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University of Toronto Scarborough
Health Studies
Caroline Barakat

Lecture 7 – Measles Historical perspective -Earliest description attributed to Rhazes (900 AD) – clinically separated smallpox and measles - believed that both proceeded from same cause -confused on the past between smallpox and measles dating back to 7 century because both caused rashes on the body; measles relatively newer...not mentioned by Hippocrates in 14BC -Prevailing theory - red rash represented the mother's menstrual blood -Measles was way for child to rid himself of the so-called 'poison‘ -welcomed disease of childhood -Measles also known as rubeola, hard measles, red measles, morbilli, hasbah -Origins of term ‘measles’ - ‘misellus’ or ‘misella’ i.e. miserable Modern History of Measles 1670 - Thomas Sydenham's observed clinical features; description of his son's attack -Clearly separate measles from smallpox, and recognized complications related to measles= cancrum oris and encephalitis -Scientists rejected the mother's blood theory and measles is infectious, contagious disease 1757 - Francis Home demonstrated the infective nature - he succeeded in transmitting measles using blood from an infected child -able to transmit measles using blood from infected child to 8/10 participants -measles easily transmitted and infectious and can move to one individual to another unless they have immunity -encephalitis = inflammation to the brain -cancrum oris = destruction of the tissue around the mouth; occurs rarely with measles Peter Ludwig Panum (1820 – 1885) -Sent by Danish government to investigate an epidemic in Faeroe Isles in1846 -Panum conducted the first epidemiological study -Geographic location ideal for an epidemiological study -geographically it consists of 17 isolated islands between Norwegian Sea and North Atlantic Ocean -climate cooler so stay at home, so transmission of disease easy -Approximately 7,800 inhabitants – 102 died of measles -Arrival of a boat noted in the local calendar -move via boat that’s heavily documented so know people -Visits from the Danish mainland were rare -Epidemic originated in a single seaman from Copenhagen and upon arrival there were clear signs of measles -On arrival, he had not recovered completely -Panum followed the course of the epidemic -He was able to establish four important facts Panum on Measles: Observations Made During the Epidemic of Measles on the Faroe Islands in the Year 1846 (A translation from the Danish)-By Peter Ludwig Panum. New York: Delta Omega Society, 1940. Distributed by American Public Health Association. 111 pp. 1. Rash appears 12 to 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 – respiratory route of transmission 4. Life-long immunity Recent history – 20th century 1910 – Hektoen (1863–1951 1963 – Enders (1897 – 1985) isolated virus and produced vaccine 1969 - Discovery of relationship between measles and a rare degenerative disease - sub-acute sclerosing panencephalitis - occurs 1 in 100,000 - develops 5 to 10 years after acute measles Etiology Family: paramyxoviridae Genus - morbillivirus -Infection of the respiratory system -respiratory epithelium first infected -Incubation period – 7 to 14 days -Direct contact - from nose & throat secretions -Period of communicability –4d before until 4d after rash appears -Highly contagious -Virus can survive in micro-droplets in the air -Humans are only hosts -Infants receives antibodies tran
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