ROMR 010 Romford Rural District Council ANNUAL REPORT of the Medical Officer of Health. 1908. To the Romford Rural District Council. Gentlemen, I have the honour to put before you my Annual Report on the Sanitary Condition of the Romford Rural District, for the year ending December 31st, 1908. In accordance with the plan adopted in previous Reports, this Report is arranged in the following divisions:— I. Summary of Action taken during the yew for Preventing the Spread of Disease. II. An account of the Sanitary Condition of the District generally. III. Statement of Enquiries made into Conditions Injurious to Health, and Proceedings thereon. IV. Table of Sickness and Mortality 2 Summary of Action taken during the year for preventing the spread of disease, No. Date. Locality. Disease. Source of Disease. Action taken. Result. 1 Jan. 1 Chadwell Heath Diphtheria One case contracted from a case in the same family. Notification Dec. 30th, 1907. Removed No further case 2 „ 1 Marks Gate Scarlet Fever One case contracted from a neighbouring case. Removed No further case 3 „ 4 Brentwood Road Diphtheria Two cases in same family as No. 239 in last year's report which was not removed. Removed No further case 4 „ 5 Chigwell Road Scarlet Fever One case contracted from a case beyond the district. Removed See No. 9 5 „ 5 South Hornchurch Enteric Fever One case. Not removed. Instruction No further case 6 „ 6 Hornchurch Diphtheria One case. Removed.. Local Nuisance. See No. 10 7 „ 7 Hornchurch Diphtheria Ditto 8 „ 7 Hornchurch Diphtheria Ditto No further case 9 „ 7 Chigwell Road Scarlet Fever Two cases in adjacent house. See No. 4. Removed No further case 3 10 Jan. 7 Hornchurch Diphtheria Another case in same family as No. 6. Removed No further case 11 „ 3 Hornchnrch Diphtheria One case. Removed. No further case 12 „ 11 Cottage Homes Scarlet Fever One case. Removed to M. A. H. No further case 13 „ 12 Dagenham Scarlet Fever One case, contracted at school. Removed No further case 14 „ 13 Hornchurch Diphtheria One case. Removed. No further case 15 „ 13 Upminster Common Scarlet Fever One case contracted beyond the district. Removed No further case 16 „ 13 Dagenham Diphtheria One case. Local nuisance 17 „ 13 Hornchurch Scarlet Fever One case. Origin obscure. Removed No further case 18 „ 15 Beacontree Heath Diphtheria One case. Local nuisance. Removed No further case 19 „ 16 Dagenham Diphtheria Ditto No further case 20 „ 16 Chadwell Heath Diphtheria One case believed to have been contracted at school. Removed No further case 21 „ 20 Rainham Diphtheria One Case. Local nuisance. Removed No further case 22 „ 20 South Hornchurch Scarlet Fever One case. Removed. Presumably contracted at school 23 21 Chadwell Heath Diphtheria One cases. Contracted from a case in adjoining district of Ilford. Removed. No further case 4 No. Date. Locality. Disease. Source of Disease Action taken. Result. 24 Jan.21 Hornchurch Diphtheria One case, believed to have been contracted at school. Removed. No further case 25 „ 22 Hornchurch Diphtheria Ditto No further case 26 „ 23 Hornchurch Diphtheria Ditto No further case 27 „ 24 Hornchurch Diphtheria Ditto No further case 28 „ 25 Chadwell Heath Diphtheria Ditto No further case 29 „ 27 Chadwell Heath Diphtheria Ditto No further case 30 „ 28 Chadwell Heath Diphtheria Ditto See No. 31 31 „ 28 Chadwell Heath Diphtheria One case, contracted from No. 30. Removed No further case 32 ,, 31 Chadwell Heath Diphtheria One case, contracted at school. Removed No further case 33 Feb. 1 Rainham Scarlet Fever A return case. Removed. No further case 34 „ 3 Hornchurch Scarlet Fever One case. Isolated at home No further case 35 „ 3 Hornchurch Diphtheria Two cases. Local insanitary condition. Removed No further case 36 „ 4 Hornchurch Scarlet Fever Two cases in one family. Origin obscure. Isolation at home Another case occurred in the family 5 37 Feb. 5 Hornchurch Scarlet Fever One case believed to be contracted from No. 36 33 „ 7 Wennington Diphtheria One case. Local insanitary condition. Removed No further case 39 „ 8 Hornchurch Scarlet Fever One case. Origin obseuie. No further case 40 „ 12 Great Warley Scarlet Fever Five cases in one family. First case contracted at School in adjoining district, and not recognised, all the other children in the family subsequently became infected. Not removed. No further case 41 „ 15 Great Warley Scarlet Fever One case, next door to above. No further case 42 „ 15 Dagenham Diphtheria One case. Not removed. No further case 43 „ 18 Bennetts Castlelane Scarlet Fever One case. Removed. No further case 44 „ 19 Hornchurch Scarlet Fever One case. Removed. No further case 45 „ 20 Hornchurch Diphtheria One case. R-moved to London Hospital No further case 46 „ 28 South Hornchurch Scarlet Fever One case. Removed No further case 47 Mar. 4 Upminster Enteric Fever One case. Contracted in London 48 „ 6 Chigwell Road Scarlet Fever One case in same family as No. 4. Presumably a reiurn case. No further case 49 „ 7 Wennington Scarlet Fever One case. Believed to have been contracted in a School in adjacent district. Removed. No further case 6 No. Date. Locality. Disease. Source of Disease. Action taken. Result. 50 May 9 Hornchurch Diphtheria One case. Removed. No further case 51 „ 9 Dagenham Diphtheria Ditto. Not removed. 52 „ 10 Cranham Scarlet Fever One case. Origin obscure Removed No further case 53 „ 11 Hornchnrch Diphtheria Ditto No further case 54 „ 11 Dagenham Diphtheria Three cases in one family Bad Sanitary condition 55 „ 12 Hornchurch Diphtheria One case. See No. 63 56 „ 13 Dagenham Scarlet Fever One case. Removed No further case 57 „ 14 Hornchurch Diphtheria Another case in same family as No. 61 58 „ 17 Hornchurch Diphtheria One case. Removed • 59 „ 19 Hornchurch Diphtheria Two cases in one family. Removed No further case 60 „ 23 Dagenham Scarlet Fever One case. Believed to be contracted at School See No. 60 61 „ 23 Dagenham Scarlet Fever Ditto. Removed No further case 62 „ 23 Dagenham Scarlet Fever Ditto No further case 63 „ 24 Dagenham Scarlet Fever One case. Removed No further case 64 May 24 Hornchurch Scarlet Fever One case. Origin obscure. Isolation at home See No. 69 65 „ 25 South Hornchurch Diphtheria One case. Removed. No further case 66 „ 50 Dagenham Scarlet Fever Four cases different families all attending same School. Removed No further case 07 April 1 North Hornchurch Scarlet Fever Two cases in one family, Removed No further case 68 „ 4 Dagenham Scarlet Fever Two cases in one family. Contracted from No 63 69 „ 6 Hornchurch Scarlet Fever One case. Origin obscure. Removed. No further case 70 „ 1&8 South Hornchurch Diphtheria Three cases in one family. Removed. First case unrecognised. No further case 71 „ 11 Hornchurch Scarlet Fever One case in same house as No. 70 No further case 72 „ 16 Hornchurch Diphtheria One case. Drain Defective. Removed No further case 73 „ 16 North Hornchurch Diphtheria Ditto See No. 80 74 „ 16 Hacton Scarlet Fever One case. Removed No further case 75 „ 16 Wennington Diphtheria One case. Drain bad 76 „ 18 Green Lane Diphtheria One case. Contracted at Ley ton. Removed 77 „ 18 South Hornchurch Diphtheria One case. Removed. No further case 78 „ 19 Rainham Diphtheria One case. 8 No. Date. Locality. Disease. Source cf Disease. Action taken Result. 