??? AC4372 Metropolitan Borough of Woolwich ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR WOOLWICH 1939 BY J. MACMILLAN, D.S.O., M.C., M B., D.P.H. Medical Officer of Health WOOLWICH: The Kentish Independent Printing Works (T.U.) 41, Wellington Street, S.E.18 65723 HEALTH COMMITTEE. At 31st December, 1939. The Worshipful the Mayor (Councillor A. E. Jago, J.P.) Councillor C. H. Darby (Chairman) Councillor A. H. Gilder ( Vice-Chairman). Alderman: Mis. E. Brooks. Councillors: J. W. Andrews Miss M. Crout, J.P. G. S. Dean Mrs. L. E. Driver G. E. Greenwood C. J. Keedy D. B. Lister S. W. Lister Mrs. E. L. Reeves E. G. Stevenson H. Vaughan Miss G. E. Walters, J.P. MATERNITY AND CHILD WELFARE COMMITTEE. Comprising the Members of the Health Committee. Alderman Mrs. E. Brooks (Chairman). Councillor Miss G. E. Walters, J.P. (Vice-Chairman). PREFACE. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Woolwich. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit the Thirty-ninth Annual Report on the health of the Metropolitan Borough of Woolwich. It is, on account of the War, shorter than its predecessors but it is hoped that sufficient material is published to give a proper general appreciation of health work and progress in the Borough during the year. Since my last report, the following staff changes have taken place:— Mr. J. Sainsbury, B.A., M.B., B.Ch., appointed as Consultant to Rheumatism Clinic, as from 14th January. Mr. R. J. Furlong, F.R.C.S., appointed as Consultant to the Orthopaedic Clinic as from 14th January. Miss M. Tyers, Woman Sanitary Inspector, appointed Health Visitor as from the 1st January. Miss D. F. Wright, Nurse-Masseuse, commenced duty on the 2nd January. Miss M. G. Roberts, Nurse-Masseuse, commenced duty on the 2nd January. Mr. E. F. Flanagan, Chiropodist, commenced duty on the 9th January. Mr. H. G. Taylor, F.R.C.S., Obstetric Consultant, relinquished his appointment on the 31st January. Mr. C. Reddington, F.R.C.S., appointed Obstetric Consultant on the 1st February. Miss B. Bryant, Clerk, Grade "A," commenced duty on the 6th February. Miss A. J. Challinor, Nurse-Masseuse, commenced duty on the 13th February. Miss M. Thomas, Woman Sanitary Inspector, commenced duty on the 20th February. Dr. R. V. Brews, Public Vaccinator, resigned his appointment on the 6th March. Miss F. A. Morgan, Health Visitor, retired on superannuation on the 1st May. Miss I. Grant, Clerk, Grade "A," resigned her appointment on the 20th May. Miss K. Wesley, Clerk, Grade "A," commenced duty on the 22nd May. Mr. R. Hillary, Clerk, Grade "A," commenced duty on the 24th May. Mr. W. Tedham, Sanitary Inspector, retired on superannuation on the 27th May. Mr. D. Buck, Clerk, Grade "A," commenced duty on the 1st June. Mr. H. Ridler, Sanitary Inspector, commenced duty on the 1st June. 4 Dr. N. J. Lawler, appointed Public Vaccinator on the 1st July. Miss E. Macintosh, Health Visitor, commenced duty on the 1st July. Miss M. Allan, Chiropodist, commenced duty on the 3rd July. Miss I. Fraser, Chiropodist, commenced duty on the 3rd July. Miss A. Klue, Health Visitor, commenced duty on the 2nd August. Mr. H. Shaw, Chief Sanitary Inspector, retired on superannuation on the 11th September. Mr. C. J. Couch, Sanitary Inspector, appointed Chief Sanitary Inspector, as from the 11th September. Mr. G. Simpson, Sanitary Inspector, commenced duty on the 11th September. Mr. H. M. Collyer, Committee Clerk, retired on superannuation on the 1st December. Miss D. O'Connor, Clerk, Grade "A," commenced duty on the 11th December. The outbreak of War brought about many changes in the work of the Department—for the first few months most of the staff were engaged in developing the casualty services of Civil Defence; health buildings were taken over for these purposes; a large temporary staff of workers (paid and unpaid) was absorbed into the Department. Some members left for service with the Armed Forces of the Crown. Fortunately, in due course, the health services were re-organised and