AC 44 13 (1) WH 34 Borough of Wombledon Public Health Department ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR ENDED 31st DECEMBER, 1961 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH 1961 Public Health Department, Town Hall, Wimbledon, S.W.19. (Wimbledon 6262) September 1962 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 1961. This Report is compiled in accordance with the instructions contained in Circular 1/62 of the Ministry of Health, and is on similar lines to previous years. The Report shews that the health of the residents has been very good during the year, and vital statistics compare favourably with those of the country as a whole. Live births numbered 892, giving Wimbledon a birth rate per thousand of population of 15.18 which is the highest rate recorded in the Borough since 1948. Of the 892 live births, 63 or 7% were illegitimate. The live birth rate for England and Wales for the year was 17.4. Deaths from all causes numbered 706 as against 668 last year, giving a death rate per thousand of the population of 10.39 compared with 9.88 in 1960 and 12.0 for England and Wales. The excess of births over deaths was 186 compared with 217 in the previous year. The infant mortality rate shewed a further decline over last year. Thirteen Wimbledon children under the age of one year died, giving an infant mortality rate of 14.57 per thousand live births, compared with 17 deaths and a rate of 19.20 in 1960. The infant mortality rate for England and Wales for 1961 was 21.6, the lowest figure on record. The stillbirth rate per thousand live and still births was 15.95. This was slightly higher than last year but compares favourably with the rate for England and Wales which was 18.7. (i) There were no maternal deaths. The principal cause of death was once again heart disease (254 deaths), especially coronary disease, while cancer of all kinds (185 deaths) was the second greatest cause. The evidence collected by the Royal College of Physicians and set out in their recently published report on "Smoking and Health," clearly establishes that heavy cigarette smoking is a cause of lung cancer and bronchitis, and probably contributes to the development of coronary heart disease and other illnesses, while atmospheric pollution is also suspected to be a contributing factor. In Wimbledon there was a big increase in deaths from cancer of the lung, 55 deaths occurring compared with 34 in 1960. Another factor of importance, as will be seen in the analysis on page 8, is that although, as usual, the highest number of these deaths occurred in men, the proportion of women dying from lung cancer is increasing. The tuberculosis death rate fell to 0.05 per 1000 population compared with 0.08 in 1960. New notifications of pulmonary tuberculosis numbered 34, an increase of 8 over the previous year. This increase in new notifications was due to an outbreak of tuberculosis which occurred in a school outside Wimbledon, but which was attended by pupils living in the Borough. Ten deaths were recorded from motor vehicle accidents, this being 5 more than in 1960. All other accidents accounted for 12 death3 as compared with 17 in 1960. Suicides totalled 9 cases as against 4 in the preceding year. With regard to infectious diseases, the year was indeed a "measles year" with the extraordinary contrast of 980 notified cases compared with only 18 in 1960. Apart from measles, which fortunately was of a very mild type, no other disease was particularly prevalent. There was one case of poliomyelitis which unfortunately proved fatal. This occurred in a young man who was admitted to hospital shortly after returning to this country from abroad, where, there is little doubt he contracted the disease. He had not been vaccinated against the disease. No cases of food poisoning were notified, which reflects in seme measure the success of the hygiene standards being maintained in the food shops and eating places in the Borough. Once again, and for the twelfth year in succession, Wimbledon was completely free from diphtheria, but there were outbreaks of the disease in some unimmunised children elsewhere in the country. Still a highly dangerous disease, it could return at any time, particularly if the level of immunity among the population is not maintained. It is therefore of the utmost importance that parents should keep their children as highly imnunised as possible and for the initial protection to be given in the first year of life. Poliomyelitis vaccination continued to be offered throughout the year to all persons up to the age of 40 years and certain other priority classes. In June the Mobile Vaccination Unit which visited Wimbledon in the autumn of 1960 returned in order that those who attended the Unit for their first two injections oould receive a third injection of vaccine. The opportunity was also taken at this time to give as many first injections as possible. (ii) The proposed use of oral vaccine was announced during the year, but the introduction of the vaccine into this country did not take place until 1962 and does not therefore belong to this Report. Same progress was made during the year towards the establishment of Smoke Control Areas throughout the Borough under the Clean Air Act 1956. 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. I would also like to express my thanks to all those associated with the local Health and Social Services, both official and voluntary, for their continued co-operation during the year. In particular, I would like to mention the contribution of the Senior Public Health Inspector and Chief Clerk in the production of this Report, and the co-operation and loyalty of all members of the Public Health Department staff. I have the honour to be, Your obedient Servant, P.J. DOODY Medical Officer of Health (iii) LIST OF CONTENTS Page Introduction (i),(ii),(iii) 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 1943 14,15 Hospitals 15 Mass Radiography 16 Home Help Service 16 Midwifery and Home Nursing 16 Welfare Foods 16 Chiropody 16 Health Visitors 17 Ambulances 17 School Health Service 17 Day Nursery 17 Clinics 17,18,19 SECTION C: SANITARY CIRCUMSTANCES: Water Supply 20,21 Sewerage and Sewage Disposal 21 Inspection of District 21,22,23 Result of Service of Notices 23,24,25 Factories Acts 1937 to 1959 25 Outwork 26 SECTION D: HOUSING: Overcrowding 27 Rehousing 27 New houses erected, etc. 28 Rent Act 1957 28 Page SECTION E: INSPECTION AND SUPERVISION OF FOOD: Milk - Registration and Licences 29 Milk — Sampling 29 Ice-cream - Sampling 30 Meat and other Foods 30 Registration of Food Premises 30,31 Unsound Food 31,32 Sampling of Food and Drugs 33-38 SECTION F: RODENT CONTROL, PETROLEUM STORAGE, ETC. Prevention of Damage by Pests Act 1949 39 Pest Control 40 Petroleum (Regulation) Acts 1928 & 1936 40 Pet Animals Act 1931 40 Clean Air Act 1956 41 Shops Act 1950 42 Diseases of Animals Acts 42 Noise Abatement Act 1960 42 SECTION G: PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES: Notifiable Infectious Diseases, etc. 43,44,45,46 Vaccination and Immunisation 47,48 Poliomyelitis Vaccination 48,49 Incidence of Infectious Diseases 50,51 Tuberculosis 52,53,54 BOROUGH OF WIMBLEDON HEALTH COMMITTEE December. 1961 Alderman T.H. Metcalf, (Chairman). Alderman Philip Corbishley, J.P., (Mayor). Alderman A.E. Ayres, (Vice-Chairman). Alderman Sir Cyril Black, J.P., D.L., M.P. Councillor W.J.M. Fisher, B.Sc., J.P. 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. 1961 Alderman T.H. Metcalf, (Chairman). Councillor J.E.V. Campbell. Councillor Miss D.M. Lord. Councillor W.A.T.J. Oldershaw, LL.B. 