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March 3, 1928


Author Affiliations

From the Department of Pediatrics of Cornell University Medical College.

JAMA. 1928;90(9):660-663. doi:10.1001/jama.1928.02690360004002

The importance of making an early diagnosis in a case of measles is well known. It is generally understood that measles is most contagious in its early stages, and therefore that early diagnosis and isolation are necessary to hold down the spread of the disease. But it is not so well known that measles may often be predicted with some confidence before the appearance of Koplik spots, the first pathognomonic sign; that measles is usually highly contagious from one to two days before the appearance of Koplik spots, and that the course and particularly the complications of measles are apt to be milder if the patient is put to bed and individually isolated at the very onset of the fever. Furthermore, New York City for the past ten or twelve years has had biennial waves of measles (fig. 1). From three to six times as many cases have occurred on

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