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Show SCARLET FEVER Scarlet fever is the most serious of the contagious diseases of childhood child-hood because it is often a severe in- lection and causes many deaths and because it may cause heart or kidney kid-ney disease. It is probably caused by a streptococcus even ev-en though unlike diseases caused by other organisms of Dr. NathanS. that Patif Davis III who have once it are usually permanently per-manently immunized against the disease. It is such a serious disease that the utmost precautions should be taken to prevent its spread even though the local quarantine regulations regula-tions do not contain such provisions. It has been shown that the large majority of children Vho have not had scarlet fever or who have not been immunized against it by repeated re-peated injections of the sterile toxin, tox-in, and a fairly large proportion of adults are susceptible to the disease. dis-ease. Scarlet fever is primarily a throat infection with an organism, a streptococcus, that forms a toxin which causes the typical rash and the damage to the kidneys, which may enter the blood stream and infect in-fect the heart or may spread to infect in-fect the mastoid or other sinuses. In a recent study of a large series of cases, it was found that at the end of a 28-day quarantine period, 63 per cent of the patients were car THE FIGHT AGAINST INFANTILE PARALYSIS C O - 1931 NO0F MTtjr n n irN- deaths i00" f '1921 -1589-1.8 I . J 1928-138 - 1.2 7 1935-1040-0.8 I940-IO26-O.8 riers of an "hemolytic streptococcus" streptococ-cus" which was probably the one causing the disease. Modern methods for the control of scarlet fever should be adopted everywhere. These include: 1. Isolation of the patient. 2. Dick tests on all contacts, including in-cluding adults to determine their susceptibility to the disease. 3. Culturing of material from the nose and throat of all contacts on blood agar plates to determine whether or not they are carriers. 4. Take the temperature and inspect in-spect the throat and the upper part of the trunk of all contacts. If the temperature and inspection lead one to suspect the imminence of scarlet fever, passive immunization immuniza-tion may be produced by injecting at least 150,000 neutralizing units of scarlet fever antitoxin or of an adequate ade-quate dose of convalescent serum (at least 40 cc). One week after the passive immunization dose or as soon as a contact is found susceptible, suscepti-ble, active immunization with five graduated doses of scarlet fever toxin is begun. If the contact gives a negative skin test and a negative culture, he needs no treatment. All who are carriers, who have positive posi-tive cultures, must be isolated and if also susceptible, must be immunized immu-nized at once by the active method. A contact who is susceptible but who has a negative culture, need not be isolated. All patients and all carriers must be quarantined until un-til cultures made from the nose and throat are negative for the hemolytic hemolyt-ic streptococcus, ixnin mothfiH? such as have been outlined were used in the care of scarlet fever patients in Evanston, 111., the number of cases dropped from 188 in 1938 to 65 in 1939 and in a series of 117 consecutive cases there were no contact cases. Regulations Regu-lations similar to those adopted in Evanston on recommendation of Drs. Gladys R. H. and George Dick should be adopted by all local and state health departments that the number of cases of scarlet fever may be reduced at least proportionately proportion-ately in all parts of the United States. "There's one liberty we have in a democracy we would be better off without that's the liberty to be needlessly unhealthy." un-healthy." ' Paul Brooks, M. D. QUESTION BOX Send questions to Dr. Nathan S. Davis III. Winnetka. 111. 'Enclose a self-addressed, stamped envelope.) Q.What would be the cause of pimples or sores in the ear? N. S. A. Dirt or acne. Q. What is the most frequent cause of strep infection and what is the best corrective? F. E. A. One of the many varieties of streptococci. Avoid people with cold and sore throats. Keep wounds or burns covered with sterile gauze. Use pasteurized milk and milk products. |