1 00:00:01,280 --> 00:00:04,320 Speaker 1: Welcome to Stuff You Missed in History Class, a production 2 00:00:04,400 --> 00:00:13,720 Speaker 1: of I Heart Radio. Hello, and welcome to the podcast. 3 00:00:13,760 --> 00:00:17,400 Speaker 1: I'm Tracy V. Wilson and I'm Holly Fry. So some 4 00:00:17,520 --> 00:00:21,479 Speaker 1: of my friends kids got scarlet fever late last year, 5 00:00:21,560 --> 00:00:23,640 Speaker 1: and their response to this was kind of like, what 6 00:00:23,880 --> 00:00:28,440 Speaker 1: is this the nineteenth century? And I remember having a 7 00:00:28,480 --> 00:00:31,920 Speaker 1: really similar feeling when I got scarlet fever as a 8 00:00:32,040 --> 00:00:36,120 Speaker 1: kid back in the nineteen eighties, because I really associated 9 00:00:36,159 --> 00:00:40,159 Speaker 1: scarlet fever with old timey children's books to me, like 10 00:00:40,840 --> 00:00:44,519 Speaker 1: The Velveteen Rabbit and Little Women, and this sort of 11 00:00:44,560 --> 00:00:47,640 Speaker 1: response to scarlet fever of like, what century is it 12 00:00:47,960 --> 00:00:51,400 Speaker 1: that's not unique to me or my friends. When I 13 00:00:51,479 --> 00:00:55,200 Speaker 1: started working on this episode, the very initial research just 14 00:00:55,320 --> 00:00:59,560 Speaker 1: turned up a ton of news articles going back many years, 15 00:01:00,240 --> 00:01:03,360 Speaker 1: all of them reporting on scarlet fever outbreaks, and all 16 00:01:03,440 --> 00:01:06,600 Speaker 1: of this with a tone of like the return of 17 00:01:06,640 --> 00:01:10,600 Speaker 1: an old disease. Um They all made it sound like 18 00:01:10,800 --> 00:01:12,880 Speaker 1: this was like a unique thing, and it was really 19 00:01:12,920 --> 00:01:16,200 Speaker 1: just year after year after year, a new headline of 20 00:01:16,200 --> 00:01:18,600 Speaker 1: a new scarlet fever outbreak with a new like an 21 00:01:18,720 --> 00:01:23,040 Speaker 1: old disease has returned. So scarlet fever is caused by 22 00:01:23,120 --> 00:01:27,000 Speaker 1: Group A Streptococcus, and over the last few months there's 23 00:01:27,040 --> 00:01:30,240 Speaker 1: been a big spike in Group A Strep infections in 24 00:01:30,480 --> 00:01:34,839 Speaker 1: many parts of the world, sometimes causing relatively minor illnesses, 25 00:01:34,920 --> 00:01:40,320 Speaker 1: but also sometimes much more dangerous and even deadly invasive infections, 26 00:01:41,360 --> 00:01:46,000 Speaker 1: usually in places where people have prompt access to medical care. 27 00:01:46,240 --> 00:01:51,080 Speaker 1: Scarlet fever specifically is pretty treatable with antibiotics, but in 28 00:01:51,160 --> 00:01:53,800 Speaker 1: the middle of the nineteenth century it was the leading 29 00:01:53,880 --> 00:01:56,840 Speaker 1: cause of death in children in some parts of the world. 30 00:01:57,800 --> 00:02:01,760 Speaker 1: A lot of times antibiotic get the credit from turning 31 00:02:01,760 --> 00:02:05,520 Speaker 1: that trend around, but it wasn't just because of antibiotics, 32 00:02:05,600 --> 00:02:08,799 Speaker 1: which is one of several kind of mysteries about this disease. 33 00:02:09,600 --> 00:02:14,320 Speaker 1: Scarlet fever usually starts with symptoms like a fever, sore throat, headache, 34 00:02:14,360 --> 00:02:18,320 Speaker 1: and sometimes nausea or vomiting. A rash usually forms a 35 00:02:18,400 --> 00:02:21,520 Speaker 1: day or two after the fever starts. The appearance and 36 00:02:21,639 --> 00:02:24,360 Speaker 1: texture of this rash can vary based on a person's 37 00:02:24,360 --> 00:02:28,200 Speaker 1: skin color. At least in the US and Europe, most 38 00:02:28,240 --> 00:02:31,520 Speaker 1: descriptions and pictures of this are of white children and 39 00:02:31,639 --> 00:02:34,360 Speaker 1: people with lighter skin. The rash is red and bumpy 40 00:02:34,440 --> 00:02:38,800 Speaker 1: and often has this texture that's described as sand papery. 41 00:02:38,840 --> 00:02:41,320 Speaker 1: In people with brown or black skin, the rash is 42 00:02:41,360 --> 00:02:44,400 Speaker 1: often the same color as the skin or slightly darker, 43 00:02:44,800 --> 00:02:47,600 Speaker 1: and while it's usually still raised in bumpy, it sometimes 44 00:02:47,639 --> 00:02:51,640 Speaker 1: doesn't have quite the same texture. Scarlet fever can also 45 00:02:51,720 --> 00:02:55,480 Speaker 1: cause something called strawberry tone that's a white coating that 46 00:02:55,520 --> 00:02:59,640 Speaker 1: can progress to a red, bumpy appearance. If you google this, 47 00:02:59,680 --> 00:03:03,840 Speaker 1: which I'm not necessarily recommending that you do, it's obvious 48 00:03:03,919 --> 00:03:08,360 Speaker 1: why they call it that. If left untreated, scarlet fever 49 00:03:08,600 --> 00:03:12,320 Speaker 1: and other strep infections can cause some really serious complications, 50 00:03:12,400 --> 00:03:16,240 Speaker 1: including organ damage and an inflammatory disease called rheumatic fever. 51 00:03:16,960 --> 00:03:21,000 Speaker 1: There's also a possible connection between strap infections and autoimmune 52 00:03:21,040 --> 00:03:24,960 Speaker 1: disease and neurological disorders and children. And again, they're also 53 00:03:25,200 --> 00:03:28,760 Speaker 1: invasive strep infections that themselves can be like really dangerous. 54 00:03:29,520 --> 00:03:33,160 Speaker 1: Streptococcus bacteria can cause a wide range of diseases, and 55 00:03:33,240 --> 00:03:35,640 Speaker 1: while strep is believed to have been one of the 56 00:03:35,680 --> 00:03:40,000 Speaker 1: most frequent causes of infectious diseases in prehistoric times, it's 57 00:03:40,000 --> 00:03:44,000 Speaker 1: not clear when exactly it started causing scarlet fever. This 58 00:03:44,080 --> 00:03:46,920 Speaker 1: is because strep only causes scarlet fever when it's been 59 00:03:46,920 --> 00:03:51,280 Speaker 1: infected with a bacteria phage. That's a virus that infects bacteria. 60 00:03:51,880 --> 00:03:55,320 Speaker 1: The bacteria phage causes the bacteria to produce a toxin, 61 00:03:55,800 --> 00:03:58,960 Speaker 1: and scarlet fever is the body's response to that toxin. 62 00:03:59,640 --> 00:04:02,800 Speaker 1: It's likely that there were strains of Streptococcus present in 63 00:04:02,920 --> 00:04:05,600 Speaker 1: much of the world prior to the fifteenth century, but 64 00:04:05,680 --> 00:04:10,280 Speaker 1: that scarlet fever specifically was introduced to some places during colonization, 65 00:04:10,760 --> 00:04:15,840 Speaker 1: including the America's, Australia and New Zealand. Scarlet fever is 66 00:04:15,960 --> 00:04:19,200 Speaker 1: most common in children, and there are just a lot 67 00:04:19,360 --> 00:04:23,240 Speaker 1: of childhood diseases that can cause similar symptoms, so a 68 00:04:23,279 --> 00:04:25,400 Speaker 1: lot of the time it's not really possible to tell 69 00:04:25,440 --> 00:04:29,320 Speaker 1: whether an early medical text or other writing is referencing 70 00:04:29,360 --> 00:04:33,039 Speaker 1: scarlet fever or some other disease that causes some combination 71 00:04:33,080 --> 00:04:35,960 Speaker 1: of like a fever, sore throat, rash, and other symptoms. 