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of inspecting and excluding children at the earliest moment, with the result that although 13 cases
out of 27 unprotected failed in the first outbreak in the Class II. in which it was introduced, yet 14
cases only out of 47 unprotected occurred in the babies' class, a result which compares favourably
with those obtained by school closure (diagram XIX).
A fresh importation of measles took place at the end of October, but, in face of the knowledge
and energy displayed by the head mistress, failed to get a foothold.
The Slade School.—At the end of September an outbreak began at this school, which spread
throughout the neighbourhood. The initial case was in a child of 5 who came from a Guardians
Home. She had only been admitted to the Home and to the school a few days ; she was noticed
ailing in school on September 26th. Through carelessness or mismanagement at the Home the school
authorities were not apprised of the nature of her complaint, and thus an outbreak commenced
which affected four schools, produced 207 cases that came to light, and occasioned 14 separate acts
of closure of classes or exclusion of non-protected children. Thus a single case which was not
immediately known of, in spite of most vigorous action quite early in the outbreak—immediately
upon the occurrence of the next two or three cases, in fact—produced an amount of illness and death
which was appalling. This serves to show what kind of an enemy measles is to fight, and how little
can be done if it gets the first advantage and forces us to act upon the defensive.
The first crop that arose from the seed thus sown came down in the form of 8 cases, distributed
in the Classrooms III. and IV. (diagram XX.), and mainly amongst children from the Home (who
attended in those two classes almost entirely, and who through negligence had been allowed to
continue to attend). Both these classes were closed from the 16th to the 24th of October ; it was
hoped that this would catch the second crop, but, unfortunately, the later cases, on October 10th, of
the first crop had not been heard of, and the second crop had not quite finished coming down when
the classes re-opened, and the two classes had to be again closed ; although, as a matter of fact, as
is usually the case, the second crop had exhausted the material in these classes, and during the
lengthened second closure only one case in each class failed. In Class III., this was the only case
which remained to have it, for 23 out of 24 possible had already contracted the disease during the
first and second crops. During the second crop period a solitary case occurred in Class II., on
October 21st, and this class was closed as soon as this was known (from October 27th to November
8th), again, however a case failed (on November 9th) after resumption, and a second closing period