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compared with 1,182 in 1897 and 1,225 in 1896; enteric fever,
116, compared with 143 in 1897 and 181 in 1896. There were
five notifications of small-pox; 10 notifications of "puerperal
fever," compared with 14 in 1897. There were also three
cases notified of continued fever, and 251 of erysipelas.
The subject of measles and its prevention was brought
before your Sanitary Committee on account of a communication
from the School Board for London recommending that power
should be given to local authorities to proceed against persons
who sent their children to school when they were suffering from
measles. A letter was also received from the London County
Council asking the opinion of the Vestry as to whether they
would approve of the application practically of all the disease
Sections of the Public Health (London) Act, except the one in
which notification is required, to measles. The matter was
referred to me for a report, of which the following is a copy:-
Gentlemen, —Referring to the communications from the School
Board and the London County Council with regard to the notification of
measles, I think that if the Act be applied at all it ought to be applied in
its entirety, and that if we take any action we should have the courage of
our opinions and boldly put measles on the list of notifiable diseases.
Whether this should be done is quite another matter, and one that I do
not support. In all considerations regarding measles the fact should be
ever present in our minds that the disease is infectious before the rash
comes out, that is, a case which really presents the symptoms of an ordinary
cold in the head may be a case of commencing measles, and have all the
power to propagate that disease.
The Sections the London County Council wish to have included in
the Act are those which relate to the disinfection, the exposure of infected
persons, and the letting of houses without disinfection. In these, proceedings
must be taken before the Magistrate, and I do not see how the Vestry,
in the absence of a proper notification certificate, can produce evidence that
measles have existed. If disinfection and the prohibition of exposure are to
check the disease, they ought to be done from the beginning and made
universal in their action. I have before pointed out that the infection exists
at a time when no medical man would feel justified in notifying measles.
Opinion among Medical Officers of Health is very much divided as to the
advisability of including measles as a notifiable disease, and the experience
gained in those places where it has been adopted has not been such as to
induce one to recommend its adoption. I, therefore, recommend that no
support be given to this proposition of the London County Council, and
that the School Board be requested to render universal the order requiring
teachers to send information to the Medical Officer of Health relating to
any children that they have excluded, either because they themselves are
ix.