Category Archives: Mrs. Curtis

Mrs. Curtis (1914): Why measles is bad

Mrs. Curtis: Protect your baby!

As I mentioned in a previous post, I often turn to my grandmother’s 1914 edition of Household Discoveries and Mrs. Curtis’s Cook Book for some historical perspective. Here’s what Mrs. C has to say about measles:

“[Measles] is a very fatal disease among young children. It causes three times as many deaths as smallpox, and nearly as many as scarlet fever. Ninety-five percent of all deaths occur in children under five years of age; the death rate in times of epidemic ranges from 4 per cent to 6 per cent.

The danger from measles is chiefly due to complication with other diseases, such as whooping cough and bronchial pneumonia, or to the after-effects, such as consumption, paralysis, meningitis, diseases of the skin and nervous disorders. Inflammation of the ear is a not infrequent complication of measles. This often leads to deafness or worse.”

Mortality rates in third-world outbreaks still reach as high as 10% of all infected children. While complications like pneumonia are much more treatable in first-world countries than they were in 1914, encephalitis and hearing loss remain worrisome measles complications everywhere.

Treatment? Um…none. Mrs. Curtis doesn’t even address it.

Prevention? Obviously, measles vaccine didn’t exist back then, so quarantine was the way to go:

“Isolate all suspicious cases, especially during periods of epidemic. Placard the premises [for two weeks]. No person from a home quarantined for measles should attend school, church, theater or public gathering. Everything coming from the patient’s room should be disinfected.”

In particularly bad outbreaks, Mrs. Curtis recommends burning whatever comes out of the patient’s room, pretty much everything but the people. (Actually, she doesn’t specifically recommend leaving the patient and family unburnt, so I can’t be sure on that one.)

When things resolve…

“…the sick room should be thoroughly disinfected with formaldehyde or sulfur, as described elsewhere.”

Finally, the ever-practical Mrs. Curtis refers the reader to the section on “Cleaning the room of a child who has died from infection.”

Then, presumably, you got on with life–a necessary survival skill for families at a time in history where as many as 2 in 5 children still died before reaching their 5th birthday, mostly from infectious diseases.

“You had to move on,” my father says today about the long-ago deaths of his two siblings (John Francis, who died at age 3 in the 1918 Spanish flu epidemic; and Donald, 4 years old, in 1925). “Otherwise it would just eat you up.”

Here’s a link to an article I wrote for Notre Dame Magazine about John Francis’s death.

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Mumps in Berkeley

"Sorry about your testicles, Greg."

There are now close to 30 confirmed or probable cases of mumps on the campus of the University of California at Berkeley (henceforth “Cal” – Go Bears!), and that number will no doubt increase.

Most people are a bit mystified about mumps. It’s that chipmunk cheek infection that little kids get, right? is a typical response I hear from parents in my practice when I ask them about it. Well, yes, mumps is fairly chipmunk-cheeky, but it can do a lot more than make a child look like an extra in a Chip-n’-Dale cartoon.

Here’s a science-heavy description from the American Academy of Pediatrics’ Red Book.

Mumps is a systemic disease characterized by swelling of one or more of the salivary glands, usually the parotid glands. Approximately one third of infections do not cause clinically apparent salivary gland swelling and may manifest primarily as respiratory tract infection. More than 50% of people with mumps have cerebrospinal fluid pleocytosis, but fewer than 10% have symptoms of central nervous system infection. Orchitis is a common complication after puberty, but sterility rarely occurs. Other rare complications include arthritis, thyroiditis,mastitis, glomerulonephritis, myocarditis, endocardial fibroelastosis, thrombocytopenia, cerebellar ataxia, transverse myelitis, ascending polyradiculitis, pancreatitis, oophoritis, and hearing impairment.In the absence of an immunization program, mumps typically occurs during childhood. Infection occurring among adults is more likely to be severe, and death resulting from mumps and its complications,although rare, occurs most often in adults. Mumps during the first trimester of pregnancy is associated with an increased rate of spontaneous abortion. Although mumps virus can cross the placenta, no evidence exists that this results in congenital malformation.

Chip-n'-Dale, pre-mumps

In layman’s terms, mumps virus:

  • attacks the salivary glands (swollen parotid glands = chipmunk cheeks), though that’s not always present
  • will cause central nervous system infection in about 1 out of 10 victims (anything from hellish headaches to encephalitis–serious inflammation of the lining of the brain)
  • increases the chances of a first trimester miscarriage
  • commonly causes swelling and inflammation of the testicles in adolescents and adults (just as bad as it sounds, fellas), and a few men will become sterile as a result
  • can cause a boatload of rare complications, including arthritis, loss of balance, heart and thyroid problems, inflammation of the ovaries, and hearing loss
  • every now and then kills someone

And in case you think mumps was a no-big-deal infection for our hardy ancestors, there’s this from the 1914 edition of Household Discoveries and Mrs. Curtis’s Cookbook (my Grandma Nell Sloan’s childcare bible; regular readers will be hearing a lot from Mrs. C in future posts). I’ve condensed it a bit:

Mumps is a glandular swelling in the angle between the jaw and the ear. It is a highly contagious but wholly unnecessary and preventable disease. The early symptoms are fever with pain below the ear on one or both sides. Within two days there is great and painful enlargement of the neck and side of the cheek. The swelling persists from seven to ten days, then gradually subsides. A second or third attack may occur and troublesome complications are common. It is always advisable to consult a physician.

Note: Mrs. Curtis does not call for the doctor very often.

I’ll talk about the reasons behind this outbreak and recent recurrences of other vaccine-preventable diseases in a future post.

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