Learn about scarlet fever’s history, when scarlet fever was identified, and occurrences of scarlet fever in the 1800s. Read about the status of the illness today.
Updated: 11/21/2023
Scarlet Fever History, Symptoms & Significance
Table of Contents
- Scarlet Fever: Overview
- Scarlet Fever: Classification and Epidemiological Information
- Scarlet Fever History
- The Significance of Scarlet Fever
- Lesson Summary
- FAQs
- Activities
Can You Diagnose Scarlet Fever Yourself?
From the lesson, we know that Scarlet fever is not that prevalent these days. However, there are still some cases of Scarlet fever that will need to be diagnosed. Please, try to answer some of the following questions and determine if the patients have Scarlet fever.
Scenario 1:
A little boy (2 years old) comes to your office with flu-like symptoms, a fever of 98.5 F, a sore throat, and swollen neck glands. There is not rash at this point. You confirm that he currently has strep throat.
- The boy definitely has Scarlet fever, he needs to be hospitalized.
- He is at risk of developing Scarlet fever, so you tell the mom to come back if he develops a rash.
- He could never get Scarlet fever from strep throat, since Scarlet fever is caused by a virus.
- You need to send him for an X-ray to be able to confirm if he has Scarlet fever.
Scenario 2:
A 7 year old girl comes to your office for the second time this week. She previously came complaining of an earache, and you confirmed she had an ear infection. You prescribed antibiotics to treat the ear infection. Five days later she comes back with a rash all over her body and a swollen face. Do you think she at risk of having or developing Scarlet fever?
- No, I think she is likely having a allergic reaction to the antibiotic.
- Yes, she is definitely having Scarlet fever because she has a rash.
- Probably the ear infection was viral, not bacterial, and it developed in Scarlet fever as a result.
- She has never been diagnosed with Scarlet fever before so she is probably at high risk of having the disease.
Answers:
Scenario 1: the correct answer is #2
Scenario 2: the correct answer is #1
How common was scarlet fever in the 1800s?
Scarlet fever reached pandemic proportions in the 19th century. It was not frequently seen in rural areas but was quite prevalent in overcrowded urban areas.
How long did scarlet fever last in the 1800s?
Scarlet fever never definitively died out in the 1800s. It did decrease with the advent of pasteurization and the understanding of germ theory in the 1860s.
Why is scarlet fever rare now?
Scarlet fever is rare in industrialized nations today. This is because of increased sanitary conditions and the understanding of germ theory. Germ theory explains the origin of infection as occurring with microscopic organisms.
When was scarlet fever a pandemic?
Scarlet fever reached its greatest pandemic proportions in the 19th century. Between 1820 and 1880 a worldwide pandemic of scarlet fever raged.
How many people died of scarlet fever in the 1800s?
The exact number of people infected with scarlet fever in the 1800s is not readily known. At times, however, the fatality rate rose to 30% in some cities.
Table of Contents
- Scarlet Fever: Overview
- Scarlet Fever: Classification and Epidemiological Information
- Scarlet Fever History
- The Significance of Scarlet Fever
- Lesson Summary
Scarlet fever is a bacterial infection related to strep throat. It has caused many deaths throughout history. It is generally easily treated and rarely seen in industrialized countries, but it is still prevalent in countries undergoing industrialization. However, during the 1800s, it was one of the deadliest diseases known to man.
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Scarlet fever is a type of streptococcus infection caused by group A Streptococcus. Scarlet fever occurs when certain strands of strep throat develop into further inflammation and infection. Unlike strep throat, scarlet fever produces the erythrogenic toxin that causes a skin rash.
Symptoms: Why is Scarlet Fever Called Scarlet Fever?
While the disease is a streptococcus infection, it is called scarlet fever because of its characteristic rash. This rash typically is bright red, like a sunburn, with raised bumps that look like goosebumps.
Symptoms of the disease are as follows:
- Severe sore throat
- Fever often over 103 degrees Fahrenheit
- Rash
- A red tongue that looks like a strawberry
- Vomiting
- Headache
- Chills
- Enlarged tonsils
- Peeling of the skin after the first week
The symptoms of scarlet fever can, indeed, be quite severe. Historically, many measures were taken to avoid infecting more people during outbreaks. At one point, the District of Columbia, among other measures, said that any carpets or other fabrics exposed to people with the disease must be boiled, burned, steamed, or soaked in a solution that would kill the bacterium.
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Transmission and Treatment
Scarlet fever has been around for centuries. Fortunately, the scientific and medical world have learned quite a bit about this disease.
Vulnerable Population
Scarlet fever can infect anyone, but it is most common in children ages 6 to 12. It rarely occurs in infants or toddlers.
Mortality Level
The mortality rate of scarlet fever has changed quite dramatically over the years. It is believed that it was originally an uncommon illness. In the 19th century, however, fatality rates could range anywhere from 2% to 30%. Antibiotics, improved sanitation, and the understanding of germ theory reduced the fatality rate to 1% to 2% in the mid-twentieth century. The fatality rate is now less than 1%.
