At the meeting of the Rushden Urban District Council on Wednesday Dr. H. S. Baker, Medical Officer of Health for the year, presented his annual report, as follows:

I have the honour to submit to you the Annual Report for 1915, concerning the Public Health of the District under your administration.

On account of a continuance of the unusual conditions the Local Government Board have not issued the usual recommendations to Medical Officers of Health as to the course and scope that their annual reports should follow, but suggest that they should, for purposes of economy in printing etc., have eliminated from them descriptive matter relating to the natural and social conditions, districts, water supply, sewerage and other matters not relevant to the actual work of the year under review. With your sanction and approval I, therefore, leave out until happier times the descriptive portion it has been my custom to include in it.

From the public health aspect, little stands out during the year which demands special or urgent comment. The adoption of the Notification of Birth Act was made compulsory upon all local authorities throughout the kingdom. The Act coming into force on the 1st September last (1915), it will not, therefore, in this report show more than the third of a working year. Any further comment necessary will be made when reviewing the Annual Statistics of Births and Deaths.

WATER SUPPLY

This has been quite up to the standard of the preceding years, copious in amounts, constant in supply and of excellent quality.

DRAINAGE AND SEWERAGE

The new works continue to give the satisfaction that was expected of them. The necessary details regarding them are embodied in the Surveyor’s Annual Report, and need not be further discussed in this.

SCAVENGING

This still goes on “just in the old sweet way” I have referred to in former years.

THE SCHOOLS

The remarks in my previous reports need no alteration for the past year. The buildings have been maintained up to quite a high state of sanitary efficiency. I am given, however, to understand that in cold snaps the heating of them is not quite all that may be desired.

The attendance of the scholars has been up to the average of former years, there have been epidemics of a minor nature mostly, without any serious results. There is, however, one serious exception. An epidemic of whooping cough was carried over from the previous year with a result, I am sorry to say, that thirteen children under the age of 5 years lost their lives from this disease. This fact requires serious contemplation by all of us in authority, for whooping cough is a preventable disease, and I feel that, most, if not all of those thirteen lives were lost in the main because from the Local Government Board downwards we have not enforced those precautions which we know can check if not altogether stop an epidemic of this nature. Parents and school teachers I am afraid do not realize the virulently contagious nature of this disease, and the necessity for early and prolonged isolation of the first cases that are noticed. This epidemic I watched spread from I believe one case imported into the town which proved fatal; there may have been other imported cases, but this one was the first case that came under my notice in private practice. There were other children in the family who were kept from school but could not be isolated from all the others when out of school and gradually but surely the epidemic spread from this area until one group of children after another were infected, and most of the susceptible children had it. There is still a sporadic case or two about, but one only comes across such by accident. I would commend these facts to the contemplation of those who have the power of making this a compulsorily notifiable disease.

MEDICAL INSPECTION OF THE CHILDREN

This has been carried out with some regularity but with what logical consequences, except in the eye department it is difficult to say.

COMMON LODGING HOUSES

One house licensed as such is under the jurisdiction of the Local Authority. It is periodically inspected and kept in a cleanly condition.

FOOD AND DRUGS

During the year several prosecutions were instituted for exposing unsound meat for sale, and convictions were secured in three cases. As the necessary details will be found in the Sanitary Inspector’s Report they will be omitted here.

No prosecutions in relation to other articles of food have occurred, but there have been several instances of the voluntary surrender of unfit or doubtful articles and these have been destroyed by or under the observation of the Sanitary Inspector.

SLAUGHTERHOUSES

These have been regularly inspected and in the absence of a Public Abattoir may in the main be considered fairly satisfactory. My remarks upon the matter in my previous report still apply, although any radical departure from the present custom can hardly be looked for under existing circumstances.

FACTORY AND WORKSHOP ACTS

These have been periodically inspected by the Sanitary Inspector and by me where there has been any occasion for reference. Complaints have been attended to punctually and any available remedy has been affected as far as possible.

Most of the factories and workshops may be classed as satisfactory, some perhaps not ideal. The workers are not too ready to avail themselves of the different enactments in the statute book to safeguard them from accident and disease. They seem to be constantly looking for someone else to do the thing they ought to do themselves.

Four new large and substantial buildings have been added to the number of factories in the town during the year.

DAIRIES AND COWSHEDS

These have also been regularly inspected and kept up to a reasonable pitch of sanitary efficiency. A quarterly report upon the health and condition of all the cows is rendered by the Veterinary Inspector and no serious disease had been found among them – where a cow has been suspect it has been eliminated from the source of supply. The result of his report for the year will be found appended in tabular form.

