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27
Ages 0-5.
"All ages."
Order.
Metropolitan Borough.
Measles
death rate.
Order.
Metropolitan Borough.
Measles
death rate.
13 Poplar 4.00 London 0.43
14 Hackney 3.88 13 Kensington 0.43
15 Finsbury 3.83 14 Hackney 0.43
16 Deptford 3.75 15 Hammersmith 0.42
London 3.70 16 Lambeth 0.40
17 Lambeth 3.39 17 Holborn 0.39
18 Hammersmith 3.05 18 Westminster, City of 0.32
19 St. Paneras 2-65 19 St. Paneras 0.29
20 Wandsworth 249 20 Fulham 0.28
21 Lewisham 2.07 21 Wandsworth 0.28
22 Stoke Newington 1.69 22 Lewisham 0.24
23 Fulham 1.63 23 Woolwich 0.18
24 Woolwich 1.45 24 Stoke Newington 0.16
25 Chelsea 1.44 25 Chelsea . 0.12
26 St. Marylebone 0.72 26 St. Marylebone 0.07
27 Paddington 0.55 27 Paddington 0.06
28 Hampstead 0.16 28 City of London 0.04
29 City of London — 29 Hampstead 0.01
In thia table where — is inserted no death occurred.
The order of the boroughs, therefore, in relation to measles mortality at "all ages"
is considerably altered if the mortality at ages 0.5 be adopted for purposes of comparison.
Thus Kensington, which is 13th in order among the boroughs in the "all ages" comparison,
takes 3rd place in the "0.5 ages" column. Bethnal-green, Stepney and Deptford, which
occupy the 3rd, Gth, and 10th places, respectively, in the "all ages" column, are more favourably
situated in the 0.5 age column, their respective places being 7th, 12th and lGth. Again,
it will be seen that the measles death rates at "all ages" of Holborn and Westminster are
below the London average, while the death rates for these districts at ages 0.5 are considerably
above the London average. Generally speaking, the age constitution of the poorer and more
overcrowded boroughs tends to place them in a less favourable position when the measles death
rates at '' all ages " are compared than when the death rates at ages 0.5 alone are considered.
The subject of measles is, as a rule, only dealt with statistically in many of the reports of
medical officers of health relating to the year 1901.
Referring to the letter of the London County Council of the 1st December, 1900, asking
the several sanitary authorities whether they were in favour of extending to measles the provisions
of the Public Health (London) Act other than notification relating to dangerous diseases,
the medical officer of health of Kensington states that in the early part of 1901 the borough
council intimated to the County Council that they were in favour of the sections of the Public
Health (London) Act which prohibit the exposure in public places of persons suffering from an
infectious disease being made applicable to measles. The medical officer of Westminster states
that the medical officers of health of the constituent districts of the borough reported in favour
of the extension to measles of the several provisions other than notification. The medical officer
of health of Finsbury reported in the same sense and his report was adopted by his committee.
A similar report was presented by the medical officer of health of Lambeth. The medical officer
of health of Camberwell held a different opinion. He states that he thinks that if measles be
added to the list of dangerous infectious diseases there should be no partial application, but that
notification should be included, and this he did not recommend.
Dr. McCleary, the medical officer of health of Battersea, refers to the frequency with
wbich serious pulmonary affections complicate the disease, particularly in persons who are not
carefully nursed, and he adds that it is much to be regretted that there are no hospitals provided
to which children suffering from measles could be removed from overcrowded and insanitary
houses. It is noteworthy that of nearly 2,000 deaths from this disease in London during 1901
onlv 226 occurred in public institutions. If severe cases which cannot be properly cared for
in their own homes were treated in hospital there is reason for thinking that better results
would be obtained than at present. Hospital provision for measles should no doubt be thought
of as relating to the treatment of such cases, and not to the isolation of infectious persons
with a view to controlling the prevalence of the disease.
Medical officers of health are, in the main, dependent upon the teachers in the elementary
schools for information concerning the incidence of measles. The London School Board
requires its teachers to give such information, and this instruction appears to be more fully
acted upon than before. Thus the medical officer of health of Islington states that in 1901 he
learnt from this source of 2,772 cases of measles, and he reports that the measures he is able to
adept have a decided effect in preventing its spread in the schools. In Hammersmith 193 cases
became known to the medical officer of health, but 50 cases were unknown to him until after
death. In Westminster 230 cases were reported in the north-eastern part of the city, and Dr.
Alk.n states the disease was probably prevalent in the south-western district, but the system of
notification was not fully adopted at the time. In Shoreditch 326 oases were reported. In
Ifolborn the borough council invited the managers of all voluntary schools to forward lists of
all children absent or excluded on account of measles. In several districts handbills were distributed
explaining the precautions which should be taken to prevent extension of the disease.