maintained, in some instances in skeleton form. In presenting this Report I desire specially to acknowledge the continued confidence and support which I have received from the Chairman and members of the Committees on Health, and from the Chairman and members of the Emergency Committee in dealing with medical problems of the war, and indeed from all members of the Council. I take this opportunity also of placing on record my sincere appreciation of the work of every member of the staff, and of every Civil Defence worker in the Casualty Service ; and of my personal indebtedness to each one of them. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, J. MACMILLAN, Medical Officer of Health. 5 VITAL STATISTICS. Table No. 1. Population. Registrar-General's Estimate of— (a) Resident population, middle of 1939 150,800 (b) Average population appropriate to the calculation of death rates 143,400 Live Births—Legitimate 2,067 Live Births—Illegitimate 66 2,133 Birth Rate per 1,000 population 14.1 Still-births 56 Still-births—Rate per 1,000 total births 26.2 Deaths 1,592 Death Rate per 1,000 population 11.1 Deaths from puerperal causes:— (а) From Sepsis — (b) From other causes 3 Death rate from puerperal causes per 1,000 total births 1.43 Deaths of infants under one year of age 103 Death rate of Infants under one year of age:— (а) All infants 49 (b) Legitimate infants 48 (c) Illegitimate infants 75 Notification of Births. After correction by inward and outward transfers the total number of Woolwich live births notified was 2,045. Of this number it is known that 1,295 took place in institutions. Deaths. The total number of deaths of Woolwich residents from all causes was 1,592. The classification by age under causes of death is shown in the following Table No. 2. 6 TABLE No. 2. Nett Deaths during the calendar year 1939. Causes of Death. Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the district. All Ages. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 35 years. 35 and under 45 years. 45 and under 55 years. 55 and under 65 years. 65 and under 75 years. 75 years and upwards. All Causes 1592 103 12 12 23 44 67 66 153 260 411 441 Typhoid and Paratyphoid Fevers 1 .. .. .. .. .. .. .. .. 1 .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 1 .. .. .. .. .. .. .. .. 1 .. .. Whooping Cough 8 .. .. 1 .. .. .. .. .. .. .. .. Diphtheria 7 .. .. 3 3 1 .. .. .. .. .. .. Influenza 15 .. .. .. 1 1 .. 1 3 .. 3 4 Encephalitis Lethargica 1 .. .. .. .. .. .. .. .. .. .. .. Cerebrospinal Meningitis .. .. .. .. .. .. .. .. .. .. .. .. Tuberculosis of the Respiratory System 99 2 .. .. 2 12 25 12 19 17 8 2 Other Tuberculous diseases 10 .. 1 .. 2 4 .. 1 1 .. .. 1 Syphilis 4 .. .. .. .. .. .. .. 1 2 1 .. General Paralysis of the Insane, Tabes Dorsalis 5 .. .. .. .. 1 .. .. .. 4 .. .. Cancer 245 .. .. .. .. 1 .. 9 40 55 87 48 Diabetes 22 .. .. .. .. .. .. 2 2 7 4 5 Cerebral Haemorrhage, etc. 85 .. .. .. .. .. .. 1 5 15 31 33 Heart Disease 447 .. .. 1 2 1 9 8 28 65 140 193 Aneurism 12 .. .. .. .. .. .. .. 4 4 3 1 Other Circulatory diseases 64 .. .. .. .. .. .. 1 2 14 27 20 Bronchitis 45 2 1 .. 2 .. 1 1 .. 10 10 18 Pneumonia.. 82 22 2 2 .. 6 4 3 9 10 16 8 Other Respiratory diseases 6 .. .. .. .. .. .. 1 1 1 1 2 Peptic Ulcer 24 .. .. .. .. .. 1 2 5 8 6 2 Diarrhoea, under 2 years 18 12 2 .. .. 1 l .. .. .. 2 .. Appendicitis 8 .. .. .. .. 1 l 1 1 2 2 .. Cirrhosis of Liver 2 .. .. .. .. .. .. .. .. 2 .. .. Other Liver diseases 10 .. .. .. .. .. .. .. 3 3 .. 3 Other Digestive diseases 25 2 2 .. .. .. 2 .. 2 4 8 5 Acute and Chronic Nephritis 44 1 .. .. .. .. 2 6 7 4 13 11 Puerperal Sepsis .. .. .. .. .. .. .. .. .. .. .. .. Other Puerperal Causes 3 .. .. .. .. .. 2 1 .. .. .. .. Congenital Debility, Premature Birth, etc. 51 51 .. .. .. .. .. .. .. .. .. .. Senility 37 .. .. .. .. .. .. .. .. .. 6 31 Suicide 12 .. .. .. .. 1 .. 2 3 1 4 1 Violence 86 3 .. 1 4 9 8 4 7 6 18 26 Other defined Diseases 113 4 .. 2 7 4 5 10 10 22 21 27 Causes ill-defined or unknown .. .. .. .. .. .. .. .. .. .. .. .. 