A brief history of scarlet fever

Scarlet fever is a disease common in children that is characterized by pharyngitis with or without exudates, fever, and a sandpaper-like rash. The disease is caused by a pyogenic exotoxin-producing group A beta-hemolytic streptococci. It is spread through person to person by contact with particles that are airborne; these organisms can also live for two weeks in non-living things like toothbrushes. The incidence of complications from scarlet fever such as rheumatic fever has decreased to 100 cases per 100,000 populations from 250 cases in Denmark since the introduction of antibiotics. Acute renal failure cases are also decreased in Hawaii and New Zealand.

There are some historians who believed that Hippocrates, the Father of Medicine, was already knowledgeable about scarlet fever. Hippocrates once described a syndrome of severe sore throat with ulcers. The Arabians such as Avicenna, Rhazes, and Ali Abbas were also described by some to have allusions to the disease, describing a measles that have more vivid colour and are more dangerous.  The first appearance of the disease on a medical literature was around 1510 to 1580 by an anatomist and medical practitioner John Philip Ingrassias from Napels. In the book “De Tumoribus praetor Naturam” Ingrassias describe the disease as having “numerous spots large and small, iery and red, of universal distribution, so that the whole body seems on fire.” Naples named the disease as “rossalia” or “rosania”, he also quoted “some there are who think that measles is the same as rossalia, but we have often seen that the two infections are distinct, trusting in our own eyes and not merely in the description of others.” The disease spread though out lower Germany between 1564 and 1565 and was called by Wierus as an epidemic of scalatina anginosa. The sore throat was accompanied with violent fever, swelling of parotid glands, erysipelatous rash, vomiting, and was particularly fatal to infants. It was Baillous who describe scarlet angionosa under the variety of “rubiolae”. It was Jean Cottyar of Poieters who was credited to be the first to describe scarlet fever in his book “De febre purpura epidemiale et contagiosa libri duo” which was published on 1578 in Paris. The symptoms were described as mild to violent fever, sore throat, redness of the eyes, headache, and general fatigue. Rashes were found on the second day of the disease, and some patients have delirium accompanying the sore throat. Daniel Sennert from Wittenberg decribed the eruption of scarlet fever in 1572 which he defined as “scarlatinal desquamation”; he was also the first to describe the early arthritis, scarlatinal dropsy and ascites associated with the disease.

It was after 200 years in 1827 when Bright realized the involvement of the renal system with scarlet fever. Streptococcal pyogenes was first described in 1874 by Billroth in patients with infections of the wounds, the organism was later named by Rosebach in 1884.  Fehleisen was the first to isolate the bacterial by culturing perierysipelas lesions on 1883. The different patterns by which the Streptococcal organism destroys blood cell was discovered by Schottmueller and J.H.Brown in 1903. The role of Streptococcal pyogenes in scarlet fever was found by Dochez, George, and Dick in the early 1900s. Dick used a small amount of erhythrogenic toxin and injected it under the skin which leads to local swelling in those with no immunity to the toxin.  Karelitz and Stempien discovered that extracts from human serum globulin and placental globulin can be used as lightening agents for scarlet fever, even though the antitoxin level may be lower compared to those from horses, this led to the development of pooling human serum from blood banks as a source of globulin.

See how do you get scarlet fever and what does scarlet fever look like