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The annual reports of medical officers of health contain the following references to the spread
of measles by schools—
Hampstead.—"Measles occasioned 58 deaths, and proved to be the most fatal cause of death
among the zymotic class. . . . The epidemic commenced in this parish towards the end of 1895,
and attacked large numbers of young children in the Netherwood Board School, spreading from that
centre to the children's homes in the adjacent streets."
Islington.—The medical officer of health gives account of the effort made by him to obtain
information as to measles which was prevalent in Islington, and especially prevalent in South.West
Islington, in the first quarter of the year. A circular letter was issued to the head teacher of every
school in the south.west registration sub.district, recommending that children attending the infant
school should be carefully examined with the object of excluding children suspected to be suffering
from this disease. The principal symptoms to be looked for were specified. A leaflet accompanied this
letter, in which advice was given as to the steps to be taken by head teachers with the object of
lessening the risk of prevalence of measles among school children. This circular and leaflet became
matter of correspondence between the London School Board and the Islington Vestry, the Board
informing the vestry "the Board have issued instructions to their teachers on the question of dealing
with infectious illnesses, and expect their teachers not to take orders from any other body or person."
The correspondence was forwarded by the Vestry of Islington to the Local Government Board, whose
reply contained the following paragraphs—
In reply, I am to inform the vestry that since the circular which was issued with the medical
officer of health's letter of the 16th January last to the proprietors of schools, school managers and
teachers, and which appears to have been limited to the case of measles, was only in the form of advice
and recommendation, the Board consider that the medical officer of health merely fulfilled his duty which
devolves upon him under article 18 (6) of the Board's General Order of 8th December, 1891.
I am at the same time to state that in view of the instructions to which reference is made in the
letter of the clerk to the School Board of the 4th ultimo, and which, as the Board assume, relate to cases
of notifiable disease as well as to those which are not notifiable, it may be well for the vestry, in dealing
with the subject of infectious diseases of the former class, to consider whether, as regards cases in which
they may in the future be advised that the exclusion of particular children is desirable, they should not
rely on the exercise of their powers under article 88 of the Education Code. I am, however, to add that
in any case where the medical officer of health finds it expedient to take such action as in the present
instance, the Board consider that it is very desirable that he should communicate with the medical
officer of the School Board on the subject, with a view to secure, as far as possible, his co.operation in
the matter."
To the statement in the last paragraph that the medical officer of health should communicate
with the medical officer of the School Board the medical officer of health of Islington takes exception
as involving delay. He refers moreover to the following regulation of the London School Board for
the guidance of managers, correspondents and teachers, and states that the information indicated
therein did not reach him.
II.—Any child showing symptoms of an infectious disease, or any child coming from a house where
an infectious disease exists, must be sent home at once and the superintendent of visitors must be
immediately informed of the case, in order that enquiries may at once be made with a view to proper
steps being taken to prevent the children living in the same house or tenement from attending school.
The medical officer of health for the district must also at the same time be informed of the child's
exclusion, and furnished with the name and address of the child and the reason of its exclusion on a form
with which the teachers will be supplied by the head office.
Hackney.—The medical officer of health writes.—
During the year one of the schools under the control of the London School Board was closed owing
to an outbreak of measles amongst the scholars attending it. My attention was called to the circumstance
immediately prior to the closure of the school. I made some enquiries, which resulted in the following
particulars:—As far as I could ascertain the first cases appeared in the infants' school about the 18th
May. After a few days—about a week—the disease appears to have spread rapidly, so that on the 14th
of June, when the department was closed, no less than 65 infants were absent owing to this cause. The
disease seems to have been introduced into the boys' and girls' school later, about the first week in June.
Here it also spread rapidly, so that by the 17th of June, when this department was closed, 46 scholars
were absent owing to the disease. Not all of the absentees were suffering from measles—some being
excluded owing to other members of their family being ill with the disease. The boys' and girls' school
was re.opened on the 22nd of June. In this school the effect of closure was not very marked, for I find
55 scholars still absent on the 30th of June. The infants' school was closed for a longer period, re.opening
not taking place until July 5th. Here closure seems to have been more effectual, for I learned on enquiry
that only two scholars were absent on the 15th of July.
This subject of school closure requires much more thorough study than appears hitherto to have
been given to it, if the greatest amount of benefit in the prevention of disease, with the least amount of
interference with school studies, is to be obtained.
Strand.—The medical officer of health reports as follows—
Measles was very prevalent in the district in the early part of the year. During the first quarter the
outbreak was worst in St. Anne's sub.district, but during thesecona quarter it was very severely felt in
the Strand sub.district; and it became necessary to require the exclusion of the children in affected
houses from the schools under section 88 of the Day School Code.
Shoreditch.—The report of the medical officer of health contains the following paragraphs—
"On May 20th, my attention being called to the number of children on the roll of the infants'
department of the Catherine.street Board School who were absent through illness, I visited the school
and ascertained that between 40 and 50 per cent. of the children were absent owing to illness from
measles and mumps. The question arose as to the closure of the infants' department. So far as
mumps was concerned, being a disease involving little or no danger to life, the interests of the school
were principally to be considered, and beyond the exclusion of infected children, no further action
would be required. With regard to measles, however, the case is different. Having ascertained that
measles was the prevailing complaint, the infants' department was kept under observation for a few
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