View report page

102
street, in a crowded quarter of the town, into hospital, as
experience teaches that it is only by dealing with the first
cases that there is any chance of successfully checking the
spread of the disease. The above procedure of removing first
cases, lias never been systematically carried out, owing
chiefly to want of sufficient hospital accommodation: no
compulsion, moreover, is used. But it is felt strongly that it
is only by dealing firmly with the first cases, removing them,
keeping the other children from school, and disinfecting
thoroughly, that there is any chance of preventing the
biennial epidemics to which Edinburgh has been subject. It
may be added that what disinfection is done, is done by the
Corporation at the public expense. As a rule, however, it is
only in those cases of measles where the bedding has been
removed for disinfection, that fumigation is done, and it is
therefore not generally done, as in scarlet fever, &c.; but it is
done in all cases where specially desired. The head teachers
of schools attended by the sick children are informed of the
occurrence of the illness. Closure of schools has been found
to be of benefit; and this, of course, could not have been clone
without the information supplied by notification.
The experience of Edinburgh may enable us to form an
approximate estimate of the number of cases that would
have to be dealt with in this Parish, should measles be added
to the list of notifiable diseases. It would vary much in
different years, and in epidemics at different periods
of the year. The average annual number of deaths from
this cause in Kensington, in the last five years, was 83:
the numbers in the successive years were 108, 124, 14, 140,
and 29. In 1889, when only 14 deaths were registered, the
disease, doubtless, was of a mild character, and the death
rate may have been as low as 2.0 per cent., or even 1.5—the
lowest rate recorded at Edinburgh—in which event the cases
of illness would have been 700 to 900; as many, therefore,
as the cases of all the 11 notifiable diseases hitherto recorded.