79 April 19 Beacontree Heath Scarlet Fever One case. Removed. An unrecognised case in same family of some weeks duration. Removed. See No. 82 80 „ 20 North Hornchurch Diphtheria One case in same house as No. 73 Drains bad. Removed No further case 81 „ 23 Hornchurch Scarlet Fever One case. Presumably infected by neighbouring case 82 „ 23 Beacontree Heath Scarlet Fever Two more cases in same family as No. 79. Removed See No. 79 83 „ 25 South Hornchurch Diphtheria One case 84 „ 27 Upminster Enteric Fever One case. Origin obscure. Instructions. No further case 85 „ 29 Hornchurch Scarlet Fever One case. Removed. No further case 86 May 4 Rush Green Scarlet Fever One case, contracted from a case in the Urban District Removed. No further case 87 „ 5 Chadwell Heath Diphtheria One case. Removed No further case 88 „ 5 Chadwell Heath Scarlet Fever One case. Contracted from No. 92. Removed No further case 89 „ 5 Beacontree Heath Scarlet Fever Two more cases in same family as No. 8'?. Removed No further case 9 90 May 8 South Hornchurch Diphtheria Two cases in same family. Bad sanitary condition. Removed. No further case 91 „ 9 Harold Wood Scarlet Fever One case contracted away. Removed. No further case 92 „ 10 Chadwell Heath Scarlet Fever One case, presumably contracted from an unrecognised case next door. Removed See No. 88 93 ,, 11 Hornchurch Scarlet Fever One case No other case 94 „ 12 & 17 JDagenham Diphtheria Two cases. Bad sanitary conditions. Removed No other case 95 „ 13 Dagenham Diphtheria Ditto No other case 96 ,, 12 & 15 Wennington Scarlet Fever Two cases contracted beyond the district. Removed. No other case 97 „ 31 Dagenham Diphtheria One case. Bad sanitary condition. Removed No other case 93 „ 23 Dagenham Diphtheria One case. Not removed 99 „ 24 Wennington Diphtheria Ditto 100 „ 26 Dagenham Scarlet Fever One case. Removed No other case 101 „ 24 & 27 Hornchurch Scarlet Fever Two cases in one family 102 „ 28 Cranham Scarlet Fevor One case. Not removed 103 June 1 Chadwell Heath Scarlet Fever Ditto See No. 109 10 No. Date. Locality. Disease. Source of Disease. Action taken. Result. 104 June 4 Dagenham Scarlet Fever One case. A return case. Removed No other case 105 „ 5 Hornchurch Scarlet Fever One case. Not removed 100 „ 13 Upminster Scarlet Fever One case. Removed Ditto 107 „ 14 Wennington Diphtheria Ditto do. Bad drain Ditto 108 „ 15 Wennington Diphtheria Ditto Ditto 109 „ 22 Chadwell Heath Scarlet Fever Another case in same house as No. 103. 110 „ 22 Dagenham Scarlet Fever One case. Supposed to have been contracted at Harking 111 „ 23 Dagenhum Scarlet Fever One case. Presumably contracted from an unrecognised case next door. Removed. Ditto 112 „ 20 Dagenham Scarlet Fever Another case infected as last 113 July 2 Wennington Diphtheria One case. Removed Ditto 114 „ 10 Upminster Enteric Fever One case. Origin obscure. Instruction Ditto 115 „ 11 Hacton Scarlet Fever Two cases. Removed Ditto 116 „ 11 Dngenham Diphtheria One case. Bad sanitary condition. Removed Ditto 11 117 July 15 Hornehurch Scarlet Fever One case. Removed No other case 118 „ 18 North Hornchurch Scarlet Fever One case. Infection imported. Removed Ditto 119 ,, 19 North Hornchurch Diphtheria One case. Removed No further case 120 „ 19 Chadwell Heath Diphtheria Ditto No further case 121 „ 27 Beacontree Heath Diphtheria One case. Dubious 122 „ 27 Wennington Diphtheria One case. Removed No further case 123 „ 27 Dagenham Diphtheria Ditto No further case 124 „ 27 Chadwell Heath Scarlet Fever One case. Not removed 125 „ 28 North Hornchurch Scarlet Fever One case, Hemovtd No further rase 126 Aug. 6 Dagenham Diphtheria One case. Had sanitary condition. Removed No further case 127 „ 7 Harold Wood Scarlet Fever One case. Removed 128 „ 7 Great Warley Scarlet Fever Six cases in one family. Infected by an unrecognised case of two weeks' standing in same family. Not removed. House in an isolated position Vi9 „ 10 Hacton Diphtheria One case. Removed No further case 130 „ 12 Dagenham Diphtheria Ditto No further case 131 „ 12 North Hornchurch Scarlet Fever Ditto No fuither case 132 „ 17 & 24 Chadwell Heath Scarlet Fever Two cases. Removed. Return case 12 No. Hate. Locality. Disease. Source of Disease. Action taken. Result. 133 Aug. 17 & 24 North Hornchurch Scarlet Fever One case. Removed No further case 134 „ 18 Harold Wood Diphtheria One case. Contracted away from home See No. 139 135 „ 24 Dagenham Diphtheria One case. Removed No further case 136 „ 24 North Hornchurch Diphtheria One case. Not removed 137 „ 28 Dagenham Diphtheria Ditto 138 „ 29 Rainham Enteric Fever One case. Not removed. Origin obscure. Instruction No further ease 139 „ 29 Harold Wood Diphtheria One case. Contracted from No. 134 140 „ 30 Dagenham Scarlet Fever One case. Contracted from an unrecognised case. Removed 141 Sept. 1 Dagenham Scarlet Fever Ditto 142 „ 3 Corbets Tey Scarlet Fever One case. Origin obscure. Removed No further case 143 „ 5 Dagenham Scarlet Fever One case. Removed No further case 144 „ 12 & 13 North Horn church- Scarlet Fever Two cases in one family. Removed 145 „ 10 Harold Wood Enteric Fever One case. Origin obscure. Instruction No further case 146 „ 13 Rainham Scarlet Fever One case. Removed No further case 147 „ 15 Wennington Scarlet Fever One case. Presumably infected at Jfurfleet School. Removed No further case 148 „ 15 Dagenham Scarlet Fever One case. Removed No further case 149 „ 15 Dagenham Scarlet Fever Ditto 13 150 Sept. 20 & 21 Dagenham Scarlet Fever Three cases. Infected at School Removed See No. 151 ,, 24 North Hornchurch Diphtheria One case. Removed No further case 152 „ 24 Dagenham Diphtheria One case. Bad drain. Removed No further case 153 „ 25 Hornchurch Diphtheria Ditto No further case 154 „ 26 Upminster Common Diphtheria Ditto No further case 155 „ 27 Upminster Enteric Fever One case. Origin Obscure. Instruction No further case 156 „ 30 Chadwell Heath Diphtheria Four cases, two 2 or 3 weeks convalescent, two present cases removed. Disease presumably imported No further case 157 „ 30 Harold Wood Diphtheria One case. Removed No further case 158 „ 30 Ardleigh Green Scarlet Fever One case in a lying-in woman. Case removed. Baby died next day No further case 159 Oct. 5 Hacton Scarlet Fever One case. Removed No further case 160 „ 7 Dagenham Scarlet Fever Two cases. Removed N o further case 161 „ 7 Wennington Diphtheria One case. Foul drain. Not removed 162 „ 11 Wennington Scarlet Fever One case. Removed No further case 163 „ 3&9 Dagenham Scarlet Fever Three cases. Removed See No. 178 164 „ 12 North Hornchurch Scarlet Fever One case. Removed No further case 165 „ 12 Wennington Scarlet Fever Two cases in one family. Removed. Ditto 166 „ 13 & 15 Dagenham Scarlet Fever Three case3 in one family, First case presumably affected at School. Removed. See No. 205 14 No. Date. Locality. Disease. Source of Disease. Action Taken. Result. 167 Oct. 13 Dagenham Scarlet Fever One case in same house as No. 174. Removed. Ditto 168 „ 15 North Hornchurch Scarlet Fever One case. Origin obscure. Removed. Ditto 169 „ 16 & 22 Harold Wood Scarlet Fever Three cases in one house, Imported from Brentwood Removed. Ditto 170 „ 18 Wennington Scarlet Fever One case, Infection beyond the district. Removed. Ditto 171 „ 27 Dagenham Scarlet Fever One case. Source of infection obscure. Not removed. See No. 140 172 „ 31 Crunham Enteric Fever One case. Instructions. No further ease 173 Nov. 2 Hornchurch Scarlet Fever Ditto. Removed. No further case 174 „ 3 Chadwell Heath Scarlet Fever Ditto No further case 175 „ 3 Wennington Scarlet Fever Three cases 176 „ 4 Dagenham Scalet Fever One case. Removed. No further case 177 „ 7 Dagenham Scarlet Fever Ditto No further case 178 „ 8 Cottage-Homes Diphtheria Two cases. Removed to M. A.B. 179 „ 10 Rainham Diphtheria One case. Faulty drain. Removed. No further case 180 „ 11 Isolation Hospital Diphtheria A nurse in the Diphtheria Ward. 181 „ 13 Rainham Scarlet Fever One case. Removed. 182 „ 14 Hornchurch Diphtheria One case. Faulty drains. No further case 183 „ 18 Dagenham Scarlet Fever Ditto 15 184 Nov. 19 & 30 North Hornchurch Scarlet Fever Three cases in one house. Imported from an unrecognized case next door. Removed. No further case 185 „ 19 North Hornchurch Scarlet Fever A case next door to previous one, of two weeks duration since desquamating. 