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34
Every notified case of measles, and a considerable number of the cases of
german measles, have been visited by one of the women visitors without
delay. Careful inquiries have been made in each case and a case paper filled
up. Upon receipt of the notification a card of advice is sent to the patient's
home, together with a printed addressod post-card form of notification—
unstamped — for the notification of secondary cases in the household. Upon
a secondary case being notified another copy of the post-card form has been
promptly sent to the parent for further secondary cases, if any.
It has long been observed that mortality from measles is very largely
restricted to the poorer classes, deaths from this cause amongst the well-to-do
being uncommon. This is probably due in part to superior stamina from
better nurture prior to the attack of measles, and perhaps also to other factors,
such as a difference of age between the patients in the two classes. But there
seems to be no doubt that it is also largely the result of improper nursing
of the patients, which is much commoner amongst the poorer classes than
the more well-to-do, and is the result of poverty, ignorance, or carelessness.
We have therefore aimed at securing something like adequate nursing for the
measles cases, and to this end "The Mayoress' Nursing Fund for Sick
Children" was instituted early in the year by the Mayoress, Mrs. J. H. Mitchell,
at the suggestion of the Medical Officer of Health. An arrangement was made
with the four local district nursing associations to send a visiting nurse to such
cases of measles as were referred to them by the Medical Officer of Health,
payment being made by the Mayoress' Fund at the rate of one shilling per
visit. In certain cases of necessity this assistance was supplemented by the
provision from the fund of milk, eggs, coal and clothing. Where the home
conditions were so bad that even with such help as this it appeared impossible
to secure reasonable accommodation for the case, the patients were removed to
the Metropolitan Asylums Board's hospitals. This, it is understood, was only
possible owing to the low inciderce of scarlet fever and other eases received by
the Board, and in some years it will probably not be possible, with the present
arrangements, to get measles cases removed on the request of the Medical
Officer of Health. Some cases were also removed to the Infirmary. The
provision of hospital accommodation for a proportion of measles cases is
essential to an effective scheme.
This work of the Nursing Fund began in April, and by the end of the year,
during which time 1,650 cases of measles were notified, 205 families were
dealt with, and 1,231 visits were paid by the nurses, the average number of
visits per family being 6.
1 patient nursed in each of 152 families.
2 patients „ „ „ „ 40 „
3 „ „ „ „ „ 10 „
4 „ „ „ 1 family.
5 ,, „ „ ,, „ 2 families.
The total number of patients nursed was 276, and 126 families received
milk and eggs, and 8 coal. The cost of this work to the end of the year was
£81 15s. 11d.
As to the effect of this work in reducing mortality, it is encouraging to
note that the number of measles deaths in 1916 was less than in any recent