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.
[Illustration: FIG. 60. One of the ways by which quarantine is
broken.]
[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.