AC 4413(1) II WIM 36 Borough of Wimbledon Public Health Department ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR ENDED 31st DECEMBER 1963 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH 1963 Public Health Department, Town Hall, Wimbledon, S.W.19. (WIMbledon 6262) September 1964 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 1963. This Report is compiled in accordance with the instructions contained in Circular 1/64 of the Ministry of Health, and is on similar lines to previous years. The Report shows 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. The Registrar General's estimated mid-1963 home population 56,980 shows an increase of 130 over 1962. Apart from an increase of 10 in 1960, this is the first increase in population noted by the Registrar General, in respect of Wimbledon since 1952, there having been a gradual but steady decline in the population since that date. Live births numbered 951 giving a birth rate of 15.84 per thousand of the population which compares with 930 births and a birth rate of 15.85 in 1962. Of the 951 births, 66 or 7% were illegitimate. The live birth rate for England and Wales for the year was 18.2. Deaths from all causes numbered 748 as against 706 last year, giving a death rate per thousand of the population of 11.54 compared with 10.39 in 1962 and 12.2 for England and Wales. The excess of births over deaths was 203 compared with 174 in the previous year. (i) Deaths of infants under one year numbered 25 giving an infantile mortality rate of 26.28 per thousand live births. This compares with a rate of 21.1 for England and Wales, the lowest figure on record. There were no maternal deaths. Deaths from a11 forms of cancer showed an increase, numbering 146 compared with 131 in 1962, and was the second greatest cause of death. Although deaths from diseases of the heart and circulatory system showed a small decline - 270 compared with 293 in 1962 - it was still the principal cause of death, and accounted for 36% of the total deaths. Deaths from cancer of the lung increased to 40 as against 32 in 1962 and followed the usual pattern with the greater proportion of deaths (33) occurring in males. The position with regard to tuberculosis was particularly gratifying in that only 14 new cases of pulmonary tuberculosis were notified during the year, the lowest figure on record. This is of particular note as this low figure follows the substantial fall in new cases mentioned in my report last year. There was a slight increase in deaths attributable to tuberculosis compared with 1962, but in recent years, with the help of modern drugs and treatment, the mortality rate has been vastly reduced. Despite this encouraging note, however, it is important to remember that the disease retains its high infectivity and intensive search for early cases must continue. Seven deaths were reported from motor vehicle accidents, this being one less than last year. All other accidents accounted for sixteen deaths which was two more than in the previous year. Suicides accounted for seven deaths, two less than in 1962. With regard to infectious disease, notifications amounted to 763 compared with 163 in 1962. The increase was due to the fact that 1963 was a "measles" year with 650 notified cases compared with 122 in 1962. There were no deaths from infectious disease. No cases of poliomyelitis were notified. For the fourteenth year in succession Wimbledon was again completely free from diphtheria, but there were cases of the disease in unimmunised children elsewhere in the country. This is still a highly dangerous disease which is always likely to reappear, and will do so if protective immunisation of children is not kept at a high level. Parents should ensure that the initial protection is given to their children in the first year of life. (ii) 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 shown to me during the year. 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 (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 14 National Assistance Act 1948 15 Mass Radiography 16 Hospitals 17 Home Help Service 17 Midwifery and Home Nursing 17 Welfare 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 Result of Service of Notices 24,25 Factories Act 1961 26 Outwork 27 SECTION D: HOUSING: Page Overcrowding 27 Rehousing 28 New houses erected, etc. 28 Rent Act 1957 29 SECTION E: INSPECTION AND SUPERVISION OF POOD: Milk - Registration and Licences 29 Milk - Sampling 30 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 it 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 1960 42 SECTION G: PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES: Notifiable Infectious Diseases, etc. 43,44,45,46,47 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. 1963 Alderman T.H. Metcalf (Chairman) Alderman George Waller 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 V.M. Green Councillor M. Price Councillor W. Reay Councillor Mrs. M.L. Seys-Phillips Councillor G.N. Smith Councillor J.A. Watson Councillor Miss E.A. Weldon, B.A. NORTH-EASTERN DIVISIONAL HEALTH SUB-COMMITTEE WIMBLEDON REPRESENTATIVES December. 1963 Alderman T.H. Metcalf (Chairman) Councillor N.E.A. Fiddes Councillor W. Reay Councillor G.N. Smith 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. Cockell, 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 D.R. Wiseman, M.A.P.H.I. M. Hughes, M.A.P.H.I. (Appointed 1.1.63) M. Jacob, M.A.P.H.I. (Appointed 1.5.63) PUPIL PUBLIC HEALTH INSPECTOR J.T. Thompson TECHNICAL ASSISTANT (CLEAN AIR) K.C. Robinson ASSISTANT RODENT OFFICER F.J. Reddington CHIEF CLERK + J.B, Richardson, A.R.I.P.H.H. CLERKS * Mrs. D. Wilson, S.R.N. * Mrs. V. Waters J.R. Gill + Miss I.D. Farrow (Appointed 1.1.63) * Miss A. Slanzi (Appointed 7.1.63) Mr. C.C. Russell (Appointed 30.12.63) A.J. Burke * Miss M.T. McCormick + Officer of the Surrey County Council. In part-time employment of the Wimbledon Borough Council. * Officer of the Wimbledon Borough Council. In parttime employment of the Surrey County Council. - 2 - SECTION A - STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres - Census, 1961) 3,212 Population (Census, 1961) 57,312 Home Population (mid-1963) 56,980 Number of occupied dwellings:- 1931 (Census) 13,325 1951 (Census) 16,047 1961 (Census) 17,566 Number of private households) 1931 (Census) 15,883 1951 (Census) 19,185 1961 (Census) 19,947 Rateable Value:- £3,566,873 Sum represented by penny rate:- £14,280 Extracts from Vital Statistics of the Year 1963 (Registrar-General's Figures) Total M. F. (Legitimate 885 464 421 Live Births (Illegitimate 66 35 31 (Total 951 499 452 (Legitimate 13 5 8 Stillbirths (Illegitimate 3 - 3 (Total 16 5 11 Live births rate per 1,000 of the estimated home population 16.68 Corrected live birth rate per 1,000 of the estimated home population 15.84 Still-birth Rate per 1,000 total (live and still) births 16.54 Total M. F. Deaths 748 344 404 - 3 - Crude Death Rate per 1,000 of the estimated home population 13.12 Corrected Death Rate per 1,000 of the estimated home population 11.54 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 26.28 Legitimate infants per 1,000 legitimate live births 27.12 Illegitimate infants per 1,000 illegitimate live births 15.15 Deaths from cancer 