ANNUAL REPORT of the MEDICAL OFFICER of HEALTH and PUBLIC HEALTH INSPECTOR for the year f 1959 I: •u«'' Digitized by the Internet Archive in 2017 with funding from Wellcome Library https://archive.org/details/b2917031x ANNUAL REPORT of the MEDICAL OFFICER of HEALTH and PUBLIC HEALTH INSPECTOR for the year 1959 Paragon Press, Botley Road, Bishop's Waltham CONTENTS PAGES I Summary of Main Features .. I II Legislation .. .. 2 III Statistics of the Area .. .. .. 2-5 IV General Provisions of Health Services for the Area 6-11 V School Health Services .. .. 11-14 VI Hospitals .. .. .. 15 VII Preventive Measures .. .. 16-32 VIII Infectious Diseases .. 33-36 IX Sanitary Circumstances of the Area .. 36-37 X Housing .. .. .. .. 37-40 XI Inspection and Supervision of Food .. 40-41 XII Rodent Control .. .. .. 42-43 XIII Summary of Inspections .. .. 44 XIV Factories.. .. .. .. 45 DROXFORD RURAL DISTRICT COUNCIL Northbrook House, Bishop’s Waltham, Southampton Tel. Bishop's Waltham 242 To the Chairman and Members of the Droxford Rural District Council I have the honour to present the Annual Report for the year 1959, on the health and sanitary circumstances of the Rural District of Droxford. It is drafted in accordance with the requirements of the Ministry of Health. The estimated population showed an increase of 500. Apart from measles, very httle infectious disease occurred. The age group for vaccination against pohomyelitis was extended to include all persons under 40 years. In addition, expectant mothers are included in a specially selected group. It is very satisfactory to record a splendid response to poliomyel- itis vaccination; and, thanks to the wisdom of the parents and the excellent co-operation of the general practitioners, over 7,000 vaccinations were carried out during the year. There has been no case of diphtheria in the district for the past seven years; but, as the Ministry points out, this is no time for complacency, as there has been a rise in the incidence of diphtheria in the country as a whole. Parents are again reminded that children should be immunised before their first birthday and should receive their first supplementary injection preferably just before school age. I should like to thank you all for your help and encouragement and I am grateful to the Officers of other Departments for their wilUng help and assistance at all tim.es, I also wish to record my grateful thanks to Mr. Lindley, the Chief Public Health Inspector, and to Mr. Wenden and Mr. Knowl- ton for their valuable co-operation and assistance in compifing this report. Medical Officer of Health, Droxford Rural District Council. LEGISLATION OF PUBLIC HEALTH SIGNIFICANCE House Purchase and Housing Act, 1959 This Act, inter alia, introduced the system of Standard Grants for the improvement of dwellings. This provides an alternative method to the Discretionary Grant scheme instituted by the Housing Act, 1949. Housing (Underground Rooms) Act, 1959 This is a short amendment Act altering the Housing Act, 1957 to allow in certain circumstances underground rooms to be dealt with without reference to the standard of fitness laid down in Section 4 of the 1957 Act. Milk and Dairies (General) Regulations, 1959 These Regulations replace previous ones made in 1949. The changes include: Registration of milk distributors is now limited to the Local Authority in whose area the premises are situated. Provision is made for compensation to be paid by the Local Authority to a person who has been debarred because of illness from employment connected with milk. Where milk is infected notice may be served by the Medical Officer of Health on the occupier of registered premises outside (as well as inside) his district. Ice-Cream (Heat Treatment, etc.) Regulations, 1959 These Regulations replace earlier ones issued in 1947. They require that ingredients used in the manufacture of ice-cream are to be pasteurized by certain methods and make it an offence to sell ice- cream which has not been so treated. STATISTICS OF THE AREA Area “Home” Population (mid 1959) Number of Hereditaments (31/3/60)... Rateable Value (31/12/59) Sum represented by a penny rate (31/3/59) 62,848 acres 21,790 6,933 £231,433 £796 4^. Ad. NATURAL AND SOCIAL CONDITIONS OF THE AREA The Rural District is situated in the south-east corner of Hampshire. The northern half lies on the chalk uplands and the remainder on the sands and clays of the Hampshire Basin. The principal watercourse is the Meon, a chalk stream and the only other rivers are the headwaters of two tertiary streams, the Hamble in the south-west and the Wallington in the south-east. there is arable farming with units of comparatively large acreage, on the tertiary formation there are small dairy farms on the clay and extensive smallholdings with strawberry growing a speciality of the district, on the loams and sands. The ancient Forest of Bere is being re-afforested by the Forestry Commission. The rural industries and related activities employ much of the population, though considerable numbers find employ- ment in towns outside of the district. VITAL STATISTICS Births M. 1958 F. Total M. 1959 F. Total Live Births (Legitimate) 184 168 352 177 161 338 (Illegitimate) 7 5 12 8 5 13 Total Live Births 364 351 Live Birth Rate per 1,000 of the estimated population (mid-1959) was 16.1 compared with 16.5 for the whole of England and Wales. Illegitimate hve births per cent of total hve births was 3.7 %. StiU Births (Legitimate) M. 3 1958 F. Total 1 4 1959 M. F. Total 2 2 4 (Illegitimate) — — — — — — Total StiU Births ... 4 4 Still Birth Rate per 1,000 total (live and still) births was 11.3 compared with 20.7 for the whole of England and Wales. Deaths From all causes 1958 M. F. Total 153 156 309 1959 M. F. Total 146 166 312 Death Rate per 1,000 estimated population was 14.3 compared with 11.6 for the whole of England and Wales. Maternal Mortality 1958 1959 Pregnancy, Childbirth, Abortion Nil Nil Maternal Mortality Rate per 1,000 total (live and still) births. Nil. 3 Infant Mortality (deaths under one year) 1958 1959 M. F. Total M. F. Total Legitimate ... 3 4 7 2 1 3 Illegitimate ... - - - _ _ _ Total Infant Deaths ... 7 ... 3 Infant Mortality Rate per 1,000 live births was 8.5 compared with 22 for the whole of England and Wales. This rate for each calendar year is not regarded as a reliable guide, for the number of births in the District is insufficient to be of significance statistically. But, if this rate is taken over a period of five years, it may then be considered reasonably reliable and one of the best indices of the social circumstances of the district. High rates are commonly associated with overcrowding and defective sanitation. It is therefore satisfactory to report that, during the past fifteen years, the quinquennial rates for this district have been consistently lower than the figures for the country as a whole. The following tables shows the rate for the district as compared with the rate for England and Wales, each over a five-year period. INFANT MORTALITY RATE (per 1,000 live births) Year Droxford Rural District England and Wales 1943 42.5 50.0 1944 33.2 46.6 1945 28.3 45.0 1946 28.5 42.0 1947 28.5 39.2 1948 26.3 35.9 1949 25.5 33.3 1950 23.7 30.6 1951 19.4 29.2 1952 15.0 27.8 1953 12.9 26.8 1954 12.1 25.76 1955 10.6 24.9 1956 12.28 23.9 1957 11.15 23.3 Causes of Death 1. Tuberculosis of Respiratory System Male 1 Female Total 1 2. Other forms of Tuberculosis — — — 3. Syphilis — — — 4. Diphtheria — — — 5. Whooping Cough — — — 6. Meningococcal Infections — — — 7. Acute Poliomyelitis — — — 8. Measles... — — — 9. Other Infective and Parasitic Diseases 1 — 1 10. Malignant Neoplasm, Stomach 4 — 4 11. „ „ Lung, Bronchus 4 1 5 12. „ „ Breast — 2 2 13. „ „ Uterus — 1 1 14. Other Malignant and Lymphatic Neoplasms 19 9 28 15. Leukaemia, Aleukaemia — 1 1 16. Diabetes ... 1 — 1 17. Vascular Lesions of Nervous System 16 27 43 18. Coronary Disease, Angina 29 24 53 19. Hypertension with Heart Disease ... 1 8 9 20. Other Heart Disease 21 49 70 21. Other Circulatory Disease 5 5 10 22. Influenza 1 1 2 23. Pneumonia 9 11 20 24. Bronchitis 5 1 6 25. Other Diseases of Respiratory System 3 1 4 26. Ulcer of Stomach and Duodenum ... 4 — 4 27. Gastritis, Enteritis and Diarrhoea ... — 1 1 28. Nephritis and Nephrosis 1 — 1 29. Hyperplasia of Prostate 2 — 2 30. Pregnancy, Childbirth, Abortion — — — 31. Congenital Malformations 1 — 1 32. Other Defined and Ill-defined Diseases 10 14 24 33. Motor Vehicle Accidents 4 1 5 34. All other Accidents — 8 8 35. Suicide 4 1 5 36. Homicide and Operations of War ... — — — 146 166 312 GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA PiiMic Health Officers of the Authority Medical Officer of Health: S. Chalmers Parry, m.a., cantab., m.r.c.s., l.r.c.p., d.p.el Engineer^ Surveyor and Chief Public Plealth Inspector: F. Lindley, m.r.p.h.l, a.m.i.s.e., m.p.h.i.a. Additional Public Health Inspectors: H. L. Wenden, cert, s.i.b. H. P. Bird, cert, s.i.b. Administrative Assistant: D. Knowlton, a.c.c.s. Laboratory Facilities Bacteriological work is carried out by the Public Health Labora- tory at the Royal Hampshire County Hospital, Winchester (Tele- phone, Winchester 3807) and specimens of clinical materials (sputum, swabs, etc.) and samples of water, milk and foodstuffs are sent for bacteriological examination to the Director, Dr. M. H. Hughes. Specimens may be deposited in the sample box placed outside the Laboratory, or they may be left at the Main Hall of the Hospital at any time when the Laboratory is closed. At weekends, and on public holidays, arrangements are made for dealing with specimens during the morning and evening. Urgent specimens can be dealt with at any time and Dr. M. H. Hughes is available at Twyford 3349 for telephone consultations when he is not in the Laboratory. Somxe specimens in connection with cases of infectious diseases, which have been admitted to the Priorsdean Hospital, are sent for bacteriological examination to