1 00:00:02,440 --> 00:00:03,320 Speaker 1: Happy Saturday. 2 00:00:03,560 --> 00:00:05,640 Speaker 2: Since one of the updates we talked about in this 3 00:00:05,680 --> 00:00:09,760 Speaker 2: week's installment of Unearthed was about scarlet fever, we thought 4 00:00:09,800 --> 00:00:12,640 Speaker 2: we would replay our episode on it as the day's 5 00:00:12,840 --> 00:00:17,240 Speaker 2: Saturday Classic. This originally came out on February eighth, twenty 6 00:00:17,280 --> 00:00:24,000 Speaker 2: twenty three. Enjoy Welcome to Stuff You Missed in History Class, 7 00:00:24,239 --> 00:00:34,240 Speaker 2: a production of iHeartRadio. Hello, and welcome to the podcast. 8 00:00:34,280 --> 00:00:37,879 Speaker 2: I'm Tracy V. Wilson and I'm Holly Frye. So some 9 00:00:38,040 --> 00:00:41,960 Speaker 2: of my friends' kids got scarlet fever late last year, 10 00:00:42,080 --> 00:00:44,120 Speaker 2: and their response to this was kind of like, what 11 00:00:44,360 --> 00:00:48,960 Speaker 2: is this the nineteenth century? And I remember having a 12 00:00:49,000 --> 00:00:52,400 Speaker 2: really similar feeling when I got scarlet fever as a 13 00:00:52,560 --> 00:00:56,600 Speaker 2: kid back in the nineteen eighties, because I really associated 14 00:00:56,640 --> 00:01:00,640 Speaker 2: scarlet fever with old timey children's books to me, like 15 00:01:01,360 --> 00:01:05,039 Speaker 2: The Velveteen Rabbit and Little Women, and this sort of 16 00:01:05,080 --> 00:01:07,960 Speaker 2: response to scarlet fever, like what century is it? 17 00:01:08,440 --> 00:01:10,920 Speaker 1: That's not unique to me or my friends. 18 00:01:11,560 --> 00:01:15,000 Speaker 2: When I started working on this episode, the very initial 19 00:01:15,040 --> 00:01:18,600 Speaker 2: research just turned up a ton of news articles going 20 00:01:18,640 --> 00:01:23,360 Speaker 2: back many years, all of them reporting on scarlet fever outbreaks, 21 00:01:23,400 --> 00:01:26,160 Speaker 2: and all of this with a tone of like. 22 00:01:26,160 --> 00:01:28,200 Speaker 1: The return of an old disease. 23 00:01:29,600 --> 00:01:31,880 Speaker 2: They all made it sound like this was like a 24 00:01:32,000 --> 00:01:34,600 Speaker 2: unique thing, and it was really just year after year 25 00:01:34,640 --> 00:01:37,839 Speaker 2: after year, a new headline of a new scarlet fever 26 00:01:37,920 --> 00:01:40,640 Speaker 2: outbreak with a new like an old disease has returned. 27 00:01:41,560 --> 00:01:45,360 Speaker 2: So scarlet fever is caused by Group A Streptococcus, and 28 00:01:45,520 --> 00:01:48,520 Speaker 2: over the last few months there's been a big spike 29 00:01:48,760 --> 00:01:52,280 Speaker 2: in Group A Strep infections in many parts of the world, 30 00:01:52,720 --> 00:01:57,400 Speaker 2: sometimes causing relatively minor illnesses, but also sometimes much more 31 00:01:57,800 --> 00:02:03,920 Speaker 2: dangerous and even deadly invasive infections, usually in places where 32 00:02:03,960 --> 00:02:08,360 Speaker 2: people have prompt access to medical care. Scarlet fever specifically 33 00:02:08,480 --> 00:02:12,240 Speaker 2: is pretty treatable with antibiotics, but in the middle of 34 00:02:12,280 --> 00:02:15,280 Speaker 2: the nineteenth century it was the leading cause of death 35 00:02:15,400 --> 00:02:18,720 Speaker 2: and children in some parts of the world. A lot 36 00:02:18,720 --> 00:02:23,240 Speaker 2: of times antibiotics get the credit from turning that trend around, 37 00:02:23,280 --> 00:02:26,600 Speaker 2: but it wasn't just because of antibiotics, which is one 38 00:02:26,600 --> 00:02:30,840 Speaker 2: of several kind of mysteries about this disease. Scarlet fever 39 00:02:31,000 --> 00:02:34,800 Speaker 2: usually starts with symptoms like a fever, sore throat, headache, 40 00:02:34,840 --> 00:02:38,840 Speaker 2: and sometimes nausea or vomiting. A rash usually forms a 41 00:02:38,880 --> 00:02:42,040 Speaker 2: day or two after the fever starts. The appearance and 42 00:02:42,120 --> 00:02:44,840 Speaker 2: texture of this rash can vary based on a person's 43 00:02:44,880 --> 00:02:48,720 Speaker 2: skin color, At least in the US and Europe, most 44 00:02:48,760 --> 00:02:52,040 Speaker 2: descriptions in pictures of this are of white children, and 45 00:02:52,040 --> 00:02:54,880 Speaker 2: in people with lighter skin, the rashes red and bumpy 46 00:02:54,960 --> 00:02:58,680 Speaker 2: and often has this texture that's described as sand papery. 47 00:02:59,360 --> 00:03:01,799 Speaker 2: In people with brown or black skin, the rash is 48 00:03:01,840 --> 00:03:04,920 Speaker 2: often the same color as the skin or slightly darker, 49 00:03:05,320 --> 00:03:08,119 Speaker 2: and while it's usually still raised in bumpy, it sometimes 50 00:03:08,160 --> 00:03:12,160 Speaker 2: doesn't have quite the same texture. Scarlet fever can also 51 00:03:12,240 --> 00:03:16,000 Speaker 2: cause something called strawberry tone that's a white coating that 52 00:03:16,040 --> 00:03:20,160 Speaker 2: can progress to a red, bumpy appearance. If you google this, 53 00:03:20,200 --> 00:03:24,400 Speaker 2: which I'm not necessarily recommending that you do, it's obvious 54 00:03:24,400 --> 00:03:28,880 Speaker 2: why they call it that. If left untreated, scarlet fever 55 00:03:29,080 --> 00:03:32,880 Speaker 2: and other strep infections can cause some really serious complications, 56 00:03:32,919 --> 00:03:36,720 Speaker 2: including organ damage and an inflammatory disease called rheumatic fever. 57 00:03:37,440 --> 00:03:41,560 Speaker 2: There's also a possible connection between strap infections and autoimmune 58 00:03:41,560 --> 00:03:45,160 Speaker 2: disease and neurological disorders and children. And again, there are 59 00:03:45,160 --> 00:03:48,640 Speaker 2: also invasive strep infections that themselves can be like really 60 00:03:48,720 --> 00:03:53,440 Speaker 2: dangerous Streptococcus bacteria can cause a wide range of diseases, 61 00:03:53,560 --> 00:03:56,000 Speaker 2: and while strep is believed to have been one of 62 00:03:56,040 --> 00:03:59,880 Speaker 2: the most frequent causes of infectious diseases in prehistoric times, 63 00:04:00,320 --> 00:04:03,720 Speaker 2: it's not clear when exactly it started causing scarlet fever. 