67770 Ac 4413(1) WIM 33 Borough of Wimbledon Public Health Department ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR ENDED 31st DECEMBER, 1960 ANNUAL REPORT of the MEDICAL OFFICER of__health 1960 Public Health Department, Town Hall, Wimbledon, S.W.19. (WIMbledon 6262) August 1961 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 1960. This Report is compiled in accordance with the instructions contained in Circular 1/61 of the Ministry of Health. In order to effect a financial saving the Report, for the first time, has been printed in the Town Hall by Multilith offset printing, instead of being sent to an outside firm of printers. It is otherwise on similar lines to previous years, apart from Section B, which has been slightly extended to give more information about the Personal Health Services. The Registrar-General's estimated mid-1960 home population, 57,460, shews an increase of 10 over 1959. This is the first increase in population noted by the Registrar-General in respect of Wimbledon since 1952, there having been a gradual but steady decline in the population since this date. Live births in Wimbledon in 1960 numbered 885, giving a birth rate, per thousand of the population, of 14.79, which compares with 846 births and a rate of 3-4.13 in 1959. This is the highest live birth rate recorded in the Borough since 1949. Six per cent of the total live births were illegitimate. The live birth rate for England and Wales for the year was 17.1. Deaths numbered 668 as against 752 in 1959. This gives a death rate of 9.88 per thousand population compared with 13.09 in 1959. The excess of births over deaths was 217 compared with 94 in the previous year. The death rate for England and Wales for the year was 11.5. The number of infant deaths (under 1 year of age) was 17 compared with 20 in the preceding year, giving an infantile mortality rate of 19.20 per thousand live births. This compares favourably with the rate for England and Wales (i) which was the low record of 21.7 per 1,000 live births. Stillbirths numbered 14 as against 15 in 1959 despite the increase in the birth rate. There were no maternal deaths. Deaths from all forms of cancer shewed a further increase, numbering 168 compared with 150 in 1959 and was the second greatest cause of death. Although deaths from diseases of the heart and circulatory system shewed a welcome decline - 220 compared with 255 in 1959 - it was still the principal cause of death, particularly among males, and accounted for 33% of the total deaths. The tuberculosis death rate was 0.08 per 1,000 population and compares with 0.07 for England and Wales. New notifications of pulmonary tuberculosis numbered 26, the same as last year, thus continuing the favourable trend noted since 1958. Deaths from cancer of the lung amounted to 34, the same number as in 1959, and as is usual the highest proportion of these deaths, 31, occurred among males. With regard to infectious diseases only 148 notifications were received compared with 762 in the preceding year. This fall in notifications was due to the exceptionally low incidence of measles. There were no deaths from infectious diseases. For the eleventh successive year no cases of diphtheria occurred in Wimbledon, but immunisation against this disease is as important as ever as outbreaks are still occurring in children elsewhere in the country. It is of the utmost importance that parents should keep their children as highly immunised as possible and particularly for the initial protection to be given in the first year of life. The situation with regard to poliomyelitis was especially satisfactory with not a single case occurring in the Borough during the year. The poliomyelitis vaccination scheme, which was extended in February to include everyone up to age 40 years, continued throughout the year and further progress was made. At the end of 1960, 11.181 or 82% of children under the age of 15 years had received 2 or more injections. In September a Poliomyelitis Vaccination Campaign Week was organised, being aimed particularly at the 26-40 years age group. The campaign was conducted with the aid of a Mobile Unit and helped to bring to the notice of the public the importance of poliomyelitis vaccination. From the summary it will be seen that the health of the residents was very good during the year, and the vital statistics compare favourably with those of the Country as a whole. In conclusion, 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 shewn to me during the year. (ii) My thanks are also due to all members of the staff of the Health Department for the loyal and efficient way in which they have carried out their duties. I would like to thank Mr. Cockell, the Senior Public Health Inspector, and Mr. Richardson, ray Chief Clerk, for their contribution in connection with the preparation of this Report. I am also indebted to my colleagues in other Departments for their ready help on all occasions. I have the honour to be, your obedient Servant, P.J. DOODY Medical Officer of Health. (iii) LIST OF CONTENTS Page Intrroduction (1),(11),( ill) Health Committee Members and Health Sub-Committee Members 1 List of Staff 2 SECTION A: STATISTICS AND SOCIAL CONDITIONS: Statistics, etc. 3,4,5,6 Population 7 Births 7 Illegitimacy 7 Deaths 7,8 Maternal Mortality 9 Infantile Mortality 9,10,11 Summary of Statistics 12 SECTION B: GENERAL PROVISION OF HEALTH SERVICES: Laboratory Facilities 13 Nursing Homes 13,14 National Assistance Act 1948 14,15 Hospitals 15 Mass Radiography 15 Home Help Service 15 Midwifery and Home Nursing 15 Health Visitors 16 Ambulances 16 School Health Service 16 Day Nursery 16 Clinics 16,17,18 SECTION C: SANITARY CIRCUMSTANCES: Water Supply 19 Public Swimming Baths 20 Sewerage 20 Inspection-of District 21 Notices Served 22 Result of Service of Notices 23 Factories Acts 1937 to 1959 25 SECTION D: HOUSING: Overcrowding 28 Rehousing 28 New houses erected, etc. 29 Rent Act 1957 29 Page SECTION E: INSPECTION AND SUPERVISION OF FOOD Milk - Registration and Licences 30 Milk — Sampling 31 Ice-cream - Sampling 31 Slaughterhouses Act 1958 31 Food Hygiene (General) Regulations 160 32 Registration of Food Premises 32 Unsound Food 33 Sampling of Food and Drugs 35-41 SECTION F: RODENT CONTROL, PETROLEUM STORAGE, ETC. Prevention of Damage by Pests Act 1949 42,43 Pest Control 42 Petroleum (Regulation) Acts 1928 & 1936 44 Pet Animals Act 1951 44 Heating Appliances (Fireguards) Act 1952 44 Clean Air Act 1956 44,45,46 Shops Act 1950 46 Diseases of Animals Acts 46 Noise Abatement Act 1960 47 SECTION G: PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES: Notifiable Infectious Diseases, etc. 48,49,50 Vaccination and Immunisation 51,52 Poliomyelitis Vaccination Campaign 52,53 Incidence of Infectious Diseases in Age Groups 54,55 Tuberculosis 56,57,58 BOROUGH OF WIMBLEDON HEALTH COMMITTEE December,, I960 Alderman T.H. Metcalf, (Chairman). Alderman Philip Corbishley, J.P., (Mayor). Councillor A.E. Ayres,(Vice-Chairman). Alderman Sir Cyril Black, J.P., D.L., M.P. Councillor W.J.M. Fisher, B.Sc. Councillor Miss D.M. Lord. Councillor P. MacHugh. Councillor W.A.T.J. Oldershaw, LL.B. Councillor W. Reay. Councillor Mrs. M.L. Seys-Phillips. Councillor J.A. Watson. Councillor Miss E.A. Weldon, B.A. NORTH-EASTERN DIVISIONAL HEALTH SUB-COMMITTEE WIMBLEDON REPRESENTATIVES December. 1960 Alderman T.H. Metcalf, (Chairman). Councillor J.E.V. Campbell. Councillor Miss D.M. Lord. Councillor Mrs. M.L. Seys-Phillips. Councillor Miss E.A. Weldon, B.A. 1 STAFF MEDICAL OFFICER OF HEALTH: P.J. Doody, M.B., B.Ch., B.A.O., D.P.H. SENIOR PUBLIC HEALTH INSPECTOR: G.H. Cockell, M.R.S.H., M.A.P.H.I. DEPUTY SENIOR PUBLIC HEALTH INSPECTOR: L.R. Godfrey, M.A.P.H.I. PUBLIC HEALTH INSPECTORS: C.L. Hunt R.G. Ayling, M.A.P.H.I. J.E. Stacey, M.A.P.H.I. PUPIL PUBLIC HEALTH INSPECTOR: J.T. Thompson ASSISTANT RODENT OFFICER: F.J. Reddington CHIEF CLERK: +J.R. Richardson, A.R.I.P.H.H. CLERKS: *Mrs. D. Wilson, S.R.N. *Mrs. V. Waters J.R Gill *Mrs. F.D. Egerton Swann +MLss I. Moss G. Matthews (Resigned 11.9.60) *Miss M.A. Fawdry (Resigned 13.8.60) A.J. Burke (Appointed 5.9.60) *Miss I.D. Farrow (Appointed 5.9.60) + Officer of the Surrey County Council. In part-time employment of the Wimbledon Borough Council. * Officer of the Wimbledon Borough Council. In part-time employment of the Surrey County Council. - 2 - SECTION A. - STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres - Census, 1951) 3,212 Population (Census, 1951) 58,141 Home Population (mid-1960) 57,460 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:- £1,286,785. Sum represented by penny rate:- £5,218. Extracts from Vital Statistics of the Year I960 (Registrar-General's Figures) Total M. F. Live Births (Legitimate 828 430 398 (Illegitimate 57 26 31 (Total 885 456 429 Total M. F. Stillbirths (Legitimate 11 6 5 (Illegitimate 3 2 1 (Total 14 8 6 Live birth rate per 1,000 of the estimated home population 15.40 Corrected live birth rate per 1,000 of the estimated home population 14.79 Still-birth Rate per 1,000 total (live and still) births 15.64 Total M. F. Deaths 668 311 357 Crude Death Rate per 1,000 of the estimated home population 11.62 Corrected Death Rate per 1,000 of the estimated home Population 9.88 - 3 - Deaths from puerperal causes - Deaths Rate per 1,000 total (live and 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 ... ... ... 19.20 Legitimate infants per 1,000 legitimate live births ... 18.11 Illegitimate infants per 1,000 illegitimate live births 35.09 Deaths from cancer ... ... ... ... ... 