72 00:04:36,560 --> 00:04:40,400 Speaker 1: There are references to various childhood fevers and rashes and 73 00:04:40,520 --> 00:04:43,800 Speaker 1: medical texts from the Mediterranean, the Middle East, and Asia 74 00:04:43,880 --> 00:04:46,240 Speaker 1: going all the way back to Hippocrates and the fourth 75 00:04:46,279 --> 00:04:49,799 Speaker 1: century BC. We don't really have a way of knowing 76 00:04:49,880 --> 00:04:53,039 Speaker 1: whether any of them were talking about scarlet fever, or 77 00:04:53,080 --> 00:04:58,080 Speaker 1: even if scarlet fever really existed. Yet, accounts describing scarlet 78 00:04:58,120 --> 00:05:01,120 Speaker 1: fever as a distinct illness started to develop in the 79 00:05:01,200 --> 00:05:06,560 Speaker 1: sixteenth century. Jovanni Philippo Ingrassias was a physician born in Sicily, 80 00:05:06,920 --> 00:05:09,440 Speaker 1: and in fifteen fifty three he described an illness that 81 00:05:09,560 --> 00:05:13,479 Speaker 1: he called rosalia. He specified that this was not the 82 00:05:13,520 --> 00:05:16,159 Speaker 1: same thing as chicken pox or measles, and that it 83 00:05:16,240 --> 00:05:20,719 Speaker 1: involved quote numerous spots, large and small, fiery and red 84 00:05:20,880 --> 00:05:24,520 Speaker 1: of universal distribution, so that the whole body appeared to 85 00:05:24,520 --> 00:05:29,200 Speaker 1: be on fire. In fifteen sixty five, Dutch physician Johann 86 00:05:29,240 --> 00:05:33,159 Speaker 1: Bayer described something similar and added another detail, which was 87 00:05:33,279 --> 00:05:37,320 Speaker 1: a severe sore throat. Then, in fifteen seventy eight, Jehan 88 00:05:37,440 --> 00:05:42,560 Speaker 1: Cottier of Foatier described an illness causing quote general weariness, headache, 89 00:05:42,600 --> 00:05:47,040 Speaker 1: redness of the eyes, sore throat, and fever. Pepura appeared 90 00:05:47,080 --> 00:05:50,479 Speaker 1: on the second or third day, accompanied by delirium and 91 00:05:50,560 --> 00:05:54,119 Speaker 1: soreness of the throat. Purpura is a rash that's caused 92 00:05:54,120 --> 00:05:56,720 Speaker 1: by the breaking of small blood vessels underneath the skin. 93 00:05:57,640 --> 00:06:01,720 Speaker 1: In sixteen thirty five, German physician Daniel Center described an 94 00:06:01,720 --> 00:06:06,240 Speaker 1: epidemic in Wittenberg in which the skin later desquamated or peeled, 95 00:06:06,600 --> 00:06:10,479 Speaker 1: something that often happens in cases of scarlet fever. Center 96 00:06:10,640 --> 00:06:14,760 Speaker 1: also described other complications that can follow scarlet fever, including 97 00:06:14,800 --> 00:06:19,200 Speaker 1: a dem up fluid in the abdomen and arthritis. Scarlet 98 00:06:19,240 --> 00:06:22,159 Speaker 1: fever was showing up in writings outside of the medical 99 00:06:22,200 --> 00:06:25,919 Speaker 1: world as well. Samuel Peeps, who comes up so often 100 00:06:25,960 --> 00:06:28,960 Speaker 1: on the show when we're talking about this period of history, 101 00:06:29,080 --> 00:06:32,440 Speaker 1: wrote this in his diary on November tenth, sixteen sixty four. 102 00:06:32,560 --> 00:06:36,039 Speaker 1: Quote my little girly Susan is falling sick of the 103 00:06:36,120 --> 00:06:39,479 Speaker 1: measles we fear or at least of a scarlet fever. 104 00:06:40,240 --> 00:06:42,880 Speaker 1: This seemed to pass pretty quickly. The next day he wrote, quote, 105 00:06:42,880 --> 00:06:46,440 Speaker 1: our little girl is better than she was yesterday. Scarlet 106 00:06:46,480 --> 00:06:49,320 Speaker 1: Fever as a term was in common use in English 107 00:06:49,320 --> 00:06:52,880 Speaker 1: at this point, as was the name scarlett tina. The 108 00:06:52,960 --> 00:06:56,240 Speaker 1: first use of the term scarlettina in medical literature is 109 00:06:56,279 --> 00:07:00,279 Speaker 1: believed to be in sixteen seventy four. English physician Amas 110 00:07:00,279 --> 00:07:04,680 Speaker 1: Sydenham wrote Medical Observations on the History and Treatment of 111 00:07:04,720 --> 00:07:08,320 Speaker 1: Acute Diseases, which was published in Latin, and in it 112 00:07:08,440 --> 00:07:13,360 Speaker 1: he described febro scarlatina. This way, quote, Scarlet fever may 113 00:07:13,400 --> 00:07:17,320 Speaker 1: appear at any season. Nevertheless, it often breaks out towards 114 00:07:17,360 --> 00:07:20,560 Speaker 1: the end of summer, when it attacks whole families at once, 115 00:07:20,920 --> 00:07:24,480 Speaker 1: and more especially the infant part of them. The patient 116 00:07:24,640 --> 00:07:28,400 Speaker 1: feel rigors and shivering, just as they do in other fevers. 117 00:07:28,800 --> 00:07:33,080 Speaker 1: The symptoms, however, are moderate. Afterwards, however, the whole skin 118 00:07:33,200 --> 00:07:37,240 Speaker 1: becomes covered with small red maculae thicker than those of measles, 119 00:07:37,280 --> 00:07:41,200 Speaker 1: as well as broader and redder and less uniform. These 120 00:07:41,280 --> 00:07:44,440 Speaker 1: last for two or three days and then disappear. The 121 00:07:44,520 --> 00:07:47,960 Speaker 1: cuticle peels off and branny scales remain lying on the 122 00:07:48,000 --> 00:07:53,000 Speaker 1: surface like meal. They appear and disappear two or three times. 123 00:07:53,960 --> 00:07:57,400 Speaker 1: This was before the development of the germ theory of disease, 124 00:07:57,520 --> 00:08:00,840 Speaker 1: and Sydenham believed that this was caused by quote a 125 00:08:00,920 --> 00:08:04,560 Speaker 1: moderate effervescence of the blood, arising from the heat of 126 00:08:04,600 --> 00:08:09,480 Speaker 1: the preceding summer or from some other exciting cause. This 127 00:08:09,640 --> 00:08:12,920 Speaker 1: made him cautious of using blood letting or enemas to 128 00:08:13,000 --> 00:08:15,600 Speaker 1: treat the patient, which is something that would have happened 129 00:08:15,600 --> 00:08:18,680 Speaker 1: with other illnesses. He believed that the blood needed to 130 00:08:18,720 --> 00:08:22,640 Speaker 1: be left to its own regulation in cases of scarlet fever, 131 00:08:22,880 --> 00:08:26,640 Speaker 1: and that blood letting or animals could introduce particles into 132 00:08:26,720 --> 00:08:30,080 Speaker 1: the blood that were harmful to it. Instead, he said 133 00:08:30,080 --> 00:08:33,160 Speaker 1: it was quote sufficient for the patient to abstain wholly 134 00:08:33,320 --> 00:08:37,800 Speaker 1: from animal food and from fermented liquors, to keep always indoors, 135 00:08:37,840 --> 00:08:40,520 Speaker 1: and not to keep always in his bed. When the 136 00:08:40,559 --> 00:08:43,640 Speaker 1: desclamation is complete, and when the symptoms are departing, I 137 00:08:43,679 --> 00:08:47,000 Speaker 1: consider it proper to purge the patient with some mild 138 00:08:47,080 --> 00:08:51,160 Speaker 1: laxative accommodated to his age and strength. So at the 139 00:08:51,200 --> 00:08:54,640 Speaker 1: same time, he noted that if a child experienced seizures 140 00:08:54,720 --> 00:08:57,920 Speaker 1: or a coma, then they needed to be treated immediately 141 00:08:58,000 --> 00:08:59,839 Speaker 1: with a blister on the back of the neck and 142 00:09:00,000 --> 00:09:04,640 Speaker 1: a dose of opium tincture. Sydenham recommended repeating this every 143 00:09:04,760 --> 00:09:08,640 Speaker 1: night until the patient had recovered, and feeding them diluted milk, 144 00:09:08,760 --> 00:09:12,720 Speaker 1: but again not animal food. So these descriptions of this 145 00:09:12,800 --> 00:09:17,200 Speaker 1: illness don't sound really pleasant, and both Sydenham and Centered 146 00:09:17,320 --> 00:09:21,560 Speaker 1: described complications and more serious cases. But like none of 147 00:09:21,600 --> 00:09:24,760 Speaker 1: this sounds nearly as frightening as scarlet fever became in 148 00:09:24,800 --> 00:09:28,000 Speaker 1: the nineteenth century. Samuel Peeps made it sound like scarlet 149 00:09:28,040 --> 00:09:31,840 Speaker 1: fever was like a lesser illness than measles would have been. 150 00:09:33,080 --> 00:09:35,320 Speaker 1: Became much worse later on, and we'll get to that 151 00:09:35,480 --> 00:09:48,280 Speaker 1: after a sponsor break Through the seventeenth and eighteenth centuries, 152 00:09:48,400 --> 00:09:52,960 Speaker 1: scarlet fever epidemics occurred regularly in Europe, with the disease 153 00:09:53,160 --> 00:09:57,000 Speaker 1: often striking a particular place every four to six years. 