146 " " diphtheria Nil " " poliomyelitis Nil " " 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 1963 PROVISIONAL FIGURES BASED ON QUARTERLY RETURNS OF REGISTRAR-GENERAL Wimbledon England and Wales Rates per 1,000 Home Population Births:- Live Births 15.84 18.2 Still Births 0.26 0.31 16.54 * 17.2 * Deaths:- All Causes 11.54 12.2 Coronary and arteriosclerotic heart disease 2.82 2.29 Whooping Cough – 0.00 Diphtheria – 0.00 Tuberculosis - all forms 0.14 0.06 Influenza 0.12 0.07 Smallpox – 0.00 Acute Poliomyelitis (including Polioencephalitis) – 0.00 Pneumonia 0.89 0.78 Malignant Neoplasm - Lung, Bronchus 0.70 0.52 Maternal Mortality – 0.28 * Rates per 1,000 Live Births Deaths:- Infant Deaths (all causes under 1 year) 26.28 21.1 Diarrhoea and Enteritis (under 2 years) – 0.53 * Per 1,000 total (live and still) births. - 5 - CORRECTED NOTIFICATIONS FOR CERTAIN INFECTIOUS DISEASES 1963 Wimbledon England and Wales Rates per 1,000 Home Population Notifications:- (Corrected) Scarlet Fever 0.66 0.37 Whooping Cough 0.40 0.73 Typhoid and Paratyphoid Fever – 0.01 Meningococcal Infection 0.01 0.01 Acute Encephalitis 0.01 0.00 Diphtheria – 0.00 Erysipelas – 0.03 Smallpox – – Measles 11.40 12.78 Pneumonia 0.19 0.30 Acute Poliomyelitis Paralytic – 0.00 Non-paralytic – 0.00 Food Poisoning 0.03 0.12 Dysentery 0.47 0.67 Ophthalmia Neonatorum – 0.02 Tuberculosis Pulmonary 0.24 0.34 Non-pulmonary 0.05 0.05 Puerperal Pyrexia 10.34 * 7.44 * * 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, 56,980, shows an estimated increase of 130 on the previous year. The natural increase by excess of births over deaths was 203. All rates used in this report sure based on the Registrar-General's figures. BIRTHS The statistics supplied by the Registrar-General show that during the year 1963, the total number of registered live births belonging to Wimbledon was 951. Of this number 499 were males and 452 females. This gives a birthrate of 16.68 per thousand of the population as compared with a rate of 16.35 per thousand in 1962, and an average of 15.76 in the last five years. A comparability factor has been supplied by the Registrar-General which enables the birthrate for Wimbledon to be compared with that for England and Wales. The corrected birthrate for Wimbledon in 1963 was 15.84 per thousand of the population, whilst the rate for England and Wales was 18.2 and has averaged 17.4 over the past five years. STILLBIRTHS - The number of stillbirths registered during the year was 16 (5 males and 11 females), this being 3 more than last year. The stillbirth rate for Wimbledon was 0.26 per thousand of the population, whilst that for England and Wales was 0.31. Illegitimacy - Of the live births registered in 1963, 66 (35 males and 31 females) were illegitimate, the same number as in the preceding year. Three of the 16 stillbirths registered were illegitimate. DEATHS The total number of Wimbledon residents who died during 1963 was 748 (344 males and 404 females), giving a death-rate of 13.12 per thousand of the population as compared with 13.29 per thousand for 1962. The corrected death-rate for 1963 was 11.54 per thousand as compared with a rate of 12.2 per thousand for England and Wales. The number of Wimbledon residents who died outside the Borough was 356, whilst 323 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 270 36% Cancer 146 19% Vascular lesions of nervous system 96 11% Diseases of the respiratory system 109 14% 621 80% The following is an analysis of the causes of death:- Males Females Total 1. Respiratory tuberculosis 4 2 6 2. Other tuberculosis - 2 2 3. Syphilitic disease - 1 1 4. Diphtheria - - - 5. Whooping Cough - - - 6. Meningococcal infections - - - 7. Acute poliomyelitis - - - 6. Measles - - — 9. Other infective and parasitic diseases 4 — 4 10. Malignant neoplasm, stomach 6 10 16 11. Malignant neoplasm, lung, bronchus 33 7 40 12. Malignant neoplasm, breast - 9 9 13. Malignant neoplasm, uterus - 7 7 14. Other malignant and lymphatic neoplasms 32 35 67 15• Leukaemia 3 4 7 16. Diabetes 2 3 5 17. Vascular lesions of nervous system 33 63 96 18. Coronary disease, angina 92 69 161 19. Hypertension with heart disease 3 6 9 20. Other heart disease 14 48 62 21. Other circulatory disease 13 25 38 22. Influenza 2 5 7 23. Pneumonia 18 33 51 24. Bronchitis 32 14 46 25. Other diseases of respiratory system 4 2 6 26. Ulcer of stomach and duodenum 3 1 4 27. Gastritis, enteritis and diarrhoea 4 2 6 28. Nephritis and nephrosis - 2 2 29. Hyperplasia of prostate 7 - 7 30. Pregnancy, childbirth, abortion - - - 31. Congenital malformations 8 2 10 32. Other defined and ill-defined diseases 14 34 48 33. Motor vehicle accidents 2 5 7 34. All other accidents 7 9 16 35• Suicide 3 4 7 36. Homicide and operations of war 1 - 1 344 404 748 - 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 0.28. The following table sets out the number of deaths and death rates per thousand total live and stillbirths for 1963:- Number of Deaths Rate ENGLAND AND WALES Maternal causes, excluding abortion 195 0.22 Due to abortion 49 0.06 Total maternal mortality 244 0.28 The estimated mid-1963 female population for England and Wales age 15 - 44 was 9,371,200. As stated there were no maternal deaths in Wimbledon during 1963. INFANTILE MORTALITY During 1963 there were 25 deaths among infants under one year of age, compared with 13 in 1962, and an average of 17 in the last five years. One of the deaths was in respect of an illegitimate child. The resultant infant mortality rate for Wimbledon per thousand live births was 26.28 compared with 13.97, 14.57, 19.20 and 23.64 in the previous four years. The infant mortality rate for England and Wales in 1963 was 21.1 the lowest figure ever recorded. Nine of the 25 deaths were due to prematurity and atelectasis, 5 were due to congenital defects or birth injuries and 6 deaths were due to pneumonia. One child died from congenital heart disease, one, who was a mongol, from heart failure, one from acute asthma and another from tonsillar sarcoma. The remaining death was due to haemophilous influenzal meningitis. The number of neo-natal deaths (i.e. those occurring during the first four weeks of life) was 16, giving a neo-natal death rate of 16.8 per thousand live births, as compared with a rate of 14.2 for England and Wales. - 9 - The perinatal death rate (i.e. stillbirths and deaths of infants under 1 week) was 32.0 per thousand live and stillbirths, while that for England and Wales was 29.3. 