LIBRARY BOROUGH OF WOOD GREEN ANNUAL REPORT of the Medical Officer of Health for the Year 1946. MALCOLM MANSON, M.C., G.M., M.A., M.D., D.P.H., Medical Officer of Health, Crurtha & Son. Ltd. (T.U.), Wood Green, Southgate, Enfield and Tottenham. WOOD 28 BOROUGH OF WOOD GREEN. PUBLIC HEALTH COMMITTEE. Alderman H. Tudor Rhys, J. P. (Chairman). The Mayor, Councillor Alderman F. G. Holmes, J. P. W. A. \ ant, J. P. The Late CounciUor B. L. Lloyd. The Deputy Mayor, Councillor Councillor J. W. Adams. J. J. Wren. councilor mrs. S. L. Fowler. Alderman E. J. Anderton, J. P. Councillor F. Hodge. Alderman A. R. Harrison. Councillor A. Vitoria. MATERNITY AND CHILD WELFARE COMMITTEE. Councillor Mrs. L. C. Vant (Chairman). Alderman Mrs. J. J. Bolster, J. P. Councillor Mrs. J. Cole. Councillor Mrs. S. L. Fowler. Councillor Mrs. H. S. Harrison. Councillor W. A. Maxfield. Co-opted Members. Mrs. E. C. Waghorne. Mrs. A. Knight. Miss D. Hiscock. 2 STAFF during 1946. *Medical Officer of Health.—Malcolm Manson, M.C., G.M., M. A., M.D., D.P.H. * Assistant Medical Officer of Health.—Margaret McDonald Miller, M.B., Ch.B., D.P.H. (resigned January, 1946). * Deputy Medical Officer of Health.—Kathleen Mary Hart, M.D., D.P.H. (commenced March, 1946). * District Sanitary Inspectors.—G. C. Billing, Cert. R.San. Inst., Cert. Meat and Food Inspection; W. McCauley, Cert. R.San.Inst, and San. Insp. Joint Board, Cert. Meat and Food Inspection; F. James, Cert.R.San.Inst, and San. Insp. Joint Board, Cert. Meat and Food Inspection. *Health Visitors.—Miss F. L. Orwin, S.C.M. ; Miss F. Medd, S.C.M.; Miss G. L. Shaw, S.C. M. ; Miss I. P. Lucas, S.C.M. (resigned May, 1946); Miss P. C. Gould, S.C.M. (commenced May, 1946). Midwives.—Miss V. Baker, S.R.N., S.C.M.; Miss C. Aherne, S.C.M., Miss E. Meyrick, S.R.N., S.C.M. (resigned March, 1946), Mrs. I. Milbank, S.R.N., S.C.M. (commenced April, 1946), Miss M. E. M. Harman, S.C.M. (commenced September, 1946). Chief Clerk.—G. W. Jones. Assistant Clerks.—W. T. Gloster, G. Penberthy, K. Overy (returned from Forces). Temporary appointments Mrs. G. Ogden, Miss J. Rider (resigned September, 1946), Miss A. Sinclair (commenced October, 1946). Clerk for Maternity and Child Welfare.—Mrs. Wass. Each of the Health Visitors holds a General Training Certificate and Miss Orwin, Miss Shaw, Miss Lucas and Miss Gould hold the Health Visitors Certificate. * Officers in respect of whom salary contributions are made under the Public Health Act by Exchequer Grants. 3 Public Health Department, White Hart Lane (Old) School, Wood Green, N.22. August 27th, 1947. To the Mayor, Alderman and Councillors, of the Borough of Wood Green. Ladies and Gentlemen, I beg to present to you my Annual Report as Medical Officer of Health for the year 1946. The Report is necessarily a short one and gives little more than an outline of the work of the Health Department throughout the year. The year has been a good one so far as the general health of the community is concerned. There has been comparitively little infectious disease. For the seventh year in succession there has been no death from diphtheria in the borough, nor has there been a death during the year from any of the commoner infectious diseases. The Birth-Rate is the highest recorded since 1920, the Death-Rate is appreciably lower than that for the previous year and the Infantile Mortality Rate of 34 per 1,000 live births, while not so good as that for 1945, compares favourably with the rate for the country as a whole. I wish to express my thanks to the Chairman and members of the Public Health and Maternity and Child Welfare Committees for their support, and to all the members of my staff for their loyal co-operation in the work of the Health Department throughout the year. Your obedient servant, MALCOLM MANSON, Medical Officer of Health. With the Compliments of the Medical Officer of Health. Town Hall, Wood Green N.22. 