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Notifiable Infectious Diseases.
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disease is highest in the first and second years of life. After the
age of five years the death rate caused by it is relatively very small.
It is therefore of the utmost importance to adopt special measures
aimed at ensuring increased safety for children under five so as to
postpone attacks of measles to a later age when it is less fatal, or
to avoid attacks by specially protecting young children until they
have attained a less susceptible age.
The cases were mainly, fortunately, mild in type; the two deaths
which occurred were deaths of infants between 1 and 2 years of age.
It was found necessary to close one Infants' School and the
Day Nursery for a short period to prevent the spread of the disease.
The number of cases notified in each of the previous 5 years
was in 1917, 743 cases; 1918, 620 cases; 1919, 159 cases; in
1920, 570 cases; and in 1921, 44 cases respectively.
Two deaths occurred, corresponding to a death-rate of 0.06 per
1,000 of the population, contrasted with 0.35 for London, and 0.15
for England and Wales.
The important steps, apart from precautionary measures to
limit as far as possible the spread of the disease, are to endeavour
to persuade the parents to obtain medical treatment in all cases
and, by instructions to the parents, to secure for the patient the
care in nursing which is so important in avoiding the serious
complications of the disease. These are the steps, amongst others,
taken by the Health Visitors in their work of "following up" the
cases notified, and this work had most beneficial results.
Notification is obligatory upon the parent unless the case has
been already notified by a Medical Practitioner in attendance.
Unfortunately in many cases a doctor is not called in, and, in a
certain proportion of these, the parent fails to notify the case to
the Medical Officer of Health. It is on this account that the
arrangement whereby Head Teachers are required to notify to the
Medical Officer of Health and to the School Medical Officer the
names and addresses of all children absent from School and
believed to be suffering from, or contacts of, a case of infectious
disease, are of the utmost importance. It is only by this means
that the majority of unnotified cases can be brought to the notice