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21
Report of the Medical Officer of Health.

One of the main difficulties in the way of reducing the mortality from measles is the fact that
parents so frequently fail to realise the serious nature of the disease. The measures referred to in the
reports which have been adopted for the prevention of the spread of measles have, for the most part
been limited to the exclusion of affected children and contacts from school, though uniformity of procedure
in this respect is far from being established. In recent years, however, the services of women
sanitary inspectors, health visitors, and voluntary workers, have rendered possible the observance
of precautionary measures, both at home and at school, in a way not hitherto attainable, and it may
be anticipated that in the course of time, the educative effect of the visits of these officers will be more
widely felt.
At the time of the exceptional prevalence of measles in the early part of 1911, and with a view
to devising improved methods of dealing with the disease a conference of London medical officers was
held on the 13th March at the offices of the Local Government Board. As a result of this conference,
the Board, on the 10th April, issued the following advice in the form of a circular letter.
"I am directed by the Local Government Board to state that they have had under consideration
the present outbreak of measles in London, and that on the suggestion of the President their medical
officer has conferred with the medical officers of the London County Council and of the various borough
councils as to the measures which may be taken for dealing with it.
At the conference the view was generally expressed that Sanitary Authorities have been hampered
in their efforts to check the spread of the disease by the absence of early information of cases,
and the question was considered whether this difficulty would be removed if measles were made a notifiable
disease.
On this question widely divergent views as to the value of notification were shown to exist. A
very large number of cases are not attended by a doctor, and it was pointed out that in such cases
the adoption of the Notification Act would be a dead letter.
It may also be observed that the notification of measles has been tried in a large number of towns
and then abandoned.
Without, therefore, expressing any view on the question whether the notification of measles would
be justified, it is clear that such other means of obtaining information as are available should be fully
utilised.
The Board find that the School Attendance Department of the London Education Authority
have supplied much valuable information as regards measles in the past, and in view of the proceedings
at the conference, it appeared to the Board that it might be practicable to arrange that this source of
information should be made more readily available.
On this question the Board have consulted the Board of Education, and it has now been arranged
that so long as the present emergency lasts, the school attendance officers will give speedy information
to the medical officers of Health of all cases of illness coming under their notice. It is hoped that, by
this means, early information of the majority of cases of measles will reach the medical officers of health.
The information thus obtained will necessarily require to be followed up. Probably many cases
will be reported which are not measles, and arrangements should be made for obtaining a proper diagnosis,
for securing that the cases are properly isolated, and for urging on the parents the need of obtaining
medical aid where such aid is required.
No doubt the Council's official who visits the home will be able to do much in the way of giving
advice as to the care and nursing of the patients.
Removal to Hospital.—The Board have been in correspondence with the Metropolitan Asylums
Board, and it is understood that that Board will agree to receive cases of measles on the recommendation
of the medical officer of health. The accommodation of the Metropolitan Asylums Board
for this purpose is necessarily limited, and arrangements will ba made by which preference will be given
to those cases most needing hospital treatment. The Board may also remind the borough council that
they have power to provide temporary hospitals, and if at a subsequent date the amount of accommodation
for measles which is available in the hospitals of the Metropolitan Asylums Board should
come to be exhausted, this power might have to be utilised.
Staff required for dealing with outbreak.—For dealing with this outbreak and properly following
up the information which will be obtained, it is essential that each medical officer of health should be
provided with an adequate staff, and the Board trust that the Council will at once appoint any
additional temporary assistants (medical and other) that may be required."
* Genuiue cases notified between March 22nd and May 12th from 391 houses.