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126
departments would be very much higher, viz., about 180 per 1,000, instead of 68 per
1,000, and the figure would be greater still among the babies' and junior classes.
Epidemics of measles, which occur with regularity in London, roughly every two
years, have been the subject of close study by the public health authorities, and all
possible and practicable means have been explored for limiting the spread of the
disease. Experience has shown that, in spite of all efforts, but little can be effected
as regards checking the incidence of the disease when it becomes epidemic, although
a good deal can be accomplished in reducing mortality. Whereas formerly class
closure and the exclusion of susceptible children were resorted to when measles
threatened to spread in a school, it was found that the interference with school
attendance was not justified by the results which accrued in the prevention of
spread. Every young child is susceptible to measles until protection is acquired
by an attack of the disease, so that during the inter-epidemic periods the mass of
susceptible material, augmented by the natural increase in births, accumulates until
the proportion is ripe for the disease to spread. Were it not for the fact that measles
is endemic in this country and that successive generations have become familiarised
with the disease, the toll of life would be greater than it is. It is well known that
where measles attacks a population unprotected by racial immunity, the death rate
is very high, both among children and adults, as for instance when soldiers from
the Antipodes and from the Highlands of Scotland were attacked during the war.
Public health administration in London in recent years has been chiefly directed
towards early treatment, the efficient nursing of cases and reduction in mortality.
Mortality.

During the epidemic of 1925-26 there were 1,034 deaths during the six months
from November to April, inclusive, which represents a considerably lower mortality
than in the 1923-24 outbreak, when, in the six months while the epidemic was in
progress, viz., December to May, inclusive, there were 1,391 deaths. The consistency
with which the mortality from measles is being reduced is indicative of the success
of the measures which are being taken by the Council and the several metropolitan
boroughs in their respective spheres of action.
The monthly distribution of the 1,034 deaths was as follows:—
November. December. January. February. March. April. Total.
No. of deaths 66 159 216 196 205 192 1,034
As usual, the heaviest burden of fatalities occurred in the age group of one to
two years, only 55 deaths in the school age period, and 5 deaths over school age having
been recorded, as will be noted below:—
Age groups. 1 year. 1—2 years. 2—5 years. 5—15 years. Over 15 years.
No. of deaths 248 462 264 55 5
Immunisation
against
measles.
As already stated (p. 120), active rest arch is being prosecuted in the direction of
measles prophylaxis, and in this country the Ministry of Health, in conjunction with
the Medical Research Council, have recently been engaged in the investigation of
methods of active immunisation against measles which it is hoped will bear fruit
in due course, but it is as yet too early to make any further statement in the matter.
The
measles
scheme.
In accordance with the decision of the Education and Public Health Committees
in 1921, after conference between representatives of the Council and the several
metropolitan boroughs, the measles scheme is put into force when the number of