Borough of Wimbledon. Public Health Department ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR ENDED 31st DECEMBER, 1954 Printed by Raynes Park Press, Lambton Road, London, S.W.20. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH 1954 Public Health Department, Town Hall, Wimbledon, S.W.19. July, 1955. 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 1954. This report is compiled in accordance with the instructions contained in Circular 1/54 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 1954 was 8.51 per thousand of the population, compared with the rate of 11.3 for England and Wales. This is the lowest death rate recorded in Wimbledon for more than forty years. The corrected live birth rate for Wimbledon during the period was 12.94 compared with a rate of 15.2 for England and Wales. There were no maternal deaths in the Borough. 1 The infant mortality rate for 1954 in Wimbledon was the second lowest on record. Twelve Wimbledon children under the age of one year died during the year, giving, an infantile mortality rate of 15.30 per thousand live births compared with the rate of 25.5 for England and Wales. With regard to infectious diseases, the figure of 200 notifications is the lowest figure recorded in the Borough for thirteen years. This was largely attributable to the exceptionally low incidence of measles. For the fifth successive year there were no cases of diphtheria in Wimbledon. Four cases of poliomyelitis were notified, two of them being associated with paralysis. One death occurred in a non-paralytic case. I should like to take this opportunity of expressing to the Chairman and Members of the Health Committee my appreciation for the consideration and courtesy which they have shown to me during the year. My thanks are also due to all members of the staff of the Public Health Department for the loyal and efficient way in which they have carried out their duties. In January, Mr. Flynn resigned from his post as Senior Sanitary Inspector after 47 years service with the Corporation, and I should like to pay tribute to the unstinting help and loyal cooperation which I always received from him. Mr. Cockell was appointed to succeed him and took up his duties on 1st February, 1954. I should also like to pay tribute to other senior members of the staff who resigned during the year — Mr. Fry, Deputy Senior Sanitary Inspector, who was replaced by Mr. Godfrey, and Mr. Berrington, my Chief Clerk, who was succeeded by Mr. Richardson. I am much indebted to my colleagues in other Departments for their ready help on all occasions. I have the honour to be. Your obedient Servant, HAROLD ELLIS, Medical Officer of Health. 2 LIST OF CONTENTS. Page Introduction 1-2 Health Committee Members and Health Sub-Committee Members 4 List of Staff 5 SECTION A: STATISTICS AND SOCIAL CONDITIONS: Statistics, etc. 6-8 Births 8 Deaths Registered 8-9 Infantile Mortality 10-11 Summary of Statistics 12 SECTION B: GENERAL PROVISION OF HEALTH SERVICES: Nursing Homes 13 National Assistance Act, 1948 13-14 Mass Radiography 14 Clean Food Advisory Committee 14 SECTION C: SANITARY CIRCUMSTANCES: Water Supply 15 Sanitary Inspectors' Visits 15-16 Notices Served 16 Nuisances abated and defects remedied 16-17 Factories Act, 1937, Part I. 18 Outworkers 19 Bakehouses 19 SECTION D: HOUSING 20-22 SECTION E: INSPECTION AND SUPERVISION OF FOOD: Milk 23 Ice cream 24 Meat and other Foods 24-25 Sampling of Food and Drugs 26-28 SECTION F: RODENT CONTROL, PETROLEUM STORAGE, ETC : 29-30 SECTION G : PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES: Diphtheria Immunisation 31 Notifiable Infectious Diseases, etc 31-34 Tuberculosis 35-36 3 BOROUGH OF WIMBLEDON HEALTH COMMITTEE December, 1954 Councillor T. H. Metcalf, (Chairman). Councillor Alick Withall, J.P., (Mayor). Councillor A. E. Ayres, (Vice-Chairman). Alderman C. W. Black, J.P., M.P. Alderman Miss D. Carver. Councillor G. S. Abbott. Councillor W. J. M. Fisher, B.Sc. Councillor Miss D. M. Lord. Councillor W. Reay. Councillor A. J. Stringer. Councillor A. Styles. Councillor J. A. Watson. NORTH-EASTERN DIVISIONAL HEALTH SUB-COMMITTEE WIMBLEDON REPRESENTATIVES December, 1954 Councillor T. H. Metcalf, (Chairman). Councillor N. S. Clarke. Councillor L. C. Grant. Councillor Miss D. M. Lord. Councillor A. Styles. 4 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). (Retired 31/1/54). G. H. Cockell, (a), (c). (Appointed 1/2/54). Deputy Senior Sanitary Inspector: H. R. Fry, (a), (c). (Resigned 23/3/54). L. R. Godfrey, (a), (c). (Appointed 17/5/54). Sanitary Inspectors: P. W. Smith, (a), (c). P. W. Jolly, (a), (c). F. W. Goldsmith, (a), (c). Assistant Rodent Officer: F. J. Reddington. Chief Clerk: t H. Berrington, B.Sc. (Econ.). (Resigned 23/10/54). |J. R. Richardson. (Appointed 11/11/54). Clerks: *J. E. Field. (Resigned 13/2/54). * S. C. Nottingham. (Appointed 15/3/54). * Mrs. V. Waters. t Mrs. S. G. Meech. Mrs. B. Plant. (Appointed 25/10/54). F. R. Brackfield. P. B. Stannett. † 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. 