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a suggestion that the duty of notifying should be specially
placed upon parents or guardians, as a very large number
of cases of this disease are never seen by a medical
practitioner.
The question, however, which I am more especially
directed to consider, is whether the system of notification
shall be utilized purely for statistical purposes, or that the
same provisions shall govern the notification of Measles
in the matter of isolation, disinfection, &c., as already
apply to the dangerous infectious diseases already included
in Section 55 of the Public Health (London) Act, 1891.
Measles occurs principally amongst children and
contributes largely to the mortality returns. Measles
however per se is not a dangerous infectious disease, the
mortality too often resulting from want of proper care and
nourishment during the convalescent stage of the disease,
the real cause of death being Bronchitis or some similar
disease as a sequel or complication of Measles. Notification
therefore would doubtless reduce the mortality by reason
of the means thereby afforded the officers of the authority
of advising those in charge of the sick as to the necessary
care to be taken.
As to the application to Measles of the various sections
referred to in the letter from the London County Council
I am of opinion that although they could doubtless with
advantage be enforced in many instances yet they would
not be generally applicable, and should therefore be adoptive
and enforced only at the discretion of the Medical Officer
of Health. I therefore recommend that in the event of
Measles being made a notifiable disease it should be
subject to the following provision :—
" That in the case of Measles, Section 60, 61, 62, 63,
64, 65, 66, 68, 69, 70, 72, 73 and 74 of the Public Health
(London) Act, 1891, shall not apply except where in the
opinion of the Medical Officer of Health the enforcement