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27
Upon mature consideration, I am of opinion that although there
can be no objection to the inclusion of measles in the term
"Dangerous and Infectious Disease" for the purpose of all the
sections quoted by the Clerk to the London County Council, yet
these sections could not be usefully applied without compulsory
notification by the medical attendant. Without this there are no
means of verifying information received from lay sources other than
by a visit by your medical officer of health, who would require to
make a medical examination in each case so as to ascertain the true
nature of the illness reported before any isolation or disinfection
could be enforced. This examination would certainly bring your
Medical Officer into collision with the other practitioners of the
district, who would vehemently resent such interference with their
patients; moreover, such examination would not only be outside
the ordinary duties of the Health Officer but would be absolutely
illegal (unless with the consent of the person inspected). Compulsory
notification under the present law by the medical attendant
would be very expensive, and would mean an addition of some
2,400 half-crowns yearly to the notification account of the borough.
In addition, it would involve nearly that number of extra visits on
the part of your inspectors. In 1898 a proposal for the compulsory
notification of measles was mooted by the School Board for London.
I then reported upon the subject, and suggested a modified form of
compulsory notification which I considered would be nearly as useful
as that required by section 55 of the Public Health (London)
Act, 1891, and not nearly so costly. I would suggest a compulsory
medical certificate limited to the first case in each household, and
enforce the reporting of subsequent cases by the parent or guardian.
If we knew of the first case in each house or family we could notify
the schools so that all children from such houses could be excluded
and the premises kept under observation. This would, of course,
necessitate an amendment of the Public Health (London) Act of
1891, and action in this direction might be recommended to the
London County Council. The matter was discussed by the Public
Health Committee on this report, but it was decided to take no
action.