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necessary nursing. No condemnation can be too strong for the practice of wilfully
exposing other members of the family to this infection. There is no greater or more
pernicious superstition than that which is so widely held, namely, that a child must
have Measles. Probably no superstition is attended with more disastrous results,
and the utter folly of such a belief cannot be too strongly emphasized.
It is somewhat difficult to reconcile the popular attitude towards Measles with
the undoubted havoc with which the disease visits districts. One explanation
possibly lies in the fact that amongst children living under favourable conditions
Measles may be a benign disease, and such children have a small percentage of fatal
cases ; but children with lowered vitality from poor food and insufficient ventilation
develop complications which make their percentage of deaths abnormally high.
Another explanation may lie in the fact that it is not generally understood
where and in what period of the illness the danger is greatest. The risk to life during
convalescence and in the late stages of the illness is not appreciated. Parents allow
themselves to be lulled into a false sense of security when the first few days of the
" fever " have passed, and the child does not appear to have developed any alarming
symptoms. Death does not very frequently occur during the eruptive stage of the
disease except in very young infants, but it cannot be too widely known that Measles
strongly favours the development of Broncho-pneumonia, which is most dangerous
to life, and is, indeed, responsible for the terrible mortality associated with Measles.
This attitude of the public affects the mortality from Measles in two ways.
Sufficient precaution is not taken to prevent the spread of the disease, and sufficient
care is not taken to avoid the later lung complications.
The isolation of every case of Measles from the first onset to the end of the
third week would undoubtedly enable an outbreak to be brought abruptly to a close,
as no second crop of cases would occur. This ideal of prompt isolation will not for the
present be accomplished, but, by the aid of the compulsory notification of the
disease, the attention paid to invaded households, will, it is hoped, secure more
precaution on the part of parents. It would also limit the cases very largely to
children over school age, as in the majority of instances the disease is introduced
into a house by a child attending school. After a certain period, the older the child,
the less susceptible he is to the disease, and even if they contract the disease, children
over five years of age rarely succumb. The age at which relatively the greatest
number of children die of Measles is the second year of life ; while after the third
year has passed, there is a rapid decrease in the proportion of children dying of the
disease.
Dr. Theodore Thompson in his report to the Local Government Board on the
control of Measles states " 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. From this different incidence