View report page

69
A very interesting and important piece of work is being carried on here at the
laboratory in collaboration with the Pathologist of the Chelmsford and Essex
Hospital in connection with Streptococcus pyogenes.
This rather formidably named creature is no less formidable than its name.
It is the germ which is common to scarlet fever, tonsillitis, mastoiditis,
erysipelas, cellulitis and a host of other suppurative conditions, not least of which
is puerperal septicaemia. When it is realised that there are nearly thirty so-called
" types " of this germ which are dangerous to man, no one of which gives complete
immunity to any other, it must be apparent that this germ is a very grave menace.
These types are strictly permanent, in other words one type can never be
transmuted into any other type.
Briefly what is being done here is to isolate the germs from the throats, nasal
discharges or ear discharges of scarlet fever patients or from other likely sources ;
these strains are sent to the Pathologist at Chelmsford for typing (a process which
requires special materials which are not on the market).
In common with other workers, we have found that in a high percentage of
cases the complications commonly attending scarlet fever, viz., otitis media,
rhinorrhæa and so-called secondaries, are due to streptococci of a different type
from those which caused the initial symptoms. It is noteworthy that a person who
has had scarlet fever in childhood through infection with one type of streptococcus
is not safeguarded against streptococcal diseases of other descriptions caused by a
different type, although it is rarely that the clinical syndrome designated “scarlet
fever ”appears more than once in the same person.
A demonstration of the usefulness of typing occurs in the event of a possible
return case of scarlet fever. If the type of Streptococcus in the throat of the new
case is of the same type as that in the throat of the discharged patient with which
it has been in contact, then the chances are that it is a true return case. In the
event of the types being different then it is quite out of the question that the new
case has been infected by the late patient and it is not a return case.
In the field of midwifery the source of the infecting organism in a case of
streptococcal puerperal septicaemia can often be traced. This may be the patient's
own throat or the throat of one of her attendants.