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15
Unfortunately, the harm done by Measles is not measured alone by the number
of deaths from the disease. The disease leaves behind the seed of future trouble.
Measles is often a cause of retarded growth and ill-health ; deafness and defects
of the eyesight are attributable to it, and it often lights up latent tuberculosis.
It is difficult to realise the apathy of the public towards Measles with the undoubted
havoc with which the disease visits districts. It is true that under favourable
conditions there may be a small percentage of fatal cases, but children with lowered
vitality from poor food and insufficient ventilation develop complications which
makes their percentage of deaths abnormally high. 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 eruption stage of the
disease except in very young infants, but it cannot be too widely known that BronchoPneumonia
is a frequent complication of Measles, and is responsible for the terrible
mortality associated with it. It is dangerous to allow a child who is actually suffering
from, or who is just getting over, Measles, to play in a cold room. Proper nursing
facilities are impossible in this district. If children could be cared for in warm and
well-ventilated rooms the progress of the illness could be regarded with equanimity
in ordinary circumstances.
It is generally agreed that Measles is spread on the largest scale by the attendance
at public elementary infant schools of children in the catarrhal stage of the disease.
The period during which Measles is actively infectious is comparatively brief, but
unfortunately this period is during the pre-eruptive and unrecognisable stage. The
occurrence of a similar spread in the boys' and girls' departments of the same schools
is prevented by the fact that most of the scholars in these departments are already
protected by a previous attack, or that the children as they grow older acquire an
increasing degree of immunity to attack, they are more resistant to the disease when
attacked.
In 1911 Measles was made a notifiable disease in this Borough for a period of
six months, but without an extended trial of a general notification of the disease
throughout London, it is impossible to express a definite opinion as to the effects
of notification. In my opinion, however, the first condition necessary in the
administrative control of the spread of Measles is compulsory notification. The
notification should be as complete as in Scarlet Fever and Diphtheria.
There must be close co-operation with the Medical Inspectors of Schools.
If a child first attends school, his record with regard to infectious diseases
should be entered on a schedule kept for that purpose. When a child attends school
suffering from the preliminary catarrh of Measles, twelve days afterwards, the first
crop of cases occurs among the children in this class. If the names of all the