64 00:04:04,360 --> 00:04:07,240 Speaker 2: This is because strap only causes scarlet fever when it's 65 00:04:07,280 --> 00:04:10,600 Speaker 2: been infected with a bacteria phage that's a virus that 66 00:04:10,680 --> 00:04:15,040 Speaker 2: infects bacteria. The bacteria phage causes the bacteria to produce 67 00:04:15,160 --> 00:04:18,599 Speaker 2: a toxin, and scarlet fever is the body's response to 68 00:04:18,720 --> 00:04:22,640 Speaker 2: that toxin. It's likely that there were strains of Streptococcus 69 00:04:22,680 --> 00:04:25,719 Speaker 2: present in much of the world prior to the fifteenth century, 70 00:04:26,040 --> 00:04:29,640 Speaker 2: but that scarlet fever specifically was introduced to some places 71 00:04:29,720 --> 00:04:35,799 Speaker 2: during colonization, including the Americas, Australia, and New Zealand. Scarlet 72 00:04:35,800 --> 00:04:39,039 Speaker 2: fever is most common in children, and there are just 73 00:04:39,320 --> 00:04:43,080 Speaker 2: a lot of childhood diseases that can cause similar symptoms, 74 00:04:43,160 --> 00:04:45,520 Speaker 2: so a lot of the time it's not really possible 75 00:04:45,560 --> 00:04:48,679 Speaker 2: to tell whether an early medical text or other writing 76 00:04:49,200 --> 00:04:52,760 Speaker 2: is referencing scarlet fever or some other disease that causes 77 00:04:52,800 --> 00:04:55,599 Speaker 2: some combination of like a fever, sore, throat, rash, and 78 00:04:55,680 --> 00:05:00,839 Speaker 2: other symptoms. There are references to various childhood fevers and rashes, 79 00:05:00,880 --> 00:05:04,279 Speaker 2: and medical texts from the Mediterranean, the Middle East, and Asia, 80 00:05:04,400 --> 00:05:06,760 Speaker 2: going all the way back to Hippocrates in the fourth 81 00:05:06,800 --> 00:05:10,320 Speaker 2: century BCE. We don't really have a way of knowing 82 00:05:10,360 --> 00:05:13,560 Speaker 2: whether any of them were talking about scarlet fever, or 83 00:05:13,600 --> 00:05:18,600 Speaker 2: even if scarlet fever really existed. Yet accounts describing scarlet 84 00:05:18,600 --> 00:05:21,640 Speaker 2: fever as a distinct illness started to develop in the 85 00:05:21,680 --> 00:05:27,080 Speaker 2: sixteenth century. Giovanni Philippo Ingracias was a physician born in Sicily, 86 00:05:27,400 --> 00:05:29,920 Speaker 2: and in fifteen fifty three he described an illness that 87 00:05:30,040 --> 00:05:33,960 Speaker 2: he called rosalia. He specified that this was not the 88 00:05:34,000 --> 00:05:36,680 Speaker 2: same thing as chicken pox or measles, and that it 89 00:05:36,800 --> 00:05:41,239 Speaker 2: involved quote numerous spots, large and small, fiery and red 90 00:05:41,360 --> 00:05:45,000 Speaker 2: of universal distribution, so that the whole body appeared to 91 00:05:45,040 --> 00:05:49,760 Speaker 2: be on fire. In fifteen sixty five, Dutch physician Johann 92 00:05:49,760 --> 00:05:53,680 Speaker 2: Bayer described something similar and added another detail, which was 93 00:05:53,800 --> 00:05:57,840 Speaker 2: a severe sore throat. Then, in fifteen seventy eight, Jean 94 00:05:57,960 --> 00:06:03,040 Speaker 2: Katyer of Poitier described an illness causing quote general weariness, headache, 95 00:06:03,120 --> 00:06:07,520 Speaker 2: redness of the eyes, sore throat, and fever. Pirpura appeared 96 00:06:07,600 --> 00:06:11,000 Speaker 2: on the second or third day, accompanied by delirium and 97 00:06:11,080 --> 00:06:14,640 Speaker 2: soreness of the throat. Purpura is a rash that's caused 98 00:06:14,640 --> 00:06:17,279 Speaker 2: by the breaking of small blood vessels underneath the skin. 99 00:06:18,160 --> 00:06:22,200 Speaker 2: In sixteen thirty five, German physician Daniel Senner described an 100 00:06:22,240 --> 00:06:26,680 Speaker 2: epidemic in Viittenberg in which the skin later desquamated or peeled, 101 00:06:27,080 --> 00:06:31,080 Speaker 2: something that often happens in cases of scarlet fever. Centern 102 00:06:31,160 --> 00:06:35,800 Speaker 2: also described other complications that can follow scarlet fever, including edema, 103 00:06:36,279 --> 00:06:40,479 Speaker 2: fluid in the abdomen, and arthritis. Scarlet fever was showing 104 00:06:40,560 --> 00:06:43,800 Speaker 2: up in writings outside of the medical world as well. 105 00:06:44,360 --> 00:06:47,000 Speaker 2: Samuel Peeps, who comes up so often on the show 106 00:06:47,040 --> 00:06:50,039 Speaker 2: when we're talking about this period of history, wrote this 107 00:06:50,120 --> 00:06:53,560 Speaker 2: in his diary on November tenth, sixteen sixty four, quote 108 00:06:53,839 --> 00:06:57,120 Speaker 2: my little Girlie Susan is fallen, sick of the measles 109 00:06:57,160 --> 00:07:00,839 Speaker 2: we fear or at least of a scarlet fever. This 110 00:07:00,960 --> 00:07:03,360 Speaker 2: seemed to pass pretty quickly. The next day he wrote, quote, 111 00:07:03,360 --> 00:07:06,919 Speaker 2: our little girl is better than she was yesterday. Scarlet 112 00:07:06,960 --> 00:07:09,760 Speaker 2: fever as a term was in common use in English 113 00:07:09,840 --> 00:07:13,800 Speaker 2: at this point, as was the name scarletina. The first 114 00:07:13,920 --> 00:07:17,120 Speaker 2: use of the term scarlatina in medical literature is believed 115 00:07:17,120 --> 00:07:21,360 Speaker 2: to be in sixteen seventy four. English physician Thomas Sydenham 116 00:07:21,560 --> 00:07:26,280 Speaker 2: wrote Medical Observations on the History and Treatment of Acute Diseases, 117 00:07:26,320 --> 00:07:29,720 Speaker 2: which was published in Latin, and in it he described 118 00:07:29,840 --> 00:07:34,480 Speaker 2: febri scarlatina this way quote scarlet fever may appear at 119 00:07:34,520 --> 00:07:38,120 Speaker 2: any season. Nevertheless, it often breaks out toward the end 120 00:07:38,120 --> 00:07:41,520 Speaker 2: of summer, when it attacks whole families at once, and 121 00:07:41,600 --> 00:07:45,440 Speaker 2: more especially the infant part of them. The patient feel 122 00:07:45,600 --> 00:07:48,840 Speaker 2: riggers and shivering, just as they do in other fevers. 123 00:07:49,320 --> 00:07:53,600 Speaker 2: The symptoms, however, are moderate. Afterwards, however, the whole skin 124 00:07:53,680 --> 00:07:57,760 Speaker 2: becomes covered with small red maculae thicker than those of measles, 125 00:07:57,800 --> 00:08:02,040 Speaker 2: as well as broader and redder and uniform. These last 126 00:08:02,080 --> 00:08:05,560 Speaker 2: for two or three days and then disappear. The cuticle 127 00:08:05,640 --> 00:08:08,960 Speaker 2: peels off and branny scales remain lying on the surface 128 00:08:09,080 --> 00:08:13,400 Speaker 2: like meal. They appear and disappear two or three times. 129 00:08:14,280 --> 00:08:17,280 Speaker 2: So this was before the development of the germ theory 130 00:08:17,280 --> 00:08:20,720 Speaker 2: of disease, and Sydenham believed that this was caused by 131 00:08:20,880 --> 00:08:24,680 Speaker 2: quote a moderate effervescence of the blood arising from the 132 00:08:24,680 --> 00:08:29,120 Speaker 2: heat of the preceding summer or from some other exciting cause. 