RELAPSE in measles is extremely rare and is, in fact, of doubtful occurrence.
A secondary rise in temperature after a normal fall indicates a complication.
Eleven eases of measles with relapses were seen in two epidemics at about the same time. From the two series of cases it would appear that overcrowding was more probably the cause of relapse than increased virulence of the germ. A. Chaufrard and G. II. Lemoine (Bull. 1116d., Jan. I. S, '96).
Two clear cases of recurrence in measlts seen. Sevestre (I3u11. INI6d., Jan. I, S, '96).
Of more than 700 cases of measles, not a single case of recurrence or relapse seen. Cornby (Bull. Aled., Jan. I, 8, '96).
Etiology.-3Ieasles is doubtless due to bacterial action, but no specific micro organism has yet been isolated.
Bacillus considered the specific organ ism of measles discovered in fourteen cases of thc disease, in the blood as well as in the sputum, and the nasal and conjunctival secretions.
It is very variable in size, sometimes as long as one-half the diameter of a red blood-corpuscle, sometimes quite small, with the appearance of diplococci. Canon and Pielicke (Brit. Med. ,Tour.. Apr. 23, '92).
Priority claimed in the discovery of the measles bacillus, prepared specimens of them having been shown as early as May, 1S7S, at a meeting of the London Pathological Society. F. Murray Braid wood (Lancet, Apr. 30, '92), Blood in 24 severe cases of measles ex amined according to the method detailed by Canon and Pielieke, with entirely negative results. .,-‘lbert Josias (La Ale& Mod., June 2, '92).
Bacillus personally observed as exist ing in the blood in measles. The bacilli in the blood vary in length from one-half micromillimetre to the diameter of a red blood-corpuscle, and in cultures grow into long threads. They stain well with all the aniline dyes, and in the longer forms a part of the protoplasm often re mains unstained. They lose their stain by Gram's method. They grow best in bouillon or sterile serous fluid from the abdominal cavity, in which a whitish, fairly heavy sediment is formed, which in older cultures becomes yellowish gray. The cultures have no character istic odor. Rabbits were always immune to the bacteria. Mice died from septi cremia three to four days after inocula tion with small quantities of the culture, the bacilli being obtained again in pure cultures from the liver and spleen.
The bacillus believed to be the specific cause of measles. Joseph Czajkowski (Centralb. f. Bakt. u. Parasit., Nos. 17 and IS, '95).
The vitality of the germ is evidently small, though it must be extremely dif fusible, for measles is the most contagious of the infectious diseases, except small pox.
Persistence of the infectious germs of measles: Four children in the same family having had measles, their clothes, the bedding, and apartments were care fully disinfected. A fifth child, born 13
months later, was wrappc,d, at birth, in mle of the blankets which had been used during the outbreak of measles, but which had been stored away during the interval. On the tenth day the infant developed typical measles. from which it recovered. J. II. Adams (Archives of Ped iatries, July. '99 .
The virulence of the micro-organism is thought to be transient. It is impor tant to note that the contagion of tneasles does not lose its virulence as quickly as has been supposed, and that death does not proceed from the attack itself, bn't almost always from one of the complications of the disease, of which bronclio-pneumonia is the most common. This latter complication is due to the presence of the streptococcus, and it is this inicro-organisin that makes the ad mission of a patient, even with a mild attack of measles, into the ward of a children's hospital dangerous, as this micro-organism is most formidable in this disease when the respiratory mucous membranes have lost their protective ciliated epithelium. Vallin (Sem. Med., Feb. 21, 1900).
Its occurrence is uncommon under six inonths, but above that age every child who has not already had it may be ex pected to contract it upon exposure.
Case of infant born on the day when the mother exhibited the morbillary rash, and at the time of birth had nasal catarrh, eonjunctivitis, and cough. When three days old the eruption was out over the whole body, the temperature was raised, and the whole clinical picture of measles was presented. Recovery oc curred after the lapse of six days. A. Bartsch (tigeskrift for Laeger, .No. 4S, '96).
Case of measles in an infant, eruption appearing thirteen days after delivery. Possible in fect ion at birth. Carstairs Donglas (Brit. Med. Jour., May 7, '11S).
Case of infant seized one week after birth xlith measles. Other children in the house had been suffering from the disease, and it is believed that infection occurred at birth. F. C. Fitz-Gerald (Brit. :Med. Oet. 1, '9S).
Adrats ate rather more susceptible to it than to the other infections diseases. Measles is endemic in all large towns, but at intervals it becomes epidemic and spreads OVer fl wide area before it expends itself. Sex is not a predisposing factor. SouucEs INFErrrox.—Measles transmitted by direct contact, but the area of contagion is larcre. Although in ; )1 t‘l_toll Otse it iS; .t,ot Nt raro. The infOCIi0IIS • ti,t` 1 1111101iTY 10St, SO 1:14.• soon beeDine Safe toe ot,tit .
tt otow eon, he-ions Ilt.4111t.ell 44 4.11.14.1\ 11,11T.t. 41i.41 1.11141eIllies