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8e90bc1a-94fa-49a5-a514-e1adecb32e63	Inspector of Factories, and no notification was received from him. Home Workers. The number of home-workers on the Register, and the nature of the work undertaken by them were as follows:—Fancy needlework, 6; Dressmaking, 3; Tailoring, 6. (7) SHOP ACTS, 1938. Inspections under the Shops Acts 1912 to 1938 have been carried out by the Chief Sanitary Inspector with the assistance of the Assistant Sanitary Inspectors. During the past year 179 shop premises were'inspected for the purposes of the above Acts. In 2 instances notice relating to the sanitary accommodation was given to the occupier. In each of these cases the notice was complied with. (8) SMOKE ABATEMENT. The chimneys of factories and other buildings were kept under observation with a view to detecting any contravention of the Byelaws.
9fd2eba7-1e2f-4ce7-ac9d-8f8e48624eef	In one instance a nuisance was detected, the nuisance being caused by the emission of black smoke. The matter was investigated and, after a written notice had been sent to the responsible person, the nuisance was abated. 12 (9) RATS AND MICE (DESTRUCTION) ACT, 1919. There were 163 complaints of infestation of premises with rats.. The rat-catcher made 423 visits to enclosed premises, and 329 visits to open spaces in connection with his duties under the Act. The number of rat-tails brought to the Public Health Office by the ratcatcher during 1939 was 785. Poison bait was laid at 110 premises, and 20 sewers were baited with poison. (10) PREMISES AND OCCUPATIONS WHICH ARE CONTROLLED BY BYE-LAWS OR REGULATIONS. Houses let in Lodgings. During the past year 73 visits were made to premises on the register of houses let in lodgings.
fc7ac1a3-d35e-4eed-a044-cf536263b41a	During the year 24 such premises were removed from the register, being no longer occupied by two or more families, and 21 premises were added to the register. The total number of such premises on the register at the end of the year was 106. Underground Rooms. No closing order in respect of any basement dwelling was made during the year. Servants' Registries. Registries for female domestic servants are controlled by bye-laws made under Part V of the Surrey County Council Act, 1925. There are 4 premises on the Register. No action for breach of the bye-laws was taken during the year. Offensive Trades. Fish-frying has been declared to be an "offensive trade" in the area and is controlled by bye-laws. During 1939 the number of premises on the Register in which fish-frying is permitted was 5. (11) SWIMMING BATHS AND BATHING POOLS.
451ec661-0f34-407d-b63a-1001cc2c6661	There is no public swimming bath or bathing pool under the management of the local authority in the Borough. A privately owned bathing pool, belonging to the Roehampton Club, and open to the public at a charge, has been in use for several years past. This pool, however, whilst closely adjacent to Barnes Borough, is situated in the Metropolitan Borough of Wandsworth. 13 In 1939 the privately owned bathing pool belonging to the Ranelagh Club was opened to the public at a charge for admission during the spell of hot weather in Midsummer. Purification of the water at the bath is carried out by means of filtration and chlorination. Bacteriological examination of water from the bath showed the water to be in a satisfactory condition for bathing purposes. (12) SCHOOLS. There are 26 schools in the 6 district. Of these 12 are Public Elementary Schools, 2 are County Secondary Schools, and 12 are private schools.
5e0cecd5-eda7-4ef9-810f-884a933cecc4	Careful investigations have been made into all outbreaks of infectious diseases amongst scholars, and exclusions from school, as necessary, were rigidly enforced in accordance with the practice described in previous Annual Reports. Details of the incidence of scarlet-fever and diphtheria (two of the more serious, but relatively more preventable, infectious diseases) among children attending school during the year are given below. Of 36 cases of scarlet fever notified during the year 17 were cases in children of school age. Of these 13 were children attending public elementary schools, and 4 were cases in children attending private schools (1 at a private school in Barnes, and 3 at private schools outside the district). Of the 4 cases of diphtheria notified during the year 3 were cases of children of school age. One of these children attended a public elementary school in the Borough, the other 2 attended schools outside the Borough.
95fa6d42-5a75-4f62-9727-e10f81d050a9	In the 12 public elementary schools cases occurred as under Number of scholars on Register. Number of scholars who suffered from:— Scarlet Fever. Diphtheria Barnes Central Boys 212 – – „ „ Girls 229 3 – Lowther J.M. and Infants 257 1 – Westfields Mixed 202 – – „ Infants 128 1 – East Sheen J.M. and Infants 424 3 – Mortlake Central Boys 191 – – „ „ Girls 219 1 – Mortlake Council J.M. and Infants 350 3 1 Mortlake C.E. Mixed 157 1 – „ „ Infants 77 – – Mortlake R.C. 153 – – Total 2,599 13 1 14 Of the 12 private schools in the district scarlet fever occurred in only 1 of them. No case of diphtheria occurred in any private school in the Borough.
a4d05f8e-10fb-4c6a-981b-678b44101f31	The incidence of infectious diseases amongst children of school age was extremely low. It is very satisfactory to have been able to restrict the numbers of cases of scarlet-fever and diphtheria amongst a total of 2,600 school children on the public elementery school registers to such small numbers as 13 scarlet-fever cases and 1 case of diphtheria during the year. (13) ERADICATION OF BED BUGS. Particulars are given below of action taken during the year in the case of dwellings found on inspection to be bug-infested. (i) Disinfestation of houses. The number of infested houses dealt with was 24. Of this number 16 were Council houses, and 8 were houses not owned by the Council. Disinfestation of the 16 Council houses was carried out by the staff of the Public Health Department. Zaldecide was employed in the case of all these houses.
f0121537-c337-44ff-aa90-646579289710	In the case of the 8 houses in which disinfestation was carried out by the owners, advice was given by officers of the Public Health Department as to the most suitable action to be taken in each particular case in dealing with the premises. During 1939 hydrogen cyanide was not employed for the disinfestation of any house. (ii) Disinfestation of household effects (excluding bedding). The number of families rehoused whose household effects were disinfested by hydrogen cyanide in the course of removal during the year are given below:— Rehoused in Council houses:— (i) From clearance areas 1 (ii) For the abatement of overcrowding 6 (iii) On general public health grounds 3 Total 10 Disinfestation of household effects by hydrogen cyanide in the course of removal has in all cases been carried out by a contractor. 15 (iii) Disinfestation of bedding and bedclothing.
44ad6a8e-bbaf-4e28-8b35-771f4c2f4b8b	In all cases disinfestation of bug-infested bedding and bedclothing has been carried out by steam-disinfection at the Council's Disinfecting Station. During the year 30 lots of bedding were disinfested by this method. (iv) Prevention of re-infestation after cleansing. In all cases of disinfestation of dwelling-houses and household effects the tenants have been advised as to the means and practices by which re-infestation after cleansing may be prevented. Following disinfestation periodical visits of inspection by the Sanitary Inspectors have been carried out for the purpose of supervision. This has had very satisfactory results. In the case of families removed from houses in slum-clearance areas or from "overcrowded" dwellings and re-housed in Council houses or flats only one instance of re-infestation was discovered.
6fd1694a-3c45-4a6b-8c7b-07412146d29e	During the years 1935 to 1939 the household effects of 185 families were disinfested, 149 of these being families rehoused from clearance areas, 20 in connection with the abatement of overcrowding and 16 on other public health grounds. 16 Section IV. HOUSING. (I) HOUSING STATISTICS FOR THE YEAR 1939. 1. Number of New Dwellings Erected during the Year:— Total erected 98 (i) By the Local Authority 14 (ii) By other Local Authorities Nil (iii) By other bodies or persons 94 2. Number of Dwellings Owned by the Local Authority:— Number of houses 241 „ „ flats 207 Total 448 3. Unfit Houses.
c79126d5-1947-4a13-97c3-7a5ddd9d6053	(I) Inspection of Dwelling Houses during the Year:— (i) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 597 (b) Number of inspections made for the purpose 2607 (ii) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations,
ca6fc02a-cfed-4f9e-9243-d6f1c6402ff4	1925 and 1932 94 (b) Number of inspections made for the purpose 1119 (iii) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (iv) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 406 (II) Remedy of Defects during the Year without service of formal notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 322 17 (iii) Action under Statutory Powers during the Year:— During 1939 no proceedings were taken under any of the following Statutory Powers:— (a)—Sec. 9, 10 and 16, Housing Act, 1936.—(Repair of dwellinghouses). (b)—Public Health Acts—(Remedy of defective conditions in dwelling-houses). (c)—Sec.
e5f8055e-d522-4ae0-8fd3-b508a53d6963	11 and 13, Housing Act, 1936—(Demolition Orders). (d)—Sec. 12, Housing Act, 1936—(Closing Orders, underground rooms). 4. Housing Act, 1936—Part IV—Overcrowding. (a) (i) Number of dwellings overcrowded at the end of the year 18 (ii) Number of families dwelling therein 18 (iii) Number of persons dwelling therein 103 (b) Number of new cases of overcrowding reported during the year 4 (c) (i) Number of cases of overcrowding relieved during the year 23 (ii) Number of persons concerned in such cases 115 (2) HOUSING CONDITIONS. Inspection of dwelling-houses and remedy of defects.
