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The death rate of London from measles has, both in 1893 and the preceding ten years, been
greater than that of the majority of the undermentioned foreign cities.

The reports of the medical officers of health in several instances refer to the neglect of parents
among the poorer classes to make effort to limit the spread of this disease.
The desirability of requiring the notification of measles is also discussed in these reports. The
medical officer of health of Kensington expresses doubt if any great advantage would result from
notification unless hospitals were provided for the reception of the sufferers who cannot be
properly treated at home. On the other hand, the medical officer of health of St. Giles states that
he is still of opinion that the notification of measles would enable measures to be taken for arresting
the spread of the disease. The medical officer of health of Wandsworth is of opinion that the spread of
measles would be better controlled if all the children in a house infected with measles could be
excluded from school, and he urges the notification of measles for this purpose. During the year the
medical officer of health of Kensington addressed a letter to the superintendent of visitors of the
Chelsea division of the London School Board, pointing out the desirability of an effort being made
to exclude from the schools all children coming from houses where the disease exists, and recommending
that a circular letter referring to the requirement of the Board that children from infected
houses shall not attend school, should be addressed to the parents of school children. He adds that this
course was not adopted.
The deaths from measles were not uniformly distributed throughout the metropolis, the
adjoining districts of Clerkenwell, St. Luke and Shoreditch suffering especially heavily. The death
rate in each district in 1893 and in the ten years 1885-92 is shown in the following table—

* See footnote (*), page 6. † see footnote (†), page 6,