186 „ 19 New rd. Dagenham Scarlet Fever One case. Child attached to Barking School, presumably infected then. Not Removed. See No. 188 & 20 6 187 „ 21 New rd. Dagenham New rd. Dagenham Scarlet Fever Another case in same house as previous case. 188 „ 21 Scarlet Fever One case attached Barking School. Removed. Ditto 189 „ 21 & 25 New rd: Dagenham Scarlet Fever Three cases next door to No. 182. Removed. See No. 214 & 220 190 „ 22 & 24 Broad street, Dagenham Scarlet Fever Two coses. Infected at School. Removed. See No. 191 „ 24 Dagenham Scarlet Fever One caes. A dubious one. 192 „ 24 Dagenham Scarlet Fever Four cases, propably infective at same school as No. 201. Removtd. No further case 193 „ 24 Dagenham Scarlet Fever Another case in same house as No. 177. Not a return caee as other case had not returned from hospital. Removed. No further case 194 „ 24 New rd. Dagenham Scarlet Fever Another case in same house as No. 197. No further case 195 „ 25 Dagenham Scarlet Fever One case. Removed. 196 „ 27 Hornchurch Scarlet Fever Ditto. Not removed. No further case 197 „ 28 South Hornchurch Scarlet Fever Ditto. Source of infection obscure. Removed. 198 „ 30 Dagenham Scarlet Fever Three cases in one house, infection imported. Removed. No further case 16 No. Date. Locality. Disease. Source of Disease. Action taken. Result. 199 Nov. 30 Dagenham Scarlet Fever One case, ditto. No further case 200 „ 30 Dagenham Scarlet Fever Two cases. Ditto No further case 20] „ 30 Wennington Diphtheria One case. Bed drains. 202 Dec. 1 Dagenham Scarlet Fever One case. Infected by No. 210. Removed. No further case 203 „ 2 North Hornchurch Diphtheria One case. Bad diains. Removed. No further case 204 „ 2 Broad street, Dagenham Scarlet Fever One case in same house as No 201. Removed. No further case 205 „ 2 Rainham Scarlet Fever One case. Not removed See No. 221 & 225 206 „ 3 North Hornchurch Diphtheria One case. Removed. Several cases occurred in this locality which I attribute to infection caught at school. See No. 221 & 225 207 „ 4 Dagenham Scarlet Fever One case. Removed See No. 221 & 225 208 „ 4 NewRd , Dagenham Scarlet Fever Another case in same house as No. 201. Removed See No. 221 & 225 209 „ 4 Rainham Scarlet Fever One case. Presumably infected by No. 217 210 „ 4 North Hornchurch Diphtheria One case. Attends same school as No. 218 211 „ 4 Ford's School,Dagenham Scarlet Fever One case. Master of school refused to have the case removed so that the school was closed till the Xmas holidays had expired. In the meantime another case occurred, both cases were then removed. See No. 221 & 225 212 „ 4 Dagenham Scarlet Fever One case. Removed See No. 221 & 225 213 „ 8 Rainham Scarlet Fever One case. Presumably infected by No. 217 17 214 Dec. 11 North Hornchurch- Diphtheria One case. Attends tami school as No. 21S 215 „ 11 North Hornchurch Diphtheria Ditto 216 „ 11 North Hornchurch Diphtheria Two cases in one family. Ditto 217 „ 11 North Hornchurch Diphtheria Ouecese Ditto 218 „ 9 Dagenham Diphtheria One case. Faulty drain. Removed See No. 221 & 225 219 „ 9 Hornchurch Scarlet Fever One case. Not removed 220 „ 10 Dagenham Scarlet Fever One case. Removed See No. 221 & 225 221 „ 11 Chadwell Heath Scarlet Fever One case. Removed See No. 221 & 225 222 „ 11 North Hornchurch Scarlet Fever One case. Not removed as the child was also suffering from Chicken-pox. Two other cases subsequently occurred next door in January, 1909 223 „ 18 Hornchurch Scarlet Fever One case. Presumably infected by neighbouring cases. Removed No further case 224 „ 21 North Hornchurch Diphtheria One case. Presumably infected by No. 229 225 „ 14 Upminster Enteric Fever One case. Origin obscure 226 „ 17 South Hornchurch- Diththeria One case 227 „ 21 North Hornchurch Diphtheria Ditto 228 „ 22 Dagenham Scarlet Fever One case. Presumably infected at school 229 „ 24 Dagenhim Scarlet Fever Another case in school house Removed. See No 223 No further case 230 „ 24 Dagenham Scarlet Fever One case. Remeved N o further case 231 „ 27 North Hornehurch Diphtheria One case. Faulty drain. Removed No further case 232 „ 31 North Hornchurch- Scarlet Fever One case. Infected by a Case in the Urban district. Removed No further case 18 During the year 1907, 406 cases of infectious disease Were notified. A considerable diminution will be noticed in the general report I received notice of 289 cases during this year. The different diseases are thus tabulated:— Scarlet Fever 161 Enteric Fever 7 Diphtheria 103 Erysipelas 16 Puerperal Fever 2 Total 289 193 of these cases were removed to the Isolation Hospital. The following is a succinct account of the different infectious diseases lequiring action by your sanitary officials during the year. In accordance with your instructions I have, since the time of receiving such instructions, visited every one notified for removal to the Isolation Hospital, before such removal, with the exception of a few instances of extreme urgency, where speedy removal was essential to the welfare of the patient, permission for such exceptions being granted by you, at my disoretion. I think this practice has been a judicious one ns it has enabled me to correct the diagnosis of some erroneously notified, and to obviate the removal of others which could be safely isolated at home, thus saving to a considerable extent the hospital expenses. In all cases of infectious disease the rooms occupied by the patient, the bedding, etc , are disinfected by the Sanitary Inspectors after removal or recovery of the patient. In cases that have been treated at home, the bedding is removed after the patient's recovery, to the Hospital for disinfection, but in cases removed to the Hospital in the early stage of the disease, it is considered sufficient to remove the clothing actually worn by the patient, and to disinfect the bedding, ete., at home. Small Pox.—No case of this disease was notified during the year. 19 Scarlet Fever.—166 cases were notified, nearly all of which occurred in the parishes of Hornchurch and of Dagenham. This disease has been unusually prevalent, not only in this district, but in most of the adjoining districts for the last two years or more. It was not quite so prevalent in this district during the last as in the previous year, the number of cases having been iu the last year 166, whilst in 1907 the number was 195. Enteric Fever has shown a remarkable decrease in numbers in this district during the past few years, 7 cases only having been notified during the past year for the whole district. Diphtheria.—102 cases were notified. In the previous year 189. Nearly all ooourrel in the parishes of Hornchurch and Dagenham. Reference will be made to this in the part of this report dealing with the different parishes comprising the district. The subjoined table shows the degree in whioh infectious disease prevailed iu the various parishes of the district. Infantile Diarrhæa was, as in the previous year, unusually absent during 1908. Dagenham, Beacontree and Chadwell lieaths. Havering. Hornchurch. Upminster, Cranham, and Corbets Tey. Great Warley. Rainham and Wennington. Scarlet Fever 79 - 55 4 10 13 Diphtheria 47 1 43 1 - 11 Enteric Fever - - 2 4 - 1 Puerperal Fever 1 - 1 - - - Erysipelas 6 - 4 5 - - 133 1 105 14 10 26 20 II.