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"By using this method of inoculation it is not possible to afford a child permanent protection
against the disease, such passive immunity only enduring for a few weeks. Permanent protection
can, however, be obtained if the dose of blood or serum inoculated is just enough to allow the development
of the disease in a mild form. It is this latter method which has been successfully used abroad
and in some institutions in this country.
"It was decided to take a working-class area in Paddington comprising 23 streets in the
neighbourhood of Clarendon Street, and to endeavour to inoculate and beneficially modify the course of
the disease in all measles contacts therein. Much of the previous work in this country in controlling
measles has been done with the serum of convalescent patients. It was impossible to obtain such
material and it was decided to use the blood of parents for the inoculation of their children. The
advantage of this is that if the parents are not ill at the time, one can afford to neglect the risk of
conveying any other disease to the children, and also parents would not object to the injection of
their own blood, whereas they might possibly object to the use of serum of unknown origin. In no
case was the blood of a parent used for a child of another family. During the epidemic 200 cases
of measles occurred in the area, with 779 contacts. Of these contacts 597 had already had measles
and 78 were considered too young to be inoculated. Of the 104 left, there was in 35 cases a definite
refusal to allow inoculation; in 39 cases the parents pleaded illness or some other excuse; 8 parents
were tubercular; and 16 other cases were not dealt with for various reasons.
"Finally only six cases came to be inoculated. In two of these the disease occurred in a modified
form and in four no disease followed. This may have resulted from the dose of blood being too large
or the children may have been naturally immune.
"This research is disappointing in the sense that little positive good resulted but it is of great
value in illustrating the difficulties of applying the new knowledge of measles in actual practice.
The Medical Officer of Health states he is not aware that work of this kind has been done previously
in this country in a working-class area. The experience in Paddington should therefore be of much
interest to other local authorities who contemplate doing such work during the next epidemic, which
may be expected next year. Dr. A. B. Porteous, who has been in charge of this work will, we understand,
deal with its technical aspects in a communication to the medical journals.
"We consider this report of such importance that we have given directions for it to be circulated
to the metropolitan boroughs for their information."
Twenty-three deaths were attributed to measles, 5 of which occurred among children under the
age of 1 year, 10 among children between the ages of 1 and 2 years, 2 among children between the
ages of 2 and 5 years, and 6 among children over 5 years of age.
The Women Sanitary Inspectors visit cases of measles with few exceptions and arrange, where
necessary, for the attendance of the District Nurses.
The cases requiring nursing assistance during the year numbered 74 under 5 years of age and
12 over 5 years of age. The number of visits paid by the nurses was 1,081 and 154 to each group
respectively.
Two hundred and seventeen cases received treatment in hospital.
GERMAN MEASLES.
As is the case with measles this disease is no longer notifiable in Paddington. In the course of
the year 87 cases came to the knowledge of the Department through various sources of information.
Five patients received treatment in hospital.
OPHTHALMIA NEONATORUM.
This disease is notifiable in London under Section 55 of the Public Health (London) Act, 1891,
the London County Council having by resolution in 1911 made this section applicable to the disease.
Nineteen notifications relating to cases of purulent eye-discharge of the new-born were received
during 1934. All of the patients recovered without any impairment of vision.
As soon as a case of this disease is notified, intensive efforts are made by the Council's Staff to
ensure that proper treatment is carried out. Daily visits are paid and private or charitable medical
treatment is invariably enforced. Where necessary the infant and its mother are removed to a hospital,
provision of this accommodation being ample. All necessary nursing attention is given by home
visiting on the part of the Paddington and St. Marylebone District Nursing Association.
In addition to true purulent discharge, 3 cases of slight discharge from the eyes of infants reported
by midwives to the London County Council were referred to this Department and received attention,
no doubt preventing the onset of the more severe form of the disease.
During 1934, 3 cases were referred to the District Nursing Association, 40 visits being paid.
Eighteen cases of ophthalmia of the new-born were treated in hospitals as in-patients.