The Birmingham age-herald., 1914-07-12
Most Prevalent Among Chil- dren Under Ten Years
 of Age
COMPLICATIONS
 VERY FREQUENT
Many Deaths Caused by Local Trouble. Best Methods of Prevention-Na- rious Types of the Disease.
 To Treat Measles Next

The puzzlng disease of children known as scarlet fever is the subject of Health Bulletin No. 12, issued yesterday by City Health Officer Dr.~R. M. Cunningham.
 Dr. Cunningham in plain terms dis cusses the known facts and suppositions of medical men about this disease. it's cause, it's effect, it's prevention and it's cure. Another children's disease will be his subject next Sunday, Measles" Bull letin No. F Is as follows:
 Bulletin No. 12-Scarlet Fever.
 This disease exists throughout the civil ized world and attacks an races. It oc- CUTS mostly in the late fall winter and early spring months. or until about the middle of May. While nursing babies rarely have it, the disease prevails most ly in children under 10 years of age. It occurs mostly in the cold and temperate climates and Is rare in the tropics.
 The specific cause has not been dis covered or at least positively identified. Therefore, we fall back upon the hypo- thetical virus or contagious principle. Whatever this is, it is communicated from person to person, and through the instrumentalty of things that have been used by or in contact with patients with the disease-books, pencils, spoons, cloth ing, bed clothing etc. The virus is very resistant to ordinary conditions and may last for years. There Is, however a well known germ, the streptococcus pyogenes, or pus making germ, almost constantly found in this dsease-locally in mild cases, and in the blood. joints, serous membranes and glands in the severe cases. Many believe that a particular strain or kind of this germ is the spe- cific cause of the disease. This is not generally accepted There Is no doubt, however, but that this gerna Is the cause of most of the complications of scarlet fever, and Is the important factor in the mortality of the disease Scarlet fever has been experimentally conveyed to chimpanzees and monkeys.
 Mode of Infection
 'The virus is contained in the secretions of the nose, throat and respiratory tract of patients, carriers, and probably en- ters through the mouth and respiratory passages The period of incubation is from two to seven days, more often two to four days. It is not contagious dur ing the period of incubation; little if any, during the period of invasion. It is most contagious during the period of eruption. Scarlet fever is readily communicable, but less so than measles or smallpox; it ranks about with diphtheria. "-Roseneau.
 It has been generally thought by the profession, and accepted by the people, that the greatest danger of communicat- ing the disease was during the period of desquamation, or the pealing off of the outer layer of the skin This is now de- nied by some but maintained by others, but all agree that the isolation of the patient should be for at least six weeks The opinion of this writer is that this stage is dangerous, though not so much as the active stage, and that the scales or calculations will maintain their con tagious principle, or the virus, for an in- definite time. Hence. the great importance of the thorough dsnfection of rooms clothing, etc.
 Milk Borne Epidemics
 "Milk is rather frequent vehicle for scarlet fever Infection The milk is practically always contaminated from hu- man sources. Trash collected 51 scarlet fever epidemics reported as spread by n ilk. Twenty-Five of these occurred in the United States and 2s in Great Britain In 35 of the epidemics a case of scarlet fever was found at the producing farm the distributing dairy, or milk shop. In three of the outbreaks the bottles re- turned from infected households and re- filled without previous sterilization. In three scarlet fever persons handled the milk or milk utensils and in 12 the cows were mill<ed by persons having scarlet ver'-Roseneau.
 There are other instances of milk-borne epidernics well established, notably in Washington and Boston. This is another