View report page

15
put aside, it is not surprising that the work in connection with this epidemic
was eventually almost entirely neglected.
It is of course useless having a disease notified unless some action is
taken subsequently, and notification is less likely to be of value in the case
of Measles than in almost any other infectious disease.
The characteristics of the disease itself are a bar to much advantage
being gained from notification, as the infective period is very great before
any appearance of the rash, and most frequently medical advice is not
obtained until the eruption has shown itself, by which time infection may
have spread to several other cases.
Then you do not possess in this District any hospital accommodation
for the reception of patients suffering from the disease, and even if this
means for isolation was provided there would be, I am convinced, the very
greatest difficulty in obtaining the parents' consent to the removal of their
children.
Notwithstanding the large annual mortality from this disease the greater
number of parents, educated as well as un-educated, look upon it with
something like contempt, as though it was a necessary evil, and part and
parcel of the child's curriculum.
Far from isolating a case as much as possible, it is not at all an uncommon
event for a parent to allow other children to be in the same room, and
even sleep in the same bed as the patient, with the express wish that "they
may all get it and have done with it," and it is this careless indifference that
is at the root of much of the evil we unfortunately experience from
epidemics of this disease.
Another item which must also be taken into consideration is the expense
which would be incurred by providing proper means for isolation and by
increasing the staff. This would of course be considerable, and is increased
by the amount which has to be paid in notification fees. During the year
the total amount of fees paid to Medical Practitioners for notifying infectious
cases was £111 8s. od. The fees for notifying Measles alone
amounted to about £80, and I do not think that any gain experienced from
the notification has hitherto been at all commensurate with the expenditure.
The consideration of the other infectious diseases is somewhat more
satisfactory, 78 cases of Scarlet Fever having been notified as against 74,