168 M " diphtheria ... ... ... ... ... Nil " " poliomyelitis ... ... ... ... Nil " " measles «.o • o # oo. «oo ... Nxl " 11 whooping cough ... ... ... ... Nil - 4 - BIRTH RATES. DEATH RATES. ANALYSIS OF MORTALITY. MATERNAL MORTALITY AND CASE RATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR I960 PROVISIONAL FIGURES BASED ON QUARTERLY RETURNS OF REGISTRAR-GENERAL Wimbledon England and Wales Rates per 1,000 Home Population Births Live Births 14.79 17.1 Still Births 0.24 0.34 15.57* 19.8* Deaths All Causes 9.88 11.5 Coronary and arteriosclerotic heart disease 2.17 2.01 Whooping Cough — 0.00 Diphtheria - 0.00 Tuberculosis - all forms 0.08 0.07 Influenza 0.03 0.02 Smallpox — - Acute Poliomyelitis (including Polioencephalitis) 0.00 Pneumonia 0.69 0.55 Malignant Neoplasm - Lung, Bronchus 0.59 0.48 Maternal Mortality - 0.39* Rates per 1,000 Live Births Deaths Infant Deaths (all causes under 1 year) 19.20 21.9 Diarrhoea and Enteritis (under 2 years) - 0.51 * Per 1,000 total (live and still) births. - 5 - CORRECTED NOTIFICATIONS FOR CERTAIN INFECTIOUS DISEASES I960 Wimbledon England and 'Wales Rates per l,000 Home Population Notifications:- (Corrected) Scarlet Fever 0.78 0.70 Whooping Cough 0.95 1.26 Typhoid and Paratyphoid Fever - 0.00 Meningococcal Infection 0.01 0.01 Acute Encephalitis - 0.00 Diphtheria - 0.00 Erysipelas - 0.06 Smal.l.pox - ' Measles 0.31 3.43 Pneumonia 0.12 0.32 Acute Poliomyelitis Paralytic _ 0.00 Non-paralytic - 0.00 Food Poisoning 0.03 0.16 Efcrsentery 0.29 0.94 Tuberculosis Pulmonary 0.45 0.46 Non-pulmonary 0.05 0.06 Puerperal Pyrexia 3.33* 11.03* * Per 1,000 total (live and still) births. 6 VITAL STATISTICS POPULATION The Registrar-General's mid-year estimate of the civilian population of Wimbledon, 57,460, shews an estimated increase of 10 on the previous year. This is the first increase of population reported by the Registrar-General since 1952, and it will be interesting to see what figure is produced when the more accurate Census of population is taken in 1961c At the last Census, in 1951, Wimbledon population was 58,141. All rates used in this report are based on the Registrar-General5s figures. BIRTHS The statistics supplied by the Registrar-General show that during the year 1960, the total number of registered live births belonging to Wimbledon was 885. Of this number, 456 were males and 429 females. This gives a birth-rate of 15.40 per thousand of the population as compared with a rate of 14.72 per thousand in 1959, and an average of 14°31 in the last five years. 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 1960 was 14.79 per thousand of the population, whilst the rate for England and Wales was 17.1 and has averaged 16.3 over the past five years. STILLBIRTHS - The number of stillbirths registered during the year was 14 (8 males and 6 females), which was 1 fewer than last year. The stillbirth rate for Wimbledon was 0.24 per thousand of the population, whilst that for England and Wales was 0.30. ILLEGITIMACY - Of the live births registered in i960, 57 (26 males and 31 females) were illegitimate, this being 6 more than in the preceding year. Three of the 14 stillbirths registered were illegitimate. DEATHS The total number of Wimbledon residents who died during 1960 was 668 311 males and 357 females), giving a death-rate of 11.62 per thousand of the population as compared with 13.09 per thousand for 1959• The corrected deathrate for 1960 was 9.88 per thousand as compared with a rate of 11.5 per thousand for England and Wales. The number of Wimbledon residents who died outside the Borough was 304, whilst 456 persons not normally resident in Wimbledon died in institutions, etc. in the Borough. - 7 - The following is an analysis of the causes of deaths- Cause Males Females Total 1. Respiratory tuberculosis 1 1 2 2. Other tuberculosis – 3 3 3. Syphilitic disease - - - 4. Diphtheria - - - 5. Whooping cough - - - 6. Meningococcal infections • - - 7. Acute poliomyelitis _ - 8. Measles - - - 9. Other infective and parasitic diseases = 1 1 10. Malignant neoplasm, stomach 14 11 25 11. Malignant neoplasm, lung, bronchus 31 3 34 12. Malignant neoplasm, breast - 19 19 13. Malignant neoplasm, uterus - 5 5 14. Other malignant and lymphatic neoplasms 35 45 80 15. Leukaemia 3 2 5 16. Diabetes 1 2 3 17. Vascular lesions of nervous system 27 66 93 18. Coronary disease, angina 70 55 125 19 o Hypertension with heart disease 2 5 7 20. Other heart disease 16 43 59 21. Other circulatory disease 10 19 29 22. Influenza 1 1 2 23. Pneumonia 19 21 40 24. Bronchitis 26 9 35 25. Other diseases of respiratory system 2 2 4 26. Ulcer of stomach and duodenum 5 2 7 27. Gastritis, enteritis and diarrhoea 2 2 4 28. Nephritis and nephrosis 1 - 1 29. Hyperplasia of prostate 12 - 12 30. Pregnancy, childbirth, abortion - - - 31. Congenital malformations 3 1 4 32. Other defined and ill-defined diseases 18 25 43 33. Motor vehicle accidents 3 2 5 34. All other accidents 5 12 17 35. Suicide 4 - 4 36. Homicide and operations of war - - _ Totals 311 357 668 – 8 – The four principal causes of death were as follows Number of deaths Percentage of total deaths Disease of the heart and circulatory system 220 33% Cancer 168 25% Vascular lesions of nervous system 93 14% Diseases of the respiratory system 81 12% Totals 562 84% MATERNAL riORTALITY No deaths in childbirth, either from puerperal sepsis or other maternal causes, were recorded during the year. Only three maternal deaths have occurred in the Borough in the last ten years. The maternal mortality rate for Si gland and Wales per thousand live and still births was 0.39° The estimated midJ.960 female population for England and Wales age 15-44 was 9,049,000. As stated there were no maternal deaths in Wimbledon during i960. INFANTILE MORTALITY During 1960 there were 17 deaths among infants under one year of age, compared with 20 in 1959 and an average of 13 in the last ten years. Two of the deaths were in respect of illegitimate children. The resultant infant mortality rate for Wimbledon per thousand live births was 19<.20. The infant mortality rate for England and Wales in 1960 was the low record of 21.7, the lowest previously recorded being 22.2 in 1959. Five of the deaths were due to congenital malformations or birth injuries and three were due to prematurity. Four children died from pneumonia, one from acute nephritis, one from pyelonephritis and one from embryoma of the liver. One of the remaining 2 deaths was due to lack of attention at birth, and the other one was an accidental death. The number of neo-natal deaths (i.e. those occurring during the first four weeks of life) was 14, giving a neo-natal death rate of 15.9 per thousand live births, as compared with a rate of 15.6 for England and Wales. The perinatal death rate (i.e. stillbirths and deaths of infants under 1 week) was 28.9 per thousand live and stillbirths, while that for England and Wales was 32.9. _ 9 . The following table sets out the number of deaths and death rates per thousand total live and stillbirths for 1960:- Number of Deaths Rate ENGLAND AND WALES Maternal causes, excluding abortion 248 0.31 Due to abortion 63 0.08 Total maternal mortality 311 0.39 Increasing importance is being paid to perinatal mortality as although perinatal deaths form only 3 to 4 per cent of all births, perinatal deaths account for eighty per cent of the total loss of infant life from the twentyeighth week of pregnancy to the end of the first year of life. The most promising way to reduce infant mortality is by concentrating on the prevention of perinatal deaths. The following table shows the cause of the 17 infant deaths which occurred during 1960, together with the age at death. Cause of death Under 1 week 2-3 weeks Total under 4 weeks 1-3 months 3-6 mcnths 6-9 months Total deaths under 1 year Congenital defect or birth injury 5 – 5 – _ _ 5 Inattention at birth 1 - ] - - - 1 Prematurity and atelectasis „.. 3 _ 3 – – – 3 iinbryorna of liver «.. - 1 1 - - 1 Pneumonia 3 - 3 - 1 - 4 Accidental death - - - - - 1 1 Acute nephritis .. „ - - - 1 - - 1 Pyelonephritis _ 1 1 - – - 1 Totals □.. 12 2 14 1 1 1 17 - 10 - INFANTILE MORTALITY DURING THE LAST 10 YEARS Cause of death 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 Prematurity and atelectasis 3 3 5 5 2 1 3 7 14 3 Congenital defects or birth injuries 9 6 4 5 5 5 3 6 4 5 Diseases of the newborn 2 – – – – – – 1 _ – Gastroenteritis - - 1 - - - - - - – Bnbryoma of liver - - - - - - – - - 1 Pneumonia 1 1 1 1 2 2 1 1 1 4 Bronchitis - - - - - - 1 - - – Acute nephritis - - - - - - - - - 1 Septicaemia 1 - - - - 1 - - - – Asphyxia (un-known cause) – – – – – – 1 – – – Accidental death 1 - 1 1 2 - - - - 1 Inattention at birth - - - - - 1 - - - 1 Bilateral pneumothorax - - - - - - - - 1 - Pyelonephritis - - - - - - - - - 1 17 10 12 12 11 10 9 15 20 17 Total neo-natal deaths included above 14 6 9 11 8 7 8 12 18 14 - 11 - SUMMAHI OF STATISTICS The following table shows the birth-rates and death-rates for Wimbledon as compared with England and Wale3 since 1941 Year Live-Birth Rate (per thousand home population) Still-Birth Rata (per thousand home population) Death-Rate (per thousand home population) Maternal Mortality (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. 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 1955 12.91 15.0 0.14 0.35 8.29 11.7 1.27 O.64 14.08 24-9 1956 13.38 15.7 0.28 0.37 9.88 11.7 — 0.56 12.40 23.8 1957 13.16 16.1 0.31 0.37 9.61 11.5 – 0.47 11.40 23.1 1958 13.24 16.4 0.36 O.36 9.89 11.7 1.29 0.43 18.89 22.6 1959 14.13 16.5 0.26 0.30 10.99 11.6 - 0.38 23.64 22.2 i960 14.79 17.1 0.24 0.30 9.88 11.5 — 0.39 19.20 21.7 *From 1941 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. _ 12 - SECTION EL - GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA LABORATORY FACILITIES The Ministry of Health Public Health Laboratory at Epsom, is available for the examination of samples of milk, ice-cream and water and of any pathological specimens. Almost al1 specimens submitted for bacteriological examination from this Department are sent to the Public Health Laboratory at Epsom. In addition, the staff is always available to assist the Medical Officer of Health in field investigations in the case of epidemics or outbreaks of food poisoning. The Laboratory at the Nelson Hospital, Merton, is also used by the Department, and is also available to general practitioners for the examination of pathological specimens. The Central Public Health Laboratory, Colindales N.W.9, is available for advice, special immunising agents and special investigations. The following is a summary of the examinations made during the years- Nose and throat swabs 53 Faeces for the typhoid and dysentery groups 356 Ice-cream samples 107 Milk samples 186 Water samples 98 Miscellaneous 6 Total 806 Samples of milk and water requiring chemical analysis, and also Food and Drug samples are sent by the Corporation to the Public Analyst, D.D. Moir, M.SCo, F.R.I.C., Southwark Street,, S.E.lo Biological examinations of milk are carried out at the Royal Institute of Public Health and hygiene Laboratory, Queen Square, W.C.l. 