—An Account of the Sanitary Condition of the district at the end of 1908. In complying with this section of the Local Government Board's instructions to Medical Officers of Health, I proceed to give, as in former years, a short account of the sanitary state of the district, uuder the same heads of localities as are given in the statistical tables. Dagenham, Beacontree, and Chadwell Heath. —Villages and scattered groups of houses, all situate in the parish of Dagenham, and occupying a very wide area, standiug on gravel and Loudon clay, some (part of Dagenham village and immediate neighbourhood) on alluvium. Population estimated 7,450. Mainly agricultural, some (Dagenham Village) employed in a large ammunition factory, and some on river-side labour. At Chadwell Heath an increasing number of residents employed in London. Water supply mainly from South Essex Water Company. An extensive system of sewerage for the more populous portion of the parish has been carried out, but is still, unfortunately, in abeyance, a condition which is causiug much anxiety to the Council, and which it is hoped will soon be remedied. Pending the completion of this work, pail-closets and cesspools are the main means of disposing of sewage. Much expense is incurred by the Council by the periodical emptying of these cesspools, and many nuisances are caused by this system of sewage disposal. Scavenging is done and dust bins and pail-closets are emptied by contract. Birth rate, 279 per 1,000. Death-rate, 8'7. Death-rate from zymotic disease, 1.4. Diphtheria prevailed to a very considerable extent, mainly in the village and its neighbourhood, during the year. Local insanitary oondition due to the bad arrangements for sewage disposal, was the cause of this, and I sanguinely look for a decided improvement in this respect when the system of sewage, so long in abeyance, is in working order. This delay in the completion of this immense sanitary improvement has caused, and is causing much anxiety to the Council, who, 1 am quite sure, are using every means in their power to hasten the desired consummation of this much-needed condition. Noak Hill stands high 011 London clay. Population 260. Agricultural. Water supply indifferent. Water area very difficult to tap. Birth-rate, 7.6. Death-rate, Nil. Death-rate from zymotic disease, Nil. 21 Havering stands high on pebble sand bounded by London and pebble clay. Population, 440. Agricultural. Birth-rate, 28.4. Death-rate, 13.6. Death-rate from zymotic disease, Nil. Privies "Water supply mainly from wells. Supply not good. Some of the outlying parts supplied by ponds. Negotiations have been conducted with the South Essex Water Company to extend their mains to the village, and this is now in course of being done. Hornchurch.—Large village and scattered groups of houses extending over a large parochial area Part of the parish adjoining and actually forming part of the town of Romford Stands mostly on gravel, partly on clay, and some small part, running down to the river Thames on alluvium. Population (estimated) 8,000. Principally agricultural. Foundry and brewery in the village, and an increasing number of residents having their occupation in London. Birth-rate, 27.2. Death-rate, 126. Death-rate from zymotic disease, 2.0. There has been a marked decrease of infectious disease in the village of Hornchurch. During the first part of the year infectious disease continued to prevail to a considerable extent as it had done in the previous year, but I am glad to report that during the last six mouths of the year only five cases of infectious disease have beeu notified as having occurred in the village aud its immediate neighbourhood. There has been an abnormal amount of infectious disease in the populous north part of the parish, and I fear that the same structural defect of the house drains leading to the main sewer exist, to a considerable extent, in this locality as has been proved to exist in the village. A systematic testing of all house drains, by competent officials, as adopted by the Council on the suggestion of the Parish Council, resulted in the discovery that 90 per cent, of these drains showed insanitary defects. Unfortunately, has been to 6ome extent, checked, at least in a compulsory sense as in proceedings taken before the Romford Justices, against an occupier who refused official interference, the case was decided against the Council It is to be hoped, however, that the occupiers and owners of houses in the parish will not in the interest of the health of their families refuse to have the salutary precaution taken of having their drains officially tested. 22 It has been noted that in nearly all cases of Diphtheria occurring in a family on the Sanitary Inspector testing the drains, as in such cases is the practice, faulty structural conditions have been found to exist. Upminster, Cranham, and Corbets Tey.—Adjoining villages standing on high ground. Mostly brick earth, some gravel. Population 2,310. Birth-rate, 18.1. Death-rate, 9.09. Death-rate from zymotic disease, 0.8. A large estate for good-class residences being now developed, many houses having been erected during the last two or three years. Water supply mainly from South Essex Co. Some outlying parts formerly badly supplied by private wells and ponds have recently been supplied by an extension of the South Essex Co.'s mains. Great Warley stands high on London clay. The most thickly populated part of the parish forms part of the town of Brentwood, the large and less populated area having scattered houses and groups of houses. Population, 2,340. Agricultural. Water supply mainly from South Essex Water Company. Birth-rate, 26 9. Death-rate, 9.08. Death-rate from zymotic disease, Nil. Rainham and Wennington lie low on gravel and alluvium at the edge of the Thames Marshy. Villages of 2,480 inhabitants, employed in agriculture, factory, and riverside work. Tidal stream runs through Rainhanm to the Thames, about a mile distant. Birthrate, 31.07. Death-rate, 10.08. Death-rate from zymotic disease, Nil, Rainham, in years past, has borne an unenviable reputation for infectious disease, notably Diphtheria. There has been a marked improvement the last three years in this respect, and the village has been much improved during the last year by the Council making several incompleted roads into roads of the first order. III.—An account of the enquiries as to the conditions injurious to health existing in the district, and of the proceedings relating to such conditions in which advice has been given, &c., &c. In addition to the cases of infectious diseases recorded in Section 1 of this report, the following insanitary conditions, &c., necessitated official interference by the Sanitary Inspectors, who called in my 23 assistance when necessary. These instances of nuisances, &c. are included in the list detailed in a later portion of this report. Dagenham, Beacontkee, and Chadwell Heaths.— Jan. 3rd.—Chadwell Heath.—Insanitary premises, accumulation of manure, animals kept so as to be a nuisance. Notice. Remedied. Jan. 3rd.—Dagenham. Damp houses owing to defective guttering. Notice. Remedied. Jan 3rd.—Ditto. Swine kept so as to cause a nuisance. Notice. Remedied. Jan. 13th.— Ditto. Insanitary premises. Notice. Remedied. Jan. 14th.—Chadwell Heath. Four houses unfit for habitation owing to dilapidation. Notice. Repaired. Jan. 17th.—Beacontree Heath. Foul ditch. Notice. Cleansed. Jan. 20th.—Accumulation of manure. Notice. Removed. Jan. 20th.—Dagenham. A house with insufficient sanitary accommodation. Notice. Remedied. Jan. 22nd.—Ditto. Insanitary premises. Accumulation of manure. Notice. Remedied. Jan. 22nd.—Foul ditch in three premises. Notice. Cleansed. Jan. 22nd.—Ditto do. do. Jan. 29th.—Chadwell Heath. Blocked drains. Notice. Remedied. Jan. 30th.—Dagenham. Accumulation of refuse. Defective water supply. Foul cistern. Notice. Remedied. Jan. 30th.—Foul ditch and insanitary premises. Notice. Remedied. Feb. 3rd.—Ditto. Foul ditch. Notioe. Cleansed. 24 Feb.3rd.—Six dilapidated cottages, no drainage. Notice. Remedied after several visits and threats of proceedings. Feb. 7 th.—Blocked drain. Notice. Remedied. Feb. 19th.