Treatment
Scarlet fever is treated with antibiotics. The primary aim is to keep consistent levels of antibiotics in a person's blood for ten days. This can be achieved with oral antibiotics, but the illness may resurface if the antibiotics are stopped prior to ten days. Because of this, some doctors will prescribe a one-time shot that will maintain the appropriate level of antibiotics in a person's blood. Penicillin is the antibiotic of choice; however, other antibiotics are effective for those allergic to penicillin.
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Scarlet fever has been around for quite a long time in many different places. Scientists and historians are unsure when it was first discovered, but a couple of theories exist. Most likely, it was first described in Ancient Greece by Hippocrates in the 4th century BCE. Others believe that Rhazes in 9th century Persia was the first to discover scarlet fever.
When Did Scarlet Fever Start?
While the first date of occurrence is up to speculation, it is known that Italian Giovanni Ingrassia gave the first definitive description in 1553. He named is "rossalia." In the 17th century, Thomas Sydenham named it "febris scarlatina."
For the people at that time, scarlet fever was not too much of a concern. It was relatively rare, and many years occurred between outbreaks. There were, however, a few epidemics in the cities of Europe during this time.
Scarlet Fever in the 1800s
The course of the disease changed drastically in the 1800s. By this time, it was one of the deadliest diseases known to mankind. This is the result of the Industrial Revolution, which brought a large number of people into the cities. These cities were overcrowded with poor sanitary conditions. While the disease was rarely seen in rural areas, cities saw constant rounds of epidemics.
Between 1820 and 1880, a worldwide pandemic of scarlet fever occurred. Both Europe and North America experienced severe epidemics of the disease. In a twelve-month period between 1858 and 1859, over 2000 people, almost all children under the age of 16, died of the disease in Massachusetts alone.
Is Scarlet Fever Still Around?
In the 19th century, scientists were quickly learning how to treat and prevent the disease. In the 1860s, scientists learned about germ theory. Germ theory, developed by Louis Pasteur, is the understanding that microscopic organisms cause disease. Milk was a leading cause of scarlet fever, and pasteurization killed those bacteria in the milk supply. Pasteurization is a process of heating every milk particle to effectively kills dangerous germs.
During this time, a test for a person's susceptibility to scarlet fever was found. This is called the Dick Test, and within 24 hours, it can detect if a person has immunity to scarlet fever.
After World War II, antibiotics became more readily available, and this drastically reduced the fatality of scarlet fever. Improved sanitary conditions reduced the prevalence of the disease.
Today in industrialized nations, scarlet fever is exceedingly rare. In countries going through their own process of industrialization, the risk is higher for many of the same reasons that the risk was higher in American cities during the Industrial Revolution.
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Prior to the 19th century, the prevalence of scarlet fever paled in comparison to other epidemics. As outbreaks and severity increased dramatically in the 1880s, it became one of the deadliest diseases of that century, and it overwhelmingly affected young people.
There are numerous examples of well-known people of history who either suffered negative consequences of scarlet fever or who lost children to the dreaded disease. Through these people, however, big advances were made. It is believed that Helen Keller lost her sight and hearing due to scarlet fever while she was a toddler. The ways she overcame her struggles have inspired people for years. John Rockefeller lost a grandson to the disease, and now Rockefeller University is one of the pioneers in biomedical research.
Scarlet fever is clearly not the only epidemic to affect humanity. Among countless others, epidemics of influenza, plague, and yellow fever have terrorized civilizations. The Black Death was one of the worst of these, which experts say claimed half of Europe's population in seven years in the 14th century. It is believed that up to 90% of Indigenous people were killed off by plagues brought to the Americas. In one summer in Philadelphia, 5,000 died of yellow fever. Scarlet fever is far less prevalent today, but it still poses a concern to people in vulnerable areas.
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Scarlet fever is a bacterial infection related to strep throat and caused by group A Streptococcus. It primarily affects children between the ages of 6 and 12. While a list of common symptoms exists, marked symptoms are a high fever, extreme sore throat, and a red rash with raised bumps. Left untreated, it can lead to death or life-altering complications.
Some believe this disease was first described by Hippocrates, while others claim the first description came centuries later with Rhazes. Regardless of the first description, it was definitively described in the 16th century. The course and severity of the disease changed throughout the years. Originally it was not very prevalent, nor was it particularly severe. This changed with the Industrial Revolution in the 19th century. When cities became overcrowded and sanitary conditions lacked, scarlet fever spread and became epidemic. This was not found in rural areas. Eventually, Pasteur's scientific understanding of germ theory, combined with the discovery of antibiotics, helped to curb the spread and treat people who became infected. The Dick Test and improved sanitary conditions helped to further reduce the spread and fatality of scarlet fever in industrialized nations. It still poses problems in countries undergoing their own industrialization.
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Video Transcript
Scarlet Fever
Strep throat is a common diagnosis today. Every kid expects to get strep throat at some point, and it's known to be pretty uncomfortable. A century ago, however, this could have been the sign that something much, much worse was coming. Historically, strep throat was often a precursor to scarlet fever.
