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27
35. The Borough experienced in the winter of 1906-7 a severer
epidemic of measles than has occurred in recent years. The
measles death-rate of last year was, however, below the average
of the ten years 1891-1900, and the death-rate of the two years
1906-7 (0.39) was very much less than the average of 1891-1900.
In fact, the epidemic of the end of 1906 and the beginning of
1907, though the most severe during this century, was mild
compared with several epidemics of the preceding decennium.
As in all measles epidemics the total deaths caused are not
found under measles. There was last year an excess of 53 deaths
from pneumonia and bronchitis at ages under five compared with
1906. At ages over five there were fewer deaths from these
causes than in the preceding year. I have no doubt that most of
these 53 deaths (perhaps more than 53) were really due to
measles and whooping cough. As noted above, the rash in
measles is often absent and perhaps more often is not noticed or
forgotten when the doctor is called in for the more urgent chest
symptoms. Consequently, knowing nothing of the measles, he
attributes the death to bronchitis or pneumonia.
The fact that the epidemic was at its height in the middle of a
rather cold winter may possibly partly account for the excessive
mortality due to the secondary symptoms of bronchitis and
pneumonia. Though it is a great mistake to think that exposure
to cold during convalescence is the principal cause of death from
measles, no doubt it is a cause, especially in severe weather.
The fatality of the disease was much greater last year in
Woolwich parish, though the number of cases reported by
school teachers proportionally to population was greatest in
Plumstead. Hence the difference of fatality in the two parishes
cannot be ascribed to any measures such as school-closure aimed
at reducing the spread of infection.
As was indicated in the special report presented last year, and
more fully developed in joint papers read by Dr. C. J. Thomas