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 25 infant deaths in Wimbledon, 15 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 25 infant deaths which occurred during 1963, together with the age at death. Under 1 week 2-3 weeks Total under 4 weeks 1-3 months 3-6 months 6-9 months 9-12 months Total deaths under 1 year Congenital defect or birth injury 4 1 5 - - - - 5 Prematurity and atelectasis 9 — 9 - - - - 9 Acute asthma - - - - 1 - - 1 Pneumonia 1 - 1 3 1 - 1 6 Tonsillar sarcoma - - - 1 - - - 1 Congenital heart disease — - — 1 - - - 1 Heart failure - - - 1 - - - 1 Haemophilous influenzal meningitis 1 - 1 - - - - 1 Totals 15 1 16 6 2 - 1 25 - 10 - INFANTILE MORTALITY DURING THE LAST lO YEARS Cause of death 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 Prematurity and atelectasis 5 2 1 3 7 14 3 7 7 9 Congenital defects or birth injuries 5 5 5 3 6 4 5 5 3 5 Diseases of the newborn - - - - 1 - - - — — Tonsillar sarcoma - - - - - - - — — 1 Embryoma of liver - - - - - - 1 - - - Pneumonia 1 2 2 1 1 1 4 - 2 6 Bronchitis - - - 1 - - - — - - Acute nephritis - - - - - - 1 - - - Septicaemia - - 1 - - - - - - - Asphyxia (unknown cause) - - - 1 - - - - - - Accidental death 1 2 - - - - 1 1 - - Acute asthma - - - - - - - - - 1 Inattention at birth - - 1 - - - 1 - - — Bilateral pneumothorax - - - - - 1 - - - - Congenital heart disease - - - - - - - - - 1 Heart failure - - - - - - - - - 1 Pyelonephritis - - - - - - 1 - - - Haemophilous influenzal meningitis - - - - - - - - - 1 Collapse of lung - - - - - - - - 1 - 12 11 10 9 15 20 17 13 13 25 Total neo-natal deaths included above 11 8 7 a 12 18 14 10 10 16 - II - SUKMART OF STATISTICS The following table shows the birth-rates and death-rates for Wimbledon as compared with England and Wales since 1944 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. 4 W. Wim. E. & W. Wim. E. &W. Wim. E. & W. Wim. E. & W. 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 O.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 1963 15.84 18.2 0.26 0.31 11.54 12.2 — 0.28 26.28 21.1 12 *From 1944 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 OP 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 year: . Nose and throat swabs 71 Faeces for the typhoid and dysentery groups 512 Ice-cream samples 67 Milk samples 105 Water samples 74 Miscellaneous 2 831 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 were carried out during the year at the Royal Institute of Public Health and Hygiene Laboratory, Queen Square, W.C.I, but this arrangement was discontinued at the end of the year and future examinations will be done at the Public Health Laboratory at Epsom. - 13 - PUBLIC HEALTH ACT 1936. PART IV - NURSING HOMES New legislation affecting Nursing Homes was introduced during the year when the Nursing Homes Act 1963 received the Royal Assent on 15th May, 1963. The Act empowers the Ministry of Health to make regulations strengthening the powers of local authorities relating to the registration of Nursing Homes under the Public Health Act 1936, and also provides that certain institutions not carried on for profit, which were formerly exempted from registration, shall cease to be exempted from 15th May, 1964* In pursuance of his powers under the Act, the Minister had made the Conduct of Nursing Homes Regulations 1963, which came into operation on 27th August, 1963. The Wimbledon Borough Council is responsible for the registration and supervision of Nursing Homes in the Borough. Seven visits of inspection were made during 1963. No new Nursing Homes 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. The position at the end of 1963 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 Nil Nil Nil Nil 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 byelaws 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. The powers available under these Acts are only invoked in extreme cases as the efforts of the Public Health Department and the social services are used in the first place to help maintain old people in their own homes. However, in cases where they are clearly unable to look after themselves they are usually persuaded to go into a Home or Hospital. If persuasion fails, and there appears to be no other possible solution it is only then that recourse is made by the Court. During 1963 it was fortunately not necessary for the Council to make application to the Court for any Orders for compulsory removal although a number of borderline cases were dealt with by the Department. The facilities available for the elderly continue to develop and improve. For those who are relatively fit in body and mind, clubs and recreational facilities are provided by voluntary organisations. For those who are less fit, the services of Home Helps, District Nurses, and Health Visitors are available to help the old people to maintain themselves In their own homes. The "Meals on Wheels" service is one of the many excellent services provided by the Guild of Social Welfare and the laundry service for incontinent patients which was recently introduced by the Council is proving of great value as it reduces the burden on relatives and enables 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. The last survey was carried out during December. 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 1958 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 464 363 827 2 1 3 6 - 6 Raynes Park 363 335 698 2 1 3 6 - 6 NORMAL MASS RADIOGRAPHY SERVICE Site Number x-rayed Significant Pulmonary Tuberculosis Primary Lung Cancer Male Female Total Male Female Total Male Female Total Wimbledon 3527 2503 6030 8 2 10 1 1 2 - 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. Horns Help Servicc 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 ae 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 Friday afternoons (Midwives Clinic) 30 Kings Road 2nd & 4th Thursday afternoons and Wednesday 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 -18- 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 (3rd in month) Health Centre, Pelham Road Tuesday mornings Russell Road Clinic Saturday mornings (1st in month) 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 Clinic 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 Friday mornings Amity Grove Clinic, Raynes Park Tuesday afternoons Relaxation and Mothercraft Russell Road Clinic Wednesday afternoons Amity Grove Clinic, Raynes Park Thursday 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 Hygienist'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 Tuesday 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 Audlology Clinics Russell Road Clinic Wednesday mornings (1st, 3rd 4 4th in month) Alternate Friday mornings Amity Grove Clinic, Raynes Park Tuesday 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 quality. With five exceptions all the dwelling houses in Wimbledon are supplied from public water mains direct to the houses. During the year 1963, samples of water were taken for bacteriological and/or chemical analysis, as follows Bacteriological Public Swimming Baths 56 Dwelling houses:- Metropolitan Water Board supply 12 Well water 8 20 Other premises Metropolitan Water Board supply 1 77 One sample 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 Other premises Metropolitan Water Board 1 This sample of water proved chemically satisfactory. Other information appertaining to water supplies, required by Ministry of Health Circular 1/64 was contained in the Annual Report 1962. - 21 - 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 There are no registered conmon 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 1963:- Complaints received General disrepair and insanitary conditions 242 Dampness 63 Overcrowding 23 Defective drainage systems 43 Blocked drainage systems 219 Defective drainage fittings 32 Defective W.C. pans and/or flushing apparatus 42 Defective service water pipes 8 No water supply 46 Absence of or defective dustbins 18 Accumulations of refuse, etc. 66 Rats and mice 244 Pigeons 10 Insect