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MEASLES.
The year 1937 was not a "measles year," and only one
death occurred from this cause. The disease was not then notifiable,
and no accurate information is available regarding the actual
number of cases which occurred in the area. Measles was made
notifiable in the County Borough of West Ham by an Order of the
Ministry of Health, dated 29th September, 1938.
The mortality statistics of measles are set out in Table X.
This table shows that in the period 1931-1935 the death rate was
roughly about a third of what it was in the period 1876-1880. This
large decline was not a continuous process, since the mortality in
the period 1876-1880 was almost doubled in the decade 1886-1895,
and a marked decline did not occur until the years which succeeded
the war. The decline in the death rate is apparently continuing,
but such a conclusion should be accepted with some reservation.
Measles, like several of the other infections of childhood, is apt
to behave in a paradoxical manner. It is regrettable that I have
not so far been able to obtain data for the years before 1876, since
these data would probably be of considerable interest. In several
areas the mortality from measles was comparatively low towards
the middle of last century, and a gradual increase took place during
the third and fourth quarter of the century. This increase is
reflected in the rates for the country as a whole for the period
1876-1890. It is possible that Table X. starts at a period
when the local rates were on the increase after a period of lowmortality,
and that at the present time we are approaching the
trough between two waves of high mortality, the crest of the first
wave having been in the period 1891-1895. It should not therefore
be assumed-that the present low rates will necessarily continue.
The rates as a whole compare favourably, so far as the
rate of decline is concerned, with those for England and Wales,
though the local rates for individual periods are, perhaps naturally,
above the national rates. As for the country as a whole,
the local rates show that the mortality is nearly always slightly
higher in males than in females.
WHOOPING COUGH.
Whooping cough is not at present a notifiable disease in
this area, and no accurate information is available regarding the
number of cases which occurred during the year. The number of
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