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. Cocke11, 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. (Resigned 10.9.61) PUPIL PUBLIC HEALTH INSPECTOR: J.T. Thompson TECHNICAL ASSISTANT (CLEAN AIR): K.C. Robinson (Appointed 4.4.61) ASSISTANT RODENT OFFICER: F.J. Reddington CHIEF CLERK: *J.R. Richardson, A.R.I.P.H.H. CLERKS: *Mr8. D. Wilson, S.R.N. *Mrs. V. Waters J.R. Gill *Mrs. F.D. Egerton Swann (Resigned 22.5.61) +Miss I. Moss *Mrs. M.D. Underwood (Appointed 23.5.61, Resigned 28.10.61) *Mrs. E.E. Barlow (Appointed 30.10.61) A.J. Burke *Miss I.D. Farrow * 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-1961) 56,990 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:- £1,309,167. Sum represented by penny rates- £5,295. Extracts from Vital Statistics of the Year 1961 (Registrar-General's Figures) Total M. F. Live Births (Legitimate 829 422 407 (Illegitimate 63 31 32 (Total 892 453 439 Stillbirths Total M. F. (Legitimate 14 6 8 (Illegitimate 3 2 1 (Total 17 8 9 Live birth rate per 1,000 of the estimated home population 15.65 Corrected live birth rate per 1,000 of the estimated home population 15.18 Still-birth Rate per 1,000 total (live and still) births 15.95 Total M. F. Deaths ... ... ... ... 706 318 388 Crude Death Rate per 1,000 of the estimated homo population 12.38 Corrected Death Rate per 1,000 of the estimated home population 10.39 - 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 14.57 Legitimate infants per 1,000 legitimate live births 12.06 Illegitimate infants per 1,000 illegitimate live births 47.62 Deaths from cancer 185 " " diphtheria Nil " " poliomyelitis 1 " " measles Nil " " whooping cough Nil - 4 - BIRTH RATES. DEATH RATES. ANALYSIS OF MORTALITY. MATERNAL MORTALITY AND CASE RATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR 1961 PROVISIONAL FIGURES BASED ON QUARTERLY RETURNS OF REGISTRAR-GENERAL Wimbledon England and Wales Rates per 1,000 Home Population Births Live Births 15.18 17.4 Still Births 0.24 0.30 15.95* 18.7* Deaths All Causes 10.39 12.0 Coronary and sclerotic heart disease 2.57 2.07 Whooping Cough – 0.00 Diphtheria – 0.00 Tuberculosis - all forms 0.05 0.07 Influenza 0.05 0.15 Smallpox – – Acute Poliomyelitis (including Polioencephalitis) 0.01 0.00 Pneumonia 0.80 0.65 Malignant Neoplasm - Lung, Bronchus 0.96 0.49 Maternal Mortality – O.33* Rates per 1,000 Live Births Deaths Infant Deaths (all causes under 1 year) 14.57 21.6 Diarrhoea and Enteritis (under 2 years) – 0.51 * Per 1,000 total (live and still) births. - 5 - CORRECTED NOTIFICATIONS FOR CERTAIN INFECTIOUS DISEASES 1961 Wimbledon England and Wales Rates per 1,000 Home Population Notifications:— (Corrected) Scarlet Fever 0.52 0.43 Whooping Cough 0.47 0.53 Typhoid and Paratyphoid Fever - 0.00 Meningococcal Infection 0.01 0.01 Acute Encephalitis - 0.00 Diphtheria - 0.00 Erysipelas 0.03 0.04 Smallpox - - Measles 17.38 16.53 Pneumonia 0.22 0.39 Acute Poliomyelitis- Paralytic 0.01 0.01 Non-paralytic - 0.00 Food Poisoning - 0.16 Dysentery 0.01 0.44 Ophthalmia Neonatorum 0.01 0.01 Tuberculosis- Pulmonary 0.59 0.41 Non-pulmonary 0.08 0.05 Puerperal Pyrexia 8.80* 10.17* * 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, 56,990, shews an estimated decrease of 470 on the previous year, although the natural increase by excess of births over deaths was 186. All rates used in this report are based on the Registrar-General's figures. BIRTHS The statistics supplied by the Registrar-General show that during the year 1961, the total number of registered live births belonging to Wimbledon was 892. Of this number, 453 were males and 439 females. This gives a birth-rate of 15.65 per thousand of the population as compared with a rate of 15.40 per thousand in 1960, and an average of 14.65 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 1961 was 15.18 per thousand of the population, whilst the rate for England and Wales was 17.4 and has averaged 16.4 over the past five years. STILLBIRTHS - The number of stillbirths registered during the year was 17 (8 males and 9 females), this being 3 more 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 1961, 63 (31 males and 32 females) were illegitimate, this being 6 more than in the preceding year. Three of the 17 stillbirths registered were illegitimate. DEATHS The total number of Wimbledon residents who died during 1961 was 706 (318 males and 388 females), giving a death-rate of 12.38 per thousand of the population as compared with 11.62 per thousand for 1960. The corrected death-rate for 1961 was 10.39 per thousand as compared with a rate of 12.0 per thousand for England and Wales. The number of Wimbledon residents who died outside the Borough was 353, whilst 392 persons not normally resident in Wimbledon died in institutions, etc. in the Borough. - 7 - The four principal causes of death were as follows:- Number of deaths Percentage of total deaths Disease of the heart and circulatory system 254 36% Cancer 185 26% Vascular lesions of nervous system 81 11% Diseases of the respiratory system 84 12% Totals 604 85% The following is an analysis of the causes of death:- Cause Males Females Total 1. Respiratory tuberculosis - 1 1 2. Other tuberculosis 2 - 2 3. Syphilitic disease 1 - 1 4. Diphtheria - - - 5. Whooping cough - - - 6. Meningococcal infections - - - 7. Acute poliomyelitis 1 - 1 8. Measles - - - 9. Other infective and parasitic diseases 1 1 2 10. Malignant neoplasm, stomach 4 7 11 11. Malignant neoplasm, lung, bronchus 45 10 55 12. Malignant neoplasm, breast - 19 19 13. Malignant neoplasm, uterus - 8 8 14. Other malignant and lymphatic neoplasms 40 49 89 15. Leukaemia 1 2 3 16. Diabetes 1 1 2 17. Vascular lesions of nervous system 23 58 81 18. Coronary disease, angina 78 69 147 19. Hypertension with heart disease 7 7 14 20. Other heart disease 20 41 61 21. Other circulatory disease 14 18 32 22. Influenza 3 - 3 23. Pneumonia 19 27 46 24. Bronchitis 17 13 30 25. Other diseases of respiratory system 3 2 5 26. Ulcer of stomach and duodenum 6 2 8 27. Gastritis, enteritis and diarrhoea - 1 1 28. Nephritis and nephrosis - 2 2 29. Hyperplasia of prostate 4 - 4 30. Pregnancy, childbirth, abortion - - - 31. Congenital malformations - 5 5 32. Other defined and ill-defined diseases 11 30 41 33. Motor vehicle accidents 6 4 10 34. All other accidents 7 5 12 35. Suicide 3 6 9 36. Homicide and operations of war 1 — 1 Totals 318 388 706 - 8 - MATFRNAL MORTALITY No deaths in childbirth, either from puerperal sepsis or other maternal causes, were recorded during the year. The maternal mortality rate for England and Wales per thousand live and still births was O.33. The following table sets out the number of deaths and death rates per thousand total live and stillbirths for 1961:- Number of Deaths Rate ENGLAND AND WALES Maternal causes, excluding abortion 220 0.27 Due to abortion 54 0.07 Total maternal mortality 274 0.33 The estimated mid-1961 female population for England and Wales age 15-44 was 9,068,000. As stated there were no maternal deaths in Wimbledon during 1961. INFANTILE MORTALITY During 1961 there were 13 deaths among infants under one year of age, compared with 17 in 1960 and an average of 13 in the last ten years. Three of the deaths were in respect of illegitimate children. The resultant infant mortality rate for Wimbledon per thousand live births was 14.57. The infant mortality rate for England and Wales in 1961 was the low record of 21.6, the lowest previously recorded being 21.9 in I960. Seven of the 13 deaths were due to congenital malformations or birth injuries, 5 were due to prematurity and 1 death was accidental. In this case the cause of death was asphyxia due to the inhalation of stomach contents, and was, therefore, probably preventable. The number of neo-natal deaths (i.e. those occurring during the first four weeks of life) was 10, giving a neo-natal death rate of 11.2 per thousand live births, as compared with a rate of 15.5 for England and Wales. The perinatal death rate (i.e. stillbirths and deaths of infants under 1 week) was 29.7 per thousand live and stillbirths, while that for England and