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cases of measles reported from the schools approaches a figure of about 1,000 per
week, a point which was reached early in November, 1925.
The scheme involves the utilisation of the services of school nurses, who visit
daily the schools where measles is reported to have occurred, examine children
in the classes affected, especially those under 5 years of age, send immediately to
the divisional officer responsible for school attendance the names and addresses of
all children absent without known cause, exclude from school all definite or suspicious
cases of measles, informing the medical officer of health of the district where necessary,
and generally give advice to the head teachers during the course of the outbreak.
The attendance officers visit the absentees at once, and where cases of measles
are discovered, a special form is despatched at once to the medical officer of health
of the district. Head teachers are also required to report, in accordance with the
usual rules, all known or suspicious cases at once on the ordinary notification form
(Form 84), to the school medical officer, medical officer of health of the district,
and the divisional officer.
The object of the scheme is to expedite knowledge of the existence of cases of
measles, in order that the borough medical officer of health may arrange for the home
to be visited in the early stages of illness, and for the case to be removed to hospital
or local nursing assistance supplied where necessary. The crucial period of measles
is usually during the first week of illness. It is during this time when complications
such as broncho-pneumonia, which are so dangerous to life, supervene, and it is,
therefore, necessary so to organise the machinery of administration as to secure that
a visit to a home is paid by the local health officers in this early period. Although
very much has been accomplished in this direction since the existing measles scheme
was introduced, the ideal has not yet been wholly attained.
It was suggested by Sir William Hamer in his report on measles, in connection
with the conference in 1921, that steps should be taken, if possible, to impose an
obligation on parents to inform the head teacher of the school of the reason for a
child's absence within 48 hours. The Council's solicitor, however, reported subsequently
that the Council had no power to make, under Section 74 of the Elementary
Education Act, 1870, or otherwise, a bye-law requiring parents to make such
notifications. The Education Committee at that time, however, undertook to
consider whether anything further could be done to secure the fuller co-operation of
parents and guardians in that direction, but no specific proposals were made. If
it is not possible to effect a compulsory measure requiring notification on the part of
parents whose children are absent from school, an attempt can be made to secure the
voluntary co-operation of parents in this matter during epidemics of measles, and
for this purpose the advice on the measles warning card, which is already sent out
to the parents of susceptible children in classes affected by measles is to be supplemented
by some appropriate words urging parents to inform the head teacher at
once if a child is absent with a supposed cold or symptoms of measles, during the
prevalence of measles. It would also appear to be desirable for the borough medical
officers of health to take similar action through their local machinery with regard to
children under school age.
The administration of the measles scheme involved a very large amount of
work on the part of the school nurses, attendance officers, head office staff and others
concerned. During the progress of the epidemic, much of the ordinary work of the
school nurses, in connection with personal hygiene schemes and medical inspection,
had to be suspended. The hours devoted by the nurses to measles work during the
17 school weeks the scheme was in operation were equivalent to the full time services
of 28 nurses. Complaints were received from numerous sources of the suspension
of the nurses' ordinary school duties, but it is hoped that, in future epidemics,this
difficulty may be to some extent overcome, although it is obvious that emergency
work of this nature must always take precedence over routine work.
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