4 STATISTICS AND SOCIAL CONDITIONS FOR THE AREA. Area (acres) 1,607 Population—Estimate supplied by the Registrar-General 50,680 Number of inhabited houses (end of 1946, according to the Rate Books) 13,250 Rateable Value, 1946 £547,847 Sum represented by a penny rate £2,156 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR. Live Births— Total. M. F. Legitimate 938 497 441 Birth Rate Illegitimate 48 24 24 19.4 per 1,000 Still Births 28 19 9 Rate per 1,000 births 27 6 Deaths 629 309 320 Death Rate 12 4 per 1,000 Deaths from Puerperal Causes:— Puerperal Sepsis Nil Rate per 1,000 Births, — Other Puerperal Causes Nil Rate per 1,000 Births, — Deaths of Infants under 1 year of age:— All Infants 34 Rate per 1,000 Live Births, 34.4 Legitimate 32 Rate per 1,000 legitimate Live Births, 34.1 Illegitimate 2 Rate per 1,000 illegitimate Live Births, 41.6 Deaths from:— Cancer (all ages) 101 Measles (all ages) Nil Whooping Cough (all ages) Nil Diarrhoea (under 2 years of age) 2 Number of Births notified 926 Number of Births Registered in the Borough 401 5 POPULATION. The mid-year estimate of population supplied by the Registrar General is 50,680, an increase of almost 6,000 over that for the previous year. This is obviously the result of the return of so many men and women from the forces, and the likelihood is that there may be a still further increase so that the population will soon be as great as it was before the war. BIRTHS. The number of live-births registered during the year was 986 which corresponds to a Birth-Rate of 19.4 per 1,000 of population. This is a very considerable increase over the rate for the previous year which was 15.9 and is the highest rate recorded in Wood Green since 1920. The number of still-births was 28, and the Still-Birth Rate 27.6 per 1,000 births, a considerably higher rate than that for 1945 which was 21.1. DEATHS. The number of deaths credited to Wood Green after the necessary adjustments had been made for inward and outward transfers was 629. This gives a Death Rate of 12.4 per 1,000 of population, which is an improvement on 13.7 the rate for the previous year. Of the total of 629 deaths no fewer than 370 or almost 59 per cent, occurred at ages over 65, and of these 113 were of persons over 80 years and 18 of persons over 90 years of age. The individual causes of death will be found in Table III in the appendix. It will be seen there that heart disease was responsible for 143 deaths, a much large number than that attributed to any other cause. Other diseases of the circulatory system caused 22 deaths and inter-cranial vascular lesions 46 deaths, so that in all, 211 deaths out of 629 were attributed to diseases of the heart and circulation. The number of deaths due to respiratory disease, apart from pulmonary tuberculosis was 99. Cancer was responsible for 101 deaths and tuberculosis for 25 deaths. Only two deaths occurred from the principal zymotic diseases. There were no deaths from enteric fever, smallpox, measles, scarletfever, diphtheria or whooping cough, but two deaths from diarrhoea in children under 2 years. The zymotic death rate was 0.04 per 1,000 of population. 6 INFANTILE MORTALITY. The number of deaths of children under 12 months was 34, which gives an Infantile Mortality Rate of 34.4 per 1,000 lire births. This is not so good as the rate for 1945 which was 27.3 the lowest ever recorded in Wood Green. It compares favourably, however, with that for the country as a whole which was 43, and with that for towns of comparable size which was 46. Of the 34 infantile deaths, 6' occurred within 24 hours of birth and 17 during the first month of life. If to these 17 deaths we add the 28 stillbirths which occurred during the year, we have a total loss of 45 infant lives either shortly before birth or in the few weeks following birth. Of the 17 neo-natal deaths no fewer than 10 were certified as premature. One was due to injury at birth and two to congenital deformities which are usually fatal. It is in the direction of reducing the number of stillbirths, and preventing the loss of so many premature babies that further progress in the saving of infant lives would seem to lie, and both these objects would be most likely of