Borough of Wimbledon Public Health Department ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR ENDED 31st DECEMBER, 1962 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH. Public Health Department, Town Hall, Wimbledon, S.W.19. (WIMbledon 6262) August, 1963. 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 1962. This Report is compiled in accordance with the instructions contained in Circular 1/63 of the Ministry of Health, and is on similar lines to previous years. I am pleased to report that the health of the Borough during 1962 was good and there were no special outbreaks of infectious disease. Live births in Wimbledon in 1962 numbered 930, giving a birth rate, per thousand of the population of 15.85 which compares with 892 births and a rate of 15.18 in 1961. There has been a steady increase in the birth rate for the past five years and the rate for 1962 was the highest recorded in the Borough since 1948. Of the 930 live births 66 or % were illegitimate. The live birth rate for England and Wales for the year was 18.0. Deaths numbered 756 as against 706 in 1961. This gives a death rate of 11.03 per thousand population compared with 10.39 in 1961. The excess of births over deaths was 174 compared with 217 in the previous year. The death rate for England and Wales for the year was 11.9. The number of infant deaths (under 1 year of age) was 13 out of 930 live births which gives an infantile mortality rate of 13.97 per thousand live births, one of the lowest rates on record. The infant mortality rate for England and Wales for 1962 was 21.6 the same rate as in 1961 when the lovrest figure ever was recorded. Stillbirths numbered only 13 as against 17 in 1961, despite the increase in the birth rate. There were no maternal deaths. (i) Heart disease, in one form or another was, as usual, the principal cause of mortality, 293 deaths being attributable to this group of diseases. Of the total, which was an increase of 39 on last year's figure, 161 were due to coronary disease of the heart. Cancer was the second greatest cause of death although the total deaths (131) were less than in the preceding year. Deaths from cancer of the lung showed a welcome decrease following the big rise in 1961 but the proportion of male deaths due to lung cancer was again relatively high. In December arrangements were made for a mobile Health Education Unit provided by the Central Council for Health Education in co-operation with the Ministry of Health to visit a number of Secondary Schools and Youth Organisations in Wimbledon in connection with the campaign to discourage smoking among children and young adults and to prevent the smoking habit. The mobile unit was staffed by two University Graduates who had been specially trained and briefed to deliver talks on the subject of smoking and health and were expert in the use of visual aids. The Unit's programme was very well presented and was fully employed during its' stay in Wimbledon but there is no way at present of assessing the results of the campaign. Eight deaths were reported from motor vehicle accidents, this being two less than last year. All other accidents accounted for fourteen deaths which was two more than in the previous year. Suicides accounted for nine deaths, the same number as in 1961. It is most gratifying to be able to report a substantial fall in the number of new cases of pulmonary tuberculosis notified during the year. Only 22 cases were notified compared with 34 in 1961. This is a most encouraging sign and it is hoped that this downward trend will continue. The treatment of tuberculosis by modern drugs has completely altered the aspects of this disease and the mortality rate has been vastly reduced. Only 4 deaths were attributable to tuberculosis in 1962 compared with 37 deaths a quarter of a century ago. The disease, however, retains its' high infectivity and intensive search for early cases must continue. The Mass Radiography Service has been of the greatest help in this respect. The Year 1962, as a whole, was not a particularly notable one as regards infectious disease but it commenced in a sensational manner due to a number of cases of Smallpox being imported into this country by the arrival by air of infected immigrants from Pakistan. This created many problems and a considerable amount of additional work. Although no cases of Snallpox occurred in Wimbledon there were a number of persons who had been in contact with cases, or believed that they may have been, in addition to travellers from Pakistan who were staying in Wimbledon, all of whom had to be kept under regular surveillance. Another problem which had to be dealt with was the overwhelming demand from the public for vaccination. (ii) Mass vaccination of the population in Wimbledon was never considered necessary, but in view of the insistent demand from a section of the public the situation had to be dealt with, and arrangements were made for exterded clinics to be held. Although mass vaccination was discouraged, anyone who was at special risk was strongly advised to be vaccinated, and anyone who was frightened about the situation, and there seemed to be many, and who really felt he should be vaccinated, was vaccinated, either at a Surrey County Council Clinic or by his General Practitioner. The public morale in this way was sustained but in dealing with the situation a tremendous burden was placed upon the staff until the "scare" had subsided. Overall, there was a big increase in the number of persons vaccinated in 1962, but as the Surrey County Council did not ask for records of adults vaccinated by General Practitioners the total number of persons vaccinated during the year is not known. Some guide to the increased number of persons vaccinated was, however, reflected in the big increase in the number of International Certificates of Vaccination which were received from the public for authentication. These certificates are required for the purpose of travel to certain foreign countries but during the Smallpox outbreak most continental countries insisted upon these certificates although they are not normally required. During 1962, 4,343 certificates were brought to the Public Health Department for authentication compared with 688 in 1961 which was the previous highest figure. Notifications of infectious disease amounted to only 163 compared with 1064 in 1961. The decrease was largely due to the low incidence of measles with only 122 cases being notified compared with 980 in 1961. There were no deaths from infectious disease. No cases of Poliomyelitis were notified. Once more, for the thirteenth year in succession Wimbledon was completely free from Diphtheria. There were, however, outbreaks of the disease in unimmunised children in some parts of the country which serves to emphasise to parents the importance of keeping their children as highly immune as possible and for the initial protection to be given in the first year of life. As I have stressed in previous reports it is only by maintaining a high level of immunity that the population will be safeguarded from the return of this dreaded disease. 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 the early part of the year oral vaccine (Sabin Vaccine) became available in this country and was first used in Clinics in Wimbledon in March and was increasingly used throughout the year. Further good progress was made during the year towards the establishment of Smoke Control Areas throughout the Borough under the Clean Air Act 1956. 