Wales was 32.2. - 9 - Although perinatal deaths represent the equivalent of only 3 to 4 per cent of the country's total births, increasing importance is being paid to perinatal mortality, as perinatal deaths account for 80% of the total loss of infant life from the twenty-eighth week of pregnancy to the end of the first year of life. It follows, therefore, that the most promising way of reducing infant mortality is by concentrating on the prevention of perinatal deaths. In Wimbledon, of the 13 infant deaths which occurred during the year, 10 died in the first week of life. The following table shows the cause of the 13 infant deaths which occurred during 1961, together with the age at death. Cause of death Under 1 week 2-3 weeks Total under 4 weeks 1-3 months 3-6 months 6-9 months Total deaths under 1 year Congenital defect or birth injury 5 - 5 - 1 1 7 Prematurity and atelectasis 5 - 5 - - - 5 Accidental death - - - - 1 - 1 Totals 10 - 10 - 2 1 13 - 10 - INFANTILE MORTALITY DURING THE LAST 10 YEARS Cause of death 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 Prematurity and atelectasis 3 5 5 2 1 3 7 14 3 7 Congenital defects or birth injuries 6 4 5 5 5 3 6 4 5 5 Diseases of the newborn - - - - - - 1 - - - Gastro-enteritis - 1 - - - - - - - - Embryoma of liver - - - - - - - - 1 - Pneumonia 1 1 1 2 2 1 1 1 4 - Bronchitis - - - - - 1 - - - - Acute nephritis - - - - - - - - 1 - Septicaemia - - - - 1 - - - - — Asphyxia (un-known cause) - - - - - 1 - - - - Accidental death - 1 1 2 - - - - 1 1 Inattention at birth - - - - 1 - - - 1 - Bilateral pneumothorax - - - - - - - 1 - - Pyelonephritis 10 12 12 11 10 9 15 20 17 13 Total neo-natal deaths included above 6 9 11 8 7 8 12 18 14 10 p I SUMMARY OF STATISTICS The following table shows the birth-rates and death-rates for Wimbledon as compared with England and Wales since 1942 Year Live-Birth Rate (per thousand home population) Still-Birth Rate (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. 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 13.39 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 0.36 8.29 11.7 1.27 0.64 14.08 24.9 1956 13.38 15.7 0.28 0.37 9.83 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 0.36 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 1960 14.79 17.1 0.24 0.30 9.88 11.5 - 0.39 19.20 21.9 1961 15.18 17.4 0.24 0.30 10.39 12.0 - 0.33 14.57 21.6 12 *From 1942 to 1946 the locel 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 LABORATORY FACILITIES The Corporation's arrangements for the examination of pathological material continued on similar lines to previous years. Bacteriological examinations of milk, ice-cream, water, swabs, sputum and other pathological specimens are undertaken by the Ministry of Health Public Health Laboratory at Epsom. The Laboratory at the Nelson Hospital, Merton, is also used for the examination of pathological specimens, and the Central Public Health Laboratory at Colindale, N.W.9, is available for advice, special immunising agents and special investigations. All examinations carried out at these Laboratories are available to the Corporation free of cost. The following is a summary of the examinations made during the years- Nose and throat swabs 110 Faeces for the typhoid and dysentery groups 138 Ice-cream samples 91 Milk samples 137 Water samples 97 Miscellaneous 2 Total 575 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.Sc., F.R.I.C., Southwark Street, S.E.I. Biological examinations of milk are carried out at the Royal Institute of Public Health and Hygiene Laboratory, Queen Square, W.C.I. 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. Nine visits of inspection were made during 1961. No new Nursing Hones were registered during the year. One Maternity Hospital and one Home for unmarried mothers were exempted, on an annual basis, from registration under Section 192 of the Public Health Act 1936. - 13 - The position at the end of 1961 was as follows Number of Homes Number of beds provided for:- Maternity Others Totals Homes first registered during the year Nil Nil Nil Nil Hones whose registrations were withdrawn during the year Nil Nil Nil Nil Homes on the register at the end of the year 5 Nil 79 79 Hones exempt from registration at end of year 2 62 14 76 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 Hones were kept, that proper attention was being paid to fire precautions, and the Council's byelaws were being complied with. NATIONAL ASSISTANCE ACT 1948 - CARS OF THE AGED Under Section 47 of the above Act, power is given to the Councils of County Boroughs 8nd 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 who was already in hospital at the beginning of 1961 as the result of an Order obtained at Wimbledon Court in September 1958, died in hospital during July. - 14 - In another case, also an old lady, it was found necessary for the Council to apply to the Court for an Order under Section 47 of the 1948 Act after every effort to get her to go to an Old Peoples Home had failed. This old lady was living in a house which was in a deplorable condition, uncleaned, unswept and unheated, and with innumerable cobwebs everywhere. There were a large number of animals, including birds and cats, in the house, which were also being neglected. She was incontinent and suffering from ulcerated legs, and was at times confused. She dressed in religious garb which was always dirty and unkempt. She refused the services of a Home Help and would only accept Meals on Wheels occasionally. After marry fruitless efforts to get her to enter an Old Peoples Heme, application was made to the Court for an Order which was granted, and she was admitted to a Welfare Heme. This Order was later extended for a period of three months, and varied to enable her to be transferred to hospital. The Order was extended once more for a period of three months, but thereafter the patient remained voluntarily 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. An increasing amount continues to be done for the elderly, particularly by the local voluntary services, and mention should be made of the many excellent services which are provided by the Guild of Social Welfare. The District Nurses and Home Helps also play an important part in keeping many old people in reasonable comfort in their cwn homes, and the close co-operation which exists between the Geriatric Department of St. Heller Hospital, the Guild of Social Welfare, the local doctors and your Medical Officer of Health is of tremendous value in dealing with these complex problems. 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, Miteham, 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. - 15 - 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 practitioners1 patients, is now available to all 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, illness, or other social emergencies. 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. Welfare Foods. National Dried Milk, orange juice, cod liver oil and vitamin tablets, are sold at reduced prices for children up to five years of age at Infant Welfare Centres during normal Clinic hours. Chiropody. A chiropody service is provided for the elderly, expectant mothers and physically handicapped persons. The service, which is given either at home or in the Chiropodist's surgery, is carried out for the County Council by an approved panel of Chiropodists. - 16 - 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 ftl1 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 subnormal. 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. CLINICS. Ante-natal and Post-natal Clinics. Health Centre, Pelham Road. Monday afternoons. Amity Grove Clinic, Raynes Park. Tuesday afternoons. 