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74
"5. To effect any useful purpose school closure must take place before
the 'first crop' falls. The old practice of waiting until the
attendance fell to a certain limit was useless in arresting the
spread of measles, and did absolutely no good.
"6. The means of arresting spread of measles other than school
closure are of enormous importance; to name two - sanitary
buildings and training of teachers; these two factors probably
have the greatest effect of all in determining the extent of
spread of an outbreak.
"7. Deaths often occur from ignorance on the part of parents.
Circulars should be sent out wherever measles has appeared in
a class (i.e., on the incidence of the first case) begging
mothers to notice colds, and upon the slightest suspicion of such
symptoms to keep the child at home for a day or two. In this
way measles would probably be checked to a far greater extent
than has been effected by any other means. Instances have
come to our notice where heartbroken mothers have stated that,
had they known, they would have treated colds seriously of
which they took no note, and thereby their children's lives
would have been saved. I suggest that circulars be thus used
during next year in Woolwich.
"8. Measles never spreads in the boys' and girls' departments. There
is no need to exclude children from infected homes who attend
the upper department. As a result of our inquiries this has
actually been carried out at Brighton with satisfactory results.
"9. There is too great a tendency to look at things from an
'attendance' standpoint. This is one of the greatest evils with
which we have to contend. The withdrawal by the Board of
Education of Article 101 was the greatest piece of official folly
ever perpetrated. If a whole department is closed, the average
attendance is not affected; but if, on the score of health, a single
class is closed by order of Sanitary Authority, or by the Council's
Medical Oificer, it is supposed that the attendances are missed,
and the effect upon the average attendance and consequent
grant is enormous. We thus have great difficulty in carrying
out our measures, as much opposition is often encountered to
the necessary closure of a single class, while the unnecessary
closure of a whole department is gladly borne or even welcomed.
"10. This is an economic question, which is not one of health at all;
and, when attendance lias fallen to a certain percentage at which
the loss of grant is so severely affected, the department should
be automatically closed independently of the question of health.
This percentage ought to be worked out."
In a Paper upon "The Control of Measles, and the Results on Inquiry into
the Benefits of Early School Closure," l.y l)r. Sidney Davies, .Medical Officer
of Health, Woolwich, in association with Dr. C. J. Thomas, Assistant Medical
Officer (Education), London County Council, read at the Second International