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the diseases being compulsorily notifiable in some districts but not so
in other (neighbouring) districts. This latter fact is particularly marked
in the case of Lambeth, where the diseases are compulsorily notifiable,
when compared (say) with Wandsworth, where the diseases are not
compulsorily notifiable, even though certain streets and roads are
shared by the two Boroughs.
The precautionary measures that are taken in the Borough of
Lambeth consist of compulsory notification, exclusion from school of
all known infected scholars and "contact" cases, disinfection in connection
with all houses that are known officially to be infected, visiting
by nurses at the houses of infected patients (with treatment as
required), and the general education of the parents and relatives and
others by pamphlets setting out the dangers of the diseases, and, on the
other hand, the simple precautionary measures that are alone necessary.
Proper nursing is a sine qua non.
It will be noted that, whilst the epidemic is becoming widespread,
and the numbers of notified cases will shortly be enormous, the registered
deaths should be proportionately few, judging by the past 10
years' experience. In this connection, German Measles is, practically,
negligible, no single death having been registered therefrom during the
past ten years (ending December 31st, 1925). During the same period,
the notified cases of Measles were 21,256, and the deaths registered
from that disease, 585, i.e. a case mortality of only 2.75 per cent.
Arranged quinquenially, the case-mortality figures are 3.3 and 2.0
respectively, showing a decrease which is due, probably, to the systematic
visiting of infected houses by Nurses under the Lambeth Nursing
(Infectious Diseases) Scheme, etc.
The figures for 1916-1925, which are quoted above, apply to
Lambeth Borough, but such epidemics, as they arise, affect also neighbouring
Boroughs and, indeed, the County of London as a whole. It
is in no sense a question of a particular locality, such as one or more
neighbouring Boroughs: it is really a pandemic over the whole of the
County of London and neighbouring Counties,as the influences, at work
causing the epidemic or pandemic, are general and widespread and do
not affect any one district only. Schools are, undoubtedly, the chief
factor.