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37. "The object of school closure is to prevent the
attendance of children in the preliminary stage of Measles, i.e.,
when they have Catarrh and are highly infectious, but owing
to the rash not having appeared, Measles is not suspected.
When one case of Measles has been present in a class, it is to
be expected that in from 10 to 14 days there will be, if the
class is not closed, three or four or more children in the class
sickening for Measles, and if these are allowed to remain (and
only exceptionally are they detected) they will probably each
infect three or four more cases, and cases will then go on
occurring until most of the susceptible children in the class or
room have been attacked. If on the other hand the class is
closed, the disease can only spread in the house and from
house to house, or perhaps to a slight extent by children playing
together out of doors, but there is no doubt that its spread
in this way is very slow and limited.
38. "To justify school closure there are two questions to
answer:—
(1) Did further cases occur after the closure and during
the period of closure ?
(2) Was the class free from Measles when the children
returned to school ?
"A satisfactory answer to these questions depends on
punctual notifications from school teachers and, unfortunately,
it is certain in some cases that these are not obtained. A
satisfactory answer to question (2) depends also on whether
the teachers are careful to exclude children coming from infected
houses, a duty I fear sometimes neglected.
39. "It appears that of the 22 classes closed no subsequent
cases were notified during the period of closure in 8, but in 3
of these I feel little doubt that cases occurred and either the
c