View report page

46
Measles still stands very high among the infectious diseases
as a cause of death in childhood. Attempts have been made to
decide what proportion of persons pass through an attack of
measles, and, it appears, that at least 95 per cent, of the population
register one attack of measles before the twentieth year of life.
Although a percentage of even 25 of children has been reported
to have a second attack, it is generally agreed that a second attack
is rare. One attack usually protects the individual from the disease
for the rest of his life. From this we conclude that suppression of
the disease is udlikely to be attained and may perhaps not be desirable.
The aim of modern preventive medicine is not the prevention
of infection but the suppression of its damage. The most successful
efforts of modern prevention rely not on preventing infection,
but diffusing it in a form in which it can be controlled.
It is well known that a summer epidemic of measles is far
less fatal than a winter one, and one is justified to employ drastic
means to postpone an epidemic in the winter even if it be only for
a few months.
We might feel inclined to close a class or department on the
appearance of a single case in December or January, in the hope
of avoiding an epidemic, when such a course would not be justified
if the outbreak started in the spring.
In the years 1921, 1922 and 1923, we were fortunate to have
a series of summer epidemics, and in those years only 5 deaths
occurred from the disease.
The occurrence of a series of summer epidemics is not the
only explanation, as we find that in the last decade there has
been a marked fall in the mortality from Measles throughout
the kingdom. The reduction throughout the kingdom has not
been so great as that which has occurred here, but sufficiently
marked as to be accountable in part by some more general cause.
It has been frequently pointed out that the great majority
oi the deaths from Measles occur amongst children under 5 years
of age. Many years ago. Dr. Theodore Thompson in a report
to the Local Government Board on the control of Measles pointed
out that the incidence of attack is different from that of death.
For while the main incidence of death is on the second year, the
incidence of attack is chiefly on the third, fourth, and fifth years.