1st and 3rd Friday afternoons (Midwives Clinic), Infant Welfare Clinics. Health Centre, Pelham Road. Tuesday and Friday afternoons. Amity Grove Clinic, Raynes Park. Monday and Wednesday afternoons. Friday mornings. - 17 - Churchill Hall, Effra Road. Tuesday afternoons. Emmanuel Church Hall, Lingfield Road. Thursday afternoons. St. Luke's Church Hall, Wimbledon Park. 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. Toddlers Clinics. Health Centre, Pelham Road. Wednesday afternoons (1st in month). Thursday mornings (3rd in month). Amity Grove Clinic, Raynes Park. Wednesday mornings. Eye Clinics. Health Centre, Pelham Road. 3rd and 4th Wednesday afternoons. Thursday afternoons. Amity Grove Clinic, Raynes Park. 2nd end 4th Tuesday mornings. - 18 - Relaxation and Mothercraft. Russell Road Clinic. Wednesday afternoons. Amity Grove Clinic, Raynea 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. Dental X-ray Clinics. Health Centre, Pelham Road. Wednesday mornings. Dental Hygienist's Clinics. Health Centre, Pelham Road. Friday mornings and afternoons. Amity Grove Clinic, Raynes Park. Tuesday end Wednesday afternoom. Speech Clinics. Russell Road Clinic. Monday mornings and afternoons. Tuesday afternoons. Amity Grove Clinic, 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. - 19 - 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 1961, samples of water were taken for bacteriological and/or chemical analysis, as follows:- Bacteriological. Public Swimming Baths 80 Dwelling houses:- Metropolitan Water Board supply 7 Well water 14 21 Artesian Well 1 102 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. One sample of well water was reported upon as unsatisfactory, but an immediate subsequent sample was satisfactory. All other samples of water proved bacteriologically satisfactory. Chemical. Public Swimming Baths 3 Dwelling houses:Well water 1 Artesian Well 1 5 - 20 - 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 1/62 is as follows:- Number of dwelling houses supplied from public water mains:- (a) Direct to the houses No record kept Population supplied Est.1961 - 56,990 (b) By means of stand-pipes Nil Population supplied Nil SEWERAGE AND SEWAGE DISPOSAL. 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 of it, but a scheme for the completion of the modernisation of the Works has not yet reached finality. INSPECTION OF THE DISTRICT. The following is a summary of the complaints received and the visits made during the year 1961s- Complaints received. General disrepair and insanitary conditions 191 Dampness 82 Overcrowding 12 Defective drainage systems 60 Blocked drainage systems 135 Defective drainage fittings 20 Defective W.C. pans and/or flushing apparatus 33 Defective service water pipes 7 Absence of or defective dustbins 28 Accumulations of refuse, etc. 43 Rats and mice 273 Insect pests, etc. 177 Smoke nuisances 49 Unsound food 105 Noise 13 Miscellaneous 94 1,322 - 21 - Visits made. Infectious diseases. Inquiries re cases of infectious disease 223 Visits re disinfection 35 Miscellaneous 13 Housing. Dwelling houses (Housing Act) 211 Dwelling houses (Public Health Act)1,571 Rent Act 1957 35 Underground rooms 62 Houses let in lodgings 14 Overcrowding 305 House Purchase & Housing Act 1959 221 Caravans 106 National Assistance Act 1948 8 Miscellaneous 266 Food & Food premises. Dairies and milk distributors 19 Ice-cream premises 160 Bakehouses Butchers' shops 117 Meat preparation premises 5 Fish shops 36 Fried fish shops 25 Restaurant kitchens 165 Confectionery shops 8 Licensed premises 9 Other food premises 430 Visits re unsound food 181 Sampling: food and drugs 160 Sampling: milk 153 Sampling: ice-cream 89 Sampling: water 103 Miscellaneous 288 General. Places of public entertainment 29 Drainage and plumbing work 1,215 Stables and piggeries 9 Clean Air Act 1956 3,885 Pet Animals Act 1951 16 - 22 - Factories (P.) 218 Factories (N.P.) 47 Factories (Building sites) 18 Outworkers' premises 62 Shops Act 1950 202 Hairdressers and barbers 20 Diseases of Animals Acts 3 Petroleum (Consol.) Act 1928 216 Heating Appliances (Fireguards) Act 1952 4 Noise Abatement Act 1960 79 Watercourses 61 Rodent control 4,244 Insect infestations 205 Refuse storage 128 Accumulations 346 Miscellaneous 487 16,587 RESULT OF SERVICE OF NOTICES. (1) Legal Proceedings. No legal proceedings to enforce compliance with Notices were instituted during the year. (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 92 Reconstructed 58 Cleansed 64 Soil pipes and ventilation shafts repaired or renewed 8 Inspection chamber covers renewed 8 Fresh air inlets repaired or renewed 9 New W.C. pans provided 13 Water waste preventors repaired or renewed 16 Gutters and rainwater pipes repaired or renewed 34 New glazed sinks provided 2 Waste pipes trapped, repaired or renewed 10 Gully surrounds repaired 6 Miscellaneous 24 - 23 - General housing repairs. Roofs repaired 53 Yards paved or repaired 5 Dampness remedied 63 Sub-floor ventilation provided 2 Walls and ceilings repaired 100 Walls cleansed 76 Ceilings cleansed 14 Floors repaired or renewed 24 Windows repaired or renewed 105 Doors repaired or renewed 19 Fireplaces repaired or renewed 20 Service water mains repaired 6 Additional light and ventilation provided 12 Miscellaneous 74 Food premises. Shops reconstructed 1 Walls repaired or redecorated 82 Ceilings repaired or redecorated 46 Floors renewed or repaired 4 Woodwork repaired or repainted 12 Lighting provided or improved 1 Ventilation provided or improved 9 Sinks provided 8 Hot water provided to sink 10 First aid kit provided or improved 36 Water supply provided 37 Risks of contamination removed 66 Outdoor clothing store provided 18 Refuse storage improved 10 Wash-hand basins provided 39 Hot water provided to wash-hand basins 53 Soap provided 26 Nailbrush provided 41 Clean towels provided 28 Sanitary accommodation repaired/cleansed 11 Intervening ventilated space provided 5 Lighting in sanitary accommodation provided 13 Ventilation in sanitary accommodation provided 2 Hand washing notices fixed 24 Rodent Control. Defects remedied in connection with ratproofing work are included in foregoing lists. - 24 - Miscellaneous. Insanitary houses cleared and disinfested/disinfected 4 Accumulations removed 13 New dustbins provided 14 FACTORIES ACTS 1917 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 42 47 2 - Factories with mechanical power 304 218 5 - Other premises under the Act (including works of building and engineering construction but not including outworkers' premises) 21 18 1 - Totals 367 283 8 - 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) 1 1 - - - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) 2 1 - - - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7):- Insufficient - 1 - - - Unsuitable or defective 9 21 - 4 - Not separate for sexes 2 6 - — — Other offences (excluding offences relating to outwork) - - - - - Totals 14 30 - 4 - - 25 - PART VIII OUTWORK - SECTIONS 110 and 111 Nature of work Section 110 Section 131 No. of outworkers in August list required by Sec.ll0(l)(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. 