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56
Mumps assumed an epidemic character in the last quarter of
the year and affected practically every elementary school. Three
hundred and fifty-four cases came under the notiee of the Medical
Officer of Health.
The control of the spread of the infection in the non-notifiable
infectious diseases presents many difficulties, the chief being the
fact that these cases cannot be recognised in the earlier stages.
It is no uncommon experience in a school, when drawing attention
of a teacher to a cough which is very suggestive of whooping
cough, for one to be told that the child has had a similar cough for
a week or more but that the child has never "whooped," and
consequently was not sent home.
Frequently one is placed in the same position of uncertainty
when asked for a definite opinion as to whether a child is, or is not,
suffering from whooping cough and the difficulty which the
teachers experience in coming to a decision can be well understood.
Again, in the case of measles, the pre-eruptive symptoms and signs
being only those of a severe "cold," a definite diagnosis cannot be
made before the rash appears
As both diseases are, without doubt, highly infectious in the
earliest stage, it follows that many other children may be infected
before the first case is definitely recognised.
There is a good deal of ignorance and carelessness on the
part of parents as to the necessary care in dealing with these
cases, but on the whole parents are willing to keep the child away
from school if they are suffering from either of these diseases.
Whatever arrangements may be made to secure notification of
these cases, it is probable that many will still reach school, and in
the event of subsequent enquiries being made, ignorance as to the
nature of the disease will always be advanced as an excuse by the
parents, and of course it is well-known that the majority of these
cases do not come under the care of a medical practitioner.
Still, even although immunity from whooping cough may
not be secured by notification and subsequent exclusion from