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. (iii) 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 Chief Public Health Inspector, and Mr. Richardson, my 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. (iv) LIST OF CONTENTS Page Introduction (i),(ii),(iii),(iv) Health Committee Members and Health Sub-Conraittee Members 1 List of Staff 2 SECTION A: STATISTICS AND SOCIAL CONDITIONS: Statisitcs| 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 SECTIONB: GENERAL PROVISION OF HEALTH SERVICES: Laboratory Facilities 13 Nursing Homes 14 National Assistance Act 1948 15 Mass Radiography 16 Hospitals 17 Home Help Service 17 Midwifery and Home Nursing 17 Vvelfare Foods 17 Chiropody 17 Health Visitors 18 Ambulances 18 School Health Service 18 Day Nursery 18 Clinics 18,19,20 SECTION C: SANITARY CIRCUMSTANCES: Water Supply 21 Sewerage and Sewage Disposal 22 Inspection of District 22,23,24 Result of Service of Notices 24,25,26 Factories Acts 1937 to 1959 26,27 Outwork 27,28 SECTION D: HOUSING: Overcrowding 28 Rehousing 28,29 New houses erected, etc.29 Rent Act 1957 29 Page SECTION E: INSPECTION AND SUPERVISION OF POOD: Milk - Registration and Licences 30 Milk ™ Sampling 30 Ice-cream - Sampling 30 Meat and other Foods 31 Registration of Food Premises 31,32 Unsound Food 32,33 Sampling of Food and Drugs 34-38 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 1951 40 Clean Air Act 1956 41,42 Shops Act 1950 42 Diseases of Animals Acts 42 Noise Abatement Act I960 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 49 Incidence of Infectious Diseases 50,51 Tuberculosis 52,53,54,55 BOROUGH OF WIMBLEDON HEALTH COMMITTEE December. 1962 The Mayor, Alderman T. H. Metcalf, J.P. (Chairman) Alderman A. E. Ayres, (Vice-Chairman) Alderman Sir Cyril Black, J .P., D.L., M.P. Councillor W. J. M. Fiaher, B,Sc., J.P. Councillor V. M. Green Councillor Miss D. M. Lord 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. 1962 Alderman T. H. Metcalf, (Chairman) Cruncillor 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. CHIEF PUBLIC HEALTH INSPECTOR: G.H. Cocke U, F.A.P.H.I., M.R.S.H. DEPUTY CHIEF PUBLIC HEALTH INSPECTOR: L.R. Godfrey, M.A.P.H.I. PUBLIC HEALTH INSPECTORS: C.L. Hunt (Resigned 1.8.62) R.G. Ayling, M.A.P.H.I. (Resigned 6.6.62). D.R. Wiseman, M.A.P.H.I. (Appointed 5.2.62). PUPIL PUBLIC HEALTH INSPECTOR: J.T. Thompson TECHNICAL ASSISTANT (CLEAN AIR): K.C. Robinson 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. C. Smith (Appointed 1.5.62 (Resigned 16.12.62 + Miss I. Moss (Resigned 30.4.62) * Mrs. E.E. Barlow (Resigned 12.5.62) A.J. Burke * Miss M.T. McCormick (Appointed 12.6.62) * Miss I.D. Farrow (Resigned 31.12.62) + 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-1962) 56,850 Number of occupied dwellings:- 11,926 1921 (Census) 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:- £1,345,128 Sum represented by penny rate:- £5,395 Extracts from Vital Statistics of the Year 1962 (Registrar-General's Figures) Total M. F. (Legitimate 864 469 395 Live Births (Illegitimate 66 23 43 (Total 930 492 438 Total M. F. (Legitimate 12 5. 7 Stillbirths (Illegitimate 1 - 1 (Total 13 5 8 Live birth rate per 1,000 of the estimated home population 16.35 Corrected live birth rate per 1,000 of the estimated home population 15.85 Still-birth Rate per 1,000 total (live and still) births 13.78 Total M. F. Deaths 756 367 389 Crude Death Rate per 1,000 of the estimated home population Corrected Death Rate per 1,000 of the estimated home population 13.29 11.03 - 3 - Death8 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:- AH infants per 1,000 live births 13.97 Legitimate infants per 1,000 legitimate live births 12.07 Illegitimate infants per 1,000 illegitimate live births 30.30 Deaths from cancer 131 " " diphtheria Nil '' " poliomyelitis Nil " '' measles Nil " " whooping cough Nil - 4 - BIRTH RATES. DEATH RATES. ANALYSIS OF MORTALITY MATERNAL MORTALITY AND CASS RATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR 1962 PROVISIONAL FIGURES BASED ON QUARTERLY RETURNS OF REGISTRAR-GENERAL Wimbledon England and Wales Rates per 1,000 Home Population. Births Live Births 15.85 18.0 Still Births 0.22 0.33 13.78* 18.1* Deaths All Causes 11.03 11.9 Coronary and arterio- sclerotic heart disease 2.83 2.20 Whooping Cough - 0.00 Diphtheria - 0.00 Tuberculosis - all forms 0.07 0.07 Influenza 0.07 0.07 Smallpox - 0.00 Acute Poliomyelitis (inclu- ding Polioencephalitis) - 0.00 Pneumonia 0.93 0.68 Malignant Neoplasm - Lung, Bronchus 0.56 0.51 Maternal Mortality — 0.35* Rates per 1,000 Live Births Deaths Infant Deaths (all causes under 1 year) 13.97 21.6 Diarrhoea and Enteritis - 0.6 under 2 years) * Per 1,000 total (live and still) births. - 5 - CORRECTED NOTIFICATIONS FOR CERTAIN INFECTIOUS DISEASES 1962. Wimbledon England and Wales Rate8 per 1,000 Home Population Notifications:- (Corrected) Scarlet Fever 0.29 0.32 Whooping Cough 0.12 0.17 Typhoid and Paratyphoid Fever - 0.00 Meningococcal Infection 0.01 0.01 Acute Encephalitis - 0.00 Diphtheria - 0.00 Erysipelas - 0.03 Smallpox - 0.00 Measles 2.1 3.95 Pneumonia 0.15 0.26 Acute Poliomyelitis - Paralytic - 0.00 Non-paralytic - 0.00 Food poisoning 0.01 0.11 Dysentery 0.01 0.57 Ophthalmia Neonatorum - 0.02 Tuberculosis - Pulmonary 0.38 0.38 Non-pulmonary 0.03 0.05 Puerperal Pyrexia 5.30* 8.02* * Per 1,000 total (live and still) birth#. - 6 - VITAL STATISTICS POPULATION The Registrar-General's mid-year estimate of the civilian population of Wimbledon, 56,850, shews an estimated decrease of 140 on the previous year, although the natural increase by excess of births over deaths was 174. 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 1962, the total number of registered live births belonging to Wimbledon was 930. Of this number 492 were males and 438 females. This gives a birthrate of 16.35 per thousand of the population as compared with a rate of 15.65 per thousand in 1961, and an average of 15.18 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 in 1962 was 15.85 per thousand of the population, whilst the rate for England and Wales was 18.0 and has averaged 17.0 over the past five years. STILLBIRTHS - The number of stillbirths registered during the year was 13 (5 males and 8 females), this being 4 fewer than last year. The stillbirth rate for Wimbledon was 0.22 per thousand of the population, whilst that for England and Wales was 0.33. ILLEGITIMACY - Of the live births registered in 1962, 66 (23 males and 43 females) were illegitimate, this being 3 more than in the preceding year. One of the 13 stillbirths registered was illegitimate. DEATHS The total number of Wimbledon residents who died during 1962 was 756 (367 males and 389 females), giving a death-rate of 13.29 per thousand of the population as compared with 12.38 per thousand for 1961. The corrected deathrate for 1962 was 11.03 per thousand as compared with a rate of 11.9 per thousand for England and Wales. The number of Wimbledon residents who died outside the Borough was 305, whilst 399 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 293 38% Cancer 131 11% Vascular lesions of nervous system 103 13% Diseases of the respiratory system 120 15% 647 83% The following is an analysis of the causes of death:- Males Females Total 1. Respiratory tuberculosis 2 2 4 2. Other tuberculosis - - - 3. Syphilitic disease 1 1 2 4. Diphtheria - - - 5. Whooping Cough - - - 6. Meningococcal infections - - - 7. Acute poliomyelitis - - - 8. Measles - - - 9. Other infective and parasitic diseases 1 1 2 10. Malignant neoplasm, stomach 11 7 18 11. Malignant neoplasm, lung, bronchus 30 2 32 12. Malignant neoplasm, breast 1 13 H 13. Malignant neoplasm, uterus - 6 6 14. Other malignant and lymphatic neoplasms 27 30 57 15. Leukaemia 2 2 4 16. Diabetes 2 4 6 17. Vascular lesions of nervous system 40 63 103 18. Coronary disease, angina 89 72 161 19. Hypertension with heart disease 8 9 17 20. Other heart disease 24 49 73 21. Other circulatory disease 12 30 42 22. Influenza 1 3 4 23. Pneumonia 22 31 53 24. Bronchitis 32 18 50 25. Other diseases of respiratory system 10 3 13 26. Ulcer of stomach and duodenum 3 2 5 27. Gastritis, enteritis and diarrhoea - 1 1 28. Nephritis and nephrosis 1 1 2 29. Hyperplasia of prostate 5 - 5 