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cases are notifiable by parents or guardians ; but only the first case occurring in a house, etc.,
during an outbreak, is notifiable by the medical practitioner in attendance, an interval of two
months since the previous case constituting an outbreak.
From 1916 to 1919, these diseases were compulsorily notifiable throughout England
and Wales ; but at the end of 1919 notification was abandoned by order of the Ministry of
Health. In a few districts, St. Pancras being one, notification was retained by means of
special regulations.
During recent years measles has tended to be prevalent in alternate years. In 1923,
the number of cases was remarkably few; it was therefore anticipated that an epidemic would
occur in 1921. The disease is highly infectious, and, when occurring in a house, children
unprotected by a previous attack seldom escape. The outbreak was severe in type and was the
cause of many deaths in young children, these deaths being chiefly due to its common
complications—bronchitis and broncho-pneumonia. The great increase in infant mortality
during the past year was chiefly due to this epidemic of measles.
During the year, 4,332 cases of measles and 270 of German measles were notified or
discovered. This represents an incidence rate of 19*8 per 1,000 of population for measles
and 1*2 for German measles. Seventy-four deaths were registered as being due to measles,
69 being of children under five years of age. This equals a death-rate of 0*34 per 1,000 of
population, and a case mortality of 1*7 per cent, of cases notified. There were no deaths from
German measles.
The cases were notified or reported as follows :—
, German
Measles. ,
Measles.
Notified by medical practitioners .. .. 3307 262
„ parents and guardians .. . . 593 5
Discovered otherwise .. . , . . 432 3
4332 270
Further statistical facts in regard to the disease will be found on pages 32 to 36.
All cases where it was considered necessary were attended by a visiting nurse once
or twice a day. During the year, 408 cases of measles were nursed, 3,371 nursing visits
beiner made.