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. Thirteen visits of inspection were made during 1960. No new Nursing Homes were registered during the year, but an application to increase the number of patients to be provided for was received from one existing Nursing Home, and this was approved. One Maternity Hospital and one Home for unmarried mothers were exempted, on sin annual basis, from registration under Section 192 of the Public Health Act 1936. - 13 - The position at the end of i960 was as followst- Number of Homes on the registers- Maternity Nil Others 5 Number of beds provided 78 The Nursing Homes in Wimbledon were again found to be maintained and run in a satisfactory manner. Close supervision was paid during the visits to the way in which the records of the Homes were kept, that proper attention was being paid to fire precautions, and the Council's byelavra were being complied with. NATIONAL ASSISTANCE ACT 1948 - CAflE OF THE AGED Under Section 47 of the above 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. The 1951 National Assistance (Amendment) Act enables Local Authorities to deal more expeditiously with very urgent cases by initial removal, for a period not exceeding three weeks. One old lady, for whom an Order under Section 47 of the 1948 Act had been obtained in September 1958, was still in hospital at the beginning of i960. This Order which had been extended during 195S and 1959, was further extended on three occasions during i960, and at the end of the year the patient was still in hospital. A number of other cases were brought to the notice of the Public Health Department during the year, but in each instance a satisfactory solution was arrived at without resort to compulsion. The care of the aged still presents a considerable problem. A great deal is done to assist them by the local voluntary services such as the Guild of Social Welfare, but in many cases the old people create their own problems by refusing to co-operate. The District Nurses and Home Helps play a vital part in assisting these elderly people, thereby enabling them to remain at home in reasonable comfort. Still more could be done if more Home Helps could be recruited. - 14 - The co-operation between the Geriatric Department of St. Helier Hospital, the Guild of Social Welfare, the General Practitioners and your Medical Officer of Health continues to improve. HOSPITALS The South West Metropolitan Regional Hospital Board is responsible for the provision of beds for cases of infectious disease. Patients from the Wimbledon area are admitted to St. George's Hospital, Tooting, or Wandle Valley Isolation Hospital, Beddington Corner, Mitcham, or, if no beds are available, to a hospital in the London area. The 'Wimbledon Hospital and the Nelson Hospital, Merton, are the local hospitals for general treatment for both inpatients and outpatients. MASS RADIOGRAPHY The mobile Chest Radiography Unit of the South West Metropolitan Regional Hospital Board continued its weekly visits to Wimbledon and Raynes Park throughout the year. This service, which was set up in December 1958, primarily for the use of general practitioners' patients, is now available to al1 members of the public, as follows:- WIMBLEDON - Car Park, Grove Hotel (opposite South Wimbledon Tube Station) Mondays, 7.30 - 8.30 p.m. RAYNES PARK - Raynes Park Station, Grand Drive Entrance Thursdays, 7.30 - 8.30 p.m. SERVICES PROVIDED BY THE SURREY COUNTY COUNCIL The following Personal Health Services, apart from the Ambulance Service, are organised on a Divisional basis. The Medical Officer of Health for Wimbledon is also the Divisional Medical Officer, and is responsible for the day to day running of these Services. Home Help Service. This Service provides domestic help in the home in cases of confinement or illness. The Service is organised by the Divisional Home Help Supervisor, Health Department, Town Hall, Wimbledon. Midwifery and Home Nursing. Certified Midwives are employed for attendance as midwives or maternity nurses at domiciliary confinements. District Nurses are available for those who require nursing at home. Both Midwives and District Nurses are based at 28/30, Kings Road, Wimbledon. - 15 - Health Visitors, Health Visitors work in the Clinics and also do home visiting. They are primarily employed as "Health Educators," to advise on the care of young children, persons suffering from illness, expectant and nursing mothers, and the measures necessary to prevent the spread of infection. They are based, according to the area they serve, either at Amity Grove Clinic, Raynes Park, the Health Centre, Pelham Road, or the Town Hall, Wimbledon. Ambulances. The Ambulance Service is provided from the Station in South Park Road, Wimbledon, and operates under the Control Station at New Maiden. School Health Service. The basis of this Service is the periodical medical and dental inspection of all children in attendance at the local schools. Special attention is given to handicapped children, some of whom require to be admitted to special schools, e.g. those for the deaf, mentally or physically sub-normal. The administrative work of this Service is conducted from the Health Centre, Pelham Road, Wimbledon. Day Nursery. A Day Nursery located at All Saints' Road, Wimbledon, is provided for the care of children up to 5 years of age, who are admitted for health or social reasons. The following are the main Clinics provided by the Surrey County Council in Wimbledon: - Ante-natal and Post-natal Clinics. Health Centre, Pelham Road. Amity Grove Clinic, Raynes Park. Infant Welfare Clinics. Health Centre, Pelham Road. Amity Grove Clinic, Raynes Park. Churchill Hall, Effra Road. Emanuel Church Hall, Lingfield Road. St. Luke's Church Hall, Wimbledon Park. - 16 - Monday afternoons. Tuesday afternoons. 1st and 3rd Friday afternoons (Midwives Clinic). Tuesday and Friday afternoons. Monday and Wednesday afternoons. Friday mornings. Tuesday afternoons. Thursday afternoons. Friday afternoons. Immunisation and Vaccination Clinics. Amity Grove Clinic, Raynes Park. Monday mornings. Saturday mornings. Health Centre, Pelham Road. Tuesday mornings. Russell. Road Clinic. Thursday evenings (Polio vaccination). Saturday mornings. Emmanuel Church Hall, Lingfield Road. Thursday mornings (1st in month) (Immunisation only). Minor Ailments. Health Centre, Pelham Road. Monday - Friday, 9.0 - 10.0 a.m. Special Examinations. Health Centre, Pelham Road. Monday and Wednesday mornings. Amity Grove Clinic, Raynes Park. Monday mornings. Eye Clinics. Health Centre, Pelham Road. 3rd and 4th Wednesday afternoons. Thursday afternoons. Amity Grove Clinic, Raynes Park. 2nd and 4th Tuesday mornings. Relaxation and Mothercraft. Russell Road Clinic. Wednesday afternoons. Amity Grove Clinic, Raynes Park. Thursday afternoons. Parentcraft. Russell Road Clinic. Thursday afternoons. Amity Grove Clinic, Raynes Park. Thursday evenings. Dental Clinics. Health Centre, Pelham Road. Daily. Monday evenings. Amity Grove Clinic, Raynes Park. Daily. - 17 - Speech Clinics. Russell Road Clinic. Monday mornings and afternoons. Tuesday afternoons. Amity Grove Clinics Raynes Park. Thursday afternoons. Orthopaedic Clinics. Health Centre, Pelham Road. Wednesday afternoons (2nd in month). Remedial Exercises. Health Centre, Pelham Road. Tuesday and Thursday afternoons. Amity Grove Clinic, Raynes Park. Friday afternoons. Audiology Clinics. Russell Road Clinic. Alternate Friday mornings. - 18 - 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 periodic examinations are made by that Authority, The supply of water has been satisfactory in both quantity and quality. With five exceptions all the dwelling houses in Wimbledon are supplied from public water mains direct to the houses. During the year 1960, samples of water were taken for bacteriological and/or chemical analysis, as follows:- Bacteriological. Public Swimming Baths 81 Places of Public Entertainment 2 Dwelling houses:- Metropolitan Water Board supply 4 Well water 14 18 Spring outlet near Caesar's Well 3 104 Four of the reports upon samples of Swimming Bath Water indicated that chlorination appeared to be inadequate. Immediate action was taken, and subsequent samples proved satisfactory. In one dwelling house the water in a storage tank was found to be unsatisfactory. The owners subsequently provided a supply direct from the main. A sample from the spring outlet near Caesar's Well was found to be contaminated. The flow was subsequently diverted to a nearby ditch and there is now no direct access to the spring outlet. All other samples of water proved bacteriologically satisfactory. Chemical. Public Swimming Baths 3 Dwelling houses:- Well water 2 Spring outlet near Caesar's Well 1 6 - 19 - All samples of water proved chemically satisfactory. One well water supply is known to be liable to have plumbo-solvent action, and the galvanized service pipe line to a dwelling house was replaced by Alkathene tubing in 1958. Subsequent samples have been free of metallic content. Other information required by Ministry of Health Circular 1/61 is as follows:- Number of dwelling houses supplied from public water mains:- (a) Direct to the houses No record kept Population supplied Est.1960 - 57,460 (b) By means of stand-pipes Nil Population supplied Nil PUBLIC SWIMMING BATHS. I am indebted to the Baths Superintendent and Engineer for the following information regarding the Public Swimming Baths:- The Wimbledon Swimming Baths include three Pools within one establishment. All the Pools are open