133 00:08:29,920 --> 00:08:33,360 Speaker 2: This made him cautious of using blood letting or enemas 134 00:08:33,400 --> 00:08:35,760 Speaker 2: to treat the patient, which is something that would have 135 00:08:35,760 --> 00:08:39,080 Speaker 2: happened with other illnesses. He believed that the blood needed 136 00:08:39,120 --> 00:08:42,439 Speaker 2: to be left to its own regulation in cases of 137 00:08:42,480 --> 00:08:46,080 Speaker 2: scarlet fever, and that blood letting or anemas could introduce 138 00:08:46,160 --> 00:08:50,000 Speaker 2: particles into the blood that were harmful to it. Instead, 139 00:08:50,160 --> 00:08:52,720 Speaker 2: he said it was quote sufficient for the patient to 140 00:08:52,800 --> 00:08:56,840 Speaker 2: abstain wholly from animal food and from fermented liquors, to 141 00:08:56,960 --> 00:09:00,640 Speaker 2: keep always indoors, and not to keep always in his bed. 142 00:09:00,800 --> 00:09:03,960 Speaker 2: When the desclamation is complete, and when the symptoms are departing, 143 00:09:04,040 --> 00:09:07,040 Speaker 2: I consider it proper to purge the patient with some 144 00:09:07,200 --> 00:09:11,600 Speaker 2: mild laxative accommodated to his age and strength. So at 145 00:09:11,600 --> 00:09:14,439 Speaker 2: the same time, he noted that if a child experienced 146 00:09:14,559 --> 00:09:17,760 Speaker 2: seizures or a coma, then they needed to be treated 147 00:09:17,840 --> 00:09:20,280 Speaker 2: immediately with a blister on the back of the neck 148 00:09:20,320 --> 00:09:24,640 Speaker 2: and a dose of opium tincture. Sydenham recommended repeating this 149 00:09:24,840 --> 00:09:28,240 Speaker 2: every night until the patient had recovered, and feeding them 150 00:09:28,320 --> 00:09:33,040 Speaker 2: diluted milk, but again not animal food. So these descriptions 151 00:09:33,080 --> 00:09:36,920 Speaker 2: of this illness don't sound really pleasant, and both Sydonym 152 00:09:37,000 --> 00:09:41,080 Speaker 2: and Center described complications and more serious cases, But like 153 00:09:41,760 --> 00:09:45,120 Speaker 2: none of this sounds nearly as frightening as scarlet fever became. 154 00:09:45,200 --> 00:09:47,920 Speaker 2: In the nineteenth century, Samuel Peeps made it sound like 155 00:09:48,040 --> 00:09:51,959 Speaker 2: scarlet fever was like a lesser illness than measles would 156 00:09:51,960 --> 00:09:55,600 Speaker 2: have been. Became much worse later on, and we'll get 157 00:09:55,600 --> 00:09:57,439 Speaker 2: to that after a sponsor break. 158 00:10:06,720 --> 00:10:06,960 Speaker 1: Through. 159 00:10:07,000 --> 00:10:11,720 Speaker 2: The seventeenth and eighteenth centuries, scarlet fever epidemics occurred regularly 160 00:10:11,880 --> 00:10:15,800 Speaker 2: in Europe, with the disease often striking a particular place 161 00:10:16,040 --> 00:10:19,160 Speaker 2: every four to six years. That same general pattern seems 162 00:10:19,200 --> 00:10:23,000 Speaker 2: to have been present in other places also. In the 163 00:10:23,000 --> 00:10:26,439 Speaker 2: eighteen twenties and thirties, though, the number of scarlet fever 164 00:10:26,520 --> 00:10:29,840 Speaker 2: cases really started to rise in a lot of places, 165 00:10:29,880 --> 00:10:34,439 Speaker 2: and so did their severity. There are several possible explanations 166 00:10:34,440 --> 00:10:37,400 Speaker 2: for why, and it's possible that all of them played 167 00:10:37,400 --> 00:10:41,840 Speaker 2: some kind of role. Nineteenth Century urbanization led to more 168 00:10:41,920 --> 00:10:46,839 Speaker 2: people living in closer quarters, often without sufficient facilities for hygiene, 169 00:10:47,240 --> 00:10:50,280 Speaker 2: which made it easier for a contagious illness like scarlet 170 00:10:50,280 --> 00:10:54,600 Speaker 2: fever to spread. But that can't account for everything, since 171 00:10:54,640 --> 00:10:58,880 Speaker 2: scarlet fever cases started increasing before this trend really started 172 00:10:58,920 --> 00:11:03,240 Speaker 2: to escalate. Some researchers have found a correlation between scarlet 173 00:11:03,240 --> 00:11:06,959 Speaker 2: fever and wheat prices. When wheat prices rose, there was 174 00:11:07,000 --> 00:11:10,280 Speaker 2: an increase in scarlet fever three years later, as though 175 00:11:10,280 --> 00:11:14,520 Speaker 2: malnutrition during pregnancy might make children more susceptible to it. 176 00:11:15,520 --> 00:11:18,720 Speaker 2: This is a correlation, though it's not necessarily a cause 177 00:11:18,720 --> 00:11:21,800 Speaker 2: and effect situation, and it is also possible that a 178 00:11:21,800 --> 00:11:24,600 Speaker 2: more virulent form of the disease evolved, which allowed it 179 00:11:24,640 --> 00:11:29,160 Speaker 2: to spread more easily and cause worse illnesses. Scarlet fever 180 00:11:29,320 --> 00:11:32,079 Speaker 2: was also introduced into parts of the world that had 181 00:11:32,120 --> 00:11:36,080 Speaker 2: never encountered it before during the nineteenth century. The first 182 00:11:36,160 --> 00:11:39,480 Speaker 2: case of scarlet fever in the archipelago of Madeira was 183 00:11:39,480 --> 00:11:43,040 Speaker 2: reported in eighteen oh six. They reached South America in 184 00:11:43,080 --> 00:11:47,280 Speaker 2: eighteen twenty nine, Greenland in eighteen forty seven, and both 185 00:11:47,320 --> 00:11:51,320 Speaker 2: Australia and New Zealand in eighteen forty eight. Although scarlet 186 00:11:51,360 --> 00:11:55,559 Speaker 2: fever had been reported in the northeastern United States for centuries, 187 00:11:55,679 --> 00:12:00,920 Speaker 2: the first case reported in California wasn't until eighteen forty nine. 188 00:12:01,080 --> 00:12:04,840 Speaker 2: Some sources will describe the nineteenth century spread of scarlet 189 00:12:04,880 --> 00:12:08,480 Speaker 2: fever as a pandemic stretching from about eighteen twenty five 190 00:12:08,559 --> 00:12:12,439 Speaker 2: to eighteen eighty five. Death rates could really vary from 191 00:12:12,520 --> 00:12:15,280 Speaker 2: place to place and from one outbreak to the next. 192 00:12:15,840 --> 00:12:18,840 Speaker 2: In places that had no experience with scarlet fever, the 193 00:12:18,880 --> 00:12:22,640 Speaker 2: mortality rate was often particularly high. As we said a 194 00:12:22,679 --> 00:12:25,439 Speaker 2: moment ago, the first cases reported in New Zealand were 195 00:12:25,440 --> 00:12:28,640 Speaker 2: in eighteen forty eight, and in Auckland that year one 196 00:12:28,760 --> 00:12:32,440 Speaker 2: out of every eight people who contracted scarlet fever died. 197 00:12:33,240 --> 