80793625-e2fa-41f4-8649-40ae7e84007d	Considering the abnormal conditions due to the war the number of dwelling-houses inspected during 1939, though fewer, compares favourably with the number inspected in previous years (597 in 1939 contrasted with 681 in 1938). House-to-house inspection under Housing Consolidated Regulations had to be curtailed towards the end of 1939, and work restricted to remedying of defective conditions in dwelling-houses discovered in the course of other work, or on complaints. The number of dwelling-houses found defective was 406 as against 488 in 1938, and the number of houses rendered fit 322 contrasted with 389 in 1938. Remedy of defects was obtained in all cases by informal action. During the year no dwelling-house was found to be in a state so dangerous or injurious to health as to be unfit for human habitation. Slum Clearance.
58d8af52-35de-408f-9b40-a12927a813e7	Fortunately all the ten Clearance Areas included in the fiveyear slum clearance programme had been dealt with before the 18 outbreak of war, and the whole of the families who had to be displaced had been re-housed either in Council houses or in the blocks of flats which had been erected by the Council specially for this purpose. Of the 147 dwelling-houses included in the clearance areas 96 had been demolished at the end of the year, and 51 awaited demolition (1 in Area No. 5 and 50 in Area No. 10). Overcrowding—Housing Act, 1936—Part IV. (1). Ascertainment of "Permitted Numbers." During 1939 applications from landlords requesting to be furnished with information as to "permitted numbers" were received in respect of 96 "dwellings" included in the Overcrowding Survey.
e89ddd90-646c-4d8b-a61c-51db97cbd7e4	Certificates giving the "permitted numbers" for these were issued, making a total number of 3,050 "dwellings" in respect of which certificates have been issued in accordance with the Act. (2). Abatement of Overcrowding. There has been no instance during the year of any dwellinghouse having again become overcrowded after the Council had taken steps for the abatement of overcrowding. During 1939 only 4 new cases of overcrowding were discovered and 23 abated, leaving a balance of 18 cases of overcrowding awaiting abatement on the 31st December, 1939.
091ceff7-d79b-4cf2-a2f5-d5cda70c9d83	Of the 23 cases in which overcrowding was relieved during 1939 11 were relieved by rehousing the families in Council houses, 1 was rehoused by the London County Council in a house on the London County Council Castelnau Estate, and the remaining 11 had become relieved in various other ways, such as the families having removed to dwellings with more accommodation, some of the members of the households having left to reside elsewhere, etc. The overcrowding survey in 1935 disclosed 140 "dwellings" in which statutory overcrowding existed Progress in the abatement of overcrowding during the four years since the date of the Survey has been as follows:— Totals Cases of Overcrowding. 1936. 1937. 1938. 1939. 1936-39.
9dd70a5f-7fdd-4ff2-870c-7d86738a1638	Awaiting abatement 1st January 140 119 109 37 140 New cases discovered 20 22 14 4 60 Total for abatement 160 141 123 41 200 Abated during the year 41 32 86 23 182 Awaiting abatement 31st December 119 109 37 18 18 19 Section v. INSPECTION AND SUPERVISION OF FOOD. MILK SUPPLY. The number of premises in the district registered as dairies is 4. The number of purveyors of milk who sell by retail in the Borough is 59. Forty-six of these purveyors retail milk from premises situated within the Borough (4 from registered dairies, and 42 from premises which do not constitute dairies); the remaining 13 purveyors retail milk in this area from premises situated outside the Borough.
670b99bb-8ce9-4304-b361-12ed9e0c3eab	The number of visits paid by the sanitary inspectors to the premises of persons engaged in the milk trade during 1939 was 78. Designated Milk. During 1939 designated milk was retailed to customers in this Borough by the same 7 purveyors details in respect of whose licences were recorded in my Annual Report for 1938. All these purveyors were granted licences to sell by retail "pasteurised" milk and four of them licences to sell "tuberculin tested" milk. In addition a licence was granted during the year to another purveyor to sell "pasteurised" milk from a milk-shop situated in the Borough. Adulteration. Nineteen samples of milk were taken by the County Inspector under the Sale of Food and Drugs Acts. Only one of these was found to be adulterated. Refusal or Revocation of Registration.
3ce5d058-6b21-4c9b-8fb7-56925cf4fb6f	The Council did not during 1939 refuse or revoke registration on the grounds that the public health was, or was likely to be, endangered by any act or default of any purveyor in relation to the quality, storage or distribution of milk. Tuberculous Milk and Tuberculous Cattle. There has been no instance where there was reason to suspect that tuberculosis was caused or likely to be caused by the consumption of milk sold in the district. There is no cowshed in the area. The Council is not a Local Authority for the purposes of the Diseases of Animals Act, 1894. 20 MEAT. Inspection of Butchers' Shops. There are 33 butchers' shops in the area. The number of visits of inspection made by the Sanitary Inspectors, who are Certified Inspectors of Meat, was 235. No diseased meat was found in the course of these inspections.
cdc598c0-de1b-4125-a1f9-b0a6027ff0bf	No proceedings were taken under the Public Health (Meat) Regulations, 1924. Slaughterhouses. There is no public slaughterhouse in the area. The only private slaughterhouse licenced in the Borough has been found to be kept in a satisfactory condition. During the year 44 notices of intention to slaughter were received. Inspection at the time of slaughter was made by the Chief Sanitary Inspector or by one of the District Sanitary Inspectors. The animals slaughtered on these occasions were 111 swine, 16 cattle and 6 sheep. During the course of inspection it was found that the intestines of 6 oxen were affected with Johnes disease. The intestines were destroyed. OTHER FOODS.
132cf34b-859b-496f-902d-b85b299508b3	Premises where food other than milk or meat is sold or prepared for sale, which include fishmongers and poulterers (18), greengrocers (51), fried fish shops (5), cooked-provision shops (36), eating houses (34), ice-cream shops (48), bakehouses (14)—total 206, were inspected periodically. The number of visits of inspection made to these during the year totalled 470. Notices as to unsatisfactory conditions discovered were served in 5 instances and the requirements of the notice in each case were complied with. The number of bakehouses in use in the Borough remained unchanged during 1939; these numbered 14, one being an underground bakehouse. Thirty-three visits of inspection were made, and in only one instance was a defective condition found; this was remedied on informal notice. ADULTERATION OF FOOD. Food and Drugs Acts, Milk and Cream Regulations, Preservatives in Food Regulations.
0ca25a9d-85b4-4a48-9f6f-88a3fc01439e	On 1st October 1939, the Barnes Council became the Local Authority under the Food and Drugs (Adulteration) Act, 1938, and 21 the Council made the necessary preparations to take over the administration within the Borough of the Acts and Regulations relating to Adulteration, etc., of Food and Drugs, the administration of which had been previously undertaken by the Surrey County Council. The County Medical Officer has supplied me with the information contained in the following Table setting out the work undertaken in this Borough by the County Inspectors. Table 3.—Return of Samples Analysed during the Year ending 31st December, 1939. Articles, Analysed Adulterated or deteriorated. Prosecutions. Convictions. Formal Informal. Total Format Informal Total.
03d4e39f-a588-4b17-8185-7cf901664073	Milk 13 6 19 1 — 1 — — Cream 1 — 1 — — — — — Preserved Sau'ges 1 — 1 — — — — — Jam 1 2 3 — — — — — Beer 4 — 4 — — — — — Cascara Sagrada — 1 1 — — — — — Totals 20 9 29 1 — 1 — — UNSOUND FOOD. In no instance was it found necessary to seize unsound food on any premises. The following articles were voluntarily surrendered and destroyed as being unfit for human consumption:— 3 stone of dog fish. 30 lbs. of ox liver. 1 pig's liver. 22 Section VI. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES.
46b916f5-e1dc-4792-b1a5-89c62852ce3e	Particulars of the incidence and distribution of the cases of infectious disease notified during the year 1939 are set out in Table XI in the Appendix in which the number of cases removed to hospital and the number of deaths in the district from these diseases are also given. The prevalence of the various notifiable infectious diseases during 1939 is shown in Table 5 which gives for comparison the number notified during each of the previous 10 years. In Table 4 the seasonal prevalence during 1939 is shown. Table 4.—Showing the Notifications of Infectious Diseases Received during 1939 arranged in Four-Weekly Periods. Fourweekly period ending Diphtheria. Scarlet Fever. Measles. Rubella. Enteric Fever. Pneumonia. Erysipelas Puerperal Pyrexia. Cerebrc-spinal Fever. Dysentery, Whooping Cough Jan.