154 00:09:57,080 --> 00:10:00,160 Speaker 1: That same general pattern seems to have been pres than 155 00:10:00,200 --> 00:10:04,199 Speaker 1: in other places. Also in the twenties and thirties, though, 156 00:10:04,240 --> 00:10:08,040 Speaker 1: the number of scarlet fever cases really started to rise 157 00:10:08,240 --> 00:10:11,119 Speaker 1: in a lot of places, and so did their severity. 158 00:10:11,720 --> 00:10:15,720 Speaker 1: There are several possible explanations for why, and it's possible 159 00:10:15,760 --> 00:10:19,240 Speaker 1: that all of them played some kind of role. Nineteenth 160 00:10:19,280 --> 00:10:23,600 Speaker 1: Century urbanization led to more people living in closer quarters, 161 00:10:23,720 --> 00:10:28,000 Speaker 1: often without sufficient facilities for hygiene, which made it easier 162 00:10:28,040 --> 00:10:31,600 Speaker 1: for a contagious illness like scarlet fever to spread, but 163 00:10:31,760 --> 00:10:35,720 Speaker 1: that can't account for everything, since scarlet fever cases started 164 00:10:35,760 --> 00:10:40,800 Speaker 1: increasing before this trend really started to escalate. Some researchers 165 00:10:40,800 --> 00:10:44,240 Speaker 1: have found a correlation between scarlet fever and wheat prices. 166 00:10:44,679 --> 00:10:47,760 Speaker 1: When wheat prices rose, there was an increase in scarlet 167 00:10:47,760 --> 00:10:52,160 Speaker 1: fever three years later, as though malnutrition during pregnancy might 168 00:10:52,200 --> 00:10:56,319 Speaker 1: make children more susceptible to it. This is a correlation, 169 00:10:56,400 --> 00:10:59,839 Speaker 1: though it's not necessarily a cause and effect situation, and 170 00:11:00,000 --> 00:11:02,480 Speaker 1: it is also possible that a more virulent form of 171 00:11:02,480 --> 00:11:05,280 Speaker 1: the disease evolved, which allowed it to spread more easily 172 00:11:05,440 --> 00:11:10,480 Speaker 1: and cause wars illnesses. Scarlet fever was also introduced into 173 00:11:10,520 --> 00:11:13,040 Speaker 1: parts of the world that had never encountered it before 174 00:11:13,280 --> 00:11:16,959 Speaker 1: during the nineteenth century. The first case of scarlet fever 175 00:11:17,080 --> 00:11:20,439 Speaker 1: and the Archipelago of Madeira, was reported in eighteen o six. 176 00:11:20,960 --> 00:11:24,720 Speaker 1: They reached South America in eighteen twenty nine, Greenland in 177 00:11:24,800 --> 00:11:28,240 Speaker 1: eighteen forty seven, and both Australia and New Zealand in 178 00:11:28,320 --> 00:11:32,200 Speaker 1: eighteen forty eight. Although scarlet fever had been reported in 179 00:11:32,240 --> 00:11:36,679 Speaker 1: the northeastern United States for centuries, the first case reported 180 00:11:36,720 --> 00:11:41,920 Speaker 1: in California wasn't until eighteen forty nine. Some sources will 181 00:11:42,040 --> 00:11:45,640 Speaker 1: describe the nineteenth century spread of scarlet fever as a pandemic, 182 00:11:46,000 --> 00:11:49,400 Speaker 1: stretching from about eighteen twenty five to eighteen eighty five. 183 00:11:50,320 --> 00:11:53,000 Speaker 1: Death rates could really vary from place to place and 184 00:11:53,080 --> 00:11:56,240 Speaker 1: from one outbreak to the next. In places that had 185 00:11:56,280 --> 00:11:59,560 Speaker 1: no experience with scarlet fever, The mortality rate was often 186 00:11:59,640 --> 00:12:02,760 Speaker 1: particular really high. As we said a moment ago, the 187 00:12:02,800 --> 00:12:06,080 Speaker 1: first cases reported in New Zealand were in eighty eight, 188 00:12:06,160 --> 00:12:09,320 Speaker 1: and in Auckland that year, one out of every eight 189 00:12:09,400 --> 00:12:13,760 Speaker 1: people who contracted scarlet fever died. The vast majority of 190 00:12:13,800 --> 00:12:16,200 Speaker 1: cases and deaths were in children between the ages of 191 00:12:16,240 --> 00:12:18,360 Speaker 1: two and ten, and no one over the age of 192 00:12:18,400 --> 00:12:21,800 Speaker 1: forty seemed to catch it at all. The worst cases 193 00:12:21,880 --> 00:12:26,280 Speaker 1: seemed to be encrowded or badly ventilated homes. There's not 194 00:12:26,400 --> 00:12:30,720 Speaker 1: a ton of exact data, though, especially in the earlier 195 00:12:30,760 --> 00:12:33,440 Speaker 1: decades of the eighteen hundreds, a lot of places didn't 196 00:12:33,440 --> 00:12:38,319 Speaker 1: have formal departments of health or public health services. Widespread 197 00:12:38,360 --> 00:12:41,800 Speaker 1: outbreaks of scarlet fever and other contagious diseases were part 198 00:12:41,880 --> 00:12:45,640 Speaker 1: of the motivation for those to be established. In some places, 199 00:12:45,679 --> 00:12:48,440 Speaker 1: there were laws in place to try to control the 200 00:12:48,559 --> 00:12:51,360 Speaker 1: spread of infectious diseases, and a lot of those laws 201 00:12:51,400 --> 00:12:53,800 Speaker 1: traced back to things like the Black Death of the 202 00:12:53,800 --> 00:12:56,440 Speaker 1: fourteenth century. But a lot of the time there just 203 00:12:56,679 --> 00:13:02,199 Speaker 1: wasn't a more systematic tracking of diseases and they're spread. However, 204 00:13:02,400 --> 00:13:06,800 Speaker 1: it's generally agreed that by eighteen forty, scarlet fever was 205 00:13:06,960 --> 00:13:10,360 Speaker 1: a leading cause of childhood death in the United States 206 00:13:10,360 --> 00:13:14,040 Speaker 1: and parts of Europe, possibly the leading cause of death 207 00:13:14,080 --> 00:13:19,440 Speaker 1: and children during widespread outbreaks throughout the nineteenth century, scarlet 208 00:13:19,440 --> 00:13:24,400 Speaker 1: fever was terrifying. Communities often used isolation and quarantine to 209 00:13:24,440 --> 00:13:27,679 Speaker 1: try to control the diseases spread, along with things like 210 00:13:27,880 --> 00:13:33,319 Speaker 1: canceling school and public gatherings, recommending the deletion and disinfection procedures, 211 00:13:33,360 --> 00:13:36,440 Speaker 1: and urging people to keep children at home and away 212 00:13:36,480 --> 00:13:41,520 Speaker 1: from other people, especially other children. The increasing spread of 213 00:13:41,520 --> 00:13:44,959 Speaker 1: scarlet fever also led to researchers learning more about it. 214 00:13:45,480 --> 00:13:50,120 Speaker 1: English physician Richard Bright made the connection between streptococcus infections 215 00:13:50,160 --> 00:13:54,040 Speaker 1: and kidney disease in eighteen thirty six. Bright was one 216 00:13:54,080 --> 