The Birmingham age-herald., 1915-05-01
HIGH SCHOOLS
 cEnfEc cTt-D

 mer being the principal method of infec- tion. It is no doubt a general infection because the blood from scarlet fever patient transfused into the blood vessels of others communicate the disease. It has been taught from time inmemorial that the scales of the peeled skin also communicates the disease. Recently great doubt has been thrown upon this method. some claiming that these scales are not infectious. The strong probability is that contact or near contact, that is within the reach of droplets in the exposed air, is necessary to produce the infection The infective virus may also be communi- cated in books, pencils, handk erchiefs, spoons, chewing gun, etc., etc. 1t is not an air borne disease except in proximity or near proximity to those infected with the disease. There is little or no danger of contracting scarlet fever from one house to another through the medium of the air, and very little danger from one room to another It may. however, be carried from house to house and from room to room by persons who have been in contact with scarlet fever patients It's communication through the instru- mentality of cloths is very doubtful. It is also very doubtful that the disease is communicated upon the streets. in the parks, playgrounds or anywhere in the open air, unless there is personal contact or near contact of those infected with the disease
 How It Is Spread
 Coughing. kissing, etc. and the use of pencils, books. etc, that have been in contact or near contact with infected person may communicate the disease. The period of incubation is from one to seven days, according to most writers, usually from two to four days. Some writers xl<.& ft i, as a It is largely a disease of childhood, the vast majority of cases occurring under 10 wears of age. From this time on the tendency to the disease steadily dimin- ishes It is said that from 90 to 60 per cent of all children under 10 years Of age who are exposed to the infection py contagion or near contagion contract the disease
 There are three types of the disease: the mild, severe and malignant Many of the first class do not report SICK or may only have slight.> sore throat, and continue their avocation, the school play or work. These mild cases are source of danger, and may communicate to others the severe or malignant type The disease has many very severe com plications, such as infia nation of the kidney, usually occurring during con valescense, severe inflammation in the throat disease of the middle ear, mas told bone, and large abcesses in the neck. It may also cause inflammation of the lining membrane of the heart and of the membrane that covers the heart The discharges from these during convalescence contain the contagious virus and may communicate the dis ease The severe type Is usually at tended by some complications, either in the throat or elsewhere. Cases of the malignant type die within a few days from an overwhelming toxaemia. It will be observed, therefore, that even after the patient with scarlet fever gets up and about if there is discharge from the nose, the ear or an abcess are ca- pablo of communicating the disaese to others.
 Prevention
 The methods of prevention are islo- lation of persons with the disease and the quarantining of those who have been exposed. and the disinfection of all the discharges, vessels and utensils used by the patient. The disease may be communicated by milk Many epidemics in the United States have occurred from the contamination of the milk or the utensils used in the handling of milk with the contagious virus. MILK bottles should be thoroughly boiled by those who have not been in contact with the
 
 the dairyman. If the dairyman steri1- izes these bottles before use 1t will largely remove this source of danger. The present epidemic of scarlet fever in Birmingham, in my opinion, proves that milk plays no part in it. From the first of May, however, the source of milk supply will be ascertained in each case. There are many difficulties in en- forcing these measures. The methods employed by this department are: first. isloating the patient; second, the guar antining of all children from this pa- tient; and, third. the disinfection. by formaldehyde of the room and all things that have come in contract with the patient. Whether these regulations arc observed or not depends upon the au- thorities in the household. 1t is inn possible, of course, for the health de- partment to watch over each case. We also find that those who report chil- dren who are quarantined in their homes for running out on the streets or leaving the premises, usually refuse to give their names, and others refuse to appear in court.
 Until the ordinance recently passed reg ulating this quarantine, we have had no authority in the premises The only safe method to prevent scarlet fever is for all children under 15 years of age to remain at home, and all other children kept off the premises. This. of course. is hardship and very difficult of execu- tion. Children who go to Sunday school, day school, church, motion pictures, who ride on street cars. etc, are more or less exposed to the disease. The statistics furnished you in tables "A" and "B'' show that the schools are undoubtedly an environment for Communicating the disease. l herewith have the honor to again recommend that where the patient develops the disease within six days after
 Makins Good work Possible