pests, etc. 157 Smoke nuisances 52 Unsound food 106 Noise 24 Miscellaneous 69 Smells and odours 81 1,545 Vlsit3 made Infectious diseases Inquiries re cases of infectious disease 223 Miscellaneous 88 Housing Dwelling houses (Housing Act) 153 Dwelling houses (Public Health Act) 1,956 Rent Act 1957 51 - 22 - Underground rooms 33 Multi-let houses 79 Overcrowding 132 House Purchase & Housing Act 1959 135 Movable dwellings 29 Miscellaneous 205 Food & Food Premises Dairies and milk distributors 23 Ice-cream premises 66 Bakehouses 27 Butchers' shops 75 Meat preparation premises 22 Fish shops 35 Fried fish shops 23 Restaurant kitchens 122 Licensing Act 1961 25 Other food premises 396 Visits re unsound food 203 Sampling: food and drugs143 Sampling: milk 145 Sampling: ice-cream 67 Samplings water 100 Miscellaneous 323 General Places of public entertainment 4 Drainage and plumbing work 1,410 Stables and piggeries 11 Nat. Survey of Air Pollution 1,499 Smoke Control Areas 6,291 Other Clean Air Act Visits 341 Pet Animals Act, 1951 4 Factories (P.) 132 Factories (N.P.)38 Factories (Building Sites) 36 Workplaces 1 Outworkers' premises 2 Shops Act 1950 (Vent.Temp.etc.) 6 Shops Act 1950 (Shop hours) 28 Hairdressers and barbers 4 Diseases of Animals Acts 8 Petroleum (Consol.)Act 1928 215 Noise Abatement Act I960 89 Pigeon Nuisances 25 Rodent Control 4,104 Insect Infestations 211 Refuse storage 115 Accumulations 359 Miscellaneous 424 20,256 - 23 - RESULT OF SERVICES OF NOTICES (!1) Legal Proceedings (a) Proceedings were instituted against the owner of a dwelling house for failing to comply with an Abatement Notice (Public Health Act, 1936: Section 93). The defendant, who pleaded not guilty, was fined £2.0.0. with £3.3.0. costs. (b) Proceedings were instituted against the owner of a dwelling house for failing to give information as to his interest in the property (Public Health Act 1936: Section 277). The defendant was fined £2.0.0. and no Order was made for costs. (c) Proceedings were instituted against the owners of shop premises for failing to comply with a Court Order to prevent a recurrence of a nuisance arising from accumulations of trade refuse in a yard space. The defendants pleaded not guilty and were fined £5.0.0. with £5.5.0. costs. (d) Proceedings were instituted against the owners of a dwelling house for failing to comply with an Abatement Notice (Public Health Act, 1936: Section 93). The Notice was complied with after the Summons had been issued and the defendants were ordered to pay £10.10.0. costs. (e) Proceedings were instituted against the owner of a dwelling house for failing to give information as to his interest in the property (Public Health Act 1936: Section 277). The defendant was fined £5.0.0. with £3.3.0. costs. (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 Reconstructed61 Cleansed 97 Soil pipes and ventilating shafts repaired or renewed 14 Inspection chamber covers renewed 20 Fresh air inlets repaired or renewed 10 New W.C. pans provided 29 Water waste preventors repaired or renewed 26 Gutters and rainwater pipes repaired or renewed 69 New lavatory basins provided 8 New baths provided 2 New glazed sinks provided 4 Waste pipes trapped, repaired or renewed 27 Miscellaneous55 General housing repairs Roofs repaired 77 Yards paved or repaired 5 - 24 - Damp proof courses provided 11 Dampness otherwise remedied 96 Walls and ceilings repaired/constructed132 Walls and ceilings cleansed 74 Floors repaired or renewed 31 Windows repaired or renewed 108 Doors repaired or renewed 22 Fireplaces repaired or renewed 10 Service water mains repaired 27 Additional light and ventilation provided 26 Miscellaneous 117 Food premises Shops constructed 1 Walls and ceilings repaired or redecorated 90 Floors renewed or repaired 13 Woodwork repaired or repainted 4 Sinks provided 4 Hot water provided to sink 7 First Aid Kit provided or improved 21 Water supply provided 13 Risks of contamination removed 46 Outdoor clothing store provided 6 Refuse storage improved 5 Wash-hand basins provided 11 Hot water provided to wash-hand basins 19 Soap provided 13 Nailbrush provided 20 Clean towels provided 15 Sanitary accommodation repaired/cleansed/provided 10 Lighting in sanitary accommodation provided 9 Hand washing notices fixed 26 Miscellaneous 10 Rodent Control Defects remedied in connection with ratproofing work are included in foregoing lists. Miscellaneous Insanitary houses cleared and disinfected/disinfested 4 Accumulations removed 31 New' dustbins provided 20 - 25 - FACTORIES ACT 1961 - PART I 1. Inspection for Purposes of Provisions as to Health Premises Number on Register Number of Inspections Written Notices Prosecutions Factories without mechanical power 40 38 3 - Factories with mechanical power 293 132 12 - Other premises under the Act (including works of building and engineering construction but not including outworkers' premises) 22 37 4 - Totals 355 207 19 - 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) 7 7 — — — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7)sInsufficient — — — — — Unsuitable or defective 40 39 — 1 — Not separate for sexes 3 6 — — — Other, offences (excluding offences relating to outwork — — — — — Totals 50 52 — 1 — - 26 - PART VIII OUTViJORK - SECTIONS 133 & 134 Nature of work Section 133 Section 134 No. of outworkers in August list required by Sec. 133(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 19 - - - - - Others - - - - - - Totals 19 - - - - - Number of addresses received from other Councils 51 Number of addresses forwarded to other Councils 34 Number of premises where outwork was carried on at the end of 1963 129 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 8 (ii) Number of families dwelling therein 10 (iii) Number of persons dwelling therein 46 - 27 - (b) Number of new cases of overcrowding reported during the year 12 (c) (i) Number of cases of overcrowding known to have been relieved during the year 18 (ii) Number of persons concerned in such cases 73 (d) Number of cases in which dwellinghouses 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, 1963:- Number of prefabricated bungalows provided since the end of the war 71 (At the end of 1963, 27 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 2,665 Number of live applications on the housing list at 31.12.63. 795 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 1963s- Private enterprise106 Local Authority 6 Number of flats created by conversion in 1963:- Private enterprise 22 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, 1963:- Applications for Certificates of Disrepair (Form I) 262 Applications withdrawn by applicants 16 Forms J sent to landlords 241 Undertakings given by landlords (Form K) 135 Certificates of Disrepair issued (Form L) 101 Applications for Cancellation of Certificates of Disrepair (Form M) 96 Certificates of Disrepair cancelled 63 Number of visits made during 1963 in connection with the Rent Act 1957- 51. 