Dr. K. Hughes, Director of the Public Health Laboratory, Milton, Portsmouth (Telephone, Ports- mouth 22331). At Portsmouth, specimens may be left at the Porter’s Lodge of the Infectious Diseases Hospital, at any time. Urgent specimens can be dealt with, when the Laboratory is closed, by telephoning the technician on call at St. Mary’s Hospital (Portsmouth 22331). Samples for chemical analysis are sent to the Public Analyst at “Spetchley”, Cobden Avenue, Bitterne Park (Telephone, South- ampton 55826). Ambulance Facilities All applications for the use of ambulances should be directed to the Ambulance Officer, Fareham (Telephone, Fareham 2170) who arranges for the most conveniently situated ambulance to attend. Hospital Car Service The use of this service may be obtained through the Ambulance Officer (Telephone, Fareham 3626). Smallpox cases (suspected or confirmed) requiring transport to hospital will be conveyed by the County Ambulance Service by arrangements made through the Beds Admission Office (Telephone, Winchester 2261) Nursing and Health Visiting in the Homes and Clinics The names and addresses of District Nurses, Midwives and Health Visitors, who practise in the district under the direction of the County Medical Officer, are shown in the following table: Names and addresses of Nurses Distriet Served Names of Health Visitors Miss A. L. Brown, s.c.m., 18 Penfords Paddock, Bishop’s Waltham. (Tel. Bishop’s Waltham 199) Waltham Chase Part of Bishop’s Waltham Miss B. M. Watson, S.R.N., S.C.M., R.S.H. Cert. *Tel. Bishop’s Waltham 107 Miss. V. J. Benson, s.r.n., s.c.m., 14 Folly Field, Bishop’s Waltham. (Tel. Bishop’s Waltham 330) Upham Part of Bishop’s Waltham Mrs. M. S. Wills, s.r.n., s.c.m., 16 Elizabeth Road, Wickham. (Tel. Wickham 2277) Shedfield (except Waltham Chase) Wickham (other than Curdridge) Boar- hunt Southwick Miss B. G. M. Osborn S.R.N., S.C.M., R.S.H. Cert. Orthopaedic Nursing Certificate *Tel. Portsmouth 31155 Miss A. L. Brown, s.c.m., 18 Penfords Paddock, Bishop’s Waltham. (Tel. Bishop’s Waltham 199) Swanmore Mrs. K. M. Zollo, s.r.n., s.c.m., 2 Bere Road, Denmead. (Tel. Hambledon 649) Denmead Hambledon Miss V. G. Chadwell, s.r.n., s.c.m., Q.N., R.S.H. CERT., U.S.A. MID. CERT., 20 The Park, Droxford. (Tel. Droxford 210) Soberton Droxford Corhampton Meonstoke Exton Miss V. G. Chadwell S.R.N., S.C.M. Q.N., R.S.H. CERT., U.S.A. MID. CERT. *Tel. Droxford 210 Miss F. R. Moore, s.c.m., 16 Glenthorne Meadow, East Meon. (Tel. East Meon 263) Warnford West Meon Miss E. J. Read, S.R.N., S.C.M., R.S.H. CERT., A.R.P.H.I. *Tel. West Meon 315 Miss A. L. Johnson, s.r.n., s.c.m., 22 Elizabeth Road, Waterlooville. (Tel. Waterlooville 3607) Widley Miss D. V. Alloway, S.R.N., Q.N., R.S.H. CERT. *Tel. W’looville 3516 Miss V. J. Benson, s.r.n., s.c.m., 14 Folly Field, Bishop’s Waltham. (Tel. Bishop’s Waltham 330) Durley Miss P. Jenkins, S.R.N., S.C.M., R.S.H. CERT. Miss J. Byatt, s.r.n., s.c.m., Leehurst, Botley. (Tel. Botley 2015) Curdridge Curbridge area of Wickham *Tel. Twyford 2021 * If the services of a Health Visitor are required, please telephone before 9 a.m. or after 5 p.m. Child Welfare Centres The following Child Welfare Centres in the Rural District are open for children under five years of age. Centre Hall Afternoons Bishop’s Waltham The Institute 1st and 3rd Fridays Denmead Memorial Hall, Main Street 4th Mondays Droxford Village Hall 1st Mondays Duriey Memorial Hall 2nd Fridays Hambledon Women’s Institute... 2nd Mondays Meonstoke The Meon Hut 1st Tuesdays Southwick Manor Hall 4th Fridays Swanmore Parish Room 3rd Thursdays Upham Village Hall 3rd Tuesdays Waltham Chase Chase Hut 2nd and 4th Wednesdays Wickham Victory Hall 1st and 3rd Wednesdays The following five centres, situate in adjoining districts, are available for children hving near the boundaries of the district:— Centre Hall Afternoons East Meon Institute Hut 1st and 3rd Thursdays Fair Oak Women’s Hall 2nd and 4th Thursdays Purbrook Deverall Hall 2nd and 4th Wednesdays Park Gate British Legion Hall 2nd and 4th Thursdays Titchfield Parish Hall 1st and 3rd Mondays The work of the voluntary helpers, who assist the medical and nursing staff at the welfare centres, is greatly appreciated. FAMILY PLANNING ASSOCIATION CLINICS G • • • S • • <D ti B B B a S a 45 +-> w o d sd d O ft cd ® 1 oo d CO cd )-H H td 1 o q q t q G- 1 {A o 1 1 1 1 1 o 1 1 m rn q q q cn q q td (N id in 4-1 M5 CN C- cd (/3 -M >> C/3 C G cd TD Fridays C/3 Tuesdays Fridays C/3 o > cd c < Q <u G "a G xt G O T3 to !-i G 45 H G TD CO 0/ G h o C 3 o s_ a u <v o > <D « oo CO O ^ 5 ^ "u CM) ^ .E II ~ ^ c£ ^ Z I ^ w> _o -1 CM) r3 c > — c cz ^ J g CL CO E <v u > t- (U C oo o o ’> ■O < <u O c (d "D c <u <-> +J fd c <L) 1_ (d o ■«-» CO CO “O C cd s- O -M u o "O >s “D td u I—f t-H H-1 o p-( o c/3 c/3 W 0:^ Q Q < <1 <d TJ cd o Cti c U( <u -(-> ^-( o iz: r\ w i- C <u U w Ch tS M—I • ^ u e cd 45 CO O U T3 cd O >> a> CO s o M5 iT to 5J O X -a <i> o 45 H (U <u v-l ■+-' c/3 CO (U cd X 3 c/3 C/3 o (5 • ^ u 45 S-J D ffi o c 53 O U c 5t O U T3 cd O o 44 O H—• C/3 55 cd 13 -i-> CO O 45 OO ♦ ^ +-< to cd W B cd 45 o cd M o a to O o 55 O 4-> -(-> Cd Ch 'd' cd O (U > ♦ ^ U e\ <o (J cd cd bO s cd Vi H 55 O a to +-» O Oh <u -i-> CO ID 45 o G a> 0/ Uh 4-> C/3 cd Chh cd H CO G O K Ut cd C+H cd S-H H W) ‘a O '5' cd G a 45 H L. o u it O c O s_ (1> E o 0) +j 4-> _E cd u c U o O G s/ o G •M ■Q 05 (U z o G G ■M ■o c G G <D o 4-» U +-» G (U +-> JG 4-1 (O L. Cft E s-. o O fc. iH- ■o 4-> G <u c •k “O rt ■M G -O O o -G 0) lO -O G c G G E o O G o ’+-» G G E 4-> G L- .G .o +J sJ V4— c <U O 4-» <u 4:^ G O O ■O -G 4-» 1- o G "O l4— (O G < 4-> * Tuberculosis The following Chest Clinics are available to patients suffering from Tuberculosis: FAREHAM—The Chest Clinic, St. Christopher’s Hospital, Wickham Road Telephone: Fareham 2263. Wednesday 9.45 a.m. Previous Patients by appointment 2.00 p.m. New Patients Evening CHnic (2nd in odd month only) by appointment Thursday 9.45 a.m. Previous Patients by appointment 2.00 p.m. A.P. Refills (weekly) Chest Physician—Dr. J. Butterworth HAVANT—The Chest Clinic, Queen Alexandra Hospital, Portsmouth Telephone: Cosham 79451 Extension 58. Monday 10.00 a.m. Previous Patients 2.00 p.m. Previous Patients Wednesday 2.00 p.m. New Patients Thursday 2.00 p.m. A.P. Refills (weekly) 5.00 p.m. By appointment (2nd in month only) Chest Physician—Dr. J. P. Sharp WINCHESTER—The Chest Clinic, Trafalgar Street Telephone: Winchester 4411 Extension 132 Wednesday 10.00 a.m. Previous Patients 2.30 p.m. New Patients Thursday 9.30 a.m. By appointment 1.30 p.m. A.P. Refills at Royal Hampshire County Hospital Chest Physician—Dr. A. Capes EASTLEIGH—The Mount Sanatorium, Bishopstoke Telephone: Eastleigh 2335 Monday 9.00 a.m. Special Cases by Dr. Capes. 2.00 p.m. Patients by appointment Evening Clinics (every 1st Monday only) by appointment—Dr. Lillie. Wednesday 9.00 a.m. J"New and Old Patients by appointment— 1.45 p.m. \ Dr. Lillie Friday 2.00 p.m. 1st only—BCG for children Chest Physicians—Dr. A. Capes Dr. D. C. Lillie *Venereal Diseases Treatment is available at the following Clinics: PORTSMOUTH—St. Mary’s Hospital Males: 10 a.m. to 12 noon, and 5 p.m. to 7 p.m. Tuesdays and Thursdays Females: 5 p.m. to 7 p.m., Mondays 2 p.m. to 4 p.m., Wednesdays 10 a.m. to 12 noon, Fridays SOUTHAMPTON—1 Cardigan Road (off New Road) Males: 9 a.m. to 12 noon, and 5 p.m. to 7 p.m. Mondays, Tuesdays, Wednesdays, Thursdays and Fridays 9 a.m. to 12 noon, Saturdays SOUTHAMPTON—Health Centre, King’s Park Road Females: 10 a.m. to 12 Noon, Mondays 2 p.m. to 4 p.m., Tuesdays 3 p.m. to 5 p.m., Thursdays 2 p.m. to 4 p.m., Fridays WINCHESTER—Royal Hampshire County Hospital Males: 10.30 a.m. to 12 noon, Saturdays Females: 2.15 p.m. to 4 p.m., Tuesdays SCHOOL HEALTH SERVICES * Orthopaedic Clinics Orthopaedic cases, requiring treatment, are seen by appointment from the Appointments Officer at each Hospital, at the following Clinics:— Alton Surgeon's Clinic, held at Lord Mayor Treloar Hospital on Fridays Remedial Clinic, held at Lord Mayor Treloar Hospital daily Winchester Surgeon's Clinic, held at the Royal Hampshire County Hospital, 1st Friday each month p.m. Remedial Clinic, held at the Royal Hampshire County Hospital, daily Fareham Surgeon's Clinic, held at St. Christopher’s Hospital, on Wednesday a.m. every 4th week. Minor Clinic, held at the County Health CHnic, West Street, as required, by appointment with the County Medical Officer Remedial Clinic, held at St. Christopher’s Hospital, on Mondays and Thursdays all day Havant Surgeon's Clinic, held at Havant War Memorial Hospital on 4th Tuesdays, p.m. Remedial Clinic, held at Health Clinic, 4 Park Way, on Tuesdays, all day (except 4th Tuesday p.m.) and Wednesdays all day Petersfielcl Remedial Clinic, held at Petersfield General Hospital, as required '^Ear, Nose and Throat Clinics Cases, referred for specialist advice, are examined at the Ports- mouth Eye and Ear Hospital or Winchester Royal Hampshire County Hospital, and treatment is carried out there or at Petersfield. * Ophthalmic Clinics These are available, by appointment, through the County Meical Officer, at the following places:— Winchester Held at Trafalgar House— 1st and 4th Mondays all day, 2nd and 3rd Mondays p.m. Havant Held at County Council Chnic, Park Way— every Monday a.m. only Fareham Held at St. Christopher’s Hospital— every Tuesday a.m. only Petersfield Held at County Council Health Chnic, Love Lane— 2nd Tuesdays, p.m. only * Orthoptic Clinics Cases, selected by the School Oculist, are referred to the Eye and Ear Hospital, Portsmouth, or from the Winchester Ophthalmic Clinic to the Royal Hampshire County Hospital, Winchester. Speech Theraphy Clinics Cases attend, by appointment, at the following centres:— Winchester Health Clinic, Trafalgar House, every Monday and Tuesday at 9.30 a.m. and Friday at 9.30 a.m. and 1.30 p.m. Fareham Health Clinic, The Assembly Hall, every Monday and Thursday at 9.30 a.m. and 1.30 p.m. and Tuesday at 9.30 a.m. Havant