dessicated — 1 1 — — — Coffee 1 5 6 — — — Coffee and chicory - 1 1 — — — Cornflour - 1 1 — — — Custard powder - 1 1 — — — Dripping, beef - 1 1 — — — Flavouring, coconut - — 2 — — — Fynnon salts - 1 1 — — — Gelatine dessert - 1 1 — — — Gelatine unsweetened - — 1 — — — dessert - 1 1 — — — Glycerine - 1 1 — — — Glycerine and honey - 1 1 — 1 1 Gravy powder - 1 1 — — — Honey —~ 1 1 — — — Ice-cream - — 7 — — — Jelly, table - 1 1 — — — Jelly, table crystals - 1 1 — — — Lemonade crystals —- 2 2 — — — Meat roll 1 — l — — — Milk 24 35 59 — 2 2 Mustard - 1 1 — — Olive Oil - 1 1 — — Onion powder (dehydrated) - 1 1 — — Paste, fish - 5 5 — — Paste, meat - 1 1 — — — Pea flour - 1 l — — — Pepper 2 9 11 — — — Pie, pork - 1 1 — — — Potato crisps — 3 3 — — — Pudding mixture - — 2 — — — Puree, apricot — 1 1 — 1 1 Rennet, essence of — 1 1 — — — Saccharin tablets — 1 1 — — — Salad cream 1 1 2 — — — Sausage, beef 9 — 11 — — — Sausage, liver -- 1 l — — — Sausage, pork 1 — 1 — — — Sausage roll •- 1 1 — — — Spice, mixed - 1 1 — — — Spice, pickling - 1 1 — — — Suet, shredded beef - 1 1 — — — Sugar, demerara 1 — 1 — — — Stuffing, sage and onion — 1 1 — — — Tapioca dessert — 1 1 — — — Teaseed oil — 1 1 — — — Throat tablets — 1 1 — — — Vinegar, malt 1 1 — — — Whisky, liqueur - 1 1 — — — Totals 44 122 166 — 4 4 24 SECTION F. — PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Notifications of Infectious Disease. During the year there were 668 cases of infectious disease notified, as compared with 969 during 1949. Of the total notifications 364 were in respect of measles and 181 in respect of whooping cough. Diphtheria. There were no cases of diphtheria notified during 1950. Three patients suspected to be suffering from this disease were found, after admission to hospital, to be suffering from tonsillitis. Immunisation against Diphtheria. The following table shows the state of immunisation in Wimbledon in relation to the child population. The authority responsible immunisation in this area is the Surrey County Council. Age at 31/12/50 \lo. immunised Total child population Under 1 10 1 year 459 2 years 647 3 years 839 4 years 763 Total under 5 years 2,718 4,558 5 - 9 years 2,896 10 - 14 years 2,137 Total 5-14 years 5,033 6,055 Percentage of children immunised Under 5 years 60% 5 to 14 years 83% Paratyphoid Fever. Three cases of paratyphoid fever were notified during the year, he patients being members of one family. Two of them — a baby ged 14 months and the father — became ill and were treated in lospital. The child's mother was subsequently found to be a carrier nd she also agreed to enter hospital for treatment. 25 The family had recently returned from a holiday in France. It is thought that the mother developed the carrier state while in France, and infected her husband and child after returning to this country, as the organism isolated was of a type which is rare in this country but frequently found in the part of France where the family had been staying. Dysentery. During December seven cases of dysentery were notified. Five of these were children in attendance at a day nursery in Wimbledon, and the remaining two cases occurred among family contacts of these children. Food Poisoning. Seven cases of food poisoning were notified during the year. Two of the patients were from one family. The remaining five were all occupants of one household. In no case was it possible to identify the infecting organism, or the food which caused the illness. An outbreak of food poisoning occurred during the year at an educational establishment in Wimbledon. Ten cases were ascertained. All except one of the patients lived outside the Borough. After exhaustive enquiries it was concluded that the illness was due to an artificial cream filling which had become infected by contamination from the nozzle of the apparatus used for introducing the filling into cakes. The casual organism was not isolated but was undoubtedly a staphylococcus. The illness was mild and all the patients quickly recovered. The Public Health (Acute Poliomyelitis, Acute Encephalitis, and Meningococcal Infection) Regulations, 1949. The above Regulations, which came into force on 1st January, 1950, replace