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68
In the spring term, Stag Lane Infants' School was the department
most heavily attacked. Stanburn School was affected towards the end of
the term and suffered much in the summer term, when Priestmead
Infants' School also was attacked.
There was one death from measles this year.
Although the disease is now notifiable, the health visitors do not
call at all houses in which there are patients, but only at those at which
there are young children or at which the notifying practitioner has asked
that a visit might be made. Apart from the notifications, the other
source of knowledge of the occurrence of measles patients is the intimation
received from the head teacher of the absence of children from schools.
These lists are studied and visits paid by the health visitors to those homes
in which there are younger contacts.
In epidemic times, over 200 cases may be notified in a week. No
hospital system could cater for admissions on this scale, nor, of course,
is it necessary that all those suffering from measles should be admitted
to hospital for treatment. Admissions are limited to those requiring
hospital treatment because of their clinical condition, usually some
complication such a pneumonia or ear infection, the very young, those
suffering as well from some other complaint, those who cannot be satisfactorily
nursed at home, or those living in poor housing conditions.
During the year, 12 patients were admitted to hospital, while the health
visitors paid 191 visits to homes at which there were patients suffering
from measles.
There is no preparation which can produce an active immunity in
humans. On the other hand, passive immunity can be induced by the
injection of various preparations of human blood including convalescent
serum, adult serum and placental extract. Such immunity, however, is of
very short duration, and a few weeks after the administration of the
serum the child is again susceptible to attack. Conferring a passive
immunity then, does nothing to reduce the almost 100 per cent, of attack
of the population at some time or other. There is, then, little advantage
in the general administration of serum to the susceptible. On the other
hand, there is a real advantage in its administration in certain circumstances.
The fatality from measles is so very high in the very young
that every effort should be made to prevent the very young from being
attacked. Then, too, it may be advisable to protect temporarily those
who are suffering from some other condition. For administrative
convenience it is advisable to cut short an outbreak which might follow
the introduction of a case of measles to a general ward of a hospital;
in all these cases the aim is to prevent the development of the attack.
In some circumstances, however, it is sufficient to ensure that the child
suffers only a mild attack. This can be done by reducing that dose
necessary to bring about protection or by giving the full dose at a later
date. A child receiving this treatment will not be protected from an
attack, but if he succumbs it will be to a modified attack, but one which
nevertheless will be followed by a life-long immunity to the disease.
The serum for administration can be obtained from the Colindale Public
Health Laboratory.