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.
- Arthur Newsholme
- Date:
- [1893]
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.
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![Notification alone is valueless. It is a means to an end ; the end being the isolation of the infectious sick and the prevention of the spread of disease. Is isolation practicable for Measles?—There are many difficulties in the way. [a). Measles attacks children of tender years, thus increasing the difficulties of hospital treatment. Judging however by our experience of Scarlet Fever, there is but little difficulty in persuading mothers to allow their children, aged 1 to 3 years, to be removed to the Sanatorium. {b). Measles is infectious from the onset of the first catarrhal symptoms, for 72 hours before the appearance of the characteristic rash, and during this time other children may have become infected. Hence there is less certainty of preventing the spread to other children than in Scarlet Fever, in which the characteristic rash appears within 12 hours. But Measles continues infectious for a further 14 or 18 days, and it is surely an insufficient reason for doing nothing during this period, that we have been able to do nothing for the first three days. [c). It is urged that only hospital accommodation on a gigantic scale would suffice for an epidemic disease like Measles, which so rapidly assumes such enormous proportions. This argument appears to beg the very point at issue. The rapid spread of measles is, in fact, always preceded by a number of sporadic cases, just as a heavy shower is preceded by drops of rain. I have made careful inquiries as to the mode of procedure in some of the towns in which Measles is already compulsorily notified. It must be admitted that in most of these the notification of Measles has been of little, if any, service. But I do not know of any town in which a prompt and persistent attempt has been made to secure the isolation, either in hospital or at home, o/ every notified case o/ Aleasles during the periods in which odd cases occur, in the intervals of an epidemic. It is perfectly true that the number of cases of Measles in an epidemic is so great that no reasonable amount of hospital accommodation would suffice. But would epidemics of so great a magnitude occur if the isolation of early cases was insisted upon ? {d). It is not improbable that for several years householders would fail to comply with the requirements of the Act, and that thus many cases would escape notification. There is little doubt that this cause would prevent compulsory notification of Measles being completely successful for many years to come. This very fact, however, forms a strong argument in favour of immediate notification. If householders require to be educated on this point, then, in the interests of the town, the process of education should be started with all possible promptitude. (c) It is also commonly stated that a large proportion of deaths from Measles occur after three or four weeks, and that hospital isolation or careful home nursing would not prevent these deaths. Table III. shews, however, that 78-6 per cent, (at least) of the deaths occur within the first eighteen days, and that proper treatment during this time would remove the greater portion of the danger. Another point is noteworthy. The hospital treatment of Measles patients would not average more than 21 days, while that of Scarlet Fever averages about 54 days. It is evident, therefore, that in a given period two-and-a-half times as many patients with Measles can be treated as with Scarlet Fever. I have frankly stated the chief difficulties in the way of notification of Measles as a means of preventing its spread. The chief advantages of such notification are as follows :— («). In inter-e})idemic periods the isolation of cases of Measles could he enforced, with an increased probability of ])reventing, or at least mitigating, the wide-spread epidemics at biennial or triennial intervals. {I)). In epidemic periods, although it would be impossible to remove every case to the Sanatorium, the most severe cases could be so removed, and thus the case-hi<)ytalitg yreatlij reduced. The more efficient nursing at the Sanatorium](https://iiif.wellcomecollection.org/image/b24398834_0006.jp2/full/800%2C/0/default.jpg)
