SCARLET FEVER

Quite accurate descriptions of scarlet fever have existed for over three hundred years. One of the best of the early descriptions was written by William Douglass, a doctor in Boston, at the time when the first epidemic of this disease on this continent occurred in 1735-1736. From the Atlantic Coast the disease gradually extended westward and ever since has appeared at intervals in all parts of this country, following the settlers into the new regions and often causing many deaths among their children. A very striking peculiarity of scarlet fever is the great variation in virulence at different times. Sometimes it is so mild that scarcely any deaths are associated with it; at other times it takes on such a high degree of virulence that it wipes out whole families of children. In cities isolated cases are always present, and at intervals of a few years epidemic outbreaks occur. For many years in this country scarlet fever has gradually become less severe and while the total cases of the disease have not been much reduced, deaths have become much fewer. In recent years the proportion of deaths in scarlet fever has varied from 1.5 to 10 per cent. The death rate is highest in infancy and decreases with advancing age. Few cases of scarlet fever occur in children under one year of age, the largest number is observed in children up to 10 years. The disease is not so infrequent in young adults, and occasional instances appear in persons of quite advanced age. In these respects it resembles diphtheria. The disease is most prevalent in late autumn and winter.