Influenza

Influenza is an acute infectious disease caused by a virus. It comes on suddenly with fever, muscular aches, chilliness, and a cough. After, an attack, serious weakness is common for some weeks. Although outbreaks of influenza have occurred for centuries only in recent years have, the different forms of virus associated with epidemics been isolated. Two forms known as influenza virus A and B have been isolated since 1933. Vaccines for inoculating against these forms have been developed but routine immunization is not advised because the uncomplicated disease is rarely fatal and because the type or nature of the virus varies from one epidemic to another.

The virus of influenza is transmitted from one person to another by droplets of fluid coughed out of the nose, throat, and lungs. An epidemic usually reaches its peak in two or three weeks and then subsides in from four to eight weeks. The worst period of the year is winter and early spring. The influenza virus seems to be constantly present among human beings and epidemics occur under the specially favorable

circumstances at aid spread of the Virus and lessen resistance.

Influenza comes on suddenly after an incubation period of a few days. The common complaints are headache, drowsiness, fatigue, and chilliness, but there may also be general illness with nausea and vomiting. The fever starts to rise and usually hangs around 1020 F. but may get up to 1040 F. A cough with dryness and irritation of the throat and tightness across the chest are common. A running nose is not nearly as frequent as with the common cold. The person with influenza feels really sick and is disinclined towards work or amusement or even reading. Pain in the eyes, with some redness, may occur. The disease itself is uncomfortable but not too serious, but secondary complications through invasion by other germs causing pneumonia, ear infection or even inflammation of the brain may make it dangerous to life. The sulfonamides and antibiotic drugs can prevent secondary complications of influenza but do not act specifically against the viruses. Most doctors recommend rest in bed, plenty of fluids, aspirin or other salicylates, codeine to quiet the cough and, if necessary, drugs to help the patient sleep. The condition must be watched most carefully when it affects the very old or very young who are more likely to get secondary infections and to be less able to resist the wear and tear that influenza causes.

Measles

Measles have been one of the most frequent of the childhood diseases. The condition is quite infectious, and is accompanied usually by a rash, with fever, cough, and inflamed eyes. Measles are caused by a specific virus which spreads easily from one person to another.

From ten to fourteen days after a child has been in contact with another who has had measles, symptoms like those of a severe cold develop. The child becomes drowsy and irritable. The eyes water and look red and the child avoids light. The appetite is poor. By the end of the third or fourth day the rash appears with individual spots that are at first pinhead size and pale red but then enlarge, become elevated and a darker red. The eruption is seen first usually on the face, scalp, and behind the ears, but then gradually covers the whole body. The fever increases as the rash breaks out. After the second or third day the rash begins to fade, the temperature falls and after seven days, usually, the patient is on the way to complete recovery.

During the first few months of life the child often has immunity from measles by antibodies derived from its mother. As the immunity wears off the child becomes susceptible, and most cases occur in children three or four years old. The child may be injected with globulin which provides immunity against measles.

Since the development of antibiotic drugs secondary complications of measles are more easily controlled. During the acute illness the child is kept at rest, given plenty of fluids, such as citrus drinks, a soft diet and good nursing. For itching of the skin a calamine lotion is used. The eyes are protected against irritation. For more severe cases convalescent serum or gamma globulin may be used. Measles are not a serious disease except for very small babies. Prevention and control of pneumonia at the earliest sign is most important.

German Measles Or Rubella

A virus like that of measles but distinct from it, as recognized by the different nature of the condition produced, causes German measles. This condition has assumed increasing importance recently, since it has been recognized that German measles infecting a prospective mother during the first three months of pregnancy can seriously damage the unborn child. German measles is a mild contagious disease with symptoms like those of a mild cold accompanied by a dark rash.

From ten to twenty days after exposure the condition begins with malaise, headache, a slight rise in temperature, and stiffness and soreness of the neck because of the enlargement of the glands at the back of the neck. The rash starts on the face and neck and spreads rapidly. The rash persists two or three days. The disease is more severe in adults and very young children. Usually one attack confers permanent immunity. Because of the dark red rash German measles is often confused with scarlet fever.

The disease is usually so mild that the only treatment is good nursing. Young married women need to be protected in times of epidemic. Often gamma globulin is given to help resistance. From fifty to ninety per cent of pregnant women who get German measles have babies damaged by the infection.

Chicken Pox

Another common childhood disease caused by a virus is chicken pox. From ten to twenty days after exposure the symptoms begin with mild headache, loss of appetite and fever. Then after thirty-six hours the eruption appears. The rash usually is seen on the body and later on the face, neck, and extremities. Little red pinpoints enlarge to papules which change to blisters or vesicles. After a few days these break and are covered by dark brown crusts. The spots may become secondarily infected from scratching and pus infection will leave scars.

Chicken pox requires little treatment except to keep the areas free from secondary infection. The fingernails of children should be kept trimmed short. The itching is controllable by a calamine lotion containing one per cent of menthol or of phenol. If secondary infection occurs, antibiotic ointments will stop the spread. Chicken pox seems to be related to the nerve condition causing blisters known as herpes zoster. The common name for herpes zoster is "shingles."

Epidemic Encephalitis

Epidemics of brain fever are not an excessively large cause of disability and death in the United States. There have, however, been outbreaks such as the one which occurred in St. Louis in 1933 in which there were more than 1,000 cases. In the St. Louis epidemic there were 100 cases for every 100,000 population and twenty per cent of those who were infected died. In various epidemics the number of cases varies from two cases for every 100,000 people to as many as twenty-two for every 100,000 people.

Now it is established that the cause of epidemic encephalitis is a virus and that the outbreaks in human beings are closely related to certain similar conditions attacking animals, particularly an epidemic of a similar condition which concerns horses. In several regions domestic birds such as chickens have been associated with the spread of the condition. In a California outbreak, the English sparrow and several species of blackbirds were involved. Research has also shown that various mosquitoes and mites as well as ticks may be associated with the spread of this virus.

In the prevention of encephalitis, control of the mosquitoes is of the utmost importance. Vaccines have been developed which may be used in outbreaks among horses. The condition is so serious that its appearance in any community should involve immediate investigation by competent health authorities.