Measles

Measles (Morbilli), an infectious disease characterised by a peculiarskin eruption with associated affection of the mucous membrane of the respiratory tract. Measles is exceedingly infectious, and is capable of transmission from person to person at a very early stage, indeed before the precise nature of the malady is definitely declared by the appearance of the characteristic symptoms. It thus happens that most people are affected by the disease in early childhood, and the individuals so attacked appear to acquire "protection" against subsequent attacks. Measles is therefore uncommon in adults, though in some exceptional instances a second or third attack of the disease has been known to occur in the same individual. After exposure to infection, a period of incubation ensues of from 12 to 14 days' duration. After the lapse of this time a person who is susceptible and unprotected becomes feverish and suffers from headache; there is watering of the eyes, sneezing, and sometimes hoarseness and cough. On the fourth day after invasion the fever increases and the characteristic eruption develops. It usually appears first on the forehead, and then travels downwards, involving the whole surface of the body, but particularly affecting the back. The rash attains its full development in two or three days, and then gradually disappears, leaving behind it, as a rule, some degree of bran-like desquamation. When the rash begins to fade the temperature usually suddenly declines, and, in the absence of complications, convalescence soon becomes established. The rash is slightly elevated above the surface of the skin. It is of a dusky pink colour, and the papules of which it consists are often arranged in a crescentic manner. It is liable to be confounded by the uninitiated with the eruption of scarlet fever, and in some instances small-pox in its early stages has been mistaken for measles. Certain complications are apt to supervene upon an attack of measles, particularly laryngitis, bronchitis, and pneumonia, while purulent ophthalmia and suppuration of the middle ear are not uncommon. Treatment consists in keeping the patient in bed in a well-ventilated room, protecting him from draughts, and feeding him during the febrile stage upon an ordinary sick diet. When convalescence is established tonics may be administered, and a more substantial diet adopted. Should complications appear, they would require special treatment. In order to prevent the spread of the disease the patient should be absolutely confined to his room during convalescence, and should not be allowed to associate with other children for at least three weeks, and then only if all desquamation and cough have ceased. The sick chamber and clothes, bedding, etc., must, of course, be properly disinfected.

German measles (rotheln) is an infectious disease, closely resembling, and often confounded with, measles. The period of incubation is probably shorter than in measles, the initial febrile stage is shorter than in that malady, and the cold in the head is absent or is a less marked phenomenon. Sore throat is, on the other hand, usually complained of, and it is said that in rotheln there is a tendency to the enlargement of the lymphatic glands. The disease is, on the whole, milder than measles, and is rarely attended by complications. Measles and rotheln are not mutually protective.