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It was evident that other Boroughs had experienced the same
difficulties as we had in the delay that arose through the return of
absences from school only being sent in once a week. The result
of this is that on Saturday morning a long list is received of names,
which refer to absences, in many cases ascribed to the presence of
measles occurring earlier in the week, and in regard to which much
valuable time had been lost. The suggestion, therefore, by the County
Medical Officer that the local authorities should at once be informed
seems to have a prima facie value. Serious difficulties arise in the way
of getting patients and guardians promptly to notify the reason for
absences from school, and the County Council dwell on the difficulties
due to their active or passive neglect. Legal proceedings, even
if successful, will hardly reach beyond the few actually proceeded
against, and it would seem the only course is to wait for an
enlightenment of public opinion, whenever that may arise.
The other proposal concerns the nursing, to which attention is
drawn further on. Although the conference passed a resolution in
favour of the compulsory notification of measles, it is gratifying to
see that the County Council do not, for the present, consider it
desirable to put it on the list of notifiable disease. As this view has
so often been dealt with in my previous reports, with a similar conclusion,
I do not again propose to discuss it further. At present,
however, it is difficult to see that any direct measures can be taken
against its spread beyond trying to keep untoward results from
all those of tender years. The cost of removing all serious cases
would be colossal, but it might be possible to take away those who
are certain to get little attention at home but where too often the
prejudice against removal is especially great. Nursing at home has
not been very successful, and, indeed, unless it can consist of
attention extending over a much greater part of the twenty-four
hours than is usually given, it is not likely to be of very great help.
One is always faced with the fact that measles ordinarily occurs in
epidemic form, and to keep the large staff of nurses always ready
would be expensive and, unless they could be used for other purposes,
wasteful to a degree.
The day when this disease will no longer be with us is very far
off, and under existing circumstances the best way of dealing with it
seems to be an attempt to minimise its dangerous complications.
These and the evil after-effects are not so prevalent among the
children of those who can afford to provide the proper attention;
and to prevent the infection is not always an advantage, on account
of the serious form it often takes among those who have never
suffered from it in childhood and who contract it later on in life.
Hospital accommodation for the serious cases among the poor
seems to be the most likely way of lessening the mischief of the
disease, but the experiment would be a costly one and by no means
certain of success.
Scarlet fever caused 19 deaths as compared with 13 last year,
an exceedingly small total compared with the number of notifications.
As usual, the great majority of deaths was of persons under 15 years,