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By the aid of notification we were enabled to ascertain the houses in which
other susceptible children lived, and to advise as to the precautions which should
be taken. We were also in possession of facts which enabled us to take advantage
of the institutional isolation and treatment of selected cases.
Our experience in some respects agrees with that of other towns where Measles
was made a notifiable disease. A large number of cases remained unreported, and
in fatal cases the first intimation we received was on the receipt of the death returns.
These cases were probably at the onset of the disease unattended by a doctor, but
it is a general experience that the percentage of cases medically attended is on the
increase, and will in future become still higher. The tendency therefore will be,
that a more complete notification will result on the adoption of compulsory notification
in any district. As in other notifiable diseases, Measles was notifiable by the
doctor in attendance as well as by the parents, but in no instance did we receive a
notification by the parents.
The adoption of compulsory notification of Measles caused a considerable amount
of extra work on the staff of the Public Health Department, and for a short period
some of the other work of the department had to remain in abeyance.
All the premises from which cases of Measles were notified were visited and
inquires made as to the conditions existing.
Any exceptional circumstances were reported to me and where there were a
considerable number of susceptible children in the house, or the facilities for nursing
the patient were grossly inadequate, the patient was, if possible, removed to the
fever hospital. Unfortunately the hospital accommodation was inadequate for the
reception of more than a small proportion of the cases, and a large number of children
were nursed in houses where the standard of isolation was very low, and the facilities
for the nursing of the patient totally inadequate.
Notice of each case was forthwith sent to the headmaster of the school attended
by the patient, or by any other children in the house.
When the sick child recovered and was free from infection, or when a death
occurred, the premises were disinfected.
I am not prepared to say what effect, if any, disinfection of the premises has
had on the incidence of the disease.
The disinfection of premises must, however, have an indirect effect by demonstrating
to the inmates the fact that the sanitary authority considers Measles to be
such a dangerous disease as to undertake the trouble and expense of disinfecting
the premises. In addition to the fumigation of the premises, the contents of the
rooms were disinfected and the rooms were efficiently cleansed by the owners.
The ages at death will be found on Table III. of the Local Government Board.