7 GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. Clinics and Treatment Centres. The clinics and treatment centres in the Borough are as set out in my Annual Report for 1938 except for the following changes:— The Maternity and Child Welfare Centre at Holy Trinity Church Hall, Beresford Street, was discontinued as from 30th January. The Maternity and Child Welfare Centre at the Old Town Hall, Woolwich, was closed on the opening of the new Central Health Centre, Market Street, Woolwich, on the 14th January. The new Centre is a combined maternity and child welfare centre and school treatment centre and provides also accommodation for the treatment of rheumatism, artificial sunlight treatment, orthopaedic treatment, dental treatment and a foot clinic. The London County Council School Treatment Centre at Brewer Street, Woolwich, was closed on the opening of this new Centre. A Maternity and Child Welfare Centre was opened at 137, Alnwick Road, Lee, S.E. 12, on 6th October. The attendances at the Maternity and Child Welfare Centres during the year were: Expectant Mothers, 3,138; Nursing Mothers, 1,795; Children, 32,124. Ambulance Facilities. The London County Council provide an ambulance service, full details of which are set out in my Annual Report for 1938. Professional Nursing in the Home. The arrangements with the six nursing associations for the nursing of cases of measles, ophthalmia neonatorum, zymotic enteritis, whooping cough and poliomyelitis, in children under five, and pneumonia, puerperal fever, puerperal pyrexia and tuberculosis were continued during 1939. The total number of visits paid by the nurses was 2,592. Midwifery Services. There are no whole-time midwives employed by the Council, the Domiciliary Midwifery Service in London being administered by the London County Council. Maternity beds are provided in the British Hospital for Mothers and Babies, the War Memorial Hospital, the Eltham Cottage Hospital, the Military Families' Hospital, St. Nicholas' Hospital, and a few in midwives' homes. At the outbreak of War, the War Memorial Hospital, the Military Families' Hospital and St. Nicholas' Hospital closed their maternity wards, and consequently a greater demand was made on the British Hospital for Mothers and Babies. 8 Health Visiting. The arrangements made for the visiting of children between the ages of one and five are described in previous annual reports. The number of such visits paid during 1939 was 14,151. The total number of visits paid by health visitors was 20,251. Infant Life Protection. The number of foster mothers with children on the register at the end of 1939 was 36, and the number of children kept by these was 40. The number of visits paid was 566. Orthopaedic Treatment. With the opening of the new Central Health Centre the orthopaedic treatment of children under five years of age was taken over from the Invalid Children's Aid Association. Dental Treatment. The number of mothers and children attending the dental clinics was 575, and the number of tuberculous persons attending was 37. Laboratory Facilities. The bacteriological work of the Council is carried out at the Woolwich War Memorial Hospital. Supply of Insulin to Persons Suffering from Diabetes. The Council's scheme for the supply of Insulin to diabetic patients who are necessitous and unable to obtain it under the National Insurance Acts was continued. Vaccination. I submit a return by the Vaccination Officer on the work carried out under the Vaccination Acts for the year 1939. TABLE No. 3. RETURN to be made on or before 14th February, 1940, by Mr. S. G. Taylor, Vaccination Officer of all Sub-Districts of the Metropolitan Borough of Woolwich Registration District, respecting the Vaccination of Children whose Births were registered from 1st January, to 31st December, 1938, inclusive:— Registration Sub-Districts comprised in Vaccination Officer's District. Number of Births returned in the "Birth List Sheets" as registered from 1st January to 31st December, 1938. Number of these Births duly entered by 31st January, 1940, in Columns I., II., IV., and V. of the " Vaccination Register " (Birth List Sheets), viz.:— Col. I. Successfully Vaccinated. Col. II. Col. IV. Number in respect of whom Statutory Declaration of Conscientious Objection has been received. Col. V. Died Unvaccinated Insusceptible of Vaccination. Had Small Pox. 1. 