Koplik's spots

Koplik spots (also Koplik's sign) are a prodromic viral enanthem of measles manifesting two to three days before the measles rash itself. They are characterized as clustered, white lesions on the buccal mucosa (opposite the upper 1st & 2nd molars) and are pathognomonic for measles. The textbook description of Koplik spots is ulcerated mucosal lesions marked by necrosis, neutrophilic exudate, and neovascularization. They are described as appearing like "grains of salt on a wet background", and often fade as the maculopapular rash develops. As well as their diagnostic significance they are important in the control of outbreaks. Their appearance, in contacts of a diagnosed case, before they reach maximum infectivity, permits isolation of the contacts and greatly aids control of this highly infectious disease.

Nobel laureate John F. Enders and Thomas Peebles, who first isolated measles virus were careful to collect their samples from patients showing Koplik's spots.

History

Koplik's spots are named after Henry Koplik (1858-1927), an American pediatrician who published a short description of them 1896, emphasising their appearance before the skin rash and their value in the differential diagnosis of diseases with which measles might be mistaken. He published two further papers on the spots, including one with a colour illustration. An anonymous reviewer of Koplik's The Diseases of Infancy and Childhood refers to the illustration as "the now famous coloured plate".

Koplik

Koplik (also known as Koplik i Poshtëm) is a town and a former municipality in the northwestern tip of Albania. At the 2015 local government reform it became a subdivision and the seat of the municipality Malësi e Madhe. It was the seat of the former Malësi e Madhe District. The population at the 2011 census was 3,734. It is situated north of the city of Shkodër.

History

Cupionich was mentioned by Mariano Bolizza in 1614, being part of the Sanjak of Scutari. It was Roman Catholic, had 60 houses, and 130 men at arms commanded by Pecha Campersa.

Koplik, being a border town, has a long history of warfare. The historical importance of Koplik owes much to the Malissori tribesmen. Their fierce independent nature insured that Koplik was often embroiled in wars against the Ottomans and the Serbs though much of its history. In the town itself there is a monument commemorating the Battle of Koplik, also known as the Battle of Deçiq on account of being fought both in Koplik and Tuzi. The battle was a result of a rebellion of Malsori tribesmen led by Ded Gjo Luli of the Traboin-Hoti tribe against Ottoman imperial authority. The battle was a costly victory for the Malsori tribesman. After the first world war and the partition of Malsia e Madhe into two component parts, the area surrounding Tuzi was given to the Kingdom of Montenegro whilst the area around Koplik remained Albanian with Koplik being created the regional capital of Malsia e Madhe. During the Ottoman occupation, many of the inhabitants of the town converted to Islam, although the rural population in Malësia e Madhe continued to be mainly Catholic. The communist regime put heavy restrictions on mobility but after the fall of communism in 1991, Koplik experienced a great influx of new settlers from the countryside.