and North Carolina were 32.6 and 27.1 per 100,000 inhabitants.
In the same year the death rate per 100,000 from measles in Pittsburgh, Pa., was 33.1; Providence, R. I., 31.9; Kansas City, Mo., 28.4; Lowell, Mass., 28.1; Albany, N. Y., 23.9; Columbus, Ohio, 23.6; Buffalo, N. Y., 22.1; and Richmond, Va., 21.1.
The death rate among those attacked varies from 1/2 to 35 per cent. If it is estimated that the death rate is 1 per cent, and the number of deaths from it in the United States during the year 1910 was 11,000, then it would follow that during that year at least 1,100,000 children suffered from this disease. When it is considered that perhaps 30 per cent of these children were of school age, and that the disease occurs most often during the months of school attendance, then it will be seen that 330,000 children were kept from school from six weeks to two months on account of measles. Leaving out of consideration the death and suffering which was produced in this way, this is a serious economic loss.
Measles is a frequent accompaniment of war, or any other occasion which brings large numbers of persons together under unhygienic conditions. In fact, measles is one of the most formidable of camp diseases. This fact is well demonstrated by morbidity and mortality statistics of the Civil War. At that time the mortality rate was very high in the general field hospital at Chattanooga, being 22.4 per cent, and in the general field hospital at Nashville it was 19.6 per cent. In 1865 there were 38,000 cases with 1,900 deaths from measles in the Confederate army. It is reported that during the Brazilio-Paraguayan War an epidemic of measles swept off nearly a fifth of the Paraguayan army in three months.
It is thus seen that measles is many times a very severe disease, one which can not be dealt with lightly, one to which we should not expose our children. A child with measles should be put to bed and kept there as long as it has any fever or cough. The room should be airy, but it should be darkened, because children with measles are very sensitive to light. The bedclothes should be light, because the child is apt to get too warm, kick off the covers, and suffer from the cold. A chilling in this way may predispose to pneumonia. Food should be light and should consist chiefly of nutritious broths, pasteurized milk, soft-boiled eggs, and the like. Ice lemonade will bring comfort to the inflamed throat. The child's eyes should be kept clean, and should the fever get high the comfort of the little sufferer may be increased by sponging with tepid water and alcohol. Sometimes it is necessary to put an ice bag to the head, but, if the child is sick enough to require this, skilled assistance should be summoned.
When the fever and cough have gone the child may be allowed to be up and about the room, but for a time should not indulge in violent exercise, because there is often some weakening of the heart muscle by the disease. The aim is to allow the heart muscle to regain its normal condition before putting too much strain upon it. The diet should be increased when the fever has gone away, and should include good, plain, strong foods. If there is a tendency to regain weight and strength slowly, the child may be given an increased amount of pasteurized cream or good butter. If the child prefers cod-liver oil, this may be substituted.
The important point about the prevention of the disease is the fact that, judging from the experiments of Anderson and Goldberger above referred to, measles is rarely transmissible after the fever has gone down. Experimenting with monkeys, they found that they were unable to transmit measles from monkey to monkey after the stage of fever had ceased. It used to be thought that the germs of measles were in the scales of skin which were shed at the close of the disease.
It is thought by some that there may be chronic carriers of measles, but this is not at all proven. It is also believed that a discharging ear following measles may be the means of continuing the transmission of the disease. This is not proven. There are on record a large number of instances which seem to point to the fact that under certain conditions a third person may carry the infection from the sick to the well. Transmission of measles to human beings by the lower animals is still unproven.
It is not known what the cause of measles is. A great many scientists have described germs which they believe to be the causal agents, but up to date these have not been positively proven
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