Hemolytic Streptococcus Infections

The streptococcus is one of the most widely distributed and variable organisms that attacks mankind. Such conditions as sore throat, sinus infections, scarlet fever, erysipelas, puerperal fever, or lymphangitis may be caused by streptococci. Other conditions associated with such streptococci include acute rheumatic fever and acute inflammations of the kidney.

Such infections are found in all races, in both sexes, at all ages, and they come on at any time of the year. Scarlet fever is said to be rare in the tropics. Very small babies, under three months of age, seldom have streptococcal infections, because they get some immunity from their mothers at the time of birth. Tonsillitis, pharyngitis, and scarlet fever are more frequent up to ten years of age. Streptococcal infections can result from contaminated food, milk, water but most frequently pass from one person to another with coughing, sneezing, spitting and what are known as "hand-to-mouth" infections.

Tonsillitis and pharyngitis are usually streptococcal infections which begin with sore throats. When there is a rash, the rash is said to represent sensitivity of the skin to the products of the streptococcus; this condition is scarlet fever. Infections of the sinuses usually follow infection of the tonsils and throat. Ear infections occur in many cases and the streptococci are said to be responsible for ten per cent of ear infections. Specific methods of inoculation against streptococci are difficult because of the many different varieties of the germ. The Dick test will indicate whether or not a child is susceptible to the streptococcus of scarlet fever and there are methods of building resistance against these streptococci by inoculating small doses of the toxin.

Regardless of the portion of the body that is attacked by the streptococci, the control of the condition is now possible through the proper use of the sulfonamide and antibiotic drugs that have been mentioned. Streptococci are especially susceptible to attack by the sulfonamide drugs. The complications of infected throats are more important than the sore throat itself. Penicillin is the antibiotic drug most frequently used in treating throats infected with streptococci. Penicillin is especially beneficial in laryngitis, pharyngitis, tonsillitis and scarlet fever. The complications of scarlet fever have in the past done more harm than the disease itself. In severe cases of scarlet fever convalescent serum may be used, and good results have been reported from use of the antitoxin.

Saline gargles and irrigations of the throat help to wash out the by-products of throat infection. One of the most significant advances is the use of sulfonamide drugs to prevent streptococcal infections. When there are outbreaks in large homes, in barracks, in asylums, or places where great numbers of people assemble, the sulfonamide drugs may be taken as a means of preventing infection with the streptococci. All sorts of attempts have been made to cut down respiratory diseases by the use of ultraviolet light in the air, by the spraying of medicated vapors or aerosols and by other techniques for keeping the germs from floating in the air. These, in general, have not been successful.

Whooping Cough Or Pertussis

A germ called the Hemophilus pertussis is now recognized as the cause of whooping cough. The germ is spread from one person to another by direct contact or through coughing, sneezing, or talking. The attack of whooping cough is usually divided into four parts, one stage running into another. About seven to fourteen days after exposure the condition begins with symptoms like those of a cold, such as sneezing, running nose, and hoarseness. The fever is mild. In the seconds stage a cough gradually becomes hard, dry, and annoying; it is more severe at night. The exudation makes this known as the catarrhal stage. During the third stage whooping develops with a wheezing inhalation of breath. The face becomes swollen and red, the tongue protrudes and the eyes water. After a whoop there may be a pause, followed by another spell of whooping and coughing. The difficulty may result in vomiting. During the fourth stage there is a gradual lessening of whooping and paroxysms of coughing. The total duration of the condition may be six to eight I weeks or more. Nowadays inoculation against whooping cough is possible with good vaccines. Children should be protected as they are protected against diphtheria.

In the treatment of whooping cough the new antibiotics have been found effective, and the disease is now much less feared. Streptomycin, aureomycin and terramycin are effective. The cough is controlled with suitable medication and sedatives. The nutrition of children must be watched carefully, as severe coughing with prolonged paroxysms may seriously interfere with taking and retaining food. Food can be given frequently and in small quantities.

Diphtheria

Diphtheria is caused by a germ called the diphtheria bacillus and known scientifically as the Corynebacterius diphtheria. The disease is transmitted by droplets thrown into the air by coughing or sneezing. Children who have recovered from the disease may carry the germ. Indirectly the condition is transmitted on books, toys, clothing, and eating utensils.

Diphtheria develops usually from one to four days after exposure. The first signs are chilliness, slight fever, and loss of appetite, sometimes accompanied by vomiting and headache. Within twenty-four hours, sore throat occurs and a membrane or yellowish-white deposit is seen in the throat and over the tonsils. Membrane may also form in the nose or larynx. The symptoms become more severe, as the lymph glands in the neck enlarge. The fever may go to 1020 F. or higher and is generally highest at the beginning of the disease. Often there is cough and, with severe infection, some prostration. All children should be inoculated with antidiphtheria toxoid as soon as possible after reaching six months of age. The power of the toxoid is well established, and now there are many cities in the United States which haven't a single death from diphtheria in a year.

The treatment of diphtheria is of the greatest importance since the prompt giving of enough antitoxin will prevent spread to important nerves or other tissues of the body. Most dangerous is spread of the membrane into the larynx and serious interference with breathing. Recent research has shown the ability of penicillin to control the growth of the diphtheria germ and, conceivably, antibiotic treatment may eventually replace other forms of treatment.