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it is almost impossible to prevent it from spreading to all who
are susceptible to the infection. The School Board do not
allow of the attendance at school of children from infected
houses, and it is possible that if measles was made notifiable,
the head teachers would have some increased facilities for
excluding children from infected houses. But this end might
be equally well attained by the adoption of a course I suggested
to the local superintendent of the School Board
visitors some years ago; viz., that when measles threatens
to become epidemic, the parents should be informed that
school attendance is not allowed in the case of children living
in an infected house. No action was taken in the matter.
I venture to think that this course should be adopted, and
proved to be ineffective, before resorting to notification, which
would certainly be costly, and also involve much labour and
trouble, probably to little purpose.
SCARLET FEVER.
The cases notified as scarlet fever were 443, as compared
with 1,011, 749, and 474, in the three preceding years successively;
viz., 245 in North Kensington, and 198 in South
Kensington. The deaths were ten, and 21 below the corrected
decennial average (31): 7 and 3 in the Town and
Brompton sub-districts respectively. Five of the deaths were
of children under five years of age. Eight of the deaths took
place at outlying public institutions, to which 343 cases were
removed, and two at home. The case-mortality was 2.1 per
cent. (4.8 in 1898); viz., 23 per cent. in hospital cases, and 2.0
per cent. in home cases. The deaths in the three preceding
years from this cause were 39, 29, and 23, respectively.
The deaths in London, as a whole, were 398 (as compared
with 942, 780, and 583, in the three preceding years successively),
and were 557 below the corrected decennial average.
Of the 398 deaths, 329, or nearly 83 per cent., took place in