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May 10, 1971

Measles, a Renewed Challenge

Author Affiliations

AMA Department of Environmental, Public, and Occupational Health Chicago

JAMA. 1971;216(6):1018. doi:10.1001/jama.1971.03180320060014

When Rhazes (860-932 AD), a physician living in the Eastern Caliphate in Persia, distinguished measles from smallpox, he provided the first accurate description of an ancient and widespread infectious disease. A relatively mild disease primarily affecting children in developed countries, it can be serious and devastating in less-well-developed lands and can be the cause of serious epidemics among nonimmune adults in isolated populations. Despite its relative mildness in recent years in countries such as the United States, measles is known to have a number of serious complications such as pneumonia, severe bronchitis, and bronchiolitis; otitis media; and encephalitis, mental retardation, behavior changes, and motor disturbances.1 Rarer complications include purpura, corneal ulceration, pneumomediastinum, and even appendicitis.

Before the licensure of an attenuated live virus vaccine in 1963, more than 4 million cases of measles are estimated to have occurred annually in the United States of which 400,000 were reported. At