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58
Eighty-nine of the deaths were of children under five years of
age, including 21 under one year; the remaining four were of
children aged five, six (two deaths), and eight years.
Assuming the case-mortality to be 4 per cent, the cases would
have been 2,325; 2,150 in the first half, 175 in the second.
Of the notifiable diseases after which disinfection has been
carried out hitherto there were 734 cases only: 403 in the first
half-year, 331 in the second. Presumably all cases of small-pox,
scarlet-fever, diphtheria, enteric fever, etc., were notified ; but of
measles-cases no information was forthcoming in respect to the great
majority.
The deaths occurred, as already stated, in 92 houses, and I heard
of 182 other houses in which the disease was alleged to have occurred.
For the bulk of information in respect to these I was indebted to the
head teachers of Board Schools acting under official instructions. The
cases in children attending school were 173 : 63 other children were
excluded on account of disease in the family or the house, children
not being permitted to attend school from an infected house.
Assuming the accuracy of the figures,* we should have had to
disinfect 274 houses (267 in four months. January to April, and 7 in
the remaining 8 months), whilst, on an average of three eases to a
bouse, about 500 houses would have gone without disinfection. It
may be anticipated that the publicity given to the Order will lead to
disclosure of a larger proportion of the infected houses.
At the present time the disease is in abeyance in the Borough.
Measles is infectious from the onset of illness. It takes two or
three weeks to incubate, and so the first case in the family may
recover before a second child falls ill.
Should disinfection be done on recovery of the first case in hope
of preventing a second? the probability being that a second child (and
others if there be more than one susceptible) will be incubating the
disease at the date of disinfection.
It is always probable that the disease will spread to all the
families in a tenemented house; parents as a rule not being in dread
of measles; indeed they commonly prefer that their children should
have the malady all together, and so get the trouble over.
The same feeling, or a sense of the inevitability of measles, often
causes parents in the house generally, to be indifferent to the risk of
infection, especially if the first case should be of a benign description.
Not seldom, moreover, the disease will spread in a tenemented house
whatever care be taken by the heads of families.
* It is noteworthy that on April 1st, the day the Order came into force, two
cases in one house were reported by a head teacher : the children were found to be
suffering from chicken-pox.