Memorandum on measles.

Date:
1911
Catalogue details

Licence: In copyright

Credit: Memorandum on measles. Source: Wellcome Collection.

    7/14 (page 3)
    The efforts hitherto made to control measles, so far as can be seen, have not in most instances greatly influenced the course of events. 3. Essential Difficulties in Controlling Measles. This lack of success is due in the main to the special charac- teristics of the disease, though the failure to secure complete interchange of information and help between parents, school officers, and medical officers of health, has also contributed to the result. Measles starts with the symptoms of a “ severe cold,” and the characteristic rash appears only on or about the fourth day of the illness. Infection is spread chiefly during this catarrhal stage and in the earliest days of the rash ; it is disseminated probably as spray when the patient coughs or sneezes. Experience shows that most persons not protected by a previous attack are susceptible to measles,# and acquire the disease when they come within range of infection. The course of events in a school class is usually as follows :—a child attends school suffering from the preliminary catarrh of measles. Twelve days later the first crop of cases occurs among the children in this class, and in twelve days more the majority of the unprotected children will have been attacked. If the first child’s attack were known of at an early date it would be practicable, by arranging for closure of the class from the tenth day (two days before the appearance of the first crop) until the first crop of cases appeared, to prevent, for the time being, further spread in the particular class. The preceding outline of the course usually pursued by a school outbreak shows how difficult is the problem. Under present cir- cumstances, the first case is rarely known to the medical officer of health, and may not be known to the school officers until the crop of cases commencing twelve days later has occurred and been recognised. It is generally agreed that measles is spread on the largest scale by the attendance at public elementary infant schools of children in the catarrhal stage of the disease. The occurrence of similar spread in the boys’ and girls’ departments of the same schools is prevented by the fact that most of the scholars in these departments are already protected by previous attack. It must also be realised that if by any means at present available the amount of measles occurring in large towns among children who attend infants’ schools were to be reduced, a somewhat corre- sponding increase would be likely subsequently to occur in the number of cases in the boys’ and girls’ departments. This con- sideration does not, however, justify the failure to adopt every practicable means for reducing the incidence of measles in younger children; inasmuch as the postponement of epidemics, so that a * In one epidemic in which this point was accurately investigated, only one out of every eight children in invaded houses, who had not previously had measles, escaped attack.