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36
every sufferer; but a bed made up on two chairs in a
stuffy living room certainly does not fulfil these
requirements. The Authorities at the Local Government
Board recognise these facts, but it is impossible
to provide hospital accommodation for any but the
worst housed cases. Acting on these lines, the
Metropolitan Asylums Board now accept for removal
cases of Measles certified by the Poor Law Medical
Officers, and also such other cases as are certified by
Medical Officers of Health to require removal on account
of faulty home conditions. 61 such cases were removed
during the year. As would naturally be expected, the
death rate amongst these was high (41 per cent.), as
many of them were not removed until after lung
complications had set in. Still, there is no doubt that
many of the survivors would have died had they
remained at home under such unfavourable conditions
as were found to exist. Measles is a disease which is
almost invariably transmitted by direct personal
infection, and as affecting school attendance is mostly
confined to the Infant Department. Based upon this
fact, the rule in force in the London County Council
Schools is to exclude from attendance in the case of
measles-infected houses, only the infants and the boys
and girls who have not had the disease.
With regard to disinfection, our rule is to offer it
in all cases, but only in twenty-one instances was it
accepted. I am not so much concerned at this refusal
as the infection of measles is short-lived, and domestic
cleansing, if thoroughly carried out, suffices for
disinfection.