1c38a30e-6d97-4410-8ca2-35fb57940907	28 - 2 - - - 4 2 - - _ * Feb. 25 1 1 3 1 — 5 — — 1 — * Mar. 25 — 7 1 2 — 2 — 1 — 1 * April 22 — 10 1 5 — — 1 — — — * May 20 — 4 - 4 — 1 1 — — — * June 17 — — 1 2 — — 2 — — — * July 15 — 1 - 5 1 — — 1 — — * Aug. 12 - 3 - 1 — — 2 — — — * Sept. 9 - 2 - 2 — - 1 1 — — * Oct. 7 - - - - - - - - * Nov. 4 - 3 - * - - - - - - - Dec.
b9f272bc-8a11-48de-b150-0011c6f14f42	2 1 1 - * — 2 - — — — 5 Dec. 30 2 2 2 * — - 1 — — — — Totals 4 36 8 22 .1 14 10 3 1 1 5 * Not notifiable. 23 Table 5.—Notifiable Infectious Diseases, 1929 to 1939. Year. 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 Diphtheria 46 41 16 1 72 29 31 4 3 1 4 Scarlet Fever 75 74 64 92 147 132 77 56 84 52 36 Enteric Fever 2 45 3 4 — 1 1 3 3 2 1 Puerperal Fever 1 — 1 1 1 1 —
8c1d10fc-6dd5-4d57-a035-07705707fdf6	2 — — — „ Pyrexia 1 2 2 4 2 2 3 1 1 4 3 Erysipelas 11 8 7 10 16 11 16 11 12 6 10 Continued Fever — - — — — — — — — - — Relapsing Fever - - - - - - - - - - - Typhus Fever - - - - - - - - - - - Small-pox - - - - - - - - - - - Cholera - - - - - - - - - - - Plague — — — — — — — — — — — Tuberculosis, P. 51 43 41 44 30 42 21 39 28 25 35 „ Non-P. 11 10 6 13 10 6 8 5 10 8 3 Cerebro-spinal Fever — — — — 2 1 — — —
53e7a37d-d7c7-425b-839d-8b34ce158e5e	2 1 Poliomyelitis — — 1 — 1 — — — 2 1 — Ophthalmia Neonatorum 1 1 - 1 - 1 1 1 1 1 - Measles 126 397 31 790 50 551 7 517 101 387 8 Rubella 123 41 16 8 23 61 5 29 9 439 22 Encephalitis Lethargica 1 - - - - - - - - - - Polioencephalitis - - - - - - - - - - - Malaria 1 - - - - - - - - - Dysentery — — — — — — — — — 1 - Pneumonia 52 16 28 30 35 36 13 21 34 18 14 Anthrax - - - — — — — — — - - Whooping Cough - - - (Not
0ba7fb7c-2cec-4db9-8c7b-9c9c93a274ff	Notifiable). - 5* (* Notifiable in Barnes Borough from October 1939 only.) NOTIFIABLE INFECTIOUS DISEASES (EXCLUDING TUBERCULOSIS). Small-pox. No case of small-pox occurred in this district during the year. Vaccination. I have not in my capacity of Medical Officer of Health had occasion to perform any vaccinations under the Public Health (Small-Pox Prevention) Regulations, 1917.
2ea1af95-af11-457e-a20b-ddedd5dbb653	24 The following particulars, with reference to the state as regards vaccination on the 31st December, 1939, in respect of the 309 infants whose births were registered between 1st January and the 31st December, 1938, have been supplied to me by the Vaccination Officer for the district:— Births Registered in 1938 309 Certificates of successful vaccination 144 Certificates of exemption 120 Certificates of postponement of vaccination — Insusceptible to vaccination 2 Died unvaccinated 19 Removed to other districts 19 Not yet accounted for in Vaccination Register 5 Diphtheria. Only 4 cases of diphtheria were notified during 1939. The incidence-rate for this disease in Barnes was 0.10, compared with 0.98 for London, and 1.14 for England and Wales per 1,000 of population.
1dc65b9b-5699-4ecc-8be0-f1d04f92704e	The incidence of diphtheria in the Borough has been extremely low for several years past; during the four years 19361939 a total of only twelve cases have been notified. The arrangements for the supply of Diphtheria antitoxin to medical practitioners, and the preventive measures described in my previous Annual Reports were continued unchanged during 1939. Diphtheria Immunisation. During 1939 the work of the Council's diphtheria immunisation clinic was continued at Essex House Maternity and Child Welfare Centre until the outbreak of war, when this Centre and the North Worple Way M. & C.W Centre were taken over for A.R.P. purposes for use as first aid posts. From this time onwards a limited number of sessions were held at the Public Health Department. Immunisation was performed by a specialist Medical Officer appointed by the Council for this purpose. (a) Work of the Clinic during the Year.
871739c2-73f0-4332-8d92-4a9ad588b932	Information is given below as to the work undertaken in connection with the scheme during the year ending 31st December, 1939:— During the above-mentioned period leaflets were issued to 246 mothers drawing their attention to the facilities available at the Clinic for their children. 25 Requests for testing, and immunisation where necessary, were received from parents during 1939 in respect of 71 children. On the 1st January 1939 there were 4 applications, received during 1938, which had not been dealt with by the end of that year. Of these cases and the 71 applications received during 1939, making 75 in all, 62 received appointments to attend at the Clinic. Five of those appointed had not attended by the end of the year, the parents having withdrawn their applications or postponed attendance on account. of ill-health of the child.
44ee22f1-ca6d-44bf-bf55-63f7f9feb250	The number of children attending for immunisation at the Clinic during the year totalled 110, consisting of the above-mentioned 57 new cases plus 53 children whose course of injections had commenced in 1938 but which had not been completed by the end of that year. The position as regards these 110 children on the 31st December, 1939 is given in the accompanying Table (page 26). In addition to the above 110 children, 182 children attended for their second post-Schick test two years after immunisation, making a total of 292 children attending during the year. Twenty-three sessions of the Clinic were held and the attendances made by the 292 children numbered 671, an average of 29 children per session. The work of the clinic has run very smoothly and the attendance of the children has been regular. (b) Method of Procedure.
e3a6283c-8b1a-4dfc-9683-02441fde118c	The procedure which has been adopted at the clinic has been as under:— All the children (including those under 5 years of age) have received a primary Schick test to ascertain their susceptibility to the disease. The immunising agent used has been T.A.M., three immunising injections of which have been given. The number of cases in which a second course of injections (usually two in number) has been required before complete immunity, as shown by the Schick test, was established has been very small. Four instances have occurred in the year's work. In every case a Re-Schick test after a negative primary Schick test, or a Post-Schick test after immunising injections, has been performed and a negative result obtained before issuing a certificate of natural immunity, or of artificial immunity after protective injections. Reactions after injections have been very few in number, and those that occurred were only slight in degree. 26 Table 6.—Diphtheria Immunisation Clinic.
723cfb60-5a7c-4e8d-b16e-369b7beb77e1	The Following Table Shows the Position on 31st December, 1939, in Respect of the 110 Children who Attended the Clinic during 1939. TOTAL CASES dealt with during 1939 Position on 31st Dec., 1939 110 (A) Continued in Attendance. 90 (1) Primary-Schick Negative:— 8 (a) Re-Schick Negative (Certificate) 4* (b) Awaiting re-Schick test 1 (c) Re-Schick Positive:— 3 (i) 3-injections, Post-Schick Negative (Certificate) 3* (ii) „ , awaiting Post-Schick test - (2) Primary Schick-Positive:— 82 (a) 3-injections and, Post-Schick Negative (Certificate) 41* (b) Awaiting Post-Schick reading 33 (c) Awaiting Post-Schick test 8 (B) Discontinued Attendance.
7c830a45-d961-46e8-b54a-ef81fe601467	20 (a) Left the District:- 2 (i) Primary-Schick, awaiting reading - (ii) Primary-Schick, Negative - (iii) „ „ Positive, 3-injections 2 (b) Discontinued for other reasons:— 18 (i) Primary-Schick, awaiting reading 2 (ii) Primary-Schick, Negative 2 (iii) „ „ Positive, 3-injections 14 (C) Number Immunised and Certificates Issued. 48 Schick tests Negative throughout 4 „ „ Negative after immunisation 44 * Cases in which Certificates of immunity have been issued. The figures in this Table do not include the 182 children, referred to previously, who attended at the Clinic during the year merely for the purpose of a Re-Schick Test two years after the date of immunisation. 27 (c) Progress since the Commencement of the Clinic.
da4d9c3e-77d3-42ab-8e93-1313fd7d6871	A summary of the progress made under the scheme since its commencement in June 1936, to-date is given hereunder:— Number of leaflets issued to parents 4,931 „ „ children for whom applications for treatment have been received 919 „ „ children who have been appointed to attend the clinic 913 „ „ children who have so far attended 908 „ „ children who have continued to attend to-date 833 „ „ children in respect of whom certificates of immunity have been issued 819 „ „ children awaiting Re-Schick test 14 „ „ children who failed to complete course 75 Number of Clinic sessions held 145 „ „ attendances made by children 5,347 Average attendance per session 37 There has been no instance of any child in the Borough who had reacted negatively to a primary Schick test, or who had been immunised after a positive Schick test, having been notified as a case of diphtheria. Scarlet Fever.