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 UK. MILK (SPECIAL EESIGNATION) 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 30 Pasteurised Milk 35 Sterilised Milk 31 - 29 - During the year 105 samples of designated milk were submitted for statutory tests. The results were as follows Designation Satisfactory Void Unsatisfactory Pasteurised 63 Nil 1 Tuberculin Tested (Pasteurised) 17 Nil 1 Sterilised 7 Nil Nil Tuberculin Tested (Farm bottled) 9 3 4 In 3 instances the methylene blue test was not carried out on samples of T.T. Farm bottled rrdlk due to the fact that the stipulated atmospheric shade temperature (70 F.) was exceeded. ICE-CREAM During the year 67 samples were submitted for bacteriological examination. The results were as follows Grade 1 53 Grade 2 4 Grade 3 6 Grade 4 4 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's licences were issued under the provisions of the Slaughter of Animals Act 1958, during the year 1963. 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. 1,795 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 I960, 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 62 Confectioners 139 Ice-Cream premises 190 Bakers 34 - 30 - Grocers 119 Provision Dealers 87 Butchers 41 Fishmongers 21 Milk distributors 44 Chemists 20 Licensed premises 71 Clubs 29 Restaurants and Cafes 74 Works canteens 19 School canteens 50 Kitchens (Hospital and Central Kitchens) 5 Food stalls/vehicles 15 Places of public entertainment 19 1,039 The number of food premises registered in accordance with Section lb of the Act is as follows:- Registered for the storage and sale of ice-cream 154 Registered for the manufacture and sale of ice- cream 1 Registered for the preparation or manufacture of sausages 33 Registered for the preparation or manufacture of potted, pressed, pickled or preserved food 41 The number of inspections of registered food premises during 1963 was 209. 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 1963. Cwts. Qrs. 1bs. Canned meat 2 3 0 Canned soup - - 12 Canned fish - - 2 Canned vegetables - 1 2 Canned fruit 1 3 25 Canned puddings - - 2 - 31 -  Cwts. Qrs . lbs. Miscellaneous cans - - 19 Meat, bacon, poultry 6 1 13 Vegetables and fruit 3 1 12 Frozen food 64 3 1 Jam - - 8 Cake - - 4 Cheese - - 1 79 Cwts. 3 Qrs. 17 lbs. The number of complaints received during the year regarding unsound food was 106. 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 one instance 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 Foreign matter in loaves of bread (3) Glass in packet of dates Foreign objects in sack of haricot beans Stone in loaf of fruit whole-meal bread Foreign matter in canned grapefruit Insect in can of peach slices Mould growth on packeted muffins Paper in fruit malt loaf Rubber band in portions of cheese spread Foreign matter in packet of frozen peas Mould growth on custard tarts Fly in packet of prepacked bacon rashers Mould growth in pork pies (3) Mould growths on wrapped loaves of bread (2) Foreign matter in bottles of milk (3) Piece of lead in cornish pasty Mould growth in packet of oats Mould growth on fruit pie Foreign matter in cooked sausage (salami) Piece of wood in packet of biscuits Foreign matter in bread rolls Mould growth in sausage roll Insect in sliced wrapped loaf of bread Mould growth in steak and kidney pie * Cigarette end in consignment of meat Foreign object in jar of pickled gherkins * Denotes legal proceedings taken. - 32 - SAMPLING OF FOOD AND DRUGS The following samples were submitted to the Public Analyst during 1963, with the results shown:- Articles Total Formal Informal Genuine Non genuine or Irregular Apple cider vinegar and pure honey 1 1 - 1 - Apricot wine 1 1 - 1 - Arrowroot 1 - 1 1 — Bacon rashers 1 1 - 1 — Beef goulash 1 - 1 1 - Beef sausages 1 1 - 1 - Beef suet, shredded 1 - 1 1 — Cheese spread with lobster 1 1 - 1 - Cherry wine 2 2 — 1 1 Chestnuts, canned 1 - 1 1 - Chicken capri 1 1 - 1 Chicken and ham pie 1 1 — 1 — Chicken and mushrooms in white sauce 1 1 - 1 - Clam chowder soup 1 - 1 1 - Cocktail gherkins 1 - 1 - 1 Coconut oil 1 1 — 1 — Cod roe 1 - 1 1 - Condensed milk 1 1 — 1 - Confectionery (flour) 3 3 - 3 — Confectionery (sugar) 3 2 1 3 - Corned beef 1 1 — 1 — Cream sherry 2 2 — - — Custard powder 1 1 - 1 - Dried apricots 1 1 - 1 — Dried pears 1 1 - 1 - Dutch honey cake 1 1 - 1 - Egg and bacon breakfast 1 1 — 1 — Eucalyptus and menthol pastilles 1 1 - 1 - Frozen chopped spinach 1 1 - 1 - Frozen sliced apples 1 1 - 1 - -33- Gambo in vinegar 1 1 - - 1 Gin 2 2 — 2 — Glycerin and thymol pastilles 1 1 - 1 - Ground almonds 1 1 - 1 - Ground nut oil Herring fillets in 1 1 - 1 - lobster sauce 1 1 — 1 - Honey 1 — 1 1 — Honey chocolate 1 — 1 1 — Ice lolly syrup 1 1 - 1 — Instant decaffinated coffee 1 - 1 1 - Instant orange juice drink 1 - 1 1 - Jam 1 1 - 1 - Jelly 1 - 1 1 — Lemon glucose drink 1 1 — 1 — Malt vinegar 1 1 - 1 — Margarine 1 1 - 1 - Marmade 1 — 1 1 - Milk 40 40 — 40 — Milk shake cordial 1 1 — 1 - Mint in vinegar 1 1 - 1 — Mushroom ketchup 1 - 1 1 — Nesquick (Strawberry flavour) 1 1 - 1 - Pheasant consomme with sherry wine 1 - 1 1 - Pickle 1 — 1 1 — Pork brawn 1 1 - 1 - Pork sausages 2 2 - — Prawn pickle 1 1 - 1 — Raspberry and rose hip syrup 1 1 - 1 Redcurrant syrup 1 - 1 1 — Rice sticks 1 - 1 1 — Rich ruby wine 2 2 - 2 - Risotto 1 — 1 1 - Risotto savory rice 1 - 1 1 - Salmon fishcakes 1 1 - 1 — Sauce madere 1 - 1 1 — Scampi savoury 1 - 1 1 — Seeded raisins 1 1 - 1 - Shandy (lemonade and beer) 1 - 1 1 — Sherry 2 2 - 2 - Sliced shrimps 1 - 1 - 1 Slimming tablets 1 - 1 1 — -34- Smoked salmon mayonnaise 1 - 1 1 - Steak and kidney pie 2 2 — 2 - Stewed steak in rich gravy 1 1 - 1 - Stuffed cabbage 1 - 1 1 - Tarragona vinegar 1 - 1 1 - Tarragona wine 2 2 - 2 - Than blanc caasegrain 1 - 1 - 1 Tomato fritter mixture 1 1 - 1 — Whisky 4 4 - 4 - Wine biscuits 1 1 — 1 - Totals 135 105 30 129 6 The following samples were submitted for special examination:- Articles Total Formal Informal Genuine Non Genuine or Irregular Bread loaf, cut wrapped 1 - 1 - 1 Bread rolls 1 — 1 — 1 Cheese 3 - 3 1 2 Gherkins 1 - 1 — 1 Milk 1 - 1 — 1 Milk (bottles) 1 — 1 — 1 Pork pies 1 - 1 - 1 .Sausage, sliced cooked 1 - 1 - 1 Sausage roll 1 - 1 - 1 Wholemeal loaf 1 - 1 - 1 Totals 12 - 12 1 11 -35- It will be seen that adverse reports were received upon seventeen samples and following is a brief account of the action taken in respect thereof:- CHERRY WINE This was a sample of un-distilled, fermented liquor made with grape juice as a fruit basis. It was not made from cherry juice and the wording of the label appeared to be misleading. After correspondence the wording on the label was amended. CHICKEN CAPRI This sample consisted of a tin containing chicken and other meat, including fat. The Public Analyst was of opinion that the description 'Chicken Capri' was not suitable for this article. As a result of correspondence with the manufacturers, new labels were produced. COCKTAIL GHERKINS This sample consisted of gherkins, vinegar, sugar, salt, spices and caramel. These ingredients were not correctly described on the label and after correspondence with the manufacturers, a new label was produced. GAMBO IN VINEGAR This was a sample of red peppers in dilute acetic acid. The article was not described by its common or usual name 'red peppers' and the fact that it contained artificial vinegar was not disclosed on the label. After correspondence with the State of Israel Food Inspection Service, the matter was referred to the Ministry of Agriculture, Fisheries and