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74
All notified cases were, as far as possible, visited either by a
Health Visitor or School Nurse in the case of children of school age.
Through the kindness of Dr. Nabarro of Great Ormond Street
Hospital, a quantity of convalescent measles serum was obtained
and used in 13 cases. It is claimed that this serum when injected
in the dose appropriate to the age of the patient within 6 days of
exposure, will afford complete protection in some 90 per cent, of
cases. The immunity is passive and lasts for some three weeks.
The same dose of serum injected between the sixth and ninth day
after exposure produces a modified or attenuated attack of measles
which confers lifelong immunity.
In the 13 cases treated, complete protection was obtained in
9 cases. In 3 other cases the serum was injected too late to afford
complete protection and very mild attacks resulted whilst in the
remaining case an attenuated attack was deliberately aimed at
and obtained. In this case there was a slight eruption but no rise
of temperature.
There is no question that if sufficient supplies of serum become
available, here is the method of controlling measles. Unfortunately,
the production of sufficient serum is very difficult. Some
attempt was made to assist by circularising local doctors requesting
them to notify all cases of adult measles and to persuade such
patients to give blood for the preparation of serum. Only two
volunteers were forthcoming and these were taken to Dr. Nabarro
for the preparation of serum from their blood. It must be clearly
understood that such donors are carefully examined before acceptance
and the blood is tested to eliminate the possibility of certain
diseases and the final serum is made up with a small percentage
of antiseptic.
The only means of organising a really satisfactory supply of
serum would appear to be on the lines of the blood transfusion
services which have now been so successfully organised by such
societies as the British Red Cross Society. The main difficulty is
the paucity of healthy adult donors convalescent from recent attacks
of measles.
A total of 20 deaths from measles were registered locally during
1932 as being due to measles. Of these 14 took place in Hospital
(Whipps Cross Hospital, 12), 3 at a children's institution, and 3 at
home.
The deaths were made up as follows:—1 to 2 years—11. 2 to 3
years—3, 3 to 4 years—1, 4 to 5 years—4, 5 to 10 years, 2.