Immunity methods in scarlet fever and measles / by R.A. O'Brien.

  • O'Brien, Richard Alfred, 1878-1970.
Date:
[1928?]
Catalogue details

Licence: In copyright

Credit: Immunity methods in scarlet fever and measles / by R.A. O'Brien. Source: Wellcome Collection.

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    The Royal Sanitary Institute.] Immunity Methods in Scarlet Fever and Measles, by R. A. O’Brien, C.B.E., M.D., D.P.H. Wellcome Physiological - Research Laboratories, Beckenham, Kent. Scarlet Fever. WE can fairly say that the basis of a sound means of prevention, diagnosis and treatment of scarlet fever is laid. Much remains to be done, but we know to-day that the patient with typical scarlet fever is positive to the Dick test in the earliest stages, will give a positive Schultz-Charlton blanching response, will yield from throat swab an almost pure culture of haemolytic streptococci which readily produce Dick toxin, and will become negative to the Dick test during convalescence—further that during the stage of toxaemia, mild or severe, the administration of potent antitoxin will cause a rapid disappearance of symptoms. We know also that we can immunise those who are Dick positive and protect them. This all represents a great advance, but it is important that wre should recognise the many gap>s in our knowledge and the need for further observation and clinical research. The Dick test is usually but not invariably positive in the patient admitted during the early stage of scarlet fever. (The variations in the statistics dealing with this point in different parts of the world will probably lessen or disappear when there has been international agreement on the strength of Dick toxin to be used for testing.) Whether the suggestion arising out of the very interesting work in America by Dochez {Journal of Experimental Medicine, 1927, XLVI., 487) and colleagues, i.e.. that the Dick test is a purely allergic response to the protein or other constituent of the streptococcus and is not a response to true toxin as in the Schick test, is true or not, we do not at present know. As opposed to this hypothesis it appears to be reasonably certain that if one allows only nurses wdio react negatively to the Dick test to take duty in scarlet fever wards, one finds that these nurses do not catch scarlet fever. Further, one can consistently convert the reaction of “ Dick positive ” children, who have been in contact with scarlet fever, to negative in 24 to 48 hours by giving 5 c.c. of concentrated scarlet fever antitoxin. These children remain negative for some days and do not develop scarlet fever. The hypothesis that the reaction is a pure reaction to toxin similar to the Schick response is in accordance with these observations and is the simpler one to hold for the moment while further research is proceeding. Schultz-Charlton Test. This test is being used for diagnosis. Its value and its limitations are being more clearly ascertained.