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precaution taken to prevent the spread of infection. After four days, however, the Metropolitan
Asylums Board notified the Public Health Department that the child was not suffering from typhus
fever or any other notifiable disease.
Other Notifiable Diseases.—With the exception of tuberculosis, which is dealt with in a separate
section, no notifiable infectious diseases, other than those to which reference has been made, were
notified during the year.
NON-NOTIFIABLE DISEASES
Measles.—This disease ceased to be compulsorily notifiable in December, 1919, but the Head
Teachers of the London County Council schools report to Medical Officers of Health all cases, both
of children suffering from measles and of children kept away from school by reason of the disease
existing in their homes.
In view of the dangerous complications which are liable to follow neglected cases of measles,
the Women Health Officers pay a great deal of attention to children suffering from this disease in
the poorer quarters of the Borough. Four hundred and nineteen visits to cases of measles were
paid by these officers during the year.
The number of cases admitted to hospital was 102.
This disease caused 25 deaths during the year. The destructive nature of measles as compared
with scarlet fever is well shown by an examination of their respective death rates during the years
1911 to 1925. Of every million people living during that period, 251 died annually from measles
and 42 from scarlet fever. Of cases of measles treated in the Metropolitan Asylums Board's Hospitals
during the same period, numbering 28,266, the case mortality was 10.6 per cent., whereas for scarlet
fever, numbering 194,975 cases, it was only 1.5 per cent.
In view of the high mortality of this disease compared with scarlet fever, the general policy
pursued in most districts in the country in giving priority of admission to isolation hospitals to cases
of scarlet fever is a matter which has been considered both by the Metropolitan Asylums Board and
the Metropolitan Medical Officers of Health. In April, 1926, a conference took place between representatives
of the Ministry of Health, the London County Council, the Metropolitan Branch of the
Society of Medical Officers of Health, and the Metropolitan Asylums Board, and as the outcome of
their deliberations, the following recommendations were made:—
(a) That the Board should allocate from time to time a number of beds for measles
and a number for scarlet fever, such allocation to be altered by the Board as circumstances
demand.
(b) That cases of scarlet fever and measles be admitted on doctors' certificates as now,
without reference to the Medical Officer of Health.
(c) That when shortage of beds for scarlet fever or measles is imminen the Board should
inform the Medical Officers of Health and accept cases only upon their recommendation,
(d) That during such shortage of beds applications for admission from general practitioners
should be referred to the Medical Officers of Health for recommendation.
(e) That the selection of cases for admission should be based on type of home rather than
type of case.
(f) That cases of measles in tenement houses where there are no facilities for home nursing
or in houses connected with shops or where a member of the family is employed
in the handling of food, should be given priority over cases of scarlet fever in single
family houses where isolation is possible.
In October, 1926, the Metropolitan Asylums Board agreed to the alterations and arrangements
for the admission to the Board's Infectious Hospitals of cases of scarlet fever and measles on the lines
set forth in the recommendations of the conference, and representations were made to the Ministry
of Health for their sanction. If the approval of the Ministry is obtained, the scheme will be put
into operation and it is earnestly hoped that it will be the means of making a large reduction in the
high mortality rate from measles amongst children.
Whooping Cough.—There were 8 deaths from this cause. The deaths in the three preceding
years were 23, 20 and 18. The Women Health Officers paid 138 visits to cases of this disease during
the year. The number of cases admitted to hospital was 34.