00:13:57,560 Speaker 1: of the first people to describe nephritis or kidney inflammation, 217 00:13:57,600 --> 00:14:00,840 Speaker 1: which came to be known as Bright's disease, and he 218 00:14:00,880 --> 00:14:04,959 Speaker 1: wrote of it, quote Scarlatina has apparently laid the foundation 219 00:14:05,000 --> 00:14:10,280 Speaker 1: for the future mischief, so Scarlatina later causing nephritis, although 220 00:14:10,920 --> 00:14:13,440 Speaker 1: his next sentence went on to say, quote exertion and 221 00:14:13,559 --> 00:14:18,040 Speaker 1: childish plays has done the same. So some questions about 222 00:14:18,240 --> 00:14:21,240 Speaker 1: don't let your kids play too hard? Yeah, they might 223 00:14:21,280 --> 00:14:25,000 Speaker 1: have kidney disease. Later, although people didn't know exactly what 224 00:14:25,160 --> 00:14:28,400 Speaker 1: caused scarlet fever yet, they did know that it spread 225 00:14:28,440 --> 00:14:32,360 Speaker 1: easily from person to person, so much so that people 226 00:14:32,400 --> 00:14:35,760 Speaker 1: thought that the disease could linger on things like clothing, bedding, 227 00:14:35,880 --> 00:14:38,840 Speaker 1: and toys for a long period of time. And in 228 00:14:38,960 --> 00:14:42,120 Speaker 1: eighteen sixty seven, Dr Michael Taylor, who was a local 229 00:14:42,120 --> 00:14:47,280 Speaker 1: physician in northwestern England, connected a scarlet fever outbreak to milk. 230 00:14:48,040 --> 00:14:51,240 Speaker 1: At this point, Louis Pester had done groundbreaking work on 231 00:14:51,280 --> 00:14:54,280 Speaker 1: what would come to be known as pasteurization, but he 232 00:14:54,360 --> 00:14:57,640 Speaker 1: was doing this work in the context of fermentation, the 233 00:14:57,720 --> 00:15:01,840 Speaker 1: idea that milk should be pasteurized that was still decades away. 234 00:15:02,240 --> 00:15:05,560 Speaker 1: Taylor knew about the work of Dr John Snow, who 235 00:15:05,600 --> 00:15:08,200 Speaker 1: had identified a water pump as the source of a 236 00:15:08,280 --> 00:15:12,640 Speaker 1: cholera outbreak in eighteen fifty four. Taylor had thought that 237 00:15:12,720 --> 00:15:16,320 Speaker 1: if water could carry a disease, then surely milk could 238 00:15:16,360 --> 00:15:20,120 Speaker 1: as well, and he had later traced a typhoid outbreak 239 00:15:20,160 --> 00:15:24,760 Speaker 1: to contaminated milk. In eighteen sixty seven, people started reporting 240 00:15:24,800 --> 00:15:28,400 Speaker 1: cases of scarlet fever in and around the town of Penrith, 241 00:15:28,440 --> 00:15:31,000 Speaker 1: which had not seen a case of scarlet fever in 242 00:15:31,080 --> 00:15:33,960 Speaker 1: more than a year. It turned out that the people 243 00:15:34,000 --> 00:15:37,160 Speaker 1: who got sick had all bought milk from the same 244 00:15:37,400 --> 00:15:41,000 Speaker 1: milk dealer whose child had gotten scarlet fever and died. 245 00:15:41,760 --> 00:15:46,000 Speaker 1: In eighteen seventy four, Theodore bill Roth of Austria identified 246 00:15:46,040 --> 00:15:49,640 Speaker 1: and named the Streptococcus bacterium, which he had found in 247 00:15:49,640 --> 00:15:52,520 Speaker 1: infected wounds and in a case of a skin infection 248 00:15:52,840 --> 00:15:57,960 Speaker 1: called arisipelas. He had observed quote small organisms as found 249 00:15:58,000 --> 00:16:03,000 Speaker 1: in either isolated or arranged pairs, sometimes in chains, and 250 00:16:03,040 --> 00:16:06,120 Speaker 1: he named them for the Greek terms strepto or chain, 251 00:16:06,560 --> 00:16:11,320 Speaker 1: and caucus or berry. Five years later, Louis Pester isolated 252 00:16:11,360 --> 00:16:14,400 Speaker 1: the same organism in the uterus and bloodstream of a 253 00:16:14,480 --> 00:16:18,840 Speaker 1: number of patients with child bed fever. Then, in eighteen 254 00:16:18,920 --> 00:16:24,280 Speaker 1: eighty four, microbiologists Friedrich Julius Rosenbach refined the organism's name 255 00:16:24,360 --> 00:16:30,280 Speaker 1: to Streptococcus pyogenes, with pyogenes from Greek words meaning pus forming. 256 00:16:31,240 --> 00:16:33,760 Speaker 1: It did not take long for the connection to be 257 00:16:33,840 --> 00:16:39,120 Speaker 1: made between Streptococcus pyogenes and scarlet fever. In eighteen eighty seven, 258 00:16:39,240 --> 00:16:42,560 Speaker 1: Dr Emmanuel Klan published a report in the Proceedings of 259 00:16:42,600 --> 00:16:46,120 Speaker 1: the Royal Society of London, saying that he had identified 260 00:16:46,160 --> 00:16:50,560 Speaker 1: the Streptococcus organism in both people with acute scarletina in 261 00:16:50,680 --> 00:16:55,320 Speaker 1: London and cows at a milk farm in Hendon, so 262 00:16:55,360 --> 00:16:57,920 Speaker 1: he believed that the milk from the Hendon farm had 263 00:16:58,000 --> 00:17:02,680 Speaker 1: caused the scarlet fever outbreak in London. This report was 264 00:17:02,720 --> 00:17:06,359 Speaker 1: the result of years of work. Klein was a bacteriologist 265 00:17:06,520 --> 00:17:09,240 Speaker 1: who had been born in Hungary and studied in Austria 266 00:17:09,359 --> 00:17:12,280 Speaker 1: before moving to England to work as a researcher at 267 00:17:12,280 --> 00:17:16,240 Speaker 1: the Brown Institution of the University of London. His scarlet 268 00:17:16,280 --> 00:17:19,760 Speaker 1: fever research had included post mortem examinations of children who 269 00:17:19,760 --> 00:17:22,920 Speaker 1: had died of it, and he had spotted similar pathological 270 00:17:23,000 --> 00:17:27,520 Speaker 1: changes in cows that he examined at the Hendon farm. 271 00:17:27,520 --> 00:17:30,840 Speaker 1: This wasn't just a matter of observing the similarities in 272 00:17:30,880 --> 00:17:34,280 Speaker 1: the sick cows and the sick children. He followed the 273 00:17:34,280 --> 00:17:37,680 Speaker 1: criteria that at that point had been outlined by Robert Coke, 274 00:17:37,800 --> 00:17:41,240 Speaker 1: now known as Coke's postulates, to show that the same 275 00:17:41,320 --> 00:17:45,240 Speaker 1: bacteria were causing both the illness and the cows, and 276 00:17:45,320 --> 00:17:48,560 Speaker 1: in the people who had drank their milk. He also 277 00:17:48,720 --> 00:17:52,280 Speaker 1: had shown that the bacteria he cultured from the sick 278 00:17:52,359 --> 00:17:57,080 Speaker 1: cows could grow and survive and basically thrive in milk. 279 00:17:57,760 --> 00:18:01,600 Speaker 1: He called this organism Micrococcus scarlet tena. Although it was 280 00:18:01,680 --> 00:18:07,240 Speaker 1: indistinguishable from the one previously named Streptococcus pogenes. This was 281 00:18:07,280 --> 00:18:10,680 Speaker 1: an important discovery, although he was using a different name 282 00:18:10,720 --> 00:18:14,199 Speaker 1: for it. Klein was the first person to connect Streptococcus 283 00:18:14,240 --> 00:18:19,080 Speaker 1: pyogenes to scarlet fever, but his results were not widely accepted. 284 00:18:19,720 --> 00:18:23,160 Speaker 1: Since Michael Taylor's discovery in eighteen sixty seven, there had 285 00:18:23,240 --> 00:18:26,960 Speaker 1: been other scarlet fever outbreaks traced to milk, and most 286 00:18:27,000 --> 00:18:30,199 Speaker 1: of the time milk from the affected dairy had been destroyed, 287 00:18:31,080 --> 00:18:34,680 Speaker 1: but most people had thought these outbreaks had a human source, 288 00:18:34,880 --> 00:18:37,439 Speaker 1: like a child who lived on the farm, or a 289 00:18:37,520 --> 00:18:40,600 Speaker 1: dairy worker, or a delivery worker who had cared for 290 00:18:40,600 --> 00:18:44,200 Speaker 1: a child with scarlet fever, or someone who had it themselves. 