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tared with 48 in 1946 but whereas none of the 48 died in 1946, one of the
16 died in 1947. This was the case of a child of 4 years of age who
unfortunately had not been immunized against diphtheria.
It is computed that 86 per cent, of all children in Westminster
between the ages of 1 to 5 years who have attended the Welfare Clinics
have been immunized against diphtheria. The incidence of other
infectious disease as shown by notifications was low in comparison with
1946, the most pronounced reductions were those relating to Scarlet
Fever, Measles and Scabies. A case of Anthrax in a docker unloading
hides from a ship from the Far East was diagnosed in the Out-patient
Department of Westminster Hospital. He was transferred to St.
Stephen's Hospital where, thanks to efficient treatment he made an
uneventful recovery. Five cases clinically diagnosed as suffering from
Botulism occurred in the autumn. One of the sufferers died soon after
admission to hospital. The other three had persistent neurological
vmptoms for some time after recovery from the acute phase. None of
the patients lived in Westminster and tribute is paid to Dr. Bradley and
Dr. Gale of the Ministry of Health who pursued careful investigations in
the districts where the patients lived or were in hospital. Investigations
were at the same time conducted by the staff of the Central Laboratory
at Colindale in collaboration with my department, but no conclusive
evidence was established as to the source of infection.
The expansion of the Maternity and Child Welfare Service to meet the
needs arising from the greatly increased birth rate continued from last
year. The staff of health visitors had increased to 14 and the activities
of the Welfare Centres continued to expand.
The close association with Westminster Hospital whereby the complete
care of the mother before, during and after confinement is in the hands
of the obstetricians of the hospital has continued to gain increasing
confidence from the women of Westminster, and has been of very great
benefit to them. In 1947 293 home confinements were conducted by
the hospital mid wives. Infant mortality at 33 per 1,000 was the lowest
ever recorded in Westminster. A very satisfactory feature was the
increase in legitimate births from 1,143 in 1946 to 1,427 in 1947, and the
decrease in illegitimate births from 218 in 1946 to 167 in 1947 ; and the
death rate in the latter had fallen from 91-7 to 65-9. The care of
illegitimate children and of those prematurely born has again received
particular attention.
The care of illegitimate children must necessarily be bound up with
child life protection for it is almost always the illegitimate baby who needs
pecial care and protection. The City Council considered that this
problem should receive the individual attention of a child protection
officer and she has been at work for two years. Her work brings her in
' lose contact with the staff of the Moral Welfare Associations and their
co-ordinated efforts have been rewarded with considerable success in
many baffling problems.
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