This deadly disease was first described gin the 1500s. Due to its contagious nature and debilitating, if not deadly, effects, outbreaks of scarlet fever were greatly feared.
Charles Dickens knew more than he would have wished about scarlet fever. His son, Charley, was afflicted by it, causing the family to leave Paris hurriedly and return to London in 1847, and it featured in several of his novels. It was a much-feared disease that caused devastating epidemics through the 19th and early 20th centuries, resulting in thousands of deaths.
The boy in this story is suffering from scarlet fever. Because the disease was so infectious, it was not uncommon for all the children in a family to contract scarlet fever and for none to survive.
I can remember my grandmother telling about the carts that rolled down the streets to remove infected people to take them to the fever isolation hospitals outside the towns during epidemics of scarlet fever or other infectious diseases.
Over the years scarlet fever has naturally declined over the past 200 years probably largely due to intake of better food and clean drinking water, improved sanitation, less overcrowding and better living conditions generally. Also, I suspect that accuracy in diagnosing scarlet fever was more difficult as diseases with rashes such as smallpox, meningococcal meningitis and measles were very common.
Fans of the Little House on the Prairie series will remember that it was scarlet fever was thought to have that resulted in Mary’s blindness. However, as there was no record of a sore throat it was more likely to have been caused by meningococcal meningitis. Both scarlet fever and meningitis have a widespread rash but they are differentiated by performing the ‘glass test’. The rash of scarlet fever becomes white with the glass test.
When penicillin was widely available in 1942 this made significant difference to the course of the diseases in that severe complications such as Rheumatic Fever with serious heart problems, Glomerulonephritis with severe kidney problems, osteomyelitis ( bone infection ) and blood borne infections are now very rare.
Now, 160 years later, it is making a comeback. Almost 3,000 cases were recorded in 2008, the highest total for a decade, and doctors fear a dangerous strain of the infection is becoming more widespread. If seems scarlet fever follows a cycle rising and falling roughly every four years – and is currently on a rising trend.
What is Scarlet Fever (Scarletina)?
Scarlet fever (sometimes called scarlatina) is an infectious disease caused by the bacteria Streptococcus pyogenes, which is commonly found on the skin or in the throat, where it can live without causing problems. However, under some circumstances, they can also cause diseases like scarlet fever.
It is most common in children between the ages of 2 and 8 years of age. I remember one Sunday evening last year I saw 6 children from the same reception class at school attend with classical signs of scarlet fever.
What are the symptoms and signs?
Symptoms include a fever, tiredness, nausea and vomiting and may be headache aswell as feeling generally unwell.
Red blotches are the first sign of the rash. These turn into a fine pink-red rash that feels like sandpaper to touch and looks like sunburn.
The rash usually starts in one place, but soon spreads to other parts of the body. It commonly affects the ears, neck, chest, elbows, inner thighs and groin, and may be itchy.
The rash blanches with the ‘glass test’ and does does not normally spread to the face.
However, the cheeks become flushed and the area just around the mouth stays quite pale ( circumoral pallor) The rash will turn white if you press a glass on it. The tongue becomes swollen and red and is often called a ‘strawberry tongue’
The rash usually fades after about a week, but the outer layers of skin, usually on the hands and feet, may peel for several weeks afterwards.
In milder cases, sometimes called scarlatina, the rash may be the only symptom.i
How do you protect yourself from scarlet fever?
The risk of infection can be reduced through general good hygiene and cleanliness, including:
•Washing your hands often, using alcohol hand rub
•Not sharing eating utensils with someone who has the infection
•Disposing of tissues promptly
What should I do if I think my child has scarlet fever?
•See their GP as soon as possible
•Make sure that your child takes the full course of any antibiotics prescribed. Although your child will feel better very quickly after starting the course of antibiotics, you must complete the course of treatment to ensure that you don’t carry the germs after you’ve recovered.
•Stay at home, away from nursery, school or work for at least 24 hours after starting the antibiotic treatment to avoid spreading the infection.
•You can help stop the spread of infection through frequent hand-washing and by not sharing eating utensils, clothes, bedding or towels.
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