Food. The matter was satisfactorily concluded between the two Ministries. SLICED SHRIMPS This sample consisted of gelatinised tapioca flour flavoured with comminuted shrimps and seasoning. The description on the label did not comply with the Labelling of Food Order, 1953. After correspondence with the importers, a new label was produced. THON BLANC CASSEGRAIN This was a sample of canned tunny fish with added salt. It did not bear a statement on the label specifying the common or usual name of the food, and the ingredient salt was not mentioned on the label. After correspondence with the importers and vrLth the Ministry of Agriculture, Fisheries and Food, it was agreed that new labels would be substituted when the present stock of labels was e:xhau3ted. -36- BREAD CONTAINING FOREIGN MATTER This sample consisted of eight slices of bread containing streaks of dark grey matter which was found to be mainly mineral oil. A warning letter was sent to the bakery firm concerned. BREAD ROILS CONTAINING FOREIGN MATTER The foreign matter in this case was a small brown stone which was Identified as charred dough. A warning letter was sent to the bakery firm concerned. CHEESE Two samples of Canadian Cheddar cheese were the subject of a complaint. The cheese was found to be rancid but there was no indication that the rancidity had developed since manufacture. It was not considered to be unfit for food but the Public Analyst's observations were passed to the wholesale firm concerned. GHERKINS A jar of pickled gherkins was the subject of a complaint and the jar was found to contain a rubber finger stall. The matter was taken up with the importers and steps were taken to prevent a recurrence of the incident. MILK This sample which was the subject of a complaint contained a fungal growth due to improper washing of the bottle. A very thorough investigation was carried out by the dairy firm concerned and steps were taken to prevent a recurrence. MILK BOTTLE A dirty milk bottle which was the subject of a complaint was found to contain an insoluble white powder. This appeared to be due to improper washing of the bottle and the matter was taken up with the dairy firm concerned. PORK PIE An individual pork pie which was the subject of a complaint was found to contain mould growth. A warning letter was sent to the vendor of the pies and arrangements were made for proper rotation of stock. COOKED SAUSAGE This sample of cooked sausage, vhich was the subject of a complaint, appeared to contain foreign matter. The Public Analyst's report indicated that the matter was a natural ingredient of the sausage and no further action was taken. -37- SAUSAGE ROLL A sausage roll which was the subject of a complaint was found to contain mould growth. Steps were taken to prevent a recurrence. WHOLEMEAL LOAF A fruit wholemeal loaf which was the subject of a complaint was found to contain foreign matter consisting of sandy siliceous matter. Steps were taken to prevent a recurrence. OTHER LEGAL PROCEEDINGS (1) A number of unlabelled tins of food offered for sale in a supermarket were the subject of legal proceedings. The defendants, who pleaded guilty, were fined a total of £30 with £6. 6. 0. costs. (2) Proceedings were instituted against a butchery firm for selling pieces of meat containing a cigarette end. The meat was, in fact, delivered by a firm outside Wimbledon to a school kitchen within the Borough. The defendants, who pleaded guilty, were fined £5 with £6. 6. 0. costs. -38- SECTION F - RODENT CONTROL PETROLEUM STORAGE. ETC. PREVENTION OF DAMAGE BY PESTS ACT 1949 The table below sunmarises surface rodent control work which was carried out during 1963. 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 1963, 145 manholes were baited and only 1 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 Notification Survey under Act Total Rats Mice Local Authority 4 20 24 5 3 14 58 Dwellings 200 897 1097 108 56 171 2802 All other including Business Premises 54 435 489 22 22 44 1244 Totals 258 1352 1610 135 81 229 4104 -39- PEST CONTROL During the year 1963, 157 complaints were received concerning insect pests, and the following is a list of the infestations dealt with:- Ants 10 Bed bugs 22 Bees 4 Beetles 6 Cockroaches 2 Fleas 5 Flies 3 Maggots 2 Wasps 100 Woodworm 3 The incidence of wasps was again generalised during 1963, 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, complaints were received regarding pigeons and these were referred to the Pests Officer of the Ministry of Agriculture, Fisheries and Food at Guildford. PETROLEUM (REGULATION) ACTS 1928 & 1936 58 licences were issued by the Department to store petroleum spirit during 1963, and the total quantity of petroleum spirit stored was 122,595 gallons. In addition, 30 licences were issued to store petroleum mixtures involving a total of 13,139 gallons, and 3 licences were issued in respect of the storage of a total of 1224 lbs of calcium carbide. 215 visits were made to premises under the provisions of Petroleum legislation. PET ANIMALS ACT 1951 5 licences to keep pet shops were issued by the Department during 1963. 4 visits were made to these premises and any infringements of the conditions of licence were rectified. -40- CLEAN AIR ACT 1956 During the year 1963, 52 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 install a furnace to which Section 3(1) of the Act applied were received, and the installations were inspected and recorded. Legal proceedings were instituted against a Company for failing to notify the Local Authority of intention to install a furnace of maximum heating capacity exceeding 55,000 B.T.U.'s per hour. The defendants, who pleaded guilty, were fined £2 with £3. 3. 0. costs. "Prior approval" under Section 3(2) of the Act was given to the installation of 3 new oil-fired furnaces during the year. In 3 instances plans which were deposited for Building Byelaw 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 chimneys in relation to Section 10 of the Act were sent to the Borough Engineer and Surveyor. National Survey of Atmospheric Pollution 5 daily smoke filter and sulphur dioxide (volumetric) instruments are sited in approved positions in the Borough. These instruments which record smoke density and sulphur dioxide content in the atmosphere, are visited daily throughout the year and recordings are sent to the Department of Scientific and Industrial Research. The Council appointed the Chairman of the Health Committee and the Chief Public Health Inspector as their representatives to the Standing Conference convened by that Department, and comprising all co-operating bodies. The Conference met twice during the year. Smoke Control Areas Progress was made during 1963 to implement the scheme which the Council approved in 1959 to enable the making of Smoke Control Orders covering the whole of the Borough. The position on the 31st December. 1963 was as whole of the Borough. The position on the 31st December, 1963 was as follows:- Confirmed Operative date The Wimbledon Smoke Control Order 1962 (No.1) 13. 2.63. 1.12.63. „ „ „ „ „ „ (No.2) 19.11.62. 1. 6.64. „ „ „ „ „ 1963 (No.3) 7.11.63. 