5 SECTION A. — STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres—Census, 1951) 3,212 Population (Census, 1951) 58,141 Home Population (mid-1954) 58,150 Number of occupied dwellings:— 1921 (Census) 11,926 1931 (Census) 13,325 1951 (Census) 16,047 Number of private households:— 1921 (Census) 13,998 1931 (Census) 15,883 1951 (Census) 19,185 Rateable Value:— £849,324. Sum represented by penny rate:— £3,433. Extracts from Vital Statistics of the Year 1954. (Registrar-General's Figures.) Total M. F. Legitimate 749 390 359 Live Births Illegitimate 35 17 18 Total 784 407 377 Total M. F. Legitimate 17 10 7 Stillbirths Illegitimate 11 Total 18 11 7 Live birth rate per 1,000 of the estimated home population 13.48 Corrected live birth rate per 1,000 of the estimated home population 12.94 Still-birth Rate per 1,000 total (live and still) births 22.44 Total M. F. Deaths 619 296 323 Crude Death Rate per 1,000 of the estimated home population 10.64 Corrected Death Rate per 1,000 of the estimated home population 8.51 Deaths from puerperal causes— Rate per 1,000 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 15.30 Legitimate infants per 1,000 legitimate live births 14.68 Illegitimate infants per 1,000 illegitimate live births 28.57 Deaths from cancer 132 „ „ diphtheria — „ „ poliomyelitis 1 measles — whooping cough — 6 Birth Rates, Death Rates, Analysis of Mortality, Maternal Mortality and Case Rates for Certain Infectious Diseases in the Year 1954. Provisional Figures Based on Quarterly Returns of Registrar-General. Wimbledon England and Wales 160 C.B.s and Great Towns including London 160 Smaller Towns (resident populat'n 25,000-50,000 at 1951 Census) (1) (2) (3) (4) Births: — Live Births Rates per 1,000 Home Population 12.94 15.2 16.8 15.4 Stillbirths 0.30 0.36 — — 22.44* 23.5* 23.3* 24.0* Deaths: — All causes 8.51 11.3 11.1 11.3 Typhoid and Paratyphoid - — — — Whooping Cough — 0.00 0.00 0.00 Diphtheria — 0.00 0.00 0.00 Tuberculosis 0.07 0.18 0.20 0.18 Influenza 0.02 0.04 0.03 0.04 Smallpox — — — — Acute Poliomyelitis (including polioencephalitis) 0.02 0.00 0.00 0.00 Pneumonia 0.33 0.41 0.45 0.41 Cancer 2.27 2.03 — — Rates per 1,000 Live Births Infant deaths (all causes under 1 year) 15.30† 25.5† 29.l† 23.7† Diarrhoea and Enteritis (under 2 years of age) — 0.8 0.9 0.5 * Per 1,000 total (live and still) births. † Per 1,000 related live births. A dash (—) under column (1) signifies that there were no deaths - in other columns that information not available. Maternal Mortality — England and Wales Rates per 1,000 live and still births. No. of deaths Rate Maternal causes, excluding abortion 402 0.58 Due to abortion 76 0.11 Total Maternal Mortality 478 0.69 Estimated mid-1954 female population 15-44 years 9,236,000 As previously stated in the report there were no maternal deaths in Wimbledon during 1954. 7 Corrected Notifications for Certain Infectious Diseases 1954. Rates per 1,000 Home Population England Wimbledon and Wales Scarlet Fever 0.84 0.95 Whooping Cough 1.25 2.39 Typhoid Fever — 0.00 Paratyphoid Fever — 0.01 Meningococcal Infection 0.02 0.02 Diphtheria — 0.00 Erysipelas 0.05 0.12 Smallpox — Measles 0.31 3.31 Pneumonia 0.31 0.60 Acute Poliomyelitis (including Polioencephalitis) Paralytic 0.03 0.03 Non-paralytic 0.03 0.01 Food Poisoning 0.22 0.19 Dysentery 0.24 0.71 Puerperal Pyrexia* 4.99 17.74 * Per 1,000 total (live and still) births. BIRTHS. The statistics supplied by the Registrar-General show that during 1954 the total number of registered live births belonging to Wimbledon was 784. In addition, 18 stillbirths were registered. This gives a birthrate of 13.48 per thousand of the population compared with a rate of 12.68 per thousand for the previous year. A comparability factor has been supplied by the Registrar-General which enables the birth-rate for Wimbledon to be compared with that for England and Wales. The corrected birth-rate for Wimbledon for 1954 is 12.94 per thousand of the population, whilst the rate for England and Wales is 15.2. DEATHS. The total number of Wimbledon residents who died during 1954 was 619, giving a death-rate of 10.64 per thousand of the population as compared with 12.56 per thousand for 1953. The corrected death-rate for 1954 is 8.51 per thousand as compared with a rate of 11.3 per thousand for England and Wales. The number of Wimbledon residents who died outside the Borough was 235, whilst 272 persons not normally resident in Wimbledon died in institutions, etc., in the Borough. 8 The four principal causes of death were as follows:— Percentage of total deaths Diseases of the heart and circulatory system 38% Vascular lesions of nervous system 12% Cancer 21% Diseases of the respiratory system 9% Total 80% The following is an analysis of the causes of death:— Cause Males Females Total 1. Respiratory tuberculosis 2 1 3 2. Other tuberculosis 1 — 1 3. Syphilitic disease 1 2 3 4. Diphtheria — — — 5. Whooping cough — — — 6. Meningococcal infections — — — 7. Acute poliomyelitis 1 — 1 8. Measles — — — 9. Other infective and parasitic diseases 2 2 4 10. Malignant neoplasm, stomach 6 9 15 11. Malignant neoplasm, lung, bronchus 22 7 29 12. Malignant neoplasm, breast — 18 18 13. Malignant neoplasm, uterus — 1 1 14. Other malignant and lymphatic neoplasms 36 30 66 15. Leukaemia, aleukaemia 1 2 3 16. Diabetes 2 1 3 17. Vascular lesions of nervous system 31 48 79 18. Coronary disease, angina 57 44 101 19. Hypertension with heart disease 6 13 19 20. Other heart disease 25 57 82 21. Other circulatory disease 12 21 33 22. Influenza 1 — 1 23. Pneumonia 8 11 19 24. Bronchitis 23 8 31 25. Other diseases of respiratory system 3 2 5 26. Ulcer of stomach and duodenum 6 3 9 27. Gastritis, enteritis and diarrhoea 1 4 5 28. Nephritis and nephrosis — 4 4 29. Hyperplasia of prostate 12 — 12 30. Pregnancy, childbirth, abortion — — — 31. Congenital malformations 1 4 5 32. Other defined and ill-defined diseases 19 21 40 33. Motor vehicle accidents 5 — 5 34. All other accidents 8 5 13 35. Suicide 4 5 9 36. Homicide and operations of war - - - Totals 296 323 619 9 INFANTILE MORTALITY. During 1954 there were 12 deaths in infants under one year of age, giving an infantile mortality rate for Wimbledon of 15.30 per thousand live births, as compared with a rate of 25.5 for England and Wales. 