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4
incidence and the rate of mortality. It is good, therefore, to learn from
the 1950 report of the Lewisham group hospital management committee
that hospital nurses are now offered the opportunity of being vaccinated
against tuberculosis with BCG vaccine, a vaccine which has been in
use abroad for many years, but which has only recently begun to find
favour in official circles here. This vaccine is designed to produce a
resistance to tuberculosis, so that when the person vaccinated receives
a chance dose of infection he or she will be more easily able to overcome
it. During 1950, 20 nurses were vaccinated in this way.
Maternity and child welfare
After a record low rate (19 per thousand live births) for any large town
in the country, which Lewisham experienced in 1949, the infant mortality
rate for 1950 increased to 25.8. This is disappointing although of course
there is no special reason why Lewisham should have the lowest rate;
it has still, at 25.8, a slightly lower rate than for the county of London
(26.3) and for the country as a whole (29.8). The causes of the increase,
as can be seen from table 4, are mainly immaturity, which accounted
for 14 more deaths than in 1949, and pneumonia, etc., which accounted
for four.
It is not known accurately what percentage of Lewisham babies are
breast fed and for how long they are breast fed, but when we took part
in a national enquiry some three years ago we were among the better
boroughs as far as breast feeding was concerned. There has been a
considerable amount of controversy about the advantages of breast
feeding and an enquiry, based on the national survey and published
by Dr. J. W. B. Douglas during 1950, suggests that, statistically,
bottle fed babies if reared in poor surroundings are less likely to survive
than breast fed babies; where however their home conditions are good
their chances of survival are not impaired. Bottle fed babies are also more
likely to suffer from measles and, during the early months of life, from
lower respiratory infections and minor attacks of diarrhoea. In spite
of these findings, however, it is not felt that any marked reduction in
infant deaths or illness would be brought about solely by raising the
incidence of breast feeding. The mortality from infant diarrhoea seems
in fact to be more related to the prosperity of the district than to the
type of feeding. The report goes on to emphasise a point which has
been made several times before and should be again repeated here,
namely that the main risk associated with artificial feeding would be
avoided if mothers were more aware of the dangers of infection and
were particularly aware of the need for cleanliness in preparing bottle
feeds.
Food hygiene
The food poisoning outbreaks which came to the notice of the
department showed a decrease in the number of cases involved
compared with the previous year. Altogether 38 cases of food poisoning
were formally notified, but in addition a number of minor cases came
to our notice as a result of other enquiries. Throughout the year the food
inspectors continued to give advice to occupiers of food shops with
regard to general hygiene, and particularly in relation to the avoidance