2. 3. 4. 5. 6. 7. 1. Plttmstead 637 230 2 - 296 32 2. Woolwich † 1237 561 2 - 508 32 3. Eltham 442 238 - - 148 19 Total 2316 1029 4 - 952 83 9 TABLE No. 3—continued. Number of these Births which on 31st January, 1940, remained unentered in the "Vaccination Register" on account (as shown by "Report Book") of:— Number of these Births remaining on 31st January, 1940, neither duly entered in the "Vaccination Register" (Columns 3, 4, 5, 6, and 7 of this Return) nor temporarily accounted for in the "Report Book" (Columns 8, 9 and 10 of this Return). *Total Number of Certificates of Successful Primary Vaccination of Children under 14 received during the Calendar Year 1939. Number of Statutory Declarations of Conscientious Objection actually received by the Vaccination Officer irrespective of the dates of birth of the children to which they relate, during the Calendar Year 1939. Postponement by Medical Certificate. Removal to Districts the Vaccination Officers of which have been duly apprised. Removal to places unknown or which cannot be reached ; and cases not having been found. 8. 9. 10. 11. 12. 13. 9 5 52 11 These figures are to be obtained from colum ns 2 and 6 of the Summar y (Form N.) 10 60 48 16 8 13 11 5 27 78 111 32 1262 926 Notes on Table No. 3. NOTE.—(a) The total of the figures in columns 3 to 11 should agree with the figures in column 2. Any cases of children successfully vaccinated after the declaration of conscientious objection had been made should be included in column 6 above and not in column 3. The number of such cases should be inserted here:—1. (b) The figures in columns 2 to 11 should not include re-registered births or cases of children born in other districts. *The total in this column should be the number of Certificates of successful primary vaccination of children under 14, actually received during the year, including any relating to births registered in previous years. The total thus given should include the Certificates of successful primary vaccination of which copies have been sent to the Vaccination Officers of other Districts. The total number of Certificates for the year 1939 sent to other Vaccination Officers should be stated here :—193. flncludes the Burrage and Herbert Wards in Plumstead Parish. (Signature; S. G. TAYLOR, Vaccination Officer. Date—13/A February, 1940. During the year ended 30th September, 1939, the number of persons successfully vaccinated or re-vaccinated at the cost of the rates was 936. This figure includes 717 primary vaccinations of persons under one year of age, 88 over one year of age, and 131 re-vaccinations. 10 SANITARY ADMINISTRATION. Complaints. During the year 2,803 complaints of nuisance were received by the Health Department. After investigation the necessary notices for the remedy or abatement of the defects or nuisances discovered were served. Sanitary Inspection of the Area. During the year 19,474 inspections including re-inspections, were carried out by the sanitary inspectors. Included in this number are the inspections on complaint of nuisances, and 622 with reference to infectious disease. The number of inspections of factories, workshops and work places was 518. Defects were found and remedied in 9 instances. The number of intimation notices served was 993 and the number of statutory notices 180. Only in 35 instances, where the owners did not comply with the statutory notices, was the Town Clerk asked to institute proceedings. It was, however, necessary to issue summonses in only 2 instances, as in all other cases the necessary steps were taken on receipt of a letter from the Town Clerk. Eradication of Bed