—Damp and dilapidated premises. Notice. Remedied. Feb. 20th.—Chadwell Heath. Blocked drain. Notice. Remedied. Feb. 20th.—Dagenham. Foul ditch. Notice. Cleansed. Feb. 20th.—Bennetts Castle Lane. Foul premises. Notice. Remedied. Feb. 27th.—Beacontree Heath. Two cottages unfit for habitation and overcrowded. Notice. Remedied. Feb. 27th.—Dagenham. Accumulation of manure. Notice. Removed. Mar. 2nd.—Chadwell Heath. Swine kept so as to be a nuisance. Notice. Removed. Mar. 2nd.—Beacontree Heath. Foul ditch. Notice. Cleansed. Mar. 4th.—Chadwell Heath. Accumulation of manure. Notice. Removed. Mar. 12th.—Dagenham. Insanitary privies, filthy premises. Mar. 12th.—Insanitary premises. Notice. Remedied. Mar. 12th.—Insufficient sanitary accommodation. Notice. Remedied. Mar. 13th.—Chadwell Heath. Foul slaughter-house. Notice. Remedied. Mar. 18th.—Dageuham. Foul ditch. Notice. Cleansed. Mar. 23rd.—Ditto. Two houses with insufficient sanitary accommodation. Notice. Remedied. 25 Mar. 25th.—Dagenham.—House damp and dilapidated. Notice. Remedied. Mar. 30th.—Marks Gate. Accumulation of manure,animals kept so as to be a nuisance. Notice. Remedied. Apr. 6th.—Beacontree Heath. Foul ditch. Notice. Cleansed. Apr. 11th.—Dagenham. House damp owing to faulty roof. Notice. Repaired. Apr. 13th.—Ditto. House with insufficient sanitary accommodation and drainage. Notice. Remedied. Apr. 18th.—Ditto do. April 22nd.—Ditto—5 cesspools foul and out of repair. Notice. Remedied. April 22nd.—Ditto—6 ditto Ditto April 27th.—Hog Hill Road.—Insanitary privy. Animals kept so as to be a nuisance. Notice. Remedied. April 30th.—Dagenham.—Accumulation of refuse. Notice. Removed. May 30th.—Ditto.—Foul ditch. Notice. Cleansed. May 22nd—Chadwell Heath.—Ditto Ditto June 12th.—Dagenham.—Defective paving to yard, defective drains. Notice. Remedied. June 20th.—Bennett's Castle Lane.—Dirty cowsheds, defective drainage. Notice. Remedied. July 2nd.—Dagenham.—Accumulation of manure. Notice. Remedied. July 3rd.—Ditto.— Damp and dilapidated house. Notice. Closed. 26 July 11th—Chadwe11 Heath—Defective paving to yard. Defective drain. Notice. Remedied. July 15th—Beacontree Heath.—Unpaved cowshed. No dairy accommodation. Notice. Remedied. July 16th.—Dagenham.—Accumulation of refuse Notice. Removed. July 19th.—Chadwell Heath.—Two cottages filthy and overcrowded. W.c. out of repair. Notice. Remedied. July 24th.—Dagenham.—Accumulation of manure. Notice. Removed August 1st.— Ditto—Blocked drain. Notice. Remedied. August 13th.—Ditto—Damp and dilapidated premises. Defective cistern. Notice. Remedied. August 22nd.—Ditto—Water from well analysed and found to be impure. Notice to close well. This was done and the South Essex Water Co.'s water laid on. August 22nd.—Ditto—Insufficient sanitary accommodation. Notice. Remedied. August 22nd.—Ditto—Accumulation of refuse. Notice. Removed. August 29th.—Ditto—Blocked drain. Notice. Remedied. August 30th.—Beaoontree Heath.—Foul ditch. Notice. Cleansed. August 30th.—Ditto—Blocked drain. Notice. Remedied. Sept. 5th.—Dagenham.—Foul ditch. Notice. Cleansed. Sept. 7th.—Ditto—Damp premises. Notice. Remedied. Sept. 7th.—Ditto—Insufficient sanitary accommodation. Notice. Remedied. 27 Oct. lst.—Dagenham.—Foul ditch. Notice. Cleansed. Oct. 7th.—Marks Gate.—Premises damp, roof faulty. Stagnant water under floor. Notice. Remedied. Oct. 8th.—Dagenham.—Insufficient drainage. Notice. Remedied. Oct. 10th.—Ditto—Overorowding. Notice. Remedied. Oct. 10th.—Beacontree Heath.—Foul ditch. Notice. Cleansed. Oct. 12th.—Dagenham.—Filthy premises. Ditto Oct. 12th.—Beacontree Heath.—Foul ditch. Ditto Oct. 16th.—Chadwell Heath.—Filthy premises. Ditto Oct. 22nd.—Dagenham.—Defective drainage. Notice. Remedied. Oct. 23rd.— Ditto—Defective drainage to 8 houses. Ditto Oct. 23rd.— Ditto—Two houses dilapidated and unfit for occupation. Notice. Remedied. Oct. 23rd.—Green Lanes—Beer house recently re-constructed without drainage. Public sewer passing the house not yet in use. Cesspool constructed to receive the sewage pending connection with sewer. Oct. 23rd.—Ditto—Two houses with no water supply. South Essex Water Co.'s water laid on Oct. 20th.—Dagenham.—Three houses unfit for occupation. Notice. Repaired. Oct. 30th.—Ditto—Dilapidated premises. Notice. Repaired. Oct. 2nd.—Ditto—Insufficient sanitary accommodation. Notice. Remedied. 28 Oct. 6th.—Chadwell Heath.—Accumulation of fish offal. Notice. Removed. Oct. 8th.—Chadwell Heath, Back Lane.—Road insanitary. Notice served on six owners. Nothing yet done. Oct. 8th.—Chadwell Heath.—A house with no water supply and deficient sanitary accommodation. Notice. Remedied. Oct. 9th.—Dagenham.—Four houses with defective drainage. Notice. Remedied. Oct. 9th.—Ditto—Six houses with blocked drains, and accumulation of sewage. Notice. Remedied. Oct. 12th.—Ditto—Filthy premises, overcrowding.—Foul ditch. Notice. Remedied. Oct. 12th.—Ditto—Insufficient sanitary accommodation.—Foul ditch. Notice. Remedied. Oct. 12th.—Chadwell Heath.—Four houses with insufficient accomodation. Notice. Remedied. Oct. 12th.—Ditto—Accumulation of refuse. Notice Remedied. Oct. 20th.—Beacontree Heath.—Accumulation of manure. Notice. Removed. Oct. 29th.—Chadwell Heath.—Accumulation of fish offal. Notice. Removed. Oct. 22nd.— Dagenham.—Blocked drain. Notice. Remedied. Oct. 24th.—Chadwell Heath.—Three houses with no water supply Notice. S.E. Co., water laid on. Oct. 24th.—Ditto—One house unfit for habitation. Notice. Remedied. Oct. 28th.—Beacontree Heath.—Foul ditch. Notice. Cleansed. 29 Oct. 29th.—Dagenham.—Damp premises. Blocked drain. Insufficient sanitary accommodation. Notice. Remedied. Oct. 29th.—Ditto—Two houses unfit for occupation. Notice. Remedied. Oct. 29th.—Ditto—Ditto Oct. 29th.—Ditto—Stable with no drainage. Accumulation of manure. Notice. Remedied. Oct. 29th.—Ditto—Accumulation of manure. Notice. Remedied. Oct. 29th.— Ditto—Blocked drain. Notice. Remedied. Nov. 6th.— Ditto—Foul ditch. Cleansed. Nov. 11th.—Ditto Ditto Nov. 20th.—Beacontree Heath.—Eleven Houses indifferent localities with insufficient sanitary accommodation. Notice. Remedied. Nov. 27th.—Dagenham.—Defective sink and waste pipe. Notice. Remedied. Dec. 2nd.—Ditto—Dilapidated premises. Notice. Repaired Dec. 11th.—Ditto—Damp premises. Ditto Dec. 14th—Ditto Ditto Ditto Dec. 14th.—Beacontree Heath.—Foul ditch. Notice. Cleansed. Dec. 14th.—Dagenham. Ditto Ditto Dec. 17th.—Defective drainage. Notice. Remedied. Dec. 21st.—Beacontree Heath.—Foul ditch. Notice. Cleansed. 30 Havering and Noak Hill. Jan. 20th.—Brock's Hill.—Two damp and dilapidated cottages, unfit for habitation. Notice. Closed. May 18th.—Noak Hill—Two dilapidated cottages. Notice. Repaired. May 18th.—Ditto—Two cottages with insanitary privies. Notice to supply pail closets complied with. July 7th.—Havering.—Foul ditch from overflowing cesspool. Remedied by piping the ditch. July 30th.—Ditto—Defective drainage to house. Drain re-constructed and nuisance abated. Sept. 4th.—Noak Hill.—Water supply to a house suspected to be impure. Analysed and found to be good. Hornchurch. Jan. 1st.—Ardleigh Green.—Foul cesspool. Notice. Cleansed. Jan. 2nd.—Wingletye Lane. Ditto Ditto Jan. 10th.—Hornchurch.—Filthy premises. Notice. Cleansed. Jan. 16th.—Harold Wood.—Accumulation of refuse. Notice. Remedied. Jan. 23rd.—High Street.—Defective W.C. Notice. Remedied. Jan. 23rd.—Ditto—Defective ventilating pipe. Ditto Jan. 25th.—Harold Wood.—Defective house drain. Ditto Jan. 31st.—Emerson Park.—Blocked drain. Ditto Feb. 6th.—South Hornchurch.—Foul ditch. Ditto Feb. 12th.—Station Lane.—Defective W.C. Ditto 31 Feb. 12th.—Church Street.—Defective and blocked drain. Notioe. Remedied. Feb. 17th.—Roneo Works.—Nuisance caused by burning refuse. Notice. Remedied. Feb. 17th.—High Street.—Defective W.C. Notice. Remedied. Feb. 19th.