County Council Health Clinic, on Wednesdays and Thursdays at 9.30 a.m. and 1.30 p.m. Child Guidance Clinic Cases are seen, by appointment, at Trafalgar House, Winchester Psychiatric Out-patient Clinic—Monday, Tuesday, Wednesday and Friday, at 2.30 p.m. at Knowle Hospital. Wickham 2271 Dental Clinics These are held, when required, for school children, pre-school children and expectant and nursing mothers by appointment at:— County Council Health Clinic, Love Lane, Petersfield (Telephone, Petersfield 954, between 9 a.m. and 9.15 a.m. for appointments) County Council Health Chnic, Park Way, Havant (Telephone, Havant 716) 4 The Square, Winchester (Telephone, Winchester 3347) County Council Health Clinic, The Assembly Hall, off West Street, Fareham (Telephone, Fareham 2937) Dental Chnic, Chamberlayne Road, Eastleigh (Telephone, Eastleigh 2498) The Manor School, Portchester (Telephone, Winchester 4411 Extension 47) Also at other premises and schools as and when required. * These services are the responsibility of the Regional Hospital Board. List of Clinics most accessible to each Parish HOSPITALS General There are no General Hospitals within the district, but the following hospitals are available:— The Royal South Hants Hospital, Southampton (Telephone: Southampton 26211) Children’s Hospital, Southampton (Telephone: Southampton 71012) The Royal Hampshire County Hospital, Winchester (Telephone: Winchester 5151) The Royal Portsmouth Hospital, Portsmouth (Telephone: Portsmouth 22281) St. Mary’s Hospital, Portsmouth (Telephone: Portsmouth 22331) Knowle Hospital (Wickham 2271), situated at Knowle in the Parish of Wickham is administered by the Regional Hospital Board, Portsmouth. Infectious Diseases There is no infectious diseases hospital in the district. Any Infectious Diseases Hospital is available for the admission of cases occurring in the district. Patients are generally admitted to the Priors Dean Infectious Diseases Hospital, Milton Road (Tele- phone, Portsmouth 22331), or to the Victoria Isolation Hospital, Morn Hill, Winchester (Telephone, Winchester 2048), or Southamp- ton Chest Hospital, (Pavihon “A”), Oakley Road, Southampton (Telephone, Southampton 71042) which are under the control of the ^ Regional Hospital Board. Special arrangements have been made for the admission of children suffering from acute poliomyelitis to Lord Mayor Treloar Hospital, Alton (Telephone, Alton 2811). Sanatoria Sanatoria for patients, suffering from Tuberculosis, are provided by the Regional Hospital Board. Smallpox The Regional Hospital Board makes provision for the treatment of cases of smallpox at Crabtree Smallpox Hospital. The Beds Admission Office (Telephone, Winchester 2261) deals with the admission of these patients. PREVENTIVE MEASURES EOOD HYGIENE It should constantly be borne in mind by all concerned in the handling, preparation and storage of food—particularly by those who work in canteens or who serve food to large numbers—that the utmost care must be taken to obviate the risk of food poisoning, which may occur even in the best equipped canteen. Any food handler should report to his employer if he is suffering from any of the following conditions: (1) Diarrhoea or vomiting (2) Septic cuts or sores, boils or whitlows (3) Discharges from the ear, eye or nose (4) Any feverish illness Customers have now become more clean food minded; and, if any uncleanliness is observed in food premises, they often complain to the management. The hygiene standard of such shops and restaurants therefore lies to some extent in their hands. A high standard of hygiene is a benefit to food traders, for it attracts business; and it is of course all in the interest of the general public to encourage safer practices. The washing of hands immediately after using the toilet is absolutely essential for everybody, for toilet paper is porous; and, once contaminated, the hands will leave bacteria behind on every- thing they touch. “No touch” technique should be practised by all food handlers. Cakes, boiled sweets, cooked food and vulnerable foods should be handled by tongs or servers and not fingered by the hands, for they are never clean enough safely to handle food of this nature. Vulnerable foods—which include pressed meat, brawn, meat pies, stews, trifles, custards and synthetic cream—are normally quite safe when prepared, but they act as ideal breeding grounds for any dangerous germs that gain access, and, if kept at warm temperatures, the germs will multiply very rapidly. Made up meat dishes and other vulnerable foods provide a perfect medium for the growth and multiplication of bacteria. The ordinary group of food poisoning organisms, (i.e. the Sal- monellae) are killed by heating, but the fact that they occur in a product, which is going to be heat treated, is no absolute safeguard against any spread—as the infection is often carried from the raw material on the hands and utensils to some article of food in the same premises, which is either already cooked or not subject to heat treatment. There is, however, another type of germ that is not killed by heat and does not even require the presence of air for it to produce its toxins if the temperature conditions are suitable and the intervals of time between the end of cooking and the consumption of food is sufficiently long. This organism is not uncommonly found in meat, so the sooner meat is eaten after cooking, the less likelihood there is for cases of food poisoning from this source of infection to occur. In 1958, there were 69 general outbreaks, 10 family outbreaks and 9 sporadic cases making a total of 88 incidents of food-poisoning due to this organism. Almost all these outbreaks were associated with meat and the meat had invariably been cooked some hours or even a day or more ahead of requirements. The report of the Public Health Laboratory Service for that year states that the spores of the present strain survive up to 4 hours’ boiling and, as the organisms is fairly wide- spread in nature, methods of prevention must be concentrated far more on care over cooking and storage. As a general rule, meat—whether as cuts or in pies or stews— should be thoroughly cooked and eaten hot; if this is impossible, it should be cooled rapidly within 1J hours of cooking and refrigerated until required. In any event, there should be the shortest possible time between cooking and eating in order to limit the number of organisms; for it is only when the organism has been allowed to multiply that trouble wiU occur. Meat, sliced after cooking in institutions, should be maintained either in the cold or at a temperature above 60° C. For minces, meat should be minced when raw and eaten freshly cooked; stookpots are a hazard, and the same chopping board should not be used for both raw and cooked meat. Pressure cooking must be considered one of the safest measures against the survival of spores. If all meat were eaten on the day it was cooked, these outbreaks would cease. Soups, stews, gravies, pies, pease pudding, etc., provide even better conditions for the multiplication of the germs than solid meat. Gravy should never be re-heated; soup and stock, if re-heated, must be boiled. A high standard of hygiene for food traders is best obtained by observing the following simple rules: (1) Protection of food from all sources of contamination (dust and droplet infection as well as from flies, cockroaches, rats and mice). (2) Personal cleanliness of “food non-handlers”. (3) Proper storage and display of food at safe temperature. A recent report from the Public Health Laboratory Service on Food Poisoning in England and Wales, states: “Good hygiene and the exclusion from food handling of persons with septic lesions on the skin will not by themselves ensure the safety of such frequently implicated food as brawn, pressed meats, ham and bacon, the additional measure is refrigeration.” But emphasis should rightly be placed on methods of preventing the food from becoming contaminated in the first place. Many outbreaks of bacterial food poisoning would never have occurred if the food, after being cooked, had been rapidly cooled and then placed in a refrigerator until actually required, instead of being left at room temperature overnight and then eaten cold, or warmed up the next day. Food should never be left in a warm humid kitchen to cool off slowly, nor in a warm oven where it has been cooked. A well ventilated larder can secure good and efficient cooling; and, as soon as it is cooled right through, it can be placed in a refrigerator. Refrigeration conserves food in a wholesome and palatable condition and definitely retards the growth of bacteria if they are present. It is, therefore, most important that vulnerable food should be stored at a low temperature in a refrigerator or a cool larder to prevent the germs from multiplying. The food must be at certain temperature and moisture conditions over a period of time before the food poisoning organisms will multiply and produce food poisoning. The Chief Medical Officer to the Ministry of Health has stated: “The remedy is largely in the hands of caterers. The general public can do little in the matter except by way of complaint, for they are not individually aware of what goes on in the kitchens of the establishments they patronise. Nowadays there is little excuse for unhygienic practice in the preparation and serving of food; the risks are well known and the simple methods by which they may be avoided are within the reach of all. That they are not practised is a direct reffection upon the managements responsible.” As a regular customer, the housewife can, however, inffuence traders by making it clear that she only chooses those who take special care to ensure the freshness and cleanliness and good storage of foods which they sell. In this connection, the Health Department would be glad to receive complaints from the general public of unhygienic methods practised in any food shops. It is not generally