Scarlet Fever

Scarlet Fever, SCARLATINA, is an infectious malady characterised by a peculiar punctiform eruption attended by sore throat and febrile disturbance. The incnbation period of the disease varies from about 24 hours to 6 or 8 days. The invasion is usually marked by shivering, headache, often vomiting, and soreness of throat. On the second day of the illness the rash appears, usually upon the chest first, but soon becoming generally diffused. The rash is "fully out" on the third or fourth day, and then begins to fade; when it has disappeared, the skin commences to desquamate, the cuticle separating in scaly flakes, which are most prominently developed on the palms of the hands and soles of the feet. The temperature is usually markedly raised on the first day of the disease, and the patient remains in a feverish condition during the development of the rash; the pulse is much accelerated also during this period. In some mstances the disease assumes quite a mild form, scarlatina simplex; in others the throat is markedly involved, scarlatina anginosa, and a condition of diphtheritic inflammation may be present. The severest form of scarlatina is the malignant variety, in which death sometimes occurs before the rash has had time to develop. There are several sequelae of scarlet-fever, to which reference must be made. Conjunctivitis, otitis, and rhinitis may be present. There is sometimes rheumatic mischief, and inflammation of the serous membrane. may occur. The most important sequela of the disease is albuminuria, associated with involvement of the kidneys. If these organs are seriously affected, there is marked dropsy and a uraemic condition may supervene. Scarlet-fever usually affects young children, and second attacks of the disease are rare. It is generally produced by the transmission of the poison from some infected person or object. It is not uncommonly conveyed by infected milk. Treatment consists in isolation of the patient, who should be kept at rest in bed and fed upon light diet. Exposure to draughts should be avoided, and the possible supervention of complications carefully watched for, that appropriate treatment may be employed without delay. If the patient be not removed to the hospital, the most rigid precautions must be taken to guard against the spread of infection.