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28 [Appendix iv.
MEASLES.
Although this disease is not included in the schedule for certification by practitioners or
notification by householders, it will be useful to place on record some of the information as to its
prevalence during the past year.*
Last year, the disease apparently entered the Parish through Hall Park, the Head Mistress of
the Infant Department of the Campbell Street Board School being the first to report any number
of cases. The earliest returns were received from her on February 14th.
The outbreak did not follow any definite course through the Parish, and the various schools were
infected in an erratic and apparently independent order. At the same time it has to be recognized
that most teachers delay calling attention to the disease until the attendances have markedly fallen
off. Long intervals elapse in the majority of reported cases between the onset of the illness and
the date of the report of the case. Many factors contribute to this, among them being the
irregular attendance common to very young children, statements by the parent that the absentee
has only a cold, and delay in placing the case of the absent scholar in the hands of the
Attendance Officer.
During the months when the schools were in session 1,191 cases of measles were brought to the
knowledge of the Department, excluding 108 cases reported by the school teachers, but not
confirmed by the statements of the parents and others. The patients were members of 825
families, living in 708 houses.
From the inquiries made the statistics in the following Tables have been compiled, the
figures for 1898, the last epidemic year, being added for comparison. (See Tables 11, 12, and 13.)
The first point worthy of notice is the fact that the number of cases reported in each
epidemic is almost identical, viz., 1,191 in 1900 and 1,196 in 1898. This suggests that a definite
proportion of the whole cases, at least, comes to the knowledge of the Department and enhances
the value of the statistics collated. From Table 11 it will be seen that the outbreak was later
last year than in 1898, and that it was of shorter duration, lasting (at its worst) for three months,
viz., April, May, and June, or two months less than in 1898, when it extended from February to
June.† At the same time the total number of attacks in May of last year (541) greatly exceeded
the maximum of any month in 1898. This was in part owing to the absence of information
of new cases during the Easter holidays. Having regard to the fact that the most common
cause of death in this disease is either bronchitis or pneumonia brought about by exposure before
complete recovery, the postponement of the main outburst until the onset of milder weather was
a distinct advantage. "With the commencement of the summer holidays, at the end of June, came
the end of information of fresh centres of infection. When the schools re-opened the epidemic had
spent itself.
The efforts made to limit the spread of infection can hardly, owing to the peculiarity in the
disease, he expected to prevent the recurrence of multiple cases in infected households. It is
desired to prevent the spread of infection to other households. The frequency of multiple cases (as
shown in Table 12) is therefore not of much importance. What is wanted, is to reduce, if
possible, the number of houses infected, and to a certain extent the increase in the total for last
year, compared with that of 1898, is disappointing. In connection with multiple infections it should
be stated that 442 secondary cases out of a total of 483 were infected prior to the first visit of
inquiry, i.e., before the case came to the knowledge of the Department.
* The sources of information and the regime consequent thereon are fully described in the Annual Report for
1898. Vide p. 60 et seq.
† In 1898 the outbreak had got pretty well out of hand before it was brought to the knowledge of the Department.
Efforts to limit its spread were not initiated until the middle of March.