8780dc58-94c5-4f10-8baf-09a0399ca0bf	The number of cases notified during 1939 was only 36. This is a low incidence, the number notified annually during the previous ten years having varied between a maximum of 147 cases and a minimum of 52 cases. The incidence-rate for this disease in Barnes was 0.92, compared with 1.53 for London, and 1.89 for England and Wales per 1,000 of population. Of the 36 cases notified 33 were removed to the Council's Isolation Hospital; in the remaining 3 cases isolation of the patient was carried out at home. Of the thirty-six notified cases 7 were young children under school age, 17 were children attending school, and 12 were patients above school age. The house-incidence of the cases was as follows:—In 31 instances only a single case occurred in the house, in one house 2 cases occurred and in another house 3 cases occurred.
a2eefd87-b96d-4236-9fb0-5a4edad19c25	The preventive measures taken in previous years were continued unchanged in 1939. 28 Measles. This disease becomes epidemic in this district every second year. During 1939 only 8 cases of measles were notified, in addition to 22 cases of german measles, compared with 387 cases of measles and 439 cases of german measles notified in 1938. Comparative death-rates from measles in Barnes and in other districts during 1939 and the previous four years will be given in the Appendix to this Report. Enteric Fever. Only one case of enteric fever was notified during the year. The patient, a female, aged 19 years, was admitted to a London general hospital on 10th June suffering from ulcerative colitis, and whilst still in this hospital she developed enteric fever, the onset of the disease being on the 2nd July. The patient was transferred to a London County Council infectious diseases hospital on the 18th July. The patient recovered.
6507c002-5931-43f6-bb96-fbf7adcfbb54	The type of infection was Bac. Paratyphosus "B." From the history the source of infection would appear to have been from another patient in the hospital whose illness was diagnosed as paratyphoid fever on the 13th June. Dysentery. One case of this disease was notified, the condition being Sonne dysentery. The patient, a child aged 1 year, was an in-patient at a London general hospital when the disease developed; the child was transferred to a London County Council infectious diseases hospital and recovered. Cerebro-spinal Fever. There was only one case of this disease notified during 1939. The patient, a female aged 55 years, was admitted to a London general hospital for observation and treatment, and the illness for which she was admitted was subsequently diagnosed as cerebrospinal fever. Pneumonia.
d972b645-7084-4928-af3e-9415a3adcca9	There were 14 cases notified as acute primary or acute influenzal pneumonia corresponding to an incidence of 0.36 cases per 1,000 of population, approximately one-third of the incidence for London (0.99), and for England and Wales (1.02). Four of the cases were removed to hospitals for treatment. 29 NON-NOTIFIABLE INFECTIOUS DISEASE. Whooping Cough. This disease was made compulsorily notifiable by medical practitioners in October, 1939, and 5 cases were notified during the last three months of the year. Prior to this date the number of cases reported to me by Head Teachers was 65, making a total of 70 cases for the year. All the cases were home-visited by the Health Visitors, who made 59 re-visits in following-up—129 home-visits in all. Seven of the cases were admitted to the Isolation Hospital.
b6adff0f-88b3-4492-a66f-bedc4308d05f	Comparative death-rates from whooping cough in Barnes and in other districts during 1939 and the previous four years will be found in the Appendix to this Report. TUBERCULOSIS. During 1939, 35 cases of pulmonary tuberculosis and 3 cases of non-pulmonary tuberculosis were notified, representing an incidencerate of 0.90 cases per 1,000 of the population for pulmonary tuberculosis, and 0.97 for all forms of the disease. Notification Register. The Register of Notifications has been kept revised in accordance with the requirements of the Public Health (Tuberculosis) Regulations, 1930. The number of cases added to or removed from the Register during the year and the number remaining on the Register on December 31st, 1939 are as under:— Table 7.—Tuberculosis Notification Register. Form of Disease. On Register 1st Jan., 1939. Cases Added. Removed from Register.
64119bd8-6a76-41e2-9400-30954fb74b52	Remaining on Register 31st Dec.. 1939. Primary Notif'' ns Otherwise. Total. Cured. Left District. Died. Total. Pulmonary 149 35 13 48 1 16 28 45 152 Non-Pulmonary 49 3 6 9 — 1 1 2 56 All Forms 198 38 19 57* 1 17 29 47 208 * Included in these figures are six patients whose names were restored to the Register. 30 Preventive Work Carried Out by the Council. There has been no change made in the preventive measures which are routinely carried out by the Public Health Department and which have been referred to in detail in previous Reports. A total of 218 home-visits were made during the year by the Health Visitors in connection with patients notified to be suffering from tuberculosis.
13762b69-de30-4cb4-b104-09351a0b36ef	It has not been found necessary to take action during the year under the Public Health (Prevention of Tuberculosis) Regulations, 1925, in respect of any tuberculous persons employed in the milk trade. Treatment—Dispensary and Institutional. The Surrey County Council is the Local Authority responsible for the treatment of all tuberculosis cases within the Borough. There were 45 residents of this district suffering from tuberculosis admitted to institutions during the year (42 of them suffering from pulmonary and 3 from non-pulmonary tuberculosis). Ten of these received institutional treatment at more than one institution. Admissions were as under:— Pulmonary Tuberculosis. To Surrey County Council Sanatorium 8 „ Surrey County Hospitals 19 „ other sanatoria 8 „ general hospitals 13 „ Public Assistance Institutions 4 Total 52 Non-pulmonary Tuberculosis. To sanatoria - „ other institutions 3 Total 3 ISOLATION HOSPITAL.
69a28b9c-e404-4af5-9cf2-112014eef319	The number of cases admitted to the Isolation Hospital during -1939 was only 55, the lowest number of admissions on record during the past twenty years. No cases were admitted from areas outside the Borough. The year was characterized by an extremely low incidence of infectious diseases generally. 31 Admissions. The diseases under treatment at the Hospital during the year were as under:— Admissions. Diphtheria 4 Diphtheria carrier 1 Septic Throat—sent in as Diphtheria 13 Scarlet Fever 33 Whooping Cough Bronchitis Dentition Whooping Cough 7 Sent in as 1 1 Mumps 1 Erysipelas 4 Total 55 Diphtheria Cases Admitted. Four cases only were admitted. One of these was a mild case, two were severe, and the other was an extremely severe attack, ending fatally on the fifth day after admission.
afd3cabd-0447-415e-b15a-b7cf39da6f55	A s this death occurred in January, 1940, it will be included for statistical purposes amongst the deaths assignable to the Borough for the year 1940. Scarlet Fever Cases Admitted. Cases of scarlet fever admitted during 1939 numbered only 33. In 21 of the patients the original attack was relatively mild; in 11 cases the attack was moderately severe, and in 1 the disease was of a severe type. No death occurred. Among the 33 cases the following complications occurred Cervical adenitis, 3; rhinorrhœa, 3; otorrhœa, 1; quinsy, 1; rheumatism, 3. Administration. (A) Cross-Infection. No case of cross-infection occurred during the year. The Cubicle Block has continued to be of the utmost service in avoiding cross-infection.
42f81112-a99d-4306-96d5-28f2691a5c61	The number of patients under 32 ment in this Block during 1939 was 42, 7 of whom were admitted during 1938 and were still under treatment at the beginning of 1939. The nature of the 35 cases admitted to the Cubicle Block during the year is given below:- Scarlet Fever (complicated or doubtful) 14 Diphtheria (complicated or doubtful) 3 Diphtheria Carrier 1 Whooping Cough 7 Mumps 1 Erysipelas 4 Septic Throat—sent in as Diphtheria 3 Bronchitis Sent in as Whooping 1 Dentition Cough 1 Total 35 (B) Incidence of Infectious Disease amongst the Staff. I am pleased to state that none of the members of the staff contracted any infectious disease during the year. (c) Accommodation for Staff. The accommodation for staff is quite satisfactory. (D) Accommodation for Patients.
667fa734-8a16-406c-a075-e4f5b63c62dd	The accommodation for patients which has been fully reviewed in my previous Annual Reports remained unchanged during 1939. Under the Surrey County Council Scheme made, with the approval of the Ministry of Health, in pursuance of Section 63 of the Local Government Act, 1929 the Barnes Borough Council are required to provide at their Isolation Hospital a minimum of eighty-three beds for the treatment of infectious disease, other than small-pox, and, if circumstances so require and accommodation is available, to admit patients from other areas within the County on financial terms to be agreed between the local authorities concerned.