30. Pregnancy, childbirth, abortion - - - 31. Congenital malformations 2 1 3 32. Other defined and ill-defined diseases 21 27 48 33. Motor vehicle accidents 4 4 8 34. All other accidents 9 5 14 35. Suicide 7 2 9 36. Homicide and operations of war - - - 367 389 756 8 MATERNAL 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 0.35. The following table sets out the number of deaths and death rates per thousand total live and stillbirths for 1962:- Number of Deaths Rate ENGLAND AND WALES Maternal causes, excluding abortion 243 0.28 Due to abortion 57 0.07 Total maternal mortality 300 0.35 The estimated mid-1962 female population for England and Wales age 15-44 was 9,235,000. As stated there were no maternal deaths in Wimbledon during 1962. INFANTILE MORTALITY During 1962 there were 13 deaths among infants under one year of age, the same number as in 1961. This compares with an average of 16 in the last five years. Two of the deaths were in respect of illegitimate children. The resultant infant mortality rate for Wimbledon per thousand live births was 13.97 compared with 14.57, 19.20, 23.64 and 18.89 in the previous four year8. The infant mortality rate for England and Wales in 1962 was 21.6 the same rate as in 1961 when the lowest figure ever was recorded. Seven of the 13 deaths were due to prematurity and atelectasis, 3 were due to congenital defects or birth injuries and 2 deaths were due to pneumonia One child died as the result of a collapse of a lung secondary to an operation for removal of lymposarcoma. 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 10.7 per thousand live births, as compared with a rate of 15.1 for England and Wales. The perinatal death rate (i.e. stillbirths and deaths of infants under 1 week) was 23.3 per thousand live and stillbirths, while that for England and Wales was 30.8. 9 The perinatal death rate is now looked upon with increasing importance as perinatal deaths account for eighty per cent of the total loss of infant life from the twenty eighth week of pregnancy to the end of the first year of life. It will be noted that of the 13 infant deaths in Wimbledon 9 occurred in the first week 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 13 infant deaths which occurred during 1962, together with the age at death. Cause of death Under 1 week 2-3 weeks Total under it weeks 1-3 months 3-6 months 6-9 months 9-12 months Total deaths under 1 year Congenital defect or birth injury 2 1 3 - - - - 3 Prematurity and atelectasis 7 - 7 - — - — 7 Collapse of lung - - - - - - 1 1 Pneumonia - - - - - 1 1 2 Totals 9 1 10 - - 1 2 13 11 INFANTILE MORTALITY DURING THE LAST 10 YEARS Cause of death 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 Prematurity and atelectasis 5 5 2 1 3 7 14 3 7 7 Congenital defects or birth injuries 4 5 5 5 3 6 4 5 5 3 Diseases of the newborn - - - - - 1 - - - - Gastro-enteritis 1 - - - - - - - - - Embryoma of liver - - - - - - - 1 - - Pneumonia 1 1 2 2 1 1 1 4 - 2 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 - - - - - - - 1 - - Collapse of lung - - - - - - - - - 1 12 12 11 10 9 15 20 17 13 13 Total nao-natal deaths included above 9 11 8 7 8 12 18 14 10 10 12 SUMMARY OF STATISTICS The following table shows the birth-rates and death-rates for Wimbledon as. compared with England and Wale s since 1943 Year Live-Birth Rate (per thousand home population) Still-Birth Rate (per thousand home population) Death-Rate (per thousand lome 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. 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 9.88 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 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 1962 15.85 18.0 0.22 0.33 11.03 11.9 - 0.35 13.97 21.6 *From 1943 to 1948 the local death-rate could not be corrected as the publication of an area comparability factor was suspended. Consequently, it is not strictly possible to compare the death-rate for Wimbledon with that for England and Wales for those years. SECTION B. - GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA 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. Considerable use is made of these facilities by the Public Health Department. In addition, the staff is always available to assist the Medical Oficer 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 for the examination of pathological specimens, and the Central Public Health Laborator 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 year Nose and throat swabs 3 Faeces for the typhoid and dysentery groups 106 Ice-cream samples 51 Milk samples 91 Water samples 69 Miscellaneous 1 Total 326 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.1. Biological examinations of milk are carried out at the Royal Institute of Public Health and Hygiene Laboratory, Queen Square, W.C.1. - 13 - PUBLIC HEALTH ACT 1936. PART IV. - NURSING HOMES. The Wimbledon Borough Council la responsible for the registration and supervision of Nursing Homes in the Borough. Nine visits of inspection were made during 1962. No new Nursing Homes were registered during the year but one Home closed down. 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. The position at the end of 1962 was as follows:- Number of Homes Number of beds provided for:- Maternity Others Totals Homes first registered during the year Nil Nil Nil Nil Homes whose registrations were withdrawn during the year 1 Nil 14 14 Homes on the register at the end of the year 4 Nil 62 62 Homes 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 Homes were kept, that proper attention was being paid to fire precautions, and the Council's byelawe were being complied with. - 14 - NATIONAL ASSISTANCE ACT 1948 - CARE 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. A number of border line cases were brought to the notice of the Public Health Department for investigation during 1962 but fortunately it was not found necessary for the Council to make application to the Court for any Orders for compulsory removal. All necessary help and advice was given in each individual case investigated, and every effort made to improve the conditions found upon inspection. Although the care of the aged still presents a considerable problem an increasing amount continues to be done for them but in many cases the old people create their own problems by refusing to co-operate. The District Nurses and Home Helps play an important part in the care of elderly persons in their own homes and the voluntary services such as the Guild of Social Welfare do excellent work with their many services such as "Meals on Wheels", Old Peoples Clubs etc. A laundry service for incontinent patients is another service recently provided for the elderly which considerably reduces the burden on relatives and makes it possible for patients to be nursed at home who would otherwise be admitted to hospital. The close liaison which has been established between the Geriatric Department of St. Helier Hospital, the Guild of Social Welfare, the General Practitioners and your Medical Officer of Health continued and strengthened throughout the year. - 15 - MASS RADIOGRAPHY The South West Metropolitan Regional Hospital Board provides this service for the whole of Wimbledon and from time to time one of their units visits the Borough and carries out surveys of groups of workers and residents in the area. These surveys are usually of one or two weeks duration. In addition to these concentrated surveys the Mobile Chest Radiography Unit visits Wimbledon and Raynes Park each week throughout the year. This Service which was set up in 1956 primarily for the use of general practitioners' 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. I am indebted to the Medical Director of the Mass Radiography Service for the following particulars of Persons examined and abnormalities found in the Wimbledon area. As these facilities are available to all, the figures do not necessarily relate to Wimbledon residents only. GENERAL PRACTITIONER CHEST X-RAY SERVICE Site Number x-rayed Significant Pulmonary Tuberculosis. Primary Lung Cancer Male Female Total Male Female Total Male Female Total Sth. Wimbledon 348 311 659 3 - 3 1 1 2 Raynes Park 326 282 608 1 - 1 3 1 4 NORMAL MASS RADIOGRAPHY SERVICE Site Number x-rayed Significant Pulmonary Tuberculosis Primary Lung Cancer Wimbledon Male Female Total Male Female Total Kale Female Total 524 577 1,101 3 1 4 1 - 1 - 16 - 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. 