11 of the 12 deaths occurred during the first four weeks of life, giving a neo-natal death-rate of 14.03 per thousand live births, as compared with a rate of 17.7 for England and Wales. The following table shows the causes of and ages at death. 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 Congenital defect or birth injury 4 1 - - 5 - - - - 5 Prematurity 4 1 - - 5 - - - - 5 Pneurtionia — — - 1 1 - - - - 1 Accidental Death - - - - - - - - - 1 Total 8 2 — 1 11 — 1 — — 12 10 Infantile Mortality during the last 10 years. Cause of death 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 Prematurity 4 6 6 8 5 5 3 3 5 5 Congenital defects or birth injuries 8 12 10 5 12 2 9 6 4 5 Diseases of the newborn - - - - - 1 2 — - - Gastro-enteritis 3 1 - - 1 2 — — 1 — Pneumonia 6 2 2 1 1 — 1 1 1 1 Bronchitis — — — — — 2 — — — — Whooping cough — — — — 1 — — — Meningococcal Meningitis - 1 - - - - - - - - T.B. Meningitis 1 — — Pneumococcal Meningitis - — — 1 — — — — —. — Septicaemia — — — — — 1 1 — — — Encephalomyelitis - - - - - - - - - - Pyelonephritis - - - - - - — — Asphyxia (unknown cause) - - - - - - - - - - Accidental death — 2 1 3 2 1 1 — 1 1 Inattention at birth - - - - - - - - - - Infanticide 1 - - - - - - - - - Other causes 6 - - - - - - - - - 29 24 20 18 22 14 17 10 12 12 Total neo-natal deaths included above 17 17 13 14 14 8 14 6 9 11 11 12 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 (per thousand home population) Still-birth Rate (per thousand home population) Death-Rate (per thousand home population) Maternal Mortality Rate (per thousand total (live and still) births) Infantile Mortality Rate (per thousand live births) 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 1951 13.26 15.5 0.24 0.36 10.93 12.5 — 0.79 20.41 29.6 1952 11.67 15.3 0.29 0.35 10.63 11.3 — 0.72 13.60 27.6 1953 12.17 15.5 0.26 0.35 10.05 11.4 1.33 0.76 16.24 26.8 1954 12.94 15.2 0.30 0.36 8.51 11.3 - 0.69 15.30 25.5 * From 1940 to 1948 the local death-rate could not be corrected 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. SECTION B. - GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. PUBLIC HEALTH ACT, 1936, PART IV. — NURSING HOMES. The Wimbledon Borough Council is responsible for the registration and supervision of nursing homes in the Borough. Ten visits of inspection were made during 1954. No additional homes were registered during the year. Two were exempted on an annual basis, from registration under Section 192 of the Public Health Act, 1936. There was one application for registration in respect of premises which had been acquired as an extension to an existing nursing home. This meant in effect the re-registration of the nursing home. At the end of the year re-registration had not been granted pending compliance with precautions against fire and means of escape. The position at the end of 1954 was as follows:— Number of homes on the register:— Maternity Nil Others 5 Number of beds provided 64 NATIONAL ASSISTANCE ACT, 1948. NATIONAL ASSISTANCE (AMENDMENT) ACT, 1951. Under Section 47 of the 1948 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 («) 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. The 1951 Act enables Local Authorities to deal more expeditiously with very urgent cases by initial removal, for a period not exceeding three weeks. In one case during 1954 it was found necessary for the Council to apply to the Court for an Order under the provisions of these Acts. Every effort had been made to give assistance to this old lady, but conditions continued to deteriorate, and in March an Order was granted 13 by the Court for the old lady to be removed to hospital. The Court later granted an extension of the Order for three months. The patient, however, died shortly afterwards. During 1954 a small number of cases were brought to the notice of the Public Health Department, but it was not necessary for the Council to use its powers in respect of any of these. All necessary help and advice was given in each individual case. In dealing with these old people the District Nursing Association and Home Help Service have rendered invaluable assistance. MASS RADIOGRAPHY. The Mass X-ray Unit of the Regional Hospital Board was stationed in South Wimbledon from 25th January to 4th March, 1954. As in previous years facilities were offered to all persons over the age of 15 years for x-ray examination of the chest. I am indebted to the Medical Director of the Mass Radiography Unit for the following details of persons who attended for examination. As the facilities were available to all, and were used by persons coming from a wide area, the statistics do not necessarily relate to Wimbledon residents only. Number of persons examined: Males 3,013 Females 3,415 6,428 A bnormalities discovered: (i) Active pulmonary tuberculosis : Males 3 Females 3 6 (ii) Inactive pulmonary tuberculosis: Males 123 Females 124 247 (iii) Non-tuberculous conditions: Males 129 Females 73 202 CLEAN FOOD ADVISORY COMMITTEE. No meetings of the Clean Food Advisory Committee were held during 1954. 