9224b089-82a7-4e7f-9358-9377089dcdfe	In connection with the Ministry of Health's Emergency Hospital Scheme, for the purpose of which all the hospitals in the country were surveyed, the Council's Isolation Hospital was inspected prior to the outbreak of war by an Inspector of the Ministry of Health and the Minister decided that the hospital was to continue to fulfil the purpose of a hospital for infectious diseases, providing accommodation in accordance with the provisions of above-mentioned Surrey County Council Scheme and admitting cases from both the civilian and military population. 33 LABORATORY FACILITIES. Pathological outfits are supplied to medical practitioners and specimens from their patients residing in the district are examined free of charge. Specimens examined during the year were as follows:— For the detection of tubercle bacilli 66 „ „ „ „ diphtheria bacilli 113 „ „ „ „ typhoid bacilli (fæces) 2 Total 181 DISINFECTION OF ROOMS AND ARTICLES, AND DISINFESTATION. (a) Disinfection after infectious disease.
c5f7d7b4-f855-471e-b074-28129403a46b	The number of rooms disinfected after infectious disease during 1939 was 93. This work is undertaken by the staff of the Public Health Department. Infected bedding and clothing is steam-disinfected after removal to the Disinfecting Station attached to the Isolation Hospital. During 1939 138 lots of bedding and clothing were steam-disinfected. (b) Disinfestation. Bedding and bedclothing from bug-infested houses is disinfested by steam at the Disinfecting Station. During 1939 3 lots of bedding from houses in slum clearance areas, and 27 lots of bedding from other houses from which the tenants were rehoused in Council houses, were dealt with by steam-disinfestation. (c) Destruction of bedding and other articles. Twenth-three lots of bedding, clothing or other articles which had been infected, or were infested with vermin, were destroyed on request.
b12d43d0-4280-474b-a13d-42e45d0ec9bf	CLEANSING AND DISINFESTATION OF VERMINOUS PERSONS. During 1939 only 1 child was treated at the Cleansing Station for verminous condition of the head; 4 children attended for the treatment of scabies. Six adults were treated for scabies during the year. 34 Section VII. MATERNITY AND CHILD WELFARE. The Barnes Borough Council is the Welfare Authority for the area. As such the Council is responsible for carrying out the duties under the Public Health Act, 1936, Part VII in connection with notification of births, maternity and child welfare, and child life protec ion. The Council is not the Local Supervising Authority under the Midwives Act. Infantile Mortality. In the absence of information from the Registrar General as to vital statistics with reference to infantile deaths assignable to the district, information on this subject will be found in the Appendix. Maternal Mortality.
84113006-eb0a-4293-8598-48c7d5aee0c3	Information on this subject will be found in the Appendix. (1) MIDWIFERY AND MATERNITY SERVICES. Ante-natal clinics, held at the Council's Maternity and Child Welfare Centres, at Essex House and at the "Health Centre," are available for expectant mothers and for post-natal cases. The work of these clinics is referred to under the heading "Maternity and Child Welfare Centres." The services of a Consulting Obstetrician are available in cases of difficult or complicated labour, and in cases of puerperal fever or puerperal pyrexia. Institutional provision for maternity cases under the Council's Maternity and Child Welfare Scheme was continued unchanged during 1939. Of the total births assignable to the district 191 occurred in institutions (hospitals or maternity homes situated either within or without the Borough).
e41aec86-a994-469e-8b17-88876b63123c	These institutional confinements occurred as follows:— In institutions within the Borough .. 65 In registered maternity homes 65 .. In institutions outside the Borough .. 126 In general hospitals 17 .. In maternity hospitals 52 .. In Public Health County hospitals 18 .. In Public Assistance institutions 21 .. In maternity homes 18 .. Total 191 35 In the case of 41 of above-mentioned 191 institutional confinements admission to hospitals or maternity homes had been arranged through the Ante-natal Clinic. During the last three months of the year, following the outbreak of war, a small number of expectant mothers were evacuated in accordance with Government's Evacuation Scheme from that part of the Borough to which the Evacuation Scheme applies. Puerperal Pyrexia and Puerperal Fever. Three cases were notified as puerperal pyrexia during the year.
fd322aae-1ab3-4935-912c-f8370addb483	In two of these cases the confinement occurred in a London maternity hospital and the patients remained in that hospital for treatment of the condition causing the pyrexia, this being due to mastitis in one instance and to slight sepsis in the other. In the third case the confinement occurred in a Nursing Home in the Borough and the patient was transferred to a London maternity hospital for treatment. All three patients recovered. A resident of this Borough whose confinement occurred in a Public Assistance Institution in an adjacent Borough developed puerperal fever which was duly notified in that area, and the patient was removed to a London maternity hospital for treatment. The disease proved fatal, and the death was assigned to the Barnes Borough as an inward transfer death; this death was the first death from child-birth assignable to the Borough since 1934. Investigations into cases of puerperal pyrexia are routinely made by the Medical Officer of Health and by the Health Visitors.
ccbc4ae1-3578-4d5c-a693-366275b74541	The Surrey County Council being the Local Supervising Authority under the Midwives Act particulars of the notification in each case notified as puerperal pyrexia are communicated by me forthwith to the County Medical Officer. The same preventive and remedial measures detailed in previous Reports have been continued during the year. The three cases of puerperal pyrexia which were notified in the Borough correspond to an incidence rate of 7.4 per 1,000 total births compared with a rate of 14.3 for England and Wales. 36 (2) NOTIFICATION OF BIRTHS. There were 312 births registered in the district during the year, 307 being live births and 5 still-births. Of the total 312 births registered, 308 had been duly notified in accordance with the provisions of the above-mentioned Act.
61cd53d9-f7e4-4cd2-93f7-069fbbd919b4	During the year notifications were received in respect of 307 births which occurred in the Borough, and of these 24 were notified by medical practitioners, and 283 by midwives. Still-Births. There were 5 still-births notified during 1939, representing 1.6 per cent. of the total births occurring in the area in the year. An enquiry was made into all cases. (3) HOME-VISITING. Three whole-time Health Visitors, who are specially qualified for the purpose, undertake the home-visiting in connection with maternity and child welfare work.
6d3dbe69-2034-4068-84e8-1583b5118fb5	A summary of the work performed by them during the year is given below:— Visits to expectant mothers 375 First visits to newly-born infants 364 Revisits to infants under 1 year 1,419 Visits to children aged 1 to 5 years 2,147 Visits in connection with Council's scheme for the supply of milk 661 Still-birth inquiries 6 Special visits to cases of measles 32 „ „ „ „ „ whooping cough 129 „ „ „ „ „ pneumonia 21 Visits to foster children 181 Visits in connection with infectious diseases other than those above specified 730 Total visits 6,065 On the outbreak of war the number of routine home-visits necessarily had to be curtailed to some extent owing to the need of utilising the services of the health visitors in assisting in the organisation and administration of the casualty services, in which connection they did valuable work. Additional work also arose connected with evacuation of children and expectant mothers and other matters associated with war conditions.
a5525eb3-98a1-4f23-a3d5-24516d75d323	In spite of this, the essential maternity and child welfare services were efficiently maintained. 37 (4) MATERNITY AND CHILD WELFARE CENTRES. At the beginning of the year Infant Welfare Clinics were held twice weekly and Ante natal Clinics twice monthly at the Essex House Maternity and Child Welfare Centre. In March, 1939, on completion of the new Health Centre at North Worple Way, Mortlake, it became possible to transfer half of the work to that Centre and it was arranged for four Infant-welfare sessions per week and four Ante-natal sessions per month to be held, the mothers and infants from Barnes parish attending at the Essex House Centre and those from the Mortlake parish attending the clinics at the North Worple Way Centre, thus relieving the overcrowding which had existed when only one centre was available. On the outbreak of war the buildings in use as maternity and child welfare centres were both taken over for Air Raid Precautions' purposes for use as first aid posts.
6af96102-875c-4e32-8f1f-d413f4448efb	In order that the facilities available at the Ante-natal and Infantwelfare clinics held at these Centres should not be interrupted the following alternative arrangements were at once put into force:— The hire of two suitable premises, one in Barnes and one in Mortlake, was arranged at which mothers could continue to obtain supplies of milk, etc., for their children. Provision was made for the attendance at the Public Health Department of expectant mothers and young children in whose case consultation with or supervision by the Assistant Medical Officer for Maternity and Child Welfare was required. Ante-Natal Clinic. During the year 155 mothers attended at the clinic; of these 139 were expectant mothers who attended as new cases. The number of attendances made by the mothers at the clinics was 414. The number of expectant mothers who attended the Council's Ante-natal Clinics represented 38.4 per cent. of the total notified births for the year.