achievement by increased attention to the health of the mother particularly in the late months of pregnancy. Much has been achieved in Maternity and Child Welfare during the past thirty years, but there is still much to be done before we can be satisfied with our efforts. MATERNAL MORTALITY. No deaths were certified as due to childbirth or any of its complications, so that for the second year in succession the Maternal Mortality Rate was nil. MATERNITY AND CHILD WELFARE. The number of live births registered as belonging to Wood Green was 986 and the number notified under the Notification of Births Act, was 926, which is 93.9 per cent. of the registered births. Of the 986 births registered, the number which actually occurred in Wood Green was 401, all the others taking place in hospitals, nursing homes or in private dwellings outside the district. The following table shows where the great majority of these births took place. 7 Nursing Homes 148 North Middlesex Hospital 133 Royal Northern Hospital 50 University College Hospital 35 City of London Maternity Hospital 30 Evacuated under L.C.C. Scheme 59 From these figures it will be seen that the percentage of Wood Green births taking place in hospital or maternity home remains relatively high, but the institutional accommodation is still not very good and many confinements still take place at home under conditions which are very difficult. This difficulty is accentuated at the moment by the high birth rate, and the acute housing shortage, but there is some prospect of it being eased somewhat by the provision of new houses, and the increase in institutional accommodation which is promised. Of the 401 births registered as taking place in the Borough, 355 were attended by the Council midwives. There are now four Council midwives, Miss M. E. M. Harman, S.C.M., having been appointed and commenced duty in Wood Green in September, 1946. CHILD WELFARE CENTRES. The total attendances at the Infant Welfare Clinics at the White Hart Lane Centre were 14,493 as compared with 11,822 during the previous year. At Alexandra Park Centre the attendances were 3,562 as compared with 3,115 during 1945. The number of children brought to the Centres was 2,315 of whom 1,312 were infants under one year and 1,003 children of from one to five years. The number of children seen at the Centres by the Medical Officer during the year was 2,189, and of these 1,274 were infants and 915 children from one to five years. Of the 34 infant deaths which occurred during the year, in 10 cases the baby had been brought at least once to one of the Centres. Ante-Natal Clinics. Ante-Natal Clinics were held at the White Hart Lane Centre on Tuesday afternoons, Friday afternoons and alternate Saturday mornings throughout the year. The number of expectant mothers 8 who attended was 665, and in addition 94 attended for post-natal examination. With the high birth rate the pressure on the AnteNatal Clinics has been very great, and it was necessary to obtain extra medical assistance for one Ante-Natal Clinic per week. Dr. V. L. James conducted the Friday afternoon clinic from February until the end of the year. Proposed new Centre in Gordon Road. At the end of the year the Maternity and Child Welfare Committee decided to convert a disused Civil Defence hut in Gordon Road, into a new Child Welfare Centre and the necessary alterations are now almost complete. When completed the new Centre should be of considerable value particularly to mothers and children in the Alexandra Park Ward, and will help to relieve some of the pressure in the White Hart Lane and Albert Road Centres. It is proposed to hold weekly Infant and Ante-Natal Clinics at the new Centre, and also regular Immunisation Clinics. Home Visiting. The Health Visitors made a total of 5,930 home visits during the year. Of these 531 were ante-natal visits to expectant mothers, 2,519 to babies under one year, and 2,880 to children of from one to five years. The Health Visitors also continued to act as Infant Life Protection Visitors, visiting registered