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The Order of the London County Council applying certain provisions of the Public Health
(London) Act to measles appears to have been beneficial in impressing upon parents the importance
of taking precautions to prevent infectious children associating with others. The more complete
returns made by school teachers to medical officers of health, informing them of children absent
from school on account of attacks of measles have been operative in the same direction, and
sanitary authorities have, by the distribution of cards or leaflets containing information as to the
measures necessary, both in the care of children who are attacked, and to prevent extension of
disease, done much to supply the knowledge which must be the basis of all efforts to limit measles
mortality. Dr. Sidney Davies is of opinion that the lower measles mortality in Woolwich is attributable
to the information thus imparted to parents.
The London County Council has revised the conditions upon which children are excluded from
schools on account of measles. The Code now provides that children suffering from measles must be
excluded for at least one month; that all children coming from homes in which measles exists must,
if they have not had measles, be excluded; children coming from infected homes, who have had
measles and are not attending infants' schools, need not be excluded. Children excluded from other
than infants' schools must remain away until the Monday following the expiration of fourteen days
from the occurrence of the first case. Children excluded from infants' schools must remain away until
the Monday following the expiration of 14 days from the occurrence of the last case.
Account of the behaviour of measles among school-attending children will be found in
an appendix (see Appendix II.). Dr. Kerr finds in the experience of the year 1905, support
for the view previously expressed that the disease tends to spread in a class where the number
of susceptible children reaches 30 or 40 per cent., and continues until the proportion of unprotected
children has been reduced to 15 or 20 per cent. It is, of course, impossible to say what is the proportion
of children who are protected by previous attack which has not been recognised, or who are naturally
insusceptible.
The early closing of infant classes on the occurrence of the first cases of measles has been
practised during the year and infant classes have been closed in 90 instances, while in 28 instances infant'3
departments, in 1 instance boys', in 1 instance girls', and in 1 instance a mixed department have been
closed during the year. (See Appendix II., p.27.)
The value of closing of schools on account of the occurrence of measles among the pupils has
continued to be tested in Woolwich by the division of the district into two parts, in one of which schools
are, on such occurrence, closed, and in the other case are not closed. The results are as yet inconclusive.
Disinfection after measles is carried out in most districts, and in the annual reports relating to
the following districts it is stated that this course is adopted:— Paddington, Kensington, Westminster,
St. Marylebone, Islington, Finsbury, Shoreditch, Bethnal-green, Poplar, Battersea, Deptford, Wandsworth,
Hammersmith, Fulham and Lambeth.
The medical officer of health of Paddington includes in his annual report an interesting table
showing the number of houses in which multiple attacks of measles occurred. Dr. Reginald Dudfield
thus states that the cases in 1905 occurred as follows:—

One of the objections which have been made to disinfection alter measles is that nouses
invaded by measles may require repetition of disinfection after a brief interval, and Dr. Dudfield
mentions that in 1905 the total number of disinfections was 1,078 and that in 36 instances a house was
twice, and in one instance three times, disinfected.
Scarlet Fever.
The cases of scarlet fever notified in the Administrative County of London during 1905 (52 weeks)
numbered 19,461, compared with 13,439 in 1904. The number of deaths registered from this cause was
549 in the vear 1905. compared with 365 in the year 1904.

The death-rate in each year since 1858 in relation to the mean death-rate of the period 18591905
will be seen on reference to diagram VIII.
The monthly case-rate and case-mortality in each of the years 1891-1905 in relation to the
mean of the whole period is shown in diagram X.
1 The Infectious Disease (Notification) Act came into force in 1889.
2 See footnote (1) p. 9.