View report page

47
In the distribution of measles mortality in London throughout the year 1902 the highest
death-rate obtained in Bermondsey (1.17) and the lowest in Stoke Newington (0.10). The
measles death-rates in London in the four quarters of the year were as follows—first quarter 0.64;
second quarter 0.62; third quarter 0.30, and fourth quarter 0.46 per 1,000 living.
The following table shows the number of deaths from measles at several age periods in
each of the metropolitan boroughs. For the purposes of this table deaths occurring in public
institutions belonging to London have been distributed to the sanitary areas in which the deceased
had previously resided.

The fact that measles is highly infective for some three days before the eruption manifests
itself militates seriously against the success of efforts made to limit the spread of the disease.
Medical officers of health receive from school teachers information of any cases of measles
occurring in the families of children attending schools, and such scholars are excluded from
school attendance for a period of three weeks. The number of cases which thus became known
in 1902 to medical officers of health is stated in some of the annual reports thus—In Paddington
information was given of 559 cases, in Hammersmith of 293 cases, and in Westminster of 294
cases. In Shoreditch 776 children were excluded from the Board Schools, either because the
scholars suffered from measles, or because the disease was present in the houses in which the
scholars dwelt. The disease rapidly spread in the infant classes of schools, and in particular
instances the class or department was temporarily closed for this reason. In Deptford the
infants departments of four schools were closed for three weeks in December. In Woolwich,
class-rooms for the whole infants' department were closed in three schools in February, in one
in March, in two in April, in three in May, in one in June, in one in October, and in one in
December. In Lambeth the attention of the medical officer of health was directed to the prevalence
of measles in two schools, but it was found that the number of cases occurring was
declining, and it was not, therefore, thought necessary to close the schools.
With a view to obtaining better knowledge of the value of school closure for the
limitation of measles, Dr. Kerr, the medical officer of the London School Board, has arranged
with Dr. Davies, the medical officer of health of Woolwich, for observation of all known
cases of measles in the houses, which with the necessary observation of the behaviour of
measles in the schools will be helpful in determining this question. Record is also being made
of the number of children at different ages who have already been attacked, and Dr. Kerr finds
that of 800 children at five years of age in seven schools 375 had been attacked before coming to
school, and 207 subsequently; while of 899 children at six years of age, 413 had had measles
before coming to school and 303 subsequently. These proportions might be expected to vary in
different years, for in London, every two or three years, measles attains increased prevalence,
attacking the susceptible children who have accumulated in the interval. It is not probable
that efforts made to limit the spread of measles will do more than postpone the age of attack,
but it may be expected, if this result can be attained, that the mortality of measles would be
diminished. In the decade 1851-60, and subsequent decades, the proportion of deaths under five
years of age from measles has ranged from 92.5 per cent. of the measles deaths at "all ages" to