THE MILK AND DAIRIES ACT, 1914

My remarks in last year’s annual report may be repeated. Nothing notable has occurred in the district under the regulations of the Act.

Four samples of milk were submitted to the County Authority for analysis during the year, all of which were found to be genuine and up to standard.

BAKEHOUSES

All are above ground, airy and for the most part well ventilated.

HOUSING, TOWN PLANNING, ETC. ACT 1919

Fifty six houses were inspected during the year under this Act.

Number of houses which on inspection were considered to be in a state so dangerous or injurious to health as to be unfit for human habitation – five.

Number of representations made to the Local Authority with a view to the making of closing orders – four.

Closing orders made – two.

Dwelling houses the defects in which were remedied without making closing orders – two.

Dwelling houses voluntarily closed by owners – two.

Number of houses demolished – two.

SANITARY ADMIMISTRATION OF THE DISTRICT

1 The Staff remains the same as in the previous year.

2 Hospital accommodations available for infectious disease remain the same as in my previous reports.

3 Chemical and Bacteriological Work during the Year.

BACTERIOLOGICAL – Eleven specimens were sent for report, with the following result :-

Diphtheria 6. 3 of which were positive. 3 negative.

Tuberculosis 5. 2 of which were positive. 3 negative.

In those cases which are reported as negative it is not right to assume that the clinical evidence as to the nature of the disease inspected was at fault. In some cases many specimens are often made before the specific organism peculiar to the disease is found; especially is this so with regard to Tuberculosis, so their lack of positive Bacteriological evidence does not warrant any relaxation of the usual precautionary measures it is thought necessary to adopt.

CHEMICAL – Two samples of water from wells were examined; these were found unfit for use, and the wells closed.

ACUTE INFECTIOUS DISEASE

Ninety three cases of notifiable infectious disease were reported, two of these (diphtheria) occurring among the troops stationed in the town, these being at once removed by the military authorities to the Isolation Hospital, leaving 91 occurring among the normal civil population to compare with 99 for the previous year.

SCARLET FEVER OR SCARLATINA

Twenty four cases were notified, against 28 in 1914. They were mostly of a mild nature with no fatalities.

SMALL POX

No cases were reported.

DIPHTHERIA, INCLUDING MEMBRANOUS CROUP

Twenty two cases in all were reported, 20 among the stationary civil population, against 18 during 1914. Three of these cases were fatal, including one removed to the Isolation Hospital at Clapham (Bedford).

ENTERIC FEVER

One case was reported, which ended fatally.

ERYSIPELAS

Eighteen cases were reported, with no fatalities, double the number for the previous year. This increase is of little importance, for most cases of this disease reported would appear to be as the result of formula rather than from import. That a disease of this character should be compulsorily notifiable and whooping cough and measles not so seems to me to be a curious anomaly, though in the latter case it has been remedied, measles being a compulsorily notifiable disease from Jan. 1, 1916, onward, and the former will I hope follow in due course.

OPHTHALMIA NEONATURUM

One case only was reported throughout the year, a highly satisfactory fact.

TUBERCULOSIS

The same methods of giving instructions to every tuberculosis patent have been pursued as in former years, the details of which are fully given in my previous reports.

A total of 27 cases of tuberculosis were reported during the year against a total of 41 for the previous year.

Thirteen deaths were registered from Phthisis (Pulmonary Tuberculosis) against nine the previous year, and seven from other forms of tuberculosis disease against five. That is a total of 22 against 14, an increase in the fatalities. Some of these would be from the notifications of other years. The increase does not imply a greater incidence or a greater virulence. Some cases are acute and rapidly end in dissolution while others of a chronic nature are a focus, under existing regulations, for the dissemination of the disease for many years.

RUSHDEN’S HIGHER DEATH-RATE
ELEVEN DEATHS FROM CANCER
SERIOUS INCREASE IN INFANTILE MORTALITY
A HIGHER BIRTH-RATE

Continuing his report, Dr. Baker says:

There are five midwives registered and practising in the district. These are under the control of the County Council, whose Inspector visits and inspect their work and apparatus. Their work so far as it comes under my observation is reasonably satisfactory.

No ante-natal clinics have yet been established.

The notification of Births Act was made compulsory from Sept. 1st, 1915.

POPULATION

The estimated population as it would be under normal conditions may be set down at 14,194. From this would have to be deducted those men who have joined the colours. But as for a period of twelve weeks there was billeted in the town the large part of a Brigade of a Welsh Division of Territorial troops the average population for the year would be quite up to the estimated number. The troops referred to would appear to have been well satisfied with their treatment by the inhabitants of the town generally, and though their presence threw a lot of extra work on those households in which they were billeted the people were glad to have them and did their best to make them welcome. No epidemic occurred during their sojourn with us, and I was given to understand that the incident of sickness among the men was less than had been in any of their previous billets, speaking well for the water supply and sanitation of the town.