Bugs. The methods adopted in Woolwich in this respect have been reported on very fully in previous reports. During 1939, 4,023 inspections of verminous houses were carried out and the necessary action was taken. Rats and Mice (Destruction) Act, 1919. The number of inspections of rat infested premises made during 1939 was 387. In 114 instances it was necessary to secure the repair of defective drains. Fifty-one premises were made rat-proof and other effective measures were taken in 22 instances. During National Rat Week held from 6th to 11th November, action similar to that of previous years was taken. The number of baits laid in sewers was 7,910. HOUSING. The total number of dwelling houses inspected for housing defects under the Public Health or Housing Acts was 3,043, and the number found not to be in all respects reasonably fit for human habitation was 1,065. The number rendered fit in consequence of informal action by the sanitary inspectors (including the service of intimation notices) was 833. Statutory notices were served in respect of 132 houses. Twenty-seven new cases of overcrowding were reported during the year and 40 cases were relieved. Of these, 12 were re-housed by the Woolwich Borough Council as part of their general housing policy, and 12 by the London County Council as part of their abatement of overcrowding policy. 11 New Houses. Certificates of a proper and sufficient supply of water were issued for 836 new houses. Of these 107 were in respect of houses built by the Council. Clearance Areas. Action was begun by the Borough Council with regard to the following areas :Margaret Cottages, Dairy Lane (2 houses), Woodhill (2 houses), Plumstead High Street (2 houses), Hull Place, and Plumstead High Street (17 houses). No enquiries in respect of these areas were held during 1939, but inquiries were held and the Orders confirmed in respect of five areas where the first steps were taken in the previous year, viz.: Garland Road and Pendrell Street (82 houses); Albert Road, No. 2 (4 houses); Sidney Cottages, Reidhaven Road (2 houses); Foreland Street, No. 1 (8 houses); Foreland Street, No. 2 (7 houses). Orders were confirmed also in respect of two areas where no objection was made, viz., Frances Street (3 houses), Inverary Place (8 houses). INSPECTION AND SUPERVISION OF FOOD. Milk. The number of milk premises on the register on the 31st December was 63, and 94 inspections were made. Two pasteuriser's licences, 10 dealer's licences and 7 supplementary licences were issued under the provisions of the Milk (Special Designations) Orders, for the sale of pasteurised milk, and 10 dealer's and 4 supplementary licences were issued for the sale of " Tuberculin Tested " milk. The number of samples of designated milk examined bacteriologically was 12. All complied with the prescribed standards. Meat Supplies. The number of animals slaughtered and inspected at the slaughterhouses in the Borough was 49,344 compared with 43,288 in 1938. Premises where Food is Prepared or Offered for Sale. All such premises, including those registered under the provisions of the Public Health (London) Act, 1936, are kept under frequent observation. The number of inspections carried out during the year was 2,138. The total weight of food surrendered including carcases and parts of carcases found to be unsound at the slaughterhouse, was 33 tons 15 cwts. Sophistication of Food. During the year 696 samples were submitted to the Public Analyst for analysis. Of these 504 were informal and 192 formal. 46 samples were reported as adulterated. 12 The following Table gives details of adulterated samples and the action taken in each case where the sample was formal. Table No. 4. Sample No. Article. Formal or Informal. Result of Analysis. Result of Legal Proceedings or other Action. 