Chapter XXVII: How Scarlet Fever Is Carried

There are certain diseases that we know to be communicable (that is, "catching"), but as yet we do not know the germ that causes them, and therefore we cannot tell just how they are carried about. We do know that they are transferred from one person to another; but not being able to locate the cause, as we can in the diseases of which we do know the germ, we cannot explain how it is done.

[Sidenote: How scarlet fever is like diphtheria]

Among the diseases of this class we find scarlet fever. In one respect scarlet fever acts much the same as diphtheria. A person may have it and not be very sick, sometimes hardly sick at all. At night a child may have a high fever, with a slightly sore throat, and the next morning he may feel perfectly well. The mother supposes that the fever was due to an "upset stomach," thinks no more about it, and sends the child to school. The next time the child takes a bath, he perhaps notices that the skin peels off over some parts of the body. This means that the high fever was due to scarlet fever, but the breaking-out (rash) was so fine that it was not noticed. It also means that all the children in the school have been exposed to the disease. These very mild cases are the most dangerous because so often they are not recognized.

[Sidenote: Why mild cases are dangerous:]

[Sidenote: (_1_) For the severe cases they cause]

There are two things to be remembered in connection with these mild forms of scarlet fever, as well as of every other communicable disease. The first is that the same cause which produces a mild form of the disease in one child may produce its most severe form in another child. You can contract a mild form of the disease from exposure to a severe case; and you can contract a severe form from exposure to a mild case. The character of the case to which you are exposed will give no indication of the form the disease will assume in your body.

[Sidenote: (_2_) For the bad after effects]

The next thing to be remembered about the mild form of scarlet fever is that, though the child may not be made very sick at the time, there may later be very bad results. A child who has had scarlet fever in such a mild form that he hardly knew he was sick, may, for a while, appear to be quite well; then suddenly he has an earache, and an abscess forms. This abscess is due to the scarlet fever germs which have gone from the throat to the ear, and as a result the child may lose his hearing entirely.

The child may not, perhaps, have an abscess, but after a time he may begin to lose flesh, and to grow pale. He does not care for his meals, does not care to play, says he is tired, and wants to lie still all the time. Finally his mother thinks it might be a good idea to have a doctor see him. The doctor examines his body carefully, and then asks for a sample of his urine. When he has examined this, he looks very serious and asks the mother when the child was sick last, and what the disease was. Perhaps she has forgotten all about the slight attack of fever, and the doctor must question her very carefully before she recalls it. At length it occurs to her, and then the doctor asks, "After this attack of fever, did you notice that the skin came off his hands and body?" She replies that she did, and then the doctor tells her that the child really had scarlet fever, and, owing to lack of care, he now has kidney disease. This is a very serious trouble, from which he may never recover, or, in case of recovery, he may always be weak and sickly. Even a mild attack of scarlet fever is not to be neglected; it is a severe and dangerous disease in its very mildest form. It not only kills a great many boys and girls, but it makes delicate in health for all their lives many of those who apparently recover.

[Sidenote: How confusion of names causes mild cases to go undetected]

We often hear people speak of two diseases which they think are not scarlet fever. These two diseases are scarlatina and scarlet rash. Now scarlatina is simply the scientific name for scarlet fever. Some doctors will tell you that you have scarlatina and that it is not exactly scarlet fever. A doctor who says this either is deceiving you or does not know any better. In either case, he ought not to be a doctor, for he lets children be exposed to a disease that is likely to kill many of them. It is the same with scarlet rash. This, too, is simply another name for scarlet fever. Changing the name does not change the disease, and you may call it scarlet fever, scarlatina, or scarlet rash--it makes no difference which; the disease is one and the same.

[Sidenote: Why quarantine is necessary for scarlet fever]

Quarantine is the only way known for preventing the spread of scarlet fever, as well as of diphtheria. If every case of scarlet fever were quarantined, we could soon stop this disease; but every case is not quarantined, because some of them are so mild that they are not recognized.

[Sidenote: How breaking quarantine shows selfishness]

Even when a case is quarantined, the people sometimes neglect the instructions given, just as they do when there is a case of diphtheria. Then there are cases that are known to be scarlet fever but are not reported to the health officers, because the people do not want to be quarantined. They simply do not want to be put to any inconvenience themselves, and although this seems a very strange way for people to act, it happens very often. There are many selfish people in the world; there are even people who will not report a case of scarlet fever because to do so might prevent their going to a party. Selfishness is at the bottom of it.

It is extremely important that a child should be absolutely free from all the little scales of skin which are thrown off after scarlet fever, before he returns to school or mingles again with others. If there is a discharge from the nose or ears after the scales have disappeared from the skin, there is still danger of spreading the disease, for these discharges often retain the infection for many months.

=Questions.= 1. Give two reasons why mild cases of scarlet fever
should be carefully treated. 2. Why is quarantine necessary? 3.
How does selfishness lead people to spread scarlet fever? 4. When
is it safe to let a scarlet fever patient mingle with well people?

=Remember.= 1. If you have scarlet fever and are not very sick,
do not think that you will not be dangerous to others; severe
cases sometimes come from exposure to the mildest cases. 2.
Mild cases of scarlet fever often leave very bad results, if
the patient is not cared for. 3. Be very careful until you are
entirely well. 4. Scarlatina and scarlet rash are nothing but
scarlet fever; keep away from people who have them. 5. Quarantine
is the only way by which we can prevent the spread of scarlet
fever; there is no medicine that will prevent it. 6. People who
violate quarantine regulations are both selfish and stupid.