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Public Health Department,
Town Hall,
St. Marylebone, W.1.
To the Mayor, Aldermen and Councillors of the Metropolitan Borough of St. Marylebone.
Mr. Mayor, Ladies and Gentlemen,
Although I have the honour to present to you the Annual Report on the health of the Borough
during 1957, most of the material it contains refers to the period before I took up my duties in
November when, first Dr. Bulman, and after his retirement Dr. Fenton, directed .the work of the
Department. I shall, therefore, on this occasion confine myself in the main to a few comments of
a general nature.
The health of the Borough was on the whole satisfactory during the year. The only notifiable
disease which reached epidemic proportions was measles, a disease which is coming to be regarded
as almost trivial since modern treatment has made possible the prevention of many of the septic
complications which previously led to so much subsequent ill-health. Only six of the 506 cases were
admitted to hospital and there were no deaths. There were eight cases of poliomyelitis of whom four
developed paralysis. Two of the paralytic cases did not live locally and contracted the disease outside
the Borough. One of these, a man, had severe paralysis and was transferred to an Orthopaedic Hospital
in Harrow. The other, a young woman, was only slightly affected. The two St. Marylebone residents,
both children, also had only slight paralysis and it is pleasing to record that at the time of writing
both have recovered completely. Although one death from poliomyelitis is recorded in Table 1,
page 30, this refers to a young man who, while his home address was in St. Marylebone was, in fact,
living and working outside London at the time.
On the 11th June, 1957, the Ministry of Health issued a memorandum on the subject of the outbreaks
of influenza which had recently occurred in the Far East. The covering letter to Medical Officers of
Health stressed the importance of the early recognition of any outbreak which might follow
introduction of the virus into this country, and the desirability of making arrangements for the
examination of laboratory specimens from any suspected cases. On receipt of this communication
an extract of the essential information contained therein was sent to general practitioners and hospitals
in the Borough with an invitation to co-operate and requesting information of any case coming to
their notice of influenza similar to those which had been occurring in the Far East. At the same time,
arrangements were made with the Central Public Health Laboratory at Colindale for any appropriate
specimens to be examined to identify the causal organism. On the 19th September, 1957, the
Ministry of Health again wrote to Medical Officers of Health stating that as there was some public
apprehension and considerable publicity about influenza, the Ministry were anxious to have immediate
information of any outbreak of the disease and thereafter progress reports. Accordingly, and as influenza
is not a notifiable disease, another letter was sent to general practitioners and hospitals inviting their
further co-operation by reporting by telephone any sudden outbreak in their practice and by supplying
the Medical Officer of Health with a note of the numbers of new cases of influenza which they had seen
during each of the three weeks of the period ending 12th October. Similarly, seventy-eight of the
larger firms and undertakings, including the Borough Council, were invited to inform the Medical
Officer weekly of the percentage of staff reported absent with influenza. A simple note for completion
and stamped addressed envelopes were sent in each case. The information obtained in this way was
very valuable and sincere thanks are due to the practitioners, hospitals and undertakings who
co-operated so willingly.
The expected epidemic, when it came, affected London equally with the rest of the country, as
judged by National Health Insurance claims for sickness, although it reached its peak here at the end
of October, somewhat later than in the North. When death rates for influenza and notifications of
acute pneumonia are examined, however, it would appear that the disease was considerably less severe
in London than in some other areas which seems to have been equally true for St. Marylebone
as for London as a whole.
The infant mortality rate for the year deserves special mention. This rate of 31.29 per 1,000 live
births is more than double that for 1956, which was 15.04. On page 6 I have discussed the statistical
implications of this and advanced reasons to support the view that such an increase could be due to
chance alone. It is also of interest to note that of the infant deaths in 1956 and 1957 all except four
in each year were due to atelectasis, premature birth or congenital malformation of one sort or another;
conditions which are all pre-natally determined and which, in our present state of knowledge, we can