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 that Authority. With three exceptions all the dwelling houses in Wimbledon are supplied from public water mains direct to the houses. During the year 1954 samples of water were taken for bacteriological examination, as follows:— Wimbledon Corporation Swimming Baths 4 Roman Well Laundry, Wimbledon Common 2 Water supplied from Well to Warren Farm Lodge, Wimbledon Common 2 Alexandra Hotel, Wimbledon Hill Road 1 These samples were reported as being satisfactory. Sanitary Inspection of the District. The following is a summary of the complaints received and the visits made during the year 1954:— Complaints received. General disrepair and insanitary conditions 381 Dampnes 90 Overcrowding 19 Defective drainage systems 12 Blocked drainage systems 92 Defective drainage fittings 17 Defective W.C. pans and flushing apparatus 49 Defective service water pipes 5 Defective chimney stacks 6 Absence of, or defective dustbins 218 Accumulations of refuse, etc 27 Rats and mice 280 Keeping of animals 2 Insect pests, etc 45 Smoke nuisance 29 Unsound food 173 Miscellaneous 87 Total 1,532 Visits made. Infectious Diseases, investigations, etc. 487 Inspections under Housing Acts 2,289 House to House Inspections (Public Health Act, 1936):— (a) number of houses inspected 30 (b) number of re-visits 30 15 House Inspections and Re-inspections 5,847 Factories, Workplaces and Outworkers premises 547 Dairies and Milkshops 98 Food Inspection 261 Food Premises and Ice Cream Premises 1,359 Sampling — Food & Drugs Act, 1938 240 Milk (Bacteriological) 325 Milk (Biological) 4 Ice-Cream 200 Water 8 Shops Act 1950 425 Petroleum (Consolidation) Act 1928 97 Prevention of Damage by Pests Act 1949 5,824 Pet Animals Act 1951 18 Heating Appliances (Fireguards) Act, 1952 53 Slaughter Houses 7 Smoke Observations 120 Miscellaneous Inspections (including visits to Piggeries, Stables, Hairdressers' premises, Watercourses, Nursing Homes, Employment Agencies) 712 Total 18,981 Notices Served. Preliminary notices or intimations 1,710 Statutory Notices 158 Result of Service of Notices. Legal proceedings. No legal proceedings were taken during the year to enforce compliance with Notices served and no work was carried out by the Corporation in default. Nuisances abated and defects remedied. The following is a summary of nuisances abated and defects remedied under the supervision of the Sanitary Inspectors:— Drains, new, provided 2 Drains, altered or repaired 52 Drains, unstopped and cleansed 70 Fresh air inlets, provided or repaired 35 Gullies, new, provided 1 Gullies, curbs, provided or repaired 15 Gutters, renewed or repaired 62 Inspection chambers, new, provided 6 Inspection chambers, altered or repaired 25 Rainwater pipes, repaired or cleared 24 Rainwater pipes, disconnected 1 Soil pipes and vents, new provided 4 Soil pipes and vents, repaired 15 16 Waste pipes, new, provided 12 Waste pipes, repaired, cleansed or trapped 36 W.C. accommodation, provided or improved 7 W.C. accommodation, ventilated space provided 6 W.C. accommodation, apartments cleansed and/or repaired 10 W.C. pans, new, provided 32 W.C.s unstopped, cleansed or repaired 24 Flushing cisterns, new, provided 7 Flushing cisterns, repaired or regulated 51 Sinks and/or lavatory basins provided 22 Urinals, cleansed or repaired 1 Accumulations removed 28 Dustbins provided 109 Brickwork, repaired or repointed 27 Dampness remedied 107 Roofs, renewed or repaired 155 Yard paving, repaired 12 Floors, renewed or repaired 73 Sub-floor ventilation provided 3 Fireplaces or ranges, renewed or repaired 77 Rooms, walls and ceilings, cleansed 125 Rooms, verminous, cleansed 1 Rooms, plasterwork repaired 227 Staircases, handrails provided 4 Staircases, repaired 12 Service water pipes, repaired 16 Water supply reinstated 4 Water storage cisterns repaired and/or cleansed 13 Windows, repaired 78 Windows, sills, renewed or repaired 30 Windows, sashcords renewed 126 Food Rooms, cleansed 24 Smoke nuisances abated 8 Miscellaneous nuisances abated 256 Rooms disinfected 143 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 99 69 7 — Factories with mechanical power 226 221 29 — Other premises under the Act (including works of building and engineering construction but not including outworkers' premises) 5 27 3 - Totals 330 317 39 — 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) 10 4 — 3 — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) 1 1 — — — Inadequate venti1ation (S.4) 7 2 1 3 — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7):— Insufficient 1 1 — 1 - Unsuitable or Defective 31 17 — 7 — Not Separate for Sexes — 2 — — — Other Offences (Excluding offences relating to outwork) 8 5 - — — Totals 58 32 1 14 — 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 cates 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. 11 1 — — — — Others — — — — — — Total 11 1 — — — — Number of addresses received from other Councils 55 Number of addresses forwarded to other Councils 33 Number of premises where outwork was carried on at the end of 1954 64 Inspections of outworkers' premises 159 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 Nil Underground bakehouses in use at the end of the year 1 19 SECTION D. - HOUSING. Housing Statistics for the year 1954. 1. Inspection of Dwelling-houses during the year:— 1(a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,264 (b) Number of inspections made for the purpose 6,040 2(a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations 1925 and 1932 Nil (b) Number of inspections made for the purpose Nil 3 Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil 4 Number of dwelling-houses exclusive of those referred to under the preceding sub-head found not to be in all respects reasonably fit for human habitation 778 2. Remedy of defects during the year without service of formal notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 541 3. Action under Statutory Powers during the year:— A. Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners Nil (b) By Local Authority in default of owners Nil B. Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 157 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 75 (b) By Local Authority in default of owners Nil C. Proceedings under Sections 11 and 13 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which Demolition Orders were made Nil (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil 20 D. Proceedings under Section 12 of the Housing Act, 1936:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil 4. Housing Act, 1936, Part IV — Overcrowding. The following table shows the position in Wimbledon at the end of 1954 with regard to overcrowding. (a) (i) Number of dwellings known to the Department to be overcrowded at the end of the year 64 (ii) Number of families dwelling therein 74 (iii) Number of persons dwelling therein 377 (b) Number of new cases of overcrowding reported during the year 11 (r) (i) Number of cases of overcrowding known to have been relieved during the year 24 (ii) Number of persons concerned in such cases 142 (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 Rehousing. I am indebted to the Housing Manager for the following information regarding rehousing in Wimbledon. These figures relate to the position at 31st December, 1954:— Number of houses requisitioned since the beginning of the war and still held under requisition 426 Number of prefabricated bungalows provided since the end of the war 71 Number of families rehoused by the Council or by private owners at the Council's instigation since the beginning of the war 2,034 Number of live applications on the housing waiting list 1,452 New houses erected, etc. I am indebted to the Borough Engineer and Surveyor for the following information:— Number of new houses and flats erected in Wimbledon in 1954: Private enterprise 36 War Damage Rebuild 1 Local authority 50 Number of flats created by conversion in 1954: Private enterprise 24 Local authority Nil 21 Housing Repairs and Rents Act, 1954. This Act came into force on 30th August, 1954, and applications from tenants for Certificates of Disrepair and from landlords for Certificates of Revocation have been received and dealt with. The following is a summary of the position on the 31st December, 1954:— Number of applications for Certificates of Disrepair 29 Number of applications cancelled 1 Number of Certificates of Disrepair issued 20 Number of applications for Certificates of Revocation 1 Number of Certificates of Revocation issued 1 22 SECTION E. — INSPECTION AND SUPERVISION OF FOOD. Milk. In accordance with the provisions of the Milk and Dairies Regulations, 1949, the handling, distribution and sale of milk continued to receive the necessary attention. The number of distributors of milk in the Borough, as shown by the register kept in accordance with the Regulations, is 41. The following licences were granted by the Council under the provisions of the Milk (Special Designation) Pasteurised and Sterilised Milk) Regulations, 1949-1953 and the Milk (Special Designation) (Raw Milk) Regulations, 1949 and 1950:— Pasteurisers' Licences Nil Dealers' Licences— Tuberculin Tested Milk 22 Pasteurised Milk 25 Sterilised Milk 30 Supplementary Licences— Tuberculin Tested Milk 9 Pasteurised Milk 10 Sterilised Milk 7 103 From the 1st October, 1954, the Regulations required bottles or other containers in which Pasteurised milk was to be delivered to the consumer to be filled only on the Pasteuriser's premises. Consequently, the filling of bottles from bulk deliveries at four dairies within the Borough was discontinued. During the year 273 samples of designated milk were submitted for bacteriological examination. The results were as follows:— Designation Satisfactory. Unsatisfactory. Pasteurised 240 5 Tuberculin Tested (Pasteurised) 13 — Tuberculin Tested (Farm bottled) 4 — Sterilised 11 — Of the 5 unsatisfactory samples, 4 failed the methylene blue test (keeping quality) and one failed the phosphatase test (pasteurisation). Subsequent samples from the same sources in each case proved satisfactory. Four samples of Tuberculin Tested (farm bottled) milk were sent to various Laboratories for animal inoculation. All these samples were found to be negative for tubercle bacilli. 23 Ice-Cream. During the year 153 samples were submitted for bacteriological examination. The results were as follows:— Grade 1 121 Grade 2 11 Grade 3 18 Grade 4 3 153 Grade 1 and 2 samples can be considered satisfactory; only 20% of the samples taken from any one vendor should be of grade 3 quality, and none of Grade 4. Investigations were made into the handling of the ice-cream from manufacturer to consumer in the cases of Grades 3 and 4 results mentioned above, and subsequent samples proved satisfactory. Meat and Other Foods. The following inspections of food premises, etc., were made by the Sanitary Inspectors during 1954:— Inspections of dairies and distributors' premises 98 Inspections of food premises 1,175 Inspections of premises where ice-cream is manufactured or sold 184 Visits to obtain samples of food and drugs 240 Visits to obtain samples of milk for bacteriological examination 329 Visits for the purpose of food inspection 261 Food and Drugs Act, 1938. The systematic inspection of food shops and other premises where food is prepared continued during the year, but the