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(2) Infection being carried in the very early stages before
diagnosis is certain, large numbers receive the poison
before you are able to prevent it. This is especially
the case in schools where the children are so closely
congregated.
(3) The Schools are the main centres for disseminating
the disease, and, with the ready help I have always
obtained from the Teachers and School Attendance
Officer, and the medical men in the district, I can
easily ascertain the cause of absence of the scholars,
and use my judgment as to whether it is expedient to
close them or not.
(4) Proper isolation is not obtainable in nearly all cases
as the houses are thickly populated, two families in
one house invariably, and one room cannot be kept
apart for sickness entirely, and the mothers must
wait upon the sick and well, as they cannot afford to
pay anyone to do it. There being no hospital to
admit cases of measles, patients cannot be removed
from their houses.
(5) Disinfection cannot be performed with the thoroughness
that one can wish. Having no disinfecting chamber
it is impossible to disinfect the clothes worn by the
patients, and it is impossible to do this thoroughly at
the houses.
(6) The expense of notification has been very great, and
I am of opinion that the increased expenditure is
hardly justified by the results obtained.
(7) That the epidemics continue every other year, and
that during the past four years they have increased
in numbers, and the disease is not of a milder type.