00:12:35,800 Speaker 2: The vast majority of cases and deaths were in children 198 00:12:35,840 --> 00:12:38,280 Speaker 2: between the ages of two and ten, and no one 199 00:12:38,320 --> 00:12:40,400 Speaker 2: over the age of forty seemed to catch it at all. 200 00:12:41,200 --> 00:12:44,440 Speaker 2: The worst cases seemed to be in crowded or badly 201 00:12:44,520 --> 00:12:49,240 Speaker 2: ventilated homes. There's not a ton of exact data, though, 202 00:12:50,000 --> 00:12:52,880 Speaker 2: especially in the earlier decades of the eighteen hundreds, a 203 00:12:52,920 --> 00:12:56,040 Speaker 2: lot of places didn't have formal departments of health or 204 00:12:56,080 --> 00:13:00,720 Speaker 2: public health services. Widespread outbreaks of scarlet fef and other 205 00:13:00,760 --> 00:13:03,800 Speaker 2: contagious diseases were part of the motivation for those to 206 00:13:03,800 --> 00:13:07,880 Speaker 2: be established. In some places, there were laws in place 207 00:13:07,960 --> 00:13:10,920 Speaker 2: to try to control the spread of infectious diseases, and 208 00:13:10,960 --> 00:13:13,080 Speaker 2: a lot of those laws traced back to things like 209 00:13:13,400 --> 00:13:16,200 Speaker 2: the Black Death of the fourteenth century, but a lot 210 00:13:16,200 --> 00:13:19,680 Speaker 2: of the time there just wasn't a more systematic tracking 211 00:13:19,720 --> 00:13:24,719 Speaker 2: of diseases and their spread. However, it's generally agreed that 212 00:13:24,760 --> 00:13:28,800 Speaker 2: by eighteen forty, scarlet fever was a leading cause of 213 00:13:28,880 --> 00:13:31,800 Speaker 2: childhood death in the United States and parts of Europe, 214 00:13:32,240 --> 00:13:37,560 Speaker 2: possibly the leading cause of death and children during widespread outbreaks. 215 00:13:37,600 --> 00:13:39,200 Speaker 1: Throughout the nineteenth century. 216 00:13:39,480 --> 00:13:44,760 Speaker 2: Scarlet fever was terrifying. Communities often used isolation and quarantined 217 00:13:44,840 --> 00:13:48,040 Speaker 2: to try to control the diseases spread, along with things 218 00:13:48,120 --> 00:13:53,800 Speaker 2: like canceling school and public gatherings, recommending ventilation and disinfection procedures, 219 00:13:53,840 --> 00:13:56,880 Speaker 2: and urging people to keep children at home and away 220 00:13:56,960 --> 00:14:02,000 Speaker 2: from other people, especially other children. The increasing spread of 221 00:14:02,040 --> 00:14:05,480 Speaker 2: scarlet fever also led to researchers learning more about it. 222 00:14:06,000 --> 00:14:10,599 Speaker 2: English physician Richard Bright made the connection between streptococcus infections 223 00:14:10,640 --> 00:14:14,560 Speaker 2: and kidney disease in eighteen thirty six. Bright was one 224 00:14:14,559 --> 00:14:18,000 Speaker 2: of the first people to describe nephritis or kidney inflammation, 225 00:14:18,080 --> 00:14:21,320 Speaker 2: which came to be known as Bright's disease, and he 226 00:14:21,400 --> 00:14:25,400 Speaker 2: wrote of it quote scarletina has apparently laid the foundation 227 00:14:25,520 --> 00:14:30,880 Speaker 2: for the future mischief, so Scarlatina later causing nephritis, although 228 00:14:31,400 --> 00:14:33,960 Speaker 2: his next sentence went on to say, quote exertion and 229 00:14:34,040 --> 00:14:38,240 Speaker 2: childish plays has done the same. So just some questions 230 00:14:38,240 --> 00:14:40,280 Speaker 2: about that. Don't let your kids play too hard. 231 00:14:40,840 --> 00:14:42,880 Speaker 1: Yeah, they might have kidney disease later. 232 00:14:43,880 --> 00:14:47,160 Speaker 2: Although people didn't know exactly what caused scarlet fever yet, 233 00:14:47,520 --> 00:14:50,480 Speaker 2: they did know that it spread easily from person to person, 234 00:14:51,360 --> 00:14:54,120 Speaker 2: so much so that people thought that the disease could 235 00:14:54,200 --> 00:14:57,280 Speaker 2: linger on things like clothing, bedding, and toys for a 236 00:14:57,320 --> 00:15:01,760 Speaker 2: long period of time. And in eighteen six, doctor Michael Taylor, 237 00:15:01,840 --> 00:15:05,400 Speaker 2: who was a local physician in northwestern England, connected a 238 00:15:05,440 --> 00:15:10,040 Speaker 2: scarlet fever outbreak to milk. At this point, Louis Pester 239 00:15:10,240 --> 00:15:12,600 Speaker 2: had done groundbreaking work on what would come to be 240 00:15:12,680 --> 00:15:15,880 Speaker 2: known as pasteurization, but he was doing this work in 241 00:15:15,920 --> 00:15:19,480 Speaker 2: the context of fermentation. The idea that milk should be 242 00:15:19,480 --> 00:15:24,120 Speaker 2: pasteurized that was still decades away. Taylor knew about the 243 00:15:24,160 --> 00:15:27,480 Speaker 2: work of doctor John Snow, who had identified a water 244 00:15:27,600 --> 00:15:30,240 Speaker 2: pump as the source of a cholera outbreak in eighteen 245 00:15:30,360 --> 00:15:34,520 Speaker 2: fifty four. Taylor had thought that if water could carry 246 00:15:34,520 --> 00:15:38,120 Speaker 2: a disease, then surely milk could as well, and he 247 00:15:38,200 --> 00:15:42,760 Speaker 2: had later traced a typhoid outbreak to contaminated milk. In 248 00:15:42,800 --> 00:15:46,680 Speaker 2: eighteen sixty seven, people started reporting cases of scarlet fever 249 00:15:46,960 --> 00:15:49,640 Speaker 2: in and around the town of Penrith, which had not 250 00:15:49,800 --> 00:15:52,480 Speaker 2: seen a case of scarlet fever in more than a year. 251 00:15:53,400 --> 00:15:55,600 Speaker 2: It turned out that the people who got sick had 252 00:15:55,720 --> 00:15:59,600 Speaker 2: all bought milk from the same milk dealer whose child 253 00:15:59,640 --> 00:16:03,400 Speaker 2: had got in scarlet fever and died. In eighteen seventy four, 254 00:16:03,560 --> 00:16:08,720 Speaker 2: Theeodor Bilroth of Austria identified and named the Streptococcus bacterium, 255 00:16:08,960 --> 00:16:11,560 Speaker 2: which he had found in infected wounds and in a 256 00:16:11,600 --> 00:16:16,080 Speaker 2: case of a skin infection called erysipellus. He had observed 257 00:16:16,160 --> 00:16:20,440 Speaker 2: quote small organisms as found in either isolated or arranged 258 00:16:20,480 --> 00:16:24,360 Speaker 2: in pairs, sometimes in chains, and he named them for 259 00:16:24,400 --> 00:16:28,560 Speaker 2: the Greek terms strepto or chain and caucus or barry. 