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73
Reference to the table inset at page 27 shows that 29 of the 53 deaths
from measles were certified during the last quarter of the year. The higher
mortality was continued into 1915.
Measles not being a notifiable disease no exact information as to the number
of rases is available. The head teachers of the Council Schools are instructed
to inform the Borough medical officer of health, of children absent from
school on account of measles and other infectious diseases (see page 30),
distinguishing between cases and suspects and contacts. During 1914, 922
children were reported in this manner as actually suffering from measles.
These cases were not verified and the numbers do not include cases under
school age.
In spite of the large mortality from measles, cases of this disease are
not visited, the staff being insufficient for the purpose. Under certain
circumstances severe cases are treated either in the Poor Law Infirmaries or
the Metropolitan Asylums Board hospitals, but in June, 1914, the admission
of cases of measles (and of whooping cough) to the latter hospitals was
suspended, owing to the increased number of scarlet fever patients to be dealt
with.
The small mortality from measles in well-to-do families shows that deaths
from it are largely preventible, and there is every reason for the spending of
public money for this purpose.
To provide hospital accommodation for any large proportion of total cases
would be a large undertaking, and this would be rendered still more difficult
by the tendency of the disease to occur in epidemic waves. But supervision
of cases in their own homes bv \isiting nurses (and, where necessary, doctors)
together with the provision in necessitous cases of the means to keep the
patients, especially in the early stages of the disease, properly supplied with
food, warmth and accommodation would probably prevent manydanyerous
complications and lead to a reduction of mortality. A fraction of the money
spent upon other infectious diseases, such as scarlet fever and diphtheria,
would go far if spent in this direction. Hospital treatment of certain cases
would no doubt be necessary, but with a disease so highly infectious and so
hard to diagnose in the early stage before the appearance of the rash, no
isolation method of prevention can be expected to go far in the direction of
the prevention of canes. In this connection it is to be borne in mind also that
there is very little evidence that scarlet fever or diphtheria have been in any
way reduced in incidence by very complete hospital isolation of recognised cases.
WHOOPING COUGH.
Tn the following table will be found the deaths and death-rate from whooping
cough for the past ten years for the whole Borough and for the four
registration sub-districts:—