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The main incidence of the outbreak was upon the Church and
Palatine Wards and although much sickness was occasioned there
was fortunately comparatively little mortality from the disease, and
it is believed that the handbills were of value in preventing the
Parish from swelling the thousands of preventable deaths from
Measles which are registered in London alone, each year.
Whereas I acknowledge with gratitude the willing assistance
rendered me by the head teachers of the Board and other schools in
ascertaining the number and addresses of the absentees from
Measles and Whooping Cough, I consider it a matter for regret
that the Regulation of the School Board for London, requiring that
the Medical Officer of Health of the District shall be informed of a
child's exclusion on account of symptoms of infectious disease, is
not given effect to as a routine practice, for it would often materially
assist the Medical Officer of Health in taking more prompt measures
to remove further risks of school infection.
TYPHOID FEVER.
Of the 18 cases notified during the year, all occurred in different
houses, in two of which there were grave insanitary conditions; in
one the insanitary conditions were slight, and in the remaining 24
there were no insanitary conditions. Two of the cases doubtless
contracted the disease outside London.
SMALL-POX AND VACCINATION.
The year has been a most momentous one with reference to
vaccination.
The Vaccination Act of 1898 was passed in a form which
differed in many important respects from the Bill as originally
introduced. The change in the age limit for primary vaccination
from three months to six months is on the whole advantageous, as
it removes the sentimental objection to submitting an infant to the
operation at a very tender age, and vaccination will not now be so
generally ascribed as the cause of those congenital diseases which
first show symptoms at about the third and fourth months of life.
The provision for vaccination being performed in the houses of the
children is also good, for doubtless the mingling of children in