throughout the year with the exception of one Pool which is closed during the winter season and used as a Public Hall. Pool No.l is 100' x 40' with a depth of 6'6" to 3'. Filtration is by a rapid sand bed system and the 130,000 gallons of water are turned over every five hours. The water is sterilised by break-point chlorination. Pool No.2 is 100' x 40' with a depth of 6'6"to 3'. Filtration is by a rapid sand bed system and the 125,000 gallons of water are turned over every eight hours. The water is sterilised by break-point chlorination. The Teaching Pool is 26' x 18' with a depth of 2'3" to 2'9". Filtration is by a Diatomateous Earth filtration plant and the 6,500 gallons of water are turned over in l½ hours. The water is sterilised by marginal chlorination. All the Pools are heated to an average temperature of 72°F., and the water supply is from the Metropolitan Water Board's mains. SEWERAGE. The arrangements for sewerage and sewage disposal in the Borough are adequate. The Corporation's Sewage Disposal Works is capable of taking the whole flow to it, but a scheme for the completion of the modernisation of the Works has not yet reached finality. - 20 - INSPECTION OF THE DISTRICT, The following is a summary of the complaints received and the visits made during the year 1960:- Complaints received. General disrepair and insanitary conditions 201 Dampness 67 Overcrowding 24 Defective drainage systems 32 Blocked drainage systems 171 Defective drainage fittings 34 Defective W.C. pans and/or flushing apparatus 25 Defective service water pipes 5 Absence of or defective dustbins 26 Accumulations of refuse, etc. 56 Rats and mice 281 Insect pests, etc. 153 Smoke nuisances 70 Unsound food 105 Miscellaneous 147 1,397 Visits made- Infectious diseases. Inquiries re cases of infectious disease 215 Visits re disinfection 70 Miscellaneous 48 Housing. Dwelling houses (Housing Act) 396 Dwelling houses (Public Health Act) 1,992 Rent Act 1957 145 Underground rooms 38 Houses let in lodgings 19 Overcrowding 58 House Purchase & Housing Act 1959 153 Caravans 74 National Assistance Act 1948 25 Water supplies 52 Miscellaneous 335 Food and Food premises. Dairies and milk distributors 50 Ice-cream premises 182 Bakehouses 93 Butchers' shops 200 Meat preparation premises 6 - 21 - Fish shops 34 Fried fish shops 33 Restaurant kitchens 179 Confectionery shops 54 Licensed premises 12 Public halls 21 School canteens 18 Other food premises 428 Visits re unsound food 173 Sampling; food and drugs 189 Sampling. milk 213 Samplings ice-cream 121 Sampling: water 117 Miscellaneous 333 General. Places of public entertainment 127 Drainage and plumbing work 1,040 Stables and piggeries 15 Clean Air Act 1956 870 Pet Animals Act 1951 4 Factories (P.) 370 Factories (N.P.) 96 Factories (Building sites) 46 Outworkers' premises 169 Rag Flock Act 1951 2 Shops Act 1950 (Vent. temp, etc.) 5 Shops Act 1950 (Shop hours) 139 Hairdressers and barbers 53 Diseases of Animals Acts 2 Petroleum (Consol.) Act 1928 285 Heating Appliances (Fireguards) Act 1952 2 Watercourses 19 Rodent control 4,533 Insect infestations 200 Refuse storage 168 Accumulations 333 Miscellaneous 651 15,210 NOTICES SERVED. Preliminary notices or intimations 479 Statutory Notices 97 Other letters 1,669 - 22 - RESULT OF SERVICE OF NOTICES. (1) Legal Proceedings. Legal proceedings were instituted against the owner of a dwelling house for failing to comply with an Abatement Notice. The case, which was heard in the owner's absence, was proved, and £5.15.6. costs were imposed, and an Abatement Order made. The Order was not complied with, and the work was carried out by the Local Authority in default, and the owner paid the cost of the works. (2) Nuisances abated and defects remedied. The following is a summary of nuisances abated and defects remedied under the supervision of the Public Health Inspectors:- Drainage and sanitary fittings. Examined and tested 136 Reconstructed 57 Cleansed 103 Soil pipes and ventilation shafts repaired or renewed 12 Inspection chamber covers renewed 8 Fresh air inlets repaired or renewed 14 Mew W.C. pans provided 34 Water waste preventors repaired or renewed 22 Gutters and rainwater pipes repaired or renewed 69 New lavatory basins provided 5 New baths provided 2 New glazed sinks provided 2 Waste pipes trapped, repaired or renewed 7 Gully surrounds repaired 12 Miscellaneous 41 General housing repairs. Roofs repaired 102 Yards paved or repaired 13 Dampness remedied 107 Damp-proof courses provided 16 Sub-floor ventilation provided 4 Walls and ceilings repaired 229 New ceilings constructed 4 Walls cleansed 198 Ceilings cleansed 67 Floors repaired or renewed 55 - 23 - Windows repaired or renewed 167 Doors repaired or renewed 32 Fireplaces repaired or renewed 20 Service water mains repaired 3 Additional light and ventilation provided 17 Miscellaneous 213 Food premises. Shops reconstructed 1 Walls repaired or redecorated S3 Ceilings repaired or redecorated 60 Floors renewed or repaired 8 Woodwork repaired or repainted 18 Lighting provided or improved 3 Ventilation provided or improved 5 Fresh air inlets removed and drain inlets trapped 2 Infestation risks removed 1 Sinks provided 5 Hot water provided to sink 13 Detergent provided 2 Clean cloths provided 1 Overall clothing provided 1 First aid kit provided or improved 32 Water supply provided 21 Risks of contamination removed 49 Outdoor clothing store provided 17 Refuse storage improved 8 Wash-hand basins provided 25 Hot water provided to wash-hand basins 33 Soap provided 31 Nailbrush provided 35 Clean towels provided 32 Sanitary accommodation provided/repaired/cleansed 7 Lighting in sanitary accommodation provided 11 Ventilation in sanitary accommodation provided 1 Hand washing notices fixed 34 Rodent Control. Defects remedied in connection with ratproofing work are included in foregoing lists. Miscellaneous. Accumulations removed 13 New dustbins provided 17 Smoke nuisances abated 4 - 24 - FACTORIES ACTS 1937 to 1959 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 43 96 3 – Factories with mechanical power 296 370 48 1 Other premises under the Act (including works of building and engineering construction but not including outworkers' premises) 37 46 1 – Totals 376 512 52 1 2. Defects Found. Particulars Number of Defects Prosecutions Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector Want of Cleanliness (s.1) - - - - - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) 4 4 - 1 - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7):Insufficient 2 3 - - - Unsuitable or defective 59 32 - 6 1 Not separate for sexes 15 10 - - - Other offences (excluding offences relating to outwork) 1 3 - - - Totals 81 52 - 7 1 - 25 - PART VIII OUTWORK - SECTIONS 110 and 111 Nature of work Section 110 Section 111 No. of outworkers in August list required by Sec.110(1)(c) No. of cases of default in sending lists to the Council No. of prosecutions for failing to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions ■ Wearing Apparel Making etc. 35 - - - - - Others 25 - - - - - Totals 60 - - - - - Number of addresses received from other Councils 71 Number of addresses forwarded to other Councils 50 Number of premises where outwork was carried on at the end of 1960 77 Inspections of outworkers' premises 169 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 - 26 - Legal Proceedings. Legal proceedings were instituted against the owner of a factory using mechanical power, under the Sanitary Accommodation Regulations 1938, for failing to comply with a written Notice to provide an intervening ventilated space between the sanitary convenience and the workroom. The Defendant pleaded guilty, and was granted an absolute discharge on payment of £5.9.0. costs. Administration. In 1959 the Factories Register was revised, and a new system of recording was introduced. The number of premises on the Register was 376, and during 1960 each of these factories has been inspected and recorded. The total number of inspections made for this purpose was 512. - 27 - I SECTION D. - HOUSING In accordance with Ministry of Health Circular l7/55, details on housing matters are omitted from this Report, but the following information is given in connection with overcrowding:- Housing Act 1957. Part IV - Overcrowding,, (a) (i) Number of dwellings known to the Department to be overcrowded at the end of the year 32 (ii) Number of families dwelling therein 36 (iii) Number of persons dwelling therein 97 (b) Number of new cases of overcrowding reported during the year 11 (c) (i) Number of cases of overcrowding known to have been relieved during the year 56 (ii) Number of persons concerned in such cases 291 (d) Number of cases in which dwelling houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil Each of the premises recorded as being overcrowded was re-visited prior to the preparation of this Report, and the records have been corrected accordingly. 