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The following table shows the number of deaths from measles at several age-periods in each
of the sanitary areas. 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.
(See footnote (1), page 7).

The number of deaths from measles in London in 1904 (2,256) shows some increase upon the
number of deaths in the preceding year. In 1903 the Order of the County Council came into force
extending to measles all the more important provisions of the Public Health (London) Act relating to
dangerous infectious diseases, except that requiring notification. These new powers were therefore in
force during the whole of the year 1904. Jt is, of course, impossible to expect that the principal object of
the Order, viz., the education of the public in the knowledge that measles is a dangerous infectious disease,
will be attained for some considerable period, but already it is satisfactory to note that progress is being
made in this direction. Thus Dr. Reginald Dudfield writes in his annual report relating to Paddington:
"After a year's experience of the working of the Order it can be said that one effect has been to impress
on the minds of a large section of the community the fact that measles is not a disease to be trifled with,
and there is little room for doubt that greater care is now exercised in dealing with the disease." Again,
Dr. Annis, the medical officer of health of Greenwich, writes; "I certainly think that the steps now
adopted in reference to this disease will help to educate the public up to understanding that this
disease is really one of a very dangerous character, for whilst the municipality took no steps to deal
with this disease, the public very naturally were inclined to think that the disease therefore was of a very
trifling character."
In discussing the administration aiming at the limitation of measles, the desire that notification
of cases should be required is expressed by some of the medical officers of health, but this desire is not
unanimous. Information given by school teachers as to the absence of children from school on account
of an attack of measles is necessarily imperfect, and is, of course, suspended during the holidays. Moreover,
it is pointed out that there is difficulty in enforcing the provisions of the Public Health Act which
apply to measles, for the reason that often when offences are committed the nature of the disease
cannot be proved. Dr. Reginald Dudfield writes on this point: "A decision given in at the Marylebone
Police Court has shown that the penal clauses of the Public Health (London) Act, cannot be enforced
in the absence of medical evidence as to the nature of the illness. An admission on the part of the
parent or guardian that he (or she) knew the patient had measles was held to be insufficient evidence
for a conviction." In cases of measles, however, very frequently no medical man is in attendance.
In the annual reports relating to the following districts the number of cases of measles brought to the
knowledge of the medical officer is stated thus :—Paddington, 896; Hammersmith, 742; Fulham, 831;
Chelsea, 251; City of Westminster, 181; St. Marylebone, 980; Hampstead, 741; Islington, 355;
Hackney, 1,121; Holbom, 444; Finsbury, 802; Bethnal Green, 728; (Poplar, 868; Bermondsey, 1,089;
Wandsworth, 2,291; Camberwell, 1,534; Deptford, 1,029; Greenwich, 1,185; Woolwich, 1,240.
The part played in the dissemination of the disease by attendance at school is discussed in a
number of the reports, and the desire expressed that children under five years of age should be excluded