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30 Report of the Medical Officer of Health.
any measures adopted for combating the mortality should be
carried out in close co-operation with the Maternity and Child
Welfare Service, and the home visiting can be done, most appropriately,
by the Health Visitors who are appointed for that
Service, rather than by the Sanitary Inspectors who investigate
other infective diseases.
The mortality is due to the occurrence of complicated cases,
and in order to lessen the incidence of complications it is essential
for information of the existence of cases to be available as early
as possible.
Measles was a notifiable disease throughout the Country
from 15)15 to 1919 and general notification was discontinued
because it was ineffective as a means of combating the mortality
from the disease. The early information essential to the success
of any efforts directed to the prevention of complications was
not forthcoming under a system of notification. Among the
reasons for this is the fact that many cases of Measles are
treated by domestic methods only and medical advice is not
sought. Added to this are the difficulties in diagnosing the
disease in the early catarrhal stage before the appearance of
the typical eruption. It is in this early stage that the infectivity
is highest, and as most of the cases are then undiagnosed,
precautions for preventing the spread of infection are not taken
when they are most needed, and notification agains fails to
give the assistance required.
During an epidemic the names of a large number of children
absent from school on account of Measles in the home, are forwarded
from day to day by the School Authorities. In previous
years this information was often not received until the children
had been away from school for some days. Frequent delays
also occurred in the visiting of these children by the Staff of this
Department owing to other calls on their time. As a result of
these delays children suffering with Measles were often not discovered
until the disease was well advanced.
The following special measures were adopted for the first time
during the epidemic of last year.