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37
In regard to the question of the completeness of notification, 525 cases
were notified by medical practitioners and 143 by parents. Thus 132 or
16 per cent. were not notified. 70 of the 132 were reported by school
teachers, and 62 discovered otherwise.
In order to check the completeness of our records of secondary cases, a visit
was later paid to all houses where a primary case but no secondary cases had
been reported, and where there were children who had not had measles. In
27 amongst 156 of such houses visited (about one-sixth) it was found that
there had been secondary cases not notified. In the 27 houses there were 40
cases discovered in this way (included in the total of 800). Seeing that
this was the case, even though the parents had been emphatically told that
any secondary cases were to be notified and supplied with cards for the
purpose, it is evident that there must have been an appreciable number of cases
never brought to our knowledge. This was probably kept within moderate
limits, however, by reports of school-teachers and other sources of information.
The cases were carefully analysed with a view to determining what proportion
of household contacts developed the diseaae. In this connection the
records as to secondary cases are to be regarded as fairly but not quite
complete. The question of whether the contacts had previously suffered from
measles is determined by the statements made by themselves and friends. It
is to be remembered that in St. Pancras there are very frequently more than
one family per house. The results are epitomized as follows:
There were 657 house or family contacts of 8 years old or over said to have had
measles already; and of these 3 developed the disease (0'5 per cent.).
There were 55 house or family contacts of 8 years old or over said never to have
had measles; and of these 4 developed the disease (7 per cent.).
There were 185 family contacts under 8 said to have had measles already; and of
these 13 developed the disease (7 per cent.).
The corresponding figures for house contacts were 294 and 7 (2 per cent.).
There were 282 family contacts under 8 said never to have had measles ; and of
these 187 developed the disease (66 per cent.).
The corresponding figures for house contacts were 306 and 67 (22 per cent.).
In connection with the question of the chance of a person who had had
measles before developing the disease again it is interesting to note that
amongst the primary cases 50 gave a history of having had measles before.
This figure is not exhaustive, as this particular point was not inquired into in
all primary cases.
The date of onset and the date when the rash was first noticed as stated by
the friends was recorded by the visitor in all cases. We were therefore
enabled to record the interval between primary and secondary cases in the
same house. The most definite date is the onset of rash, and in the following
table is given the number of days between the appearance of the rash in the
primary and secondary cases respectively in 226 cases. Where the interval