former regulations with slight modifications. Conditions notifiable under the new Regulations include poliomyelitis (paralytic or non-paralytic), acute encephalitis (infective or post-infectious) and meningococcal infection. Details of the notifications received under these Regulations during 1950 are given below :— Poliomyelitis — 12 cases. Of the twelve cases of poliomyelitis, nine were associated with paralysis, as follows :— Paralysis of back, arm and leg, and bulbar paralysis 1 case Paralysis of skeletal and respiratory muscles 3 cases Paralysis of legs, trunk and arm 2 cases Paralysis of both legs 2 cases Bulbar paralysis 1 case 26 There was one death from this disease, in a patient who came to Wimbledon from an area of Lincolnshire where a number of cases were known to have been occurring. This patient was unwell when he arrived in Wimbledon and was admitted to hospital two days later. Meningococcal Infection — 3 cases. Three patients were removed to hospital with meningococcal infections, and two of these — a girl aged four years and a baby aged eight months — died shortly after admission. Acute Encephalitis — no cases. 27 28 Notifiable Diseases during 1950. DISEASE Number of Cases Notified in Various Age Groups Total Cases Notified Total Cases removed to Hospital Total Deaths Under 1 1-3 3-5 5-10 10-15 15-25 25-45 45-65 65 and over Scarlet Fever — 4 17 40 3 2 2 - . 68 32 - Puerperal Pyrexia — — — — — 1 — - — 1 — __ Measles 9 57 98 186 7 4 3 — — 364 9 __ Whooping Cough 12 35 61 70 3 — — — — 181 2 - Acute Primary or Influenzal Pneumonia 1 — - 1 _ 2 7 6 3 20 - 25* Meningococcal Infection 1 - 1 — — — — 1 — 3 3 2 Acute Poliomyelitis (Paralytic) — 1 — 2 2 — 4 — — 9 9 1 „ „ (Non-paralytic) — — 1 1 — 1 — — - 3 2 - Ophthalmia Neonatorum 1 - — — — — — — — 1 _ - Erysipelas — — — — — — — 1 - 1 1 _ Paratyphoid Fever — 1 — — — — 1 1 - 3 3 — Dysentery — 3 3 — — — 1 - 7 1 — Food Poisoning — 1 — — — — 4 — 2 7 — — TOTALS 24 102 181 300 15 10 22 9 5 668 62 28 * All forms. 29 Notifications of Infectious Disease during the last 10 years. DISEASE 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 Diphtheria 15 10 20 24 8 7 4 4 6 - Dysentery — 3 — 89 18 4 2 — 2 7 Encephalitis Lethargica, acute __ -_ -_ _ 1 - - Enteric Fever (including Paratyphoid) 8 6 - - - - 1 - 3 Erysipelas 9 12 11 11 11 12 5 2 7 1 Food Poisoning 3 — — — 1 — — 5 2 7 Malaria — 1 - 1 1 7 — — — - Measles 77 556 272 57 586 339 253 481 707 364 Meningococcal Infection 9 7 10 3 6 5 5 3 2 3 Ophthalmia Neonatorum 6 8 6 9 10 8 4 2 2 1 Pneumonia 20 20 30 25 27 26 32 15 19 20 Poliomyelitis 1 — — 1 4 2 25 4 10 12 Puerperal Pyrexia 2 6 9 6 8 10 3 5 8 1 Scarlet Fever 39 100 186 77 46 37 51 95 55 68 Whooping-cough 144 34 115 117 54 114 157 231 149 181 333 763 659 420 780 571 541 849 969 668 Tuberculosis:— Pulmonary 71 64 59 66 76 84 87 87 96 102 Non-Pulmonary 12 16 12 10 16 12 8 6 10 13 TUBERCULOSIS. During the year, 115 cases of tuberculosis were added to the Register, as compared with 106 in 1949. Of these, 95 were new cases, and the remaining 20 were transfers from other areas. The following cases were removed from the Register Pulmonary Non-Pulmonary. M. F. M. F. Deaths 11 5 — 1 Stated to have recovered 6 2 — Removed from district 15 18 2 2 32 25 2 3 There were 29 admissions to hospitals or sanatoria during the year. The following table gives an analysis of the notifications received:— 31 TUBERCULOSIS — 1950. AGE GROUPS CASES ADDED TO THE REGISTER DEATHS Primary Notifications (Form A) Cases Discovered otherwise than by Notification Total Cases added to the Register 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 - — 2 - - - - - - - 2 — — — — — 1 — 5 Years -- 1 - 1 - - - - - 1 - 1 - - - - 5 — 10 1 4 - - - - - - 1 4 - - - - - - 10 — 15 2 1 - — -' - - ~~~ 2 1 - - - - - - 15 — 20 „ 1 6 - - - - - - 1 6 2 3 1 - 20 — 25 ,, 9 11 - 3 - 3 2 - 9 14 - - - - - - 25 — 30 ,, 9 4 - - 3 1 - - 12 5 - - 1 - - - 30 — 35 ,, 5 6 - - 2 - - - 7 6 - - - 1 - - 35 — 45 „ 4 6 - - 2 2 - - 6 8 - 1 3 1 - 1 45 — 55 ,, 3 2 2 - 1 1 - 1 4 3 2 - 2 2 - - 55 — 65 ,, 3 1 2 - 1 2 - - 4 3 2 - 4 - - - 65 and Over 3 — -— - 1 1 - - 4 1 - - - - - 40 42 6 4 10 10 2 1 50 52 8 5 11 4 - 1 82 10 20 3 102 13 15 \ 1 92 V 23 115 16