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development of School notification. It is to be hoped now that the
Medicnl Inspection of School Children is an accomplished fact, this
system may be utilized in conjunction with Health Visiting to secure
the detection of the earliest cases, and to adopt preventive measures
before an Epidemic has become out of control.
There is one difficulty under present conditions which always
confronts us. When a case occurs in a class, the only practicable
method is to close that class for a fortnight, and to keep all the
children under observation during the incubation period. Unfortunately,
the closure of a single class is more serious financially
than the closure of the whole department, and the occurrence
of a single case does not justify the latter course.
It may be of interest to record the result of closing a school
on the occurrence of a single case. A case of Measles, N.S. was
notified from the South Acton Infant School, on December 16th,
1908. The child had been ill since December nth, and the rash
appeared on December 14th. The introduction of the disease into
the district can be traced with a fair decree of definiteness.
A child D.I. aged 14 months, attended the out-patients department
of the Paddington Green Children's Hospital on November
19th. At the time, Measles was prevalent in the Western boroughs
of the administrative County of London.
The child exhibited symptoms of Measles on November 28th,
and the rash appeared on December 3rd. The disease was of a
severe type and the child died on December 5th.
As stated above N.S. was notified on December 16th, and inquiries
made amongst children absent from school revealed two
more cases. One of the latter attended South Acton School and was
taken ill on December 9th. This child used to live in the same
house as D.I. did, and had been to see the latter during her illness.
Two classes in the school were affected, and the children above
referred to had attended when suffering from the initial symptoms of
Measles. The first crop would be due to fall somewhere between
December 18th and December 23rd.
As the interference with the work of the school would be very
slight, it was decided to close the department for the Christmas