593 Camphorated Oil Informal Contained water, 1 per cent. — 602 Cheddar Cheese Informal Fat deficient, being only 33.9 per cent, of the dry substance of the cheese. — 649 Peppercorns Informal Contained pimento (allspice), 3.7 per cent. — 663 Condensed Full Cream Milk, Sweetened Informal 3 per cent, deficient in milkfat, and equivalent to only 11 pints of milk instead of lg pints, as declared. — 712 Milk Formal 21 per cent, of the fat abstracted. Vendor fined 20s. with 21s. costs. 784 Margarine Informal Incorrectly labelled. The wrapper was cut in half, only "Marga" in letters ¼ in. high remaining as a label. Other descriptive matter and a coupon were also printed on the halfwrapper. — 802 Margarine Informal Incorrectly labelled. In addition to the word "Margarine,"other descriptive matter was printed on the wrapper. 802 Margarine Informal Incorrectly labelled. In addition to the word "Margarine," other descriptive matter was printed on the wrapper. — 807 Milk Formal 6 per cent, of the milk-fat abstracted. — 816 Fruit Butter Grapefruit. Informal Contained 8 dead ants — 35 Margarine Informal Incorrectly labelled. Other descriptive matter in addition to the word "Margarine" was printed on the wrapper. — 37 Sweets — Rum and Butter Toffees. Informal Contained 8.3 per cent, of Margarine fat. — 13 TABLE No. 4—continued. Sample No. Article. Formal or Informal. Result of Analysis. Result of Legal Proceedings or other Action. 57 Margarino Informal Incorrectly labelled. Other descriptive matter in addition to the word "Margarine "was printed on the wrapper. — 68 Milk Formal 5 per cent, of the milk fat abstracted. Ordered to pay 12s. 0d. costs. 92 Blackcurrant Jam— Full Fruit Standard. Informal Contained not more than 18 per cent, of blackcurrant fruit. — 96 Malt Vinegar "(Pure, Finest Quality). Informal Contained not less than 30 per cent, of unmalted or artificial Vinegar. — 101 Margarine Informal Incorrectly labelled. Other descriptive matter in addition to the word "Margarine" was printed on the wrapper. — 103 Glac£ Fruits Informal Consisted of sugar - coated jellies, coloured and flavoured to represent fruits. — 105 Celery Cheese Informal Contained 12.1 per cent, of Fat, corresponding to a deficiency of 51 per cent. — 120 Glauber's Salt Informal Consisted of effloresced Glauber's Salt, equivalent to 116-2 per cent, or crystalline sodium sulphate. — 121 Glauber's Salt Informal Consisted of effloresced Glauber's Salt, equivalent to 113-7 per cent, of crystalline sodium sulphate. — 150 Blackcurrant Jam— Full Fruit Standard. Formal Contained not more than 23 per cent, of blackcurrant Stock withdrawn from sale. 151 Natural Orange Squash. Informal Consisted of a mixture of sugar, citric acid and water, with not more than 20 per cent, of orange juice, and coloured red with an artificial dye and preserved with 260 parts per million of sulphur dioxide. — 198 Grey Powders (3 years) Informal Consisted of 12 powders of an average weight of 1.90 grains, containing:— Mercury, 6 per cent.; Chalk, 16 per cent.; Milk Sugar, 78 per cent. — 14 TABLE No. 4—continued Sample No. Article. Formal or or Informal. Result of Analysis. Result of Legal Proceedings or other Action. 201 Gregory's Powder Informal Contained:— Magnesium Oxide, 59 per cent.; Magnesium Carbonate, 9 cent.; Rhubarb, 22 per cent.; Ginger, 10 per cent. — 207 Celery Cheese Formal Contained 11.7 per cent, of fat, corresponding to a deficiency of 53 per cent. Cautionary letter. 238 Milk Formal 7 per cent, of the milk-fat abstracted. Vendor ordered to pay 20s. 0d. costs. 242 Hum and Butter Lumps. Informal The sample contained: Ruinflavoured toffee (fat-free), 96.9 per cent. Margarine, 3 .1 per cent. — 260 Sausages Informal Contained sulphur dioxide:— 280 parts per million. — 288 Jam, Red Plum, Full Fruit Standard. Informal Contained not more than 37 per cent, of red plum fruit. — 318 Milk Formal Contained not less than 4 per cent, of added water. Vendor cautioned. 320 Milk Formal Contained added sugar. 1.20 per cent., and small proportion of added water. Vendor cautioned. 