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days and it being found that the number of absentees through measles continued to increase I put
myself into communication with the medical officer of the School Board, who informed me on the
29th that the infants department had been closed. The department was closed for three weeks, and so
far as I have been able to ascertain, with beneficial results with regard to the prevalence of measles in
connection with the school."
Poplar.—The medical officer of health of Poplar and Bromley states that "a large number of
children at one time of the year were away from Cubitt.town board school with measles, but there was
no need to take steps to close the school."
Wandsworth.—The medical officer of health of Putney and Roehampton reports as follows—
On the 25th February the National schools in both Putney and Roehampton were closed for three
weeks and at the same time the managers of the various Sunday schools were requested to do the
same. The closure of the elementary schools is the only effective means in our power of putting a
stop to the spread of these epidemics. In this case it was followed by a marked diminution in the
number of cases. Unfortunately the closure of schools cannot come in force at so early a period as
we could wish, as we have no certain means of knowing to what extent it is epidemic, and are sometimes
made aware of it only when the certificates of death resulting therefrom are registered.
The medical officer of health of Wandsworth states—
The public schools were, as is usually the case, the principal means of spreading the disease, and
I advised that the infant department of the schools chiefly affected should be closed for a period of
three weeks. The infants' departments of Waldron.road, Garratt.lane and Swaffield.road schools were
closed from the 14th of May to the 8th June, and the same department of Eltringham.street school from
May 22nd to June 15th. Standard I. department of the last school was also closed from 29th May to
15th J une. These measures seemed to have a beneficial effect, as only three deaths occurred after the
10th of June.
On the subject of notification of measles the following opinions are expressed—
Plumstead.—The medical officer of health writes—
The primary schools are the great means of spreading the infection of measles, and it is probably to
the school managers and teachers that we must mainly look for contending with the spread of infection.
The present School Board regulations are excellent as far as they go, but they do not go far enough.
The teachers of the various schools act independently, and are neither in communication with each other
nor with the medical officer of health. I have therefore proposed a school notification of measles, viz., that
teachers should send me word of any children they exclude from school on this account. If this were
done I should know at once when measles was prevalent among the children of any one school, and in
special cases should know ill,time when it was wise to recommend the closure, say of the infant department
of a school, a proceeding which I have no doubt might at times greatly assist in staying an
epidemic. I should also be able, in cases where children in one house attend two or more schools, to
warn the teachers of the other schools to exclude those children. The health committee approved of my
recommendation, and I found that the great majority of the teachers would willingly co.operate in the
proposed plan. The vestry has not yet, however, authorised me to incur the small expense requisite for
printing notification forms, &c. I would again strongly urge that no moderate expenditure should be
allowed to weigh against the health and lives of the children of the parish.
Paddington.—The medical officer of health thus writes—
What the sanitary authority requires, to be in a position to cope with the disease, is a knowledge of
the first case in each house or family, so that the children may be excluded from the schools, the families
kept under observation, and the necessary disinfection carried out. Notification of the first case in the
family by the medical practitioner, when called in, and systematic reports of absentees by school
teachers are the most promising methods of keeping the sanitary authority in touch with the disease.
Hospital isolation would, except under special circumstances, appear to be unnecessary. Having regard
to the highly infectious condition of the patient from the first onset of symptoms, before even a diagnosis
can be made, removal to hospital does not afford much promise of effect towards limiting the spread of
infection.
Kensington.—The medical officer of health refers to a previous report by him on this subject in
which he expressed the opinion—
That it would be little or no use to have notification of measles unless hospital accommodation was
provided on a large scale for the use of the sufferers therefrom.
Fulham.—The medical officer of health refers to a previous report by him in which he expressed
the opinion—
That, at any rate, a modified system of notification of measles should be tried, by which the first
attack in every house invaded shall be notified, but no subsequent case arising in the same house within
thirty days.
Westminster.—The medical officer of health writes—
During the past year the attention of the Public Health Committee has been directed to the question
of compulsory notification of this disease, by more than one metropolitan sanitary authority ; but having
had practical experience in the matter of notification of measles the committee have decided to take no
action in the matter.
Hampstead.—The annual report of the medical officer of health contains the following
paragraph—
The question as to the desirability of adding measles to the list of infectious diseases notifiable under
the provisions of the Act has been considered by the Public Health Committee more than once. Having
regard to the general susceptibility to measles, the young ages at which children are attacked, and the
highly infectious pre.eruptive stage, when it is difficult to distinguish the complaint from an ordinary
catarrh, it did not appear that the advantages to be gained were adequate, or that public opinion was
ripe for the measure. With notification must go hospital isolation, and it is probable that if measles is
to be provided for by the Asylums Board, the present accommodation of beds would have to be
doubled.