260 00:16:29,400 --> 00:16:33,160 Speaker 2: Five years later, Louis Paster isolated the same organism in 261 00:16:33,200 --> 00:16:36,320 Speaker 2: the uterus and bloodstream of a number of patients with 262 00:16:36,480 --> 00:16:41,680 Speaker 2: child bed fever. Then, in eighteen eighty four, microbiologist Friedrich 263 00:16:41,760 --> 00:16:47,320 Speaker 2: Julius Rosenbach refined the organism's name to Streptococcus pyogenes, with 264 00:16:47,400 --> 00:16:52,240 Speaker 2: pyogenes from Greek words meaning pus forming. It did not 265 00:16:52,400 --> 00:16:56,000 Speaker 2: take long for the connections to be made between Streptococcus 266 00:16:56,000 --> 00:17:00,560 Speaker 2: piogenes and scarlet fever. In eighteen eighty seven, doctor Emmanual 267 00:17:00,640 --> 00:17:03,520 Speaker 2: Klein published a report in the Proceedings of the Royal 268 00:17:03,600 --> 00:17:07,520 Speaker 2: Society of London saying that he had identified the Streptococcus 269 00:17:07,640 --> 00:17:12,439 Speaker 2: organism in both people with acute scarletina in London and 270 00:17:12,720 --> 00:17:16,480 Speaker 2: cows at a milk farm in Hendon, so he believed 271 00:17:16,520 --> 00:17:19,119 Speaker 2: that the milk from the Hendon farm had caused the 272 00:17:19,160 --> 00:17:23,719 Speaker 2: scarlet fever outbreak in London. This report was the result 273 00:17:23,800 --> 00:17:27,359 Speaker 2: of years of work. Klein was a bacteriologist who had 274 00:17:27,400 --> 00:17:30,600 Speaker 2: been born in Hungary and studied in Austria before moving 275 00:17:30,600 --> 00:17:33,200 Speaker 2: to England to work as a researcher at the Brown 276 00:17:33,320 --> 00:17:37,520 Speaker 2: Institution of the University of London. His scarlet fever research 277 00:17:37,560 --> 00:17:40,720 Speaker 2: had included post mortem examinations of children who had died 278 00:17:40,760 --> 00:17:44,000 Speaker 2: of it, and he had spotted similar pathological changes in 279 00:17:44,160 --> 00:17:48,639 Speaker 2: cows that he examined at the Hendon farm. This wasn't 280 00:17:48,760 --> 00:17:52,440 Speaker 2: just a matter of observing the similarities in the sick cows, 281 00:17:52,520 --> 00:17:55,719 Speaker 2: and the sick children. He followed the criteria that at 282 00:17:55,720 --> 00:17:58,720 Speaker 2: that point had been outlined by Robert Koch now known 283 00:17:58,720 --> 00:18:02,840 Speaker 2: as Coke's postulates, to show that the same bacteria were 284 00:18:02,960 --> 00:18:06,119 Speaker 2: causing both the illness in the cows and in the 285 00:18:06,119 --> 00:18:09,800 Speaker 2: people who had drank their milk. He also had shown 286 00:18:09,880 --> 00:18:13,760 Speaker 2: that the bacteria he cultured from the sick cows could 287 00:18:13,800 --> 00:18:18,720 Speaker 2: grow and survive and basically thrive in milk. They called 288 00:18:18,720 --> 00:18:23,520 Speaker 2: this organism Micrococcus scarletine. Although it was indistinguishable from the 289 00:18:23,520 --> 00:18:29,080 Speaker 2: one previously named Streptococcus pyogenes. This was an important discovery, 290 00:18:29,240 --> 00:18:32,399 Speaker 2: although he was using a different name for it. Klein 291 00:18:32,560 --> 00:18:36,720 Speaker 2: was the first person to connect Streptococcus pyogenes to scarlet fever, 292 00:18:37,480 --> 00:18:41,360 Speaker 2: but his results were not widely accepted. Since Michael Taylor's 293 00:18:41,359 --> 00:18:44,680 Speaker 2: discovery in eighteen sixty seven, there had been other scarlet 294 00:18:44,760 --> 00:18:48,000 Speaker 2: fever outbreaks traced to milk, and most of the time 295 00:18:48,200 --> 00:18:52,080 Speaker 2: milk from the affected dairy had been destroyed, but most 296 00:18:52,119 --> 00:18:55,560 Speaker 2: people had thought these outbreaks had a human source, like 297 00:18:55,680 --> 00:18:58,800 Speaker 2: a child who lived on the farm, or a dairy worker, 298 00:18:59,040 --> 00:19:01,560 Speaker 2: or a delivery world who had cared for a child 299 00:19:01,600 --> 00:19:06,040 Speaker 2: with scarlet fever or someone who had it themselves. Taylor 300 00:19:06,119 --> 00:19:08,720 Speaker 2: had showed that the cows could carry the disease, which 301 00:19:08,760 --> 00:19:11,159 Speaker 2: could mean that destroying the milk was not enough to 302 00:19:11,160 --> 00:19:14,359 Speaker 2: stop an outbreak, that the cows themselves might have to 303 00:19:14,400 --> 00:19:19,560 Speaker 2: be culled. Destroying potentially contaminated milk was a financial hardship 304 00:19:19,600 --> 00:19:23,520 Speaker 2: for dairy farms, but destroying their cows was far worse, 305 00:19:23,600 --> 00:19:26,480 Speaker 2: and people resisted the idea that cows could be a 306 00:19:26,520 --> 00:19:30,320 Speaker 2: source of infection, although a few people had tried applying 307 00:19:30,359 --> 00:19:34,800 Speaker 2: Louis Passenger's heat treatment process to milk almost twenty more 308 00:19:34,920 --> 00:19:40,359 Speaker 2: years past before German agricultural chemists Franz von Suchslet suggested 309 00:19:40,359 --> 00:19:44,639 Speaker 2: that milk be routinely treated with pastorization, and a big 310 00:19:44,800 --> 00:19:48,280 Speaker 2: reason for that was that so many diseases were being 311 00:19:48,359 --> 00:19:54,560 Speaker 2: transmitted through milk, not just scarlet fever, but also typhoid, diphtheria, tuberculosis, 312 00:19:54,600 --> 00:19:58,840 Speaker 2: and various gastrointestinal illnesses. It still took a while for 313 00:19:58,880 --> 00:20:02,800 Speaker 2: pastorization to catch on, though there were concerns that pasteurizing 314 00:20:02,840 --> 00:20:05,840 Speaker 2: milk destroyed the nutrients in it, or affected the flavor, 315 00:20:05,960 --> 00:20:09,400 Speaker 2: or made it harder to digest, but by that point 316 00:20:09,520 --> 00:20:12,840 Speaker 2: scarlet fever rates were on the decline, and we'll talk 317 00:20:12,880 --> 00:20:24,920 Speaker 2: more about that after a sponsor break. Although the number 318 00:20:24,920 --> 00:20:27,800 Speaker 2: of scarlet fever cases was declining at the end of 319 00:20:27,800 --> 00:20:30,600 Speaker 2: the nineteenth century and the disease didn't seem to be 320 00:20:30,720 --> 00:20:34,440 Speaker 2: as deadly as it had been in the early twentieth century, 321 00:20:34,440 --> 00:20:37,480 Speaker 2: it was still seen as a major public health concern. 322 00:20:38,200 --> 00:20:39,000 Speaker 1: In England. 