number of such premises in the area is not yet available. The number of food premises registered in accordance with Section 14 is as follows:— Premises registered for the storage and sale of ice-cream 117 Premises .registered for the manufacture and sale of ice-cream 3 Premises registered for the preparation or manufacture of sausages 41 Premises registered for the preparation or manufacture of potted, pressed, pickled or preserved food 13 24 Unsound Food. The following is a list of the unsound food surrendered during the year:— Bacon 55 lbs. Beverages 5 jars Biscuits 79 lbs. & 1 pkt. Cakes 258 Cereals 4 packets Cheese 211 lbs. & 10 tins Coffee 1 bottle Confectionery 6 lbs. & 4 pkts. Cordials 13 bottles Cream 1 tin Crumpets 1 packet Custard 2 tins Eggs 4 Fish (fresh) 137½ lbs. Fish (preserved) 81 tins & jars Flavouring 2 bottles Fruit (fresh) 20¼ lbs. Fruit (preserved) 428 tins Fruit salad 1 jar Gherkins 1 jar Ham 9¾ lbs. & 5 tins Ice-cream 83 lbs. Jams 71 jars & 26 tins Liver (ox) 31½ lbs. Liver (sheep) 42 lbs. Macaroni 4 packets Margarine 24 lbs. Meat (fresh) 3,016½ lbs. Meat (preserved) 165 tins Meat Paste 3 jars Milk (Evaporated) 331 tins Nuts 177 tins Olive Oil 1 bottle Peanut butter 2 jars Pickle 2 jars Puddings (Christmas) 20 lbs. Puddings 4 tins Rice 6 packets Salad cream 3 jars Salt 4 tins Sandwich spread 2 tins Sausages 30 lbs. & 10 tins Sausages and beans 2 tins Soups and stews 48 tins Spaghetti 3 tins Steak and onions 5 tins Suet 3 lbs. Syrup 2 tins Tomato 3 tins 25 Tomato sauce 2 bottles Tripe 15 lbs. Vegetables (preserved) 195 tins All unsound food was destroyed at the Corporation's Refuse Works. Sampling of Food and Drugs. The following samples were purchased during 1954 and were submitted to the Public Analyst, with the results shown:— Articles Total Formal Informal Genuine NonGenuine Aniseed balls 1 1 - 1 - Apple vinegar 1 1 - 1 — Aspirin tablets 1 1 — 1 — Banana crush 1 1 — 1 — Beef steak 1 1 — 1 — Blackcurrant juice 1 1 — 1 — Brandy 1 1 — 1 — Bread 1 — 1 - 1 Butter 2 — 2 — Cake mixture 1 — 1 1 — Cake and pudding mixture 1 1 — 1 — Cherries, glace 1 1 — 1 — Chocolate, drinking 1 1 — 1 — Chutney 1 1 — 1 — Cigarettes (confectionery) 1 1 — 1 — Cocoa 1 1 — 1 — Coconut chips 1 1 — 1 — Coconut sugared 1 — 1 1 — Coffee 2 2 — 2 — Coffee and chicory essence 1 — 1 1 — Cooking fat 1 1 — 1 — Crab, dressed 1 — 1 1 — Crabmeat, fancy 1 1 — 1 — Currants 1 1 — 1 — Custard powder 2 2 — 2 — Dates, stoned 1 1 — 1 — Fish paste 1 — 1 1 — Fish cakes 1 — 1 1 — Gin 1 1 — 1 — Grapefruit juice 1 1 — 1 — Honey, English 1 — 1 1 — Honey, Empire 1 — 1 1 — Horseradish 1 1 — 1 — Ice-Cream 3 3 — 3 — Jam, Strawberry 1 1 — 1 — Lard 1 1 — 1 — Lemon flavour powder 1 1 — 1 — Lemon juice 2 1 1 2 — Lemon oil capsule and citric acid tablet 1 1 — 1 — Licorice bar 1 1 — 1 — Licorice confectionery 1 1 — 1 — Liquid paraffin 2 1 1 2 — Lung syrup 1 1 - 1 - C/Fwd. 47 37 10 46 1 26 Articles Total Formal Informal Genuine Non. Genuine B/Fwd. 47 37 10 46 1 Malt vinegar 2 2 — 2 - Maltivite tablets 1 1 — 1 - Margarine 6 6 — 6 - Marzipan, almond 1 1 — 1 - Milk 46 46 — 46 - Mincemeat 4 — 4 - Nougat 1 1 — 1 - Nut crisp 1 1 — 1 - Olive oil 2 1 1 2 - Orange cordial 2 2 — 2 - Peas, garden 1 — 1 1 - Peas, processed 1 1 — 1 - Peel, mixed, cut 1 1 — 1 - Peppermints 1 1 — 1 - Pineapple juice 1 — 1 1 - Plum pudding 1 1 — 1 - Pontefract cakes 1 — 1 1 - Potatoes 1 — 1 1 - Prunes, dried 1 1 — 1 - Raisins 1 1 — 1 - Sardine and tomato paste 1 1 — 1 - Sausages (beef) 2 2 — 2 - Sausages (pork) 1 1 — 1 - Scotch broth 1 1 — 1 - Sponge cake 1 1 — 1 - Steak pudding 1 1 — 1 - Stout 3 2 1 2 1 Sugar (pieces) 1 1 — 1 - Table jelly 1 — 1 1 - Tea 1 1 — 1 - Tea, triturated 1 1 — — 1 Tomato Juice cocktail 1 — 1 1 - Tonic water 1 1 - 1 - Vita-glucose 1 1 — 1 - Whisky 6 6 — 5 1 Wine jelly 1 1 — 1 - Winter candy twist 1 1 — 1 - Totals 151 132 19 148 4 It will be seen that adverse reports were received upon 4 samples, and the following is an account of the action taken in respect thereof:— Bread. This informal sample consisted of a loaf of bread contaminated with flour containing living and dead insect larvae and their excretions. The Public Analyst expressed the opinion that this mass was formed by the activities of the Mediterranean flour moth which could have been in the sack of flour when delivered to the bakery. A warning letter was sent to the firm concerned. Stout. As the result of a complaint, a partially filled bottle of stout was submitted to the Public Analyst as an informal sample. In his opinion the stout was genuine, but the bottle stopper was contaminated with 27 pine oil. Proceedings were instituted against the firm responsible for bottling this article, and the defendants pleaded guilty. A fine of £5 was imposed, together with £6 costs. Tea. This formal sample of tea was reported upon as being genuine small leaf tea, whereas the article was described on the packet as triturated tea. This wording, in the Analyst's opinion, signified tea which had been ground to a fine powder, and he considered the description to be false and misleading. As the result of correspondence with the tea firm concerned the packets were withdrawn and satisfactorily worded packets substituted. Whisky. The Public Analyst reported that this informal sample contained 2% of excess water. Proceedings were instituted against the retailer, who pleaded guilty. The defendant was given an absolute dischaige upon payment of £7 costs. Other Legal Proceedings. Four prosecutions were taken under the provisions of the Fyod and Drugs Act, 1938. Details of these cases are given below: — A retailer was summoned for selling a marshmallow in wliich was embedded a piece of glass. The defendant pleaded guilty and was given an absolute discharge on payment of £5. 