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.

    15/24 (page 15)
    ascertained that the persons who were removed to hospital were of a much poorer class ; he noted, also, that on the average there was considerably less susceptible material at home, when the patient was not so removed. Since these home-treated cases differed from the hospital patients in these all-important respects, it is obviously impossible to come to any reliable conclusion from Dr. Niven’s statistics as to what would have had happened had all the cases been treated at home. In the year mentioned 358 primary cases were treated at their own homes; there were 351 other un- protected persons under fifteen in these households, and 69 (19'6 per cent.) subsequent cases occurred. More unsatisfactory are the results when home isola- tion is uniformly adopted for all classes. During the last few years interesting and instructive reports have been kindly sent me by Dr. Chapin, Superintendent of Health of the City of Providence, U.S.A., and I shall quote from his statis- tics. Providence has a population which has risen from 132,000 in 1890 to 193,000 in 1904, and home treatment had until recently been practically the only method employed. During eight years, up to and including 1903, scarlet fever was acquired by no fewer than 26’1 per cent, of the 4,412 persons in infected families under twenty-one, other than the prim.ary cases. (During this period 3,023 patients, out of a total of 3,315 cases, had been treated at home.) This high percentage of secondary cases forms a draw- back to hom.e isolation, which is clearly a serious one, serious not only to the individuals, but also to the community. In the previous section it was shown that in a not inconsiderable proportion of the convalescents from both diphtheria and scarlet fever infectivity was protracted beyond the period of isolation. The multiplication of cases in the infected homes may thus have an effect not to be estimated merely by the number of secondary cases. Scarlatinal sore throats, also, to which I have referred as occurring in homes infected, with scarlet fever are, of course, not included among the secondary cases, yet they are quite possibly highly infectious. Second Method.—The second form of home isolation consists in effectually separating the susceptible children by sending them away. This, so far as the children are con- cerned, is much superior to the other method, but it is ob- viously of limited application, and there is some risk of in- fecting fresh households. In Providence, during the last seventeen years, from 652 families infected with scarlet fever Loc. dt.