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immunised. Of the children under five years of age, two thousand
eight hundred and fifteen, representing 60 per cent., had been
immunised. Of the school children of five to fourteen years of
age, six thousand and seventy two, representing 56 per cent.,
had been effectively Immunised by receiving primary or reinforcing
injections within the past five years and two thousand eight hundred
and ninety four, representing 26 per cent., who had been previously
immunised, were in need of reinforcement.
Measles. Six hundred and seventy seven cases were notified
in 1957, compared with two hundred and seventy five cases in
1956. The case rate was 8.57 per thousand of population, compared
with 14.09 per thousand of population for England and Wales.
There was no death.
Measles was epidemic from January to April and the incidence
declined slowly to quiescence in September. The highest prevalence
was in the West Central and North Wards. Two hundred and fifty
six of the cases were Infants under five years of age, and fifteen
were babies under one year.

Epidemics of Measles recur at intervals of approximately
two years. The infection spreads rapidly among susceptible
children. There is always difficulty in recognising the early
catarrhal signs of illness. Measles commences like a common
cold with a rise of temperature, running of the nose, an occasional
sneeze, watering of the eyes and a slight sore throat. The child
is usually out of sorts and disinclined for food or play. After
three to five days the rash appears. The catarrhal phase
is highly infectious. Prevention of infection requires early
recognition of the symptoms and early isolation. It is important
that babies and weakly children should be protected from acquiring
infection. Isolation should be continued until all symptoms and
signs have disappeared. The danger of complications by secondary
infection has been reduced by the Judicious use of Sulphonamides
and antibiotics, but there is sometimes an exceptional child
who reacts badly to this virus infection and careful nursing and
careful convalescence are always necessary. The illness can be
prevented or modified by the Injection of gamma globulin early
in the incubation period. A small quantity is available to
doctors for cases of special risk. Health visitors are informed
of notified cases of children under five years of age so that
they may give advice where necessary.
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