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Report of Medical Officer of Health.] 31
The figures in Table 13 show clearly the special liability of young school-attenders to the
disease. Assuming that the school ages lie between 3 and 15 years, and that children aged 6 years
pass from the infant department to the boys' (or girls') school, the cases among the two classes
(both sexes, whole Parish) were:—
1900. 1898.
Infants, 3-6 607 552
Boys
Girls
6-15 251 307
The frequency with which medical attendance is obtained for patients ill with measles has
been much discussed. Inquiries on the subject were made during the past year, and it appeared
that at 314 out of 708 houses practitioners were in attendance on 519 (out of 1,191) children.
As to the value of disinfection, no definite opinion can yet be given. The form in which the
work has been recorded makes it difficult to state the facts with absolute accuracy. It appears that
disinfection was done for 467 families (the patient being the only one child in 12 of the houses),
and that 12 further cases occurred therein at dates varying from 2 days to 1 month after disinfection.
Disinfection was refused 348 times (in 29 houses the patient was the only child in the
house), and 9 cases occurred subsequently to such refusal at intervals of 4 to 40 days subsequent
to the date of offer to disinfect. The two sets of cases are set out below:—
Disinfection refused 348 instances.
There were no other children to infect in 29 instances.
In the remaining 319 households 9 cases occurred on the following days—day fixed
for disinfection, 4th, 6th, 9th, 15th — 16th, 18th, 26th, and 40th days.
Disinfection performed 467 instances.
There were no other children to infect in 12 instances.
In the remaining 445 households 12 cases occurred on the following days—2nd,
5th, 6th, 7th, 8th—33rd, 100th.
Assuming, as was probably the case, that the patients who sickened on the days indicated in
italics were infected at the time disinfection was done, or offered and refused, there remain 4 cases
in the first group and 2 in the second apparently occurring after disinfection was due or done.
The cases in the latter group occurred at intervals far in excess of the incubation of the disease,
suggesting independent sources of infection. In any case the data are insufficent to base any
trustworthy conclusions on.
In 1898 the Medical Officer of the School Board for London directed the attention of the Board
to the presence of children in the Board's schools whilst suffering from measles. This is, unfortunately,
not an uncommon experience, children having been found in school with the rash fully out.
In a communication to the London County Council, the School Board urged that measles ought to
be declared to be a "dangerous infectious disease." No one who has had experience with the poorer
classes would deem measles to be anything else; but it so happens that it is not a "dangerous
infectious disease "at law. Consequently there are in the Metropolis no legal powers to compel
measures to be taken with a view to reduce the prevalence and mortality of the disease. To that
extent metropolitan authorities are in a more helpless position than are the provincial.
In the provinces the section of the Public Health Act, 1875, which enables disinfection to be
enforced, if certified by the medical officer of health to be requisite (Section 120), applies to any
"infectious disease," while those relating to removal to hospital, exposure of infected person, things,
&c., to any "dangerous infectious disease." There is no definition of what is an "infectious" or a
"dangerous infectious" disease except that contained in the Notification Act of 1890, and there
"dangerous infectious disease" is defined "for the purposes of this Act," i.e., for notification. The
position of provincial local authorities who have adopted the Infectious Disease (Prevention)
Act, 1890, is not quite so strong, inasmuch as the adoption of that Act repeals Section 120 of the