Infectious Diseases: German Measles Epidemic

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INFECTIOUS DISEASES

Spring 1964 is the best of times for a German measles party. The rules call for lots of kissing games in an unventilated room, so that all the little boys and, more especially, all the little girls get the infection. It is consistently so mild an inconvenience that for children of both sexes it is best to have it and get it over with; one bout generally confers lifelong immunity. There is just one vital precaution. No infected child should be allowed anywhere near a woman who is—or even may be—in the first three months of pregnancy; if she has escaped the disease in childhood, the virus may cause blindness or crippling heart defects in the fetus.

Grandma Was Right. Last week tens of thousands of Americans had German measles, and the vast majority had caught it willy-nilly without the fun of a party. "It comes in waves, two to four years apart," said Chicago's Health Commissioner Samuel Andelman. "When it starts, it's like fire in straw." The fire had spread from New England, down the Eastern seaboard and westward to the Continental Divide. It has not yet hit the West Coast in full force. It will.

Grandma had the best name for the disease: "threeday measles."* The usual symptoms are a mild sore throat, a light rash, and a fever of not more than 102°. In children, some swelling of the lymph glands is common but is usually not severe. Only rarely does the virus of three-day measles lead to pneumonia or brain inflammation. But it may occasionally be fatal. Last week three children's deaths associated with the current epidemic had been reported from Chicago, and a Connecticut teen-ager had died of encephalitis. Less predictable and less understood is a complication among adults: pain in the joints, sometimes so severe that it is compared with that of rheumatoid arthritis, though it lasts only three to seven days.

Rationed Shots. Researchers are checking to make sure that the rubella virus has not mutated to a more virulent strain. So far, they have no evidence that this has happened.

Though work on a vaccine is being pushed, none can be ready this year. Last week came a hint that German measles may be one of the first virus diseases to yield, at least partially, to drug treatment. University of Michigan researchers told the Federation of American Societies for Experimental Biology that amantadine, a drug synthesized by Du Pont chemists, works against German measles virus in the test tube. And it is safe enough to have been used with promising results on influenza patients. Such a drug may help children, but proving its safety for pregnant women will take years.

If a woman who is pregnant, or thinks she may be, is exposed to German measles, she should get a shot of gamma globulin. Many state and city health departments offer it free in such cases. The precious blood fraction is now in such demand that some states are rationing their supply, limiting it to women who know they are pregnant.

*The German tag was attached because the disease was mistakenly thought to be especially common in Germany. The medical term, rubella, is bad because it invites confusion with rubeola, the true "red" or "seven-day" measles.