LOCAL BIRTH RATE

277 births were registered during the year – as against 246 in 1914 – of which 150 were males and 127 females, by no means too high a preponderance in view of the accelerated wastage of the best male lives going on in various parts of the world. The annual birth rate would thus be 19.52 per thousand inhabitants, when it was only 17.68, the average for the last five years being 19.20.

There were no transferable births.

Fourteen were illegitimate – nine males and five females.

LOCAL DEATH RATE

129 deaths were registered as occurring among the stationary population, and 16 were transferred to us as belonging to our population but occurring out of the district in such institutions as Hospitals, Asylums and Workhouses, thus making our total number 145, an increase of 27 over the figures for 1914, giving an average death per thousand inhabitants of 10.21, against that of 8.9 for the previous year. The increase is largely due to the 13 deaths from whooping cough I have referred to previously. Although the rate is higher than for the previous five years it is still relatively to the general death rate of the kingdom quite reasonably low, especially to that of most industrial districts.

INFANTILE MORTALITY

Relating to deaths occurring among children before attaining their first complete year of life.

The total of 30 is an increase of 12 over that of the preceding year, an alteration in the wrong direction which one is very sorry to see under any circumstances, but more especially under those obtaining at present. The principal factor in this is again the fatalities from whooping cough (still for some unaccountable reason absent from the schedule of notifiable diseases). 14 were males, 16 females, giving an average of 108.3 deaths per 1,000 births, a very considerable increase upon that of 1914 when it was reasonably low at 73.1.

Eight deaths were from congenital debility, malformation, and premature birth, and may be looked upon as unavoidable. The remaining 22 were mostly from diseases which in the main could be prevented. Space prevents me from saying a good deal under this heading that I should like to say.

ZYMOTIC DISEASES

Eighteen deaths occur in this group of infectious diseases against 12 for 1914 if infantile diarrhoea is excluded three deaths occur from the latter cause. Of these, thirteen were directly due to whooping cough and its consequences – again giving reason to think furiously. Three were the result of diphtheria, one of measles, and one from enteric fever, the latter the only fatal case that has occurred in the district for many years, the town being remarkably free from this fever since the completion of the water supply and drainage system.

CANCER AND OTHER MALIGNANT GROWTHS

Eleven deaths occurred from this group of diseases, all in persons over 45 years of age – three between the ages of 45 to 65, the remainder all being over 65. In the previous year 18 deaths were registered in this group.

RESPIRATORY DISEASES OTHER THAN TUBERCULOSIS

Fifteen deaths are placed in this group, six of them in persons under five years, eight of them in those over 65, only one occurring in the intermediate ages. The total number is seven in excess of 1914, and does not include the 13 deaths from whooping cough, a decidedly respiratory disease.

PNEUMONIA AND BRONCHO PNEUMONIA

Ten cases in all are recorded under this heading. Six of them as acute lobar pneumonia, four as broncho pneumonia, though this latter also appear as a secondary cause in some of the fatal cases of whooping cough. Only one fatality from each of the divisions of this group occurred in 1914.

Three fatalities occurred from other respiratory causes not coming under any of the previous groups.

VIOLENT DEATHS

Three fatalities of this nature occurred. Two were suicides from drowning, the other followed upon injuries sustained by being knocked down by a bicycle at night. All were elderly persons over 60.

INCIDENCE OF DEATHS IN THE FOUR QUARTERS OF THE YEAR

1st quarter ……….. 43 3rd quarter ………… 26

2nd quarter ………. 33 4th quarter …….……43

Fifty deaths occur under 5 years of age.

Five between the ages of 5 and 15 years.

Eight between the ages of 15 and 25 years.

Sixteen between the ages of 25 and 45 years.

Twenty three between the ages of 45 and 65 years.

Forty three at the age of 65 years and over.

The greater number of fatalities will thus be seen to occur between the extremes of age, grading off each way.

All the necessary tables are appended giving details of the statistics not otherwise noted in this and the Sanitary Inspector’s report. I have endeavoured to avoid duplication by omitting from my own many details and statistics that more properly are included in the latter.

In conclusion I would ask to thank the members of the Council for the ready consideration of any suggestions I have thought it necessary to make, the Council staff to whom I have had to apply for information not available at first hand, and especially to Mr. F. J. Allen, the Sanitary Inspector, for his ready help throughout the year and assistance in compiling the tables for this report.