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40
Eleven deaths were of infants under one year and 59 of children
aged one to five years. Only 4 of the deaths occurred amongst
children over five years of age.

Of the 33 deaths from measles during the fourth quarter of the
year, no less than 20 occurred in the last month, and there is evidence
pointing to a rising wave of epidemicity spreading throughout
the Borough. Every precaution, that can be, is taken to prevent the
spread of infection, but from the nature of the disease, together with
the indifference shown by the parents in failing to recognise its
fatal character, especially in the poorer and more crowded districts,
it is a most difficult, one might add an impossible, task, to secure
that proper precautions are observed to prevent the spread of
measles, once it has got a start. The absence of any satisfactory
system of notification, or of means of securing isolation, are further
factors which give rise to difficulty in adequately dealing with this
disease. The only information available as to the incidence of the
disease is that obtained from the Public Elementary Schools. This,
when received, is more often than not too late to be of any effective
use, and it is clear that the time has arrived when more satisfactory
preventive measures should be undertaken to prevent the heavy
mortality which periodically has to be recorded from measles.
The disease is accountable for more deaths annually, with the exception
of tuberculosis, than all the other infectious diseases put together,
and that it is, at least as regards fatality, amenable to proper treatment,
when suitable measures are taken to secure this end, is shown
by the fact that in the district of the Borough inhabited by the
more prosperous and better housed class, the disease is rarely fatal.
The infant departments of the Public Elementary Schools are, as
pointed out in previous annual reports, largely responsible for the
spread of measles, and it is to be regretted that steps are not taken
to prevent the attendance of children under 5 years of age from
attending school. It is amongst children under this age that
practically all fatalities from measles occur, and were these young
children excluded from attendance, a twofold object would in my
opinion be attained, a decreased risk of infection and a diminished
incidence of mortality.
The preventive measures taken at present in the Borough are,
when cases are notified to the Health Department, the homes of the