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. 17 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 Nursery 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 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. 1st & 3rd Tuesday afternoons (Midwives Clinic). 30, Kings Road. 2nd & 4th Thursday afternoons and Wednesday afternoons. (Midwives Clinic). Infant Welfare Clinlca. Health Centre, Pelham Road. Tuesday and Friday afternoons Amity Grove Clinic, Raynes Park. Monday and Wednesday afternoons Friday mornings. Churchill Hall, Effra Road Tuesday afternoons. 18 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 Saturday mornings. Emmanuel Church Hall, Lingfield Road. Thursday mornings. (1st in month) (Immunisation only). Minor Ailments. Health Centre, Pelham Road. Monday - Friday. 9.00 - 10.00 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, 2nd. 3rd. & 5th in month) Amity Grove Clinic, Raynes Park Tuesday mornings. (1st in month) Eye Clinics. Health Centre, Pelham Road Thursday mornings. Amity Grove Clinic, Raynes Park Wednesday mornings. Relaxation and Mothercraft. Russell Road Clinic Wednesday afternoons. Amity Grove Clinic, Raynes Park Tuesday afternoons. - 19 - 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 Hyglenlst's Clinics Health Centre, Pelham Road Friday mornings and afternoons Amity Grove Clinic, Raynes Park Tuesday mornings and afternoons Speech Clinics. Russell Road Clinic Monday mornings and afternoons Amity Grove Clinic, Raynes Park Thursday afternoons. Orthopaedic Clinics. Health Centre, Pelham Road Wednesday afternoons (4th in month). Remedial Exercises. Health Centre, Pelham Road Tuesday and Thursday afternoons. Amity Grove Clinic, Raynes Park Tuesday mornings. Audiology Clinics. Russell Road Clinic Wednesday mornings (1st, 3rd and 4th in month) Alternate Friday mornings. Amity Grove Clinic, Raynes Park. Tuerday mornings (2nd in month) - 20 - 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 auality. With five exceptions all the dwelling houses in Wimbledon are supplied from public water mains direct to the houses. During the year 1962, samples of water were taken for bacteriological and/or chemical analysis, as follows:- Bacteriological. Public Swimming Baths 58 Dwelling houses:- Metropolitan Water Board supply 5 Well water 7 12 Other Premises:- Metropolitan Water Board supply 1 71 Eight of the reports upon samples of Swimming Bath Water indicated that chlorination appeared to be inadequate. Action was taken, and subsequent samples proved satisfactory. All other samples of water proved bacteriologically satisfactory. Chemical. Dwelling Houses:- Metropolitan Water Board 1 This sample 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. - 21 - Other information required by Ministry of Health Circular 1/63 is as follows:- Number of dwelling houses supplied from public water mains:- (a) Direct to the houses No record kept. Population supplied Est.1962 - 56,850 (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. REGISTERED COMMON LODGING HOUSES. These are no registered common lodging houses within the Borough. INSPECTION OF THE DISTRICT. The following is a summary of the complaints received and the visits made during the year 1962:- Complaints received. General disrepair and insanitary conditions 220 Dampness 41 Overcrowding 13 Defective drainage systems 25 Blocked drainage systems 172 Defective drainage fittings 29 Defective W.C. pans and/or flushing apparatus 19 Defective service water pipes 13 Absence of or defective dustbins 25 Accumulations of refuse, etc. 82 Rats and mice 236 Insect pests, etc. 138 Smoke nuisances 51 Unsound food 121 Noise 22 Miscellaneous 39 Alleged nuisance from Sewage Works outside Borough Boundary 566 1,812 * Includes petition with 464 signatures. - 22 - Visits made. Infectious diseases. Inquiries re cases of infectious disease 145 Miscellaneous 22 Housing. Dwelling houses (Housing Act) 192 Dwelling houses (Public Health Act) 1,363 Rent Act 1957 40 Underground rooms 36 Multi-let Houses 5 Overcrowding 287 House Purchase & Housing Act 1959 105 Moveable dwellings 51 Miscellaneous 264 Food & Food Premises. Dairies and milk distributors 20 Ice-cream premises 63 Bakehouses 52 Butchers' shops 90 Meat preparation premises 24 Fish shops 37 Fried fish shops 10 Restaurant kitchens 85 Licensing Act 1961 45 Other food premises 431 Visits re unsound food 311 Sampling: food and drugs 98 Sampling milk 121 Sampling: ice-cream 66 Sampling: water 74 Miscellaneous 258 General. Places of public entertainment 48 Drainage and plumbing work 844 Stables and piggeries 6 Nat. Survey of Air Pollution 1,604 Smoke Control Areas 6,800 Other Clean Air Act Visits 513 Pet Animals Act, 1951 13 Factories (P.) 130 Factories (N.P.) 38 Factories (Building Sites) 14 Workplaces 2 - 23 - Shops Act 1950 (Vent. Temp, etc.) 5 Shops Act 1950 (Shop hours) 258 Hairdressers and barbers 24 Exhumations 8 Petroleum (Consol) Act 1928 113 Noise Abatement Act 1960 81 Pigeon Nuisances 24 Rodent Control 4,285 Insect infestations 159 Refuse storage 92 Accumulations 339 Miscellaneous 433 20,128 RESULT OF SERVICE OF NOTICES. (1) Legal Proceedings. (a) Proceedings were instituted against the owner/occupier of a dwelling house for failing to comply with a Closing Order made under Section 17 (l) of the Housing Act 1957. The defendant, who pleaded not guilty was fined £5.0.0. with £2.2.0. costs. (b) Proceedings were instituted against the owner of shop premises for failing to abate a statutory nuisance arising from accumulations of trade refuse in yard space. The defendant pleaded guilty and was fined £5.0.0. Special costs of £10.0.0 were awarded against defendant together with £5.5.0. legal costs. In addition, an Order was made to prevent recurrence of the nuisance for e period of two years. (2) Nuisances abated and defects remedled. 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 129 Reconstructed 39 Cleansed 108 Soil pipes and ventilation shafts repaired or renewed 3 Inspection chamber covers renewed 4 Fresh air inlets repaired or renewed 7 New W.C. pans provided 16 Water waste preventers repaired or renewed 12 Gutters and rainwater pipes repaired or renewed 31 New lavatory basins 4 - 24 - New glased sinks provided 2 Waste pipes trapped, repaired or renewed 9 Gully surrounds repaired 6 Miscellaneous 23 General housing repairs. Roofs repaired 35 Yards paved or repaired 6 Damp proof courses provided 2 Dampness remedied 71 Sub-floor ventilation provided 6 Walls and ceilings repaired/constructed 86 Walls cleansed 70 Ceilings cleansed 29 Floors repaired or renewed 24 Windows repaired or renewed 56 Doors repaired or renewed 10 Fireplaces repaired or renewed 8 Service water mains repaired 4 Additional light and ventilation provided 19 W.C. apartment cleansed 4 Miscellaneous 55 Food premises. Walls repaired or redecorated 87 Ceilings repaired or redecorated 61 Floors renewed or repaired 25 Woodwork repaired or repainted 12 Lighting provided or improved 3 Ventilation provided or improved 5 Sinks provided 2 Hot water provided to sink 2 Detergent provided 5 First Aid Kit provided or improved 26 Water supply provided 18 Cold storage facilities provided 1 Risks of contamination removed 49 Outdoor clothing store provided 9 Refuse storage improved 8 Wash-hand basins provided 19 Hot water provided to wash-hand