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148
have myself called to see the patient. When satisfied that the case
is one of Measles, a letter is written to the school Medical Officer
asking him to close the class for a certain period varying from six
to fifteen working days (ten to 21 days interval) according to circumstances.
The average total period of closure in 1904 was under 13
days (including only about 9 working days). When it was known that
a large proportion of the children in a class had had Measles, only
those children have been excluded who were stated not to have
already suffered from the disease.
Results of investigation.—The appended tables summarise the
results of the investigation. They compare notifications and deaths
in the West or non-closure district with those in the East or closure
district, both for the period January 1903, to September 1905 inclusive
and for the two preceding years 1901 and 1902, when early closure
was not enforced at all.
Tables 1 and 2 shew the age incidence of notifications and deaths
in each district and during each period. Table 3 shews the wards
and their populations in each district together with the total cases
notified in each district and the deaths in each ward during 1903 to
1905 (September). Table 4 shews the schools in each district, with
the numbers on the roll and the cases notified during 1903-5 (Sept.).
Table 5 shews the same items for 1901-2. The notifications for the
schools only include children attending school. The notifications
of each ward include children not attending school who have been
notified by school teachers, owing to brothers or sisters being excluded
on their account, and also a few cases notified by parents or
others. Table 6 shews the notifications and death rates for each
district in each period of time i.e., before and after closure was
commenced.
The following facts appear from the investigation:—
1. The largest number of cases notified was between the ages of
five and six years, and the next largest number between
four and five.
2. Over three-fourths of the cases notified were between three
and seven years of age.
3. Closure appears to have no appreciable effect on the age
incidence.
4. More than half the deaths were in children under two years
of age, and only two out of 123 were in children over seven.
5. During the two years (1901 and 1902) preceding closure, the
notification rate was much higher in the east or closure
district than in the west or non-closure district, viz., as 21.5
to 15.4.
6. There was a great increase of notifications during the
second period, 1903-5. In the west or non-closure district
the notification rate increased from 15'4 to 29.6, and in the
east or closure district from 21.3 to 31.4.
7. During 1903-5 there was a higher rate of notifications in the
closure district than in the non-closure (31.4 compared
with 29.6).
8. Comparing the two periods of time before and after closure
commenced, in the latter period there was an increase of