30 - - - - - Others - - - - - - Totals 30 - - - - - Number of addresses received from other Councils 70 Number of addresses forwarded to other Councils 61 Number of premises where outwork was carried on at the end of 1961 92 Inspection of outworkers' premises 62 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 - SECTION D. - HOUSING In accordance with Ministry of Health Circular 17/55, 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 19 (ii) Number of families dwelling therein 21 (iii) Number of persons dwelling therein 135 (b) Number of new cases of overcrowding reported during the year 10 (c) (i) Number of cases of overcrowding known to have been relieved during the year 25 (ii) Number of persons concerned in such cases 109 (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, 1961:- Number of prefabricated bungalows provided since the end of the war 71 (At the end of 1961 9 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 2,419 Number of live applications on the housing list for (a) accommodation in Wimbledon 461 (b) accommodation in Frimley and Cemberley 218 - 27 - 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 1961:- Private enterprise 134 Local Authority Nil Number of flats created by conversion in 19:- Private enterprise 42 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, 1961:- Applications for Certificates of Disrepair (Form I) 252 Applications withdrawn by applicants 13 Forms J sent to landlords 233 Undertakings given by landlords (Form K) 131 Certificates of Disrepair issued (Form L) 100 Applications for Cancellation of Certificates of Disrepair (Form M) 93 Certificates of Disrepair cancelled 65 Number of visits made during 1961 in connection with the Rent Act 1957 - 35. - 28 - 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 38. Milk (Special Designation) Regulations 1960. 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 which will remain in force until 31st December, 1965, were issued under the Regulations during 1961:- Dealers (Pre-packed Milk) Licences - Tuberculin Tested Milk 28 Pasteurised Milk 30 Sterilised Milk 34 During the year 137 samples of designated milk were submitted for bacteriological examination. The results were as follows:- Designation Satisfactory Void Unsatisfactory Pasteurised 96 16 Nil Tuberculin Tested (Pasteurised) 15 Nil Nil Sterilised 8 Nil Nil Tuberculin Tested (Farm bottled) 2 Nil Nil Each of these samples was subjected to (1) the methylene blue test and (2) the phosphatase test. In 16 instances the methylene blue test was not carried out on samples of Pasteurised milk due to the fact that the stipulated atmospheric shade temperature (70º F.) was exceeded. Three 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. - 29 - ICE-CREAM. During the year 91 samples were submitted for bacteriological examinat The results were as follows:- Grade 1 89 Grade 2 2 Grade 3 Nil Grade 4 Nil 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. MEAT AND OTHER FOODS. There are no slaughterhouses within the Borough, and no slaughtermen'8 licences were issued under the provisions of the Slaughter of Animals Act 1958, during the year 1961. The Report upon the review of slaughterhouse facilities, which was referred to in the Annual Report 1960, was accepted by the Minister of Agriculture, Fisheries and Food, and notice of this acceptance was published in the Wimbledon Boro' News on the 10th March, 1961. 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. 2,018 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 (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 followings- Greengrocers 68 Confectioners 139 Ice-cream premises 209 Bakers 35 Grocers 124 Provision dealers 89 Butchers 45 Fishmongers 21 - 30 - Milk distributors 38 Chemists 25 Licensed premises 74 Clubs 29 Restaurants and Cafes 79 Works canteens 12 School canteens 52 Kitchens (Hospital and Central Kitchens) 5 Food stalls/vehicles 17 Places of public entertainment 16 1,077 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 151 Registered for the manufacture and sale of icecream 1 Registered for the preparation or manufacture of sausages 42 Registered for the preparation or manufacture of potted, pressed, pickled or preserved food 40 The number of inspections of registered food premises during 1961 was 326. 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 1961:- Cwts. qrs. lbs. Canned soups 7 1 8 Canned meat 17 0 6 Canned fish 16 1 11 Canned vegetables 7 0 16 Canned fruit 13 3 21 Canned milk or cream 9 Meat, bacon, poultry, etc. 9 1 21 Fish 1 27 Cheese 1 Jam 2 0 0 Flour and cereals 23 - 31 -  Cwts. qrs. lbs. Pickles, 5 Sausages 1 6 Meat paste 1 Frozen food 1 2 9 Vegetables 1 12 Beverages 2 Meat pies 12 Biscuits 1 3 8 Fruit juices 11 Miscellaneous canned food 4 3 18 83 1 3 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 two 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:- Maggot in packet of scone-mix. Mould in packet of suet. Maggots in slabs of cooking chocolate. Mould growth in loaves of bread. Foreign matter in wrapped pork pie. Nail in loaf of bread.* Foreign matter in bottles of milk. Safety-pin in bottle of orange drink. Poppy seeds in loaf of bread. Larvae in bread roll. Colour in cooked cauliflower. Mould growth in pork pie (2).* Wasp in bun. Foreign matter in loaves of bread. Glass in loaf of bread. Maggots and larvae in box of chocolates. Nail in butter. Foreign body in tin of luncheon meat. Foreign matter in sultanas. Foreign matter in tin of fruit salad. * Denotes legal proceedings taken. - 32 - SAMPLING OF FOOD AND DRUGS The following samples were submitted to the Public Analyst during 1961 with the results shown:- Articles Total Formal Informal Genuine Non genuine or irregular Almonds 1 1 — 1 — Bacon pastie 1 1 - 1 - Baking powder 1 - 1 1 - Ballichong 1 1 — 1 - Beechams powder tablets 1 1 - 1 - Beef, minced 1 1 - 1 - Beef suet 1 1 - 1 - Beer, canned 1 1 - 1 - Bicarbonate of Soda 1 1 - 1 - Bitter lemon drink 1 1 - 1 - Brawn 1 1 - 1 - Cheese 2 2 - 2 - Cheese and tomato spread 1 1 - 1 - Cheese spread with shrimp 1 1 - 1 - Cheese biscuits 2 2 - 2 - Cherries in syrup, canned 1 1 - 1 - Chicken pie, frozen 1 1 - 1 — Chocolate, instant 1 1 - 1 - Chocolate flavoured drink 1 - 1 1 Chop suey 1 1 - 1 - Coconut, desiccated 2 1 1 2 - Coconut oil 1 1 - 1 - Coffee, instant 1 1 - 1 - Confectionery, chocolate 2 2 - 2 - Confectionery, sugar 6 5 1 6 — Confectionery, flour 6 6 - 6 - Cordial 4 4 - 4 — Coined beef 1 1 - 1 - Cornish pastie 1 1 - 1 - Cough mixture 1 1 - 1 — Cough pastilles 1 1 - 1 — Cream, canned 1 1 - 1 - Cream, double 2 1 1 2 - Creamed rice 1 1 - 1 — Crumpets 1 1 — 1 — C/fd. 53 48 5 53 - Articles Total Formal Informal Genuine Non genuine or irregular B/fd. 53 48 5 53 — Curry biscuits 1 1 - 1 — Dates, stoned 1 1 — 1 — Faggots 1 1 - 1 — Fish paste 1 1 — 1 — Flour, self-raising 2 1 1 — French dressing 1 — 1 11 — Fruit juice 1 - 1 1 — Glace cherries 1 1 — 1 — Ham and beef rissoles 1 1 — 1 — Hamburgers 2 - 2 2 - Ice-cream 1 1 - 1 — Ice-cream mix 1 — 1 1 — Icing sugar 2 2 - 2 - Jellied veal 1 1 — 1 — Jelly, table 2 2 - 2 - Kruschen salts 1 1 — 1 — Lemon crystal drink 1 1 — 1 — Lime marmalade 1 1 - 1 - Macaroni 1 — 1 1 - Meat pudding, canned 1 - 1 1 - Meringue powder 1 - 1 — 1 Milk 55 55 - 55 — Milk, condensed 1 - 1 1 — Milk, evaporated 1 1 - 1 — Minced meat 1 1 - 1 - Mixed grill, canned 1 1 — 1 — Mushrooms, canned 1 1 - 1 - Oranges, fresh 1 1 — 1 - Peel, mixed 2 1 1 2 — Pineapple juice 1 1 - 1 — Plums, canned 1 1 - 1 - Pork luncheon meat 1 1 - 1 — Pork pie 1 1 — 1 - Pork sausages 2 1 1 2 Ravioli, canned 1 1 - 1 - C/fd. 148 131 17 145 3 - 34 - Articles Total Formal Informal Genuine Non genuine or inferior B/fd. 148 131 17 145 3 Rice 1 1 - 1 - Salad cream 1 1 - 1 - Salted peanuts 1 1 - 1 - Sausage roll 1 1 - 1 - Saveloys 1 1 - 1 - Seasoning 1 1 - - 1 Slimming biscuits 1 1 - 1 - Steak and kidney, fresh 1 1 - 1 - Steak and kidney pie, canned 1 - 1 1 - Stewed steak and kidney, canned 1 - 1 1 - Tomato ketchup 1 - 1 1 - Tomato puree 1 1 - 1 - Tomato relish 1 - 1 1 - Tripe 1 1 - 1 - Trout, canned 1 1 - 1 - Vegetable juices 1 1 - 1 - Vinegar 1 - 1 1 - Totals 165 143 22 161 4 The following samples were submitted for special examinations- Articles Total Formal Informal Genuine Non genuine or irregular Cauliflower 1 - 1 1 - Cherries, canned 1 - 1 — 1 Corned beef, canned 1 - 1 - 1 Flour 4 - 4 4 - Fruit cocktail, canned 1 - 1 1 - Milk bottle 1 - 1 - 1 Pork pies 2 - 2 - 2 Sultanas 1 - 1 1 - White bread 4 - 4 2 2 Totals 16 - 16 9 7 It will be seen that adverse reports were received upon eleven sample* and following is a brief account of the action taken in respect thereof MERINGUE POWDER. This informal sample of meringue pcwder contravened the Labelling