basins 24 Soap provided 16 Nailbrush provided 33 Clean towels provided 17 Sanitary accommodation repaired/cleansed/provided 7 Intervening ventilated space provided 2 Lighting in sanitary accommodation provided 8 Ventilation in sanitary accommodation provided 1 Hand washing notices fixed 21 - 25 - Rodent Control. Defects remedied in connection with ratproofing work are included in foregoing lists. Miscellaneous. Insanitary houses cleared and disinfested/disinfected 4 Accumulations removed 22 New dustbins provided 8 FACTORIES ACT 1961 - 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 41 38 3 - Factories with mechanical power 295 130 26 - Other premises under the Act (including works of building and engineering construction but not including outworkers' premises) 18 14 – – Totals 354 182 29 - - 26 - 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) - — — - - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7):- Insufficient - - - - - Unsuitable or defective 42 29 - - - Not separate for sexes 7 1 - - - Other offences (excluding offences relating to outwork - - - - - Totals 49 30 - - - PART VIII OUTWORK - SECTIONS 133 & 134. Nature of work Section 133 Section 134 No. of outworkers in August list reauired by Sec. I33(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 25 - - - - - Others - - - - - - Totals 25 — - - — - - 27 - Number of addresses received from other Councils 64 Number of addresses forwarded to other Councils 45 Number of premises where outwork was carried on at the end of 1962 118 Underground bakehouses in use at the end of the year 1 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 14 (ii) Number of families dwelling therein 16 (iii) Number of persons dwelling therein 80 (b) Number of new cases of overcrowding reported during the year 4 (c) (i) Number of cases of overcrowding known to have been relieved during the year 9 (ii) Number of persons concerned in such cases 73 (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, 1962s- Number of prefabricated bungalows provided since the end of the war 71 (At the end of 1962, 11 had been demolished). - 28 - Number of families rehoused by the Council or by private owners at the Council's instigation since the beginning of the war 2,506 Number of live applications on the housing list for:- (a) Accommodation in Wimbledon 547 (b) Accommodation in Frimley and Camberley 164 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 1962:- Private enterprise 120 Local Authority 11 Number of flats created by conversion in 1962:- Private enterprise 47 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, 1962:- Applications for Certificates of Disrepair (Form I) 254 Applications withdrawn by applicants 14 Forms J sent to landlords 234 Undertakings given by landlords (Form K) 131 Certificates of Disrepair issued (Form L) 100 •Applications for Cancellation of Certificates of Disrepair (Form M)95 Certificates of Disrepair cancelled 67 Number of visits made during 1962 in connection with the Rent Act 1957 - 40. SECTION E. - INSPECTION AND SUPERVISION OF POOD 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 4.2.. MILK (SPECIAL DESIGNATION) REGULATIONS 1960 The following licences, which will remain in force until 31st December, 1965, have been issued under the Regulations:- Dealers (Pre-packed Milk) Licences - Tuberculin Tested Milk 31 Pasteurised Milk 34 Sterilised Milk 36 During the year 91 samples of designated milk were submitted for statutory tests. The results were as follows:- Designation Satisfactory Void Unsatisfactory Pasteurised 61 10 Nil Tuberculin Tested (Pasteurised) 11 2 Nil Sterilised 5 Nil Nil Tuberculin Tested (Farm bottled) 2 Nil Nil In 12 instances the methylene blue test was not carried out on samples of pasteurised milk due to the fact that the stipulated atmospheric shade temperature (70°F.) was exceeded. ICE-CREAM During the year 51 samples were submitted for bacteriological examination. The results were as follcws:- Grade 1 49 Grade 2 NIL Grade 3 2 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. - 30 - MEAT AND OTHER POODS. 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 1962. 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. 1,785 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 following Greengrocers 67 Confectioners 137 Ice-cream premises 196 Bakers 34 Grocers 124 Provision dealers 89 Butchers 42 Fishmongers 21 Milk distributors 42 Chemists 22 Licensed premises 74 Clubs 32 Restaurants and Cafes 79 Works canteens 15 School canteens 52 Kitchens (Hospital and Central Kitchens) 5 Food stalls/vehicles 17 Places of public entertainment 18 1,066 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 icecream 1 Registered for the preparation or manufacture of sausages 35 Registered for the preparation or manufacture of potted, pressed, pickled or preserved food 37 - 31 - The number of inspections of registered food premises during 1962 was 207. 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 1962. Cwts. Qrs. lbs. Canned soups - 1 10 Canned meat 5 - 15 Canned fish - — 4 Canned vegetables 3 2 11 Canned fruit - 3 3 Meat, bacon, poultry etc. 7 - 4 Fish - 2 11 Cheese — - 1 Jam — — 16 Cereals — — 1 Sauce & Pickles — 3 2 Frozen food 6 — 22 Vegetables 2 - - Fruit Juices - - 6 Vegetable juices 19 - 9 47 cwts. 3 qrs. 3 lbs The number of complaints received during the year regarding unsound food was 121. 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:- Wood in jar of marmalade. Metal in can of vegetable and beef broth. Metal in packet of cornflakes. Cyst in kidney. Fly in piece of cheese. * Metal in mince pie. Foreign matter in loaf of bread. 32 Foreign body in piece of cheese. Comb teeth in Swiss Bun. Metal in meat pie. Chemical residues on fresh garden peas. Insect in loaf of bread. Glass in can of garden peas. Mould in cheese rolls. Foreign body in pork sausages. Mould growth in wrapped loaf of bread. Glass in jar of cream. Wood in loaf of bread. Wood in sponge cake. Foreign body in bread roll. Bristle in packet of butter. * String in bread roll. Bacterial and yeast grcwth in cottage cheese. Foreign matter in bottle of milk. Rubber glove in can of pineapple. Cardboard in loaf of bread. * Foreign matter in pork pie. * Denotes legal proceedings taken. 33 sampling of food and drugs. The following samples were submitted to the Public Analyst during 1962, with the results shown:- Articles Total Formal Informal Genuine Non genuine or Irregular Alka Seltzer Tablets 1 1 - 1 - Angel Cake 1 1 - 1 - Apple Flakes 1 1 - 1 - Apples 1 1 - 1 - Beef dripping 1 1 - 1 - Beef sausages 1 1 - - 1 Blue Cheese dressing 1 1 - - 1 Buttermilk drink 1 1 - 1 - Cascara Segrada Tablets 1 1 - 1 - Chicken Stock Cubes 1 1 - 1 - Cocktail Sausages, canned 1 1 - 1 - Coffee, Viennese 1 - 1 1 - Crab, canned 1 - 1 1 - Cream, canned - 1 1 - - Cream, dairy 1 1 - 1 - Creamed rice, canned 1 1 - 1 - Curd cheese 1 1 - 1 - Currants 1 1 - 1 - Dairy Cream Sponge 1 1 - 1 - Dehydrated potatoes 1 1 - 1 - Dried baking yeast 1 - 1 1 - Figs 1 1 - 1 - Fish cakes 1 1 - 1 - Gravy mix 1 - 1 1 - Gravy powder - 2 - - - Hot-dog relish 1 - 1 1 - Irish stew, canned 1 1 - 1 — C/fd. 29 23 6 27 2 34 Articles Total Formal Informal Genuine Non Genuine or Irregular B/fd. 29 23 6 27 2 Lemon, glycerine & honey mixture. 