323 00:20:39,119 --> 00:20:43,200 Speaker 2: For example, isolation hospitals were established for people with contagious 324 00:20:43,240 --> 00:20:47,520 Speaker 2: illnesses who could not effectively be isolated at home. During 325 00:20:47,560 --> 00:20:50,320 Speaker 2: outbreaks of scarlet fever. There could be house to house 326 00:20:50,480 --> 00:20:53,800 Speaker 2: visits to find sick people so they could be isolated 327 00:20:53,840 --> 00:20:57,520 Speaker 2: in the hospital. Unfortunately, it is really not clear how 328 00:20:57,640 --> 00:21:00,560 Speaker 2: much or whether this really helped slow the spread of 329 00:21:00,560 --> 00:21:04,960 Speaker 2: the disease. And also people with different contagious diseases were 330 00:21:04,960 --> 00:21:08,280 Speaker 2: all being housed in the same hospitals, and this led 331 00:21:08,280 --> 00:21:10,760 Speaker 2: people to say that the isolation hospital was where you 332 00:21:10,840 --> 00:21:12,960 Speaker 2: went when you caught one disease, so that you could 333 00:21:13,000 --> 00:21:17,159 Speaker 2: come out with all the rest. Welcome to Petri dish Arms. 334 00:21:18,920 --> 00:21:23,520 Speaker 2: You'll get a bed and probably seven different things. That's 335 00:21:23,600 --> 00:21:26,760 Speaker 2: not great, no good. Other efforts to control the spread 336 00:21:26,760 --> 00:21:30,480 Speaker 2: of scarlet fever also did not help a nineteen fifteen 337 00:21:30,560 --> 00:21:33,640 Speaker 2: article in the American Journal of Nursing described it this way, 338 00:21:33,960 --> 00:21:37,400 Speaker 2: quote it seems to cling to whatever object it encounters. 339 00:21:37,760 --> 00:21:41,240 Speaker 2: In no other disease has the infection been apparently conveyed 340 00:21:41,560 --> 00:21:44,600 Speaker 2: with such frequency by objects which have come in contact 341 00:21:44,880 --> 00:21:48,199 Speaker 2: with those ill as clothes, books, toys, and the like. 342 00:21:49,000 --> 00:21:52,720 Speaker 2: This article recommended that quote all hangings, carpets, and upholstered 343 00:21:52,760 --> 00:21:55,320 Speaker 2: furniture are to be taken from the room before the 344 00:21:55,320 --> 00:21:58,720 Speaker 2: patient is brought in. The furniture left should be of 345 00:21:58,760 --> 00:22:02,240 Speaker 2: a kind readily clem. There should be no such fancied 346 00:22:02,240 --> 00:22:05,240 Speaker 2: attempts at purifying the air as by hanging up sheets 347 00:22:05,520 --> 00:22:09,600 Speaker 2: wet with disinfectants. Such measures are not only useless, but 348 00:22:09,680 --> 00:22:13,280 Speaker 2: tend to give a false sense of security. Needless to say, 349 00:22:13,320 --> 00:22:18,320 Speaker 2: the patient should be provided with bedclothing, nightgown towels, eating utensils, 350 00:22:18,320 --> 00:22:23,199 Speaker 2: and drinking vessels for his exclusive use. Yeah, it is 351 00:22:23,320 --> 00:22:27,760 Speaker 2: no longer believed that scarlet fever is just transmitted readily 352 00:22:27,800 --> 00:22:30,840 Speaker 2: and for a long period of time in things like curtains. 353 00:22:32,520 --> 00:22:36,280 Speaker 2: This article also recommended disinfecting anything that the sick person 354 00:22:36,320 --> 00:22:39,520 Speaker 2: had used, using either a five percent solution of carbolic 355 00:22:39,560 --> 00:22:43,200 Speaker 2: acid or a two percent solution of creosol, and anything 356 00:22:43,240 --> 00:22:46,679 Speaker 2: that had been used for coughing or sneezing into was 357 00:22:46,760 --> 00:22:51,240 Speaker 2: to be burned. Also, the recommended treatment for patients themselves 358 00:22:51,359 --> 00:22:54,280 Speaker 2: was at least three weeks in bed, even if they 359 00:22:54,359 --> 00:22:58,399 Speaker 2: only had a mild case. Around this same time, people 360 00:22:58,440 --> 00:23:01,760 Speaker 2: were making more discoveries about scarlet fever, something that really 361 00:23:01,920 --> 00:23:06,040 Speaker 2: escalated during the nineteen teens and twenties. In nineteen fifteen, 362 00:23:06,080 --> 00:23:10,160 Speaker 2: English bacteriologists Frederick William Twart and his brother were using 363 00:23:10,240 --> 00:23:12,760 Speaker 2: colonies of bacteria as part of an effort to find 364 00:23:12,760 --> 00:23:16,879 Speaker 2: a way to grow smallpox vaccine in a lab. Twart 365 00:23:16,920 --> 00:23:20,679 Speaker 2: discovered areas where the bacteria couldn't grow, and found that 366 00:23:20,720 --> 00:23:24,160 Speaker 2: a substance from these areas was capable of passing through 367 00:23:24,200 --> 00:23:28,439 Speaker 2: a porcelain filter that trapped most bacteria. He published an 368 00:23:28,520 --> 00:23:31,080 Speaker 2: article in The Lancet about what he described as a 369 00:23:31,080 --> 00:23:35,639 Speaker 2: filter passing virus that attacked bacteria. His work didn't get 370 00:23:35,680 --> 00:23:37,920 Speaker 2: a lot of attention, but this was the first known 371 00:23:37,920 --> 00:23:43,640 Speaker 2: description of a bacteria phase. French microbiologists Feligues Derrell made 372 00:23:43,680 --> 00:23:47,280 Speaker 2: the same discovery independently of torte about two years later 373 00:23:48,240 --> 00:23:51,600 Speaker 2: in the nineteen twenties, husband and wife researchers George and 374 00:23:51,680 --> 00:23:55,000 Speaker 2: Gladys Dick, made a series of discoveries about scarlet fever 375 00:23:55,080 --> 00:23:59,119 Speaker 2: and its cause. While working in Chicago. They confirmed the 376 00:23:59,240 --> 00:24:04,480 Speaker 2: link between the disease and Streptococcus bacteria, and they identified 377 00:24:04,520 --> 00:24:08,040 Speaker 2: a toxin produced by the bacteria that was the cause 378 00:24:08,080 --> 00:24:11,880 Speaker 2: of scarlet fever. They also developed a skin test known 379 00:24:11,920 --> 00:24:14,399 Speaker 2: as the Dick test to show whether a person was 380 00:24:14,480 --> 00:24:16,159 Speaker 2: susceptible to scarlet. 381 00:24:15,840 --> 00:24:16,600 Speaker 1: Fever or not. 382 00:24:17,400 --> 00:24:20,159 Speaker 2: They were nominated for the Nobel Prize in Medicine for 383 00:24:20,200 --> 00:24:24,160 Speaker 2: the sork in nineteen twenty five in nineteen twenty six. 384 00:24:24,200 --> 00:24:28,120 Speaker 2: In nineteen twenty seven, two different pairs of researchers discovered 385 00:24:28,119 --> 00:24:32,040 Speaker 2: a bacteria phase that could change a non toxogenic strain 386 00:24:32,080 --> 00:24:35,520 Speaker 2: of strap into a toxogenic one. In other words, to 387 00:24:35,600 --> 00:24:38,320 Speaker 2: turn a variety of strap that did not cause scarlet 388 00:24:38,359 --> 00:24:42,679 Speaker 2: fever into one that did. Various researchers started trying to 389 00:24:42,720 --> 00:24:46,760 Speaker 2: develop an inoculation for scarlet fever using either the bacteria 390 00:24:47,280 --> 00:24:51,159 Speaker 2: or various modifications of the toxin that it produced. In 391 00:24:51,240 --> 00:24:55,960 Speaker 2: nineteen twenty eight, American microbiologist Rebecca Craighill Lancefield developed a 392 00:24:55,960 --> 00:25:00,639 Speaker 2: system for classifying strep bacteria into groups based on the 393 00:25:00,760 --> 00:25:05,480 Speaker 2: antigens found on the bacteria. Initially, she proposed two groups, 394 00:25:05,560 --> 00:25:08,440 Speaker 2: group A and group B. As we said earlier, scarlet 395 00:25:08,480 --> 00:25:12,080 Speaker 2: fever is group A. Today there are many more groups. 