291 00:18:45,119 --> 00:18:48,000 Speaker 1: Taylor had showed that the cows could carry the disease, 292 00:18:48,000 --> 00:18:50,520 Speaker 1: which could mean that destroying the milk was not enough 293 00:18:50,560 --> 00:18:53,679 Speaker 1: to stop an outbreak, that the cows themselves might have 294 00:18:53,760 --> 00:18:58,560 Speaker 1: to be culled. Destroying potentially contaminated milk was a financial 295 00:18:58,600 --> 00:19:03,040 Speaker 1: hardship for dairy farm but destroying their cows was far worse, 296 00:19:03,119 --> 00:19:05,960 Speaker 1: and people resisted the idea that cows could be a 297 00:19:06,000 --> 00:19:09,760 Speaker 1: source of infection. Although a few people had tried applying 298 00:19:09,840 --> 00:19:14,320 Speaker 1: Louis Pasteur's heat treatment process to milk, almost twenty more 299 00:19:14,400 --> 00:19:19,840 Speaker 1: years passed before German agricultural chemists Franz Vum Suckslet suggested 300 00:19:19,880 --> 00:19:24,200 Speaker 1: that milk be routinely treated with pasteurization, and a big 301 00:19:24,280 --> 00:19:27,760 Speaker 1: reason for that was that so many diseases were being 302 00:19:27,800 --> 00:19:32,359 Speaker 1: transmitted through milk, not just scarlet fever, but also typhoid, 303 00:19:32,400 --> 00:19:37,600 Speaker 1: diphtherory a, tuberculosis, and various gastro intestinal illnesses. It still 304 00:19:37,640 --> 00:19:40,280 Speaker 1: took a while for pasteurization to catch on, though there 305 00:19:40,320 --> 00:19:44,119 Speaker 1: were concerns that pasteurizing milk destroyed the nutrients in it, 306 00:19:44,240 --> 00:19:47,040 Speaker 1: or affected the flavor, or made it harder to digest. 307 00:19:47,760 --> 00:19:51,480 Speaker 1: But by that point, scarlet fever rates were on the decline, 308 00:19:51,840 --> 00:20:02,880 Speaker 1: and we'll talk more about that after a sponsor break. 309 00:20:03,640 --> 00:20:06,960 Speaker 1: Although the number of scarlet fever cases was declining at 310 00:20:06,960 --> 00:20:09,439 Speaker 1: the end of the nineteenth century and the disease didn't 311 00:20:09,520 --> 00:20:12,560 Speaker 1: seem to be as deadly as it had been in 312 00:20:12,600 --> 00:20:15,119 Speaker 1: the early twentieth century, it was still seen as a 313 00:20:15,280 --> 00:20:20,600 Speaker 1: major public health concern. In England. For example, isolation hospitals 314 00:20:20,600 --> 00:20:23,879 Speaker 1: were established for people with contagious illnesses who could not 315 00:20:24,000 --> 00:20:28,320 Speaker 1: effectively be isolated at home. During outbreaks of scarlet fever, 316 00:20:28,400 --> 00:20:31,520 Speaker 1: there could be house to house visits to find sick 317 00:20:31,600 --> 00:20:35,480 Speaker 1: people so they could be isolated in the hospital. Unfortunately, 318 00:20:35,560 --> 00:20:38,240 Speaker 1: it is really not clear how much or whether this 319 00:20:38,440 --> 00:20:41,320 Speaker 1: really helped slow the spread of the disease. And also 320 00:20:41,880 --> 00:20:45,760 Speaker 1: people with different contagious diseases were all being housed in 321 00:20:45,800 --> 00:20:48,480 Speaker 1: the same hospitals, and the sled people to say that 322 00:20:48,520 --> 00:20:51,200 Speaker 1: the isolation hospital was where you went when you caught 323 00:20:51,200 --> 00:20:53,160 Speaker 1: one disease, so that you could come out with all 324 00:20:53,200 --> 00:20:58,919 Speaker 1: the rest. Welcome to Petri dish Arms. You'll get a 325 00:20:58,960 --> 00:21:04,840 Speaker 1: bed at probably seven different things. It's no good. Other 326 00:21:04,920 --> 00:21:08,080 Speaker 1: efforts to control the spread of scarlet fever also did 327 00:21:08,119 --> 00:21:11,520 Speaker 1: not help. A nineteen fifteen article in the American Journal 328 00:21:11,520 --> 00:21:14,639 Speaker 1: of Nursing described it this way quote, it seems to 329 00:21:14,640 --> 00:21:18,480 Speaker 1: cling to whatever object it encounters. In no other disease 330 00:21:18,520 --> 00:21:22,360 Speaker 1: has the infection been apparently conveyed with such frequency by 331 00:21:22,400 --> 00:21:27,200 Speaker 1: objects which have come in contact with those ill as clothes, books, toys, 332 00:21:27,200 --> 00:21:31,520 Speaker 1: and the like. This article recommended that quote all hangings, carpets, 333 00:21:31,520 --> 00:21:34,400 Speaker 1: and upholstered furniture are to be taken from the room 334 00:21:34,440 --> 00:21:38,040 Speaker 1: before the patient is brought in. The furniture left should 335 00:21:38,040 --> 00:21:40,880 Speaker 1: be of a kind readily cleansed. There should be no 336 00:21:41,040 --> 00:21:44,040 Speaker 1: such fancied attempts at purifying the air as by hanging 337 00:21:44,119 --> 00:21:48,120 Speaker 1: up sheets wet with disinfectants. Such measures are not only 338 00:21:48,280 --> 00:21:51,640 Speaker 1: useless but tend to give a false sense of security. 339 00:21:51,920 --> 00:21:55,080 Speaker 1: Needless to say, the patients should be provided with bedclothing, 340 00:21:55,280 --> 00:21:59,680 Speaker 1: nightgown towels, eating utensils, and drinking vessels for his ex 341 00:22:00,000 --> 00:22:04,320 Speaker 1: elusive use. Yeah, that's it. Is no longer believed that 342 00:22:04,680 --> 00:22:08,080 Speaker 1: scarlet fever is just transmitted readily and for a long 343 00:22:08,160 --> 00:22:12,560 Speaker 1: period of time, and things like curtains. Uh. This article 344 00:22:12,600 --> 00:22:16,480 Speaker 1: also recommended disinfecting anything that the sick person had used 345 00:22:16,680 --> 00:22:19,560 Speaker 1: using either a five percent solution of carbolic acid or 346 00:22:19,600 --> 00:22:23,040 Speaker 1: a two percent solution of creosol, and anything that had 347 00:22:23,080 --> 00:22:28,240 Speaker 1: been used for coughing or sneezing into was to be burned. Also, 348 00:22:28,280 --> 00:22:31,840 Speaker 1: the recommended treatment for patients themselves was at least three 349 00:22:32,000 --> 00:22:34,919 Speaker 1: weeks in bed, even if they only had a mild case. 350 00:22:36,080 --> 00:22:39,560 Speaker 1: Around this same time, people were making more discoveries about 351 00:22:39,560 --> 00:22:43,119 Speaker 1: scarlet fever, something that really escalated during the nineteen teens 352 00:22:43,119 --> 00:22:48,080 Speaker 1: and twenties. In nineteen fifteen, English bacteriologist Frederick William Twart 353 00:22:48,200 --> 00:22:51,320 Speaker 1: and his brother were using colonies of bacteria as part 354 00:22:51,320 --> 00:22:53,640 Speaker 1: of an effort to find a way to grow smallpox 355 00:22:53,720 --> 00:22:58,200 Speaker 1: vaccine in a lab. Towart discovered areas where the bacteria 356 00:22:58,320 --> 00:23:01,800 Speaker 1: couldn't grow and found that a substance from these areas 357 00:23:01,880 --> 00:23:05,520 Speaker 1: was capable of passing through a porcelain filter that trapped 358 00:23:05,640 --> 00:23:09,560 Speaker 1: most bacteria. He published an article in The Lancet about 359 00:23:09,560 --> 00:23:14,119 Speaker 1: what he described as a filter passing virus that attacked bacteria. 