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18
Medical Officers of Health Annual Report.
would be required in the case of measles as compared
with scarlet fever.
As to the desirability of measles being added to the
list of diseases in which notification is compulsory, we
were requested to report by your Sanitary Committee,
and the following is the report we presented:—
The Board of Works for the wandaworth District.
REPORT OF THE MEDICAL OFFICERS OF HEALTH
AS TO THE NOTIFICATION OF MEASLES.
In regard to the advisability of adding measles to the list of
diseases of which notification is compulsory, we beg to report that
no new facts have come to our knowledge which have led us materially
to modify the views we expressed in our report presented to
you in May, 1891, and which will be found in our Annual Report
for that year.
We must admit, first of all, that we should not expect so
much benefit from the notification of measles as we do from the
notification of soarlet fever. In the first place, there is no present
provision for the isolation of measles in hospitals, nor does it
appear practicable, and efficient isolation at their homes is by no
means an easy matter in the kind of house where most of the
deaths from measles occur. Secondly, in measles, unfortunately,
the infectious stage commences before the rash, and therefore
before the disease is recognized in the majority of instances, so
that by the time we should receive the information that one child
was ill with measles there would probably be many more already
infected with it.
On the other hand, however, it is clear that the way measles
spreads, usually, is by the elementary schools, and we might expect
to be able to do a good deal to prevent that mode of spreading if
we could keep away from school all those who had been exposed
to the infection, and before they themselves had shown symptoms
actually of measles. This might largely be done if measles were
notified. All the children in a house where a case was notified