UNITED STATES PUBLIC HEALTH SERVICE MEASLES 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.