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]
Catalogue details

Licence: Public Domain Mark

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.

    4/8 (page 4)
    years, but rather of some increase. It should be stated here tliat no evidence exists that Measles is spread in any other way than by personal infection; there is not the slightest reason for connecting its origin with defective drains or any other insanitary conditions ; though it is much more easily spread among the poor through conditions of overcrowding and dense aggregation of population, and among them is also much more prone to be fatal owing to luifavourable conditions of nursing. On looking at the columns for Typhoid Fever and Scarlet Fever there is a marked contrast. Typhoid Fever, if we except the year 1881, in which an outbreak due to an infected milk supply occurred, has steadily declined with improvements in main sewerage and house drainage, and with the abolition of cesspools. Scarlet Fever again shows a remarkable decline in fatality. Diagram II. indicates that at intervals of not more than three years, this disease in the past has assumed epidemic proportions. Since 1882, when the Borough vSanatorium came into full operation, the umal j^eviodiml rhe in mortality from Scarlet Ferer has failed to appear. It may be admitted: {a) That Scarlet Fever has probably become a considerably milder disease of late years; {h) That apart from(a)the superiority of hospital over home treat- ment of this disease is so great that the number of deaths has been lowered to a greater extent than the number of cases.* As, in Brighton, we have had compulsory notification of vScarlet Fever only since March, 1891, it is impossible to prove how far the diminished virulence of the disease is the cause of this lowered mortality. I am strongly of opinion, however, that this does not account to more than a small extent for the striking and continuous fall in mortality from Scarlet Fever which is shown in Diagram II. The Diagram seems to point irresistibly to the conclusion that, with the increasing use of the Borough Sanatorium, the possibilities of infection have been reduced, and consecpiently the mortality from Scarlet Fever has been lowered. I know of no factor competent to have produced this result, apart from the isolation of patients at the Sanatorium. In 1891 (ten months) 70 per cent, of the cases, and in 1892 72 ])er cent, of the cases of Scarlet Fever were removed to the Sanatorium. The remaining cases were all such as were isolated with a fair degree of efficiency at home, as otherwise removal to the Sanatorium would have been pressed. ■With such a favourable result for Scarlet Fever, the question naturally suggests itself, whether results approaching this in success might not be obtained for Measles ? Before answering this question, the measures already attempted may l)e stated. Summary of measures already adopted.—No measures can be taken without a knowledge of the cases, and measures taken after the receipt of death certificates can evidently be of little use. Every endeavour has therefore been made to obtain voluntary information of all cases of Measles. Information has been received from school attendance officers, district visitors, poor law medical officers, and the pul)lic dispensaries Since the 8tli of October, by arrangement with the Clerk of the School Board, each teacher has filled up, at weekly intervals, a list of absentees whose cause of absence is suspected to be Measles or some other infectious disease. During the recent epidemic two additional temporary inspectors were employed to visit cases of Measles. Altogether during last year 1,276 cases of Measles came to our knowledge, viz. :— 776 houses having one case in each house, ,, ,, two cases ,, ,, ,, three ,, ,,- J) )> four )) )> five ,, 136 ol 12 3 ♦ Duiiiii; 1802, of 'AH'Z cjises of Scarlet Kevei-, 276 were treated at the Sanatorium and 4 in otlier Ho.spitals, with a mortality of 1 TN per cent. ; 102 were treated at home, with a mortality of 1-96 per cent.