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that have resorted to this measure. For, as I have already
pointed out, every measure likely to supplement the deficiencies
in information provided by compulsory notification should be
adopted, and subsequent precautions to prevent the spread of the
disease should be thorough. So much as this, however, cannot
be said of any district visited where trial has been made of compulsory
notification of Measles; and accordingly it would be
unjust to draw conclusions as to the value of this measure from
any results hitherto apparent in these Districts. The problem of
how to obtain control of Measles is one of great difficulty for
Sanitary Authorities. It is clear, however, that a necessary preliminary
to taking- precautions against spread of this disease is
the possession of knowledge as to its occurrence, and my inveigation
of methods that may be employed to this end has led me
to the conclusion that compulsory notification of Measles, properly
utilised, is likely to prove of no little value. It is a measure
which, in my judgment, should be adopted by every Sanitary
Authority, whether Urban or Rural, that is desirous of obtaining
control of Measles. ...."
There is much to be said in favour of the view expressed in
the Local Government Board's Report, and in view of the failure
of Sanitary Authorities to obtain effective control of the explosive
outbreaks of Measles which from time to time spread through the
Metropolis with a high resultant of mortality, I am inclined to
agree therefore that the time has arrived when compulsory notification
of Measles will have to be adopted before the efforts of
the Sanitary Authorities will be effective in controlling these
outbreaks.
The question of the attendance of children under five years at
the Public Elementary schools is, in my opinion, a factor in the
spread of Measles which cannot be ignored. In 1909 the
Consultative Committee of the Board of Education inquired into
the question, before which Committee your Medical Officer of
Health had the honour of being invited to give evidence. The
terms of reference of the Inquiry suggested by the Board of
Education were "to consider and advise the Board of Education
in regard to the desirability or otherwise, both on Educational
and other grounds of discouraging the attendance at School of
children under the age of (say) five years on the assumption that,
in the event of the change being found generally desirable, the
monies now payable by the Board of Education in the shape of
grants in respect of the attendance of such children should still
be payable to the Local Education Authorities in greater relief of
their expenditure in educating children over five years of age."
In July, 1908 the Consultative Committee issued its Report
upon the " School attendance of children below the age of five."
The Report proper of the Committee is contained in Part II. of