London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Paddington 1905
[Report of the Medical Officer of Health for Paddington, Metropolitan Borough of]
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MEASLES. 33
In one family disinfection was required three times. The sequence of events was—
f. 6; sickened C v.; disinfection 20 v. | f. 7 ; sickened 31 v.; disinfection 13 vi.
f. 9 ; sickened 14 vi.; disinfection 29 vi.
The second and third patients were apparently infected at a late stage of the preceding
attack, and were incubating the disease at the date of disinfection.
Looking at the facts here set out, there does not appear to be reason for holding that
disinfection is useless to stop the spread of the disease.
The provision of hospital accommodation for measles has been urged, but, while
admitting that such accommodation might be expected to save life and mitigate suffering,
there are special points connected with the disease which appear to afford strong arguments
in opposition to any proposal to provide accommodation on a large scale out of the rates.
The first point is the fact that death occurs usually very early in the attack. The fatal
cases for the past three years have been specially tabulated to show this. (See below.)
The first point is the fact that death occurs usually very early in the attack. The fatal cases for the past three years have been specially tabulated to show this. (See below.)
| Per cent. of all fatal attacks. | ||||||
|---|---|---|---|---|---|---|
| Duration of Illness. | 1903. | 1904. | 1905. | 1903. | 1904. | 1905. |
| Less than 1 week | 1 | 0 | 8 | 3 | 6 | 13 |
| Between 1 and 2 weeks | 14 | 12 | 26 | 48 | 34 | 41 |
| „ 2 and 3 „ | 8 | 9 | 22 | 28 | 26 | 25 |
| „ 3 and 4 „ | 2 | 9 | 3 | 7 | 26 | 5 |
| „ 4 or more ,, | 4 | 3 | 4 | 14 | 8 | 6 |
| 29 | 35 | 63 | 100 | 100 | 100 | |
In other words, an average of 50 per cent. (taking the three years together) of the fatal cases
ended fatally within a fortnight of the onset of the disease.
The initial stages of the disease last four days, and usually diagnosis is not arrived at
until the fifth day. It is feared that many of the cases terminating fatally within even the
second week would be too ill to be removed to hospital when the diagnosis was made. It is
very doubtful whether the removal of the remaining cases would have such an influence in
limiting the spread of infection as to neutralise the opposite effect due to the patients kept
at home.
The second point is the special characteristic of the explosive character of the outbreaks
of the disease. Epidemics recur, under present circumstances, every 18 or 20 months
(approximately each alternate year), and the duration of each epidemic is but a few weeks
During the past year the numbers of cases recorded in four weekly periods were—
Qr. 1. Qr. 2. Qr. 3. Or. 4.
Wks. 1-4... 29 cases. Wks. 14-17...151 cases. Wks. 27-30...200 cases. Wks. 40-43... 96 cases.
„ 5-8... 32 „ „ 18-21...317 „ „ 31-34... 58 „ „ 44-47...136 „
„ 9-13... 166 „ „ 22-26...417 „ „ 35-39... 33 „ „ 48-52... 56 „
This may be stated in another and perhaps more striking way :—
During the first 10 weeks of the year, the weekly totals ranged from 2 to 18 cases in a week.
10th-33rd „ „ 13 „ 114
34th-40th „ „ „ 2 „ 11
„ 41st-52nd „ „ „ 8 „ 50 ,,