of Food Order 1953 inasmuch as the requirement for additional, sugar to make forms of meringue was not made clear to the purchaser by the wording of the carton. After correspondence the manufacturers altered the wording and submitted a new carton for approval. PORK SAUSAGES. Notices as to preservative contained were not exhibited in the shops at the time of purchase of these samples of pork sausages. The Public Analyst reported that the samples contained 65 parts per million and 320 parts per million respectively of sulphur dioxide. Informal action was taken to ensure the future display of notices. SEASONING. A formal sample of seasoning did not disclose on the label the specific ingredients, as required by the Labelling of Food Order 1953. Following a discussion, the manufacturers amended the wording to conform to the Order. - 36 - CANNED CHERRIES. A can of red cherries in syrup was found to contain a skin-like substance suspended in the syrup. The Public Analyst reported that the lacquer coating inside the can had stripped away and that areas of the underlying metal were exposed. Analysis showed that the syrup contained both tin and iron and that the metal contamination, although not excessive, was affecting the flavour of the cherries. This was likely to increase with prolonged storage. The cherries were of foreign origin, and the distributors for the United Kingdom undertook to carry out an investigation. The matter was not resolved at the time of writing this report. CANNED CORNED BEEF. A complaint was received regarding foreign matter of a coarse fibrous nature in a can of corned beef. The Public Analyst reported that this was a mass of bovine hairs matted together with fat and meat substance. As the corned beef was of foreign origin the Ministry of Agriculture, Fisheries and Food undertook to deal with the matter. MILK BOTTLE. An empty milk bottle containing foreign matter and a mould growth was sent to the Public Analyst. It was alleged that the filled bottle was delivered to a customer in that condition. The Public Analyst reported that the foreign matter consisted of dried milk residue together with a mould growth. The Dairy firm investigated the complaint in order to ensure that the incidence would not be repeated. PORK PIE (1). Small black objects scattered on the top of a wrapped pork pie were examined by the Public Analyst. The objects proved to be burned pastry which probably originated during the baking process. The manufacturer undertook to exercise greater care in the bakehouse. PORK PIE (2). A pork pie purchased at a shop in the Borough was found to contain a mould growth. Subsequently the remaining stock of pies at the shop were surrendered and destroyed. Legal proceedings were instituted against the vendor, who pleaded guilty to a charge of selling a pork pie not of the quality demanded by the purchaser. The Defendant was fined £5 and was ordered to pay £3,3,0. costs. - 37 - WHITE BREAD (l). Part of a loaf of white bread containing foreign matter was submitted to the Public Analyst for examination. The foreign matter proved to consist of poppy seeds which appeared to have been accidentally incorporated in the dough. The Bakery firm was advised as to this incident. WHITE BREAD (2). Half a loaf of white bread containing foreign matter was submitted to the Public Analyst. The foreign matter proved to be part of a flour sack label. The Baker was interviewed and a warning given. OTHER LEGAL PROCEEDINGS. An oval l½" nail was found embedded in a wrapped sliced loaf of bread which was supplied from a bakehouse outside the Borough. Legal proceedings were instituted, and the Defendants pleaded guilty. They were fined £5 and ordered to pay £2.2.0. costs. - 38 - SECTION F. - RODENT CONTROL PETROLEUM STORAGE. ETC. PREVENTION OF DAMAGE BY PESTS ACT 1949 The table belew summarises surface rodent control work which was carried out during 1961. The inspection and treatment of sewers, and of the Corporations 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. During 1961, 126 manholes were baited and 48 showed evidence of rodent infestation. The 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 1961 action was taken in one instance under the provisions of Sections 4 and 5 of the Act. Work was carried out by the Department in default and the costs recovered from the owner, without resorting to legal proceedings. Type of Property Number of Properties inspected as a result of:- Number of Properties found to be infested by:- Number of Treatments carried out including retreatments Number of inspections made including reinspections Notifica tion Survey under Act Total Rats Mice Local Authority 2 18 20 5 2 12 139 Dwellings 228 620 848 131 54 196 3,040 All other including Business Premises 57 358 415 26 22 57 1,065 Totals 287 996 1,283 162 78 265 4,244 - 39 - PEST CONTROL During the year 1961, 177 complaints were received concerning insect peste, and the following is a list of the infestations dealt with:- Ants 8 Bed bugs 15 Bees 1 Beetles 9 Caterpillars 1 Cockroaches 8 Crab lice 1 Fleas 7 Flies 16 Maggots 3 Moths 1 Spiders 1 Wasps 99 White mite 1 Wood lice 1 Woodworm 5 The incidence of wasps was again generalised during 1961, 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, 13 complaints were received regarding squirrels, pigeons, moles and rabbits, and these were referred to the Pests Officer of the Ministry of Agriculture, Fisheries and Food at Guildford. PETROLEUM (REGULATION) ACTS 1928 & 1936 56 licences were issued by the Department to store petroleum spirit during 1961, and the total quantity of petroleum spirit stored was 107,428 gallons. In addition, 27 licences were issued to store petroleum mixtures involving a total of 12,989 gallons, and 3 licences were issued in respect of the storage of a total of 42 cwts.of calcium carbide. 216 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 1961. 16 visits were made to these premises and any infringements of the conditions of licence were rectified. - 40 - CLEAN AIR ACT 1956 During the year 1961, 49 complaints were received with regard to smoke or grit emission, and the necessary observations were made and remedial action taken. 21 notices of proposal to instal a furnace to which Section 3(1) of the Act applied were received, and the installations were inspected and recorded. "Prior approval" under Section 3(2) of the Act was given to the installation of 3 new oil-fired furnaces during the year. In 4 instances plana which were deposited for Building Bye-law approval showed in each case the proposed construction of a chimney. After examination of the plans, followed by discussions with the applicants, opinions 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. National Survey of Atmospheric Pollution. The use of the standard deposit gauges and lead peroxide instruments sited within the Borough was discontinued in April 1961. These instruments were replaced by 5 daily smoke filter and sulphur dioxide (volumetric) instruments sited in approved positions in the Borough. It is proposed to commence recording on the 1st January, 1962, and the instruments will be visited each day. After standardisation, the recordings will be sent each month to the Department of Scientific and Industrial Research for publication in the Atmospheric Pollution Bulletin, together with the results of measurements by 562 Local Authorities and other Organisations. 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. Smoke Control Areas. Progress was made during 1961 to implement the scheme which the Council approved in 1959 to enable the making of Smoke Control Orders covering the whole of the Borough. A Technical Assistant, to assist in this work, was appointed, and Smoke Control Area No.l was surveyed. In December the Council made an Order in respect of this Area, and at the end of 1961 the Order was awaiting submission to the Minister of Housing and Local Government for confirmation. The total number of visits made during 1961 under the Clean Air Act 1956 for all purposes was 3,885. - 41 - SHOPS ACT 1950 The total number of Shops Act inspections during 1961 was 202. 