SCARLET FEVER

Wairarapa Times-Age, 8 November 1938, Page 8

SCARLET FEVER

COMPLICATIONS MUST BE GUARDED AGAINST. We appear to be faced with the possibility of one of the periodic invasions of scarlet fever to which we are liable. Such epidemics occur at intervals, and in this country are usually limited in extent. Scarlet fever is always to be regarded as a serious disease. While measles, mumps, etc., can have dangerous .complications, the risk of permanent damage following scarlet fever is greater than with any of the ordinary epidemic infectious diseases. It is important to remember that scarletina is only another name for scarlet fever, and must never be considered a disease of a trivial nature. Scarlet fever is a special form of infection in which the streptococcus germ is combined with other germs which are too small to be stopped by a filter. This combination causes the symptoms.

Epidemics of scarlet fever are most common amongst children, but appear in serious forms in armies, and where large numbers of people are grouped together. One attack usually gives immunity, for it is unlikely that a second attack can occur in the same person.

Symptoms and Treatment. The onset is usually very sudden, there is high fever, usually a shivering attack and vomiting is very common. There is headache, pains in limbs, and a sore throat. The rash appears on the second day of the illness. It is a bright scarlet rash of a very fine spotted pattern, the spots are very small and close to one another, and are not much raised above the surrounding skin. The rash fades if it is pressed upon by the thumb, but returns immediately. The tongue is very red, but is covered with a white fur, the result resembling a strawberry in appearance. The throat is very red, the tonsils are enlarged, and may be covered with white material resembling the membrane that occurs in diphtheria. In many cases the glands in the neck over the tonsils are swollen and tender. The complications are excessively large glands, even with abscesses, inflammation of the middle ear, arthritis of the joints, and, most serious of all, Bright’s disease.

The treatment is rest in bed on a diet almost confined to milk foods and fruit drinks. Plenty of water or suitable fluids must be given to replace the fluid lost by the fever and to keep the kidneys acting. The patient must be kept in bed for at least three weeks, even if the symptoms are slight. The diet needs careful conIrol by a doctor. Keep the patient warmly but lightly clad. It is necessary to isolate the patient, especially from all young children. The law compels some isolation, the period of which depends largely on the judgment of the attending doctor. It should be four to five weeks in the very mildest cases and longer in others. A case remains infectious until peeling is quite complete, and there remains no discharge from the ear or nose.

The spread of scarlet fever is relatively easily prevented, because a rash appears early which allows for early isolation, whereas with such diseases as measles a most dangerous lime for infection is before the rash.