1 1 - 1 - Liquid fruit pectin 1 1 - 1 - Malt Vinegar - - - 2 - Marzipan confectionery 1 - 1 1 - Meringues 1 1 - 1 - Milk 30 30 - 30 - Milk diet - 1 1 2 - Milk shake syrup 1 1 - 1 - Minced meat 1 1 - 1 - Nutmeg, ground 1 - 1 1 - Oranges 1 1 - 1 - Orange squash cordial 1 1 - 1 - Peas, canned 1 - 1 1 - Pork sausages 3 3 - 2 1 Prawns, canned 1 1 - 1 - Prawn curry, Indian 1 1 - 1 - Raspberries, canned 1 1 - 1 - Saffron 1 - 1 1 - Scotch eggs 1 1 - 1 - Shrimps, canned 1 1 - 1 - Spam 2 - 2 - Sugar confectionery 5 5 - 5 - Vanilla sugar 1 1 1 Totals 90 78 12 87 3 35 The following samples were submitted for special examination:- Articles Total Formal Informal Genuine Non Genuine or Irregular Beef Puree 1 - 1 - 1 Bread & Cheese Rolls 1 - 1 - 1 Chocolate Liqueur Novelty 1 - 1 - 1 Cottage Cheese with Chives 1 - 1 - 1 Creamed Rice Pudding 2 - 2 1 1 Green Peas in Pod 1 - 1 1 - Lemon Curd 1 - 1 - 1 Minced Beef 1 - 1 1 - Mince-pie 1 - 1 - 1 Orangeade 1 - 1 1 - Pork Pie 1 - 1 - 1 Pork Sausage 1 - 1 1 - Vegetable Juice - Celery 1 - 1 1 - Totals 14 - 14 6 8 It will be seen that adverse reports were received upon eleven samples and following is a brief account of the action taken in respect thereof:- BEF.F SAUSAGES AND PORK SAUSAGES. The Public Analyst reported that these samples contained an added preservative and no notices to this effect were exhibited in the retail shops at the time of purchase of the samples. The Health Committee instructed the Town Clerk to send warning letters to the retailers concerned. BLUE CHEESE DRESSING. Two labels were affixed to the bottle containing this formal sample of Blue Cheese Dressing which had been imported from the U.S.A. The wording on each of the labels was not identical and in neither case did it conform to the requirements of the Labelling of Food Order 1953. Correspondence with the distributors resulted in stocks being withdrawn and en undertaking was given that subsequent stocks would be correctly labelled. 36 beef puree. Two complaints were received from residents of Wimbledon regarding Beef Puree Baby Food which had been purchased locally. Sample tins were examined and found to be in a "blown" condition. Shops in the Borough were visited and a quantity of tins of Beef Puree were surrendered for destruction. Samples were submitted to the Public Analyst. Legal proceedings were instituted against the manufacturers of this article. The defendant company pleaded guilty and was fined £5.0.0. on each of two charges together with a total of £7.7.0. costs. bread and cheese rolls. A purchaser complained that the cheese in bread rolls was in a mouldy condition at the time of purchase. The report by the Public Analyst confirmed that the cheese was, in fact, mouldy, and the matter was resolved informally after an interview with the cafe proprietor who prepared the cheese rolls. CHOCOLATE LIQEUR NOVELTY. A label said to have been affixed to a chocolate novelty, in the form of a bottle, described the contents as being 1/lOth pint and 80° proof liqueur. The complainant alleged that the novelty did not in fact contain any liqueur. This was confirmed by the Public Analyst upon his examination of part of the novelty. Upon investigation it was discovered by the Importer that supplies had now been discontinued. The Health Committee instructed the Town Clerk to send a warning letter in this case. cottage cheese with chives. A partly used carton of cottage cheese with chives was submitted to the Public Analyst who reported that the article was unfit for consumption. Investigation revealed that the carton had been exposed for sale for a period of time in excess of normal shelf life. The Health Committee instructed the Town Clerk to send a warning letter to the person concerned. creamed rice pudding. A can of creamed rice pudding was the subject of a complaint of an acid metallic taste. Examination by the Public Analyst showed that the contents were adversely affected by bacteria gaining admission to the can through a defective seam and that the metallic taste was due to the by-products of bacterial growth. Informal action was taken to ensure that there would be no repetition of this incident. 37 lemon curd. A jar of lemon curd was the subject of a complaint when it was alleged that the curd was unfit for consumption. The sample was submitted to the Public Analyst who confirmed that the article had a nasty taste and a peculiar smell. The manufacturers were interviewed and the matter had not been resolved at the time of writing this report. MINCE PIE. A fragment of metal was found in a mince pie alleged to have been purchased from a bakers shop in Wimbledon. Legal proceedings were instituted against the baker who pleaded guilty and he was fined £10.10.0. with £3.3.0. costs. PORK PIE. An individual pork pie containing some foreign matter was the subject of a complaint. Upon examination by the Public Analyst the foreign matter was found to be siliceous earthy matter and animal tissue. Fibres of hemp or jute were also present. Legal proceedings were instituted against the manufacturers of the pie. The defendants pleaded guilty and were fined £10.0.0. with £5.5.0. costs. OTHER LEGAL PROCEEDINGS. (1) Four pieces of string were found embedded in a bread roll purchased from a local bakers shop. Legal proceedings were instituted and the firm was fined £5.0.0. with £3.4.0. costs. (2) Proceedings were instituted under the Food Hygiene (General) Regulations 1960 against a person in charge of a meat delivery vehicle for not wearing a clean and washable head covering whilst carrying meat from the van to a shop. The defendant was fined £2.0.0. with £2.2.0. costs. 38 SECTION F - RODENT CONTROL. PETROLEUM STORAGE. ETC. PREVENTION OF DAMAGE BY PESTS ACT 1949. The table below summarises surface rodent control work which was carried out during 1962. 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. During 1962, 124 manholes were baited and 29 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 and river banks, on a contract basis. 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 5 20 25 6 2 17 113 Dwellings 188 912 1100 135 41 179 2864 All other including Business Premises 47 496 543 23 26 51 1308 Totals 240 1428 1660 164 69 247 4285 39 PEST CONTROL. During the year 1962, 138 complaints were received concerning insect pests, and the following is a list of the infestations dealt with:- Ants 20 Bed bugs 21 Bees 3 Beetles 14 Cockroaches 2 Fleas 2 Flies 3 Maggots 1 Mosquitoes 1 Wasps 66 Woodworm 5 The incidence of wasps was again generalised during 1962, 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, 22 complaints were received regarding squirrels, pigeons and rabbits, and these were referred to the Pests Officer of the Ministry Agriculture, Fisheries and Food at Guildford. PETROLEUM (REGULATION) ACTS 1928 & 1936. 57 licences were issued by the Department to store petroleum spirit during 1962, and the total quantity of petroleum spirit stored was 114,945 gallons. In addition, 28 licences were issued to store petroleum mixtures involving a total of 12,974 gallons, and 3 licences were issued in respect of the storage of a total of 4,628 lbs of calcium carbide. 113 visits were made to premises under the provisions of Petroleum legislation. legal proceedings. Two offences relating to the storage of petroleum mixtures in excess of the permitted quantity without a licence was the subject of legal proceedings. In each case the defendants pleaded guilty and fines of £3.0.0. and £5.0.0. together with costs of £2.2.0. and £1.1.0. respectively were imposed. PET ANIMALS ACT 1951. 7 licences to keep pet shops were issued by the Department during 1962. 13 visits were made to these premises and any infringements of the conditions of licence were rectified. 40 CLEAN AIR ACT 1956 During the year 1962, 51 complaints were received with regard to smoke or grit emission, and the necessary observations were made and remedial action taken. 19 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 2 new oil-fired furnaces during the year. In 2 instances plans 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 sent to the Borough Engineer and Surveyor. National Survey of Atmospheric Pollution. 