360 00:23:14,320 --> 00:23:16,520 Speaker 1: His work didn't get a lot of attention, but this 361 00:23:16,600 --> 00:23:20,560 Speaker 1: was the first known description of a bacteria phage. French 362 00:23:20,640 --> 00:23:25,359 Speaker 1: microbiologist Felix Derell made the same discovery independently of tort 363 00:23:25,600 --> 00:23:29,520 Speaker 1: about two years later. In the nineteen twenties, husband and 364 00:23:29,560 --> 00:23:32,840 Speaker 1: wife researchers George and Gladys Dick made a series of 365 00:23:32,880 --> 00:23:36,680 Speaker 1: discoveries about scarlet fever and its cause. While working in Chicago. 366 00:23:37,560 --> 00:23:42,240 Speaker 1: They confirmed the link between the disease and Streptococcus bacteria, 367 00:23:42,520 --> 00:23:46,679 Speaker 1: and they identified a toxin produced by the bacteria that 368 00:23:46,800 --> 00:23:50,240 Speaker 1: was the cause of scarlet fever. They also developed a 369 00:23:50,280 --> 00:23:53,000 Speaker 1: skin test known as the Dick test to show whether 370 00:23:53,080 --> 00:23:57,040 Speaker 1: a person was susceptible to scarlet fever or not. They 371 00:23:57,080 --> 00:23:59,720 Speaker 1: were nominated for the Nobel Prize in Medicine for the 372 00:23:59,760 --> 00:24:04,879 Speaker 1: sore in ninety five. In ninety six and ninety seven, 373 00:24:05,320 --> 00:24:09,119 Speaker 1: two different pairs of researchers discovered a bacteria phage that 374 00:24:09,200 --> 00:24:12,520 Speaker 1: could change a non toxogenic strain of Strep into a 375 00:24:12,600 --> 00:24:16,399 Speaker 1: toxogenic one. In other words, to turn a variety of Strep. 376 00:24:16,440 --> 00:24:19,400 Speaker 1: That did not cause scarlet fever into one that did. 377 00:24:20,359 --> 00:24:24,160 Speaker 1: Various researchers started trying to develop an inoculation for scarlet 378 00:24:24,200 --> 00:24:28,520 Speaker 1: fever using either the bacteria or various modifications of the 379 00:24:28,600 --> 00:24:33,760 Speaker 1: toxin that it produced. In nine, American microbiologist Rebecca craig 380 00:24:33,840 --> 00:24:38,639 Speaker 1: Hill Lancefield developed a system for classifying Strep. Bacteria into 381 00:24:38,680 --> 00:24:43,480 Speaker 1: groups based on the antigens found on the bacteria. Initially, 382 00:24:43,520 --> 00:24:46,240 Speaker 1: she proposed two groups, the group A and Group B. 383 00:24:46,600 --> 00:24:49,959 Speaker 1: As we said earlier, scarlet fever is group A. Today 384 00:24:49,960 --> 00:24:53,240 Speaker 1: there are many more groups. She was also one of 385 00:24:53,280 --> 00:24:57,120 Speaker 1: the first people to demonstrate that Strep. Infections could lead 386 00:24:57,160 --> 00:25:01,080 Speaker 1: to rheumatic fever. The first sulfa drugs were developed in 387 00:25:01,119 --> 00:25:03,560 Speaker 1: the nineteen thirties, and we're used as a treatment for 388 00:25:03,600 --> 00:25:08,120 Speaker 1: strep infections, including scarlet fever. But the big medical breakthrough 389 00:25:08,320 --> 00:25:12,160 Speaker 1: was penicillin. We did a whole episode on penicillin's development 390 00:25:12,160 --> 00:25:17,440 Speaker 1: back in September. Today, penicillin and amoxicillin are the antibiotics 391 00:25:17,480 --> 00:25:21,040 Speaker 1: most often used to treat scarlet fever, with other antibiotics 392 00:25:21,119 --> 00:25:24,840 Speaker 1: recommended for people who are allergic to those. Today, in 393 00:25:24,920 --> 00:25:28,200 Speaker 1: most children, scarlet fever clears up quickly as long as 394 00:25:28,240 --> 00:25:33,440 Speaker 1: antibiotic treatment begins promptly. Yeah, that made the myxicillen shortages 395 00:25:33,600 --> 00:25:36,159 Speaker 1: that were happening at the end of last year in 396 00:25:36,200 --> 00:25:40,520 Speaker 1: a lot of places particularly scary for folks. So penicillin 397 00:25:40,640 --> 00:25:44,240 Speaker 1: is often credited with turning scarlet fever from a terrifying 398 00:25:44,359 --> 00:25:46,919 Speaker 1: and deadly disease to one that's considered to be a 399 00:25:46,960 --> 00:25:51,000 Speaker 1: relatively mild childhood illness most of the time. As we 400 00:25:51,080 --> 00:25:54,600 Speaker 1: said earlier, though deaths from scarlet fever were becoming less 401 00:25:54,640 --> 00:25:59,800 Speaker 1: and less common decades before penicillin was introduced. We don't 402 00:26:00,040 --> 00:26:03,439 Speaker 1: totally know why. Starting in the nineteen eighties, though, the 403 00:26:03,480 --> 00:26:07,840 Speaker 1: opposite started to happen, as invasive strep infections started to 404 00:26:07,880 --> 00:26:11,600 Speaker 1: become more common in spite of the existence of antibiotics 405 00:26:11,640 --> 00:26:15,600 Speaker 1: to treat them. Scarlet fever specifically started to become more 406 00:26:15,640 --> 00:26:17,920 Speaker 1: prevalent in a lot of parts of the world starting 407 00:26:17,920 --> 00:26:21,520 Speaker 1: in about two thousand and eight. Increased rates of scarlet 408 00:26:21,560 --> 00:26:24,280 Speaker 1: fever were first reported in parts of Asia, and then 409 00:26:24,280 --> 00:26:26,480 Speaker 1: in the UK and other parts of Europe, and then 410 00:26:26,520 --> 00:26:30,280 Speaker 1: in the US. The UK, for example, saw a sudden 411 00:26:30,320 --> 00:26:35,000 Speaker 1: spike in scarlet fever cases starting in twenty and soon 412 00:26:35,080 --> 00:26:37,320 Speaker 1: the rate of scarlet fever was higher there than it 413 00:26:37,359 --> 00:26:40,840 Speaker 1: had been in almost fifty years. At first, it seemed 414 00:26:40,880 --> 00:26:44,159 Speaker 1: like this wasn't leading to a similar increase in fatalities, 415 00:26:44,560 --> 00:26:48,120 Speaker 1: but a year later invasive strep infections started to increase 416 00:26:48,160 --> 00:26:52,679 Speaker 1: there as well. Worldwide, there was a fivefold increase in 417 00:26:52,720 --> 00:26:55,679 Speaker 1: the number of scarlet fever cases between twenty eleven and 418 00:26:56,920 --> 00:26:59,560 Speaker 1: with a drop in twenty after the start of the 419 00:26:59,600 --> 00:27:04,920 Speaker 1: COVID nineteen pandemic and a lot of places, the general 420 00:27:04,960 --> 00:27:07,919 Speaker 1: trend of when scarlet fever cases are the highest was 421 00:27:08,000 --> 00:27:11,800 Speaker 1: like sort of nearing its end when the COVID nineteen 422 00:27:11,840 --> 00:27:16,560 Speaker 1: pandemic really started. Although health officials thought there might be 423 00:27:16,680 --> 00:27:20,560 Speaker 1: some more dangerous strain of Strep bacteria that was causing 424 00:27:20,560 --> 00:27:23,960 Speaker 1: this increase, some whole genome sequencing of samples from a 425 00:27:23,960 --> 00:27:26,080 Speaker 1: lot of different sick children found that there was not 426 00:27:26,320 --> 00:27:29,320 Speaker 1: one strain that was responsible for most of the illnesses. 