—Wingletye Lane.—Foul cistern. Ditto Feb. 27th.—Slewin's Farm.—Foul cowshed. Ditto Feb. 29th.—Ardleigh Green.—Dirty bakehouse. Ditto March 2nd.—Ditto—Blocked drain. Ditto March 2nd.—Ditto—Foul cesspool. Ditto March 7th.—North Hornchurch.—Five foul cesspools. Notice. Remedied. March 7th.—Ditto—Blooked drain. Notice. Remedied. March 9th.—Harold Wood.—Harold Wood School visited. Outbreak of Measles. School closed for a month. March 18th.—Roneo Works.—Ditch polluted by waste water from works. Notice. Drained with sewer. March 42th.—Walden Road.—Foul cesspool. Notice to connect with sewer complied with. March 2ith.—Hornchurch.—Diphtheria having been very prevalent for some time, I suggested that the surface ventilators of sewers should be closed, and ventilating shafts erected in their place. Nine shafts were erected in the village and others in the north- west portion of the parish. March 30th.—Harold Wood.—Foul drain. Notice. Cleansed. March 30th.—Hay Green.—Foul cesspool to cottage. Notioe to supply pail closets and to connect slop water with the sewer complied with. 32 March 31st.—Abbs Cross.—Foul cesspool. Notice. Cleansed. April 1st.—South Hornchurch. Ditto Ditto Ditto April 1st.—Ditto Ditto Ditto Ditto April 3rd.—White Hart Lane—Blocked drain. Notice. Remedied. April 4th.—Kyme Road.—Complaint made of meat suspected to be bad. Examined but not condemned. May 1st.—Hacton.—Cistern imperfect. Notice. Repaired. May 8th.—Ardleigh Green.—Blocked drain. Notice. Remedied. May 8th.—Harold Wood.—Cowshed filthy and badly paved. Surroundings insanitary. Notice. Remedied. May 18th.—Squirrels Heath.—Cottage overcrowded. Notice. Remedied. May 26th.—Attended and gave evidence at public enquiry at West Ham respecting the undesirability of the Grange, Harold Wood, recently purchased by the West Ham Corporation for the purpose of a Scarlet Fever Convalescent Home, owing to its being close to Harold Wood school and surrounded by dairy farms. June 2nd.—Harold Wood.—Foul closets and drains. Notice. Remedied. June 6th.—Abbs Cross.—Foul cesspool. Notice. Cleansed. June 10th.—Harold Wood.—Swine kept so as to be a nuisance. Notice. Removed. June 10th.—Ditto—Blocked drain. Notice. Remedied. June 14th.—Squirrels Heath.—Foul cesspool. Notice Cleared. 33 June 16th.—Emerson Park.—Nuisance from escape of sewer gas, from defective air outlet, Notice. Remedied. Aug. 24th.—South Hornchurch.—Accumulation of offensive manure close to cottages. Notice. Removed. Aug. 29th.—Wood Lane.—Water supply to cottages reported to be bad. The water comes from a spring in a gravel pit in a piped ditch for some distance, and the water allowed to collect in a dipping hole, used by the cottage residents. Several analyses were made of this water and on one occasion, that from the dipping hole was found to be impure, the water from the pipe before discharging into the dipping hole being found to be good. Report to the Council to this effect. Aug. 22nd.—Globe Road.—Accumulation of manure. Notice. Removed. Oct. 1st.—Harold Wood.—Blocked drain. Notice. Removed. Oct, 17th—Ditto Ditto Ditto Oct. 17th—Ditto Ditto Ditto Oct. 17th—Ditto Ditto Ditto Nov. 20th—Ditto Dilapidated cottage. Notice. Repaired. Dec. 2nd.—Ardleigh Green.—Dirty bakehouse. Notice. Cleansed. Dec. 12th.—South Hornchurch.—Defective pail closet. Foul ditch and blocked drains. Notice. Improvement only partial. Dec. 21st.—Hornchurch.—Drain of Public School suspected to be defective. Tested and found to be so and whole system of drains overhauled and put right. 34 Upminster, &c.— Jan. 7 th.— Cranham School.—Foul cesspool. Notice. Cleansed. Mar. 21st.—Upminster.—Overcrowded cottage. Notice. Remedied. April. 14th.—Upminster—Foul drain. Notice to connect with sewer complied with. May lst.—Upminster.—Dirty cottage. Notice. Remedied. Aug. 6th.—Upminster Common.—Dilapidated cottage. Unfit for habitation. Notice. Closed. Aug. 7th.—Imperfect water supply. As the S.E.W. mains have been recently extended to this locality. Notice was served on owner of cottages to lay on this supply. This was done. Aug. 28th.—Upminster.—Dilapidated dustbins, Notice. Remedied. Sept. 7th.—Upminster.—Refuse adjoining neighbours' garden complained of. Visited and no nuisance found. Dec. 9th.—Upminster.—Blocked drain Notice. Remedied. Great Warley.— Feb. 3rd.—Dairy and cowshed in an insanitary condition. Notice. Remedied. Sep. 18th.—Cesspool overflowing into ditch. Notice. Remedied. Oct. 6th.—Blocked W.C. and drains. Notice. Remedied. Rainham and Wennington.— Jan. 8th.—Rainham —Cottage overcrowded. Notice. Remedied. Jan. 12th.—Ditto—Accumulation of manure. Ditto Ditto 35 Jan. 12th.—Ditto—Cesspool overflowing. Notice to connect with sewer complied with. Feb. 8th.—Ditto—Defective w.c. Notice. Remedied. March 5th.—Ditto—Insufficient drainage to cottages. Notice. Remedied. March 20th.—Ditto—Nuisance at railway siding caused by accumulation of manure and stagnant sewage. Manure removed and siding connected with sewer. April 2nd.—Ditto—Eight houses with defective yard paving and drain. Notice. Remedied. April 2nd.—Wennington —Damp houses. Notice. Remedied. May 3rd.—Rainham.—Filthy and overcrowded house. Notice. Remedied. May 13th.—Rainham—Insanitary cowshed. Notice. Closed and new building erected. May 24th.—Rainham—Cottage dilapidated. Notice. Repaired. May 23rd.—Wennington—Water cistern foul. Notice, Remedied. July 18th.—Wennington—Damp premises. Defective yard paving and drainage. Notice. Remedied. Sept. 6th.—Rainham.—Undrained stable. Notice. Remedied. Sept. 9th.—Ditto—Blocked drain. Ditto Ditto Sept. 10th.—Ditto—Insufficient drainage to cottages. Notice. Remedied. Oct. 9th.—Ditto—Cesspool overflowing. Notice to connect with sewer complied with. Oct. 24th.—Ditto—Damp premises. Blocked drain. Notice. Remedied. 36 Nov. 20th.—Wennington—Three dilapidated houses. Notice. Remedied. Dec. 2nd.—Ditto—Animal kept so as to be a nuisance. Notioe. Remedied. Dec. 13th.—Rainham.—Defective drainage to cottages. Notice. Remedied. The following is a complete list of the Nuisances, &c„ reported by the Sanitary Inspectors, in which action has been taken by them, my aid being called in in those instances which were considered necessary. Nuisances abated 219 Filthy houses cleansed 14 Overcrowding abated 10 Houses repaired 41 Houses closed 17 Sample of water analysed 18 Animals improperly kept 24 Pail Closets provided 47 Cowsheds closed 1 Improved water supply 19 Total 410 The various bake-houses, dairies, cowsheds and slaughter-houses have been periodically visited and, when insanitary, have been remedied. Sanitary improvements have continued during the year, the Council always responding to complaints from the Sanitary Officials and from private persons, and giving instructions for official action towards remedying insanitary conditions as far as is possible. New roads have been and are being constructed in various recently developed localities. 37 Locality. 1904 I90S. 1906. 1907. 1908. Tables of mortality, &c., completed according to the requirements of the Local Government Board, are included with this report. The birth and death-rates for the several localities for the last live years are shown in the following table BirthRate. DeathRate. BirthRate. DeathRate. BirthRate. DeathRate. BirthRate. DeathRate. BirthRate. DeathRate. Dagenham, Beacontree and Chadwell Heaths 36.2 15.04 31.5 13.1 29.4 11.4 32.6 13.4 27.9 8.7 Havering 26.9 4.9 21.9 12.1 22.1 11.1 22.1 11.5 20.4 13.6 Horn church 23.7 11.7 6.5 10.0 29..5 10.3 24.5 9.5 27.2 12.6 Upminster. Cranham, and Corbets Tey 23.5 14.3 14.1 7.3 19.04 8.5 18.2 7.8 18.1 9.09 Great Warley 26.5 7.0 33.4 12.1 36.01 8.5 31.8 12.8 26.9 9.08 Rainham & Wennington 26.5 17.7 32.4 11.1 34.1 13.7 33.1 11.4 31.07 10.03 Diseases of a zymotic character proved fatal in 28 instances. The death-rate for this class of disease for the entire district being: 1-2 per 1,000. The following table shows the nature and distribution of fatal zymotic disease on the different localities of the district. 