View report page

82
Recent Investigation on Cross Type Infection in Scarlet
Fever.
It may be assumed that the basic idea in the establishment
of fever hospitals was protection of the public from-spread of
infection, with a secondary but not less important consideration,
i.e., protection of the patient by the provision of hygienic
surroundings and skilled nursing.
The examination of these principles in the light of
modern knowledge establishes some conflict with a concept of
their merit in so far as Scarlet Fever is concerned.
The association of the streptococcus pyogenes with Scarlet
Fever has been known for some time, but only in recent years
has this particular organism been shown, by means of serum
tests, to be possessed of types responding differently to reactions
employed in their identification.
Assuming that a patient on admission to a ward is
infected by a certain type of streptococcus pyogenes, it is not
to be expected now that during the course of isolation in
common with other patients he will preserve that type and
that type only.
*Of 100 patients in a London Fever Hospital whose type
of organism was established on admission, no less than 57
were found on discharge to be harbouring a different type
of organism and the only reasonable conclusion is that they
acquired the other type, or even types, of organism, as the
result of their association with other patients.
Further, it has been proved that more than 80 per cent,
of patients discharged from fever hospitals carry in their
naso-pharynx streptococcus pyogenes, although clinically they
present no abnormal condition, and it has been found even,
during the course of investigation in a London Fever Hospital
already referred to,* that 48 patients in whom the type of
streptococcus on admission was ascertained by serological
tests, were possessed on discharge of a type, or types, varying
from that they harboured on admission.
* The figures in this connection are those of Drs. Allison
and Brown of the Ministry of Health.