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64
1899]
The result of course is calamitous. Many are stricken with
secondary diseases, particularly pneumonia, and less often with
bronchitis. It is no surprise, therefore, to find that 117 deaths out
of the 155 in which measles was ascribed as the primary cause,
were set down to pneumonia and bronchitis. These 117 deaths
represent just 75½ per cent of all the deaths from measles.
One has only to look at the spot maps which are kept in the
Public Health Department to see at a glance that the mortality
occurrs chiefly among the poor, the uneducated, the uninformed,
and rarely among those that are educated and well to do. There
is no doubt that much good could be effected if these people could
be reached, and instructed. Ordinary notification, as I have pointed
out before now is not speedy enough to enable Sanitary
Authorities to effect much good, nor would a tenth of the
cases be heard of, because medical men are only exceptionally called
in, that is to say when the patients have come into a parlous state
because of the supervention of pneumonia or bronchitis. It is to
anticipate such attacks as these that the earliest information is
desired. I expressed an opinion before, and I am still of the same
mind, that the earliest notification can only be obtained from the
school teachers of our great elementary schools, who are the very
first to hear of the presence of disease in their scholars, and who
ought to be as much compelled by the law to send information to
the Medical Officer of Health as the Medical Officer of Health is
compelled to send information of other infectious diseases to the
school teachers.
Closure of Schools for Measles—It was not necessary to
close any schools as a whole, although in a few instances, acting on
requests from me the school authorities closed class rooms in the
Infants' departments of the following schools :—
Upper Hornsey Road.
Matthias Road Board School.
Ambler Road ,,
Cottenham Road „