There is such a striking difference in the severity of cases of scarlet
fever that the name "scarletina" was for a long time applied to mild
cases with the feeling that possibly it represented an altogether
different disease. At the present time the disease is more intelligently
diagnosed, and while there is vast difference in the severity of the
sickness, it is all the same thing. Of the ordinary cases, about 5 per
cent terminate fatally; that is, in a village or a community where a
hundred cases occur, there would be five deaths. If the epidemic,
however, is of the severe form, a larger percentage of deaths occur,
often reaching 20 per cent of those affected. It has been noted that as
an epidemic progresses, the disease becomes more serious, and a
death-rate of only 5 per cent may, in the course of an epidemic lasting
several months, gradually increase to one of 20 or 25 per cent. For this
reason strong efforts ought to be made to stamp out an epidemic while it
is in the first stages.
Besides the possibility of contagion from the skin as it comes off, to
prevent which the antiseptic ointment is used, contagion also occurs
through clothing used in the sick room. In fact, the contagiousness of
scarlet fever is probably as malignant as any other infectious disease.
It has been observed that a year after a case of scarlet fever in a
house, the unpacking of a trunk or the unrolling of a bundle would set
free the contagion and would result in new cases of the disease. The
writer learned recently of a family in which a child had died of scarlet
fever and some of its clothing had been packed away in the attic. A
younger sister grew up, married, moved away, and some twenty years after
the death of the child, came back to her former home on a visit with her
own little girl. The grandmother, visiting the attic, found the clothing
packed away so long before, gave it to her grand-daughter to wear, and
in ten days the child was dead with the same disease.
There are a number of cases where scarlet fever seems to have been
carried by infected milk, and great care must be taken on dairy farms to
avoid any possibility of this kind of infection. To prevent the disease
being transmitted after apparent recovery, thorough disinfection should
be practiced. The patient's body should be very carefully and completely
and continuously covered with antiseptic ointment which prevents the
distribution of the contagion in small particles of skin. The sick room,
after the patient's recovery, should be thoroughly disinfected, and all
bedding steamed or boiled. All the surfaces in the room should be washed
with a solution of carbolic acid, 1 in 50, or corrosive sublimate, 1 in
1000.
_Measles._
Public-domain text, read in full here on John Shaqi.
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