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elapses between the appearance of the rash and death, but in
this epidemic the deaths in most of the cases occurred early in
the illness. The increased fatality towards the end of the
epidemic cannot therefore be accounted for on the assumption
that the deaths in July were of cases notified in the earlier
months. Neither can the geographical distribution of the
epidemic account for the increased fatality during the later
stages. (As will be pointed out, on a later page, social conditions
play an important part in the mortality from Measles.)
It is almost the general experience that as an epidemic
progresses the cases become more severe in character. The
increase of severity seems to be entirely due to the concentration
of the poison, and school closure may have the effect of
diluting the poison. School closure may diminish the
virulence of an epidemic by removing children from a vitiated
atmosphere.
It has been pointed out in previous Annual Reports that
the age at which relatively the greatest number of children die
of measles is the second year of life. After the third year has
passed there is a rapid decrease in the fatality of the disease.
It is impossible to state in figures what is the case fatality at
different age periods. Practically, all cases occurring amongst
children of school age are reported, but, unless there are
children of school age in the house, very few children under
three years of age are notified as suffering from the disease.
The ages at death were as follows:—
Under 1 year, 1 to 2. 2 to 3. 3 to 4. 5 to 6. 6 to 7.
6 19 6 5 3 1
The ages of the cases reported from the schools were as
follows:—
3 to 4 years. 4 to 5. 5 to 6. 6 to 7. 7 to 8. Over 8 years.
41 120 140 105 56 31
Although the above tables are not complete, they are sufficient
to show that the incidence of attack is different from that