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again may "carry" the specific germ of an infectious disease and be infectious to others without
suffering themselves.
An outbreak of Diphtheria which occurred in one of the Schools of the district provides typical
examples of these occurrences.
In February, 1920, an undue prevalence of diphtheria was noted in one of the Schools, 25
cases having occurred in the neighbourhood, 18 of which attended the School. The school was visited
by one of the Medical Staff. Children in the classes where a case had been reported were carefully
examined for any signs suggestive of Diphtheria, particular attention being paid to the examination
of children from a family in which a case of Diphtheria was known to have occurred. Nasal and
throat swabs were taken for bacteriological examination from all cases considered suspicious.
As a result of this examination, one girl who appeared healthy was found to be a "carrier"—
an example of a "carrier" where the individual carrying the germ had not herself been a sufferer,
although her sister had been notified as a case of Diphtheria 116 days previously.
A second source of infection was traced to a boy in another class who infected two cases at
home, and two cases in his own class. This boy was the first of the 25 cases under review to be notified,
and it was found that he had been attending school with a "running" nose, the discharge from which
was found, on swabbing and bacteriological examination, to contain Diphtheria bacilli 110 days after
his original discharge from hospital—an example of a "carrier" where the individual carrying the
germ had himself been a sufferer and was intermittently infectious over a long period, the bov having
been free from Diphtheria on discharge from the Hospital.
No further cases were reported from the school after these two "carrier" cases were excluded
for treatment.
Sanitary Work.
The passing of new Acts of Parliament relating to Housing has had its reflection in the work
of the Sanitary Department.
The total number of complaints received during the year from householders as to the insanitary
condition of property was 3,164, or a greater number than has ever before been received by the Department
in any year. The number of notices served on owners as a result of these complaints has
similarly been the greatest on record.
Since the passing of the Increase of Rent and Mortgage Interest (Restrictions) Act, 1920, it
has been somewhat easier for the Health Department to get the work of sanitary repairs carried out,
but the large arrears of sanitary work which increased during the war period have yet to be dealt
with, and it will probably be some years before the housing of Willesden is all that could be desired
by the Council. When the building of a sufficient number of new houses has been completed it is
hoped that labour and materi>'? will be freed for dealing with the necessary repairs to the old, and
that, in consequence, good housing conditions will again prevail in Willesden.
Motor Ambulance Service.
This service was first instituted in 1913, when seven motor vehicles were purchased by the
Council in connection with Hospital work, the conveyance of Physically and Mentally Defective
Children to School, Disinfection, and Health work generally. The service has been much appreciated
by the public, and the number of calls upon the Ambulance Station has increased year by year. During
the year ended 31st March, 1920, the total number of calls in connection with Infectious Diseases and
Disinfection'and Sickness and Accident was 3,886, as compared with 2,185 in the preceding year,
while the total number of miles run by the service was 61,306 as compared with 54,174 during the
year ended 31st March, 1919.
An all-night service has now been established, but this is only partial, as there is only one
man on duty, and any calls coming when he is out cannot be dealt with at once.
The vehicles are now in their eighth year of service, when the amount of repair work required
naturally increases. In these circumstances, and in view of the increased calls upon the Ambulance
Station, it becomes a matter of increasing difficulty to meet all demands.
Mothers and Children under Five Years.
No extension of the Council's work in connection with Maternity and Child Welfare has taken
place during the year, but the public demand for attention at the Council's Clinics has increased.
In 1920,53,291 attendances were made at the Clinics by Mothers and Children under 5 years for
medical or dental treatment and advice, as compared with 33,748 attendances in the year 1919, or an
increase of 58 per cent.
The School for Mothers has similarly shewn a growth in attendances from 1,089 in 1919 to
2,354 in 1920, or an increase of 116 per cent.
It is difficult to estimate the value of the continuous medical supervision of the mother and child,
but it is pleasing to note that the Infant Mortality rate for the year 1920 has fallen to 65 per thousand
births as compared with 83 in the previous year, and is the lowest figure yet recorded in Willesden.
The Infant Mortality rate for the 96 great towns in England and Wales, including Willesden for 1920,
was 85 per thousand births.