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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    their lueclianieal removal, hut in some degree to a specific })actericidal action on tlie })art of tlie mucous membrane or its secretion, tlie development of which j)roj)erty was in some cases considerably delayed. The (juestion as to how j>ersons suffering from these infectious di.seases lose the contagium. and cease to be infectious, seems to me both an interesting and an important one, which has not yet Ijeen sufficiently discussed. If it does de])end on a spf*cific jiroperty which the ti.ssues develo]) in the course of the illness, there is hope that measures may be devised for hastening the onset of this action. The ]uovision of a method of effectually and s]>eedily lemovimr infection is as ini])ortant to the public health as the discovery of an antito.xin. To return to the relation between segregation and ]>ro- longed infectivity, it is probable, from analogy, and from tlie fact that infection is sometimes prolonged in cases treated by home isolation, that segregation is not wholly responsible. But I should regal'd it as possible that it has some effect. To express it in the terms of the theory to which I have just leferred, I see no rea.son why a specific bactericidal action, if one exists, should not in some ca.ses be shortlived, just as in di])htheria the antitoxic ])roperty is. Under these circumstances the patient might re-ac(iuire infectivity from his neighbours without the necessity of re-acquiring the disease. Results.—What is the influence of the segregation hos])ital on the occurrence of cases in the households attacked ? I)i-. Xiven* re])orts that in Manchester, during the year 1901. there were 1,5IU cases removed to hos])ital. There were ‘2,937 un])rotected persons under fifteen left, and .35fi sub.se(|uent casest occurred, a ])ercentage of 121. In atldition, 3 f) per cent, of these children aeipiired scarlet fever after the discharge of the primary case from hos])ital. Thus, in all, ITi'T percent, of th(‘ uiqu'oteeted children in these households acijuired the di.sease. Com})arison with the results at Providence of the treatment of all classes at home would suggest that the removal to a segregation hosjiital had very considerably re- duced the risk to suscejitible persons in the infected house- holds, (juite a])art from the undeterminable influence on the health of the community. One woidd not be justified in saying how much, for all the conditions may not be the same in the two instances. • i ll. t In lK>th ProvUlenco and .^^anc•hcster. wlicn cases have occurred nearly sinuil- taneonsly in one house they have l>een treated in thest* statistics a- primary and nuhstNiuent.