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17
The reasons for making an infectious disease notifiable are to study its incidence and to
check its prevalence. So far as the former is concerned we already know almost everything
about chicken-pox that notification can teach us and the incidence of the disease as regards
season, climate, age of patient, social status, etc., has been thoroughly studied already. The
disease itself can neither be cured, nor do we know any method of protecting against the
disease by vaccination or inoculation. It is not notification, but laboratory research which
can help us to find a means to control chicken-pox.
All we can do when a case of chicken-pox is notified is to send a sanitary inspector to the
house to give general advice about the spread of infection. Owing to the extreme infectiousness
of the disease this advice has very little effect in preventing the disease from spreading
through a family. If notification were effective one would expect the disease to decline in
prevalence ; such is not the case, the number of notifications being substantially the same in
1925 as in 1923. One would also expect Paddington to have less chicken-pox than neighbouring
Boroughs without notification. Figures are not available for comparison, but it is evident
that Paddington with notification is little or no better off than Boroughs without notification.
I can see no valid reason for continuing the compulsory notification of chicken-pox, having
in view the expense necessarily incurred by such a measure.
The question of continuing the compulsory notification of chicken-pox was still under consideration
at the end of the year.
Chicken-pox is not usually nursed in an institution, but in 20 cases removal to an institution
was effected for various reasons.
TYPHOID FEVER.
Twelve cases of this disease were notified in 1926, of whom 3 apparently contracted the disease
abroad. Possibly a few of these cases proved to be mistakes in diagnosis.
Two cases were certified as having died from typhoid fever.
It is not often possible to trace the source of infection in typhoid fever.
MEASLES.
Measles has been notifiable in the Borough since 1914 under various Orders and Regulations,
those at present in operation being " The Metropolitan Borough of Paddington (Measles and German
Measles) Regulations, 1920."
The only other part of London in which measles is notifiable is the Port of London, but sections
60-65, 68-70 and 72 of the Public Health (London) Act, 1891, were extended to measles as a dangerous
infectious disease throughout the County of London by order made by the London County Council
on April 1st, 1903. The effect of this order is to enable local authorities to disinfect after measles
and to safeguard the public in several ways against spread of infection.
In addition to the cases medically certified a number of cases come to the knowledge of the Department
through reports from schools, parents, etc.
There were, in 1926, 1,931 cases certified by medical practitioners, and 549 cases reported from
other sources, the corresponding figures for 1925 being 1,254 and 296.
The number of reported cases is analysed in the adjoining table in 4 weekly periods for the various
wards. A measles epidemic commenced in November and December, of 1925, and reached its height
during January, of 1926. This epidemic declined in intensity during February, and matters then
slowly improved until August, when the disease had almost disappeared. Only occasional cases
were reported during the rest of the year.
The women Sanitary Inspectors visit cases of measles with few exceptions, and arrange, where
necessary, for the attendance of the District Nurses. During 1926 the Inspectors' visits totalled 2,705.
One hundred and sixty cases of measles in children under the age of 5 years were visited by the
District Nurses, the number of visits paid being 1,397.
Forty cases over the age of 5 years were visited by the District Nurses, the number of visits being
265.
Two hundred and twenty-five cases of measles were removed to hospital during the year. It
was learnt during the year that the Metropolitan Asylums Board propose to provide accommodation
for increased numbers of measles patients.
The number of deaths from measles was 34, 31 being of persons under the age of 5 years. Measles
is a disease which is apt to be fatal to young children, and even when recovery ensues the disease is
often followed by a period of ill-heath or debility.