3cea3843-758d-440a-90fb-4ab7524fb6ff	In addition to those expectant mothers who attended at the Council's Clinic there were 15 mothers who had booked their confinements at Hospitals, or Maternity Hospitals, and attended the Ante-natal Clinics of those institutions; this corresponds to a further 3.7 per cent. of the total births in which mothers, not under ante-natal supervision by doctors or midwives, attended at an ante-natal clinic, equalling a total of 42.1 per cent. under ante-natal clinic supervision. 38 At each session of the clinic a medical officer with special gynaecological and obstetrical experience attends and is assisted by two health visitors, each of whom holds the Certificate of the Central Midwives Board. Infant-Welfare Clinics. The number of new cases, the total number of infants and young children attending at the Centre, and the total attendances made by them during 1939 are given below:— Year Year New Cases:— 1938. 1939.
f46fa6c6-a056-482e-b394-45b34320f7b7	Infants under 1 year 238 211 Children 1 to 5 years 99 70 Total 337 281 Number of Children attending during the year:— Infants under 1 year 366 365 Children 1 to 5 years 326 501 Total 692 866 Number of attendances made by:— Infants under 1 year 4,078 3,281 Children 1 to 5 years 3,247 2,579 Total 7,325 5,860 Mothers 6,245 5,057 The average attendance per week has been 115; the average attendance of infants under one year being 65 per week, and of children aged 1 to 5 years, 50 per week. The number of infants under one year of age attending for the first time during 1939, namely 211, represents 53.0 per cent. of the total births occurring in the year.
c06e8590-8e3a-4c55-821e-65227ffb0260	A Medical Officer and two Health Visitors, kindly assisted by Voluntary Helpers, are in attendance at the Centre at each session. The number of consultations with the Medical Officer at the centre was 2,296 as contrasted with 2,466 in 1938. 39 Sixty-five children under five years of age were referred to hospitals for treatment (31 from the Infant-welfare Clinic and the remaining 34 through other sources); 30 of the children were admitted as in-patients. Forty children were referred to special departments of London general hospitals, 13 to hospitals for children and 12 to special hospitals, including orthopaedic, ophthalmic and heart hospitals. The practice of supplying dried milk, etc. at the Centre at cost price, or free in necessitous cases, was continued during 1939. The total dried milk which was supplied during the year was 4,211 pounds.
a86b556c-f124-4af4-bf28-6e4ddb09dc4e	During the year fresh milk was supplied to expectant mothers and nursing mothers and to children under 5 years of age. The total fresh milk which was supplied during the year was 2,646 gallons. The following are the number of cases in which a supply of fresh milk was granted:—to expectant mothers, 18; to nursing mothers, 20; to children under 5 years of age, 105: Total 143. In each instance, in accordance with the Council's Scheme, the supply of milk has not been granted for a period longer than a month at a time. The cases have been reviewed in every instance before continuing or renewing a supply. In all cases in which fresh milk has been supplied it has been stipulated that the milk supplied shall be "pasteurized" milk. (5) LOCAL GOVERNMENT ACT, 1929.
b411d8cf-80fc-496d-a31d-8bdc99004b04	Under the above-mentioned Act it is the duty of the Council, firstly, to perform the functions of a Local Authority under the Public Health Act, 1936, Part VII as regards Child Life Protection, and secondly, to make contributions towards the expenses of certain Voluntary Associations (viz. two nursing associations and a day nursery) in so far as they were providing maternity and child welfare services within the area. Child Life Protection. The health visitors carry out the duties of Child Life Protection Visitors under Part VII of the Public Health Act, 1936. In carrying out the necessary supervision of foster-children the Health Visitors made 181 home-visits, giving advice as to the proper care and management of the children and ascertaining that the conditions under which they were living remained satisfactory. It was not found necessary to institute proceedings during the year for any contravention of the provisions of the Act.
d82239f6-b673-4abb-b34e-902265e62695	40 The following is a summary of the cases on the Register during 1939:- Foster-mothers on the Register at the beginning of the year 10 „ „ added to the Register 6 „ „ removed from the Register, having ceased to have care of children 13 „ „ on the Register at the end of 1939 3 Foster-children on the Register at the beginning of the year 17 „ „ in respect of whom Notice of Reception was received 21 „ „ removed from the Register during the year:— Returned to care of parents 26 Transferred to the care of foster- mothers outside the area 2 35 Removed with foster-mother to another area „ „ on the Register at the end of 1939 3 After the outbreak of war a large number of the foster-mothers in the district, who had care of children, either removed from the district with the children or returned them to the care of their parents.
b908be6b-43d6-4476-bb20-431806547476	At the end of the year there were only 3 children in the care of foster-mothers in the Borough. Voluntary Associations, (A) Voluntary Nursing Associations. (a) Nursing in connection with maternity and child welfare. The Council contributed £20 per annum to each of the two District Nursing Associations, this contribution being made, in accordance with the Council's scheme, in respect of maternity and child welfare services provided. Home nursing for expectant mothers, cases of ophthalmia neonatorum, and cases of measles, whooping-cough, diarrhoea and poliomyelitis in children under five years of age are included in the services provided for under the scheme. (b) Nursing of general medical and surgical cases.
5d23fd82-6d98-41ed-860f-8fb6266fa7e0	In addition to the payment of £40 referred to above as a contribution authorised under the Maternity and Child Welfare Scheme, the Council made a further contribution, in respect of the nursing of general medical and surgical cases, of £50 in the case of the Barnes District Nursing Association, and £75 in the case of the Mortlake District Nursing Association, respectively. 41 In connection with nursing of general medical and surgical cases, other than those specifically provided for maternity and child welfare purposes, the number of home-visits made by the two District Nursing Associations' nurses respectively were as under:— Barnes District Nursing Association, 6,136 home-visits (58 being to cases of pneumonia and 27 to cases of influenza). Mortlake District Nursing Association, 15,650 home-visits. (B) Barnes and Mortlake Day Nursery.
6831b0c4-d632-40d2-b7ce-4bc626ea25bd	During the year the Council made a contribution of £357 towards the expenses of the Barnes and Mortlake Day Nursery in accordance with the Scheme made, for the provision of Maternity and Child Welfare Services, under Sec. 101 of the Local Government Act. In accordance with the Council's Scheme the provision of this service is made for children for whom adequate care cannot be provided in their own homes by reason of the unavoidable absence of the mothers at work, or other cause which necessarily prevents adequate care being provided at home; if the accommodation available cannot be filled with children whose mothers go out to work any vacancies should go to children requiring care and supervision owing to unsatisfactory home conditions. The accommodation at the Day Nursery is for 26 children under five years of age. The number of attendances made by children during 1939 were as follows:—Whole-day attendances 2,746; half-day attendances 606. Following the outbreak of war the Day Nursery was closed for a few weeks.
1beefcca-ced9-4f2e-a73a-be4259074e6d	The arrangements in force for the prevention of spread of infectious disease, including the exclusion of patients and contacts as occasion required, were continued during 1939. The following exclusions were made:—6 children were excluded suffering from whooping-cough, and 1 child as a suspected case of that disease; 1 child suffering from mumps, and 1 as a contact; and 1 child suffering from chicken-pox. (6) OPHTHALMIA NEONATORUM. There was no case of this disease notified in 1939. Borough of Barnes. APPENDIX TO THE ANNUAL REPORT OF THE Medical Officer Of Health 1939. VITAL STATISTICS. 44 BOROUGH OF BARNES. VITAL STATISTICS.
7f556ab2-a155-46a4-a29c-3009c1cd05f0	The following statistical information relating to the Borough has been completed on receipt of the Local and National Statistics issued by the Registrar-General in connection with Population, Birth-rate, Death-rates, Maternal Mortality, Infantile Mortality, and Incidence of Notifiable Infectious Diseases. Birth-rate. The birth-rate for 1939 was 9.6 per 1,000 of the population compared with 12.3 for London, and 15.0 for England and Wales. The birth-rate for the Borough has been declining for many years, having reached the record low figure of 8.4 in 1936; in 1938 it was 9.2. The birth-rate has been lower than the death-rate for the area for several years past. Death-rate. The death-rate for 1939 was 10.8 per 1,000 of the population which is precisely the same rate as for the year 1938 and for 1934.
fbcfa695-2e0e-4726-b499-77acc7a568c3	The rate for 1939 is not indicative of any unusual mortality. The rates for 1936 and 1937 were 11.7 and 11.4 respectively. The rate of 10.8 for Barnes compares with one of 11.9 for London, and 12.1 for England and Wales. Maternal Mortality. There was only one death from maternal causes assignable to the Borough during the year 1939. This death was due to "puerperal sepsis," and there was no death from "other puerperal causes." The total maternal mortality rate for Barnes was 2.51 per 1,000 total (live and still) births, compared with a rate of 2.82 for England and Wales.
a004769b-e107-495f-a32a-cb23310f7802	Prior to the above-mentioned death in 1939 there had been no death due to "puerperal sepsis" since 1934; there has been no death from "other puerperal causes" since 1933, a period of six years. The average annual maternal mortality rate for Barnes from all puerperal causes during the five-year period 1935-1939 was 0.5 per 1,000 total births. 45 TABLE I.—STATISTICAL SUMMARY, 1939. Population (Registrar-General's estimate):— (a) Resident, Mid-1939 (For calculation of Birth-rates) 40,820 (b) Average (Appropriate to calculation of Death-rates and incidence of notifiable infectious diseases) 39,040 Births:— Birth-rate (per 1,000 of population) .. 96 Live Births:— Total.