appreciated that the germs which commonly cause food poisoning do not necessarily alter the smell, taste or appearance of the food. Protection of the family hes in personal hygiene, kitchen hygiene and the good management of the buying, storing, cooking and cooling of the food. HEALTH EDUCATION The Central Council for Health Education has continued to keep this Department informed of all their up-to-date posters and pam- phlets. Eood Poisoning Statistics 1951-58 (from reports P.H.L.S.) Year General Outbreaks Family Outbreaks Sporadic Cases Total Incidents 1951 343 287 2,717 3,347 1952 372 340 2,807 3,519 1953 492 422 4,363 5,211 1954 506 630 4,880 6,016 1955 612 723 7,626 8,961 1956 563 616 6,534 7,713 1957 473 501 6,097 7,071 1958 285 601 6,414 7,300 It is encouraging to note in the above table, for the third year in succession, there has been a drop in the reported incidence of food poisoning (i.e. from 473 in 1957 to 285 in 1958). This improvement may well have resulted from the higher standard of cleanhness de- manded by the Food Hygiene Regulations. But it will be seen that, in 1958 family outbreaks are still high. They increased by 20 % and sporadic cases, which are those that are unconnected, as far as is known, increased by 5 %. It is, therefore, clear from the figures of the thousands of incidents (representing many more thousands of people affected) that more health education is needed; for much of this poisoning is preventable. Egg products are possibly one of the main sources of salmonellae in foods. And it is possible that, if egg and egg products, meat and meat products, and feeding stuffs and fertilizers could be protected from contamination with salmonellae in the first place, or if all products likely to be contaminated with salmonellae could be adequately heat- treated, the incidence of food poisoning would fall considerably. Whilst latest food hygiene regulations may help to decrease food poisoning due to organisms other than salmonellae, there will be little difference in the general picture so long as the distribution of contaminated food stuffs is allowed to continue. Authorities state there is no evidence to show that food poison- ing organisms are present in the flora of newly caught fish or that fish suffer from salmonellae infections; but the situation is quite different with poultry or meat. Salmonellae are often present in the intestines of both diseased and healthy animals. The infection may easily be spread in slaughterhouses and food shops or kitchens by dogs, cats, rats, mice or even pigeons, as each of these species may carry the germ. But infection of beef and beef products appears to occur more frequently after slaughter and possibly after the meat has left the slaughterhouse. “Prevention of salmonellae food poisoning depends on knowing more of the potential sources of contamination and is a long term problem; otherwise the remedies for the elimination of food poison- ing are simple and can easily be applied.” Statistics show that people are spending more on food than ever before; and one of the causes of food poisoning in families might be partly due to changes in our food habits. Although the processed foods, deep frozen foods, etc., are prepared under excellent and hygienic conditions, like other foods, they can easily be contaminated and become a vehicle for food poisoning, it not properly handled and stored. As proved before, most of the cases of food poisoning, in which it was possible to trace the food, have been due to processed and made-up meat dishes. In order to encourage good habits of personal hygiene among members of the staff of catering establishments, housewives and others, the Ministry of Health has prepared several illustrated, colour- ed posters on the subject including the “For Health’s Sake” series Wash your hands. Cover all cuts, sores and burns, before handling food. Keep food covered from flies. Keep cooking utensils clean. Cool food quickly. Keep the lid on dustbins. These good posters and the counter-card with black fingerprints, that emphasises the warning “Please Don’t Touch—hands leave germs” cover most of the essential points of good food handling and are a great asset when linked with routine inspection and super- vision. Regrettably, it has not been possible to carry this out owing to shortage of staff. The seeds of good hygiene are sown at home; but, if they are to germinate and develop successfully, cultivation must be encouraged at school. ACCIDENTS IN THE HOME More people are killed by accidents in the home than by accidents on the road, the fact is not really surprising since people spend much more time in their houses; but it does mean that we must do every- thing we can to reduce home accidents. Over 6,000 persons die annually in England and Wales as a result of accidents in their homes. Most fatalities result from four main causes—falls, poisoning, burns and scalds, and suffocation, and of these, about 700 are due to burns and scalds. More than four-fifths of the fatalities concern the young and the old, and as high a proportion as two-thirds involve infants under one year and elderly people of seventy-five and over who are prone to falls, gas poisoning and burns. The majority of home accidents are preventable. Accidents in Children According to the Chief Medical Officer’s most recent report to the Ministry of Health, 733 children, including 638 under five years of age, suffered fatal accidents in their homes. This figure of 733 fatalities, which forms 11 % of all fatal domestic accidents is, happily, the lowest figure yet recorded, but most burns and scalds and poison- ing accidents to children must be regarded as preventable. These must be attributed mainly to inadequate supervision; but carelessness, thoughtlessness, apathy and lack of knowledge of the adults in charge all play their part. Women and girls suffer more than twice as many burning accidents as men and boys, for full skirted loose garments present a much greater fire risk than narrow or close fitting ones. Occasionally children have been found suffocated by plastic bibs or bags. The U.S. National Safety Council reported 28 fatalities from plastic “garment bags” between January and June. It seems that the plastic bag becomes electrically charged and, if pulled over a child’s head, it clings tenaciously and resists removal. If a small child is found dead with a plastic bib firmly plastered over his face, the adhesive qualities of saliva and food remnants around the baby’s mouth are generally blamed. But, now the electrical properties of the bib may be called in question. Plastic bibs should always be secured to the baby’s clothes to prevent disaster; and small children should not be allowed to play with plastic bags or they may use them as “space helmets” etc. Plastic bags must be regarded as potentially lethal to young children. Accidents in Old People The accident rate is high in old people. With increase in age, physical and mental deterioration may reduce the capacity to co- ordinate thought and action. Some old people become fatigued, forgetful or absent-minded, and these psychological features may be accompanied by physiological changes, failing vision, impaired hear- ing and sense of smell, and muscular weakness. The infirm and the handicapped are also liable to accidents through inexpert handling of heating and lighting apphances and inability to avoid obvious hazards. Falls account for nearly two-thirds of fatal home accidents and three-quarters of these fatalities affect people of seventy-five and over. The majority of the victims are women. Thermal Accidents Statistics about non-fatal accidents are not available but it is estimated that each year not less than 50,000 persons need hospital treatment for burns and scalds caused by domestic accidents and that about 80% of the deaths, resulting from extensive burns, are due to clothing catching fire. Most of these accidents are due to the clothing coming in contact with the heating element or flame of an unguarded or inadequately guarded coal, gas, electric or oil heating appliance. “Open” fires are responsible for more fatal accidents than any other type. Scalds have a much lower death rate than burns, but the incidence nearly equals that of burns and the degree of disfigurement or dis- ablement may be equally severe. They occur most commonly in children under five years of age, and the most serious accidents result from children falling into buckets or basins of hot water placed on the floor. They may also be caused by children pulling over themselves vessels, saucepans or pans containing hot fluids or fat or by puUing the flexes of electric kettles. Approximately two-thirds of the hospital admissions for scalds, sustained at home, occur in children under five years of age. Preventive Measures The majority of these burning and scalding accidents could be avoided, and, in spite of the publicity that has been given to the subject during recent years, the position has not much improved. While propagarxda of all kinds plays a valuable part in preven- tion, it is the personal contact of doctors, nurses and social workers with the people in their homes that is likely to bring the most re- warding results. Under the Children and Young Persons Acts, 1933 and 1953, parents and guardians are liable to a fine if a child of 12 years or under is seriously injured from burns caused by an unguarded “heating appliance liable to cause injury to a person by contact therewith”. The Heating Appliances {Fireguards) Act, 1953, and the Regula- tions made under it require that, from the 1st October, 1954, all gas, electric and oil fires mmst be fitted, when sold, with a guard attached. Some householders have still taken no steps to acquire guards for the fires purchased before the Regulations came into force. Efficient Fireguards The most effective simple way of reducing the number of serious burning accidents is by the use of the properly designed and