5s. Od. costs. A retailer was summoned for selling a loaf of bread in which was embedded a piece of a cigarette. The defendant pleaded guilty and was given an absolute discharge on payment of £1. 16s. 6d. advocate's fee. A retailer was summoned for selling a loaf of bread in which was embedded a cockroach. The defendant pleaded guilty and was fined £10. Costs awarded amounted to £3. 10s. 6d. A retailer was summoned for the sale of a loaf of bread in which was embedded a piece of glass. The defendant pleaded guilty and was fined £25. Costs awarded amounted to £3. 3s. Od. 28 SECTION F. - RODENT CONTROL, PETROLEUM STORAGE, ETC. PREVENTION OF DAMAGE BY PESTS ACT, 1949. The following table gives a statement indicating the action taken during 1954. Type of Property Number of Properties inspected as a result of: Number of Properties found to be infested by: Treatment carried out by Department Number of Inspections made Notification Otherwise Total Rats Mice Rats Mice Local Authority 3 31 34 4 — 4 — Dwelling Houses 239 487 726 123 67 89 11 5824 Business Premises 38 355 393 37 26 36 19 Agricultural — 1 1 — — — — Totals 280 874 1154 164 93 129 30 5824 The inspection and treatment of sewers, and of the Corporation's Depots, etc., was undertaken by the Borough Surveyor's Department, and details are not included in the figures given above. The Public Health Department continued to undertake the routine disinfestation of schools and school canteens owned by the County Council within the Borough, as and when necessary, on a contract basis. PETROLEUM (CONSOLIDATION) ACT, 1928. 67 licences were issued by the Department to store petroleum spirit during 1954, and the total quantity of petroleum spirit stored was 84,920 gallons. In addition, 9 licences were issued to store petroleum mixtures involving a total of 410 gallons, and 4 licences were issued in respect of the storage of a total of 47 cwts. of calcium carbide. 97 inspections were made of various premises in respect of which licences had been issued. PET ANIMALS ACT, 1951. 7 licences to keep pet shops were issued by the Department during 1954. 18 visits were made to these premises and various infringements of the conditions of licence were rectified. 29 HEATING APPLIANCES (FIREGUARDS) ACT. 1952. This Act, together with Regulations made thereunder, prohibits the sale or letting of unguarded electric fires, gas fires and oil heaters. The Regulations exempted until the 1st October, 1954, certain appliances which were manufactured before the date of the operation of the Regulations. Since the 1st October, 1954, 53 visits have been made in connection with this Act and 174 electric, gas and oil appliances have been examined and the prescribed tests applied. Of these, 62 were found not to conform to the standards laid down and were either modified or withdrawn from sale. SHOPS ACT, 1950. As far as possible inspections have been made of the sanitary accommodation, and heating and ventilation of shops, and improvements have been effected as circumstances have permitted. Surveys are carried out regularly to observe compliance in respect of general closing hours, half day closing and Sunday trading, with individual visits as necessary in respect of conditions of employment of young persons. The total number of inspections made for the purposes of this Act during 1954 was 425. DISEASES OF ANIMALS ACTS. One suspected case of fowl pest was reported during 1954, but this was not confirmed. In consequence of Orders made by the Minister of Agriculture and Fisheries, particularly with regard to outbreaks of foot and mouth disease, a number of enquiries were dealt with. One licence for the movement of animals was issued by this Department. 30 SECTION G. — PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Notifications of Infectious Disease. During the year there were 200 cases of infectious disease notified as compared with 1,267 cases during 1953. Of the total notifications, 74 were in respect of whooping cough and 49 in respect of scarlet fever. Poliomyelitis. 4 cases of poliomyelitis occurred during the year, 2 of them being associated with paralysis. One death occurred in a child of 11 years. Diphtheria. There were no cases of diphtheria in Wimbledon during 1954. One child suspected of suffering from diphtheria was found after admission to hospital to be suffering from a haemolytic streptococcal infection of the throat. Immunisation against Diphtheria. The Authority responsible for immunisation in this area is the Surrey County Council. The following table shows the number of children in Wimbledon under the age of 15 years who have been immunised against diphtheria. Age at 31/12/54 No. immunised Under 1 year 43 1 - 4 years 2,054 Total under 5 years 2,097 5-9 years 3,766 10-14 years 2,790 Total 5 - 14 years 6,556 Meningococcal Infection. Two patients were removed to hospital with suspected meningococcal infections. One of these, a girl of 2 years, died shortly after admission. The infection in this case was found, on post-mortem, to be due to H. influenza. This child's home was in Plymouth but she was staying in Wimbledon on holiday at the time. In the second case the diagnosis of meningococcal infection was confirmed after admission to hospital. 