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servant, and was the only inmate of the house who had not been
vaccinated. She took the disease in a malignant lorm, and for some
time was very dangerously ill. None of the other inmates contractedSmall
Pox.
It was ascertained on enquiring into the case that a relative living
at Acton, had been the only visitor to the house within the incubation
period. I subsequently examined him and found a few small scars of
recent Small Pox.
Dr. Garry Simpsom, the Medical Officer of Health for Acton,
quite agreed with the diagnosis, and it was further confirmed by the
occurrence of a case of typical Small Pox (notified on the 4th of May,
to Dr. Simpson), the patient living in the same house at Acton as this
man.
On the 10th of Sept., a case of Small Pox was notified from the
South side of the District. From the 23rd to the 30th August, she
had been living at a house in Acton, in which a child was suffering
from Chicken Pox. A person working at the house was said to have
recently had Small Pox. Dr. Simpson investigated these cases, and
confirmed the Chicken Pox, but there was no evidence of Small Pox,
so the source of infection remained untraced.
During the year two persons who had been in contact with cases
of Small Pox outside the District, were kept under daily observation
during the incubation period.
Measles.
During April, May and June, Measles was very prevalent
throughout the District. It first appeared and for a time was limited
to the South Side of the District. Since the disease is not notifiable
we have no meams of estimating exactly the number of cases which
occurred. The outbreak, however, was so widespread that there
can have been but very few families with susceptible children which
escaped attack.
There were 5 deaths registered as directly due to measles, a rate
of 0-4 per 1000 living, which is about the average rate for the County
generally. The disease was of a mild character and we may assume a
low case mortality. This varies from 1 per cent, to 5 per cent, of
those attacked, but for the County generally it does not often exceed
1 per cent. : we may therefore infer an outbreak of 400 to 500 cases.
The disease chiefly spreads through contact of children in school, and
except by school closure in the early stage of an outbreak, but little
control can be exercised over its spread. This is due to the fact that
the disease is infectious before characteristic symptoms appear.
Many parents seem to regard measles as one of the necessary
evils of childhood, and in many cases do not seek medical advice or
take any measures to isolate their children when attacked. It is true
that when measles appears in a family, atttempts to protect the other
susceptible members are usually futile: but by very simple
precautions it can be prevented spreading outside the house.