fixed fireguard of the British Standard Specification. It forms a protection from burning by falling into an open fire, by children tampering with one, or by clothing accidentally brushing against a fire. Safer Clothing The most frequent cause of serious burns is clothing catching alight. The provision of fireguards for all types of fires and the choice of safer garments for women and children to wear will reduce these accidents. The flammable nature of nearly all fabrics currently in use makes the guarding of fires doubly important. Pyjamas are much safer than nightdresses, particularly for children. Full skirted party dresses and other loose flimsy garments also require special caution. A special Committee, set up by the British Standards Institution, recommended that a standard of durable flame-resistance of fabrics should be established and that goods, offered for sale to the public as flame-resistant, should be warranted as such and identified accord- ingly. It is now possible to buy children’s clothing, made of flame- resistant material; you can also buy material to make up yourself. It may be slightly more expensive, but surely it is worth spending about two shiUings a yard more to prevent serious burns to young children. Prevention of Scalding Accidents Overcrowding is frequently a contributory factor, and the kitchen is the most dangerous room. There is no doubt that kitchen discipline and kitchen design could do much to reduce the incidence of scalds. The cooker and the sink should not be on opposite sides of the room, but should be sited along one wall, or two adjacent walls, and jointed by a work surface. Although in some cases, scalding accidents may be precipitated by the shape, design and use made of the kitchen or by the form of domestic equipm.ent, it is nevertheless clear that the majority of incidents are due to carelessness. While the final responsibility for the prevention of burns and scalds in the home must rest with the householders, every authority, organisation and individual has something to contribute to the provision of safety in the home and it is only by the combined efforts of everyone that the incidence of burns and scalds can be reduced. * Accidents in the Home—Burns and Scalds (Ministry of Health). OLD PEOPLE’S WELFARE In this District, there are two Old People’s Homes, under the control of the County Council, which provide accom.modation for old people from all parts of the county—Kitnocks House, Curdridge (Telephone, Botley 2553) and Corhampton House, Corhampton (Telephone, Droxford 20). I am indebted to Mr. F. J. Bryan Long, County Welfare Officer, for the following information on the County Council’s scheme for short stay accommodation in Old People’s Homes, and for Boarding- out Elderly People in private households. Provision of Short Stay Accommodation in Old People’s Homes The Welfare Committee of the County Council operate a scheme whereby any places temporarily vacant in the County Homes for old people are made available to elderly persons to enable the relatives or friends with whom they live to take a holiday. Such temporary vacancies arise when residents are in hospital or away on holiday and when a new resident needs time to clear up his affairs. Some use is also made of sick bays during the summer months when there is less demand for nursing care. This scheme has enabled families to take a rest from giving constant attention to elderly relatives and has been of help also in times of illness and other domestic crises, when a younger relative or friend has been temporarily unable to care for an elderly person. During the year, a total of 78 old people in the County were given a holiday in this way, the length of stay varying between a week and a month. Accommodation under this scheme cannot be offered to old people needing regular medical and nursing care; generally they should be able to wash and dress themselves, get to the dining room for meals and attend to their own toilet. Applications for short stay admission may be made either to the local Area Welfare Officer or direct to the County Welfare Officer at The Castle, Winchester. Boarding-out Scheme for Elderly People* The Welfare Department first began a “home finding” scheme in 1952. No separate record is kept of the expenses involved in running this scheme and, indeed, it would be extremely difficult to compile such a record since arrangements are often made in the course of a day’s journeys when a number of other matters are dealt with in addition to this. The National Assistance Board make a weekly grant sufficient to pay for board and to allow for Is. 6d. to \0s. 6d. a week pocket money. No average charge figure is available. Terms are negotiated separately in each case in the light of the standard of accommoda- tion and services oifered, the financial resources of the applicant and any other relevant factors. The total number of officers at present involved is fourteen but none are fully occupied on this scheme. Foster homes are found through Press advertisements and con- tacts through voluntary and statutory bodies. Foster homes are found mainly on a short stay basis but con- siderable numbers of people are permanently boarded. Visiting is done by county Welfare Officers. Some old people often share a home with another. Alternative action to boarding out is considered when applications are made. Eighty-five have been successfully placed in permanent accom- modation. One hundred and fifty-one have been successfully placed in short stay accommodation. Also, one hundred and three have been successfully placed for three months to two years. * “Boarding out Schemes for Elderly People” produced by The National Old People's Welfare Council. , Chiropody Service Very good Chiropody services have been established for old people by the British Red Cross Society, the Hampshire Council for Social Service and the numerous Local Old People’s Welfare Committees. The Minister of Health has suggested that, at this stage, priority should be given to the elderly, the physically handicapped and expectant mothers and that Local Health Authorities might wish to develop their Schemes by using existing voluntary services. The Hampshire County Council will make grants to both the British Red Cross Society and the Hampshire Council of Social Service; and the latter will make small grants to the various Local Old People’s Welfare Committees. Further development of the Chiropody Service in relation to the physically handicapped and expectant mothers will be dealt with through the British Red Cross Society. Home Help Service Applications for Home Helps should be made to the District Organiser, Home Help Office, Town Hall, Petersfield (Telephone, Petersfield 771, Extension 13). INTERNATIONAL TRAVEL Travellers from abroad, who may have been contacts of small- pox or other dangerous diseases while out of this country, are re- quired to show their doctors notices issued to them on arrival at airports in the event of their becoming ill during the succeeding 21 days. Passengers undertaking international travel must be in possession of certain vaccination certificates, depending upon the place of departure, the countries of transit and the destination. International certificates are issued in connection with smallpox, yellow fever and cholera. The International Sanitary Regulations, 1956, specify the follow- ing periods for the validity of international certificates of vaccination. Type of Vaccination Validity {after date of vaccination or inoculations) Smallpox—primary vaccination Begins 8 days Ends 3 years Smallpox—re-vaccination At once 3 years Cholera—primary vaccination 6 days 6 months Cholera—re-vaccination within six months At once 6 months Yellow Fever—primary vaccination 10 days 6 years Yellow Fever—re-vaccination within six years At once 6 years But the health authorities of some countries vary these periods and details of immunisation requirements can be obtained from the airline or steamship company concerned, or from the Consulates of the countries to be visited. Persons who are required to be vaccinated or inoculated against more than one disease are advised to tell the doctor of all the vaccina- tions or inoculations needed as they may have to be done in a particular order with certain minimum intervals. The vaccinations against smallpox and cholera must be recorded on the international certificate form prescribed by the World Health Organisation, dated and signed by the doctor doing the inoculation, authenticated and stamped at the office by the Health Department of the District. The international certificate forms must be obtained by the traveller himself from the travel agency or Ministry of Health, except those for yellow fever which are held at certain recognised centres where the vaccination is performed. In this area, yellow fever vaccinations are carried out at the Pathological Laboratory of the Royal South Hants and Southamp- ton Hospital, Exmoor Road, Southampton, on Tuesdays by appoint- ment (Telephone. Southampton 26211). For inoculations where no international certificate is required, an ordinary certificate by the doctor is sufficient. SMALLPOX VACCINATION The speed of air travel makes the task of preventing the imported case of smallpox particularly difficult; so the earhest possible detec- tion of the disease is of the utmost importance in preventing the spread. Outbreaks of smallpox in this country generally arise from the importation of the disease from abroad; smallpox may be introduced into this country in an insidious way as in 1957 through the entry of persons in apparent good health but in whom smallpox is incubating. In such circumstances, the disease—modified by vaccination— has often gone unrecognised until it has appeared in classical form in others exposed to infection. During 1958, a case occurred on board ship in a member of the crew of an inward bound vessel. This necessitated immediate re- vaccination of passengers