427 00:27:30,040 --> 00:27:33,119 Speaker 1: Some researchers have suggested that the bacteria may have started 428 00:27:33,200 --> 00:27:37,120 Speaker 1: producing a more aggressive form of the toxin that causes 429 00:27:37,160 --> 00:27:40,639 Speaker 1: the disease. It's also not clear what has caused this 430 00:27:40,720 --> 00:27:44,359 Speaker 1: most recent spike in scarlet fever cases that started towards 431 00:27:44,400 --> 00:27:48,920 Speaker 1: the end of in the northern hemisphere. Scarlet fever cases 432 00:27:49,080 --> 00:27:52,199 Speaker 1: usually peak in the late winter or early spring, so 433 00:27:52,320 --> 00:27:55,840 Speaker 1: this outbreak happened out of season. At this point, this 434 00:27:55,920 --> 00:27:59,440 Speaker 1: is all really speculative, with some of those speculations being 435 00:27:59,440 --> 00:28:02,399 Speaker 1: more based less than others, like the measures put in 436 00:28:02,440 --> 00:28:04,439 Speaker 1: place to try to control the spread of the COVID 437 00:28:04,520 --> 00:28:08,919 Speaker 1: nineteen pandemic lead to people not being exposed to other diseases. 438 00:28:09,160 --> 00:28:12,120 Speaker 1: It's also possible that kids who might have gotten strip 439 00:28:12,240 --> 00:28:15,320 Speaker 1: or scarlet fever over the last couple of years didn't 440 00:28:15,640 --> 00:28:18,600 Speaker 1: and are instead just getting it now. But there have 441 00:28:18,640 --> 00:28:22,439 Speaker 1: also been totally baseless claims pointing to either COVID nineteen 442 00:28:22,560 --> 00:28:26,160 Speaker 1: vaccines or the flu vaccine is somehow causing a rise 443 00:28:26,240 --> 00:28:29,760 Speaker 1: in strep infections. There is no credible evidence for either. 444 00:28:30,840 --> 00:28:33,639 Speaker 1: They were not doctors, so we cannot possibly comment on 445 00:28:33,760 --> 00:28:38,520 Speaker 1: every conceivable thing that has been postulated about the spike 446 00:28:38,600 --> 00:28:42,400 Speaker 1: and scarlet fever cases. Like it does seem possible that 447 00:28:42,480 --> 00:28:45,320 Speaker 1: it is an extension of the spike that was happening 448 00:28:45,320 --> 00:28:48,920 Speaker 1: before the pandemic started, that kind of paused during the 449 00:28:48,920 --> 00:28:52,240 Speaker 1: pandemic peak when so many places were taking a lot 450 00:28:52,240 --> 00:28:55,920 Speaker 1: of mitigation measures. As we said at the top of 451 00:28:55,920 --> 00:28:58,320 Speaker 1: the show, though a lot of folks experience with scarlet 452 00:28:58,360 --> 00:29:00,440 Speaker 1: fever is not from their own illnes us or the 453 00:29:00,480 --> 00:29:04,120 Speaker 1: illness of their children. It's literature. So we'll close out 454 00:29:04,120 --> 00:29:07,080 Speaker 1: with just a few of the most famous examples. First, 455 00:29:07,200 --> 00:29:10,440 Speaker 1: there is Little Women by L. M. Alcott, in which 456 00:29:10,480 --> 00:29:14,320 Speaker 1: Beth gets scarlet fever and is extremely sick. She dies 457 00:29:14,640 --> 00:29:18,240 Speaker 1: years later, and while the book doesn't give a specific cause, 458 00:29:18,320 --> 00:29:22,600 Speaker 1: it's usually interpreted that she had developed rheumatic fever after 459 00:29:22,640 --> 00:29:27,520 Speaker 1: that scarlet fever case. Alcott's real life sister, Elizabeth Sewell Alcott, 460 00:29:27,600 --> 00:29:30,160 Speaker 1: died at the age of twenty two, two years after 461 00:29:30,200 --> 00:29:33,680 Speaker 1: having had scarlet fever, and then Alcott published Little Women 462 00:29:33,800 --> 00:29:38,160 Speaker 1: ten years later in eighteen sixty eight. Another past podcast 463 00:29:38,240 --> 00:29:41,840 Speaker 1: subject with a scarlet fever connection is Laura Ingalls Wilder, 464 00:29:41,840 --> 00:29:45,440 Speaker 1: whose real sister Mary became blind after what the family 465 00:29:45,480 --> 00:29:50,680 Speaker 1: described as brain fever, probably some form of meningitis or encephalitis. 466 00:29:51,480 --> 00:29:53,800 Speaker 1: In the book The Shores of Silver Lake, set in 467 00:29:53,840 --> 00:29:57,240 Speaker 1: eighteen seventy nine, the fictional version of Mary becomes blind 468 00:29:57,560 --> 00:30:00,800 Speaker 1: after she and the rest of the family contracts scarlet fever. 469 00:30:01,640 --> 00:30:05,640 Speaker 1: And yet another example that incorporates both fiction and reality. 470 00:30:06,120 --> 00:30:09,720 Speaker 1: Several of the von Trapp family contracted scarlet fever in 471 00:30:09,720 --> 00:30:12,960 Speaker 1: the early nineteen twenties, and their mother, Agatha, contracted it 472 00:30:13,000 --> 00:30:15,760 Speaker 1: while caring for them and died in nineteen twenty two. 473 00:30:16,640 --> 00:30:19,520 Speaker 1: This led to a young woman named Maria being hired 474 00:30:19,600 --> 00:30:21,720 Speaker 1: from a convent to work as a tutor with the 475 00:30:21,760 --> 00:30:25,760 Speaker 1: convalescing children, and the family later became a performing group 476 00:30:25,800 --> 00:30:29,520 Speaker 1: called the trap Family Singers, that, of course inspired the 477 00:30:29,560 --> 00:30:33,280 Speaker 1: musical The Sound of Music. Lastly, of course, there's The 478 00:30:33,360 --> 00:30:37,000 Speaker 1: Velveteen Rabbit or How Toys Become Real by Marjorie Williams, 479 00:30:37,040 --> 00:30:39,920 Speaker 1: which was published in nineteen two, and in this book, 480 00:30:39,960 --> 00:30:42,680 Speaker 1: a little boy gets a velveteen rabbit as a Christmas present, 481 00:30:42,680 --> 00:30:45,520 Speaker 1: and then there's a whole story about how nursery magic 482 00:30:45,640 --> 00:30:48,400 Speaker 1: can make a toy real through the strength of a 483 00:30:48,480 --> 00:30:51,680 Speaker 1: child's love. This little boy then gets scarlet fever and 484 00:30:51,680 --> 00:30:53,960 Speaker 1: it's very sick for a long time, and once he's better, 485 00:30:54,000 --> 00:30:56,520 Speaker 1: there's a plan to take him to the seaside while 486 00:30:56,600 --> 00:30:59,840 Speaker 1: his room is disinfected, and all of his toys and 487 00:31:00,000 --> 00:31:02,480 Speaker 1: books and everything he has played with is going to 488 00:31:02,520 --> 00:31:04,640 Speaker 1: be burned, which, as we talked about it is a 489 00:31:04,680 --> 00:31:08,320 Speaker 1: real thing that people would do. So the doctor then 490 00:31:08,360 --> 00:31:12,200 Speaker 1: describes the velveteen rabbit as quote, a mass of scarlet 491 00:31:12,240 --> 00:31:16,400 Speaker 1: fever germs. Fortunately, the nursery magic fairy appears and makes 492 00:31:16,400 --> 00:31:19,400 Speaker 1: the velveteen rabbit real, so he is not burned. But honestly, 493 00:31:19,960 --> 00:31:24,160 Speaker 1: this story is kind of horrifying. It's the meanest thing ever. 494 00:31:24,480 --> 00:31:27,640 Speaker 1: I remembered it being sad from like my own childhood, 495 00:31:27,680 --> 00:31:29,720 Speaker 1: Like I remembered feeling sad about it. And I'm pretty 496 00:31:29,720 --> 00:31:32,320 Speaker 1: sure I have like a copy of the book with 497 00:31:32,360 --> 00:31:35,040 Speaker 1: its original illustrations and all that, like in the house somewhere, 498 00:31:35,680 --> 00:31:40,040 Speaker 1: but I read it at my desk while working on 499 00:31:40,080 --> 00:31:43,240 Speaker 1: this episode, and I mean maybe it was my emotional 500 00:31:43,280 --> 00:31:48,360 Speaker 1: state that there was a lot of just weeping over 501 00:31:48,400 --> 00:31:51,760 Speaker 1: this story, and I was like, why did they give 502 00:31:51,800 --> 00:31:56,440 Speaker 1: this to children? I will tell you a velveteen rabbit 503 00:31:56,480 --> 00:32:00,480 Speaker 1: story on Friday. Okay, that'll be great. We can talk 504 00:32:00,520 --> 00:32:03,560 Speaker 1: more about our literature experiences with scarlet fever. So if 505 00:32:03,600 --> 00:32:06,760 Speaker 1: anybody's kids have had scarlet fever, I hope everybody has 506 00:32:06,800 --> 00:32:09,640 Speaker 1: recovered nicely and you were able to find some of moscilling, 507 00:32:09,680 --> 00:32:12,719 Speaker 1: because I know that was tough for a while. Um, 508 00:32:12,760 --> 00:32:18,120 Speaker 1: and now I have some listener mail. This listener mail 509 00:32:18,240 --> 00:32:20,920 Speaker 1: is from Aaron, and Aaron wrote hello ladies while I 510 00:32:21,000 --> 00:32:24,000 Speaker 1: typically and went to skip out before listener emails. I 511 00:32:24,040 --> 00:32:26,080 Speaker 1: was at work the other day and happens to catch 512 00:32:26,120 --> 00:32:29,520 Speaker 1: your correction about the Marx Brothers versus the Three Stooges. 