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64
One case was treated in an isolation hospital, one in Redhill Hospital,
while the third was treated at home.
MEASLES.
Measles is an infection to which practically everyone succumbs,
mostly in childhood, and rarely more than once. In many urban districts
a periodicity of epidemic incidence occurs, probably the result of any
epidemic having attacked most of the susceptibles, so that there is a lapse
of time before the growth of sufficient numbers of susceptibles to be
available to be attacked as an outbreak. This district apparently took
on the periodicity of London, in which an epidemic occurred every two
years, the even years. The usual course of events then was there to be
a rising incidence from the November of the odd year, building up to the
main outbreak in the early months of the even year, with a sharp decline
of the epidemic in the early summer months. There would then be little
measles until the developing incidence nearly 18 months later.
The war years saw a marked change in this periodicity. The 1940
outbreak was postponed until the summer. The odd years, which should
have been relatively free, had an incidence approximately half of that of
the epidemic years, while in 1944 no epidemic came along. The notification
figures from the year 1940 (the first complete year for notification)
were 2,285, 1,275, 2,509, 1,516 and 593. 138 of these 593 were the rising
incidence presaging the explosive attack of 1945 when 1,316 cases occurred
in the first quarter, a weekly average of 100, but of over 200 for March.
191 cases in the first week of April were followed by a rapid fall, the
number declining from 97 to 25 in the last week of June, the weekly
average for the quarter being 61. The disease faded out in the third
quarter, in which altogether only 63 cases were notified. In all, 2,184
notifications were received during the year.
Measles is not one of the diseases that is ordinarily notifiable. It
was made so temporarily in 1914-18, but in the inter-war period was
notifiable only in a few districts, and in those notification was not ordinarily
applicable to all cases. Notification of all cases in the household was
called for in the latter part of 1939. While everything should be done to
encourage a serious view to be taken of measles, as this is one of the killing
diseases of childhood and notification is probably helpful in that way, it
is unfortunate that notifications are received only from medical attendants,
whereas it is the family which does not summon a doctor for a case
of measles that needs the help the more. For this reason, then, the
returns of the head teachers of the primary schools, about the absences
of children from school on account of infection, are studied, and the health
visitors call at those homes at which there are cases of measles and also
small Children. Routine visits are not paid to households from which
the ordinary notification of measles have been received.
In the Spring term Roxbourne (146), Cannon Lane (134), Glebe (103),
and Vaughan Road (101), all had over 100 cases. Stanburn, Welldon
Park and Stag Lane had over 50. No schools were anything like so
heavily infected in the summer term, only one, Whitefriars, in April
having as many as 30 cases.