38  Dagenham. j Havering. Upminster. Horn church. Rainham. Great Warley. Measles 1 - - 4 - - Diphtheria 5 - 1 8 1 - Enteric Fever 0 - 1 - - Scarlet Fever 4 — - 3 - — ISOLATION HOSPITAL. The following eases were admitted into the Isolation Hospital from the Rural District during the year. Scarlet Fever 127 Diphtheria 78 I have, as in previous reports, much pleasure in testifying to the satisfactory way in which, as far an I know, the duties of inspection, &c , are carried out by the Sanitary Inspectors. Area and population of district: Area, in acres 29,951 Population 20,415 General death-rate 10.1 per 1,000. Infant death-rate (under 1 year) 2.2 per 1,000 I am, Gentlemen, Your obedient Servant, ALFRED WRIGHT. The Lodge, Romford, March 4th, 1909. 39 TABLE I. Vital Statistics ok Whole District during 1903 and Previous Years. ROMFORD RURAL DISTRICT. Year. Population estimated to Middle of each Year. Births. Total. Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Non-residents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all ages belonging to the District. Under 1 yr. of age At all Ages. Number. Rate.* N umber. Rate per 1000 Births' registered. Number. Rate.* Number. lute.* 1 2 S 4 5 6 7 8 9 10 11 12 15 1898. 11,400 551 33.5 66 101 250 15.2 12 262 15.9 1899. 11,770 593 35.3 84 141 251 15.2 9 265 15.3 1900. 17,380 476 27.3 21 554 255 14.6 11 266 15.3 1901. 18,990 569 28.9 90 157 266 14.0 16 7 5 271 14.2 1902. 19,500 583 30.0 62 105 235 22.3 11 0 7 211 12.2 1903. 20,000 623 36.1 66 109 248 12.4 15 6 22 261 13.2 1904. 20,415 551 36.8 96 174 274 13.4 16 2 21 293 14.3 1905. 21,000 654 31.1 86 130 251 12.1 8 1 23 256 12.9 1906. 21,500 634 21.4 87 137 241 11.1 8 3 24 262 12.1 1907. 19,415 602 27.3 51 84 242 11.0 29 4 11 212 11.0 Aver, ages for rears 18981907 5,857 583 30.20 10..4 119 252 13.20 10 2 14 264 13.30 1908. 23,282 622 26.7 8 87 214 9.1 25 7 30 237 10.1 * Rates in columns 4, 8, and 13, calculated per 1,000 of estimated population. Area of District in acres (exclusive of area covered by water), 29951 Total population at all ages, 18,990 Number of inhabited houses, 3995 Average number of persons per house, 4.7 At Census of 1901. 40 I. Institutions within the District receiving Sick and Infirm persons from outside the District. Isolation Hospital. West Ham Small-pox Hospital II. Institutions outside the District receiving sick and infirm persons from the District. Union Infirmary. Romford Cottage Hospital. Eastern London Hospitals. III. Other Institutions, the deaths in which have been distributed among the several localities in the District. TABLE II. Vital Statistics or Separate Localities in 1908 and previous years. ROMFORD RURAL DISTRICT. Names of Localities. Dagenham, Beacontrek and Chadwell heaths. Havering. Noak Hill . Hornchurch. Upminster, Cranham, and Corbets Tey. Great Warley. Rainham and Wennington. Year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under I year. Population estimated to middle of each year. Births registeied. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. a. b. c. d. a. b. c. d. a. b c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. 1898 5,020 160 83 33 500 7 3 4,770 121 61 13 1,920 43 31 4 1,920 62 22 3 2,300 72 17 4 1899 5,200 181 64 23 500 12 1 4,800 106 76 27 2,000 40 24 5 1,830 69 29 3 2,340 42 33 14 1900 5,500 181 90 31 504 5 5 3 5,000 168 70 15 2.020 51 31 4 1,970 30 30 12 2,390 79 25 10 1901 6,000 228 87 41 407 11 1 259 5 2 6,100 165 76 25 1,274 29 20 3 1,900 56 30 11 2.080 65 39 14 1902 6,300 223 69 18 407 7 6 1 259 4 4 6,610 177 83 24 1,900 19 19 5 1,910 59 17 11 2,100 74 36 13 1903 6,500 229 83 35 410 4 260 6 3 6.803 191 58 13 1.900 41 28 4 1,930 59 29 8 2,160 93 83 0 1904 6,700 246 102 38 405 7 2 260 2 1 6,900 154 88 32 1,956 46 28 5 2,000 53 14 6 2,200 51 39 15 1905 6,900 252 91 41 410 9 5 2 260 3 6 7,500 209 75 16 2,000 39 15 6 2,000 51 14 6 2,300 73 89 11 1906 7,130 221 87 33 415 9 6 2 260 5 4 7,700 210 75 13 2 100 40 12 3 2,100 76 12 4 2,400 73 33 18 1997 7,300 238 93 27 415 4 4 260 3 7,350 103 71 10 2,300 38 23 4 2,150 67 28 9 2,450 57 33 16 Averages of Years 1898 to 1907. 6,255 216 85 31 436 7 3 6,396 181 73 18 1,941 38 23 4 1,976 60 22 6 2,272 68 32 12 1908 7,450 298 65 21 440 9 6 1 262 2 8,000 218 101 16 2,310 44 21 4 2,340 63 19 2,480 78 25 10 42 TABLE 111. Cases of Infectious Disease notified during the Year 1908, in the Romford Rural District. Notifiable Disease. Cases notified in Whole District. No. of Cases Removed to Hospital from each Locality. No. of Cases Removed to Hospital from each Locality. At all Ages. At Ages —Years. Dagenham, Beacontree and Chadwell Heaths Noak Hill. Havering. Hornchurcb. Upminster. Cranham, and Corbets Tey. Great Warley. Rainham and Wennington. Dagenham, Beacontree and Chadwell Heaths Havering. Noak Hill. Hornchurcb. Upminster, Cranham, and Corbets Tey. Great Warley. Rainham and Wennington. Total cases removed to Hospital. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 102 ... 24 68 5 5 ... 47 ... ... 43 1 ... 11 29 ... ... 40 1 ... 5 72 Erysipelas 16 ... ... ... 2 10 4 6 ... ... 4 5 ... 1 ... ... ... ... ... ... ... ... Scarlet Fever 166 ... 38 110 8 10 ... 79 ... ... 55 4 10 18 67 ... ... 41 5 ... 13 126 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 7 ... ... ... 4 3 ... ... ... ... 2 4 ... 1 ... ... ... ... ... ... ... ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 2 ... ... ... ... 2 ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... * ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 293 ... 62 178 19 30 4 133 ... ... 105 14 10 31 93 ... ... 81 6 ... 18 190 Isolation Hospital—Romford Joint Hospital, Rush Green, Romford. Total available beds—50. Number of Diseases that can be concurrently treated, 3 43 TABLE IV. Causes of, and Ages at, Death during Year 190S. Romford Rural District. Causes of Death. Deaths at the subjoined ages of "Residents" whether occurring in ok beyond the district Deaths at am. ages of "Residents" belonging to Localities, whether occurring in or beyond the district. Total Deaths whether of "Residents" or 'non-residents' in Public Institutions in the District. All Ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Dagenham, Beacontree and Chadwell Heaths Hornchurch. J Havering. Upminster, Cranham, and Corbets Tey. Great Warley. Rainham and Wennington. Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 5 ... 3 1 ... 1 ... 1 4 ... ... ... ... ... ... Scarlet Fever 7 ... 3 4 ... ... ... 4 3 ... ... ... ... 9 ... Whooping-cough 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... Diphtheria (including Membranous Croup) 14 1 5 8 ... ... ... 5 8 ... 1 ... ... 16 ... Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 2 ... ... 1 ... 1 ... ... 1 ... 1 ... ... ... ... Other contin'd ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 10 7 3 ... ... ... ... 3 2 ... 1 ... 4 ... ... Enteritis 2 2 ... ... ... ... ... 1 1 ... ... ... ... ... ... Puerperal Fever 1 ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis (Pulmonary Tuberculosis) 18 1 ... 1 1 15 ... 6 7 ... 2 2 1 ... ... Other tubercular Diseases 13 5 5 2 ... ... 1 4 4 ... 2 1 2 ... ... Cancer, Malignant Disease 20 ... ... ... ... 9 11 4 10 ... 2 3 1 ... ... Bronchitis 14 3 ... ... ... 3 8 3 6 ... ... 1 4 ... ... Pneumonia 11 5 ... 2 ... 4 ... 5 5 ... ... 1 ... ... ... Pleurisy 1 ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... Other Diseases of Respiratory Organs ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver Venereal Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 12 12 ... ... ... ... ... 