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Chapter 65
Contagious Diseases
What are the first symptoms of measles?
Measles comes on rather gradually with cough, sneezing, watery eyes and nose, much like an ordinary cold in the head. The eruption appears after three or four days, first upon the face and neck as small red spots, and spreads slowly over the body.
Is measles a serious disease?
In infants and during the winter season it is likely to be very serious on account of the danger of bronchitis and pneumonia, which frequently accompany it. In children over four years old it is generally not severe. No child should be voluntarily exposed to this disease, and particularly one who is delicate or prone to disease of the lungs should be protected against it.
When and how is measles contagious?
Measles may readily be conveyed from the very beginning of the catarrh, two or three days before any eruption is present. It is not often carried by healthy persons. Its poison does not cling long to a sick room.
What is German measles?
German measles, or rubella, is a distinct disease and has nothing to do with ordinary measles. It is extremely rare for a child to be much sick with it. There is usually a very extensive eruption which may cover the body, but few other symptoms.
What are the first symptoms of scarlet fever?
Generally it comes suddenly, with vomiting, high fever, and sore throat. The eruption usually appears within twenty-four hours as a red blush, first upon the neck and chest, and spreads rapidly.
When and how is scarlet fever contagious?
Scarlet fever is only slightly contagious for the first one or two days of the attack. It is most contagious at the height of the disease and during desquamation. It may be carried by healthy persons and by the clothing or bedding from the sick room.
How does whooping-cough begin?
For a week or ten days it cannot be distinguished from an ordinary cold on the chest. Then the attacks of coughing gradually become more severe and vomiting may follow. After a severe coughing fit the breath is caught with a peculiar noise known as the "whoop."
How does chicken-pox begin?
It usually comes out gradually, as widely scattered pimples over the scalp, face, and body, many of which soon become small vesicles, resembling tiny blisters. There is itching and local discomfort but little fever, and the child rarely seems to be very ill.
How does diphtheria begin?
Sometimes suddenly, but usually gradually, with sore throat and swelling of the glands of the neck, with white patches upon the tonsils, or a free discharge which may be bloody, from the nostrils.
How does mumps begin?
As a swelling upon the jaw, beneath the ear. As it increases it extends forward upon the cheek and backward behind the ear. It affects one or both sides.
Mumps is not very common in young children, and in them it is usually mild. After twelve or thirteen years it is likely to be more severe.
How long after exposure do the first symptoms appear in the different diseases?
In scarlet fever in from three to five days, rarely later than a week; in measles in from nine to fourteen days, occasionally as late as twenty days; in whooping-cough in from one to two weeks; in chicken-pox in from fourteen to sixteen days; in German measles in from ten to sixteen days. In diphtheria the time varies much; it may be only one day, and it may be one or two weeks. In mumps it is usually a little less than three weeks, the average being twenty days.
Which of these diseases are most contagious?
Measles and chicken-pox are very contagious, and very few children who have not had them can come near a person suffering from either disease without taking it. Whooping-cough is almost as contagious as measles, and for young babies even more so. A very close exposure is not necessary in the case of either of these diseases, and whooping-cough can undoubtedly be contracted in the open air. Scarlet fever and diphtheria are much less contagious; for both of these a pretty close exposure is necessary.
How long should a child with any of these diseases be kept away from other children?
With measles, for two weeks after the rash has gone; with scarlet fever, for at least four weeks after the rash has gone, and longer if the peeling is not over or if the ears are running; with whooping-cough, for two months, or so long as the paroxysmal cough continues; with chicken-pox, until all crusts have fallen off, or for about three weeks after the eruption appears; with German measles for one week after the eruption has faded; with diphtheria, at least ten days after the throat is well in a very mild case, and four weeks if the case has been severe; with mumps for one week after the swelling has gone.
What should be done when a child shows the first symptoms of serious illness?
The child should be put to bed. If it is an infant the food should be diluted to one half the usual strength; if an older child, only fluid food should be given. If the child seems feverish, take the temperature If the bowels are constipated, give a teaspoonful of castor oil; but no other medicine without the doctor's orders. Send for the doctor at once, and until he comes carefully exclude all other children from the room.
By what nursery training may the examination and treatment of sick children he made much easier?
By teaching all children to gargle, to show the throat, to take pills, and by constantly teaching them to regard the doctor as the child's best friend, and his visits as a great treat. On no account should a child be frightened into obedience by threats of what the doctor will do.
With care and patience most children may be taught to gargle and take pills at four or five years, and to show the throat willingly at two or three. All these matters should be made a part of the child's education.