0a160c33-001a-4a46-b306-fc636c18ae20	M. F. Legitimate 376 197 179 Illegitimate 21 8 13 Total 397 205 192 Still Birth-rate (per 1,000 total births) 17 3 Total . M. F. Still Births (Legit. 7; Illegit. Nil) 7 4 3 Deaths:— Death-rate, all causes (per 1,000 of population) 10.8 Total. M. F. Deaths (all causes) 422 201 221 Death-rate from Cancer (per 1,000 of population), 84 deaths 2.15 Death-rate from Zymotic Diseases (per 1,000 of population) 003 Deaths from Measles (all ages) Nil , , Whooping Cough (all ages) Nil , , Diarrhoea (under two years of age) 1 Death-rate from Maternal Causes (per 1,000 total births) 2.
fb107d6c-744c-45fe-aea5-bf456cc392a9	51 Deaths from Puerperal Sepsis 1 , , Other Puerperal causes Nil [Note : Births for purpose of this rate = 398 (Live, 391; Still, 7)] Death-rate of infants under one year (per 1,000 live births) 40.9 Death-rate for Legitimate infants (8 deaths) 216 Illegitimate infants (8 deaths) 3810 [Note: Births for purpose of these rates=Total, Legit. 370; Illeg. 21], 391 ; 46 Table II.—Vital Statistics of the Borough of Barnes during 1939 and previous 5 Years. Year. Population estimated to middle of each year. r.g. Registered Births. Total Deaths Registered in the District. Transferable Deaths Nett Deaths belonging to the District. Uncorrected Number. Nett. Of nonresidents registered in the District. Of residents registered in the District.
047a6cbc-f20c-41a4-b2bd-4138d2996fee	Under 1 year of age. At all ages. Number. Rate. Number. Kate per 1,000 nett births. Number Rate Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 11 1934 42,050 281 356 8.5 252 6'0 17 218 25 70.2 453 10.8 1935 42,030 288 393 9.4 205 4.9 18 204 19 48.3 391 9.3 1936 41,560 259 351 8.4 271 6.5 12 227 19 54.1 486 11.7 1937 41,100 278 365 8.9 252 6.1 25 242 13 35.6 469 11.
d057a823-ae80-4eb6-b67c-d7c3048bc0e1	4 1938 40,960 309 378 9.2 237 58 15 219 26 68.7 443 10.8 1939 a 40,820 307 397 9.6 215 5.5 14 221 16 40.9 422 10.8 b 39.040 (a) For calculation of Birth Rates; (b) For calculation of Death Rates, 47 Table III.—Birth-rate, Death-rate, and Analysis of Mortality during the Year 1939, with corresponding rates for England and Wales, 126 Great Towns, 148 Smaller Towns, and for the County of London for comparison. BirthRate pek1.000 Total Population. Annual Death-rate per 1,000 Population. Death-rate per 1000 Births. maternal Mortality Hate per 1,000 Total Births All Causes. Enteric Fever.
e8933df0-0add-49c2-90cb-522511c70d82	Small-pox Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Diarrhœa and Enteritis (under 2 years;. Total Deaths under One Year. All Causes. Puerperal Sepsis Other Causes. England and Wales 15.0 12.1 0.00 0.00 0.01 0.01 0.03 0.05 0.21 4.6 50 2.82 0.74 2.08 126 County Boroughs and Great Towns, including London 14.8 12.0 0.00 0.00 0.01 0.00 0.03 0.05 0.19 6.3 53 Not available 148 Smaller Towns (Estimated Resident Populations 25,000 to 50,000 at Census, 1931) 15.
00ef87c6-046d-489d-8553-506d7a8fbf94	6 11.2 0.00 0.00 0.01 0.00 0.02 0.04 0.20 3.0 40 London 12.3 11.9 0.00 0.00 0.00 0.00 0.03 0.02 0.18 8.2 48 Barnes Borough 9.6 10.8 0.00 0.00 0.00 000 0.00 0.00 0.33 2.6 41 2.51 2.51 0.00 48 Table IV.—Causes of Death during the Year 1939. Causes of Death (Registrar-General's short list of causes).
a68a8155-a93e-4dd9-8cda-395ef45ab91c	Total Deaths Male Female 1 Typhoid and Paratyphoid fevers — — — 2 Measles — — — 3 Scarlet Fever — — — 4 Whooping Cough — — — 5 Diphtheria — — — 6 Influenza 13 6 7 7 Encephalitis Lethargica 3 2 1 8 Cerebro-spinal fever — — — 9 Tuberculosis of respiratory system 22 14 8 10 Other tuberculous diseases 3 2 1 11 Syphilis 1 — 1 12 General paralysis of the insane, tabes dorsalis — — — 13 Cancer, malignant disease 84 41 43 14 Diabetes 3 1 2 15 Cerebral haemorrhage, etc.
89bbb6f4-0166-46ee-a93f-2ba44bb4ed3f	29 11 18 16 Heart Disease 102 51 51 17 Aneurism 2 2 — 18 Other circulatory diseases 17 6 11 19 Bronchitis 9 3 6 20 Pneumonia (all forms) 20 9 11 21 Other respiratory diseases 3 2 1 22 Peptic ulcer 7 3 4 23 Diarrhoea, etc. (under 2 years) 1 — 1 24 Appendicitis 2 2 — 25 Cirrhosis of liver 1 1 — 26 Other diseases of liver, etc.
95dafa59-642b-4c68-be2b-1d643e1ed646	2 1 1 27 Other digestive diseases 7 5 2 28 Acute and chronic nephritis 11 4 7 29 Puerperal sepsis 1 — 1 30 Other puerperal causes — — — 31 Congenital debility, premature birth, malformations, etc. 9 5 4 32 Senility 15 6 9 33 Suicide 3 3 — 34 Other violence 22 10 12 35 Other defined diseases 30 11 19 36 Causes ill-defined or unknown — — — All Causes 422 201 221 Infantile Mortality.
868d1e49-3be3-4673-b343-63d45f0fbfe4	During 1939 the number of deaths of infants under one year of age was 16, representing a rate of infantile mortality of 41 per 1,000 registered births ; this rate is a low one for the Borough, being little higher than the record low rate of 36 for the year 1937, in which year the deaths numbered 13. The infantile mortality rate in 1939 for London was 48, and for England and Wales 50. 49 Table V.—Infant Mortality during the Year 1939. Causes of death, at various ages, of infants under one year. Cause of Death Under 1 Week. 1-2 Weeks. 2-3 Weeks 3-4 Weeks. Total under 4 W'ks 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total under 1 Year Deaths in the Borough Deaths outside the Borough.
c6b82524-1833-45c9-bd34-fe73525b7f84	Deaths in Institu'ns Cengenital Debility 2 1 . . 3 . . . . 3 1 2 1 Premature Birth 4 . . . 4 . . . . 4 . 3 1 Congenital Malformations . . 1 . 1 . . . . 1 . 1 1 Injury at Birth 1 . . . 1 . . . . 1 1 . . Diarrhoea and Enteritis . . . . . . 1 . . 1 . 1 1 Pneumonia (all forms) . . . . . 1 . . . 1 . 1 1 Violence 3 . . l 4 . . . . 4 4 . . All causes 10 1 1 1 13 1 1 . . 15* 7 8 5 *Note.—The number of deaths assigned by the Registrar-General is 16,
a91c4a48-e21b-4376-8d96-673d20dd34f5	but the number compiled from the Local Registrar of Death returns and the Registrar-General's inward and outward transfer returns is only 15, In the absence of information as to Cause and Age in the case of this additional death it has not been possible to include it in the above Table. Of the total 16 deaths assigned by the Registrar-General to Barnes it should be noted that:— (а) Only 7 of them were deaths registered in the Borough, and of these 5 were unknown newly-born infants found dead on the Thames foreshore. (b) As regards cause of deaths 9 of the deaths were due to causes in Division No. 31 of the Registrar-General's Short List, namely congenital debility, premature birth, malformations, etc. In the case of these nine infants death occurred at ages varying between a few minutes and two weeks.
8cd11db3-a8d6-454d-92e5-fb1c126ef51f	(c) Of the total deaths 8 were deaths of legitimate infants and 8 illegitimate, included in the latter being the five unknown newly-born infants found dead. Amongst the total births assignable to the Borough births of illegitimate infants numbered 21, and the occurrence of 8 deaths amongst these infants represents the very high mortality for illegitimate infants of 381 per 1,000 illegimate births, contrasted with a mortality rate of only 22 per 1,000 for legitimate infants. From a careful analysis of the infantile deaths which occurred during the year, regard being had to the circumstances of the deaths, the particular causes from which death occurred and the ages at death, it can be appreciated that in the case of a large proportion of them preventive or curative measures available under the Maternity and Child Welfare Services could have had little effect. 50 Infectious Diseases Mortality.
d1ddfc51-739d-41f3-8dc4-6efe4a97b630	The death-rate for 1939 from each of the seven principal epidemic diseases (zymotic diseases) are given separately in Table VI., and in Table VII. the zymotic death-rate for the five years, 1934 to 1938, are contrasted with the rate for 1939. In each of these Tables the death-rates for London and for England and Wales are shown for comparison ; the death-rates for Barnes compare very favourably with those. Table VI.—Epidemic Diseases : Death-rate per 1,000 of the Population, 1939. Disease. Barnes. London. England and Wales.
