Effort to prevent scarlet fever may take two directions; the first
is directed toward limiting the spread from the sick individual and
consist of isolation and disinfection; the second concerns itself with
the production of immunity in susceptible children. Similar to the
Schick test in diphtheria, we have the Dick test in scarlet fever. If a
very small quantity of the toxins of scarlet fever is injected into the
skin of a person the result will vary according to whether the person
is susceptible or immune to the disease. In the susceptible person a
redness of the skin appears where the injection was made, while in the
immune person this does not occur. In this way it is possible to pick
out the children who will not contract scarlet fever if exposed. Those
who give a positive reaction with the Dick test, i.e.--show a redness
of the skin at the point of injection of the toxin--may be rendered
immune by a process of vaccination. This consists of three injections
at intervals of a week of small quantities of scarlet fever toxins
or poisons. Little or no disturbance follows the administration of
suitable amounts of the toxins, but usually an immunity results. There
is every reason to believe that the immunity produced in this manner
will be permanent as is that which follows an attack of the disease.
Children who have been exposed to scarlet fever should be kept away
from other children for 10 days after the last exposure. To prevent
spread of the disease the sick child must be isolated and this must
be continued for four or five weeks, and in every case until all
discharges from the nose and ears have stopped. The throat must also
have become normal before the child is released. Removal of the tonsils
does not appear to render children less susceptible to scarlet fever,
but diseased tonsils when scarlet fever occurs add to the gravity
of the case by favoring severe throat and nasal complications and
especially extension to the ear. The details of isolation and terminal
disinfection are discussed in detail in connection with their use in
these diseases as a group.
Proper pasteurization of milk will prevent the spread of scarlet fever
through this common food of children.