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Scarlet Fever and Tonsillitis in Relation to Acute Rheumatism

1950; BMJ; Volume: 1; Issue: 4660 Linguagem: Inglês

10.1136/bmj.1.4660.992

0959-8138

T. C. Macdonald,

Dermatological and COVID-19 studies

While the infectious nature of rheumatic fever was lated by Hirsch the aetiologic agent is still not positively identified.The various hypotheses have been set forth by Hadfield and Garrod (1947), who say: It seems to us indisputable that more progress has been made towards identifying haemolytic streptococci as the cause of disease than in any other direction."Galabin (1932) and Longstaff showed the rzlationship between mortality rates of rheumatic fever, erysipelas, scarlet fever, septicaemia, and puerperal fev er. Atwater 1927) published similar figures.Accurate morbidity figures are not so easy to obtain.It was'felt, therefore, that some information might be drawn from R.A.F. and W.A.A.F.sickness records, as these had certain advantages not usually found.The numbers were large, the population at risk was known, medical care was at all times easy of access, and the recording system is well tried.There is no difference in nutrition, whether in quality or in quantity of food; clothing is identical, and living conditions vary very little.There is a rough standardization for age by the fact that children, adolescents, and the aged are not in the Service.The figures for the sexes are given separately.On the other hand, one condition which facilitates infectiotT by Streptococcus pyogenes is present.This is the communal living and, in particular, sleeping in barrack rooms.Other factors are overcrowding and constant influx of newcomers into each little community.I will consider only figures for the Forces in this country.