1.10.64. „ „ „ „ „ 1963 (No.4) Order made 12.12.63. and submitted to the Minister of Housing and Local Government. -41- At the end of the year survey was proceeding in proposed Smoke Control Area No. 5. The area covered by Orders either in operation or confirmed but not operative, or under survey, is 1,697.8 acres. The total number of dwelling houses involved in these areas is 5,873. The total number of visits made during 1963 in connection with the Clean Air Act 1956, for all purposes was 6,632. SHOPS ACT 1950 The total number of Shops Act inspections during 1963 was 34. 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 1963. 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. Four Movement Licences were issued under Orders affecting the Wimbledon area for the movement of pigs. 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 Powsrs and Duties of the Health Committee. During 1963, 24 complaints were received and 89 visits were made under the Act. -42- SECTION G - PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES During the year there were 763 cases of infectious disease notified compared with 163 in 1962 and 1,064 in 1961. The increase over 1962 was almost entirely due to the high incidence of measles, 650 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 There were no cases notified in Wimbledon during 1963, but this disease is still prevalent in some parts of the world and constant vigilance has to be maintained. From time to time notice is received of persons arriving in this country who have been in contact with smallpox. All such contacts are kept under surveillance until the possibility of developing the disease has disappeared. -43- It is recommended that children should be vaccinated against smallpox in the first two year8 of life, and this should be done preferably in the second year of life. Not only does this provide protection at least until the age of 8Chool 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 38 cases of scarlet fever notified during 1963 with 17 in 1962, 30 in 1961 and 45 in 1960. 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 100.4 F or more has occurred within fourteen days after childbirth or miscarriage. During the year 10 notifications were received, all of which occurred in hospital. Nine of the ten patients had addresses outside the Borough. In 1962 5 cases were notified. PNEUMONIA Eleven cases of acute primary or influenzal pneumonia were notified during the year, compared with 9 in 1962 and 13 in 1961. The total number of deaths from all forms of the disease during the year was 51 compared with 40 in 1962. MEASLES 650 cases of measles ware notified compared with 122 in 1962. The high incidence over 1962 illustrates how this disease is more prevalent in alternate years. The measles was mild with little by way of complications and no deaths. 301 cases occurred in children in the 5/9 age group and 312 cases in children under 5 years of age. -44- WHOOPING COUGH Whooping cough notifications showed an increase in 1963 with 23 cases compared with 7, 27, 55, 5 and 10 in the last five years. Whooping cough is one of the most serious 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 second or third month. POLIOMYELITIS During the past six years there have been only 3 confirmed cases of poliomyelitis in Wimbledon all of which occurred in unvaccinated persons. No cases occurred in 1963. This most satisfactory state of affairs indicates how effective vaccination has proved in the control of this disease. Routine vaccination against poliomyelitils is now undertaken almost entirely with oral vaccine. A high proportion of Wimbledon children have been vaccinated against poliomyelitis. MENINGOCOCCAL INFECTION One case occurred in a boy of 4 years who was admitted to hospital with initial symptoms of swollen glands of neck, severe headache and vomiting. This was notified as a case of meningococcal infection although the diagnosis was not confirmed by bacteriological examination. The rest of the family remained well. DIPHTHERIA There were no cases. Every effort is made through propaganda and other means to remind the public of the need for immunisation, but the level of immunisation is still below what is aimed at. Parents are strongly advised to have their children immunised, and it is of particular importance that the initial protection is given in the first year of life. - 45 - FOOD POISONING There were 2 confirmed cases. One of these was a baby of 11 months who was admitted to hospital with a respiratory infection, vomiting and diarrhoea. Salmonella Cholerae Suis was isolated from faecal specimens. This was an isolated case of Salmonella Cholera Suis infection which could not be related to food. In the other case the patient, a woman of 37 years suffered stomach pains, diarrhoea and high temperature after eating food at a dinner dance held outside the Borough. Stool examination revealed that she was infected with Salmonella Anaturn. This case of food poisoning was associated with other cases which occurred after the dinner dance. The outbreak was investigated in the area in which it occurred. An outbreak occurred when 37 diners and staff of a Wimbledon Hotel became ill after having eaten souffle at luncheon. Shigella Shigae, a dysentery organism, was isolated from one sample of cooked semolina forming the base of the souffle. Cultures on a sample of raw semolina were sterile. No pathogenic organisms were isolated from faecal specimens taken from members of the hotel staff. Another outbreak occurred in a Telephone Exchange canteen when 20-30 persons became ill with sickness and diarrhoea after lunch. Samples of food consumed that day were examined and all cultures were sterile. A delivery of fertilisers including bone meal, for horticultural use were delivered to the building the day before the Illness and some of this was known to have blown into the canteen kitchen from a split bag. Cultures from the bone meal yielded a moderate growth of an unidentified Salmonella. This was not considered to have caused this incident as Salmonella was not isolated from any other specimen. DYSENTERY 27 cases of dysentery were notified compared with 1 in 1962, 1 in 1961, 17 in I960, U in 1959 and 24 in 1958. There was one main outbreak which occurred in a school where a number of cases of diarrhoea were reported. Following extensive bacteriological investigation 5 pupils and the mother of one of the pupils were found to be positive for Shigella Sonnei. The patients were put under treatment and the infection cleared up over a period of several weeks. There were two other family outbreaks, one involving 6 children all of whom had symptoms of sickness and diarrhoea and were identified ae suffering from sonne dysentery on investigation. The other small family outbreak concerned 4 children, 3 of whom were admitted to hospital for treatment. There was also 1 other case associated with this family outbreak in a child of 3 years who had been in contact with this family. - 46 - The remaining cases occurred either singly or among not more than two persons in individual families in various parts of the Borough, and were unrelated to each other. 