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42
Measles may therefore be said to have been prevalent in
London towards the end of 1931.
Having regard to the intercommunication between Acton and
the Metropolitan Boroughs, it can easily be understood that the
disease would soon be introduced here. Usually we are able to
trace the first case, but in this instance we were unable to do so.
We were aware of a case in the South West Ward in
December, but this child was under school age, and was probably
not the source of infection of the school cases. The family came
from Scotland, and the child was ill on arrival, so ill that he was
confined either to bed or to the house during his stay in the district.
On the reopening of the schools after the Christmas
holidays, 3 cases were reported, one from the South-East Ward,
and 2 from the South West Ward. The 3 children all attended the
Rothschild Infants Department, and the course of the outbreak
throughout, coincided with the school distribution of the victims.
In January the cases were limited to the South West and
South East Wards west of Acton Lane, and south of the North
London Railway, because the children of the Rothschild Road
Infants Department and Beaumont Park Infants Department were
drawn from this area, and these two were the departments in which
the disease first made its appearance, afterwards the outbreak
spread northwards and eastwards throughout the district.
No disease observes so regular a periodicity as Measles, and
once an outbreak occurs in a populous district, it is doubtful if
any measures are efficient to control an epidemic. In Acton, the
disease appears almost regularly every other year. Formerly, we
used to have a major epidemic and a minor epidemic or as they
are sometimes called an epidemic and a hypo-epidemic at regular
intervals. In recent years, the epidemics do not vary much in their
virulence or fatality from year to year. Although an epidemic
cannot be controlled there has been a very considerable reduction
in Measles mortality. Many factors have entered into the causation
of this reduced fatality. Part of it is due to the lowered birth rate,
though this only explains a small part of the reduced morbidity
of Measles. A fuller appreciation of the causes of death in the
sufferers from the disease, and an application of methods of prevention
of these causes probably have had a much greater
influence.