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UNITED STATES PUBLIC HEALTH SERVICEMEASLES
By
W. C. RUCKER
Assistant Surgeon General, United States Public Health Service
SUPPLEMENT NO. 1
TO THE
PUBLIC HEALTH REPORTS
JANUARY 24, 1913
[EDITION OF JUNE, 1916]
WASHINGTON
GOVERNMENT PRINTING OFFICE
1916
MEASLES.
By W. C. RUCKER, Assistant Surgeon General, United States Public Health
Service.
Over 11,000 American children died of measles in the year 1910. This did
not include a large number who died of broncho pneumonia, a great number
of cases of which, in children, are caused by measles. Sixty eight and
two tenths per cent of all deaths from broncho pneumonia occur in children
under 5 years of age, a time of life when measles is most apt to occur.
But the story of the ravages of this disease is not complete without the
mention of the large number of cases of tuberculosis which follow an
attack of it. Less frequently inflammation of the ear or the eye may be
left behind as a mark of a visitation of this common disease. From a
public health standpoint, then, measles is a disease of prime importance.
Long association with a disease breeds a contempt for it, and measles, in
common with the other diseases of childhood, has come to be looked upon as
an unavoidable accompaniment of youth.
Each autumn when school opens there is an increase in the number of cases
of measles, and as the season progresses they gradually increase, and
winter frequently sees the disease spreading in epidemic form. Hirsch has
collected data of 309 epidemics of measles, and has classified them
according to season; summer had 43, autumn had 76, winter had 96, and
spring had 94 epidemics.
Measles is a disease of close association; hence its increase during the
colder months.
Frequently a child will go to a party and engage in innocent games in
which children are brought in close contact with one another. Perhaps
among the guests there is one with reddened, watery, eyes, which are
sensitive to light. The eyelids are perhaps a little puffy, and the guest
has a hard, high pitched cough. The other children pay no attention to
this, and the games go on uninterruptedly. In this way a single child in
the beginning stages of measles may easily affect 15 or 20 others. This is
frequently the case when kissing games are played.
About 10 days later the children who have exposed themselves to the
disease begin to sicken. They, too, have red, watery, sensitive eyes and
puffy eyelids. In fact, in rather severe cases the whole face has a rather
swollen, puffed appearance. The throat feels parched and a dry, irritating
cough increases the discomfort. The child is apt to come home from school
feeling drowsy and irritable, not infrequently complains of chilly
sensations, and may even have a chill. At night the irritation increases,
the child is feverish, the whites of the eyeballs show little red lines
upon them, and the little sufferer has the appearance of being just ready
to cry.
If the anxious mother takes the child to the window in the morning, raises
the curtain, and examines the little one's throat she will see that the
hard palate and back of the throat are a dull, angry red. Perhaps there
are a few little red spots on the hard palate, and if the mother will look
closely at the lining membrane of the cheek she will see some small
white tipped, reddish spots. These are called "Koplik's" spots, and are
one of the signs of measles.
The child is kept from school that day, and that night his fever is higher
than it was the night before. He rolls and tosses about the bed and wakes
up his mother a good many times to ask for a drink of water. This sort of
thing continues for 3 or 4 days; then, one morning when the child is
having its bath the mother sees some little dusky red spots along the hair
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