2 6 1 1 2 ... ... ... Diseases and Accidents of Parturition ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Heart Diseases 36 4 1 ... 2 23 6 10 11 3 3 6 3 ... ... Accidents 5 1 ... 1 1 2 ... 1 ... ... ... ... 2 ... ... Suicides ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Senile Decay 23 ... ... ... ... ... 23 4 11 2 3 1 2 ... ... A1J other causes 42 11 2 6 3 17 3 11 19 ... 4 2 6 ... ... All Causes 237 52 23 26 8 75 53 65 101 6 21 19 25 ... 25 TABLE V. INFANTILE MORTALITY DURING THE YEAR, 1908. Deaths from stated Causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 Week. 2-3 Weeks. 3-4 Weeks. Total under 1 month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under One Year. All Causes Certified 9 4 1 2 4 3 5 4 3 5 2 o r i 2 3 50 Uncertified .. 1 1 i Common Infectious Diseases. Small-pox .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Chicken-pox .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Measles .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Scarlet Fever .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Diphtheria: Croup .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 .... Whooping Cough .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Diarrhœa, all forms .... .... .... .... 1 .... .... 1 .... .... .... 2 .... 2 2 8 Diarrhœal Diseases. Enteritis, Mucoenteritis Gastro-enteritis .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Gastritis, Gastrointestinal Catarrh .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Wasting Diseases. Premature Birth 7 .... .... 2 1 .... 1 .... .... .... .... .... .... .... .... 11 Congenital Defects .... 2 .... .... .... .... .... .... 1 .... .... .... .... .... .... 3 Injury at Birth .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Want of Breast-milk Starvation .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Atrophy, Debility, Marasmus .... 1 .... .... .... 1 2 .... .... 1 .... .... .... .... .... 5 Tuberculous Diseases. Tuberculous Meningitis .... .... .... .... .... .... 1 .... .... .... .... .... .... .... .... 1 Tuberculous Peritonitis; Tabes Mesenterica .... .... .... .... .... .... .... 1 .... .... .... 2 .... .... .... 2 Other Tuberculous Diseases .... .... .... .... .... 1 .... .... .... 1 .... .... 1 .... .... 3 Other Causes. Erysipelas .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Syphilis .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Rickets .... .... .... .... .... .... 1 .... .... .... .... .... .... .... 1 Meningitis (not Tuberculous) .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Convulsions .... .... .... .... .... .... .... .... .... 1 .... .... .... .... .... .... Bronchitis .... .... 1 .... 1 .... .... 1 .... .... .... .... .... .... .... 3 Laryngitis .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... Pneumonia .... 1 .... .... .... 1 1 .... 2 .... .... .... .... 1 .... Suffocation, overlaying .... .... .... .... 1 .... .... .... .... .... .... .... .... .... .... 1 Other Causes 3 .... .... .... .... .... .... 1 .... 2 .... 1 .... .... .... 7 Population estimated to middle of 1908, 23,282. Births in the year, legitimate, 614; illegitimate, 8. Deaths in the year, legitimate, 48; illegitimate, 4. Death from all causes at all ages, 237. 45 ESSEX COUNTY COUNCIL Parishes of Hornchurch, Upminster, Havering, Cranham, Great Warley, Noak Hill. No. 1 District. Summary of Work done through the Sanitary Inspector in the Rural Sanitary District of Romford during the year ending December 31st, 1908. (To be sent to the Clerk to the County Council with ths Medical Officer of Health's Annual Report. Total Number for year. Notes, Results of Inspection, &c. 1 Complaints received 2 Nuisances detected without complaint 3 Nuisances abated 4 Notices served 54 5 Summonses taken out Nil. 6 Convictions Nil. 7 Cottages inspected All in district 8 Lodging-houses inspected None in district 9 Slaughter-houses inspected 9 10 Bakehouses inspected 12 11 Dairies and Milk Shops inspected 6 12 Cowsheds inspected 34 13 Workshops inspected 17 14 Filthy houses cleansed, sec. 46 Public Health Act, 1875 4 - 15 Houses disinfected As required by M.O.H. 16 Overcrowding abated 2 17 Houses placed in habitable repair 4 18 Houses closed, Upminster and Havering 12 19 Houses erected or re-built for which Water "Certificates" were applied Surveyor's duty 46  Total Number for year. Notes, Results of Inspection, &c. 20 "Certificates" granted Surveyor's duty 31 „ deferred „ 22 Wells sunk or improved supplies of Water afforded S.E.W. Co.'s main extended to Upminster Common 23 Wells cleansed or repaired 0 24 Wells closed Nil. 25 Houses connected with sewers Surveyor's duty 26 Houses connected with water mains „ 27 Earth, pail, or improved Privies constructed or existing Privies altered 8 28 Privies and W.C.'s repaired; W.C.'s supplied with water 10 29 Cisterns cleansed, repair ed, or covered 30 Animals improperly kept, removed 2 31 Samples of water taken for Analysis 12 32 Compensation paid for destruction of infected bedding Nil. 33 Seizures of unsound Meat, &c. 2 No action taken (Signed) ARTHUR CORNELL, Inspector of Nuisances. 47 COUNTY OF ESSEX. Parishes of Dagenham, Rainham, and Wennington. Summary of Work done through the Sanitary Inspector in the Rural Sanitary District of Romford during the year ending December 31st, 1908. Total Number for year. Notes, Results of Inspection, &c. 1 Complaints received 22 2 Nuisances detected without complaint 133 3 Nuisances abated 173 4 Notices served 112 5 Summonses taken out 6 Convictions 7 Cottages inspected. 427 8 Lodging-houses inspected 9 Slaughter-houses inspected 5 10 Bakehouses inspected 6 11 Dairies and Milk Shops inspected 14 12 Cowsheds inspected 12 One closed. 13 Workshops inspected 14 14 Filthy houses cleansed, sec. 46 Public Health Act, 1875 10 15 Houses disinfected 156 16 Overcrowding abated 7 17 Houses placed in habitable repair 37 18 Houses closed 4 19 Houses erected or re-built for which Water "Certificates" were applied 20 "Certificates" granted 21 „ deferred 22 Wells sunk or improved supplies of Water afforded 19 23 Wells cleansed or repaired 24 Wells closed 2 48  Total Number for year. Notes, Results of Inspection, &c. 25 Houses connected with sewers 4 26 Houses connected with water mains 6 27 Earth, pail, or improved Privies constructed, or existing Privies altered 36 28 Privies and W.C.'s repaired; W.C.'s supplied with water 30 29 Cisterns cleansed, repaired, or covered 2 30 Animals improperly kept removed 22 31 Samples of water taken for Analysis 3 32 Compensation paid for destruction of infected bedding 33 Seizures of unsound Meat, &c. {Signed) GEORGE T. CARTER, Sanitary Inspector. 49 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES, AND HOMEWORK. 1.—INSPECTION. Including Inspection made by Sanitary Inspectors ok Inspectors of Nuisances. Premises. Number of Inspections Written Notices. Prosecutions. Factories (Including Factory Laundries) 21 None None Workshops (including Workshop Laundries 19 Several „ Workplaces 6 Total 46 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts: Want of Cleanliness 1 1 Total 1 1 Nil. Nil. 50 3.—HOME WORK. NATURE OF WORK. OUTWORKERS' LISTS. Lists received from Employers twice in the year. Addresses of Outworkers. Inspection of Outworkers' premises Lists. Outworkers. Received from other Councils Forwarded to other Councils. Contractors. Workmen. Wearing Apparel— Making, &c. 1 2 Brush Making 2 2 Total 3 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. Number. Bakehouses 9 Dressmakers 4 Tailor and Mantle Makers 4 Hasness Makers 5 Laundries. 2 Total number of workshops on Register 24 5.—OTHER MATTERS. Class. Number. Matter notified to H. M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s 133). 1 printed at the "essex times" office, romford.