31 Food Poisoning. During the year there were two outbreaks of food poisoning, and in addition 6 isolated cases occurred. Outbreak No. 1. This was a small outbreak in which three children of a family of six suffered from food poisoning, due to an organism known as Salmonella typhi-murium. The patients were treated at home and made good recoveries. The origin of the infection was not discovered. Outbreak No. 2. In this second outbreak, which was also of a minor character, four children in a family of eight were involved. As in the previous case the organism responsible was Salmonella typhi-murium. The source of the infection was not traced. Of the remaining cases all but one were treated at home. In this case, a girl of 18 years, the onset of the illness was about 19th June, and on 30th June the patient was admitted to hospital with symptoms of abdominal pains and diarrhoea. The organism responsible was Salmonella-senftenberg type, and although the source of infection was not definitely established, it was believed by the Central Public Health Laboratory Service to have had some connections with pork, ham or chopped ham, in view of the number of incidents of this type which were occurring throughout the country at the time. Dysentery. Fourteen cases of Sonne dysentery were notified during the year. These included five patients from one family, one of whom was engaged in an occupation concerned with food handling. It was not necessary to serve this person with a notice under the Public Health (Infectious Diseases) Regulations 1953, prohibiting her from carrying out her employment whilst a carrier of shigella sonnei, as she voluntarily agreed to give up her work. Compensation was paid for loss of earnings by the Council during the patient's absence from her employment. 32 33 Notifiable diseases during 1954. DISEASE Number of Cases Notified in Various Age Groups Total Cases Notified Total Cases removed to Hospital Total Deaths Under 1 1-2 3-4 5-9 10-14 15-24 25-44 45-64 65 and over Scarlet Fever - 7 11 28 2 1 — — — 49 22 — Measles — 5 6 5 1 1 — — — 18 — — Whooping Cough 2 17 26 25 1 — 2 1 — 74 — — Acute Poliomyelitis (Paralytic) — — 1 1 — — — — — 2 2 — „ „ (Non-paralytic) — — — 1 1 — — — — 2 2 1 Meningococcal Infection — 1 — — — — — 1 — 2 2 1 Puerperal Pyrexia — — — — — 1 3 — — 4 3† — Dysentery — 2 2 4 1 — 4 1 — 14 — — Paratyphoid Fever — — — — — — — — — — — — Erysipelas — — — — — — 1 2 — 3 1 — Pneumonia (Acute Primary or Influenzal) — — 1 3 — 2 4 1 7 18 3 19* Food Poisoning — — 3 3 3 1 1 1 1 13 1 — Ophthalmia Neonatorum 1 — — — — — — — — 1 — — TOTALS 3 32 50 70 9 6 15 7 8 200 36 21 * All Forms. † These 3 patients were already in hospital. 34 Notifications of Infections Disease during the last 10 years. DISEASE 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 Diphtheria 8 7 4 4 6 - - - - - Dysentery 18 4 2 — 2 7 53 36 19 14 Encephalitis Lethargica, acute - - - 1 - - - - - - Enteric Fever (including Paratyphoid) - - - 1 - 3 - 1 1 - Erysipelas 11 12 5 2 7 1 5 3 3 3 Food Poisoning 1 — — 5 2 — 4 — 6 13 Malaria 1 7 — — — - 1 — - - Measles 586 339 253 481 707 364 758 337 896 18 Meningococcal Infection 6 5 5 3 2 3 2 1 1 2 Ophthalmia Neonatorum 10 8 4 2 2 1 - — - 1 Pneumonia 27 26 32 15 19 20 27 74 29 18 Poliomyelitis 4 2 25 4 10 12 4 2 11 4 Puerperal Pyrexia 8 10 3 5 8 1 2 5 22 4 Scarlet Fever 46 37 51 95 55 68 136 128 96 49 Whooping-cough 54 114 157 231 149 181 166 112 183 74 780 571 541 849 969 668 1,158 649 1,267 200 Tuberculosis:— Pulmonary 76 84 87 87 96 102 93 84 104 66 Non-Pulmonary 16 12 8 6 10 13 6 5 2 8 TUBERCULOSIS. During the year 74 cases of tuberculosis were added to the Register compared with 106 in 1953. Of these 48 were new cases and 26 were transfers from other areas. An analysis of the notifications received is given overleaf. The following cases were removed from the Register:— Pulmonary Non-Pulmonary. M. F. M. F. Deaths from tuberculosis 6 4 — - Deaths of patients suffering from tuberculosis through other causes — — — — Recovered cases 11 9 4 4 Removals from district 30 41 — 5 47 54 4 9 During the year two schoolchildren were found to have developed tuberculosis. One case occurred in a girls' school and the other in a mixed private school. A full epidemiological survey was carried out on those scholars whose parents gave their consent, including pupils who had recently left school, together with teaching and domestic staff. A total of 729 Mantoux tests were carried out at the two schools, and arrangements were made for the positive reactors to undergo an x-ray examination of the chest through the co-operation of the Mass X-Ray Unit of the Regional Hospital Board. The results of these investigations indicated that none of the pupils had been infected at school. These epidemiological surveys are becoming much more common, as it is the practice now for Chest Physicians to recommend that all pupils should be Mantoux tested and all staff x-rayed in any school where a case of pulmonary tuberculosis is discovered among the pupils. 35 36 TUBERCULOSIS, 1954. 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 - - - - - - - - - - - - - - - - 1 — 4 Years 1 - - - - - - - 1 - - - - - - - 5-9„ - - - - - - - - - - - - - - - - 10—14 „ 1 — - 1 — — - - 1 - - 1 - - - - 15 — 19 „ 4 1 - — — 1 - — 4 2 - — - — - - 20— 24 „ 5 4 1 — 3 — - 1 8 4 1 1 - 1 - - 25— 29 „ 1 4 2 2 4 6 - — 5 10 2 2 — — — — 30 — 34 „ 5 2 - — 3 3 - — 8 5 — - - — - - 35 — 44 „ 3 — - — 1 — - — 4 - — — 3 1 — — 45 — 54 „ 1 1 — 1 — 1 - — 1 2 — 1 — — - — 55 — 64 „ 1 2 — — 1 — - — 2 2 — — 1 — - - 65 and Over 4 — — — — 3 - — 4 3 — — 2 2 - - 26 14 3 4 12 14 - 1 38 28 3 5 6 4 - - 40 7 26 1 66 8 10 - 47 27 74 10