Measles (rubeola)
- Benson.A.R,
The onset of measles is decidedly different from that of the diseases just described. The first symptoms to be noticed are a discharge from the nose, usually attributed to a cold, and soreness and inflammation of the eyes. There is a slight rise of temperature (101° - 102°), and a dry, troublesome cough. Headache is sometimes present, but rarely vomiting. The child is almost invariably cross and irritable, and cries at the slightest provocation. During this time the throat, if examined, appears dark red and congested. Sometimes small white dots with a dark bluish base (Koplik's spots) may be detected on the inside of the cheeks if examination is made for them in the daylight.
About four days after the first symptoms are noted the skin eruption appears. It is apt to be seen first upon the chest and spreads rapidly over the whole body, the temperature increasing until the rash is fully developed. The rash is dark red, almost coppery in appearance, and the spots appear to be slightly elevated on the surface of the skin. These spots run together, but there are frequent areas of healthy skin, so that the general appearance is mottled rather than the diffused redness of scarlet fever. The eruption becomes darker, almost purplish, and fades slowly. There is usually itching of the skin.
The cough and nasal symptoms often increase and cause much discomfort. The eyes remain sore and severe inflammation of the conjunctiva may result. The eruption remains for two or three days, and the temperature falls rapidly as the eruption fades. During the acute stage of the disease there is frequently stomach or intestinal disturbance, usually in the form of diarrhoea. After the eruption fades, the skin peels, but the flakes of skin are very fine and will not be detected unless careful examination is made.
The eyes and ears are frequently infected in measles, and serious inflammation of these organs is to be expected. The most frequent complications, however, are bronchitis and pneumonia. Cough and temperature existing after the eruption has disappeared should be regarded with suspicion. The weakened lung tissue also provides fertile soil for the tubercle bacilli, and many cases of pulmonary tuberculosis are traceable to an attack of measles. The lowered vitality of the child after measles enables the tubercle bacilli to obtain a strong foothold.
It is not impossible for an individual to have more than one attack of measles, but oftentimes one of these attacks is unrecognized German measles.
Nursing : The child should be kept in bed during the attack, and care should be taken to prevent a bright light from striking the eyes. It is not necessary, however, to exclude fresh air, so long as the ordinary precautions against taking cold are observed, nor should the child be kept uncomfortably warm, as is so often done.
The eyes should be cleansed of all discharge with warm water, and the nasal passages kept as free as possible. The skin may be anointed with olive oil to prevent itching, or if this is not effective, the skin may be dusted with powder.
The child may be given plenty of cool water to drink, but a liquid diet should be insisted upon.
Bryonia may be given, a teaspoonful every hour, during the first stages, especially if the cough is dry, hard and troublesome, if there is much headache and the eruption is slow in appearing.
Chamomilla should be administered in the same way if the mental symptoms predominate, if there is much irritability and fretfulness.
Arsenicum is indicated if there is gastric irritability with loose movements, high fever, and excessive thirst.
It is of the utmost importance to allow a long period of convalescence after measles. Many children are allowed to go out before they are entirely well and frequently contract diseases of the lungs as a result. Perhaps there is no other disease of childhood which leaves the patient's vitality in such a lowered condition as measles, and for this reason a long rest, preferably in the country, should follow an attack. Frequent examination of the lungs should be made, and more than ordinary care should be used to prevent taking cold.
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| Measles |
About four days after the first symptoms are noted the skin eruption appears. It is apt to be seen first upon the chest and spreads rapidly over the whole body, the temperature increasing until the rash is fully developed. The rash is dark red, almost coppery in appearance, and the spots appear to be slightly elevated on the surface of the skin. These spots run together, but there are frequent areas of healthy skin, so that the general appearance is mottled rather than the diffused redness of scarlet fever. The eruption becomes darker, almost purplish, and fades slowly. There is usually itching of the skin.
The cough and nasal symptoms often increase and cause much discomfort. The eyes remain sore and severe inflammation of the conjunctiva may result. The eruption remains for two or three days, and the temperature falls rapidly as the eruption fades. During the acute stage of the disease there is frequently stomach or intestinal disturbance, usually in the form of diarrhoea. After the eruption fades, the skin peels, but the flakes of skin are very fine and will not be detected unless careful examination is made.
The eyes and ears are frequently infected in measles, and serious inflammation of these organs is to be expected. The most frequent complications, however, are bronchitis and pneumonia. Cough and temperature existing after the eruption has disappeared should be regarded with suspicion. The weakened lung tissue also provides fertile soil for the tubercle bacilli, and many cases of pulmonary tuberculosis are traceable to an attack of measles. The lowered vitality of the child after measles enables the tubercle bacilli to obtain a strong foothold.
It is not impossible for an individual to have more than one attack of measles, but oftentimes one of these attacks is unrecognized German measles.
Nursing : The child should be kept in bed during the attack, and care should be taken to prevent a bright light from striking the eyes. It is not necessary, however, to exclude fresh air, so long as the ordinary precautions against taking cold are observed, nor should the child be kept uncomfortably warm, as is so often done.
The eyes should be cleansed of all discharge with warm water, and the nasal passages kept as free as possible. The skin may be anointed with olive oil to prevent itching, or if this is not effective, the skin may be dusted with powder.
The child may be given plenty of cool water to drink, but a liquid diet should be insisted upon.
Bryonia may be given, a teaspoonful every hour, during the first stages, especially if the cough is dry, hard and troublesome, if there is much headache and the eruption is slow in appearing.
Chamomilla should be administered in the same way if the mental symptoms predominate, if there is much irritability and fretfulness.
Arsenicum is indicated if there is gastric irritability with loose movements, high fever, and excessive thirst.
It is of the utmost importance to allow a long period of convalescence after measles. Many children are allowed to go out before they are entirely well and frequently contract diseases of the lungs as a result. Perhaps there is no other disease of childhood which leaves the patient's vitality in such a lowered condition as measles, and for this reason a long rest, preferably in the country, should follow an attack. Frequent examination of the lungs should be made, and more than ordinary care should be used to prevent taking cold.
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