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, 1960s- Number of prefabricated bungalows provided since the end of the war 71 (At the end of 1960 4 had been demolished). Number of families rehoused by the Council or by private owners at the Council's instigation since the beginning of the war 2,316 Number of live applications on the housing list for s- (a) accommodation in Wimbledon 459 (b) accommodation in Frimley and Camberley 204 - 28 - New houses erected. etc. I am indebted to the Borough Engineer and Surveyor for the following informations- Number of new houses and flats erected in Wimbledon in 1960s- Private enterprise 154 Local Authority 37 Number of flats created by conversion in 1960:- Private enterprise 67 Local Authority Nil RENT ACT 1957. This Act came into force on the 6th July, 1957, and in certain respects modified the powers and duties of Local Authorities under the Rent Acts and other enactments. Those Sections of the Housing Repairs and Rents Act 1954 relating to Certificates of Disrepair were repealed by the new Act which provided for an entirely new procedure in connection with applications by tenants for Certificates of Disrepair. The following is a summary of the position on the 31st December, 1960s- Applications for Certificates of Disrepair (Form I) 250 Applications withdrawn by applicants 13 Forms J sent to landlords 229 Undertakings given by landlords (Form K) 129 Certificates of Disrepair issued (Form L) 98 Applications for Cancellation of Certificates of Disrepair (Form M) 86 Certificates of Disrepair cancelled 60 Number of visits made during 1960 in connection with the Rent Act 1957 - 145. - 29 - SECTION E. - INSPECTION AND SUPERVISION OF FOOD MILK. In accordance with the provisions of the Milk and Dairies (General) Regulations 1959, 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 33. The following licences were granted by the Council under the provisions of the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949 to 1953 and the Milk (Special Designation) (Raw Milk) Regulations 1949 to 1954:- Pasteurisers' Licences Nil Dealers Licences- Tuberculin Tested Milk 26 Pasteurised Milk 26 Sterilised Milk 31 Supplementary Licences - Tuberculin Tested Milk 10 Pasteurised Milk 10 Sterilised Milk 9 112 Milk (Special Designation) Regulations I960. The Milk (Special Designation) Regulations 1960 came into operation on the 1st October 1960. These Regulations consolidated and re-enacted, with amendments, the Milk (Special Designation) (Raw Milk) Regulations 1949 to 1954, and the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949 to 1953. The following licences were issued under the new Regulations during 1960:- Dealers (Pre-packed Milk) Licences - Tuberculin Tested Milk 1 Pasteurised Milk 1 30 During the year 186 samples of designated milk were submitted for bacteriological examination. The results were as follows s- Designation Satisfactory Unsatisfactory Pasteurised 124 Nil Tuberculin Tested (Pasteurised) 14 Nil Sterilised 11 Nil Tuberculin Tested (Farm bottled) 37 Nil Five samples of Tuberculin Tested (Farm bottled) milk were sent to the Royal Institute of Public Health and Hygiene Laboratory for animal inoculation. These samples were found to be negative for tubercle bacilli. ICE-CREAM. During the year 107 samples were submitted for bacteriological examination. The results were as follows:- Grade 1 101 Grade 2 1 Grade 3 3 Grade 4 2 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. Action was taken in respect of the 5 unsatisfactory samples mentioned above, and subsequent samples proved satisfactory. The two Grade 4 samples were taken from a mobile van, and it was found that part of the equipment was not in a sterile condition. MEAT AND OTHER FOODS. There are no slaughterhouses within the Borough, and no slaughtermen's licences were issued under the provisions of the Slaughter of Animals Act 1958, during the year 1960. In November 1960 a Report upon the review of slaughterhouse facilities, carried out in accordance with the provisions of Section 3(1) of the Slaughterhouses Act 1958, as to the existing and probable future requirements for slaughterhouse facilities within the Borough, and upon the slaughterhouse facilities which were available or likely to become available to meet requirements, was submitted to the Council. The Report indicated that there were no slaughterhouses in the Borough, and that facilities for the procurement of supplies of home killed meat were satisfactory. A copy of the Report was sent to the Minister of Agriculture, Fisheries and Food. 31 FOOD AND DRUGS ACT 1955. The inspection of food premises has formed an important part of the work of the Public Health Inspectors during the past year. 2,461 visits were made to premises in which foodstuffs, intended for human consumption, were prepared, stored or sold. All food premises must comply with the Food Hygiene Regulations 1955 (after the 1st October 1960 - Food Hygiene (General) Regulations 1960), and a considerable amount of work has been done under the Regulations during the year. In general, it has been found that food traders within the Borough are co-operative and I have reason to believe that the assistance and advice given by the Department is appreciated. The register of food premises includes the following:- Greengrocers 68 Confectioners 141 Ice-cream premises 215 Bakers 35 Grocers 126 Provision dealers 92 Butchers 45 Fishmongers 21 Milk distributors 38 Chemists 25 Licensed premises 73 Clubs 0 Restaurants and Cafes 80 Works canteens 12 School canteens 51 Kitchens (Hospital and Centred. Kitchens) 5 Food stalls/vehicles 16 Places of public entertainment 16 1,089 The number of food premises registered in accordance with Section 16 of the Act is as follows:- Registered for the storage and sale of ice-cream 150 Registered for the manufacture and sale of ice- cream 2 Registered for the preparation or manufacture of sausages 43 Registered for the preparation or manufacture of potted, pressed, pickled or preserved food 38 The number of inspections of registered food premises during 1960 was 476. 32 UNSOUND FOOD. Following the closing down of the Corporation's refuse disposal works at the end of 1955, arrangements were made with Merton and Morden U.D.C. for the reception of unsound food surrendered to the Health Department. This system is still operating satisfactorily. The following is a list of unsound food surrendered during 1960;- Cwts. qrs. lbs. Canned soups 1 2 Canned meat 6 1 22 Canned fish 27 Canned vegetables 3 25 Canned fruit 3 2 21 Canned milk or cream 1 1 Meat, bacon, poultry, etc. 7 0 7 Fish 1 2 7 Cheese, butter, fat 9 Sugar, jam and syrup 1 4 Flour and cereals 5 Salt, pickles, sauces 1 6 Sausages 3 1 9 Spaghetti 1 1 Frozen food 1 0 8 Confectionery 10 Beverages 12 Meat pies 2 Dried fruit 2 Canned puddings 14 26 0 26 The number of complaints received during the year regarding unsound food was 105. These included references to extraneous matter in food and a detailed investigation was made in each case. Informal action was taken in the majority of cases, but in three instances it was necessary to institute legal proceedings. Particulars of these proceedings are referred to later in this Report. The complaints of extraneous matter in food included the following:- Rubber band in Polish rye bread. Foreign matter in bottle of yoghurt. Foreign matter in loaves of bread. Foreign matter in steak and kidney pie crust. Mineral matter in fruit loaf. Cigarette end in carton of caster sugar.* 33 Bird droppings on loaf of white bread.* Splinter of wood in crust of loaf of bread. Mould growth on wrapped loaves of bread. Foreign matter in bottles of millc. Maggot infested confectionery. Tobacco embedded in crust of loaf of white bread.* Cloth in loaf of bread. Maggots in dried fruit. Fly in minced meat. Mould in pork pie. Foreign matter in veal, ham and egg pie. Fresh egg, thought to be preserved egg. Cordial in fermenting condition. Foreign matter in dispensed medicine. Peaches in syrup with unpleasant taste. * Denotes legal proceedings taken. 34 SAMPLING OF FOOD AND DRUGS The following samples were submitted to the Public Analyst during 1960, with the results shown:- Articles Total Formal Informal Genuine Non genuine or irregular Apples 1 1 — 1 — Apple pie 1 1 — 1 — Baby food 1 — 1 1 — Bacon 1 1 _— 1 — Beef loaf, minced 1 1 — 1 — Beef suet 1 1 — 1 — Beetroot, canned 1 1 — 1 — Blackcurrant drink 1 1 — 1 — Braised steak, canned 1 — 1 1 — Bread 1 1 — 1 — Buttered rolls 1 — 1 1 — Cereal 1 1 — 1 — Cheese spread 1 1 — 1 — Cherry wine 1 1 — 1 — Chicken and veal pie 1 1 — 1 — Chutney 1 — 1 1 — Cocktail sausages 1 1 — 1 — Cocoa 1 1 — 1 — Coconut 1 1 — 1 — Coffee and chicory essence 3 3 — 3 — Coffee, instant 1 1 — 1 — Confectionery, sugar 6 6 — 6 — Confectionery, flour 8 7 1 8 — Cordials 3 3 — 3 — Cornish pasties 1 1 — 1 — Cough syrup 2 2 — 2 — Cream, canned 2 — 2 2 — Cream, thick, canned 1 — 1 — 1 Cucumber salad 1 1 — 1 — Currants 1 — 1 1 — Curry powder 1 1 — 1 — Dressed crab, canned 1 — 1 1 — Dripping 1 1 — 1 — Dubonnet 1 1 — 1 — Faggots 2 2 — 2 — Fish cakes 1 1 - 1 — C/fd. 55 45 10 54 1 35 Articles Total Formal Informal Genuine Non genuine or irregular B/fd. 55 45 10 54 1 Fish paste 1 1 - 1 - Fruit salad, canned 1 1 - 1 - Garlic 1 1 — 1 — Gin 2 2 - 2 - Ginger, crystallised 1 1 - 1 - Gooseberries in syrup 1 1 - 1 - Haddock fillet 1 1 - 1 - Herring roes, csinned 1 - 1 1 - Hogs pudding 1 1 - 1 - Jelly 1 1 - 1 - Lemonade powder 2 2 - 2 - Liquid paraffin 1 1 - 1 - Liver sausage 1 1 - 1 - Liver salts 1 — 1 1 - Mandarin oranges 1 1 - 1 - Marmalade 1 1 - 1 - Marzipan 1 1 - 1 - Milk 60 60 - 60 - Milk, evaporated 2 1 1 2 - Milk, flavoured 1 - 1 - 1 Minced chicken in jelly 1 — 1 1 - Mineral water 1 1 — 1 - Mortadella 1 1 — 1 - Mushroom ketchup 1 1 - 1 - Mustard 1 - 1 1 — Orange crush, canned 1 - 1 1 - Orange drink 1 1 - 1 - Peel, mixed 1 1 — 1 - Pickles 1 1 — 1 — Pork, salted belly 1 1 — 1 — Pork pie 1 1 — 1 - Pork roll, stuffed 1 1 - 1 - Pork sausages 1 1 - 1 - Pork sausage meat 1 1 - 1 - Pudding mixture 1 1 1 - Puff pastry 1 1 - 1 - C/fd. 153 136 17 151 2 36 Articles Total Formal Informal Genuine Non genuine or irregular B/fd. 153 136 17 151 2 Ratafias 1 1 - 1 — Rhubarb, canned 1 1 - 1 — Rice 1 1 - 1 — Rissoles 1 1 - 1 — Rum 1 1 - 1 — Sausage, canned 1 — 1 1 — Salad cream 1 1 - 1 — Salmon spread 1 — 1 1 — Sardines in tomato 1 1 - 1 — Saveloys 1 1 - 1 — Sherry 1 1 - 1 — Sorrel-in- brine 1 1 - 1 — Soup 2 1 1 2 — Soup mixture 1 - 1 1 — Sponge pudding 1 — 1 1 — Steak and kidney, fresh 1 1 - 1 — Stewed steak, canned 2 2 - 2 — Strawberry jam 2 2 — 2 — Tea 1 1 1 — Vegetable juices 1 - 1 1 — Vinegar, cider 1 1 — 1 — Vinegar, malt 1 1 — — 1 Whisky 2 2 — 2 — Zinc and castor oil cream 1 - 1 1 - Totals 181 156 25 178 3 37 The following samples were submitted for special examinations:- Articles Total Formal Informal Genuine Non genuine or irregular Caster sugar 1 — 1 — 1 Danish cream 1 — 1 1 - Fresh egg 1 — 1 1 — Lemon drink 1 — 1 — 1 Medicine 1 — 1 — 1 Milk 1 — 1 — 1 Minced meat 1 — 1 — 1 Peaches in syrup 2 — 2 2 — Polish rye bread 1 — 1 - 1 Veal, ham and egg pie 1 — 1 — 1 White bread 3 — 3 — 3 Yoghurt 1 — 1 — 1 Totals 15 — 15 4 11 It will be seen that adverse reports were received upon fourteen samples and the following is an account of the action taken in respect thereof. THICK CREAM. An informal sample of pure thick cream was purchased and was submitted to the Public Analyst for examination. His Report indicated that the milk fat content was 23.2% by weight, whereas the Food Standards (Cream) Order 1951 requires a minimum of 48% milk fat. The retailer voluntarily suspended sales, and the importers and the wholesale distributors supported this action, and remaining stocks were withdrawn. A new label omitting the word "thick" was approved, and subsequently the cream was re-issued under the new label. FLAVOURED MILK. The Public Analyst indicated that this informal sample was an article of food containing two or more ingredients, i.e. milk, flavouring and colouring, but that the colouring was not specified on the label as required by the Labelling of Food Order 1953. Negotiations were commenced with the milk distributors for the wording of the cartons to be altered, but at the time of the preparation of this Report the automatic vending machine from which the sample was obtained had been removed from the premises. 