foster-mothers and fosterchildren at regular intervals. There were 6 foster-mothers and 6 foster-children on the Register at the end of the year. Free Food. Free food consisting of dried milk, and cod-liver oil emulsion was issued to necessitous expectant and nursing mothers attending the Centres at a cost of £16 5s. 6d. Cod-liver oil, fruit juice and vitamin tablets were issued at the Centres with the co-operation of the staff of tbe Local Food Office. The returns received month by month for the London Divisional Food Office show that not sufficient advantage is taken by many mothers of this special provision of cod-liver oil, fruit juice and vitamin tablets for children under five years of age. The return for the four weeks ending December 28th, 1946, showed that the weekly average issue represented the following percentages of the total potential:— 9 Cod-liver Oil 56.94 per cent. Orange Juice 56.05 per cent. Vitamin Tablets 60.00 per cent. This means that rather less than three children out of every five for whom this special provision is available, are actually receiving the benefit. Home Help. The services of three home helps were made use of during the year, the number of confinements in which help was given being 40. Domestic Help. Four domestic helps were in more or less constant employment throughout the year, the number of homes in which assistance was provided beiug 60. Many of the cases in which help is provided are of a very chronic nature, and require a good deal of time. If a larger number of domestic helps were available, a considerably larger number of cases could be dealt with, and the service be much expanded, but our experience has shown that it is difficult to obtain a sufficient number of the type of woman who is keen on this work. Day Nurseries. Both nurseries were filled to capacity throughout the year, except during the months of May and June, when the numbers at St. Michael's were much reduced by an outbreak of measles among the children. The average daily attendance at St. Michael's for the whole year was 27, and at the White Hart Lane Nursery 41. The health of the children has, on the whole, been good. With housing conditions such as they are at present, and the urgent need for more women to be employed in industry, the demand for the admission of children to the nurseries, is very great and is reflected in very long waiting lists. From time to time there has been considerable questioning, both in the medical and in the lay press, of the value of day nurseries as a feature of our social services, and while few would deny that the proper place for a young child is his own home and the best guardian his mother, it must be remembered that under present housing conditions the home environment is not always very satisfactory, and that there are many cases where the mother's care is for one reason or another not always available. So long as these conditions exist, and while the present need for the services of women in industry remains, the service to be rendered to the community by well-managed day nurseries will be a very real one. 10 INFECTIOUS DISEASE. Table IV in the Appendix gives details of all the cases of infectious disease notified during the year. The total of 671 is very much higher than the figure for 1945, which was 494, but the increase is almost entirely accounted for by the greatly increased prevalence of measles in 1946. Only seven cases of diphtheria were notified, and for the seventh year in succession no death from this disease occurred in Wood Green, a highly satisfactory record. 