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49
such an early age ; whilst the facts that Measles is a disease
which is highly infectious in its very early stages [i.e.,
before the appearance of the rash and, therefore, before the
true nature of the disease may be realised), and that medical
men are not called in or consulted at all in a large proportion
of the cases, must not be forgotten. It is perfectly
true that measles causes a large number of deaths yearly,
and it is also true that the notification of Measles might be
useful in the sense that infected houses would be visited,
and insanitary conditions (when found) remedied, children
more rigorously (than at present) kept from school, infected
houses be disinfected, and the Officers of a Sanitary
Authority brought more into contact with the mothers of
infected children, and so a process (slow though it might
be) of education in sanitary matters, and in the dangers and
proper treatment of Measles, result; but whether the good
that would accrue in this way would be at all proportionate
to the expense, is quite another matter, and one that needs
the careful and serious consideration of an Officer of Health
before he ventures to advise his Authority to incur it, more
especially when we consider the peculiarities of this
particular disease and the difficulties, already pointed out,
in connection therewith. Further, a large increase in the
sanitary staff would be necessary for the purpose of carrying
out this additional inspection of Measles-infected houses,
and for the proper carrying out of the subsequent disinfection.
To sum up the matter shortly, it may be stated that
simple notification of Measles is not advisable, and that
notification followed by isolation, disinfection, etc., impossible
at present (at least in London), conclusions which
appear (to me at least) to be borne out by the experience
of those Sanitary Districts that have already adopted
D