The infectivity and management of scarlet fever / by W.T. Gordon Pugh.

  • Pugh, William Thomas Gordon, 1872-1945.
Date:
1905
Catalogue details

Licence: In copyright

Credit: The infectivity and management of scarlet fever / by W.T. Gordon Pugh. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    (lescjuamating cuticle, but in tlie throat and nasal cavities, is decidedly strong. In scarlet fever therefore, as in dij)litheria, it is inij)ossible to ascertain definitely by clinical means when the patient has been freed from infection. It must not be assumed, however, that prolonged in- fect ivity is the rule ; it is probable that the majority of })atients are free from infection at the end of the minimum j)eriods of i.solation usually prescribed—the six weeks for scarlet fever and the four weeks for diphtheria. It would seem imj)o.ssible to discover by clinical means the minority who retain infection longer, and difficult even to differentiate tho.se by whom transmission of infection is likely. The impres- sion derived from experience has been that such transmission is es])ecially liable to occur from those who suffer from rhinitis at the time of their discharge, or have suffered from this complication during their period of isolation, and this im- ])ression has been supported by statistics whenever subjected to that test. A nasal discharge, therefore, while not to be regarded as ])roof that the patient continues infectious, is a symptom to be viewed with considerable suspicion, for if the contagium is still resident on the mucous membrane of the nose, it will unfailingly act as a vehicle for its distribution. Review of Suggested Methods of Indirect Infec- tion.—Having accpiired, from a study of the con- valescent, more or less definite ideas regaiding the infectivity of scarlet fever, one is now in a position to consider critically the various ways which have been suggested for indirectly ac(piiring the disease. Milk.—1 shall deal very briefly with milk as a vehicle of infection. Several outbreaks* of scarlet fever have been ])roved to the satisfaction of the medical officers concerned to be due to the consumption of contaminated milk. It is ])0ssible that this occurs more freipiently than is known, for the milk su])])lied in towns often comes from various sources. ])asses through several hands, and suffers much blending l)efore it reaches the consumer, and it is thus difficult to trace the career of any given sample. Unrecognised Cases—I next come to the influence of unrecognised cases, which there is reason to believe is one of the chief causes of the failure of isolation to eradicate the disease. It is now widely appreciated that scarlet fever, like diphtheria; may exist in an extremely mild form, so mild that a considerable number of cases do not come under medical Hactpriolofry of Milk, by .Swithiubrink and Newman.