73 cases of scarlet fever were notified without a death, and there were no deaths from measles or whooping cough. There were 76 notifications of pulmonary tuberculosis with 22 deaths, and 10 notifications of nonpulmonary tuberculosis with three deaths. There were 33 cases of pneumonia notified, and 36 deaths from this disease. DIPHTHERIA IMMUNISATION. Immunisation against diphtheria was continued as in former years, the number of children immunised during the year being 990. Of these 741 were under five years, the vast majority of them being immunised about the date of their first birthday, and 249 were at ages from 5 to 15 years. The material used in all cases was Alum Precipitated Toxoid, provided free by the Ministry of Health. At the end of the year it was estimated that 60 per cent. of the children under 5 had been immunised, and 81 per cent. of those from 5 to 15. SCABIES. All cases of scabies requiring treatment during 1946 were sent to the Hornsey Cleansing Station, by arrangement with the Hornsey Borough Council, and a total of 147 cases were so dealt with. Of these, 19 were under school age, 54 were school children, and 74 were adults. The number dealt with in the previous year was 171. BACTERIOLOGICAL WORK. Since the beginning of February, 1946, all the bacteriological work which used to be carried out at the Joint Isolation Hospital has been done instead at the Central Public Health Laboratory, Colindale, which caters for all the Local Health Authorities in North-West Middlesex. 11 The specimens examined during the year were as follows:— Positive. Negative. Total. Diphtheria 15 187 337 Haemolytic Streptococci 126 Vincent's Augina 9 Faeces 20 141 161 Sputum (for tuberculosis bacilli) 23 36 59 Pertussis — 1 1 193 365 558 In addition, 18 Ice Cream samples were examined and one specimen of drinking water. DISINFECTION AND DISINFESTATION. The number of articles dealt with at the Disinfecting Stationwas as follows:— Articles disinfected 277 Articles destroyed 42 One hundred and thirty-seven rooms were disinfected on account of infectious disease, and 136 rooms disinfested on account of the presence of vermin. WORK OF THE SANITARY INSPECTORS. The following tables give a very brief summary of the routine work of the Sanitary Inspectors during the year:— Inspections and Re-inspections of dwelling houses:— Total 4,889 Enquiries in connection with Infectious Diseases:— Total 186 Inspections of registered premises :— Total 448 Miscellaneous Inspections:— Total 217 Work Carried Out:— Drains reconstructed 1 Drains repaired 52 New water closets Nil Water closets repaired 132 Premises cleansed, etc. 4 Rooms disinfested 136 Accumulations of refuse removed 3 Keeping of animals discontinued Nil Dampness in premises remedied 611 Houses repaired 923 Miscellaneous 437 Total 2,299 12 Investigations in connection with Housing Applications:— Total 2,755 Rent Restrictions Acts. Certificates granted under above heading during 1946:— Total 17 INSPECTION AND SUPERVISION OF FOOD. (a) Milk Supply. The following licences for the sale of milk under special designations have been granted:— Tuberculin Tested. Accredited. Pasteurised. 5 — 14 Supplementary Licences to sell milk from premises which are outside the area of the Licensing Authority. Tuberculin Tested. Accredited. Pasteurised. 3 - 4 (b) Other Foods. The undermentioned foodstuffs were certified as unfit for human consumption during the year:— Unfit by reason of Decomposition: 8 tins of Apricots. 1 bag of Barley. 3 tins of Brisling. 78 tins of Beans. 2 tins of Beetroot. 1,140 Crumpets. 68 tins of Crawfish. 1 bottle of Pickled Cabbage 5 tins of Carrots. 29¼ lbs. of Cheese. 3 tins of Corned Mutton. 1 packet of Cocoa. 1 bag of Coffee and Chicory. 119 tins of Corned Beef. 1 tin of Dried Egg. 1,971 Eggs. 3 jars of Mincemeat. 12 tins of Macaroni. 6 bags of Oats. 88 tins of Peas. 39 tins of Pilchards. 8 tins of Pork Luncheon Meat. 4 ½ lbs. of Pork Luncheon Meat. 5 jars of Plums. 12 tins of Plums. 2 jars of Piccalilli. 1 tin of mixed Fruit Pudding. 3 tins of Peaches. 1 tin of Pears. 6,000 lbs. of Pears. 2 jars of Pickled Mustard. 1 packet of Pudding Mixture. 13 Unfit by reason of Decomposition—continued: 6 Camembert Cheeses. 3 packets of Flour. 1 bottle of Culinary Flavour. 949 Fish Cakes. 26½ stones of Smoked Fish. 8 stones of Cod Fillet. 5 stones of Sand Dabs. 2½ stones of Smoked Whiting. 34 stones of Smoked Haddock. 71 stones of Kippers. 27 gallons of Whelks. 4 jars of Fish Paste. 19½ lb. of Galantine. 