38 MALT VINEGAR. This was an informal sample of malt vinegar upon which the Public Analyst reported as containing only of acetic acid, whereas it should have contained not less than l+%> It appeared that the article had suffered in quality as the result of prolonged storage. The retailer voluntarily surrendered the whole of his remaining stock of this vinegar, and it was destroyed. CASTER SUGAR. A sugar encrusted cigarette end was found in a 1-lb. carton of caster sugar and was the subject of a complaint. The sugar and the cigarette end were examined by the Public Analyst, and legal proceedings were instituted agajnst the refiners. After a lengthy Hearing the case against the Defendants was dismissed. LEMON DRINK. A gallon jar of lemon drink prepared from whole fruit was the subject of a complaint. The Public Analyst reported that it was fermenting but that it was not unfit for human consumption. The drink contained benzoic acid as a preservative in an amount slightly less than the maximum permitted by Preservatives Regulations, and although fit for human consumption it was not of the usual quality demanded. As the result of correspondence with the manufacturers, steps were taken by them to prevent a recurrence. MEDICINE. As the result of a complaint, a bottle of medicine which was dispensed by a local Chemist upon a Doctor's prescription, was sent to the Public Analyst. It was alleged that the medicine contained particles of glass, but upon examination the relatively large needle like crystals present were due to extensive decomposition of the mixture. This, in turn, was due either to deterioration of the ingredients or to the fact that a stock solution of one of the ingredients kept in the dispensary was not freshly prepared. The facts were reported to the Health Committee, and a warning letter was sent to the Chemist concerned. MILK. A partially filled 1-pint bottle of milk was sent to the Public Analyst for examination following a complaint of the presence of stains on the inside surface of the bottle. These stains were found to consist of a dried-up residue of milk discoloured by dust and dirt. The milk was normal in composition and no foreign matter in solution was found. The Dairy concerned undertook to take steps to prevent a recurrence of this incident. - 39 - MINCED MEAT. A quantity of minced meat was the subject of a complaint, and upon examination a disintegrated blowfly was found in the meat. The specimen was sent to the Public Analyst, who confirmed the presence of a complete blowfly which had obviously been sold with the minced meat. The facts were reported to the Health Committee, who instructed the Town Clerk to send a warning letter that any future similar incident could result in legal proceedings. POLISH RYE BREAD. A rubber band was found in a loaf of Polish rye bread, and this was the subject of a complaint. The Public Analyst was of opinion that the rubber band had been baked in the loaf of bread. The facts were reported to the Health Committee, and a warning letter was sent to the Bakery firm concerned. VEAL. HAH AND EGG PIE. Black pellet-like objects on the top crust of a wrapped veal, ham and egg pie were the subject of a complaint. These pellets had the appearance of rat droppings, but upon examination they were found to consist of a mixture of carbonised flour and fat. As a result of correspondence, the manufacturers took steps to prevent a recurrence of this incident. WHITE BREAD (1). Part of a sliced wrapped loaf of white bread was found to contain shreds of tobacco. Legal proceedings were instituted against the Baker concerned for selling a loaf which was not of the quality demanded by the purchaser. The Defendant pleaded guilty and was fined £5, and was ordered to pay £2.2.0. costs. WHITE BREAD (2). As the result of a complaint a loaf of white bread was found to be fouled upon the top crust with bird droppings and showed signs of having been pecked away by birds. The Public Analyst confirmed this opinion. Legal proceedings were instituted against the Bakery firm concerned, who pleaded guilty to a charge of selling a loaf of bread not of the quality demanded by the purchaser. The Defendants were fined £15, and were ordered to pay £3.3«0. costs. WHITE BREAD (3). A sliced wrapped loaf of white bread containing foreign matter was submitted to the Public Analyst for examination. The foreign matter was found to consist of dough slightly discoloured by compounds of iron and containing 40 some solid oily substance. The total amount of the contaminant was very small, and subsequently the Bakery firm concerned undertook to revise their machinery cleaning routine to prevent a recurrence of this incident. YOGHURT. A complaint was received regarding a jar of yoghurt, the surface of which was discoloured. The Public Analyst found the discolouration to be due to particles of dust and dirt. This foreign matter was on the inner surface of the glass jar but it did not penetrate the yoghurt to any significant extent. The Dairy firm concerned was interviewed, and steps were taken to prevent a recurrence of this incident. OTHER LEGAL PROCEEDINGS. The occupier of food premises was summoned under the provisions of the Food and Drugs Act 1955 for failing to comply with the requirements of the Food Hygiene Regulations 1955 in respect of the condition of the premises. The Defendant pleaded not guilty. The offences were proved and the Defendant was granted an absolute discharge upon payment of £1.5.0. costs on each of four summonses. 41 SECTION F. - RODENT CONTROL. PETROLEUM STORAGE. ETC„ PREVENTION OF DAMAGE BY PESTS ACT 1949 The table on page 43 summarises certain rodent control work which was carried out during 1960. The inspection and treatment of sewers, and of the Corporation's Depots, etc., was undertaken in collaboration with the Borough Engineer and Surveyor's Department. Each year 10% of the total manholes in the whole sewer system are test baited, and maintenance treatment is carried out on these, and other manholes known to be infested, twice in each year. It is pleasing to record that there has been a steady decrease in rat infestation in sewers over the years, the figures for 1960 being 189 manholes baited, and 26 showing evidence of infestation. The Health Department continued to deal with rodent treatment and disinfestation work in Surrey County Council owned property within the Borough, including schools, school canteens and river banks, on a contract basis. During 1960 no legal action was required to be taken under the provisions of the Act, and this is an indication of the co-operation received from householders and business people. PEST CONTROL During the year 1960, 153 complaints were received concerning insect pests, and the following is a list of the infestations dealt with;- Woodwonn 3 Beetles 6 Cockroaches 4 Bed bugs 8 Ants 6 Maggots 1 Fleas 2 Bees 8 Flies 6 Hornets 2 Moths 1 Wasps 106 The incidence of wasps was again generalised during 1960, and it is considered that the service provided by the Department in the destruction of wasps nests plays a great part in the Council's Food Hygiene policy. In addition, 6 complaints were received regarding squirrels, pigeons and rabbits, and these were referred to the Pests Officer of the Ministry of Agriculture, Fisheries and Food at Guildford. - 42 - - 43 - Rodent Control Type of Property Number of Properties inspected as a result of s:- Number of Properties found to be infested bys:- Number of Treatments carried out including retreat- ments Number of inspections made including reinspections Notifica tion Survey under Act Total Rats Mice Local Authority 2 15 17 5 2 14 141 Dwellings 219 738 957 137 60 207 3,264 All other including Business Premises 48 489 537 20 19 34 1,128 Totals 269 1,242 1,511 162 81 255 4,533 PETROLEUM (REGULATION') ACTS 1928 & 1936 56 licences were issued by the Department to store petroleum spirit during 1960, and the total quantity of petroleum spirit stored was 108,868 gallons. The amount of petroleum spirit passing through these licensed installations in the course of a year is in the region of 2,300,000 gallons. In addition, 29 licences were issued to store petroleum mixtures involving a total of 12,682 gallons, and 3 licences were issued in respect of the storage of a total of 42 cwts. of calcium carbide. 285 visits were made to premises under the provisions of Petroleum legislation. PET ANIMALS ACT 1951 6 licences to keep pet shops were issued by the Department during 1960. Visits were made to these premises and various infringements of the conditions of licence were rectified. HEATING APPLIANCES (FIREGUARDS') ACT 1952 During 1960, 2 visits were made in connection with the Act, and appliances examined were found to conform to the standards laid down. CLEAN AIR ACT 1956 During the year 1960, 70 complaints were received with regard to smoke or grit emission, and the necessary observations were made and remedial action taken. 