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I he apparent increase 111 incidence upon school children is to a large extent to be explained by
more complete notification on the part of the teachers, especially those in non-provided schools.
School closure.—The numbers of schools under special investigation for the three most
dangerous diseases affecting school children during the year were as follows :—
Diphtheria—Provided 133 164
Non-provided 31
Scarlet Fever—Provided 319
Non-provided 103 422
Measles—Provided 412
Non-provided 174 586
The numbers of schools or classes closed for the various diseases are given below in tabular form.
The closures on account of measles have been more numerous than last year, but the larger number
of closures is not the direct outcome of the increased prevalence of the disease. School closure in outbreaks
of measles is undertaken purely as a preventive measure, since we have proved it to be futile
to take this step as a means of checking an outbreak when once measles is established in school; it is
therefore only carried out on the first appearance of the disease in a classroom. Several considerations
are to be weighed before closing a room at this stage. For instance, notification by the teachers
must be definite and prompt; the proportion of children protected by previous attack must be known ;
the age of the children and the existence or progress of the disease in other parts of the school should
also be considered. Even when carried out successfully, closure in London only postpones an attack
for a few months, and is of little value except when applied to babies' rooms.
In scarlet fever outbreaks, closure is seldom applied, individual inspection and exclusion of
suspicious cases being found to be of much greater utility in controlling the disease. This subject is
dealt with fully on pages 47-53.

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