and crew; admission of the patient to a smallpox hospital and surveillance of all on board. Yet five further cases arose in the country before the disease was eradicated. It is something of a paradox that the application of preventative measures, so easily and fully available, should in a great many instances have to . wait the occurrence of the very condition they are designed to prevent before advantage is taken of them. In England and Wales in 1958, the percentage of infants under the age of one year, who were vaccinated, was 44.5 and the figure for 1959 was 45%. It is still far below what may be regarded as satis- factory. This low acceptance rate and the resulting lack of protection to the individual and the community is causing much concern; the aim should be to see that every healthy infant is vaccinated—not only because routine baby vaccination is thought to be justified as the first step in establishing a satisfactory immunity in late years, but also on account of the immediate protection thereby conferred, and the occurrence of outbreaks of imported smallpox from time to time only confirms that the extent of immunity against this disease is not sufficient to prevent an epidemic. It is therefore important that primary vaccination should be carried out; it is far too frequently refused because parents are under the impression that it will harm their babies. If ihQ first vaccination is put off until adolescence or later, there may be a slight risk; but it is believed that the risks attending primary vaccination are less in in- fancy than at any other age and, since many persons will need to be vaccinated at some time, it is highly desirable that this should be done early in life, if only as an insurance against possible untoward effects of vaccination later on. Smallpox is no longer endemic in Europe and the chance of the individual stay-at-home Englishman ever encountering it may be re- mote, but not everyone remains at home and vaccination is often a pre-requisite for travel or for entry into many countries, as well as an essential personal protection in those areas in which smallpox is endemic. It is necessary in certain types of employment within this country and obhgatory for service with the Armed Forces. So, the probability is that for one reason or another a substantial number of residents in this country will find it desirable to be vaccinated on some occasion during their lives. The ideal time for the first vaccination is during the first six months of infancy—preferably about the third month. The “acceptance” rates for infant vaccinations vary considerably in different parts of the country. In this district, the percentage of children under the age of one year, who were vaccinated, was 52.1 %. The susceptibility of the community as a whole to epidemic smallpox of either the mild or the severe variety cannot be greatly diminished by routine infant vaccination alone. To guard against the social disruption and economic loss which invariably results from the rapid spread of any form of smallpox, it is necessary for the re- vaccination of school children as well as vaccination of infants to be done as a routine. The re-vaccination of children within two or three years of first entering school not only maintains or revives their individual protec- tion, but is likely to facilitate substantially the control of local out- breaks of smallpox. It also ensures that any further vaccination in later life will be less likely to have any serious reactions or comphca- tions. Re-vaccination carried out at school age, is practically trouble free; and this procedure, done as a routine at least once on all children primarily vaccinated in infancy, would substantially diminish the chance of rapid spread of smallpox. During the year, three hundred and twenty nine vaccinations against small pox were carried out: Pre-School School Over 15 Vaccination Children Children years of age Primary 207 17 18 Re-vaccination 7 20 60 Total 214 37 78 DIPHTHERIA IMMUNISATION The following information has been based on reports from the Ministry of Health and Registrar General and on pamphlets issued by the Central Council for Health Education. During the year 1958, there was an increase both in the incidence and mortality of diphtheria in England and Wales. The number of cases of diphtheria rose from 37 in 1957 to 78; and deaths from 4 to 8 in 1958. In 1959, the number of cases rose again from 78 to 102. This is the second time in succession that there has been a rise in the incidence of diphtheria for many years. ^ The rise in incidence in the past two years has been due to a number of sporadic outbreaks, fortunately on a small scale. Events in 1958 and 1959 should act as a warning to those who feel that diphtheria is a thing of the past, and that an increase in its incidence is improbable. It is quite clear that there is still a danger that this disease could again become a serious problem and that efforts to maintain a high level of immunisation of children cannot be relaxed. The Immunisation Campaign got well under way after 1943 and each year until 1957 showed a drop in the number of cases. The average number of cases before the Campaign was 50,000 a year. , Although complete eradication of the disease from an area where cases occur endemically is not an easy matter, there is evidence that there are good prospects for maintaining freedom once it had been gained. Experience over the last few years has shown that in school com- munities, where immunisation rates are low, diphtheria infection when once introduced can gain momentum and lead to an outbreak. The need for early immunisation and for the booster dose is there- fore stressed. A more complete protection in the under-5 age group would soon cause a reduced incidence in the early school (5-9) age group and the disease might well be almost eliminated. Only if an adequate level of immunisation is maintained can diphtheria be driven alto- gether from this country. The great majority of parents nowadays have never seen or heard of a case of diphtheria among their neighbours’ children and are more afraid of illnesses they know than of the dangers of diphtheria. If parents leave their children unprotected, there may well be other outbreaks. Although the number of immunisations given to babies under 1 year has decreased only very slightly, the number of “Booster” doses for school children has dropped considerably over the past few years. Complacency, resulting from what has already been achieved, or loss of interest or of confidence in immunisation, m.ay mean that diphtheria will go on occurring endemically and epidemically in this country indefinitely, with the ever-present risk of a return of high mortality; but a vigorously continued immunisation programme, combined with existing methods of epidemic control may free us entirely from the disease except for the occasional imported case. Authorities recommend that all children should be immunised before •their first birthday—preferably at the age of seven or eight months and they should receive a booster or reinforcing dose just before entering school, and again every four or five years throughout school life. Alternatively, if an extra booster is given at 15 to 18 months as well as the one at school entry, there is probably no need for further booster doses during school life. Owing to the fact that immunity against diphtheria takes several weeks to develop, those who have been inoculated earlier in life will have the advantage of receiving protection against diphtheria at short notice. It is therefore of the utmost importance for parents to realise that active immunisation in the first year of life and reinforcing doses of prophylactic in later years are just as necessary in the absence of diphtheria epidemics as in their presence. Immunisation helps the body to build up natural defences against the disease and gives almost certain protection against death from diphtheria. Resistance to diphtheria is rather like a car battery that needs topping up to maintain its fuU efficiency. So children should be immunised in the first year of life and have their first “topping up” before reaching school age. In this district 52.2% of the children born during the year 1958 were immunised before they attained the age of one year. Although children up to five years of age are the most susceptible age group, all under fifteen years should be immunised. During the year, four hundred and seven immunisations against diphtheria were carried out: Immunisation Pre-School Children School Children Primary 2 — Re-inforcing or “Boosters” 3 25 Combined Primary Diphtheria & Whooping Cough 31 — Combined Primary Diphtheria & Tetanus 1 4 Combined “Booster” Diphtheria & Whooping Cough 1 14 Combined “Booster” Diphtheria & Tetanus 2 8 Triple Primary 275 16 Triple “Booster” 5 20 Total 320 87 Children may be immunised by their own doctors, or at a Child Welfare Centre. The following table gives the annual incidence of diphtheria since 1942: 1942 1943 1944 1945 1946 1947 1948 1949 1950 Cases — 4 1 2 1 — - — - Deaths ... - - - — — — — — — 1951 1952 1953 1954 1955 1956 1957 1958 1959 Cases — 1 - - — — — - - Deaths ... — - — — — - — — — It is satisfactory to record that there have been no deaths from diphtheria since the Council’s scheme for diphtheria immunisation by general practitioners in this district commenced in 1935. WHOOPING COUGH IMMUNISATION This Council was the first Council in Hampshire and, indeed, one of the first in the country, to adopt a Whooping-Cough Im- munisation Scheme. The Council’s Scheme for Whooping-Cough Immunisation by general practitioners was commenced in 1942. At the beginning of 1955, the Hampshire County Council’s Scheme for Whooping Cough Immunisation began operating through- out the whole of Hampshire. The scheme includes combined immunisation against Whooping- Cough and Diphtheria, triple immunisation against Whooping- Cough, Diphtheria and Tetanus