PREVENTION OF SCARLET FEVER

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.