396 00:25:12,680 --> 00:25:15,360 Speaker 2: She was also one of the first people to demonstrate 397 00:25:15,440 --> 00:25:19,959 Speaker 2: that strep infections could lead to rheumatic fever. The first 398 00:25:20,080 --> 00:25:22,959 Speaker 2: SULFA drugs were developed in the nineteen thirties and were 399 00:25:23,040 --> 00:25:26,399 Speaker 2: used as a treatment for strep infections, including scarlet fever. 400 00:25:27,119 --> 00:25:30,679 Speaker 2: But the big medical breakthrough was penicillin. We did a 401 00:25:30,680 --> 00:25:35,760 Speaker 2: whole episode on penicillins development back in September. Today, penicillin 402 00:25:35,840 --> 00:25:39,359 Speaker 2: and amoxicillin are the antibiotics most often used to treat 403 00:25:39,400 --> 00:25:42,919 Speaker 2: scarlet fever, with other antibiotics recommended for people who are 404 00:25:42,960 --> 00:25:47,320 Speaker 2: allergic to those. Today, in most children, scarlet fever clears 405 00:25:47,400 --> 00:25:51,600 Speaker 2: up quickly as long as antibiotic treatment begins promptly, and 406 00:25:51,720 --> 00:25:55,480 Speaker 2: that made the amoxicillin shortages that were happening at the 407 00:25:55,600 --> 00:25:58,040 Speaker 2: end of last year in a lot of places particularly 408 00:25:58,080 --> 00:26:03,280 Speaker 2: scary for folks. Penicillin is often credited with turning scarlet 409 00:26:03,280 --> 00:26:06,480 Speaker 2: fever from a terrifying and deadly disease to one that's 410 00:26:06,520 --> 00:26:09,960 Speaker 2: considered to be a relatively mild childhood illness most of 411 00:26:09,960 --> 00:26:13,760 Speaker 2: the time. As we said earlier, though deaths from scarlet 412 00:26:13,760 --> 00:26:17,840 Speaker 2: fever were becoming less and less common decades before penicillin 413 00:26:17,960 --> 00:26:22,919 Speaker 2: was introduced, we don't totally know why. Starting in the 414 00:26:22,960 --> 00:26:26,640 Speaker 2: nineteen eighties, though, the opposite started to happen, as invasive 415 00:26:26,760 --> 00:26:30,560 Speaker 2: strep infections started to become more common in spite of 416 00:26:30,600 --> 00:26:35,120 Speaker 2: the existence of antibiotics to treat them. Scarlet fever specifically 417 00:26:35,160 --> 00:26:37,440 Speaker 2: started to become more prevalent in a lot of parts 418 00:26:37,480 --> 00:26:40,080 Speaker 2: of the world starting in about two thousand and eight. 419 00:26:40,840 --> 00:26:43,800 Speaker 2: Increased rates of scarlet fever were first reported in parts 420 00:26:43,840 --> 00:26:46,119 Speaker 2: of Asia, and then in the UK and other parts 421 00:26:46,160 --> 00:26:49,920 Speaker 2: of Europe, and then in the US. The UK, for example, 422 00:26:50,040 --> 00:26:53,560 Speaker 2: saw a sudden spike in scarlet fever cases starting in 423 00:26:53,600 --> 00:26:56,920 Speaker 2: twenty fifteen, and soon the rate of scarlet fever was 424 00:26:57,000 --> 00:26:59,680 Speaker 2: higher there than it had been in almost fifty years. 425 00:27:00,280 --> 00:27:02,760 Speaker 2: At first, it seemed like this wasn't leading to a 426 00:27:02,800 --> 00:27:07,080 Speaker 2: similar increase in fatalities, but a year later, invasive strep 427 00:27:07,119 --> 00:27:09,359 Speaker 2: infection started to increase there as well. 428 00:27:10,200 --> 00:27:12,000 Speaker 1: Worldwide, there was a five. 429 00:27:11,960 --> 00:27:15,359 Speaker 2: Fold increase in the number of scarlet fever cases between 430 00:27:15,359 --> 00:27:18,600 Speaker 2: twenty eleven and twenty twenty, with a drop in twenty 431 00:27:18,640 --> 00:27:22,480 Speaker 2: twenty after the start of the COVID nineteen pandemic. Yeah 432 00:27:22,480 --> 00:27:26,160 Speaker 2: and a lot of places, the general trend of when 433 00:27:26,200 --> 00:27:29,280 Speaker 2: scarlet fever cases are the highest was like sort of 434 00:27:29,440 --> 00:27:33,520 Speaker 2: nearing its end when the COVID nineteen pandemic really started. 435 00:27:34,680 --> 00:27:38,560 Speaker 2: Although health officials thought there might be some more dangerous 436 00:27:38,800 --> 00:27:42,160 Speaker 2: strain of Strep. Bacteria that was causing this increase, some 437 00:27:42,280 --> 00:27:45,000 Speaker 2: whole genome sequencing of samples from a lot of different 438 00:27:45,040 --> 00:27:47,919 Speaker 2: sick children found that there was not one strain that 439 00:27:48,000 --> 00:27:51,399 Speaker 2: was responsible for most of the illnesses. Some researchers have 440 00:27:51,400 --> 00:27:54,720 Speaker 2: suggested that the bacteria may have started producing a more 441 00:27:54,880 --> 00:27:59,080 Speaker 2: aggressive form of the toxin that causes the disease. It's 442 00:27:59,119 --> 00:28:02,320 Speaker 2: also not clear what has caused this most recent spike 443 00:28:02,359 --> 00:28:05,240 Speaker 2: in scarlet fever cases that started toward the end of 444 00:28:05,280 --> 00:28:09,399 Speaker 2: twenty twenty two in the northern Hemisphere. Scarlet fever cases 445 00:28:09,600 --> 00:28:12,639 Speaker 2: usually peak in the late winter or early spring, so 446 00:28:12,840 --> 00:28:16,280 Speaker 2: this outbreak happened out of season. At this point, this 447 00:28:16,440 --> 00:28:19,960 Speaker 2: is all really speculative, with some of those speculations being 448 00:28:19,960 --> 00:28:23,240 Speaker 2: more baseless than others. Like the measures put in place 449 00:28:23,280 --> 00:28:25,440 Speaker 2: to try to control the spread of the COVID nineteen 450 00:28:25,520 --> 00:28:29,399 Speaker 2: pandemic led to people not being exposed to other diseases. 451 00:28:29,640 --> 00:28:32,680 Speaker 2: It's also possible that kids who might have gotten strap 452 00:28:32,760 --> 00:28:36,000 Speaker 2: or scarlet fever over the last couple of years didn't 453 00:28:36,160 --> 00:28:39,080 Speaker 2: and are instead just getting it now. But there have 454 00:28:39,160 --> 00:28:42,959 Speaker 2: also been totally baseless claims pointing to either COVID nineteen 455 00:28:43,080 --> 00:28:46,680 Speaker 2: vaccines or the flu vaccine as somehow causing a rise 456 00:28:46,720 --> 00:28:50,280 Speaker 2: in strep infections. There is no credible evidence for either. 