Report on the recent epidemic of measles in Brighton, with a discussion of the possibility of the employment of further measures for preventing the high mortality from this disease / by Arthur Newsholme.

  • Newsholme, Arthur, Sir, 1857-1943.
Date:
[1893]
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Credit: Report on the recent epidemic of measles in Brighton, with a discussion of the possibility of the employment of further measures for preventing the high mortality from this disease / by Arthur Newsholme. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    GfRT ON THE RECENT EF MEASLES IN BRIGHTON, With A Discussion of the Possibility of the Employment of Further Measures for Preventing the High Mortality from this Disease. BY Arthur Newsholme, M.D., Medical Offieer of Health for Brighton. During 1892 Brighton suffered severely from Measles. In the first quarter of the year no deaths were recorded from this disease; during the second quarter the number of deaths registered as due to this disease was 5 ; during the third quarter 13 ; and during the fourth quarter of the year 99. The total number of deaths from Measles during the year was 117. This number had only been exceeded in 1882, in which 178 deaths, and in 1883, in which 138 deaths from Measles were registered. The following report deals with the circumstances under which these deaths occurred ; the preventive measures which were taken with indifferent success ; the causes of this indifferent success; and the lines upon which, if any, greater success may be hoped for in the future. Dealing with the first point, we may first consider the incidence as to age of the deaths from Measles. A glance at Table I. will shew that of the total deaths 84'6 per cent, occurred under three years of age, while in the epidemic of 1882 only 654 per cent, of the deaths were at ages under three. It is difficult to find an explanation for the increase in 1892 in the proportion of the deaths from Measles under three years to total deaths from this cause, though it probably indicates a somewhat more severe type of disease. Were we able to state the total number of cases of Measles in the two years 1882 and 1892, the number of deaths per 100 cases (case-mortality) and therefore the relative severity of the disease in the two years might at once be stated. In the absence of compulsory notification of Measles, this is of course impossible. Failing this, information as to the duration of the illness in fatal cases may throw some light on the question. In Tables II. and III. I have classified all the available data on this point. The last great epidemic was in 1882, but unfortunately at that date the day of disease on which death occurred was not so accurately stated as during the last three years. There is a tendency (on the inspection sheets) for aggregation of fatal cases on the seventh, fourteenth and twenty-first days, and for this reason I have arranged all the figures in groups of six days. It is doubtful if even after this has been done complete reliance can be placed on the figures for 1882. The deaths from Measles during 1890 and 1891 (60 and 27 respectively) have been grouped together. The varying number of deaths in which the date of death was not stated causes a further difficulty ; but notwithstanding these essential weaknesses of the figures. Table III. enables us to draw some very useful deductions. Thus, in 1882, 45-5 per cent, of the total deaths from Measles occurred during the first twelve days, as compared with 61'0 per cent, in 1890-91, and with 62-4 per cent, in 1892. It is evident that if these figures are to be trusted. Measles kills at an earlier date than it formerly did. (I state this conclusion with reserve, owing to the doubt as to the precision of the figures for 1882.) There is a slightly greater tendency to early death in the great epidemic of 1892 than in the minor epidemic of 1890-1. The earlier date of death in 1892 must be connected Avitli the fact shewn in Table I., that 84-6 per cent, of the fatal cases were in children under three years of age, as compared with only 65 4 per cent, in 1882. There can be little doubt that 1401 o 25 18/2/93.