Scarlet fever is an acute, highly contagious disease characterized by a
sudden onset with chill, vomiting, or convulsions; a high fever of from
a week to ten days’ duration; a very rapid pulse; severe sore throat; a
bright red rash, appearing on the second day, lasting about a week, and
followed by desquamation and a marked tendency to nephritis.
The most serious complications are nephritis, suppurative inflammation
of the middle ear (otitis media), inflammation of the endocardium or
pericardium, and pneumonia.
Scarlet fever, while contagious at all periods, is probably most so
during the period of desquamation. The organism may cling to furniture,
clothing, etc., and reproduce the disease after very long periods. The
contagion may be carried by persons coming in contact with the sick,
or the disease may be transmitted through the air of the sick-room or
through clothing, utensils, etc., which have been used by the sick.
=Prevention of contagion= consists in isolating the patient; in
disinfecting everything that has been in contact with him; in anointing
the patient’s body with an antiseptic oil until desquamation is
complete; and in thoroughly disinfecting the room after the patient’s
removal.
=Management.=—Have the patient, if possible, in a large, airy room,
preferably at the top of the house. Keep the temperature uniform and
the room well ventilated. Wear a loose wrapper and cap, and leave these
inside the room when obliged to leave it.
With cloths moistened with a 3 per cent. solution of carbolic acid wipe
the floor, furniture, sills, door-knobs, mantelpiece, etc., once a day,
but never dust or sweep. Thoroughly disinfect the secretions of the
patient and all articles used by him before they leave the room.
Allow the patient no food except what has been ordered, which will
usually be milk, koumiss, junket, fruit-juices, and gruels. Encourage
the patient to drink water freely. Apply to the body, at least once a
day, a bland ointment. Note temperature, respiration, pulse, stools,
quantity of nourishment, sleep, and effect of baths and medicine as
in typhoid fever. Note especially the quantity and appearance of the
urine, and have a sample in a clean bottle ready each day for the
physician’s examination.
Keep the nose and throat clean with mild antiseptic sprays or
washes. Relieve pain in the throat, unless otherwise directed, with
ice-poultices or hot-water compresses.