457 00:28:51,360 --> 00:28:54,200 Speaker 2: There were not doctors, so we cannot possibly comment on 458 00:28:54,280 --> 00:28:59,040 Speaker 2: every conceivable thing that has been postulated about the spike 459 00:28:59,120 --> 00:29:02,920 Speaker 2: and scarlet fever cases. Like it does seem possible that 460 00:29:03,000 --> 00:29:05,800 Speaker 2: it is an extension of the spike that was happening 461 00:29:05,840 --> 00:29:09,440 Speaker 2: before the pandemic started that kind of paused during the 462 00:29:09,440 --> 00:29:12,720 Speaker 2: pandemic peak, when so many places were taking a lot 463 00:29:12,720 --> 00:29:14,440 Speaker 2: of mitigation measures. 464 00:29:15,440 --> 00:29:16,200 Speaker 1: As we said at. 465 00:29:16,080 --> 00:29:17,640 Speaker 2: The top of the show, though a lot of folks 466 00:29:17,680 --> 00:29:20,680 Speaker 2: experience with scarlet fever is not from their own illness 467 00:29:20,760 --> 00:29:22,080 Speaker 2: or the illness of their children. 468 00:29:22,520 --> 00:29:23,440 Speaker 1: It's literature. 469 00:29:23,600 --> 00:29:25,520 Speaker 2: So we'll close out with just a few of the 470 00:29:25,560 --> 00:29:30,480 Speaker 2: most famous examples. First, there is Little Women by L. M. Alcott, 471 00:29:30,520 --> 00:29:33,520 Speaker 2: in which Beth gets scarlet fever and is extremely sick. 472 00:29:34,240 --> 00:29:37,560 Speaker 2: She dies years later, and while the book doesn't give 473 00:29:37,600 --> 00:29:41,760 Speaker 2: a specific cause, it's usually interpreted that she had developed 474 00:29:41,840 --> 00:29:46,520 Speaker 2: rheumatic fever after that scarlet fever case. Alcott's real life sister, 475 00:29:46,640 --> 00:29:49,800 Speaker 2: Elizabeth Sewell Alcott, died at the age of twenty two, 476 00:29:49,840 --> 00:29:53,160 Speaker 2: two years after having had scarlet fever, and then Alcott 477 00:29:53,200 --> 00:29:56,320 Speaker 2: published Little Women ten years later in eighteen sixty eight. 478 00:29:57,200 --> 00:30:00,920 Speaker 2: Another past podcast subject with a scarlet fef connection is 479 00:30:01,000 --> 00:30:05,200 Speaker 2: Laura Ingles Wilder, whose real sister Mary became blind after 480 00:30:05,240 --> 00:30:09,320 Speaker 2: what the family described as brain fever, probably some form 481 00:30:09,360 --> 00:30:13,160 Speaker 2: of meningitis or encephalitis. In the book The Shores of 482 00:30:13,200 --> 00:30:16,480 Speaker 2: Silver Lake, set in eighteen seventy nine, the fictional version 483 00:30:16,480 --> 00:30:19,240 Speaker 2: of Mary becomes blind after she and the rest of 484 00:30:19,280 --> 00:30:24,000 Speaker 2: the family contract scarlet fever. And yet another example that 485 00:30:24,120 --> 00:30:28,160 Speaker 2: incorporates both fiction and reality. Several of the von Trapp 486 00:30:28,240 --> 00:30:31,680 Speaker 2: family contracted scarlet fever in the early nineteen twenties, and 487 00:30:31,760 --> 00:30:34,760 Speaker 2: their mother, Agatha contracted it while caring for them and 488 00:30:34,840 --> 00:30:38,160 Speaker 2: died in nineteen twenty two. This led to a young 489 00:30:38,200 --> 00:30:41,240 Speaker 2: woman named Maria being hired from a convent to work 490 00:30:41,280 --> 00:30:44,240 Speaker 2: as a tutor with the convalescing children, and the family 491 00:30:44,520 --> 00:30:48,000 Speaker 2: later became a performing group called the Trap Family Singers 492 00:30:48,600 --> 00:30:52,840 Speaker 2: that of course inspired the musical The Sound of Music. Lastly, 493 00:30:52,960 --> 00:30:56,040 Speaker 2: of course, there's The Velveteen Rabbit or How Toys Become 494 00:30:56,120 --> 00:30:59,400 Speaker 2: Real by Marjorie Williams, which was published in nineteen twenty two, 495 00:30:59,560 --> 00:31:01,840 Speaker 2: and in the book, a little boy gets a velveteen 496 00:31:01,920 --> 00:31:03,880 Speaker 2: rabbit as a Christmas present, and then there's a whole 497 00:31:03,880 --> 00:31:07,440 Speaker 2: story about how nursery magic can make a toy real 498 00:31:08,000 --> 00:31:09,600 Speaker 2: through the strength of a child's love. 499 00:31:09,720 --> 00:31:11,440 Speaker 1: This little boy then gets. 500 00:31:11,200 --> 00:31:13,600 Speaker 2: Scarlet fever and it's very sick for a long time, 501 00:31:13,640 --> 00:31:15,680 Speaker 2: and once he's better, there's a plan to take him 502 00:31:15,680 --> 00:31:19,640 Speaker 2: to the seaside while his room is disinfected, and all 503 00:31:19,680 --> 00:31:22,120 Speaker 2: of his toys and books and everything he has played 504 00:31:22,160 --> 00:31:24,840 Speaker 2: with is going to be burned, which, as we talked about, 505 00:31:24,840 --> 00:31:27,640 Speaker 2: it is a real thing that people would do. So 506 00:31:27,760 --> 00:31:31,440 Speaker 2: the doctor then describes the velveteen rabbit as quote, a 507 00:31:31,600 --> 00:31:36,080 Speaker 2: mass of scarlet fever germs. Fortunately, the nursery magic theory 508 00:31:36,120 --> 00:31:38,640 Speaker 2: appears and makes the velveteen rabbit real, so he is 509 00:31:38,720 --> 00:31:42,680 Speaker 2: not burned, but Honestly, this story is kind of horrifying. 510 00:31:43,240 --> 00:31:46,560 Speaker 2: It's the meanest thing ever. I remembered it being sad 511 00:31:46,640 --> 00:31:49,360 Speaker 2: from like my own childhood, Like I remembered feeling sad 512 00:31:49,360 --> 00:31:51,120 Speaker 2: about it. And I'm pretty sure I have like a 513 00:31:51,320 --> 00:31:54,560 Speaker 2: copy of the book with its original illustrations and all that, 514 00:31:54,600 --> 00:31:58,040 Speaker 2: like in the house somewhere. But I read it at 515 00:31:58,120 --> 00:32:02,080 Speaker 2: my desk while working on this episode, and I mean, 516 00:32:02,320 --> 00:32:04,960 Speaker 2: maybe it was my emotional stated. There was a lot 517 00:32:05,160 --> 00:32:11,120 Speaker 2: of just weeping over this story, and I was like, 518 00:32:11,240 --> 00:32:13,160 Speaker 2: why did they give this to children? 519 00:32:14,600 --> 00:32:18,600 Speaker 1: I will tell you a velveteen rabbit story on Friday. Okay, 520 00:32:19,040 --> 00:32:19,760 Speaker 1: that'll be great. 521 00:32:20,440 --> 00:32:23,840 Speaker 2: We can talk more about our literature experiences with Scarlet Fevers. 522 00:32:28,600 --> 00:32:31,640 Speaker 2: Thanks so much for joining us on this Saturday. If 523 00:32:31,640 --> 00:32:33,800 Speaker 2: you'd like to send us a note, our email addresses 524 00:32:33,960 --> 00:32:38,560 Speaker 2: History Podcast at iHeartRadio dot com, and you can subscribe 525 00:32:38,560 --> 00:32:41,680 Speaker 2: to the show on the iHeartRadio app, Apple Podcasts, or 526 00:32:41,680 --> 00:32:43,720 Speaker 2: wherever you listen to your favorite shows.