The infectivity and management of scarlet fever / by W.T. Gordon Pugh ; issued by the Medical Officers of Schools Association.

  • Pugh, W. T. Gordon (William Thomas Gordon)
Date:
1905
Catalogue details

Licence: In copyright

Credit: The infectivity and management of scarlet fever / by W.T. Gordon Pugh ; issued by the Medical Officers of Schools Association. Source: Wellcome Collection.

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    At Birmingham, while only 6 per cent, of all cases had an abnormal condition of the nose at the time of discharge, no fewer than 22'9 per cent, of the infecting cases had been noted as leaving with such abnormality. Dr. Knyvett Gordon relates that rhinorrhoea was asso¬ ciated with 39 out of the 174 alleged infecting cases which occurred in Manchester in the years 1902 and 1903 ; in 8 cases it had been present at the time of leaving hospital ; in 31 it appeared later. Professor Simpson found that of 90 discharged patients whom he regarded as probably the cause of fresh outbreaks, 49 had nasal discharge, 5 a sore nose, and 15 a cold in the head with running at the nose. But it must be noticed that rhinorrhoea does not neces¬ sarily prove infectious in the family. It may be calculated from the Birmingham statistics that less than one-eighth of the cases discharged with a morbid condition of nose became associated with return cases. This may be due to one of the following causes : The exposed children may not be sus¬ ceptible ; the discharge may never actually be conveyed to them ; or the discharge may not in all cases carry with it the infecting virus. It is probable that the last is most fre- cprently the correct explanation, for in diphtheria the rhinorrhoea which sometimes occurs in convalescence is often found not to be associated with the presence of the Klebs-Loeffler bacillus. In other words, the risk attached to rhinorrhoea would appear to be that, if the infect¬ ing agent is still present on the mucous membrane of the nose, the discharge will act as a vehicle for its distribution. From many observations it seems likely that in both scarlet fever and diphtheria persons may be released from isolation, still carrying the contagium on their mucous membranes, and yet prove harmless, unless catarrh is set up and the resulting discharges act as carriers of infection. The Ears.—Otitis is also a common complication of scarlet fever. Among nearly 11,000 patients treated in the Board’s hospitals during 1903, 15 per cent, suffered while in hospital from otorrhoea. Even this does not include all, for, not rarely, it occurs for the first time after the patient has left hospital. Otorrhoea, which has ceased for weeks, is apt to recur when the child comes again under home conditions. The frequency of this complication being admitted, what is its potentiality for transmitting infection ? Dr. Millard states that otorrhoea was present on discharge in 2'2 per cent, of alleged infecting cases, as compared with 1'5 per cent, of all cases. The inquiry is to some extent obscured by