5 daily smoke filter and sulphur dioxide (volumetric) instruments were sited in approved positions in the Borough during 1961 and recordings were commenced in January, 1962. These instruments, which record smoke density and sulphur dioxide content, are visited daily throughout the year, and after standardisation the recordings are sent to the Department of Scientific and Industrial Research and are eventually recorded in the Department's Atmospheric Pollution Bulletin, together with the results of measurements by other Local Authorities. The Council appointed the Chairman of the Health Committee and the Chief Public Health Inspector as their representatives to 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 1962 to implement the scheme which the Council approved in 1959 to enable the making of Smoke Control Orders covering the whole of the Borough. Wimbledon Smoke Control Order 1962 (No.l) was made by the Council in February, 1962, and this Order was the subject of a public enquiry. The Minister of Housing and Local Government had not published the result of the enquiry by the end of the year. (This Order was, in fact, confirmed in February, 1963). The Wimbledon Smoke Control Order 1962 (No. 2) was confirmed by the Minister in November, 1962 and this Order becomes operative on the 1st June, 1964. At the end of 1962 Smoke Control Area No. 3 was in process of survey. 41 The Council submitted to the Minister of Housing and Local Government a revised programme in accordance with Circular 4/1962. This new programme provides for 9 Smoke Control Areas, covering 2,479 acres to be dealt with by the end of 1966. It also provides for the target year for completion of the whole programme to be 1975 instead of 1980 as previously notified. The total number of visits made during 1962 in connection with the Clean Air Act 1956, for all purposes, was 7,315. SHOPS ACT 1950. The total number of Shops Act inspections during 1962 was 263. 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 1962. Copies of Orders made by the Ministry of Agriculture, Fisheries and Food in respect of other outbreaks of foot and mouth disease, anthrax, swine fever and fowl pest were received. 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 1962, 22 complaints were received and 81 visits were made under the Act. An infringement of the Noise Abatement Act 1960 by the operation after 7 p.m. of loud-speaker chimes attached to an ice-cream vehicle was the subject of legal proceedings. The Defendant pleaded guilty and was fined £2.0.0. with £3.3.0. costs. 42 SECTION G. - PREVALENCE OF. AND CONTROL OVER. INFECTIOUS AND OTHER DISEASES During the year there were 163 cases of infectious disease notified compared with 1,064 in 1961, and 148 in 1960. 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 Borough:- Smallpox Cholera Diphtheria (including Membranous Group) 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 tcwards the end of December, 1961 and the early part of January, 1962 a number of Pakistan immigrants who entered this country through London Airport later developed smallpox. Arising from these importations outbreaks of anallpox occurred in various parts of England and Wales on a scale unknown in this country in recent years. 43 There were some suspected contacts in Wimbledon, and these were kept under daily surveillance until the possibility of developing the disease disappeared. To meet the increased demand from the public for vaccination, existing clinic facilities were expanded to cater particularly for (a) children under the age of 5 years who had not been previously vaccinated (b) persons who believed they may have been in contact with a case of smallpox, and (c) persons who considered they were at special risk or going abroad. The supply of vaccine was adequate and general practitioners were supplied by the Public Health Department if they were experiencing difficulties in getting vaccine through their normal method of supply. Health staffs, such as Medical Officers, Health Visitors, Public Health Inspectors and Hospital Staff whose work might lead to exposure to infection, were advised of the necessity of being re-vaccinated. These outbreaks which caused the deaths of 26 persons in England and Wales drew public attention to the fact that smallpox is still prevalent in many parts of the world and constant vigilance on the part of the Public Health and Medical services is always necessary. SCARLET FEVER There were 17 cases of scarlet fever notified during 1962 compared with 30 in 1961, 45 in 1960 and 74 in 1959. None of the cases was treated in hospital. The infection continued to be of a mild type. There were no deaths from the disease. 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 5 notifications were received, 4 of the cases occurring in hospital and I at home. The 4 hospital notifications had addresses outside the Borough. In 1961 8 cases were notified. 44 PNEUMONIA Nino cases of acute primary or influenzal pneumonia were notified during the year, compared with 13 in 1961 and 7 in 1960. The total number of deaths from all forms of the disease during the year was 40 compared with 46 in 1961. MEASLES There were 122 cases notified during the year compared with 980 in 1961. Generally speaking the measles was mild in type with little by way of complications and no deaths. All the cases notified were treated at home. WHOOPING COUGH Only 7 cases of whooping cough were notified in 1962 compared with 27, 55, 5, 10 and 108 in the last five years. This is the second lowest number of notifications received since whooping cough became notifiable in 1940. It is most gratifying to see a fall in the number of cases of whooping cough as this 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 the third or fourth month. FOOD POISONING There was one confirmed case in a child of 22 months who was admitted to hospital following temperature and diarrhoea over a period of three weeks. Stool examination revealed that the child was infected with salmonella-typhi-murium. Specimens examined from other members of the fanily were negative. The source of the infection in this case was not discovered. DIPHTHERIA There were no cases. The present level of imnunisation 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 imnunisation. Throughout the country as a whole in recent years, Diphtheria has become more conmon, and it is, therefore, more important than ever that parents should have their children inmunised, and that the initial protection should be given in the first year of life. 45 MENINGOCOCCAL INFECTION One case occurred in a child of seventeen months who was admitted to hospital with initial symptoms of lassitude, high temperature and fretfulness. This was considered to be a case of meningococcal meningitis and was notified as such although this diagnosis was not confirmed by bacteriological investigation. The child made a good recovery. DYSENTERY For the second year running only one case of dysentery was notified compared with 17 in 1960, 11 in 1959 and 24 in 1958. This case was a young married woman who became ill with diarrhoea after returning from holiday in Spain. Bacteriological investigation revealed that she was infected with shigella sonnei but faeces specimens examined from other hone contacts proved negative. 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. POLIOMYELITIS No case of poliomyelitis occurred. In the past five years there have been only 3 confirmed cases of poliomyelitis all of which occurred in unvaccinated persons. This most satisfactory state of affairs indicates how effective vaccination has proved in the control of this disease. Routine vaccination against poliomyelitis is now undertaken almost entirely with oral vaccine. A high proportion of Wimbledon children have been vaccinated against poliomyelitis. WINTER EPIDEMICS In the first 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 225% of the average weekly figure. This figure increased to 385% of the average weekly figure for the week ending 9th January, 1962 but from the week ending 16th January there was a steady decline in new sickness benefit claims and by the end of January the position had returned to normal. 