London's Pulse: Medical Officer of Health reports 1848-1972

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Acton 1936

[Report of the Medical Officer of Health for Acton]

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70
that in addition to this permanent immunity which an attack of
Measles confers a certain amount of temporary latent immunity
also occurs during the epidemic. This temporary latent immunity
may be brought about in many ways. A breast-fed infant seldom
contracts Measles. He is born with a certain amount of natural
immunity ; how long this natural immunity persists is not known,
but whilst it lasts, he may come in contact with Measles and yet
not exhibit the usual symptoms of the disease. He may, though,
be acquiring a certain amount of latent immunity through successive
sub-clinical doses, and these may be, but are not usually, of sufficient
strength to give him a permanent immunity throughout his
life. In any case, the immunity is sufficient to tide him over that particular
epidemic. It is through the acquisition of natural immunity
that under present social conditions an epidemic of Measles
comes to an end in a large urban community. This does not mean
that individual children cannot be protected from Measles during
an epidemic but that efforts to prevent the spread of an epidemic
of Measles in a community are usually a failure.
These considerations have effected a changed outlook in
the measures which are adopted during an epidemic. At the present
time, we concentrate upon the individual because the disease itself
very rarely kills. It simply predisposes the patient to the great
risk of secondary infections, and it is from these complications,
usually broncho-pneumonia, that death occurs. Probably, some
of the lessened mortality in recent years has been due to the institutional
treatment which has been available. We have been
fortunate to have available accommodation for Measles at the
Fever Hospital in the last three epidemics, and we did not refuse
any application by a doctor last year. 65 cases were admitted with
5 deaths. Unfortunately many of the cases are admitted because
of the complications which have already set in, but this is inevitable.
It would be almost impossible to remove every case of uncomplicated
Measles during an epidemic. A selection has to be" made, such
as the existence of unfavourable home conditions, complications,
&c.
In former days, also, in addition to the deaths which occurred
from the disease, we had a large number of children who had been
maimed and scarred by the discharging ears and inflamed eyes
frequently left as a complication and sequelae of Measles. For these
reasons, when a Measles epidemic occurs, we pay less attention to
the spread of the disease in the community and more to the treatment
of the disease in the individual either in the home, or in a hospital.


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