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The methods adopted for the limitation of dangerous infectious diseases are not as yet in
the same degree available for the limitation of measles. There is no obligation on the medical
practitioner or the householder to notify measles; hospitals have not been provided for the isolation
of persons suffering from measles; nor is it illegal to expose such persons in a public place;
and further, the sanitary authority has no power to require the disinfection of a house which has
been occupied by a person so suffering.
Information as to the occurrence of measles in the homes of children attending the London
School Board schools, and which becomes known to the teacher, is required by the Board to be
given to the medical officer of health of the district, whose authority when this is done promptly, is
able usefully to exercise its powers of exclusion from school of particular scholars, or to temporarily
close the school or part of the school. With respect to disinfection, sanitary authorities
often give opportunity for the disinfection of a house if the occupier be willing to permit this to
be done.
The report of the medical officer of health of Paddington states that 1,191 cases of measles
were brought to his knowledge in 1900, the number of deaths in the district in that year being
50; the medical officer of health of Islington received notice of 1,619 cases of measles, the
number of deaths in that district being 161; in the Strand district 50 cases were reported, the
number of deaths being 5. In other districts the number of children excluded from school
attendance on account, of measles is given, but the actual number of cases of this disease known to
the medical officer of health is not stated. The facts as to the three districts mentioned show that
the number of cases kuown to have occurred to each death was as follows—
No. of cases
District. per death.
Paddington 24
Islington10
Strand 10
Average 13
For the purposes of comparison similar proportions may be given for Edinburgh, where
the notification of cases of measles was obligatory. I extract the number of cases from a
paper by Dr. Harvey Littlejohn on "Ten Years of Compulsory Notification of Infectious Diseases
in Edinburgh," using those years for which I can find the number of deaths from measles
occurring in Edinburgh stated in the annual summary of the Registrar-General for England.
The following figures are thus obtained—
No. of cases of
Year. measles per death.
1882 46
1883 22
1884 26
1885 50
1886 32
1887 51
1888 38
1889 33
Average 32
It is probable therefore from these figures that the cases of measles occurring in London
which became known under existing arrangements were but a small proportion of the total cases.
The information obtained from school teachers is, moreover, not continuous, for it is necessarily
interrupted during the school holidays.
The constitution of new administrative bodies in London under the London Government
Act of 1899 led the London County Council to renew with the several borough councils the
proposal that measles should for certain provisions of the Public Health (London) Act be declared
a dangerous infectious disease. The following letter was accordingly addressed to them—
Spring Gardens, S.W.,
1st December, 1900.
Sir,
I am directed to inform you that the Public Health Committee of the Council have under consideration
the question whether it is advisable that the Council should include "Measles" in the term
" Dangerous and Infectious Disease," for the purposes set out in the following sections of the Public
Health (London) Act, 1891—
Section 68, which prohibits, under a penalty, the exposure of infected persons and things.
Section 60, which gives power to sanitary authorities to require the cleansing and disinfection
of infected premises, and the disinfection or destruction of infected articles, and contains other
provisions as to compensation and shelter during disinfection.
Section 61, under which sanitary authorities can require bedding, clothing, etc., to be delivered
up to them for disinfection, and must pay compensation for any unnecessary damage.
Section 62, which prohibits, under a penalty, the casting of infectious rubbish into ash-pits
without previous disinfection.
Section 63, which prohibits, under a penalty, persons from knowingly letting houses in
which infected persons have been lodging, until such premises have been disinfected.
Section 64, which provides for a penalty on persons letting houses who make false statements
as to infectious disease.
Section 65, which provides for a penalty on persons ceasing to occupy houses without disinfection
or notice to owner, or making false answer.
Section 66, which provides for the removal to hospital of infected persons without proper
lodging.