4 tins of Chopped Ham. 4 tins of Jam. 1 jar of Jam. 21 packets of Master Mix. 90 Meat Cakes. 557 tins of Milk. 2 tins of Dried Milk. 10 tins of Meat and Vegetables. 5 tins of Spam. 2 bags of Semolina. 3 packets of Semolina. 2¾ lbs. of Luncheon Sausage. lbs. of Pork Sausage. 78 tins of Salmon. 43 tins of Sardines. 1 tin of Shrimp. 101 tins of Stewed Steak. 40 tins of Sausage Meat. 4¼ lb. of Sausage Meat. 1 bottle of Sauce. 10 tins of Soup. 4 packets of Soup. 6½ lb. of Bung. 2 tins of Meat Paste. 7 tins of Tomatoes. 3 bottles of Tomatoes: 1 tin of Tongue. 2 tins of Mixed Vegetable. Unfit by being contaminated by Rats, Mice, Cats, etc.: 24 bags of Self Raising Flour. 7 bags of Plain Flour. 13 bags of Oats. 9 bags of Semolina. 31 packets of Semolina. 5 bags of Cake Mix. 26 packets of Cake Flour. 8 packets of Sponge. 4 packets of Cremola. 155 packets of Dessert Mould. 5 packets of Cocoa. 7 packets of Golden Dawn. 7 packets of Caramel Cake. 3 packets of Custard. 1 lb. of Oatmeal. 2 lbs. of Macaroni. 6¼ lbs. of Tea. 1 lb. of Split Peas. 2 lbs. of Dried Egg. 60 Meat Cubes. 48 packets of Pancake Mix. 10 packets of Cake Mixture. 1 packet of Jelly. 6 packets of Soup. 1 packet of Barley. 5 packets of Scone Mixture. 1 jar of Apricots. 1 packet of Sponge Mixture. 5 packets of Edible Cake Decoration. 14 Unfit by being contaminated by Moth, Larvae, etc. : 520 packets of Dessert Mould. 3 bags of Flour. 21 packets of Flour. 7 packets of Cake Flour. 2 packets of Master Mix. 5 packets of Scone Mixture. 1 packet of Cake Mixture. 1 packet of Baking Powder. 1 packet of Sponge Mixture. 1 packet of Jelly. Unfit by being Stale, Wet or Mouldy: 48 lbs. of Chocolate Biscuits. 34¼ lbs. of Biscuits. 1,188 Crumpets. 246 Fish Cakes. 8½ cwt. of Sugar. 68 lbs. of Oats. 129 lbs. of Flour. 7 packets of Bun Flour. 8 packets of All Bran. 87 lbs. of Prunes. 2½ lbs. of Sweets. 21 lbs. of Liquorice Allsorts. ½ lb. Chocolate Macaroons. 1lb. of Turkish Delight. 7lbs. of Assorted Creams. 7lbs. of Liquorice and Coconut Rock. Unfit by being contaminated by splintered or broken glass: 5 lbs. ot loiiee Crunch. 5½ lbs. of Fruit Centres. 33 lbs. of Jam. 20 bottles of Sauce. 5 lbs. of boiled Sweets. 3½ lbs. of Dolly Mixture. 4 jars of Marmalade. 2 jars of Lemon Curd. 4 lbs. of Sugar. 5 bottles of Plums. 3 bottles of Piccalilli. Unfit by containing foreign bodies: 1 tin of Dried Egg. Unfit by reason of bone taint: 1 hock of bacon. Unfit by reason of fermentation: 128 half-quartern loaves. Unfit by reason of bruising: 4 lbs. of English fore-quarter flank. Unfit by reason of Gaseous Lymphadenitis: 4 lbs. of Lamb. 15 Hats and Mice (Destruction) Act, 1919. 521 premises have been, inspected, and it was found necessary to carry out treatment in 162 of these. One thousand eight hundred and fifty-eight visits were made. During June and July a maintenance treatment of the soil sewers was carried out. A maintenance treatment consists of pre-baiting the manholes •on each of two days, followed by poison baiting, those manholes -which showed a pre-bait take. 638 manholes were pre-baited; in 363 of these a pre-bait was [registered and they were poison baited. The Public Health Department and the Borough Engineer's Department co-operated in carrying through the sewer treatment, three squads of three men each being supplied by the Borough Engineer. 16 APPENDIX. Table I. Vital Statistics of Wood Green, 1931-46. Year. Population estimated to middle of each year. Nett Births belonging to the District. Nett Deaths belonging to the District. Under 1 year of age. At all ages. Total No. Rate per 1,000 live births. Illegitimate No. Rate per 1,000 illegitimate births. No. Rate per 1,000 population . Total No. Rate per 1,000 population. Illegitimate No. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) 1931 54,520 719 13.2 30 32 44 2 66 549 10.1 1932 54,500 681 12.5 20 28 41 4 200 556 10.2 1933 54,210 601 11.1 24 32 53 2 83 565 10.4 1934 53,755 564 10.5 16 21 37 2 125 562 10.5 1935 53,470 570 10.7 22 27 47 1 45 529 9.9 1936 53,620 700 13.1 23 38 54 0 — 588 10.9 1937 53,510 659 12.3 21 32 48 2 95 593 11.1 1938 53,190 652 12.3 17 25 38 1 59 540 10.1 1939 52,700 and 50,700 624 11.8 25 21 34 2 83 594 11.7 1940 46,230 605 13.1 42 23 39 3 71 737 15.9 1941 43,870 523 11.9 25 16 31 0 — 589 13.4 1942 44,840 704 15.7 29 25 37 1 34 573 12.7 1943 44,710 756 16.8 37 31 41 0 — 553 12.3 1944 44,060 824 18.7 46 26 31 5 108 564 12.8 1945 44,940 694 15.9 47 19 27 1 21 616 13.7 1946 50,680 986 19.4 48 34 34 2 42 629 12.4 17 Table II. Birth-Rate, Death-Rate and Analysis of Mortality during 1946. Birth-rate per 1,000 population. Annual Death-Rate per 1,000 Population. Rate per 1,000 Births. All Causes. Typhoid and Paratyphoid Fevers. Smallpox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Diarrhoea and Enteritis (under 2 years). Total Deaths under 1 year. England and Wales 19.1 11.5 0.00 0.00 0.00 0.00 0.02 0.01 0.15 4.4 43 126 County Boroughs and Great Towns (including London) 22.2 12.7 0.00 0.00 0.01 0.00 0.02 0.01 0.13 6.1 46 148 Smaller Towns (population 25,000-50,000 at Census 1931) 21.3 11.7 0.00 0.00 0.00 0.00 0.02 0.01 0.14 2.8 37 London 21.5 12.7 0.00 0.00 0.01 0.00 0.02 0.01 0.12 4.2 41 Wood Green 19.4 12.4 0.00 0.00 0.00 0.00 0.00 0.00 0.04 2.0 34 18 Table III. Causes of Death during the year 1946. Causes of Death. Male. Female. Typhoid and Paratyphoid Fevers — - Cerebro-Spinal Fever — — Scarlet Fever — — Whooping Cough — — Diphtheria — — Tuberculosis of Respiratory System 15 7 Other forms of Tuberculosis 1 2 Syphilitic Diseases 4 1 Influenza — 2 Measles — — Acute Polio-myelitis and Polio-encephalitis — 1 Acute Inf. Encephalitis — 1 Cancer of Buc. Cav. and Oesophagus—Male 7 — Uterus—Female — 3 Cancer of Stomach and Duodenum 8 4 Cancer of Breast — 10 Cancer of all other sites 37 32 Diabetes 1 - Intra-Cranial Vascular Lesions 29 37 Heart Disease 58 85 Other Diseases of Circulatory System 8 14 Bronchitis 27 29 Pneumonia 21 15 Other Respiratory Diseases 5 2 Ulcer of Stomach or Duodenum 4 3 Diarrhoea under 2 years of age 1 1 Appendicitis 2 2 Other Digestive Diseases 7 12 Nephritis 11 9 Puerperal and Post-Abort. Sepsis — — Other Maternal Causes — - Premature Birth 4 3 Congenital Malformations, Birth Injuries, Infantile Diseases 9 7 Suicide 4 5 Road Traffic Accidents 4 - Other Violent causes 6 8 All other causes 36 25 Totals 309 320 19 Table IV. Infectious Diseases Notified during the year 1946. Notifiable Disease. Cases Notified in Whole Borough. Total Cases Notified in each Ward. Total Cases removed to Hospital or Sanatorium. Total Deaths. All Ages. At Ages—Years. AlexandraBowes. Town Hall. Noel Park. Under 1 year. 1 to 5 years. 5 to 10 years. 10 to 15 years. 15 to 20 years. 20 to 25 years. 25 to 35 years. 35 to 45 years. 45 to 55 years. 55 to 65 years. 65 & upwards. Scarlet Fever 73 - 19 34 7 8 1 1 2 1 - - 30 23 20 51 - Diphtheria 7 - 3 — 3 — - - - 1 - - 3 3 1 7 - Cerebro-Spinal Fever 3 - 1 - 1 - - - 1 - - - 1 - 2 3 - Enteric Fever 1 - - - - - - 1 - - - - - 1 - 1 - Erysipelas 10 - - - - - - - 1 5 2 2 3 4 3 3 - Pneumonia 33 1 6 3 1 2 - 3 4 2 5 6 6 22 5 15 36 Acute Poliomyelitis — - — — — — - - - - - - - - - - 1 Puerperal Pyrexia 2 - - - - - 2 - - - - - - 1 1 1 - Pulm. Tuberculosis 76 - 1 1 1 7 11 15 18 12 9 1 31 21 24 43 22 Non-Pulm. Tuberculosis 10 - 1 1 — 2 2 2 1 — — 1 2 7 1 2 3 Malaria 3 - — — — — — 2 1 - - - 1 2 - 1 - Measles 346 5 169 159 1 1 2 6 3 - - - 180 71 95 8 - Whooping Cough 89 6 56 23 1 - 1 2 - - - - 31 28 30 1 - Ophthalmia Neonatorum 5 5 - - - - - - - - - - 2 3 - 4 - Dysentery 10 1 2 - - - 1 2 2 2 - - 3 5 2 4 - Food Poisoning 3 - - — — — - 2 - - — 1 - 3 - - — Totals 671 18 258 221 15 20 20 36 33 23 16 11 293 194 184 144 62 20 Table V. TUBERCULOSIS. New Cases and Mortality during 1946. Age Periods. New Cases. Deaths. Respiratory, Nonrespiratory. Respiratory. Nonrespiratory. M. F. M. F. M. F. M. F. 0 - - - - - - - - 1 1 1 1 - - - - - 5 — 2 1 1 — — — 1 15 12 8 2 2 — — — 1 25 9 10 1 1 3 4 — — 35 8 12 1 — 3 2 — — 45 7 5 — — 3 1 — — 55 8 1 — — 4 — — — 65 and upwards 1 — 1 — 2 — 1 — Totals 46 39 7 4 15 7 1 2 Above includes transfers (10) from other Districts 7 non-notified tuberculosis deaths occurred.