View report page

36
printed or verbal, to be given concerning the precautions which should be taken. In measles, especially,
difficulty is experienced from the fact that the disease often occurs without the patient being
under medical treatment or supervision. Thus, in Hampstead, of 283 cases brought to the knowledge
of the medical officer of health, no medical practitioner was in attendance in 51. In Holborn the same
fact was observed in 17 out of 124 cases, and in Bethnal Green in 137 out of 599 cases, or some 20 per
cent, of the cases in the three districts.
Many of the reports show the steps taken in the schools to prevent extension of measles, through
school attendance, either by way of closure of schools or classes, by exclusion from school of children
from invaded houses, or by the more recent method of exclusion from school in some cases of children
who are not known to be protected by previous attack. In Woolwich it was deemed necessary to
exclude from attendance at most of the schools all children under five years of age for some weeks
during the year, and this course was adopted iu Lewisham in the case of three schools.
Reference will be found on page 106 to a memorandum issued in 1909 by Dr. Newsholme and
Dr. Newman, medical officers of the Local Government Board and Board of Education respectively,
dealing with the administrative measures necessary for the prevention of the spread of infectious
diseases among children attending elementary schools.
As in previous years, the medical officers of health of Paddington and Hampstead shew the
number of houses in which there occurred during the year more than one case of measles, thus :

Thus of 581 houses invaded in these districts multiple cases occurred in 253.
Scarlet Fever.
The cases of scarlet fever notified in the Administrative County of London during 1909 (52 weeks)
numbered 17,254, compared with 22,072 in 1908 (53 weeks). The number of deaths registered from
this cause was 383 in the year 1909 (52 weeks), compared with 548 in 1908 (53 weeks).
The scarlet fever case.rates, death.rates and case.mortality for 1909 and preceding periods are
shown in the following table :—

The death.rate in each year since 1858 in relation to the mean death.rate of the period 1859.
1909 will be seen on reference to diagram IX. It will be observed that the death.rate of 1909 was
the same as in 1900, 1903 and 1904, the lowest death.rate recorded in London.
The monthly case.rate and case.mortality in each of the years 1891.1909 in relation to the
mean of the whole period is shown in diagram XI.
It will be seen from the following table that in the peiiod 1904.8 the London scarlet fever death.
rate was exceeded by that of Liverpool, Manchester, Birmingham, Sheffield, West Ham, Salford and
Leicester, and in 1909 was in addition exceeded by that of Newcastle.on.Tyne.
1 The Infectious Disease (Notification) Act came into force iu 1889.
2 See footnote (2), page 6.