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Measles.
I wish to bring to the attention of the Committee the services again rendered by the
Rover Scouts of the District in the prevention of Measles. The names I wish to present are
H. Bennett, 115, Cambridge Road.
L. Gaydon, 283, Martindale Road.
Philip King, 30, Midsummer Avenue.
I wish to place on record my great appreciation of the services rendered by these individuals
in the prevention of Measles in the area of the Borough Council, particularly to Mr.
Bennett and Mr. King who have been blood donors on this occasion for the second time.
Measles for 1936 has come and gone, and again I have to report that we have been able,
through the action of the above-mentioned Rover Scouts, to keep both the Hounslow Hospital
and Mogden Isolation Hospital open throughout the outbreak, and in addition prevent a number
of cases of Measles in the private practices of the area. The mortality has been negligible.
Again I want to draw attention to what Measles really means. Before the War when I
was M.O.H. at Wimbledon I had 43 deaths from Measles in that area. I had 4 children dead
in one house, two in the flat upstairs and two in the flat downstairs. The house in question was
a comparatively modern house with ample air space surrounding it, wide streets and from the
point of view of external sanitation a satisfactory house. The condition there was undoubtedly
one of which the secondary cause was subnormal nutrition.
Had these 43 deaths been Smallpox the country would have been in uproar from end to
end, but as it was Measles nobody took much notice.
Measles has to be considered not only as a death dealing disease which will be found
year after year to head the list of deaths from infectious diseases in the country, always outnumbering
those from Diphtheria and Scarlet Fever, but it also leaves behind it a trail of damaged
lives and it is not fully appreciated what the extent of the damage really is
Amongst the better class schools mastoids occur in some epidemics in large numbers but
deaths are very few as nutrition is good. 1 remember one of the ablest Headmasters 1 have ever
come across taking me round one of the schools in Wimbledon after the outbreak referred to
and saying " I cannot tell you how it is, what it is or why it is except that it is Measles, but I
can point out a number of children who have never been the same since they have had Measles.
They cannot concentrate in the same way, their intelligence seems somehow at fault, in fact they
are totally different children, and yet it is difficult to put one's finger on exactly what is wrong."
He took me round the school and pointed out child after child. As far as clinical observation
was concerned there seemed to be nothing for one to put one's finger on and yet his shrewd
observation had found a legacy of damage which, in his opinion, was from the child's point of
view, serious.
The present position with regard to prevention is that there are three main methods of
dealing with an outbreak. It must be first understood that it is quite impossible to prevent
every case by widespread inoculation.
The first method in use is Convalescent serum prepared from the blood of children who
are recovering from an attack of Measles. This is not a practical Proposition as the parenls
of small children are very averse to having their children bled in order to provide serum for
safeguarding some other stranger's child. As the majority of cases of Measles occur round
about 5, it is quite understandable that the parents object to children of this tender age being
bled.
The second method is by using convalescent serum from young adults who have had
Measles. This is available from volunteers who have no connection with the patient but should
be available in the case of every young married couple in connection with their own children.
The efficiency of Convalescent Serum was considered to be some 20-30% higher than that
of Adult Serum which was put as low as 60%. However, more recent research in the London
County Council Fever Hospitals has shown that the Adult Serum approximates much more
closely than was originally thought to that of Convalescent Serum which is somewhere in the
region of 80-90%.
It must be clearly understood that there is not the same efficiency with Measles Serum as
there is with protection from Diphtheria by means of immunisation with the preparations that
have been in use for some time. Unfortunately the reputation of the immunising substances
has had a bad shock by reason of a preparation which was forced on the market for one shot
purposes, which only gave an efficiency of some 65%. In this district with the preparation which
wp are using for Diphtheria Immunisation we are now getting some 97-98% efficiency.
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