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Report of the Medical Officer (Education).
131
Suggestions for the improvements of our regulations would be welcomed, but no practical hints
for betterment are forthcoming from those who criticise the regulations now in force.
Direct knowledge of measles cases is very incomplete, the lacunae can only be filled by some
form of notification. The majority of measles cases are not attended by doctors. Notification by
doctors, is therefore, wholly insufficient; if all cases were seen by doctors and notified, it would cost
about £8,000 per annum to local authorities in London for fees alone.
Immediate notification by the householder to the school should be required in the case of any
illness of a suspicious nature in any child of school age. For children below school age the medical
officer of health might be notified.
Hospital provision for the worst cases might do something to reduce the chance of secondary
septic infections, to mitigate the type of disease, and to diminish the death rate. In the case of measles
it is unlikely that there would be the beneficial effect there is in diphtheria or scarlet fever, of preventing
further spread in the family.
No useful changes have been suggested in the regulations of the Education Authority in regard
to school attendance. It is very urgent in this as in other zymotics that there should be no indirect
inducements to teachers to keep infective children in school. The abolition of the epidemic grant since
902 has acted to some extent as a promoter of disease among school children.
Figure 9.—The thick black curve shows the probabie incidence of measles cases in the various years of life
in London in 1909 as deduced from mortality returns. The thin curve shows the probable curve if school effect was
permanently removed. The dotted curve gives the cases as known from school notification.
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