Are Your Children Healthy? Scarlet Fever

Hello, again History Lovers!

In 1923 The Farmer’s Wife–A Magazine For Farm Women began a series regarding the healthcare of rural babies and children written by Dr. Walter R. Ramsey a leading pediatrician of his time. The Editors encouraged mothers to read the articles, cut them out and paste them in a scrapbook, and to tell their neighbors about the information. Keep in mind this was well before the availability of penicillin when childhood illnesses could be debilitating or fatal. Our two-year stint with Covid-19 has been an immersive experience in the anxiousness and vulnerability that mothers of yesteryear had to have felt during outbreaks of serious childhood illnesses.

Today I’m feeling particularly grateful for the availability of antibiotics while raising my children.

Scarlet Fever–Scarlatina

Regard Every Case, However Mild, As Most Serious

“Scarlet Fever is perhaps the most treacherous of all the diseased which affect children. You never know just what it is going to do next. I may be so severe from the onset as to end fatally within a few days, or it may be so mild that it is almost impossible to say that it is scarlet fever at all. Even in the mild cases of so-called Scarlatina, serious complications may arise.

It is, therefore, imperative that all cases of scarlet fever of whatever degree of severity be regarded as serious.

The time from exposure until the child comes down with the disease, varies from two days to a week. The onset is usually sudden with vomiting, sore throat, and rapidly rising fever. The throat is inflamed and frequently covered with a grayish-white membrane, not unlike that found in diphtheria.

The two diseases may be present at the same time, and it is only by a culture from the throat and a microscopic examination that the proper diagnosis can be made.

After twenty-four or forty-eight hours the tongue usually presents the strawberry appearance. The rash begins usually on the neck and chest and rapidly spreads over the body; is not blotchy like measles but rather of a mustard plaster character and in typical cases is scarlet in color.

The glands in the neck frequently become swollen and very tender and later may form an abscess and have to be opened by the physician.

Abscess of the middle ear is common and requires skilled attention, as frequently the drum must be opened to evacuate the pus. By early opening through the canal, mastoid involvement i.e., infection of bone cells behind the ear, may be prevented.

Another frequent and serious complication is inflammation of the kidneys. This often occurs in mild cases, even after they are thought to be well and are permitted to run about and have the usual things to eat. In these cases, it will be noticed that the face is puffy, especially under the eyes, and the ankles and feet are swollen, so that the ridges of the stockings and shoes can be readily seen in the skin. The urine is scant in quantity and often highly colored.

Another serious complication of scarlet fever is heart involvement. It may produce serious symptoms from the beginning or be found later in life. Many of the boys rejected from the army in the late war, were suffering from some heart affection, many instances of which have their origin in scarlet fever during childhood.

Inflammation of the joints is also common in scarlet fever and may result in serious and permanent disability.

From what I have already said it will be apparent that scarlet fever is a disease that should be under the supervision of a skilled physician from the very onset.

All cases of scarlet fever should be kept in bed for a much longer period than is usually thought necessary.

The disease is usually contracted from some other person who has it. The infection comes from the discharges from the throat or nose and not from the scalings, as is generally supposed.

A very common carrier is the milk that may readily be infected from someone, such as a milker who has the disease in a mild form, but who does not know it. One of the worst local epidemics I have ever seen of scarlet fever and malignant sore throat resulted from the infection of the milk supply by the milker.

If all milk for children were properly pasteurized or boiled for two minutes, many of them would miss such diseases as scarlet fever, diphtheria, typhoid, and tuberculosis from which many of them now suffer.”

~FWM