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 1961. 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. Three 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. During 1961, 13 complaints were received and 79 visits were made under the Act. Four offences gave rise to legal proceedings. Three of the infringements were caused by the operation after 7.0 p.m. of loudspeaker chimes attached to ice-cream vehicles, and the other case was for a similar offence committed before 12.0 noon. In three cases the Defendants pleaded guilty, and were each fined £1 and ordered to pay £1.1.0. costs. An absolute discharge was given to the Defendant in the fourth case on payment of £1.5.0 costs. - 42 - SECTION G. - PRSVALENCE OF. AND CONTROL OVER. INFECTIOUS AND OTHER DISEASES During the year there were 1,064 cases of infectious disease notified compared with 148 in 1960, and 762 in 1959. The increase over 1960 was almost entirely due to the high incidence of measles, 980 cases. The following infectious diseases are notifiable to the Medical Officer of Health of the Borough:- 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 No case of smallpox was notified in the Borough during the year, but all Health Authorities were warned by the Minister of Health to be on the alert following the diagnosis of smallpox in a man who arrived at London Airport on 25th December, 1961 from an aircraft which he boarded at Karachi. This was the beginning of a number of cases of smallpox which were imported into this country from Pakistan, and which resulted in outbreaks in various parts of England and Wales on a scale unknown to this country in recent years. - 43 - These outbreaks served to draw attention to the fact that smallpox is still prevalent in many parts of the world, and constant vigilance is always necessary. It also underlined the importance of vaccinating children in the first two years of life. Not only does this provide protection at least until the age of school entry, but it also makes it likely that subsequent re-vaccination will result in a rapid revival of immunity with a diminished risk of severe local reaction. SCARLET FEVER There were 30 cases of scarlet fever notified during 1961 compared with 45 in 1960, 74 in 1959 and 80 in 1958. One of the cases was 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 100.4ºF. or more has occurred within fourteen days after childbirth or miscarriage. During the year 8 notifications were received, all of which occurred in hospital. The 8 patients all had addresses outside the Borough. In 1960 3 cases were notified. PNEUMONIA Thirteen cases of acute primary or influenzal pneumonia were notified during the year, compared with 7 in 1960 and 18 in 1959. The total number of deaths from all forms of the disease during the year was 46, compared with 40 in 1960. MEASLES An epidemic of measles of unprecedented magnitude and duration occurred during the first half of the year, with 980 cases being notified compared with 18 in 1960. The measles was mild with little by way of complications and no deaths. The majority of the cases (486) occurred in children in the 5/9 age group, and 448 in younger children. 14 of the cases were treated in hospital. - 44 - WHOOPING COUGH There was a decrease in notifications in 1961, 27 being received compared with 55 in I960, and 5, 10, 108 and 82 in the four previous years. Only one of the notified cases was admitted to hospital. Whooping cough is one of the most serious of childhood illnesses and immunisation of all infants against the disease is strongly recommended. Most babies are now immunised against whooping cough with a triple antigen combining whooping cough, diphtheria and tetanus and this treatment should be commenced by at least the third month. POLIOMYELITIS Only one case occurred, but unfortunately this proved to be fatal. This was a man of 35 years who was admitted to hospital shortly after returning to this country from a holiday tour of the Middle East. There was severe paralysis in this case and the patient died ten days after admission to hospital. It seems very probable that the man was infected while he was abroad. He had not been vaccinated against poliomyelitis. There were a considerable number of contacts who had to be traced as the patient had returned home to this country by air during the time he was believed to be infectious, but no further cases were reported. This was the first case of poliomyelitis to have occurred in Wimbledon since 1959 and would indicate that vaccination is proving effective in the control of this disease. A high proportion of Wimbledon children have been vaccinated against poliomyelitis. MENINGOCOCCAL INFECTION One case occurred in a child of six years who was admitted to hospital with sickness and headache and pain at the back of one leg. This was considered by the hospital to be a case of meningococcal meningitis and was notified as such although no pathological organism was isolated. The child made a good recovery. DIPHTHERIA There were no cases of diphtheria in Wimbledon, but in England and Wales there were 62 confirmed cases, 10 more than in the previous year. These figures show clearly that diphtheria is still about and these numbers will increase unless immunisation is maintained at a high level. Every effort is made through propaganda and other means to remind parents of the importance of obtaining protection for their children, but the level of immunisation is still below what is aimed at. It is particularly important that children are given their initial protection in their first year of life. - 45 - OPHTHALMIA NEONATORUM For the first time since 1954 a case of ophthalmia neonatorum was notified in the Borough. The patient, a baby of a few days, was removed to hospital and made a good recovery. DYSENTERY Only one case of dysentery was notified compared with 17 in I960, 11 in 1959 and 24 in 1958. The notified case was of a child of 13 months but no causative agent was identified on examination of the patient or the contacts. Every case of dysentery, and suspected case, 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. FOOD POISONING No cases of food poisoning occurred during 1961. ERYSIPELAS Two cases were notified, one of which was removed to hospital. Both recovered. WINTER EPIDEMICS In the second week of January information was received from the local office of the Ministry of Pensions and National Insurance that the percentage of new sickness benefit claims of the insured population was 180$ of the average weekly figure. This figure increased to 350$ of the average vreekly figure for the week ending the 7th February, but from the week ending the 14th February there was a steady decline in new sickness benefit claims and by the end of February the position had returned to normal. This heavy outbreak of illness was due to an epidemic of influenza including & rather mixed lot of virus infections. The attendance at schools was also affected, although only partly due to influenza and colds, as chickenpox, measles and mumps were also prevalent at the time. In general the influenza was of a mild type although in some cases, involving elderly persons, serious complications occurred. - 46 - 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 688 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 inmunlty 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 54% and there is every need to raise this figure. The following shews the number of vaccinations carried out during the year»- Primary vaccinations 619 Re-vaccinations 112 MOPPING