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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    ir, there were thus removed 1,051 persons, mostly ehilclren, none of whom had had the disease. Fifty-two (5 ])er cent.) were attacked while away from home. Dr. Chapin informs me that scarlet fever patients are isolated at Providence until desquamation luvs ceased, and live weeks was, until March, 19tt2, the time laid down as tlie minimum jieriod of isolation. It is interesting to find that nineteen of the above persons who had been thus sent awaytrom the infected houses were attacked on their return home, a j)ercentage on the infected families of 2’9. These cases corres})ond closely to the return ca.ses of fever hospitals, flescribed by some writers as ]>urely a “ hos|)ital ])heno- menon.” That similar instances of late infection are rarer when the other method* of home isolation is adopted may possibly be due to the more su.sceptible material being to a great extent used up in the secondary cases. Segregation Hospitals.—Hospital treatment also i> of two kinds. The first is the segregation hosi)ital, where wards of from 12 to 2(.), or more, beds are ])rovided for scarlet fever patients, smaller wards for combined diseases, and single- bedded rooms, usually (piite inadequate in nunPoer, for doubt- ful or complicated cases re([uiring complete isolation. Drawhack's.—It is needless for me to indicate the advantages of hospital treatment for the j)oorer classes, and 1 shall confine myself to pointing out the drawbacks attaching to segregation. (1) There is the risk, a small risk as a rule, which erroneously certified patients run of ac(piiiing the disease in hospital. Scarlatina often assumes a mild type, and there is sometimes difficulty, by the time the }>atient iias arrived at the hos|)ital. in deciding whether or not the diagnosis is correct. (2) Then there is the ])ossibility of infection by some secondaiy disease. 'Fliis danger is not confined to fever hospitals, but attaches to all institutions where sick children are collected together. A child admitted with scarlet fever may be at the same time incubating a second infectious disease which he transmits to some of his fellow patients. (.‘1) Again, the period of isolation is on an average longer than when the patient is treated at home. This, however, may be due to the fact that, while many practitioners still ■ Extract from Or. Chaj)in‘s report : “Since 1805, there must have been ut lea>t I.Hih) families in which susceptible children remainetl after the removal of the warning-iffn- • . . The disease recurred in thirty families after removal of the F'liu'jird (in twenty wituin a month): . . . aud in seven other families livinj? in ihe «!inv hoU'C i in five within a month