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cinemas, fairs, etc., is not ordinarily advocated, but people should no!
travel for such gatherings to or from an area where there is an outbreak
of poliomyelitis.
3. Schools. (a) Exclusion. All family contacts should be excluded
from school for period of 21 days. This means all school children,
teachers, school nurses, school meal workers, clerical assistants and
caretakers in whose household a case has occurred. Similarly, close
school contacts of an affected school child who have been in contact
with him up to five days before the onset of his illness should be excluded
for the same period. In the light of present day practice in some school
classes this may amount to class closure, but in most cases exclusion will
relate only to those immediately around the child in class, his intimate
friends or his gang. Children who have recovered from an attack of
poliomyelitis should not be allowed to return to school until the expiry
of six weeks from the onset of the disease.
MEASLES
Measles is a disease which had a marked biennial incidence, an
outbreak starting in the last months of the year to reach a peak in the
spring of the next year, fading to extinction by the late summer or autumn,
after which the district would be free until the development of the next
outbreak. This district has not as yet acquired this typical biennial
periodicity. A typical invasion in the early months of one year is not
followed by any real freedom in the next year, while sometimes the period
of heaviest invasion has been postponed to the later months in the year.
1953 was a year which showed the more characteristic prevalence of the
disease as seen in an urban community. From a weekly incidence of
200 in the first two months of the year, the attack rate fell to a weekly
notification of only eight in May and then followed almost complete
freedom in the second half of the year. There was in the latter weeks
no building up of cases which is the usual prelude to an invasion in the
early months of the following year, and in fact there was no such invasion
in 1954. At the other end of the year, too, there was no building up of
cases to give any warning of an outbreak in the early part of 1955. The
actual number of cases of measles notified in 1954 was only 41. Tlese
few cases were evenly distributed throughout the year. This is the
smallest number of notifications in any one year since measles was first
made notifiable in 1939.
The disease was generally mild in character; there were no deaths.
Because such a high proportion of the population suffers from
measles and that mostly in childhood, this infection can be more
damaging than many other diseases which are thought to be more
serious. The danger was the result not so much of the attack of measles
as the effect of the secondary invaders. These can be much more readi;
controlled now than was possible only a few years ago by the exhibition
of antibiotics. The result is that, even when it is prevalent, meases
now is responsible for much less damage than was the case not man.
years ago. There is as yet no preparation which can be used to set up