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143
The number of cases of measles, viz., 8,119, reported as occurring among pupils
attending the Council's schools during 1927 was the lowest on record. It is true
that the period corresponded with the trough of the measles wave, following the
epidemic of 1925-6, but with the exception of 1921, when 8,317 cases were reported,
no such low prevalence has been experienced since 1906 when the number of cases
of measles among school children was first recorded.
Mcasles.
Measles has, within recent years, tended to become more explosive in its epidemic
phases and outbreaks occur at more regular intervals, namely every two years.
These periodic prevalences last about six months. Owing to exhaustion of susceptible
material for attack the disease then becomes quiescent during an approximate
period of eighteen months, when it commences to become active again. Apart from
immunisation by means of serum from convalescents, every known method of control
has been attempted with a view to checking its spread during these epidemics, but so
far without success. Unfortunately these explosive outbreaks have always been
accompanied by a high mortality and within recent years it has been the object of
the Council, in co-operation with the metropolitan borough councils, to concentrate
more upon preventing the complications of the disease which are the real cause of
the deaths and extensive injury to health which follow in the wake of an attack
of measles if proper medical attention and efficient nursing are not provided at an
early stage of the illness. The scheme of control was fully set out in last year's
annual report and it was then stated that attention during the next epidemic, which
was due towards the end of 1927, would be directed towards the provision of home
nursing or isolation hospital accommodation as regards the more overcrowded and
insanitary areas, where medical advice is not usually sought and where nursing
arrangements in the home are impracticable. The earlier the knowledge of cases
of measles becomes available, the sooner may assistance be offered in the matter
of home nursing and the greater the chance of averting complications.
The epidemic, which was due in November, 1927, commenced almost in the week
it was expected, for towards the end of that month the disease commenced to show
signs of considerable activity judging from the number of cases reported from the
schools. The scheme of control was put into force early in December. Plans had
been fully prepared for classifying the schools according to the average social class
of the children attending, and when the epidemic commenced the school nurses were
drafted in the first place into those schools which were situated in overcrowded and
badly housed areas, as soon as measles appeared therein, for the purpose of supervising
the children and ascertaining in co-operation with the school attendance
officers which of the absentee children were likely to be suffering from or developing
measles, and with a view to informing the borough medical officer of health in such
cases, so that he in turn might arrange for removal of the patients to hospital or for
a district nurse to be provided, according to circumstances. It was already stated
in the report of 1926 that the Metropolitan Asylums Board had undertaken to give
preference to the admission of measles cases over scarlet fever cases, into their
hospitals if the supply of beds was insufficient to meet the requirements for both
diseases. At the end of 1927 the children being treated for measles in the M.A.B.
hospitals numbered 1,063.
During the epidemic which is now in progress, a new feature, which constitutes
a definite step in advance, was introduced in connection with the propaganda for
impressing upon parents the seriousness of measles and the need for obtaining early
medical advice. It has for long been realised that one of the chief obstacles towards
the efficient control of measles is the nonchalant attitude of parents generally toward
the disease, and the tendency to regard it as a minor ailment of childhood which is
unavoidable and therefore "the sooner it is over before Johnny goes to school the
better." This lamentable, but unfortunately general, view of the matter among
the poorer classes especially has been responsible for innumerable domestic tragedies.
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