The Topeka state journal., 1919-12-27
Health and Happiness
DISCUSSIONS OF DISEASES THAT MUST BE MET
IN NEARLY EVERY HOUSEHOLD
BY DIR. EARLE G. BROWN.
Health Officer, City of Topeka.

! the stage of invasion is gradual, both
the fever and the catarrhal symptoms
increasing gradually up to the appear
ance of the eruption The number of
days of this stage varies from / to
10, the average being to days. 1t
| is characterized by running eyes and
nose, dry cough, pain in the back
| and drowsiness. During this stage the
| fever is high, but usually falls pre-
vious to the time of the eruption.
''Koplik spots" may be found as a
| blush white spot upon red ground.
Located on the inside of the cheeks
! opposite the molar teeth. This sign is
| of value in that it enables the physi-
clan to make a diagnosis to days
before the skin eruption.
The rash usually appears the third
to the fifth day of the disease. First
| behind the ears, neck and roots of the
! hair on the forehead, last on the lower
eXtremities. Occurs as small red
spots. which gradually become larger,
, and always separated by areas of nor
>mal tissue. The eruption fades in or
der of its appearance, averaging
about five days.
With the appearance of the erup-
ton, the fever again rises. The eyes
are red and very sensitive to light.
| The cough is frequent and annoying.
AS the eruption disappears the tenn
perature declines rapidly, often reach
ing normal in / to 2 days. Within a
day or two after the fever has ceased,
the rash fades and very soon the pa
tient is conyalescent.
Except in children under 8 years of
age the deaths from measles are few,
but in institutions containing young
children no epidemic disease is SO IA
tai. Holt says the general mortality
is to per cent, but may range from
! 5 to 35 per cent. Holt further states
death in 40 was broncho pneumonia.
CDr,,1Ho.t;o.z
The greatest danger arises from
lung complications and the frequency
is greatest in children under 2 years
of age. In two epidemics in the Nurs-
cry and Chiid's hospital. 900 cases,
nearly all in children under 3 years of
age, broncho pneumonia occurred in
about 40 per cent. and of these 10
2.477 cases. embracing several epi-
denies among children of all ages,
pneumonia developed in 10 per cent
The mortality is very high among
aboriginal races. In the Samoan is-
lands, 1000 deaths followed the in
PRODUCTION of the disease there in
1908. In comparison, the death rate
according to Heissler in German
epidemic of 2,SS1 cases was only 1
per cent. Measles in institutions is
often complicated by diphtheria. Epi-
denies of whooping. cough and
measles frequently occur together>or
follow each other.
German measules is a disease SINH
lar to measles but distinct from it.
The initial symptoms are practically
absent, but when present may last
only kaH day. The eruption is sim
liar to that of measles. but the spots
are smaller and fade in two to four
days. Moderate fever may be present.
The other preliminary symptoms may
ttbe present, but to a much less degree
than in measles.
In the book OF mortality statistics
issued by the director OF the census
for 1917, there were 1915 deaths
from measles in the United States, a
rate of 14.3 per 100000 population.
This rate stands out in vivid contrast
for 1915, which was "a per 100000
population. The rate for Kaasas in
1914 was 4.3: 1915, 40; 1915 SIS;
1917, 1879. Great variations may be
expected in view of the epidemic char
acter of the disease
The rules of the state board of
health require the disease to be re-
ported and the home to be pIacarded.
| No member of the household except
those who have had the disease shall
be permitted to leave the quarantined
home. The minimum duration of the
| quarantine shall be seven days after
| the appearance of the rash and until
all discharges from the nose, ears and
| throat have disappeared and the
cough is ceased.