and immunisation against Whooping- Cough alone; but it does not provide for the immunisation against Whooping-Cough alone after the age of five years. Combined Whooping-Cough and Diphtheria immunisation with or without Tetanus is often preferred for the primary immunisa- tion of young children, so as to reduce the total number of inocula- tions needed for immunisation against three infections. The final report of the Whooping-Cough Immunisation Com- mittee of the Medical Research Council, designed to test the effective- ness of newer vaccines, confirmed that combined diphtheria-pertussis vaccine was as effective as the pertussis vaccine alone. The Medical Research Committee concluded that pertussis vaccines, which come up to the required standard, will produce “substantial protection” against the disease. In general, a reduction of about 10% in the uninoculated (or a 90 % protection) may be expected. But it will be appreciated that the problems of diagnosing an attack of Whooping-Cough, much modified by immunisation, are already common and troublesome in general practice. While Diphtheria Immunisation has been commenced generally at the seventh or eighth month, Whooping-Cough Immunisation is usually started much earlier—at about the third or fourth month of infancy—and according to authorities, there is no reason why Diphtheria immunisation, or triple immunisation against Whooping- Cough, Diphtheria and Tetanus, should not be given at the earlier age. During the year, 377 immunisations against Whooping-Cough were carried out, as shown by the table in the section on Diphtheria Immunisation. POLIOMYELITIS VACCINATION During the year, 7,465 vaccinations (Primary and Boosters) were carried out: Under 15 Over 15 Vaccination Years Years Primary 2463 1330 Booster 3114 558 Total 5577 1888 This phenomenal success is due not only to the general practi- tioners, who have given practically all the inoculations, but also to the parents who have so wisely seized the golden opportunity. PERSONAL PRECAUTIONS AGAINST POLIOMYELITIS The World Health Organisation has issued six points for the personal protection of the public against poliomyelitis. The six rules for the individual to observe are as follows: (1) Wash hands frequently, especially before eating (2) Protect food from flies; thoroughly wash uncooked food, such as fruit and vegetables (3) Avoid intimate association, such as shaking hands with families in which poliomyelitis has occurred within three weeks (4) Treat feverish illnesses with caution; bed rest, or at least avoiding over-exertion for a week is advisable (5) Avoid over-exertion (6) Avoid unnecessary travel to and from communities where the disease is prevalent PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES Particulars of the cases of Infectious Diseases, which were notified during the year and comparative notification rates for the whole of England and Wales, are shown in the following table: Diseases Total Cases Notified Rate per 1,000 c >/ the Population Droxford R.D. England & Wales Dysentery ... 3 0.14 0.78 Measles 304 13.9 11.9 Pneumonia 3 0.14 0.59 Scarlet Fever 2 0.09 1.1 Whooping Cough ... 6 0.28 0.75 Food Poisoning 1 0.05 0.22 Meningitis 1 0.05 0.02 Erysipelas 3 0.14 0.07 Encephalitis 1 0.05 0.006 Typhoid 1 0.05 0.003 Only certain forms of pneumonia are notifiable. An analysis of the total notified cases according to age groups is given below: Age Group Dysentery Measles 1 Pneumonia Scarlet Fever Whooping Cough Food Poisoning Meningitis Erysipelas Encephalitis Typhoid Under 1 year 6 1 1 1- 2 years ... — 21 2- 3 • 1 28 — — 1 — — — — — 3- 4 ... —■ 19 4- 5 >> ... — 32 — — 1 — — — — — 5-10 >> ... 2 166 — 1 3 — — — 1 1 10-15 95 ... — 31 — — — — — — — — 15-20 59 • • • — — — — — — 1 — — — 20-35 55 * ■ • — 1 35-45 55 • • • — — — — — — — 1 — — 45-65 55 • • • — — — — — — — 2 — — Over 65 years... ■' ■ 3 1 ■ ' Totals ... 3 304 3 2 6 1 1 3 1 1 The following table shows the number of infectious diseases notified during the year, and the parishes in which they occurred: Parish Dysentery Measles Pneumonia Scarlet Eever Whooping Cough Pood Poisoning Meningitis Erysipelas Encephalitis Typhoid Bishop’s Waltham 2 3 Boarhunt — 18 Corhamptonand Meonstoke 16 Curdridge — 8 — - Denmead 1 102 1 - 1 —— 1* Droxford — 18 Durley... — — - —- 1 Exton 1 Hambledon ... 6 1 2 Shedfield 6 —— 3 Soberton 26 Southwick and Widley 8 Swanmore 9 — 2 Upham — 1 Warnford 4 1 West Meon ... 2 Wickham — 76 2 1 1 — — — 1 — Totals ... 3 304 3 2 6 1 1 3 1 1 little girl, who suffered from typhoid, had been on a visit to Germany and developed the disease on her return to this country. There was no local ^urce of infection; she was a mild case and made an uninterrupted recovery. The Phage Type was E.l. WEIGHT LIFTING Dr. Graham-Bonnalie gives the following practical advice on how to lift heavy weights with safety:— If it is not possible to raise the weight from the floor by extending the knees, or to lift it any higher by means of the arms, then the weight is too great for the particular person to lift. It is probably correct to say that the trunk, except as a support for the arms, should not be used at all in the act of lifting. Lifting is not a feat of strength, but a matter of mechanics. A heavy weight should be lifted by numbers:— "T" V;' '**. •’ r.' .‘(if * -X i' ' • 'I *''?*#' ***^'^*'^ V''"'* ■* * ' t: 'f c ; j ^ "i Jli ,.1 'Ml - i-. *- <• ^■■•?; f ■, ■ *=■ ‘ K, .^s-r ^ ^ r ^ ^ %r ^fe|| ■ If?* . ■».■:■ .'. ni» ■ *»• l t iii^. . -r>' ra V 'Vv'-^' j I .- ' * ^ .->s."^ - j-.: : .^.■ • . * .'»■' ■■’*'- * *K..- I r// * '■ V.-i*** s.- ^ j'-i'H V I f t -1 r \ t ^ i ■•' . k ■1 A .M-- ‘ I ■"^4 .?•» r •’■ 1 I’ ' : :# . . t - i ;J if ;:r * _ _ ' r .Cii^s.. > ’ *■ •tf . '-* ?r' . <’7 1 ♦ " : ^■"i r . K 4 <-J j' 1 :*'• ’;' : -y. - , . r i ’ . .■^ ^ •* fr ^.-r* ^’(■il * <^*i• I ,.. ymMU I .,4(- " # <^‘*1- >^Srff>--_-■ *L^? ST' !§.*:- . '■-’ •■ *' ■* ' ■# 5‘' TUBERCULOSIS At the end of the year, the total number of cases on the register was 245. The following table gives the number of cases of Tuberculosis registered in the district at the beginning and end of 1959: Respiratory Non-Respiratory M. F. Total M. F. Total Number on Register at beginning of the year (1959) 107 70 177 31 33 64 New additions to the register dur- ing the year 7 5 12 — 1 1 Removals from the Register during the year 4 4 8 1 — 1 Number on Register at end of the year 110 71 181 30 34 64 Analysis of new cases and deaths according to age groups: Age Period New Cases Deaths Respiratory Non- Respiratory Respiratory Non- Respiratory M F M F M F M F 0-1 1-5 5-15 15-25 — 1 — 1 — — — — 25-35 2 3 — — — — — — 35-45 2 1 — — — — — — — • ... 55-65 1 2 1 -- 1 — 75 and over — — — 1 — — — — Age unknown Totals 7 5 — 1 1 — — — SCABIES Facilities for the treatment of Scabies are available at Ports- mouth Disinfestation Chnic. Appointments for cases requiring treatment are made through this department. Scabies should be regarded as a family infection; and all members of the same family should present themselves for treatment simultaneously—whether or not they complain of “The Itch” and show evidence of scabies at the time. Otherwise an early case may escape detection and the parasite may thrive in one member and re- infect the others. PEDICULOSIS Where necessary, cases of Pediculosis (head lice) may be referred for treatment, by special appointment, at any of the following centres: Fareham Eastleigh Petersfield whichever is the most convenient. Pediculosis should also be regarded as a family infection; and, when a child is found to be verminous, all the members of the famnly should offer themselves for examination. This wise practice would ensure that any undetected case in the family would receive imm.ediate treatment and that there would be no further spread of infection to others. THE REPORT OF THE SURVEYOR AND CHIEF PUBLIC HEALTH INSPECTOR SANITARY CONDITIONS OF THE AREA Water Supply No extensions were made during the year and there are now piped supplies throughout the District provided by the Portsmouth and Gosport Water Company, the Southampton Corporation and two private estates. Drainage and Sewerage Further progress has been made during the year with the Bishop’s Waltham sewerage scheme by the submission to the Plan- ning Authority of plans of the disposal works and pumping station and the provision of technical information required by the Ministry of Housing and Local Government. Public Cleansing The cesspool emptying scheme, which allows for four free empty- ings per year, continues in operation, as does the collection of night soil and household refuse. The following summary gives particulars of work during the year under review: Dustbin Cesspool Cesspool E.C. Emptyings Emptyings Loads Emptyings 278,482 5,608 10,719 137,898 Household refuse is collected by direct labour fortnightly throughout the district with the exception of Bishop’s Waltham, Shedfield and Wickham, where it is made weekly. Salvage This year a slight drop in total income occurred. In May there was a fall in the price of books and magazines, and a corresponding drop in the quantities collected, although the tonnage of waste paper showed a further increase. The following amounts of salvageable materials were collected: Tons Cwts. Qtrs. Lbs. Waste Paper 192 0 1 25 Steel and Iron 9 2 1 13 Mixed Metals 1 13 3 1 Rags and Woollens 7 0 0 10 Bottles 560 gross Tyres 90 (in number) Salvage is collected concurrently with refuse. The total receipts were £1,848 II5. ?>d. Comparative figures of waste paper collection are set out below: 1957 Weight—151 tons, - cwts. 2 qtrs. 12 lbs. Receipts—£1,161 Os. 7d. 1958 169 tons, 4 cwts. - qtrs. 23 lbs. £1,236 10s. 3d. 1959 192 tons, - cwts. 1 qtr. 25 lbs. £1,230 15s. 5d. HOUSING STATISTICS (Public Health) Inspection of Dwelling-houses during the year; (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing I. L-O I ••• ••• ••• •** ••• ^ ^ (b) Number of inspections made for the purpose ... 