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45
[1919
MEASLES.
During the year 1,269 cases of Measles were notified, being 146 more than
in the corresponding period of 1918. The attack rate was equal to 3.85per 1,000
ot the civil population. 1,192 visits were paid by the two Health Visitors, who
specially reported to the Medical Officer of Health on-each case where a nurse
was needed, as a result of which 383 visits were made by the nurses of the
North London Nursing Association at a cost of £19 3s. to the Council, in
accordance with the terms of the agreement entered into with the Association.
The Medical Officer of Health has never been in favour of the notification
of this disease, because he believes that the good effected by it is not in any
way commensurate with the care, trouble and time spent in visiting them, but
primarily because little good can be effected. He would not, however,
object to measles complicated with pneumonia among children under five
years old, or, indeed, of any children similarly afflicted, being notified, because
he thinks that by the attendance of nurses on poorer persons, who cannot
afford to employ them, a number of lives might be saved. He believes,
however, that to prevent much of the measles at present occurring, it would be
wise not to allow children under five years of age attending the public elementary
schools, and he would welcome the prohibition of the attendance of these
children at them. He has had a large experience of this disease in the
North of England, and many years ago he, when Medical Officer of Health
of Sunderland, had an alarming one, when he was able to compare an epidemic
in this borough with its behaviour in a neighbouring town which possessed
an Act making the disease notifiable. This was in 1885, when an epidemic
occurred in Sunderland and in some of the North-East coast towns which no
measures or barriers were able to control.
At one time measles was not the prevalent disease it is to-day, and on
looking at the past records of the borough of Sunderland at the time when the
epidemic occurred, he was surprised with the large increase in its death-rate,
which from 1851-1860, with 428 deaths, was 0.41 per 1,000. A similar rate
persisted in the next decade, and a slightly decreased one in the ten years
following, while in the ten years 1880-1889 it rose one hundred per cent.
The writer at that time was much struck with the impossibility of
controlling the disease, the deaths from which had so largely increased, and in
studying the matter very closely was driven to the conclusion that nothing
had occurred from the earlier years to cause the increase in the prevalence of
the disease except the establishment of the public elementary schools; for it
was then that the children became aggregrated in large numbers unknown to
previous generations.
It might be mentioned here that some short time before the war, the
Rt. Hon. John Burns, M.P., who was then the President of the Local