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88
The question arises now whether the Act would be equally effective in
the case of measles. On account of the peculiarities attending the
course of this disease, especially its very great infectiousness during
the preliminary stages, when the children are still attending school,
we are unanimously of the opinion that we could never control
epidemics of this disorder to the same extent as in the case of the other
diseases under the Act. But although we could not expect as much
benefit from its notification as in these other cases, it would undoubtedly
enable us to control and limit the dissemination of the
disease to a certain extent. We would then be in a better position
to prevent children from infected houses attending school, who would
otherwise become in their turn centres for spreading the contagion.
It would also assist us to have isolation and disinfection carried out
much more efficiently than can be done at the present time.
This would, doubtless, especially in the presence of an epidemic,
involve a large amount of additional work and expense, and probably
an addition to the sanitary staff.
In considering the question whether the benefit obtained would
be commensurate with the additional labour and expense, we desire to
point out that there is a mortality attending this disease much greater
than that from scarlet fever. In our Annual Eeport for 1888 we drew
attention to this grave fact in connection with the incidence of measles,
and the same thing is borne out by the Registrar General's last
Annual Eeport. During the year 3,291 deaths occurred from measles
and only 784 from scarlet fever. From these figures we infer that
there must have bean during these twelve months wide spread
epidemics of measles throughout the Metropolis, as it is a matter of
common experience, that comparing case with case, measles is not
attended with such serious results as follow scarlet fever. This great
mortality is a matter therefore for serious consideration, and is to be
regretted the more as it is the direct result to a very large extent of
carelessness and want of medical supervision.
In comparing the mortality of these two diseases during the last
ten years, it is very remarkable to notice the diminution attending
that of scarlet fever and the increase in that from measles. This
diminution in the former has coincided in point of time with the
greater number of admissions into the Asylums Board Hospitals. In
other words, as isolation has been carried out more effectively the
number of deaths has rapidly diminished. "We have good reason to
believe that a similar result would follow if isolation could be carried
out in the case of measles, and we are of the opinion that such could
be done to a much larger extent than obtains at the present time if
each fresh case were at once notified to the Medical Officer of Health.
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