With a disease of so high a degree of infectivity and so rapid
in its spread, collaboration is essential between the Medical
Officer of Health and the bacteriologist for the eradication of
outbreaks in schools and day nurseries. Sulpha drugs have
proved to be most successful from the point of view of prophylaxis
and in the treatment of this disease, (see graph page 46.)
A variety of conditions are caused by haemolytic streptococci,
including scarlet fever, erysipelas and puerperal infection.
The distinguishing characteristics of scarlet fever are fever,
sore throat, "strawberry" tongue and a rash. Scarlet fever
differs from streptococcal sore throat by the presence of a rash.
No disease has changed more than scarlet fever in recent
years. It is, to-day, a trivial disease and is no longer regarded
with dread; the fatality rate is almost nil. Notification of this
disease seems hardly necessary, as streptococcal sore throat is
not notifiable. Isolation and concurrent disinfection are still
practised, especially in cases of severity or of an exceptional
nature. With a disease so mild in nature, as scarlet fever is at.
present, the question of immunisation does not arise, (see
graph page 47.)
The results of the local application of penicillin since its
discovery have been most successful in the treatment of this
disease. The duration of treatment is now days instead of
weeks. Resulting blindness is now almost unknown. Occasionally
failure is encountered owing to the presence of a
penicillin-resistant organism, (see graph page 48.)
The Value of Immunisation for Diphtheria.
Immunity to infections such as diphtheria, scarlet fever,
measles and chicken pox, normally exists in the first few months
of infanthood owing to the presence of antibodies obtained from
the mother. These antibodies gradually disappear and are not
replaced. Immunity can, however, be induced artificially. In
the past the measures used to protect the individual from
diphtheria was the use of a specific antitoxin. This passive
immunisation was practised when a case occurred in a family
and it was necessary to protect the other children who had been
exposed to infection.
Passive immunisation has now been replaced by active
immunisation which is best carried out in early infancy, preferably
not later than 8 months of age. The resulting immunity