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number of other susceptible children who are thrown more or less into
intimate contact with it, contract the disease. Dr. Kerr calls the first
case the seed, and the children infected by this child the first crop.
The children of the first crop may act as seed for a second crop. So
that he holds, that closure of schools, to be effectual, must take place
before the first crop develops, that is to say, it must be carried
out on the occurrence of the first case in a susceptible class. If it is
deferred until the first crop has appeared, then the seed will have so
widely spread that practically all the susceptible children will have
received the infection, and will form the second crop.
For practical purposes it must be assumed that all children who
have not already suffered from the disease are susceptible, so that to
work the system of individual exclusion, it is necessary to know the history
of all the children in a class with respect to measles. Dr. Kerr
holds that the balance in favour of closure, even at the earliest
opportunity is doubtful, and that later, it is without doubt, futile.
The following letter was received :—
London County Council.
Education Offices,
Victoria Embankment, W.C.
3rd April, 1906.
Dear Sir,
I have to inform you that the Council has adopted the
undermentioned regulations for the exclusion from school of
children suffering from measles, or coming from houses where
measles exists
" Children suffering from measles must be excluded for at
least one month."
Children coming from houses where measles exists, but who
are not themselves suffering from the disease, should be dealt
with as follows :—
(1) A child attending other than an Infants' school, who has
had measles need not be excluded from attendance at school.
(2) A child attending other than an Infants' school who has
not had measles must be excluded from attendance at school
until the Monday following the expiration of 14 days from the
occurrence of the first case.
(3) A child attending an Infants' school whether or not it
has had measles, must be excluded from attendance at school
until the Monday following the expiration of 14 days from the
occurrence of the last case.
This procedure supercedes the existing regulation, Sub sec. 5
of Section C of Article III. of the Provisional School Management
Code.
Yours faithfully,
(Signed) James Kerr,
Medical Officer (Education).
H. W. Roberts, Esq., M.R.C.S.,
Borough of Deptford.
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