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1910] 156
"In former years it has been the practice to close the infants' department
as soon as this infection made its appearance ; but this practice has not been
found to be altogether efficient, for the children, instead of mixing at school,
mixed with each other in the streets, in the parks, and in the playgrounds, and
thus, although in a much lesser degree, spread the infection.
"About 12 months ago the Local Government Board and the Board of
Education conferred together and issued a memorandum to the Medical Officers
of Health and School Medical Officers on the prevention of the spread of
infectious disease among the children attending public elementary schools, and
made the following recommendations for the exclusion of individuals suffering
from Measles:—
' Children attacked by measles should be kept from school for four weeks.
' In large towns, and in the smaller districts where the majority of
' children over seven years of age who are attending public elementary schools
' have had measles, the practice is frequently adopted, when measles breaks out
' in a household, of excluding from school attendance only those children of
' the same household who attend the infant school, and those older children
' of the same household who have not had measles. These particular children
' of the same household should be excluded from school until 21 days from the
' date of the onset of the illness of the last patient with measles m the
' house.
' The above procedure can be recommended as the result of experience
' in large districts. It is a compromise which is obviously not a counsel of
' perfection, and may need future modification.'
"In that Memorandum they point out that school closure has probably more
frequently taken place on account of an epidemic of measles than for any other
disease, but that as the closure has been commonly deferred until a large
proportion of the children are already absent, it has proved useless in populous
districts—at least for preventing the spread of the disease.
"I quite agree with this statement, because about the yeax 1885 an epidemic
of this disease occurred in Sunderland which was so severe that for a considerable
time the weekly death-rate ran very high, and finally reached a
figure equal to 47 per 1,000 per annum. Such a death-rate, I need hardly say, not
only alarmed the people of the Borough, but excited very considerable interest at
the Local Government Board, whom I kept acquainted from day to day with the
progress of the epidemic. The schools were closed and everything was done
that forethought could suggest, but nothing seemed to be of avail, and it ran