46 This heavy outbreak of illness was due to bronchitis, influenza and colds undoubtedly associated with the cold spell which occurred during January. The Schools in Wimbledon were unaffected by this outbreak of illness among the working population, in fact School attendance figures during the period in question were extremely good. 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 4343 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 during their first two years, preferably during the second year. Smallpox vaccination is voluntary and is carried out by general practitioners or at Surrey County Council Clinics. The following shews the number of vaccinations carried out during the year:- Primary vaccinations 1405 Re-vaccinations 1448 47 WHOOPING COUGH IMMUNISATION As in the case of smallpox vaccination, immunisation against whooping cough, diphtheria, tetanus and poliomyelitis is carried out either by general practitioners or at Surrey County Council Clinics. The following figures show the number of children immunised against whooping cough and those who received reinforcing doses during the year (this includes those children who received protection with combined antigens). Number of children inmunised 810 Number of children boosted 212 DIPHTHERIA IMMUNISATION The following table gives details of the number of children under the age of 15, who were inmunised for the first time during the year 1962, together with those who received reinforcing doses during the years- Under 5 years 816 Between 5 and 15 years 55 Number of children given reinforcing doses during 1962 930 TETANUS IMMUNISATION Active immunisation against tetanus is available for those who desire it in the same way as other immunising procedures. Although not a conmon disease, the mortality rate is high, and immunisation is recommended. During the year 885 children received protection. 48 POLIOMYELITIS VACCINATION In February, 1962 live attenuated Poliovirus vaccine (Sabin vaccine) became available in this country for routine vaccination against Poliomyelitis. It has the advantage of being given by mouth and was first used In the clinics in Wimbledon on 31st March, 1962. The recommended course of this oral vaccine consists of three doses each of three drops, given at intervals of four to eight weeks, and a reinforcing dose is offered to all immunised children joining school. The vaccine can be administered on a lump of sugar or in syrup. Oral vaccine is available to all persons aged between six months and forty years and persons at special risk (including medical and nursing staff and pregnant women). Open clinics, where vaccination can be carried out without prior appointment, continued to be held at Amity Grove Clinic, Raynes Park and at Russell Road Clinic, Wimbledon on Saturday mornings throughout the year. The weekly Poliomyelitis clinic held on Thursday evenings at Russell Road Clinic was curtailed to a monthly clinic in September, the clinic being held on the first Thursday evening in the month until the end of the year. The following table shews the position with regard to poliomyelitis vaccination at 31.12.62:- Class Number who have received a primary course of vaccination. Children born in the years 1943 to 1962 13,060 Young persons born in the years 1933 to 1942 4,830 Others 4,388 Total 22,278 Number of persons who have received a re-inforcing injection/dose of vaccine 19,827 4,151 children between the ages of 5 and 12 years have received a fourth injection/dose. 49 NOTIFIABLE DISEASES DURING 1962 DISEASE Number of cases Notified in Various Age Groups Total Cases Notified Total Cases removed to Hospital Total Deaths. Under 1 1-2 2-3 3-4 4-5 5-9 10-14 15-24 25 and over Scarlet Fever - - 2 1 3 8 - 3 - 17 - - Measles 1 18 13 11 12 60 2 4 1 122 - - Whooping Cough 4 - 1 1 - 1 - - - 7 - - Meningococcal Infection - 1 - - - - - - -- 1 1 - Puerperal Pyrexia - - - - - - - - 5 5 4* - Dysentery - - - - - - - - 1 1 - - Pneumonia (Acute Primary or Influenzal) - - - - - - - - 9 9 - - Food Poisoning - 1 - - - - - - - 1 1 - TOTALS 5 20 16 13 15 69 2 7 16 163 6 - * These 4 patients were already in hospital 50 NOTIFICATIONS OF INFECTIOUS DISEASE DURING THE LAST 10 YEARS DISEASE 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 Dysentery 19 14 2 15 9 24 11 17 1 1 Encephalitis acute - - - 1 1 - 4 - - - Enteric Fever (Typhoid) - - - - - - 1 - - - Paratyphoid Fever 1 - - - 1 1 1 - - - Erysipelas 3 3 2 6 1 3 1 - 2 - Food Poisoning 6 13 2 11 1 8 8 2 - 1 Malaria - - - 1 - - - - - - Measles 896 18 813 64 660 134 627 18 980 122 Meningococcal Infection 1 2 - 1 1 1 - 1 1 1 Ophthalmia Neonatorum - 1 - - - - - - 1 - Pneumonia 29 18 21 34 24 25 18 7 13 9 Poliomyelitis 11 4 11 7 10 1 1 - 1 - Puerperal Pyrexia 22 4 7 12 25 19 11 3 8 5 Scarlet Fever 96 49 77 110 59 80 74 45 30 17 Whooping Cough 183 74 139 82 108 10 5 55 27 7 1267 200 1074 344 900 306 762 148 1064 163 Tuberculosis Pulmonary 65 40 36 44 50 25 26 26 34 22 Non-Pulmonary 1 7 4 6 2 1 5 3 5 2 51 TUBERCULOSIS During the year 49 new cases were added to the register of tuberculous persons compared with 66 in 1961 and 56 in 1960. Of the 49 additions 24 were primary notifications, 24 were transferred from other areas, and I was an un-notified death. An analysis of the notifications received is given overleaf. One hundred and fifty-nine cases were removed from the register for the following reasons:- Pulmonary Non-Pulmonary M. F. M. F. Deaths from tuberculosis 2 2 - - Deaths of patients suffering from tuberculosis through other causes 8 2 1 - Recovered cases 16 13 1 2 Removals from district 47 42 13 10 73 59 15 12 New notifications of pulmonary tuberculosis amounted to 22 cases, the lowest figure recorded for Wimbledon and compares with 34 cases in 1961 and an average of 27 in the last five years. The notification rate was 0.38 per thousand of the population, the same as for England and Wales. Deaths from all forms of tuberculosis amounted to 4 compared with 3 last year giving a death rate per thousand population of 0.07 the same as for England and Wales. While fluctuations are bound to occur in dealing with relatively small numbers, on the average the local death rate tuberculosis has steadily declined, as it has nationally. The Council is responsible for rehousing, one of the most important measures in the prevention of this disease, and also for disinfection. Treatment for cases of tuberculosis is the responsibility of the Regional Hospital Board, who provide both sanatorium and dispensary treatment. Vaccination against tuberculosis with B.C.G. is offered to all 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. 52 PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS 1925 PUBLIC HEALTH ACT 1936 (Section 172) During 1962 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 TUBERCULOSIS 1962 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- 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 " 2 - - - - - - - 2 - - - - - - - 15 - 19 " - — — — - 1 - - - 1 - - - 2 - - 20 - 24 " 2 — 1 — 2 — - - 4 - - 1 - - - - 25-29 " 1 - - - 1 2 2 - 2 2 2 - - - - - 30 - 34 " — — — - 3 1 — — 3 1 — - - - - - 35 - 44 " 1 2 - - 3 4 - - 4 6 - - 1 - - - 45-54 " 4 2 — — 3 - - - 7 2 - - 2 - - - 55 - 64 " 3 - - - 1 1 - - 4 1 - 2 - - - 65 and Over 3 2 - 1 - - - - 3 2 - 1 5 2 1 - Age not known - - - - 1 - - - 1 - - - - - - - 16 6 1 1 14 9 2 - 30 15 2 2 10 4 1 - 22 2 23 2 / 45 4 14 1 24 25 49 15 54 TUBERCULOSIS: The following table shows the number and types of cases on the register at December 31st for the last 10 years. Year Pulmonary N on-Pulmonary Total No.on Register at 31st December Male Female Male Female 1953 285 292 40 36 653 1954 287 274 39 32 632 1955 262 226 31 27 546 1956 270 222 32 28 552 1957 274 219 30 24 547 1958 274 209 29 25 537 1959 257 193 29 27 506 1960 228 189 29 26 472 1961 230 171 31 19 451 1962 188 217 18 8 341 55