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Lecture 7

Lecture 7 In-class Notes [Measles]

Health Studies
Course Code
Caroline Barakat

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Historical perspective
-The origin of measles is unknown
-Earliest description is attributed to Rhazes (900AD) - separated smallpox and measles clinically
but thought they proceeded from the same cause
-Prevailing theory was that the red rash represented the mothers menstrual blood that
accumulates during the child’s stay in the womb
-Disease was welcomed - a way for the child to rid himself of the so called ‘poision’
Modern history of Measles
-Began in 1670, with Thomas Sydenham’s (also known as ‘father of clinical ovservation’)
description of his son’s attack
-He was the first to clearly separate measles from smallpox, and he recognized complications
such as cancrum oris (noma disease that leads to the destruction of tissue around the mouth)
and encephalitis (inflammation of the brain)
-At the same time, scientists rejected the mothers blood theory
-Francis Home (1757) demonstrated the infective nature of measles - succeeded in transmitting
measles using blood from an infected child (8/10)
Peter Ludwig Panum (1820 - 1885)
-Sent by Danish govn’t to investigate an epidemic of measles in the Faeroe Isles in 1846
-Geographic location ideal for an epidemiological study: 17 isolated islands
-Situated between the Norwegian Sea and the North Atlantic Ocean, approximately halfway
between Scotland and Iceland
-Approximately 7,800 inhabitants
-Current population of 50,000
-Arrival of a boat was noted in the local calendar and provided an excuse for the gathering of the
entire population
-Visits from the Danish mainland were rare, but dates were well documented
-Epidemic originated in a single seaman from Copenhagen, who presumably left the city with no
signs of measles
-On arrival, he had become infectious; had not recovered completely
-Panum followed the course of the epidemic from village to village, and island to island, using
the known movement of people and boats
-He was able to establish four important facts
1. Rash appears 12-14 days after contact with an infected person
2. Infectivity is greatest 3 to 4 days before the rash appears
3. Contagious nature of disease, probably spread by droplets, and not miasmic in
4. Life-long immunity - based on findings that inhabitants over 64 years of age were
immune if they had suffered from measles as children during an earlier epidemic
that occurred in 1781
Recent history - 20th century
-1910 - Hektoen (1863 - 1951) identified the virus
-1963 - Enders (1897 0 1985) was able to grown the virus and produce an effective vaccine
Lecture 7 - Measles Feb 24, 2010
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