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If we compare the six years before, and the same period after
notification was adopted, we find that the number of births during
1888-1893 slightly exceeded that of 1894-1899, and, therefore, the
number of susceptible children would, if anything, be larger in the
former period, but the mortality from the disease was lower during
the former period.
The result cannot be deemed satisfactory. Dr. Millard, who
formerly was Medical Officer of Health for Burton, attributes this
want of success to the fact that many cases were unreported, and also
to the early stage at which Measles is infectious. A medical attendant
is not always called in when Measles makes its appearance in a family;
while the householder rarely reports the presence of Measles in his
dwelling, whether a doctor has been called in to see the case or not.
To this extent, therefore, compulsory notification commonly fails to
afford to Sanitary Authorities complete knowledge of all the cases
that occur in their district.
In view of the experience gained by those towns that have placed
Measles amongst the compulsory notifiable diseases, it appeals that
success is more probable along other paths, more especially in a
development of school notification. The appointment of a Health
Visitor enables the Council to utilise the information thus obtained.
As soon as a case is reported, the house is visited, and if there
is no doctor in attendance, general instructions are given as to the
management of the case and isolation of the patient. Circulars are
also distributed. Except in exceptional circumstances, disinfection
is not carried out.
Under the conditions which prevail, we have no choice in the
matter, but in the present state of our knowledge of the disease, it is
doubtful if disinfection would be of much value. In the case of
Diphtheria, Typhoid, and Consumption, we know that the germs
which cause these diseases can survive for long periods on articles of
apparel or bedding or on the walls of rooms which have not been disinfected.
Outside the body, the measles-germ has probably a very
short life, and to substantiate this. I may record the result of inquiries
made by Dr. Newsholme in Brighton. In the spring of 1904. there