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 illnees but will spread rapidly in nurseries and schools unless quickly checked. ACUTE ENCEPHALITIS There was one case in a girl of seven years who was admitted to Hospital with initial symptoms of headache, photophobia, sickness, off food, sleepy. This was a case of encephalitis in which the virus was not isolated. The child made a good recovery. WINTER EPIDEMICS In the first week of February 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 281% of the average weekly figure. This figure increased to 319% of the average weekly figure for the week ending 12th February, 1963 but from the week ending 19th February there was a steady decline in new sickness benefit claims and by the end of February the position had returned to normal. In this heavy outbreak of Illness influenza was not specially noticeable although there was some Virus 'A1 influenza about. The medical certificates submitted to the Ministry for sickness benefit were generally for colds, bronchitis, respiratory infections, gastro enteritis and some influenza. 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 small pox, yellow fever and cholera. When completed by the medical practitioner, his signature must be authenticated by the Medical Officer of Health. During the year 821 requests were received for certificates of vaccination or inoculation to be authenticated for the purpose of travel abroad. - 47 - SMALLPOX VACCINATION Every effort is made to maintain a high level of Immunity to smallpox by vaccination of infants during their first two years, preferable 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 years- Primary vaccinations 164. Re-vaccinations 33 WHOOPING COUGH IMMUNISATION As is the case with 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 immunised 747 Number of children boosted 259 DIPHTHERIA IMMUNISATION The following table gives details of the number of children under the age of 15, who were imnunised for the first time during the year 1963, together with those who received reinforcing doses during the yeari- Under 5 years 747 Between 5 and 15 years 30 Number of children given reinforcing doses during 1963 941 - 48- 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 inmunisation is recommended. During the year 901 children received protection and 486 received a reinforcing dose. POLIOMYELITIS VACCINATION 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. Routine vaccination against poliomyelitis is new undertaken almost entirely with oral vaccine. 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. 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, but were curtailed to monthly clinics during 1964. The following table shows the position with regard to poliomyelitis vaccination at 31.12.63:- Class Number who have received a primary course of vaccination Children born in the years 1943 to 1963 13,854 Young persons born in the years 1933 to 1942 4,879 Others 4,482 Total 23,215 Number of re-inforcing injections/doses of vaccine given - 24,495 - 49 - NOTIFIABLE DISEASES DURING 1963 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 - - 3 2 7 18 5 2 1 38 1 - Measles 19 57 73 81 92 301 19 6 2 650 1 - Whooping Cough. 1 - 5 2 2 13 - - - 23 1 - Meningococcal Infection - - - - 1 - - - - 1 1 - Puerperal Pyrexia - - - - - - - 5 5 10 *10 - Dysentery 1 - 1 1 1 14 4 2 3 27 4 - Pneumonia (Acute Primary or Influenzal) - - - - - - - - 11 11 1 - Food Poisoning 1 - - - - - - - 1 2 1 - Encephalitis - - - - - 1 - - - 1 1 - TOTALS 22 57 82 86 103 347 28 15 23 763 21 - * These 10 patients Mere already in hospital - 50 - NOTIFICATIONS OF INFECTIOUS DISEASE DURING THE LAST 10 TEARS DISEASE 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 Dysentery 14 2 15 9 24 11 17 1 1 27 Encephalitis acute - - 1 1 - 4 - - - 1 Enteric Fever (Typhoid) - - - - - 1 - - - - Paratyphoid Fever - - - 1 1 1 - - - - Erysipelas 3 2 6 1 3 1 - 2 - - Food Poisoning 13 2 11 1 8 8 2 - 1 2 Malaria - - 1 - - - - - - - Measles 18 813 64 660 134 627 18 980 122 650 Meningococcal Infection 2 - 1 1 1 - 1 1 1 1 Ophthalmia Neonatorum 1 - - - - - - 1 - - Pneumonia 18 21 34 24 25 18 7 13 9 11 Poliomyelitis 4 11 7 10 1 1 - 1 - - Puerperal Pyrexia 4 7 12 25 19 11 3 8 5 10 Scarlet Fever 49 77 110 59 80 74 45 30 17 38 Whooping Cough 74 139 82 108 10 5 55 27 7 23 200 1074 344 900 306 762 148 1064 163 763 Tuberculosis- Pulmonary 40 36 44 50 25 26 26 34 22 14 Non-Pulmonary 7 4 6 2 1 5 3 5 2 3 - 51 - TUBERCULOSIS During the year 43 new cases were added to the register of tuberculous persons compared with 49 in 1962 and 66 in 1961. Of the 43 additions 17 were primary notifications, 24 were transferred from other areas, 1 was an un-notified death, and one was a posthumous notification. An analysis of the notifications received is given overleaf. At the end of the year, after taking into account all the additions and deletions, there were 326 cases remaining on the tuberculosis register, a drop of 15 on the previous year. 300 were cases of pulmonary tuberculosis and 26 cases of non-pulmonary tuberculosis. New notifications of pulmonary tuberculosis amounted to 14 cases, the lowest figure ever recorded for Wimbledon and compares with 22 cases in 1962 and an average of 24 in the last five years. The notification rate was 0.24 per thousand of the population, compared with 0.34 for England and Wales. Deaths from all forms of tuberculosis amounted to 8 compared with 4 last year giving a death rate per thousand population of 0.14 compared with 0.06 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. - 52 - Fifty-nine cases were removed from the register for the following reasons Pulmonary Non-Pulmonary M. F. M. F. Deaths from tuberculosis 4 2 - 2 Deaths of patients suffering from tuberculosis through other causes 1 1 - - Recovered cases 10 7 - 1 Removals from district 16 12 2 1 31 22 2 4 Treatment for case8 of tuberculosis is the responsibility of the Regional Hospital Board, who provide both sanatorium and dispensarytreatment . 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 1963 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 The following table shows the number and types of cases on the register at December 3lst for the last 10 years. Year Pulmonary N on-Pulmonary Total No.on Register at 31st December Male Female Male Female 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 188 127 18 8 341 1963 175 125 19 7 326 - 54 - TUBERCULOSIS 1963 ACE GROUPS CASES ADDED TO THE REGISTER DEATHS Primary Notifications (Form A) Cases Discovered otherwise than by Notification Total Cases added to the Register Pulmonary NonPulmonary Pulmonary NonPulmonary Pulmonary NonPulmonary Pulmonary NonPulmonary Males Females Males Females Males Females Males Females Males Females Males Females Males Females Males Females Under 1 Year - - - - - - - - - - - - - - - - 1-4 Years - 1 1 - - - - 1 - 1 1 1 - - — 1 5-9,, - - - - - - - - — - — - - - — 10-14 " 1 — - - - - - - 1 - - - - - — — 15-19 " 1 - - - - 1 — - 1 1 - - - - - - 20-24 " - 1 - - 1 1 - 1 1 2 - 1 — - • — 25 - 29 " 1 3 1 - 1 4 - - 2 7 1 - - - - - 30 - 34 " 2 1 - - - 3 - - 2 4 - - - - - - 35 - 44 " - - - - 4 3 - - 4 3 - - - - - - 45-54 ,, 1 - 1 - 1 1 - - 2 1 1 - - - - - 55 - 64 ,, 1 - - - 2 - - - 3 - - - 4 - - - 65 and Over 1 - — 1 — — 1 1 1 - 1 1 3 — 1 Age not known - - - - - - - - - - - - - - - - 7 7 3 - 10 13 - 3 17 20 3 3 5 3 - 2 14 3 23 3 37 6 8 2 17 26 43 10 - 55 -