175 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consohdated Regulations, 1925 and 1932 21 (b) Number of inspections made for the purpose ... 94 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 21 (4) Number of dwelhng-houses (exclusive of those referred to under the preceding sub-head) found not to be, in aU respects, reasonably fit for human habitation ... ... ... ... ... ... Nil Remedy of Defects during the year without service of Formal Notices: Number of defective dwelhng-houses rendered fit in consequence of informal action by the Local Authority or their officers 16 Action under Statutory Powers during the year: (a) Proceedings under Section 9,10 and 16 of the Housing Act, 1957:— (1) Number of dwelling-houses in respect of which Notices were served requiring repairs ... ... Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By Owners Nil (b) By Local Authority in default of owners Nil (b) Proceedings under Public Health Acts:— (1) Number of dwellings in respect of which Notices were served requiring default to be remedied ... 5 (2) Number of dwelling-houses in which defaults were remedied after service of formal notices: (a) By Owners 2 (b) By Local Authority in default of owners Nil (c) Proceedings under Section 16 (4), 17 (1) and 24 Housing Act, 1957:— (1) Number of dwelling-houses in respect of which Demolition Orders were made 18 (2) Number of dwelling-houses demohshed in pursuance of Demolition Orders 8 (3) Undertakings given 2 Overcrowding Statutory overcrowding does exist in a minor degree within the area, but, under existing circumstances, no direct action is taken; cases are referred to the appropriate Committee for consideration when allocating new houses. Housing Act, 1949 Housing Repairs and Rents Act, 1954 Rent Act, 1957 Rents Act inspections 38 Improvement Grant inspections 344 New Houses and Buildings Comparative figures are given for the last nine years: Number of Plans approved by the Council: Type of Plan 1951 1952 1953 1954 1955 1956 1957 1958 1959 Houses 32 51 58 146 112 148 119 137 210 Additions and Altera- tions 55 46 52 56 81 52 49 43 32 Conversions and Adaptations 14 10 9 6 11 6 5 5 9 Garages 32 41 44 44 101 60 81 87 241 Bathrooms and Drain- age Installations ... 41 49 72 61 100 80 108 71 138 Farm Buildings 37 22 22 17 2 1 8 5 8 Sheds and Stores 17 12 15 6 13 9 3 5 7 Shops, Halls, Offices, etc. — — — — 3 11 4 15 9 The number of new units of housing erected by private enterprise or provided by the Local Authority over the same period was: By whom erected or provided 1951 1952 1953 1954 1955 1956 1957 1958 1959 By Private Enterprise 14 37 37 47 90 108 115 87 127 By Local Authority— (a) Houses 40 46 56 72 61 31 35 27 35 (b) Hutments — — 10 — — — — — — On the 31st December, 1959, there were a further 31 Council Houses in course of erection. , Housing (Financial Provisions) Act, 1958 House Purchase and Housing Act, 1959 The House Purchase and Housing Act, 1959 introduced an entirely different form of grant called the standard grant. This enables an owner to secure a grant of half the cost of providing, subject to a maximum of £155, the “standard amenities” which his house lacks at the time of application. The five standard amenities are: 1. Fixed bath or shower in a bathroom. 2. Wash-hand basin. 3. Hot water supply. 4. Water closet in or contiguous to the dwelling. 5. Satisfactory facilities for storing food. To be eligible for grant the dwelling which lacks any or all of these amenities must possess them all when the improvement works have been completed. The owner can demand this standard grant as of right provided the conditions of the scheme are fulfilled. During the year 10 applications for standard grants were received. The following table gives the comparative figures for the number of Discretionary grant applications and the amount of grants approved for each year: Year No. of Aplications Approved New Units of Housing Provided No. of houses improved Owner Occupiers Tenanted Total Amounts approved 1952 4 1 2 5 £ 508 (£36 recovered) 1953 2 — 3 — 3 317 1954 14 17 5 12 4225 1955 48 4 65 23 46 16210 (£185 un- paid due to with- drawal) 1956 55 1 60 27 34 16132 1957 60 2 72 32 42 18623 1958 33 2 34 18 18 6325 1959 74 — 82 50 32 18648 Totals 290 9 340 157 192 80988 INSPECTION AND SUPERVISION OF FOOD Milk Supply Under the Milk (Special Designations) (Specified Areas) (No. 2.) Order, 1954, all milk sold by retail within the Droxford Rural District must be either Tuberculin Tested or Pasteurised. The Licensing of Producers/Retailers remains the duty of the Ministry of Agriculture, Fisheries and Food, while the licensing of Dealers is the responsibility of the Local Authority. Licences issued under the Milk (Special Designations) (Pasteuris- ed and Sterilised Milk) Regulations, 1949-1953: Dealers’ Licences to use the designation “Pasteurised” 5 Supplementary Licences to use the designation “Pasteur- ised” 10 Supplementary Licences to use the designation “Sterilised” 4 Licences issued under the Milk (Special Designation) (Raw Milk) Regulations, 1949-1953: Dealer’s Licences to use the designation “Tuberculin Tested” ... ... ... ... ... ... ... 6 Supplementary Licences to use the designation “Tuberculin T ested^* X. ••• ••• ••• ••• 10 Food Hygiene Regulations, 1955 Alterations have been made to several food premises and the opportunity has been taken to bring them up to the required standard. Meat Inspection Since the establishment of the Wessex Slaughterhouses Board, all meat inspection for this area is done at the Funtley Abbatoir, Fareham, except the inspection of pigs slaughtered at Knowle Mental Hospital for consumption on Crown Property. This slaughter- house is exempt from licensing. There remains one knackers’ Yard in the district, which is hcensed by the Wessex Slaughterhouses Board on receipt of recommendation from this Authority. Food Adulteration This section of the Food and Drugs Act, 1955, is operated by the County Council. Details of the samples taken under the Food and Drugs Act, 1955, during the year ended 31st March, 1960: Article Number Taken Genuine Unsatisfactory Cream 1 — Drugs 1 — Meat products 1 — Spirits 7 — Milk 42 — Milk, Channel Islands 24 — Other Foods 2 — Total 78 — RODENT CONTROL t- <D 0^ U r3 E E T3 C 03 a» c 00 4-) 0 03 U. c t*- 1 0 ■M _— =3 0 0 1. 4-) "D c (U 0 0 '&_ U. TD rt C u 03 Vi 0) 03 U c QJ “o 03 > 4-1 0) c 1- 0 o. u (V 1 _c .. u 0 0 \0 -Q 0 0 "D Vi C jc 03 ^ u i- p3 <D ^ E C ^ 03 Z >- ■ E <D a Vi _C 4-> ^ m 4-> 13 f- ^ — Cl o +-» ^ 4J +J c: C 'i O <U O ^ .E^ a> <t3 > c o 1- cy 4-> O to • "n rt -O ^ C i- VO O ^ ■5 o) .E c: O i-. o (U +-» V) C O .9-5 4-1 n c 4_) ._ V) _c: E ^ LU u z D Z < < 0^ u. 0 LU u z lU -j < > iU oc a. c 6 "o U o tn w ^ rrt TO (D M W CO S-' o-c ft o ^ ■*-* O M «5 XI n) g “ 3 :S "c 0 ® u X § T! 4) CO u Q) 0 m 00 m 00 c c 00 OV • M u S CA <U Xi CO '4-» 2 fd 3 ft z )-i 0 . 0’ 2 t3 CO ffl 0 73 >H 0 •oS m 00 00 ro 298 U 0 »■? ft 0 0 • ^ 0) T3 OJ CO 0 'C! M 00 CO IS ® m 00 Tj- m 0 <4H -S H > ® 0 x; 0 VO Xi ^ CO 0 _o t: JH X S c T) ’n, <D 3 « U i ri i 120 i : 120 <N 00 r- 0 r- 0 VO 00 V-) 0 0 >0 v-i on E-i VO i> C/3 0 C/3 3 0 x: W) ft! TS 3 H 04 0 u C l4 * 0 03 0 c ft 0 Ul u ft <u Cft 0 Ui i Uh C/1 r> c/3 C/3 0 43 fft a> C/D 0 *Vh C/3 P g Lh Ph 0 0 <u < X3 4-> 3 W) Uh Ph 3 ft 0 H 0 < 3 C/3 4-> H • 'o 03 _c ftl _o 0 0 c/3 D bX) hJ Q m < MEASURES OF CONTROL BY LOCAL AUTHORITY <s CO o •j'i ^ qI S g S o- O g (D tjl s u n o o c l" M U o b c °- ^ B (uw B M ^ ro fl) H fN gig 0.2 ij Hh 73 c ■^73 C — •O <U CQ .2 0) m “J >-t 0) T) l-ll I ^ B*- - o C m s Jx -Q 01 ■*-» C (U ^ O <U ijTJ •5-s s ^ r 3 s >H CO 73 C ci.2 != o 0) CO ® xn (d si CQ (d «4-l <D O 73^ •9 -£3 73 •£! B O 0) U S C > (U 5: CO « 4) 01 01 M )H o J. “ ® c 2® E- B o IS 01 ® ® u 0) 2 a B 01 <4-1 0) 73 0) O o • 0) <D o a A o CQ U cu d >* E- u Ok o (H a, lu O U 04 >-• E^ : VO • m ; 1 m m ’ cn (N CN r-H • >ri in : ; : : oo 'T VO '■O O (N : I oo o^ m VO ! ^ r- r- fx oo o <s CO fN VO On cn Tl- fN CO <N C4 : J u <D c a • H o £-1 O Oh u* (U H CO C/5 a> (/> P O) a • t-( 03 (O 'c o ;h PU o o Ui (U IH Ph c/5 4-> 13 < ffi bO G cj •4—» 13 o o * ^ '33 <u G • *—H C/5 >-n G O • ^ W) hJ Q 1 pq < \ SUMMARY OF INSPECTIONS MADE AND NOTICES SERVED Building Inspections Foundations Concrete over site ... Damp Proof Courses Intermediate Drains Tested Final Inspections Building Inquiries Inspections Short-lived Materials Section 53 Council House Inspections Town Planning Inspections Public Health Act, 1936 Drains and Sewer Ditches controlled by the Council Blocked and Insanitary Drains and Cesspools Defective and Insanitary Closet Accommodation Dangerous Buildings Refuse Tips Filthy and Verminous Premises Verminous Persons... Disinfestations Nuisances (other than Houses) Section 92 Re-inspections for the purpose Water Supply Infectious Diseases (visits) Disinfections Moveable Dwellings, Section 269 Other Inspections Food and Drugs Act, 1955 Carcases Inspected Inspections, other Foods Food Premises, Section 13 Milk Distribution ... Factories Act, 1937 Power Factories Non-Power Factories Out Workers Petroleum Regulations Inspections Miscellaneous Rodent Control (by Public Health Inspector) ... Housing Applications Other Visits Samples Taken Water Milk Ice Cream FACTORIES ACT, 1937 Part 1 of the Act 1. Inspections for the purpose as to health. Premises Number on Register Inspections Number of written notices Factories with mechanical power 59 3 — Factories without mechanical power 3 3 — Other premises under the Act (including works of building and engineering con- struction, but not including outworkers premises) Totals 62 6 — DISTRIBUTION Councillors Parish Councils General Practitioners Officials (a) Central Ministries Agriculture, Fisheries and Food Health Housing and Local Government Director of Statistics (b) Local Medical County Medical Officer Laboratory Service Medical Officers of Health Nursing District Nurses Health Visitors Inspectors Public Health Inspectors Inspector of Weights and Measures Welfare Officer H.M, Factory Inspector