c446eb91-89ca-4599-95e1-2ac73f529a1e	Small-pox 0.00 0.00 0.00 Enteric Fever 0.00 0.00 0.00 Measles 0.00 0.00 0.01 Scarlet Fever 0.00 0.00 0.01 Whooping Cough 0.00 0.03 0.03 Diphtheria 0.00 0.02 0.05 Diarrhoea (under 2 years) 0.03 0.11 0.07 Zymotic Death Rate 0.03 0.16 0.17 Table VII.—Zymotic Death-rate for 1939, contrasted with the Death-rates for the previous Five Years. Year. Barnes. London. England and Wales.
dab31f3d-b06c-4b4f-8a13-6015a0f523e9	1934 0.12 0.56 0.34 1935 0.14 0.26 0.24 1936 0.12 0.48 0.30 1937 0.00 0.29 0.23 1938 0.20 0.33 0.23 1939 0.03 0.16 0.17 Measles and whooping-cough were made compulsorily notifiable throughout England and Wales in October, 1939. Measles had continued to be a notifiable disease in Barnes since the last war, but whooping-cough has not previously been notifiable in this Borough. Both diseases are responsible for a large number of deaths, especially among younger children. Mortality rates from these diseases in Barnes, contrasted with the rates for London and for England and Wales, are given hereunder.
b57ea61e-600e-411d-8214-ff8e1f0dbe66	51 Table VIII.—Measles : Death-Rate per 1,000 of Population. Year. Barnes. London. England & Wales. 1935 0.00 0.00 0.03 1936 0.02 0.14 0.07 1937 0.00 0.01 0.02 1938 0.02 0.06 0.04 1939 0.00 0.00 0.01 Average Rate 1935-1939 0.01 0.04 0.03 Table IX.—Whooping Cough: Death-Rate per 1,000 of the Population. Year. Barnes. London. England & Wales.
e2f0f4f0-c134-47d6-8423-ac1a94d2b17b	1935 0.00 0.04 0.04 1936 0.02 0.07 0.05 1937 0.00 0.06 0.04 1938 0.02 0.03 0.03 1939 0.00 0.03 0.03 Average Rate 1 1935-1939 J 0.01 0.05 0.04 Incidence of Notifiable Infectious Diseases. The incidence of all infectious diseases in the Borough in 1939 was very low. Comparison between the incidence of certain of the notifiable infectious diseases in Barnes, and in London and England and Wales, is shown below:— Table X.—Infectious Diseases : Incidence per 1,000 of the Population in 1939. Disease. Barnes. London. England and Wales.
e2d9bbf2-bbc6-44c2-8d58-1e38366baa15	Small-pox 0.00 0.00 0.00 Scarlet Fever 0.92 1.53 1.89 Diphtheria 0.10 0.98 1.14 Enteric Fever 0.03 0.03 0.04 Erysipelas 0.26 0.37 0.34 Pneumonia 0.36 0.99 1.02 52 Table XI.—Notifiable Infectious Diseases, 1939. Diseases. Total Cases Notified. Ages, in years. Parish Removed to Hospital.* Total Deaths of Residents,† Uncer 1 year 1 to 2. 1 2 to 3. 3 to 4. 4 to 5. 5 to 10. 10 to 15. 15 to 20. 20 to 25. 25 to 35 35 10 45.
6a0a9fda-e7e1-40d2-9f3c-51164ee68dd4	45 to 65. 65 and over. Barnes Mortlake. Diphtheria 4 - - - - 1 1 2 - - - - - - - 4 4 — Scarlet Fever 36 1 - 2 1 3 10 7 3 l 5 l 2 — 15 21 33 — Measles 8 — l 2 l — — 2 — — 2 — — — 3 5 — — Rubella 22 3 3 1 — - — 2 8 4 — — 1 — 4 18 — — Enteric Fever 1 - - - - - - - 1 - - - - - — 1 1 — Pul. Tuberculosis 35 - - - - - 2 — 9 1 5 8 9 1 18 17 42 22 Non.-Pul.Tuberculosis 3 — — 1 —
ee951c88-dfab-44e6-bd8c-67d0edd94a44	1 — - - - - 1 — — 1 2 3 3 Pneumonia 14 - - 1 — 1 1 — 2 — 2 4 2 1 9 5 4 20 Erysipelas 10 - - - - — — - - - 1 1 6 2 4 6 4 - Puerperal Pyrexia 3 - - - - - - - - 2 - 1 - - 2 1 3 - Dysentery 1 — 1 — - — — - - - - - - - — 1 1 — Cerebro-spinal Fever 1 - - - - - - - - - - - 1 - - 1 1 — Whooping Cough 5 2 2 - - - - - - - 1 - - - 1 4 7 - All Diseases 143 6 7 7 2 6
0aa25d6f-9827-4fa4-9150-2f59b050b81a	14 13 23 8 16 16 21 4 57 86 103 45 Information as to admission to Hospitals will be found under the headings of the various diseases. †The deaths recorded in this column are the total corrected number of deaths assignable to the District, and are not necessarily deaths of persons recorded as notified during the year. 53 Tuberculosis—Notification and Mortality. Table XII.—Tuberculosis : New Cases and Mortality, 1939. Age-Periods. New Cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. Male Fem'le Male Fem'le Male Fem'le Male Fem'le 0-1 years - - - - - - - - 1-5 „ — — 1 1 - — — 1 5-10 „ 1 1 1 - - - - - 10-15 „ - - - - - -
a5effa22-3258-4f45-9da7-20b1e45fa3f7	- - 15-20 „ 6 4 1 — 1 - 1 - 20-25 „ — 1 — — 1 1 — — 25-35 „ 4 2 2 — 3 5 — — 35-45 „ 8 2 — 1 3 1 1 — 45-55 „ 4 1 — — 1 1 - - 55-65 „ 6 1 — — 3 - - - 65 „ and over 3 — — — 2 — — — All ages 32 12 5 2 14 8 2 1 *In addition to primary notifications, all other new cases coming to the knowledge of the M.O.H. are included in these figures. New Cases. Particulars of the new cases of tuberculosis coming to the knowledge of the Medical Officer of Health during 1939 are given in Table XII. above.
201e0bf1-c34b-4f1a-829a-2d3ce68b12c2	Of the 51 new cases during the year 38 (35 pulmonary, 3 non-pulmonary) were primary notifications ; the other 13 new cases (9 pulmonary, 4 non-pulmonary) were brought to my knowledge in the following manner :—Notifications transferred from other areas on change of address, 10; information from death returns, 2 ; other sources, 1. Mortality. The number of deaths during 1939 from tuberculosis was 25 (22 pulmonary, 3 non-pulmonary), corresponding to a death-rate per 1,000 of the population of 0.56 for pulmonary tuberculosis and 0.64 for all forms of the disease. Non-notification. Information as to the ratio of non-notified tuberculosis deaths to total tuberculosis deaths for the year is given hereunder. There were during 1939, 25 deaths from tuberculosis assigned to this Borough.
040c9870-125f-47db-8ceb-d01e1889bdfd	Of these deaths 22 had been notified to me in 54 accordance with the Tuberculosis Regulations during the lifetime of the patient. Three of the deaths had not been so notified, giving a ratio of 3 to 25, or a percentage of 12 per cent. No instance occurred of wilful neglect or refusal to notify. R. W. SIMPSON & CO. LTD., PRUXTERS, 15, BAliNES HIGH STREET, S.W.13
e450ba57-3fec-40b0-9e2c-8ffebbb6c57f	BARN 8 BOROUGH OF BARNES Annual Report of the Medical officer of Health For the Year 1940 BOROUGH OF BARNES the Annual Report of the Medical Officer of Health for the year 1940 W. F. Twining McMath, m.d.Beif.. M.R.c.p.Lond., l.m., d.p.h. Medical Officer of Health. BOROUGH OF BARNES. STAFF OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health. W. F. Twining McMath, M.D.Belf., M.R.C.P.Lond., L.M., D P.H. Assistant Medical Officer of Health. A. V. B. Crawford, M.B., B.Ch., B.A.O.Dub., D.P.H.Eng. Chief Sanitary Inspector. C. S. Perchard, Cert.R.San.Inst., Cert. Meat and Foodlnsp. Additional Sanitary Inspectors.
c688cde7-df98-4f27-a982-aeb1bcd53dc8	G. G. Gardiner A. A. Brown R. H. Street Cert.San.Insp., Cert. Meat and Food Insp. Temporary Sanitary Inspector. E. Kilner, Cert.San.Insp., Cert. Meat and Food Insp. Health Visitors. Miss M. Parnell, S.R.N., S.C.M., Cert. Health Visitor. Miss J. McNish, S.C.M., Cert. Gen. and Fever Trained Nurse. Miss O. L. Wilson, S.R.N., S.C.M., Cert. Health Visitor. Chief Clerk. R. E. Forrest. Assistant Clerks. R. A. Billen. Miss K. D. Elliott. G. K. Shilleto. G. E. Tydeman. Temporary Clerks. Miss B. Haydon. Miss K. P. Morcom. Miss H. Wheatley.

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