870 visits of inspection were made in connection with these complaints, and to boiler houses situated in industrial premises. A system of recording industrial boiler house plant was introduced during the year, and records are being compiled of all industrial installations, and other installations exceeding a rating of 55,000 B.T.Us. per hour. "Prior approval" under Section 3(2) of the Act was given to two new oilfired furnaces during the year. In 6 instances, plans which were deposited in accordance with Building Byelaws showed in each case the proposed construction of a chimney. After examination of the plans, followed by discussions with the applicants, opinion upon the heights of the chimneys in relation to Section 10 of the Clean Air Act 1956, were submitted to the Borough Engineer and Surveyor. Legal Proceedings. In 2 instances legal proceedings were instituted against the occupiers of industrial premises for contraventions of The Dark Smoke (Permitted Periods) Regulations 1958. Both the offences concerned the emission of dark smoke for - 44 - a period exceeding ten minutes in the aggregate in a period of eight hours. The Defendants pleaded not guilty, but the cases were found proven and a fine of £5 was imposed in each case, together with costs of £5.5.0. and £3.3.0. respectively. Part of the Council's evidence was obtained by means of a "telesmoke," it being impracticable to compare densities by means of a standard Ringelmann chart. It is satisfactory to record that this evidence was accepted. During 1958 two standard deposit gauges and two lead peroxide instruments were sited, one of each at Wimbledon Cemetery and at Cannizaro Nursery. These two sites were approved by the Department of Scientific and Industrial Research and recordings were commenced on the 1st April, 1958. After exposure for one month, the collecting jars and lead peroxide candles are sent to the Public Analyst for examination. When the results are received, a copy of each is sent to the Department of Scientific and Industrial Research for publication in the Atmospheric Pollution Bulletin, together with the results of observations by 506 Local Authorities and other Organisations. The following tables give the results of recordings up to December 1960s Cannizaro Nursery Site. Month Deposit per month (in tons per sq. mile) S02 per day (i.n milligrams per 100 sq. centimetres of candle) Insoluble Solids Soluble Solids Total Solids January 3.1 2.3 5.4 1.9 February 4.1 3.8 7.9 1.7 March 5.2 8.9 14.1 2.4 April 4.1 4.3 8.4 0.9 May 7.9 6.2 14.1 1.1 June 7.0 9.0 16.0 0.8 July- 4.7 5.8 10.5 0.3 August 5.0 3.9 8.9 0.7 September 3.6 5.1 8.7 0.6 October 3.3 5.3 8.6 0.9 November 2.7 4.2 6.9 0.7 December 4.4 5.0 9.4 1.8 - 45 - Wimbledon Cemetery Site. Month Deposit per month (in tons per sq. mile) SO2 per day (in milligrams per 100 sq. centimetres of candle) Insoluble Solids Soluble Solids Total Solids January 5.3 3.1 8.4 2.9 February 5.1 5.3 10.4 2.6 March 6.4 9.9 16.3 3.4 April 6.3 5.0 11.3 1.6 May 14.7 8.0 22.7 1.6 June 7.0 5.0 12.0 1.2 July 5.0 3.7 8.7 0.5 August 3.1 5.0 8.1 0.4 September 3.9 7.1 11.0 1.0 October 3.7 8.0 11.7 1.5 November 2.0 4.2 6.2 1.4 December 7.9 7.5 15.4 2.5 The Council appointed the Chairman of the Health Committee and the Senior Public Health Inspector as their representatives on the Standing Conference convened by the Department of Scientific and Industrial Research, and comprising all co-operating bodies. This Conference met twice during the year. No progress was made during 1960 to implement the scheme which the Council approved in 1959 to enable the making of Smoke Control Orders covering the whole of the Borough. Since the end of 1960, however, a Technical Assistant (Clean Air Act) has been appointed, and at the time of writing the inspection work upon the proposed first 3noke Control Area has been commenced. SHOPS ACT 1950 The total number of Shops Act inspections during 1960 was 144, Sanitary accommodation and heating and ventilation of shops has been kept under observation, and any necessary action has been taken in respect of general closing hours, half-day closing and Sunday Trading. DISEASES OF ANIMALS ACTS No outbreaks of disease occurred within the Borough during 1960. Copies of Orders made by the Ministry of Agriculture, Fisheries and Food in respect of outbreaks of foot and mouth disease, anthrax and fowl pest were received. _ 46 - During April an outbreak of foot and mouth disease occurred within the area of the Borough of Epsom and Swell, and an Order made under the Foot and Mouth Disease (Infected Areas Restrictions) Order 193, included the Borough of Wimbledon- The necessary signposting of roads during the period of the restriction was undertaken by the Surrey County Council. Two visits were made during the year to a piggery which is licensed by the Council under the Diseases of Animals (Waste Foods) Order 1957 for the boiling of foodstuffs for the feeding of animals. NOISE ABATEMENT ACT 1960 This Act came into operation on the 27th November, 1960, and was added to the Powers and Duties of the Health Committee. No offences under this Act were recorded up to the end of 1960. - 47 - SECTION Go - PREVALENCE OF. AMD CONTROL OVER, INFECTIOUS AND OTHER DISEASES During the year there were 148 cases of infectious disease notified compared with 762 in 1959, and 306 in 1958. The decrease was due mainly to a drop in the number of notifications of measles. The following infectious diseases are notifiable to the Medical Officer of Health of the Boroughs- Smallpox Cholera Diphtheria (including Membranous Croup) Erysipelas Scarlet Fever Typhus Enteric or Typhoid Fever Relapsing Fever Tuberculosis (all forms) Ophthalmia Neonatorum Malaria Dysentery Acute Primary Pneumonia Acute Influenzal Pneumonia Puerperal Pyrexia Measles Whooping Cough Meningococcal Infection Acute Poliomyelitis - Paralytic Acute Poliomyelitis - Non-Paralytic Acute Encephalitis - Infective Acute Encephalitis - Post Infectious Food Poisoning Plague Para-typhoid Fevers Anthrax. SMALLPOX There were no cases notified in Wimbledon during 1960, but this disease is still prevalent in some parts of the world and constant vigilance has to be maintained. From time to time notice is received of persons arriving in this country who have been in contact with smallpox. All such contacts are kept under surveillance until the possibility of developing the disease has disappeared. In the Ministry of Health's memorandum on vaccination against smallpox, it is recommended that all Public Health Officers likely to deal at short notice with cases of smallpox shall be regularly re-vaccinated at not more than yearly intervals. During the year ten members of the Public Health Department staff, including clerical staff, were vaccinated or re-vaccinated. - 48 - SCARLET FEVER There were 45 cases of scarlet fever notified during 1960 compared with 74 in 1959, 80 in 1958 and 59 in 1957 Four of the cases were treated in hospital. There was no mortality from the disease, which continued to be of a mild type, PUERPERAL PYREXIA The Puerperal Pyrexia Regulations 1951 define this illness as any febrile condition occurring in a woman in whom a temperature of 100.4 F. or more has occurred within fourteen days after childbirth or miscarriage. During the year 3 notifications were received, all of which occurred in hospital. The 3 patients all had addresses outside the Borough. In 1959 11 cases were notified. 3 PNEUMONIA Seven cases of acute primary or influenzal pneumonia were notified during the year, compared with 18 in 1959 and 25 in 1958. The total number of deaths from all forms of the disease during the year was 40, the same number as in 1959. MEASLES There were 18 cases notified during the year compared with 627 in 1959. The low incidence of this disease was not unexpected as measles tends to be epidemic in alternate years. The disease generally remained mild in character and none of the patients was removed to hospital. WHOOPING COUGH There was an increase in notifications in 1960, 55 being received compared with 5 in 1959, and 10, 108, 82 and 139 in the four previous years. Of the total notifications only two were admitted to hospital. Whooping cough can be fatal especially in very young children, and in any event can be very debilitating. The immunisation of all infants against the disease is strongly recommended, with the treatment commencing by at least the third month of life. MENINGOCOCCAL INFECTION One case occurred in a child of 15 months who was admitted to hospital with a purpuric rash and pyrexia. This was considered to be a case of meningococcal meningitis and was notified as such after the child's discharge from hospital, although it had not been confirmed by bacteriological investigation. The child made a good recovery. _ 49 _ FOOD POISONING Only 2 cases of food poisoning were notified,, both unrelated to one another. In one case in a boy of 12 years, who was admitted to hospital, Salmonella typhi-murium was isolated following bacteriological investigation. Other members of the family were not infected. In the other single case the causal organism was not isolated. DIPHTHERIA There were no cases. The present level of immunisation is still below what is aimed at, and every effort is made through propaganda and other means to remind the public of the need for immunisation. Diphtheria is still about, in fact in England and Wales during 1960, 52 cases were notified. It is only by maintaining a high level of immunity that the population will be safeguarded from the return of this dreaded disease. DYSENTERY Seventeen cases were notified compared with 11 in 1959 24 in 1958 and 9 in 1957. Bacteriological investigations carried out in respect of all the notified cases, 2 of whom were admitted to hospital, revealed that 15 were infected with Shigella sonnei. There were 4 small family outbreaks, in no way related to one another, involving 11 of the total cases notified. The remaining cases occurred singly in various