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The large number of 10,375 notified cases of children under five
years (i.e., 48.7 per cent, of the total) during the past ten years is
explained by the fact that many children are infected at their homes by
their older brothers and sisters, who have contracted the disease at
school. School influence is, therefore, indirect, as well as direct, in
connection with the spread of Measles (and, of course, of other
infectious diseases).
Compulsoiy notification of a disease is of value, according as it is
accompanied by isolation accommodation in institutions and other
preventive measures as required. Unfortunately, since Measles (and
German Measles) became compulsorily notifiable in the Borough of
Lambeth, there has been no adequate institutional isolation accommodation
available for the patients notified. The information, however,
obtained from these diseases being made compulsorily notifiable
throughout the Borough as from January 1st. 1916, has been of value,
in that the other preventive measures (excluding institution isolation)
have been able to be taken in consequence of the knowledge so
afforded, viz., notified cases have led to the visiting systematically of
infected houses as soon as the notifications have been received. Again,
in the absence of adequate isolation institutional accommodation,
arrangements were made with nursing organisations for the visiting by
nurses at the homes of notified patients, on instructions by the Medical
Officer of Health, under the Lambeth Nursing (Infectious Diseases)
Scheme. This visiting of infected houses by nurses has, undoubtedly
been of value, in so far as the treatment of patients is concerned.
Nursing is everything in a case of Measles, and many lives may be (and
have been) saved, and much subsequent dangerous illness avoided by
the timely assistance and help of the nurses employed. Further, the
official visitings of the infected houses by the Sanitary Inspectors, and
the ensuring of the exclusion from schools of both patients and "contacts"
by the systematic sending of written communications to the
head-teachers of the schools concerned, and the leaving at the infected
houses of the official pamphlets and disinfectants, have been of the
greatest use.
Had efficient and adequate institutional accommodation been provided
for the isolation and treatment of the notified cases, the outbreak
of Measles (and German Measles) might have been prevented from