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15
This result was obtained though the majority of the children
were at an age when complications from Measles are common. As
a matter of interest it might be mentioned that all the cases were
treated with M & B 693, as a possible preventive of pulmonary
complications though the figures are too small in themselves to be
of much use.
There were other factors which influenced the results. Most
of the cases occurred during the warm months of the year, and a
summer epidemic of Measles is always less fatal than a winter one.
The cases arose from one source of infection, and it used to be held
that an epidemic became more fatal if the infection was mixed
and massive.
The vast majority of the cases were diagnosed and treated
in an early stage of the illness. Many of the cases were sent into
'hospital before the rash had appeared. In the early or catarrhal
stages, Koplik's spots appear on the mucous membrane of the
mouth, and many of the cases were diagnosed and sent to the
hospital on the appearance of Koplik's spots. It is at this stage
that the disease is most infectious, and this early diagnosis not only
limited the infection and probably saved many other children, from
developing, the disease, but contributed also to the good results of
hospital treatment. In general practice, the doctor is not called in
to see the patient at this early stage, and thus does not have a good
chance of diagnosing the case in the catarrhal stage. It is usually
only possible to detect these early cases when a careful inspection
of contacts is made, which in this instance was made by the doctors
in charge of the medical supervision of the refugee children."