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All of the above sections have been in force since 1892, in respect to the notifiable diseases,
named in section 55 (8), but the offences specified have been of rare occurrence; or, at any rate,
rarely heard of, and probably it will not be otherwise now that measles is added to the list.
But the main significance of the Order is in connexion with other sections, 60 and 61, which
provide for the cleansing and disinfecting of infected premises and articles therein, a course which,
if carried out thoroughly, will certainly involve, at times, but for limited periods only, considerable
labour and no little expense to the sanitary authority.
In this connexion it may be pointed out that measles becomes epidemic about every second
year, continues with variable severity for a time, and then dies down. In some years the deaths
are relatively few. Thus, in Kensington, they were but 29, 18, 33, 33 and 24 in the years 1891,
1893, 1895, 1897 and 1899 respectively; in other years the deaths have been numerous, e.g., 109,
108, 173, 120 and 98 in the years 1892, 1894, 1896,1898 and 1900. The average number in the ten
years 1892—1901 was 79; whilst those from scarlet fever, diphtheria, and enteric fever within the same
period were only 26, 57 and 17 respectively. The deaths from scarlet fever exceeded 30 on three
occasions only in the ten years—the maximum number being 59; the maximum from diphtheria
was 89, whilst 23 was the highest number recorded from enteric fever.
There is no very wide variation in the annual number of the deaths from notifiable diseases,
as a class, nor in the prevalence of them (as shown by notifications), and no difficulty has been, at
any time, experienced in regard to disinfection after them. With measles it is otherwise; for in
consecutive periods of a few weeks the cases may range from, practically, zero to thousands.
I may take 1896, the year of maximum fatality in the Borough during the past decennium,
for an illustration.
During the first four-weekly period there were only three deaths from this cause. In the
second period the number rose to 17; in the following five periods the deaths were 20, 32, 45, 24
and 19 respectively: 157 in 24 weeks. During the remainder of the year only thirteen deaths were
registered, seven of them in the eighth four-weekly period.
The case-mortality of measles may be taken at, say, 4 per cent.* On this basis there were
some 3,925 cases in 24 weeks, and only 400 in the remaining 28 weeks.
The greatest number of deaths was in the fifth four-weekly period, 45, corresponding to,
say, 1,100 cases.
It must be obvious that disinfection—if it could be carried out universally—would, with so
many cases in so short a period, involve a heavy strain; probably, however, the greater proportion
of the cases would remain unknown.
Heads of families too commonly make light of measles, rarely seeking the help of the sanitary
authority, and oftentimes not even that of the doctor, in regard to it. What will happen
consequent to the steps taken by the County Council in making known the provisions of the Order
remains to be seen.
With a view to arrive at an approximate estimate of the number of cases in which
disinfection might be required, I made a study of the subject in the light of the mortal statistics for
1902.
The deaths were 93 (11 above the corrected decennial average): 86 in the first half-year,
7 in the second. They occurred in 92 houses.
Seventy-seven of the deaths belonged to North Kensington—in St. Charles Ward 26,
Golborne 13, Norland 25, Pembridge 13; and 16 to South Kensington—in Holland Ward 6, Earl's
Court 1, Queen's Gate 1, Redcliffe 5, and 3 in Brompton.
The deaths were spread over 61 streets; there was one death in each of 40 streets; there
were two deaths in each of 13 streets; three in each of two streets ; four in each of four streets and
five in one street.
* The case-mortality at Edinburgh in ten years 1880-89 (30,000 cases) was 3·1 per cent.