458 DIPHTHERIA, SCARLET FEVER, AND TETANUS 



acteristics of the disease, and the best methods of controlhng 

 it. If a physician is consulted as soon as suspicious symptoms 

 appear, he can administer antitoxin immediately and probably 

 prevent a serious case of the disease. Children should be taught 

 to keep pencils and all articles handled by other children out 

 of their mouths. Since diphtheria is a droplet infection, the 

 same rules for prevention apply here as in other diseases spread 

 by this means. Patients who are convalescing from diphtheria 

 should be kept away from well persons until all danger of spread- 

 ing the infection is eliminated. 



Scarlet Fever 



Scarlet fever is a disease similar to diphtheria, in that it works 

 through toxins. The causative organism has not been definitely 

 isolated. A chain form of spherical bacteria called streptococci 

 is always found in the nose and throat of scarlet fever patients, 

 but there is considerable doubt as to whether this is really the 

 causative organism. Seventy per cent of the deaths from scarlet 

 fever are among children under ten years of age. 



A test, similar to the Schick test, has recently been prepared 

 to determine the presence or absence of scarlet fever immunity. 

 It was devised by two doctors, G. F. and G. H. Dick, and is 

 called the Dick test. It consists of putting small quantities of 

 toxin prepared from the streptococcus bacillus under the skin of 

 the child to be tested. There is a reaction similar to that in the 

 Schick test. 



If a child is not immune, subsequent doses of toxin are inocu- 

 lated. It is not necessary to neutralize the toxin with antitoxin 

 as in the case of diphtheria, because the scarlet fever toxins are 

 not as powerful as the diphtheria toxins. This inoculation cre- 

 ates an active immunity in the child by stimulating its body to 

 make its own antitoxins. The Dick test and its subsequent in- 

 oculations are not used to the extent of the Schick test and inoc- 



