Epidemic Measles at Samoa

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Epidemic Measles at Samoa

MAY 19, 1894.] MEMORANDA. 

BY SAMUEL H. DAVIES L.R.C.P. L.R.C.S.EDIN. L.F.P.S.GLAsG. Savaii Samijoa S. Pacific.

Until a few months ago measles had not entered this group. It was conveyed to Tonga 500 miles south of us by the New Zealand steamner Upulu in June last and from accounts we have received it nearly decimated that group. The same steamer brought the contagium to our group nearly three months afterwards. Here as in Tonga the epidemic was at first mild. Comparatively few died in Samoa during the period of the fever and rash. The sequele and complications have caused the mortality. I have not been able to obtain accurate statistics of the deaths from this recent epidemic throughout Samoa as the ten inhabited islands of this tropical and volcanic group lie between five parallels of longitude or with the intervening straits cover nearly 270 miles; but judging from the accurate returns obtained here including a nfth of Samoa and also from reports obtained from missionaries and others no fewer than 1000 of the entire population of 34500 died from measles up to the end of December 1893 and nearly half of these adults. Since then there have probably been a few hundreds more. The epidemic was not malignant. Our mortality has arisen principally from gastritis enteritis diarrhoea and dysentery. A few died from suppressed measles. The craving the natives manifest for raw fish unripe or over-ripe fruit and especially half-cooked fresh pork became morbid during the period of convalescence. Many lest they should be told to avoid these abstained from procuring foreign medicine. Nine-tenths of the deaths could have been prevented by care in diet. The worst cases of diarrhoea and dysentery brought to me yielded to treatment. Cases under ones own personal supervision and where instructions were followed recovered. With the common strumous diathesis it has excited no surprise to see so many adults as well as children suffering from enlarged suppurating glands in cervical and submaxillary regions and in groin etc.; not a few had parotid abscess with suppuration. Numerous abortions and cases of premature labour occurred but none died with ordinary treatment. Single and multiple abscesses are an every-day occurrence here but these have multiplied nearly tenfold since the advent of measles. Before the rash had disappeared a large number of adults passed intestinal worms by the mouth. Now that two months have elapsed since the last cases of fever and rash a mild but persistent form of remittent fever is prevailing. This with glandular and respiratory affections are the most common ailments at this season. In the mission dispensary I am daily seeing cases of sickness the starting point of which was measles. The two epidemics of influenza at the end of 1891 and January 1893 increased the tendency of the Samoans to chest affections. Measles will be found to have still further intensified their susceptibility to respiratory diseases; and the frequent deaths as well as the many debilitated natives one daily meets with give evidence that we have not yet reached the end of the measles epidemic -an epidemic which will long be remembered as not one of the entire population seems to have escaped.