Measles may be termed the opprobrium of present-day sanitary
science. With the doubtful exception of diphtheria, it is the only
zymotic disease which has not proved amenable to preventive dis-
cipline.

A. Campbell Munro ( 1890-1)

Measles and its death-toll [is a] question of national importance.
Its satisfactory solution is one of the greatest problems of latter-
day preventive medicine.

Frederick Waldo and David Walsh ( 1896)

'Measles is known to all mankind', wrote Frederick Waldo and David Walsh
in 1896. 'The mere mention of measles suffices to carry one back to the nurs-
ery and the schoolroom, when "catching" maladies were looked upon as a nec-
essary part of the game.' ¹ There was no question of avoiding measles; it is one
of the most infectious diseases known to man; a disease from which almost
everyone will suffer, unless protected by immunization. Its ubiquity, and its
nature, usually as a mild infection of early childhood, have so moulded the
popular perception of the disease across generations that it is generally
regarded, in Western Europe at least, as a disease of small account. The roots
of this attitude lie far back in the past. In the great Victorian cities and in the
countryside, among all social classes, measles was mostly thought to be harm-
less, an integral part of a child's experience. ² It is a comprehensible attitude,
for ordinary measles is a mild disease, requiring nursing, but little in the way
of treatment. In the nineteenth century, nevertheless, it was one of the major
killers of children under 5 years old.

Middle-class mothers in the 1860s and 1870s were well aware of the dangers
of measles. Isabella Beeton described it as a 'much-dreaded disease' which
entailed 'more evils on the health of childhood than any other'. ³ For measles
can be one of the most formidable of the infectious diseases of childhood.
Mild in itself, it can assume a life-threatening form in certain circumstances,
in 'virgin-soil' populations, and in the severely undernourished. It also predis-
poses sufferers to secondary bacterial infections, which may result in perma-
nent hearing and respiratory injury. Under adverse social conditions, and

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