513 00:32:29,960 --> 00:32:32,560 Speaker 1: Imagine my surprise and delight at your defense of the 514 00:32:32,600 --> 00:32:36,440 Speaker 1: Stooges as I was currently restocking the gift shop at 515 00:32:36,520 --> 00:32:40,320 Speaker 1: the only Three Stooges museum in the country. The Stoogeum 516 00:32:40,600 --> 00:32:44,240 Speaker 1: located just outside of Philadelphia, Pennsylvania. When people find out 517 00:32:44,240 --> 00:32:47,720 Speaker 1: where I work, they are usually astonished that such a 518 00:32:47,760 --> 00:32:51,360 Speaker 1: place exists and are intrigued to find out more. We 519 00:32:51,440 --> 00:32:55,240 Speaker 1: house the largest collection of stooge Bilia or maybe stooge 520 00:32:55,240 --> 00:32:59,080 Speaker 1: abilia in the world, where there were three floors, ten 521 00:32:59,080 --> 00:33:02,160 Speaker 1: thousand square feet exhibit space and well over ten thousand 522 00:33:02,200 --> 00:33:06,280 Speaker 1: items on display. This doesn't even include our research library, 523 00:33:06,480 --> 00:33:10,600 Speaker 1: photo and document archives, film vault in additional storage spaces 524 00:33:10,640 --> 00:33:13,959 Speaker 1: for objects not on display. I was so touched when 525 00:33:14,000 --> 00:33:17,200 Speaker 1: Tracy talked about the students having intelligence and meaning behind 526 00:33:17,240 --> 00:33:20,800 Speaker 1: all the slapstick. I'm gonna pause the conversation and say, 527 00:33:20,800 --> 00:33:22,920 Speaker 1: I want to credit Holly for being part of that 528 00:33:22,960 --> 00:33:26,320 Speaker 1: conversation too and bringing nuance I had and necessarily thought about. 529 00:33:27,120 --> 00:33:30,000 Speaker 1: Uh so, And then the email goes on to say, 530 00:33:30,040 --> 00:33:32,000 Speaker 1: because that is what my coworker and I try to 531 00:33:32,040 --> 00:33:35,120 Speaker 1: express when educating the public about our collection. Not only 532 00:33:35,160 --> 00:33:38,440 Speaker 1: were the three Stooges, in their various iterations, masters of 533 00:33:38,480 --> 00:33:42,120 Speaker 1: comedic timing and among the hardest working entertainers of their day, 534 00:33:42,600 --> 00:33:45,480 Speaker 1: They're over fifty year career can stand as a microcosm 535 00:33:45,520 --> 00:33:49,200 Speaker 1: of the modern entertainment industry, from vaudeville through early films, 536 00:33:49,520 --> 00:33:52,000 Speaker 1: the studio system in the dawn of television to the 537 00:33:52,000 --> 00:33:56,040 Speaker 1: start of marketing to children and onward. The Stooges were 538 00:33:56,120 --> 00:33:58,440 Speaker 1: never looked on with much respect, but I think that 539 00:33:58,480 --> 00:34:00,800 Speaker 1: their lives and careers fast dating one and would be 540 00:34:00,880 --> 00:34:03,800 Speaker 1: a great podcast subject. There's even a bit of scandal. 541 00:34:04,040 --> 00:34:07,760 Speaker 1: Did Stooge founder Ted Healy get murdered? The jury is 542 00:34:07,800 --> 00:34:10,000 Speaker 1: still out on that one. Just a quick plug in 543 00:34:10,040 --> 00:34:12,360 Speaker 1: the museum and its founder Gary lassen Or in the 544 00:34:12,440 --> 00:34:16,080 Speaker 1: process of publishing a book about the stooges lengthy touring 545 00:34:16,120 --> 00:34:20,720 Speaker 1: career called A Tour de Farce, which is a great title. 546 00:34:21,920 --> 00:34:25,279 Speaker 1: It chronicles forty years and thousands of three Stooges live 547 00:34:25,320 --> 00:34:28,360 Speaker 1: appearances throughout the US and abroad, and contains never before 548 00:34:28,360 --> 00:34:31,880 Speaker 1: seeing photos and stories. Thanks for granting me that little boost, 549 00:34:31,920 --> 00:34:33,560 Speaker 1: and if you guys are ever interested in doing a 550 00:34:33,640 --> 00:34:36,120 Speaker 1: podcast about the Stooges, feel free to reach out. We 551 00:34:36,239 --> 00:34:38,480 Speaker 1: love to help with research. Thanks again for your defense 552 00:34:38,920 --> 00:34:41,960 Speaker 1: of who we affectionately call the boys in Stooge. We 553 00:34:42,040 --> 00:34:45,480 Speaker 1: trust Aaron ps. We get emails all the time of 554 00:34:45,520 --> 00:34:48,400 Speaker 1: people mixing up the Marx Brothers and the Stooges. Someone 555 00:34:48,480 --> 00:34:51,240 Speaker 1: even tried to donate a picture of the Marx Brothers 556 00:34:51,280 --> 00:34:58,120 Speaker 1: to our collection once I found this email. Very delightful obviously, um, 557 00:34:58,160 --> 00:35:02,239 Speaker 1: and I also will reiterate I feel like, based on 558 00:35:02,320 --> 00:35:07,600 Speaker 1: my limited experience, that a lot of people, whether confusion 559 00:35:07,800 --> 00:35:12,040 Speaker 1: or misremembering or whatever, uh, mix up the Marx Brothers 560 00:35:12,080 --> 00:35:15,920 Speaker 1: and the Three Stooges, and that Three Stooges folks seem 561 00:35:16,000 --> 00:35:18,360 Speaker 1: to have a lot more humor about this than Marx 562 00:35:18,440 --> 00:35:23,360 Speaker 1: Brothers folks do. Um. That is just my impression based 563 00:35:23,400 --> 00:35:26,360 Speaker 1: on emails and looking at stuff on the internet. So 564 00:35:26,400 --> 00:35:29,040 Speaker 1: thank you so much. I did not know that museum existed. 565 00:35:29,080 --> 00:35:31,040 Speaker 1: I've been to Philadelphia a couple of times. Not sure 566 00:35:31,080 --> 00:35:34,640 Speaker 1: exactly how far outside of Philadelphia it is, but man, 567 00:35:34,680 --> 00:35:36,600 Speaker 1: I'm glad to know that's a thing. Yeah. Same, It 568 00:35:36,719 --> 00:35:38,680 Speaker 1: just went on my list of places I must visit. 569 00:35:39,000 --> 00:35:41,880 Speaker 1: Yeah yeah. So, if you would like to send us 570 00:35:41,880 --> 00:35:44,640 Speaker 1: a note about this or another podcast or history podcast 571 00:35:44,719 --> 00:35:46,759 Speaker 1: that I heart radio dot com and we're all over 572 00:35:46,840 --> 00:35:50,840 Speaker 1: social media. Missed in History That's Real? Find our Facebook, Twitter, Pinterest, 573 00:35:50,880 --> 00:35:54,000 Speaker 1: and Instagram, and you can subscribe to our show on 574 00:35:54,040 --> 00:35:56,319 Speaker 1: the I Heart Radio app and wherever real to get 575 00:35:56,320 --> 00:36:03,640 Speaker 1: your podcasts. Stuff you Missed in History Class is a 576 00:36:03,680 --> 00:36:06,880 Speaker 1: production of I Heart Radio For more podcasts from I 577 00:36:06,960 --> 00:36:10,160 Speaker 1: heart Radio, visit the I heart Radio app, Apple podcasts, 578 00:36:10,280 --> 00:36:16,239 Speaker 1: or wherever you listen to your favorite shows. H