The infectivity and management of scarlet fever / by W.T. Gordon Pugh.

  • Pugh, William Thomas Gordon, 1872-1945.
Date:
1905
Catalogue details

Licence: In copyright

Credit: The infectivity and management of scarlet fever / by W.T. Gordon Pugh. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    observation at all, and so are never isolated. There are patients also with nrarked throat affection, in whom the rash either does not occur, or has such a brief existence as to escape notice. It is not at all unusual for such cases to be admitted into hospital under certificate of diphtheria ; cultures prove negative and desquamation, suggestive of scarlet fever, ensues, in spite of the fact that no rash has been observed before or after admission. Scarlatinal Sore Throat.—Again, it is within the experience of every one that throat inflammation is apt to arise in households in which scarlet fever has be?n notified, and I think we are justified in considering it probable that many of these cases are scarlatinal in nature. Murchison wrote many years ago : “ I have frequently found that when one or two children in a house have had scarlatina every adult in the same dwelling has suffered from a severe angina. ’ ’ In cases of this kind which have come under my observation, although the throat affection has been severe, no rash has been observed, nor has desquamation followed. Healthy Infection Carriers.—The part played by the healthy infection-carrier comes next under considera- tion. The virulent diphtheria bacillus, it is known, may exist in the throats of healthy persons, who have been inti- mately exposed to infection, and under a variety of circum- stances, it is believed, may be communicated to others who develop the disease. It is possible that in scarlet fever healthy persons may similarly carry the infective agent in their throats, but in the absence of bacteriological evidence this must remain uncertain. Even in diphtheria we have no means of estimating the magnitude of the part the bacillus- carrier takes in the spread of infection. I may mention, however, that it is very rarely that one hears of either disease occurring in the homes of any of the staff of a fever hospital, or among their friends. This is in spite of the fact that 10 per cent, of the nurses who have been examined while on duty in the diphtheria wards of the North-Eastern Hospital have been found to harbour the bacillus in their throats. Tempopary Immunity—This, incidentally, leads me to raise rather an interesting point. Nurses and medical officers, not infrequently, do not develop sca,rlet fever until they have worked for many weeks, or even months, in the scarlet fever wards. Patients, admitted under an erroneous diagnosis, may be in these wards for a fortnight or three weeks before they acquire the disease. The explanation usually given is that the susceptibility of an individual varies from