COUGH IMMUNISATION The following figures show the number of children inmunised 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 cr at Surrey County Council Clinics. Number of children immunised 749 Number of children boosted 326 DIPHTHERIA IMMUNISATION The following table gives details of the number of children under the age of 15, who were immunised for the first time during the year 1961, together with those who received reinforcing doses during the year:- Under 5 years 791 Between 5 and 15 years 104 Number of children given reinforcing doses during 1961 1,205 47 TETANUS IMMUNISATION Active immunisation against tetanus is available for those who desire it in the same way as other immunising procedures. Although not a common disease, the mortality rate is high, and immunisation is reconmended. During the year 802 children received protection. • POLIOMYELITIS VACCINATION Vaccination is proving very effective in the control of acute poliomyelitis and has now taken its place as a routine procedure alongside the wellestablished protective injections against diphtheria, whooping cough, tetanus and smallpox. Protection against poliomyelitis continued to be offered throughout the year to all persons up to the age of 40 years and certain other priority classes. Persons over the age of 40 years may be vaccinated by their family doctors. The Mobile Vaccination Unit which visited Wimbledon in the autumn of I960 returned to this area during the week 5th - 10th June, in order that those who attended the Unit for their first two injections could receive a third injection of vaccine. In addition to offering third injections, the Unit was also available to give first injections to those not previously vaccinated. A further extension to the scheme was announced by the Minister during the year when he asked Local Health Authorities to offer a fourth re-inforcing injection to children between the ages of 5 and 11 years. This fourth injection is given not earlier than one year after the third dose, but as soon as possible thereafter. Open Clinics, where vaccination can be carried out without prior appointment, continued to be held at Amity Grove Clinic, Raynes Park, on Saturday mornings, and at Russell Road Clinic on Saturday mornings and Thursday evenings throughout the greater part of the year, although there was some curtailment of Clinics towards the end of the year due to a shortage of vaccine. - 48 - The following table shews the position with regard to poliomyelitis vaccination at 31.12.61:- Class Number vaccinated with 2 injections since the beginning of the scheme Children born in the years 1943 to 1961 12,217 Young persons born in the years 1933 to 1942 4,682 Persons born before 1933 who have not passed their 40th birthday 3,489 Others 587 Total 20,975 Number of persons given a third injection under the extended Scheme 16,312. 3,444 children between the ages of 5 and 12 years have received a fourth injection. - 49 - 50 NOTIFIABLE DISEASES DURING 1961 DISEASE 'Number of cases Notified in Various Age Groups Total Cases Notified Total Cases removed to Hospital Total Deaths Under 1 1-2 2.4 3-4 4-5 5-9 10-14 15-24 25 and over Scarlet Fever 5 5 14 3 1 2 30 1 _ Measles 27 72 126 119 107 486 24 12 7 980 14 - Whooping Cough 4 3 4 1 1 11 2 - 1 27 1 - Meningococcal Infection _ _ - - - 1 - - - 1 1 - Puerperal Pyrexia _ _ _ _ _ _ _ 5 3 8 8* _ Dysentery _ 1 - - - - - - - 1 _ _ Poliomyelitis _ _ _ _ _ _ _ - 1 1 1 1 Pneumonia (Acute Primary or Influenzal) _ _ _ _ — - - 2 11 13 4 - Erysipelas _ _ _ _ _ _ _ _ 2 2 1 - Ophthalmia Neonatorum 1 - - - - - - - - 1 1 - TOTALS 32 76 130 125 113 512 29 20 27 1064 32 1 * These 8 patients were already in hospital* 51 NOTIFICATIONS OF INFECTIOUS DISEASE DURING THE LAST ID YEARS DISEASE 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 Dysentery 36 19 14 2 15 9 24 11 17 1 Encephalitis acute _ - - - 1 1 - 4 - _ Enteric Fever (Typhoid) - - - - - - - 1 - - Paratyphoid Fever 1 1 - - - 1 1 1 - - Erysipelas 3 3 3 2 6 1 3 1 - 2 Food Poisoning - 6 13 2 11 1 8 8 2 - Malaria - - - - 1 - - - - - Measles 337 896 18 813 64 660 134 627 18 980 Meningococcal Infection 1 1 2 - 1 1 1 - 1 1 Ophthalmia Neonatorum - - 1 - - - - - - 1 Pneumonia 24 29 18 21 34 24 25 18 7 13 Poliomyelitis 2 11 4 11 7 10 1 1 - 1 Puerperal Pyrexia 5 22 4 7 12 25 19 11 3 8 Scarlet Fever 128 96 49 77 110 59 80 74 45 30 Whooping Cough 112 183 74 139 82 108 10 5 55 27 649 1267 200 1074 344 900 306 762 148 1064 Tuberculosis:- Pulmonary 56 65 40 36 44 50 25 26 26 34 Non-Pulmonary 3 1 7 4 6 2 1 5 3 5 TU3ERCULOSIS During the year 66 new cases were added to the register of tuberculous persons compared with 56 in I960 and 70 in 1959. Of the 66 additions 39 were primary notifications, 24 were transferred from other areas, and 3 were un-notified deaths. An analysis of the notifications received is given overleaf. Ninety cases were removed from the register for the following reasons:- Pulmonary M . F. Non-Pulmonary M. F. Deaths from tuberculosis - 1 2 - Deaths of patients suffering from tuberculosis through other causes 5 4 _ _ Recovered cases 15 16 3 4 Removals from district. 18 19 _ 3 38 40 5 7 At the end of the year, after taking into account all the additions and deletions there were 451 cases remaining on the tuberculosis register, a drop of 21 on the previous year. 401 were cases of pulmonary tuberculosis and 50 cases of non-pulmonary tuberculosis. New notifications of pulmonary tuberculosis amounted to 34, an increase of 8 over the previous year, compared with an average of 32 in the last five years. This increase in notifications was due to an outbreak of tuberculosis which occurred in a County school outside Wimbledon, when 14 primary cases of tuberculosis were discovered among pupils. Eight of the infected pupils lived in Wimbledon. There were 3 deaths from all forms of tuberculosis which represents a death rate of 0.05 per 1000 population compared with 0.08 in the previous year, and 0.07 for England and Wales. The steady improvement in the death rate from pulmonary tuberculosis is encouraging, but it is essential that continued vigilance is maintained particularly in schools where one teacher may unwittingly infect a group of pupils. While treatment of tuberculosis by modem drugs has completely altered the a3pects of this disease, it is necessary to remember that there are still a large number of cases on the register receiving treatment and attention at the Chest Clinic, and breakdown and infectivity in such cases is always a possibility. 52 I VACCINATION AGAINST TUBERCULOSIS B.C.G. vaccination against tuberculosis is offered to school children between the ages of 13 and 14 years, and to students attending further education establishments» The object of the scheme is to provide resistance to tuberculosis during the adolescent period when children are most susceptible to the infection. The scheme is operated through the County School Health Service. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS 1925 PUBLIC HEALTH ACT 1936 (Section 172) During 1961 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. 53 - 54 - TUBERCULOSIS 1961 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 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 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 5-9 " _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 10-14 " 7 1 — _ _ _ _ _ 7 1 _ _ _ _ _ _ 15 - 19 " 1 3 3 _ 1 1 _ _ 2 4 3 _ _ _ _ _ 20 - 24 " 1 3 _ _ 1 1 _ _ 2 4 _ _ _ _ _ _ 25-29 " 2 _ _ _ 1 4 _ _ 3 4 _ _ _ _ _ _ 30 - 34 " 2 — — _ 5 _ — — 7 _ _ _ _ _ _ _ 35 - 44 " 1 2 _ _ 3 1 _ _ 4 3 _ _ _ _ _ _ 45 - 54 " 2 _ _ 1 1 2 1 _ 3 2 1 1 _ _ _ 1 55 - 64 " 5 _ _ _ 1 _ _ _ 6 _ _ _ 2 1 2 _ 65 and Over 3 1 1 _ 3 1 _ — 6 2 1 — 3 3 _ — Age not known _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 24 10 4 1 16 10 1 _ 40 20 5 1 5 4 2 1 34 5 26 1 60 6 9 3 39 27 66 12