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The cases reported do not, unfortunately, represent the full number of attacks, the disease
not being notifiable and the sources of information as to its occurrence being limited, mainly, to
the public elementary schools. All teachers are not equally careful to report the cases known
to them, and information of cases during the school holidays is dependent on the Staff of the
Department hearing of the attacks in the course of their other duties. It is, however,
believed that the cases reported represent a fairly constant proportion of the total—that is
suggested by the approximately constant fatality rates—and, what is of more importance, the
cases known are those which require the assistance and advice which the Officers of the
Department are able to give. The largest proportion of missed cases are believed to occur
in the southern Wards, where medical advice is more freely sought.
The average number of cases to a house was 1.9 in 1907, compared with 1.8 in 1906, 1.7
in 1905 and 1.8 in 1904 and 1903. The percentage of secondary to all cases was 46.0 last
year; 44.4, 44.1, 47.1, 44.6 in the years 1906 and backwards.

The deaths recorded during the year numbered 37, an increase of 21 above the total for
the preceding year, and included 20 of males and 17 of females. The deaths certified as due
to measles do not represent the total mortality due to that disease, but inquiries are made
wherever the omission to mention measles as a cause of death has been suspected. A fatal
issue may follow an attack of the disease after a considerable interval, when the original
cause has been lost sight of and the death is certified as due to some secondary cause instead
of being attributed to the primary (measles). Corrections for such omission are impracticable,
and the fatality of the disease based on the known cases and the deaths certified as due to it
must be accepted.
The 1,284 known cases and the 37 deaths represent a fatality equal to 2.8 per cent. of the
cases. Having regard to the fact that there was an epidemic during the year and to its
occurrence in the fourth quarter, that fatality is satisfactorily low. Evidence is wanting as to
the true fatality of the disease, the estimates published varying from 2 to 10, or even, in
certain epidemics to as high a figure as 40-50 per cent. During the five years 1903-07, 5,415
cases have been reported, and 194 deaths registered as due to measles, which figures give an
average fatality of 3.5 per cent. That rate is undoubtedly too high, and it is probable that
the true rate for the Borough would be somewhere about 2 per cent. Apparently the disease
is more fatal among males than females, as appears from the appended figures:—(See next page)