parts of the Borough. In 2 cases formally notified as suffering from dysentery no causative agent was identified on examination. Every case of dysentery is followed up systematically, and the importance of personal hygiene in preventing the spread of infection stressed at all times. Dysentery is generally a mild illness but will spread rapidly in nurseries and schools unless quickly checked. POLIOMYELITIS For the first time since 1943 no case of poliomyelitis was notified in the Borough. In 1959 there was one case and in 1958 also there was only one confirmed case, neither patient having been vaccinated against poliomyelitis. This is a most satisfactory state of affairs and would suggest that vaccination is proving effective in the control of this disease. A high proportion of Wimbledon children have been vaccinated against poliomyelitis. - 50 - PUBLIC HEALTH (INFECTIOUS DISEASES) AMENDMENT REGULATIONS 1960 These Regulations, which came into operation on 1st December, 1960, make Anthrax notifiable to the Medical Officer of Health Medical practitioners are already required under the Factories Act 1937 to notify the Chief Inspector of Factories of cases of Anthrax contracted in any factory. CERTIFICATES OF VACCINATION AND INOCULATION In order to prevent the spread of infectious disease, certain countries require that visitors should be vaccinated or inoculated against specified diseases. International certificates have been prescribed for smallpox, yellow fever and cholera. When completed by the medical practitioner, his signature must be authenticated by the Medical Officer of Health. During the year 640 requests were received for certificates of vaccination or inoculation to be authenticated for the purpose of travel abroad. SMALLPOX VACCINATION Every effort is made to maintain a high level of immunity to smallpox by vaccination of infants in their early months. This is carried out by general practitioners or at Surrey County Council Clinics. The percentage of infants under one year vaccinated in this Borough during the year was 56% and there is every need to raise this figure to at least 75%. The following shews the number of vaccinations carried out during the years- Primary vaccinations 577 Re-vaccinations 72 WHOOPING COUGH IMMUNISATION The following figures show the number of children immunised and those who received reinforcing doses during the year (this includes those children who received the combined diphtheria and whooping cough prophylaxis). As with smallpox vaccination, whooping cough and diphtheria immunisation is carried out either by general practitioners or at Surrey County Council Clinics. Number of children immunised 632 Number of children boosted 104 - 51 - DIPHTHERIA IMMUNISATION The following table gives details of the number of children who were immunised for the first time during the year 1960:under 5 years 673 Between 5 and 15 years 170 The following table shows the total number of children in Wimbledon under the age of 15 years who had received immunising treatment by the end of the years- Under 5 years 2,283 Between 5 and 15 years 6,659 Number of children given reinforcing doses during 1960 755 TETANUS IMMUNISATION Active immunisation against tetanus is available for those who desire it in the same way as other immunising procedures. During the year, 536 children received protection,, POLIOMYELITIS VACCINATION Ample supplies of vaccine enabled poliomyelitis vaccination to continue unabated throughout 196O In February a further extension of the scheme was announced to include all persons up to the age of 40 years and certain other priority classes. The initial response to the extended schane was very poor, as it was throughout the country, and in an effort to improve the acceptance rate in the 26 - 40 years age group a Poliomyelitis Vaccination Campaign was organised in Wimbledon and Merton and Morden during the week 26th September - 1st October, The Campaign was conducted with the use of a Mobile Unit equipped with a Public Address System, and was based at various strategic points in Wimbledon and Merton and Morden. A total of 781 persons received their first injections during "Polio Week," and the Unit returned to the same points four weeks later to give the second injections. This Campaign and associated publicity increased the interest in poliomyelitis vaccination, but this particular age group are reluctant to avail themselves of the benefits of vaccination, and despite our efforts the acceptance rate at the end of 1960 had risen to only 22%. - 52 - Open Clinics, where vaccination can be carried out without prior appointment, continued to be held throughout the year at Amity Grove Clinic, Raynes Park, on Saturday mornings, and at Russell Road Clinic on Saturday mornings and Thursday evenings. The following table shews the position with regard to poliomyelitis vaccination at 31.12.60;- Class Number vaccinated with 2 injections since the beginning of the scheme Children born in the years 1943 to 1960 11,181 Young persons born in the years 1933 to 1942 4,319 Persons born before 1933 who have not passed their 40th birthday 2,215 Others 159 Total 17,874 Number of persons given a third injection under the extended Scheme - 13,991. - 53 - - 54 - NOTIFICATIONS OF INFECTIOUS DISEASE DURING THE LAST 10 YEARS DISEASE 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 Dysentery 53 36 19 14 2 15 9 24 11 17 Encephalitis acute - - - - - 1 1 - 4 — Enteric Fever (Typhoid) - - - - - - — — 1 _ Paratyphoid Fever - 1 1 - - - 1 1 1 - Erysipelas 5 3 3 3 2 6 1 3 1 - Food Poisoning 4 - 6 13 2 11 1 8 8 2 Malaria 1 - - — - 1 — - - - Measles 758 337 896 18 813 64 660 134 627 18 Meningococcal Infection 2 1 1 2 - 1 1 1 - 1 Ophthalmia Neonatorum - - - 1 - - - - — - Pneumonia 27 24 29 18 21 34 24 25 13 7 Poliomyelitis 4 2 11 4 11 7 10 1 1 - Puerperal Pyrexia 2 5 22 4 7 12 25 19 11 3 Scarlet Fever 136 128 96 49 77 110 59 80 74 45 Whooping Cough 166 112 183 74 139 82 108 10 5 55 1158 649 1267 200 1074 344 900 306 762 148 Tuberculosis:- Pulmonary 56 56 65 40 36 44 50 25 26 26 Non-Pulmonary 4 3 1 7 4 6 2 1 5 3 - 55 - NOTIFIABLE DISEASES DURING I960 Number of cases Notified in Various Age Groups Total Cases Notified Total Cases removed to Hospital Total Deaths DISEASE Under 1 1-2 2-3 3-4 4-5 5-9 10-14 15-24 25 and over Scarlet Fever — 2 1 3 3 25 8 2 1 45 4 - Measles 1 5 3 1 2 4 1 - 1 18 — - Whooping Cough 5 3 3 10 - 27 5 - 2 55 2 - Meningococcal Infection - 1 - - - - - - — 1 1 — Puerperal Pyrexia — — - - - - - 2 1 3 3* - dysentery — 2 — - 1 6 3 - 5 17 1 - Pneumonia (Acute Primary or Influenza) 1 — — — — — 1 1 4 7 — — Food Poisoning - — - - - - 1 - 1 2 1 — TOTALS 7 13 7 14 6 62 19 5 15 148 12 — * These 3 patients were already in hospital. TUBERCULOSIS During the year 56 new cases were added to the register of tuberculous persons compared with 70 in 1959 and 80 in 1958. Of the 56 additions 29 were primary notifications, 19 were transferred from other areas, and 8 were restored cases. An analysis of the notifications received is given overleaf. Ninety cases were removed from the register for the following reasons:- Pulmonary Non-Pulmonary Deaths from tuberculosis M. F. M. F. 3 1 - 1 Deaths of patients suffering from tuberculosis through other causes 2 2 - - Recovered cases 21 11 - 2 Removals from district _29_ 15 2 1 55 29 2 4 The figure of 5 deaths from all forms of tuberculosis represents a death rate per 1,000 population of 0.08, and compares with a rate of 0.10 in 1959 when there were 6 deaths. The rate for England and Wales in i960 was 0.07. The number of deaths from tuberculosis has declined steadily over a number of years, both locally and nationally, but as these rates become smaller fluctuations from year to year must be expected. In spite of the advances which have been made in the diagnosis and treatment of tuberculosis, there are no grounds for complacency and it should be remembered that there are many cases on the register and receiving treatment at the Chest Clinics. New notifications of pulmonary tuberculosis amounted to 26, the same number as in 1959, which compares with an average of 34 in the last five years. At the end of i960 there were 472 cases remaining on the tuberculosis register, 417 being cases of pulmonary tuberculosis and 55 cases of nonpulmonary tuberculosis. VACCINATION AGAINST TUBERCULOSIS Vaccination against tuberculosis with B.C.G. is offered to *11 children jetween the ages of 13 and 14 years, and is carried out in the Secondary Schools and County Council's Clinics normally in the autumn term. The object of the scheme is to provide resistance to tuberculosis during ihe adolescent period when children are most susceptible to the infection. The scheme is operated through the County School Health Service. - 56 - PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS 192? PUBLIC HEALTH ACT 1936 (Section 172) During i960 it did not become necessary to use the powers given under the above legislation. These powers prohibit persons suffering from pulmonary tuberculosis from entering upon employment involving the handling of milk, and the compulsory removal and detention in hospital, in certain circumstances, of persons suffering from tuberculosis. - 58 - TUBERCULOSIS I960 CASES ADDED TO THE REGISTER Primary Notifications (Form A) Cases Discovered otherwise than by Notification Total Cases added to the Register DEATHS AGE GROUPS Pulmonary NonPulmon ary Pulmonary NonPulmon ary Pulmonary NonPulmon ary Pulmonary NonPulmon ary 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 " — 2 — — — 1 — — — 3 — — — — — — 10-14 " — — — — — — — — — — — — — — — 1 15 - 19 " — — — — — — — — — — — — — — — — 20 - 24 " 2 2 - — — 1 — — 2 3 — — — — — — 25 - 29 " — 3 — 1 3 2 - — 3 5 — 1 - — - — 30 - 34 " 1 1 - - 1 1 — 1 2 2 — 1 - — — — 35 - 44 " 4 3 — — 2 2 — 1 6 5 — 1 — — — — 45 - 54 " 1 1 — — 1 4 — — 2 5 — — — 1 — — 55 - 64 " 1 1 — — 3 1 — — 4 2 — — 2 1 — — 64 and Over 3 — 2 — 1 2 — — 4 2 2 — 3 1 — — Age not known — — — — — — — — — — — — — — — — 13 13 2 1 11 14 — 2 24 27 2 3 5 3 — 1 26 3 25 2 51 5 8 1 29 27 56 9