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 carbonized-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.

Measles

Measles, one of the most common diseases of childhood, is not to be regarded lightly, for very often its sequelae - running ears, weak eyes, and bronchial coughs - may prove very serious and troublesome. Tuberculosis of the lungs not infrequently follows in the wake of measles. The early symptoms of measles are so mild that often the child is out of doors, at school, or about his usual play, until the second or third day of the fever. He was supposed merely to be suffering from a simple "cold in the head."

On the third or fourth day the patient begins heavy sneezing and wears a stupid expression; and it is then that the mother ascertains that his temperature is perhaps 101 to 102 F. He is put to bed and the next day the rash usually appears. The rash is peculiar to itself, not usually mistaken for anything else, being a purplish red, slightly elevated, flattened papule, about the size of a split pea. The coughing, which is very annoying, usually remains until about the seventh or eighth day - at which time the fever also disappears.

The bowels must be kept open; a daily bath be given - in which has been dissolved a small amount of bicarbonate of soda (simple baking soda) - after which an oil rub should be administered. The nose should be frequently sprayed with three percent camphor-menthol-alboline spray, while the throat is gargled with equal parts of alcohol and water. The feet should be kept warm by external heat, while the physician in charge may order additional attention to the chest, such as a pneumonia jacket, etc.

Care should be taken to guard against "catching cold," for bronchitis or pneumonia is quite likely to develop in many cases of measles. The eyes should be protected by goggles and the room should be darkened; under no circumstances should the little patient be allowed to read. Carelessness in this respect may mean weakened eyesight all the rest of his life. Until two weeks after the rash has disappeared, the little fellow should be kept by himself, for the desquamation keeps up almost continuously during this time.

The food during the course of the disease is a liquid and soft diet. Children should never be allowed to go to a party or gathering with a cold in the head; the mothers of a group of small children will never forget the time that one certain mother allowed her little fellow to attend a party with "simply a cold in the head." He laughed, talked, and sneezed during the afternoon and when he went home the rash appeared that night, while eight of the ten exposed children came down with measles during the next two weeks.

Chickenpox

The incubation period of chickenpox is from ten to seventeen days. It is a mild disease, with a troublesome rash consisting of widely scattered pimples appearing over the scalp, face, and body. These pimples soon became vesicles (small blisters), which in turn quickly become postural, afterwards drying up with heavy crust formation. Severe itching which attends these pustules may be greatly allayed by either the daily carbolic-acid-water bath or a baking-soda bath. The itching must be relieved by proper measures, for if the crust is removed from the top of the blebs by scratching, a scar usually results. The bowels should be kept open, the diet should be soft. Rigidly isolate, for chickenpox is highly contagious.

Smallpox

This disease occurs oftenest during the cold season. It spares no one unless vaccinated, attacking children and adults alike. The early symptoms are: headache, pain in the back, high fever, vomiting, and general lassitude. In many respects these resemble the symptoms of the grippe, while on the third day the eruption appears. The pimples are hard and feel like shot under the skin. Within a day or two these shot like pimples have grown and pushed themselves beyond the skin into little conical vesicles which soon turn to pus. By the eighth or ninth day crusts are formed over the vesicle, beginning to fall off about the fifteenth day.

Patients are quarantined usually eight weeks and when a case of smallpox in the home breaks out everyone in the family should be revaccinated. The strictest isolation is important from the first of the disease.

We will not enter into the treatment of smallpox, for medical aid is sought at once and usually the patient is removed to a special isolation hospital.

Tags: Pediatrics

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About the Author

Dr. William S. Sadler M.D. was a well-known American psychiatrist and college teacher in the school of medicine at the University of Chicago. For over sixty years he practiced his profession in Chicago, thirty-three years being associated in practice with his wife, Dr Lena Kellogg Sadler. The doctors were pioneers in the research on the mysterious Urantia Papers.