SCARLET FEVER
Scarlet fever is one of childhood's most dreaded diseases because of, first, its long quarantine; second, its terrible possibilities of contagion; and, third, its sequelae.
Absolute quarantine is necessary until ten days after the last signs of desquamation have disappeared.
This disease is always alarming because of the possibilities of its sequelae—the danger of pneumonia, inflammation of the ears, abscesses of the glands of the neck, and nephritis (inflammation of the kidneys).
Scarlet fever is highly contagious at any time during its onset and course. Among the first symptoms of the disease are sore throat, swollen glands, fever, etc. Vomiting on a street car or at the movie may spread the disease to more than one child who might otherwise have escaped. One child who may have only a very light form of the disease may give it to another child in the most severe form. Any such group of classic symptoms—vomiting, fever, rapid pulse, and sore throat—should cause any parent immediately to isolate the little sufferer for several days—awaiting the "rash"—which usually puts in its appearance after three or four days of increasing temperature.
This rash has an appearance "all of its own," unlike any other. Because the fine "meal-like" red points are in such close proximity, the skin assumes a smooth "lobster red" color that is never to be forgotten. After three days of increasing redness, the color begins slowly to fade, and after four or five days of this fading a peculiar peeling takes place, whose scales vary in size from a small fleck to casts of the whole of the soles of the feet and the palms of the hands.
During the height of the disease, the throat is very red, the tonsils are not only inflamed, but covered over with white patches, the head aches and the tongue possesses a peculiar coating through which peep the red points of the swollen papillae, presenting the classic "strawberry tongue" of scarlet fever.
After ten days the fever disappears and the "real sick" stage of the disease is in the past.
Each morning of the ten previous days a small dose of Epsom salts is usually administered and the itching, which so often accompanies the rash, is relieved by carbolized-water sponge baths.
The nose, throat, and ears receive daily care—sprays to the nose and gargles to the throat, as well as special swabbing to the tonsils.
The physician in charge of the case will note the urinary findings, guard the heart and kidneys, prevent the spreading of the scales of desquamation by frequent rubbing of the skin with oil, and otherwise work for the future well-being of the patient.