343 Lard Informal Consisted of a mixture of edible oils and fats of vegetables and animal origin. — 345 Lard Formal Consisted of a mixture of edible oils and fats of vegetable and animal origin. — 347 Lard Informal Consisted of a mixture of edible oils and fats of vegetable and animal origin. — 355 Butter Informal Contained water—16.1 per cent. — 358 Luncheon Sausage Informal Contained sulphur dioxide:— 230 parts per million. — 359 Liver Sausage Informal Contained sulphur dioxide:— 85 parts per million. — 360 Beef Sausages Informal Contained sulphur dioxide:— 450 parts per million. — 362 Luncheon Sausage Informal Contained sulphur dioxide:— 50 parts per million. — 15 TABLE No. 4—continued Sample No. Article. Formal or Informal. Result of Analysis. Result of Legal Proceedings or other Action. 428 Zinc Ointment Informal Zinc Oxide, 7 per cent, excessive. — 439 Sago Informal Consisted entirely of seed tapioca. — 460 Glace Fruits Informal Consisted of coloured, fruitflavoured Jellies, coated with sugar. — 467 Glace Fruits Informal Consisted of sugared jellies, coloured, flavoured and moulded to resemblo glace fruits. — 472 Meat Pie Informal Contained boric acid: 0.015 per cent. — 483 Glace Fruits Formal Consisted of coloured, fruit flavoured jellies, coated with sugar. — 484 Glace Fruits Informal Consisted of sugared jellies, coloured, flavoured and moulded to resemble glace fruits. — Food Poisoning. The number of notifications of cases of food poisoning was 16. PREVALENCE AND CONTROL OF INFECTIOUS DISEASES. Notifications. The total number of notifications received was 2,047. The classification under diseases was as follows:— Table No. 5. Diphtheria 123 Ophthalmia neonatorum 43 Scarlet Fever 374 Encephalitis Lethargica 1 Enteric Fever (including Paratyphoid) 8 Dysentery 21 Cerebrospinal Meningitis 9 Puerperal Fever 6 Poliomyelitis 4 Puerperal Pyrexia 42 Polio-encephalitis 1 Erysipelas 51 Zymotic Enteritis 56 Smallpox — Measles 43 Pneumonia 265 Whooping Cough 998 Malaria 2 Diphtheria. The amount of anti-toxin supplied to medical practitioners during the year was 76,000 units. The number of children immunised during the year was 368. 16 Ophthalmia Neonatorum. Forty-three cases were notified, 4 of which were admitted to hospital. Nursing assistance was provided under the Council's scheme in 32 cases. Tuberculosis. The number of new cases examined was 1,025. Of these 190 were definitely tuberculous. 389 contacts were examined, of which 24 were definitely tuberculous. The total number of attendances at the Dispensaries was 4,937, and 3,724 visits were made by nurses to homes of patients. 181 domiciliary visits were paid by the Tuberculosis Officer or an Assistant Medical Officer, and 438 cases were referred to the Dispensaries by medical practitioners. 570 specimens of sputum were examined, of which 129 were positive ; and 1,197 X-ray examinations were made. The number of cases on the register on the 31st December, 1939, was 923. 104 patients received artificial pneumothorax treatment. Additional nourishment was granted in 313 instances. 37 patients received dental treatment under the Council's scheme. 350 patients were admitted to hospitals, sanatoria or training colonies. The Tuberculosis Care Committee continued their meetings and rendered valuable assistance in various ways to the needy tuberculous and their families. Disinfection and Disinfestation . The number of rooms disinfected after cases of infectious disease, etc., was 1,886. Of these 324 were rooms which had been occupied by tuberculous persons. 1,056 rooms were disinfected for verminous cases. 28,707 articles were disinfected at the Disinfecting Station. The number of school children cleansed at the Cleansing Station, White Hart Road, in accordance with the terms of the agreement with the London County Council was 1,645. The number of adults cleansed was 34. TABLE OF CONTENTS, page Health Committee 2 Maternity and Child Welfare Committee 2 Preface 3 Vital Statistics 5 General Provision of Health Services in the Area 7 Sanitary Administration 10 Housing 10 Inspection and Supervision of Food 11 Prevalence and Control of Infectious Diseases 15