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incidence of the disease, judging from the number of deaths, was in
the North Camberwell district, where they numbered 40, as compared
with 29 last year. Next highest comes North Peckham, where
there were 12 less than last year's total. South Camberwell had 14
deaths, 10 more than last year, while South Peckham with 5, and
St. George's with 19, both show a decrease of 15. In nearly all the
fatal cases the deaths were certified as being due to measles as the
primary cause, with pneumonia or broncho-pneumonia as the
secondary one.
The subject was vigorously taken up by the daily press, and, as
usual, all sorts of suggestions were made as to the course to be
taken. The notification of the disease was the favourite measure to
be recommended, but it must have been urged by those who are
ignorant or not mindful of the fact that this disease is infectious
before the rash appears, consequently the greater part of the mischief
is done before any notification would be possible. There is
again the fact that many, if not the majority of, cases of measles
are not attended by a doctor, and this especially in the poorer
districts, where overcrowding is at its greatest, and where from lack
of power to afford any isolation the disease is most certain to spread.
There is also the experience of those places where compulsory notification
has been actively put into practice and has been a failure.
Yet so firmly fixed is the idea of the value of notification that we find
that a resolution calling for the compulsory notification of measles
was passed even at the Conference held by the London County
Council, not without dissent, it is true, some speakers wishing
to limit it to epidemic periods and others to the first case appearing
in a household.
However, the Local Government Board have not yet put
measles on the list of notifiable diseases, nor up to the present
have the London County Council made it applicable to London, so
that it would appear that they, at all events, are not yet convinced.
If notification were to be made obligatory, and the section of the
Act which renders it incumbent on the householder to notify were
rigidly enforced, it might have some effect, especially if one or two
were fined, for it might make the doubtful mother call in the parish
or private doctor.
The information received by the schools has also been suggested
as forming a means whereby the existence of cases can be discovered,
but for the purpose of minimising infection the information, on
account of the channels through which at present it has to filter,
cannot be very effective. It is unlikely that the Sanitary Inspectors
will be able to visit on the same day that the authorities at the
school are informed of the existence of measles, and even if they do,
the rash of the disease is certain to have been out for one day at
least, the pre-eruption stage of the disease having already occupied
three days. Unless the teachers were to send down a list to the
Sanitary Office twice a day, and we had a number of Inspectors
ready to at once set out and deal with them, there must be a delay
fatal to the prompt isolation and the removal where home segregation