Strep throat is caused by an infection of Group A Streptococcus, a type of bacterium that makes you sick. Certain strains of Streptococcus then cause further infection and inflammation, generally noticeable by skin rashes (from which scarlet fever gets its name). Scarlet fever itself is a bacterial infection similar to strep throat, but which can cause rash, high fevers, and fatalities. Scarlet fever was once among the deadliest diseases in many societies. It was greatly feared and difficult to treat. So, where did it come from, and where did it go? The history of scarlet fever can be divided into three rough time periods, so let's take a look and see how this deadly disease has impacted human history.
Period One
We don't know exactly where scarlet fever came from or when this bacteria first started infecting humans. Some paleoepidemiologists (people who study ancient diseases) think that the Greek founder of Western medicine, Hippocrates, may have described scarlet-fever-like symptoms back in the 4th century BCE. Others claim that the first person to positively identify scarlet fever was the Persian physician and philosopher Rhazes, who lived in the 9th century CE. The first absolutely definitive description of the disease dates to 1553, when Italian physician Giovanni Ingrassia identified it and named it ''rossalia''.
The name ''scarlet fever'' came later, when British physician Thomas Sydenham labeled it febris scarlatina in 1676. It was, at the time, seen as a relatively mild disease. There were good reasons to feel this way&madsh; the scarlet fever of this period appeared rarely and with years between diagnoses. There were a few epidemics in some of Europe's larger cities, but they were brief. In a world that had seen hundreds of thousands lost to plagues, the relatively lower number of deaths to a rare scarlet fever weren't that frightening.
Period Two
This all began to change around the 1820s. Western Europe and the United States were going through the Industrial Revolution. Social changes that resulted from this included huge population booms, the rise of dangerously overcrowded cities, and poor hygiene in low-income urban areas. In this world, the bacteria that caused scarlet fever thrived. In fact, the fatality rates of scarlet fever in Great Britain rose from 2% of cases in the late 18th century, to 15% in 1834. In some cities, fatality rates reached over 30% of cases, making it one of the deadliest diseases of the mid-19th century.
Children were always the worst affected, and proved to be highly susceptible. Charles Darwin lost two children to scarlet fever in the 1850s. Scarlet fever is also believed to have caused the 19-month old Helen Keller to lose her hearing and sight. John Rockefeller lost a two-year old grandson to scarlet fever, which is why Rockefeller University remains one of the world's leading biomedical research centers in the world today.
While scarlet fever had been a rare disease before, it bred in the unhygienic and overcrowded urban centers and started becoming a fact of life, constantly reoccurring in cycles of epidemics. This was a trend, but one limited to industrializing urban centers. Rural areas around the world did not see the same spike in aggressive scarlet fever, so we can pretty confidently attribute this to urban living conditions.
Period Three
By the end of the 19th century, things were beginning to change. Social reformers were pushing for better living conditions for the urban poor. Policymakers started to see urban cleanliness as a public health and safety measure that impacted everybody, and people like Rockefeller were pouring money in to medical research.
Why the sudden shift in attitudes? For one, our understanding of disease changed a lot in the 19th century. It wasn't until the 1860s that scientist Louis Pasteur formally developed a reputable theory claiming that microscopic organisms caused disease. Germ theory changed everything, from our ideas about sanitary living to how we processed our foods. In fact, the germ-killing process called pasteurization was also invented by Pasteur. It was used almost immediately to process milk, which had been a leading source of scarlet fever-causing bacteria before that.
The third period of scarlet fever history saw a dramatic decline in both the cases of scarlet fever and the rates of mortality. In fact, by the mid-20th century, mortality rates were back down between 1 and 2%. This continued to fall after antibiotics became readily available following World War II. In most Western nations, scarlet fever is extraordinarily rare today, but we can't ignore the risk. Nations in southern Asia, Africa, and the Americas have all been going through major periods of industrialization since the 1970s. Industrialization in these parts of the world has had many of the same characteristics as industrialization in Western societies, and amid the overcrowding and poor urban conditions, scarlet fever is emerging. Yes, we have antibiotics and we understand germ theory this time, but the risk is still there. Scarlet fever may not have had its last scare.
Lesson Summary
Let's review. Scarlet fever is a bacterial inflectional similar to strep throat, but which can cause rash, high fevers, and fatalities. The disease has been around for a long time, and historians generally sort its history into three periods. Period One includes the beginning to the 19th century; Period Two takes place in the 19th century; and Period Three runs from the late 19th century to the present.
Basically, from unknown beginnings, scarlet fever appeared rarely and intermittently. It was worst among children, but fatality rates were much lower than other diseases. However, industrialization in Western societies led to cramped cities, poor hygiene, and rampant disease, and thus scarlet fever became one of the deadliest infections in many urban centers. Nevertheless, germ theory, pasteurization, and improved social conditions helped reverse the spread of scarlet fever. Antibiotics continued this in the 1950s and beyond, but scarlet fever is still a risk in nations undergoing massive industrialization trends today. There's a long history to scarlet fever, and it may not be over just yet.
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Scarlet Fever History, Symptoms & Significance
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