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63
parents (they are sufficiently familiar with it to make their evidence reliable),
a notice to exclude is sent to all schools attended by children living in the
house. At the expiration of ten days from the date of onset of the disease, a
visit is made by the disinfector, and if the patient be recovered and no
other child be ill, disinfection is carried out—otherwise it is postponed, and
further visits are paid at intervals of not more than seven days, until the
patients be well. On the fifteenth day after disinfection, a further visit is
paid, and if no infectious sickness be present in the house, it is "cleared," and
a certificate of freedom from infection sent to the schools.
In 24 houses further attacks were reported subsequent
to disinfection being carried out, but in nine
instances only could the subsequent cases be held to
mean that disinfection failed to spread infection. In
the other 15 instances the secondary attacks were due
either to apparently independent fresh source of infection
or to some other patient, a member of another
family usually, being still ill and the disinfection of the
house incomplete. In all the nine instances of failure
the subsequent attack was evidently due to the disease
being in the incubation stage at the time of disinfection.
This is one of the great difficulties to be overcome
in connection with measles. Two patients were
apparently attacked twice during the course of the
epidemic.
The Code drawn up by the School Board for London
for use in the Board's Schools directs the teachers
to report to the medical officer of health of the district
in which the scholar resides every case of measles
coming to their knowledge. It was found that this
provision was not understood by the teachers, but when
pointed out to them, was very generally acted on. It