July 25, 2026 • 32 mins
This 2023 episode covers scarlet fever, which is treatable with antibiotics. But in the middle of the 19th century, it was the leading cause of death in children in parts of the world, and today, there are several ongoing mysteries about the disease.
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Speaker 1 (00:02):
Happy Saturday.
Speaker 2 (00:03):
Since one of the updates we talked about in this
week's installment of Unearthed was about scarlet fever, we thought
we would replay our episode on it as the day's
Saturday Classic. This originally came out on February eighth, twenty
twenty three. Enjoy Welcome to Stuff You Missed in History Class,
(00:24):
a production of iHeartRadio. Hello, and welcome to the podcast.
I'm Tracy V. Wilson and I'm Holly Frye. So some
of my friends' kids got scarlet fever late last year,
and their response to this was kind of like, what
(00:44):
is this the nineteenth century? And I remember having a
really similar feeling when I got scarlet fever as a
kid back in the nineteen eighties, because I really associated
scarlet fever with old timey children's books to me, like
The Velveteen Rabbit and Little Women, and this sort of
(01:05):
response to scarlet fever, like what century is it?
Speaker 1 (01:08):
That's not unique to me or my friends.
Speaker 2 (01:11):
When I started working on this episode, the very initial
research just turned up a ton of news articles going
back many years, all of them reporting on scarlet fever outbreaks,
and all of this with a tone of like.
Speaker 1 (01:26):
The return of an old disease.
Speaker 2 (01:29):
They all made it sound like this was like a
unique thing, and it was really just year after year
after year, a new headline of a new scarlet fever
outbreak with a new like an old disease has returned.
So scarlet fever is caused by Group A Streptococcus, and
over the last few months there's been a big spike
in Group A Strep infections in many parts of the world,
(01:52):
sometimes causing relatively minor illnesses, but also sometimes much more
dangerous and even deadly invasive infections, usually in places where
people have prompt access to medical care. Scarlet fever specifically
is pretty treatable with antibiotics, but in the middle of
the nineteenth century it was the leading cause of death
(02:15):
and children in some parts of the world. A lot
of times antibiotics get the credit from turning that trend around,
but it wasn't just because of antibiotics, which is one
of several kind of mysteries about this disease. Scarlet fever
usually starts with symptoms like a fever, sore throat, headache,
and sometimes nausea or vomiting. A rash usually forms a
(02:38):
day or two after the fever starts. The appearance and
texture of this rash can vary based on a person's
skin color, At least in the US and Europe, most
descriptions in pictures of this are of white children, and
in people with lighter skin, the rashes red and bumpy
and often has this texture that's described as sand papery.
(02:59):
In people with brown or black skin, the rash is
often the same color as the skin or slightly darker,
and while it's usually still raised in bumpy, it sometimes
doesn't have quite the same texture. Scarlet fever can also
cause something called strawberry tone that's a white coating that
can progress to a red, bumpy appearance. If you google this,
(03:20):
which I'm not necessarily recommending that you do, it's obvious
why they call it that. If left untreated, scarlet fever
and other strep infections can cause some really serious complications,
including organ damage and an inflammatory disease called rheumatic fever.
There's also a possible connection between strap infections and autoimmune
(03:41):
disease and neurological disorders and children. And again, there are
also invasive strep infections that themselves can be like really
dangerous Streptococcus bacteria can cause a wide range of diseases,
and while strep is believed to have been one of
the most frequent causes of infectious diseases in prehistoric times,
it's not clear when exactly it started causing scarlet fever.
(04:04):
This is because strap only causes scarlet fever when it's
been infected with a bacteria phage that's a virus that
infects bacteria. The bacteria phage causes the bacteria to produce
a toxin, and scarlet fever is the body's response to
that toxin. It's likely that there were strains of Streptococcus
present in much of the world prior to the fifteenth century,
(04:26):
but that scarlet fever specifically was introduced to some places
during colonization, including the Americas, Australia, and New Zealand. Scarlet
fever is most common in children, and there are just
a lot of childhood diseases that can cause similar symptoms,
so a lot of the time it's not really possible
to tell whether an early medical text or other writing
(04:49):
is referencing scarlet fever or some other disease that causes
some combination of like a fever, sore, throat, rash, and
other symptoms. There are references to various childhood fevers and rashes,
and medical texts from the Mediterranean, the Middle East, and Asia,
going all the way back to Hippocrates in the fourth
century BCE. We don't really have a way of knowing
(05:10):
whether any of them were talking about scarlet fever, or
even if scarlet fever really existed. Yet accounts describing scarlet
fever as a distinct illness started to develop in the
sixteenth century. Giovanni Philippo Ingracias was a physician born in Sicily,
and in fifteen fifty three he described an illness that
he called rosalia. He specified that this was not the
(05:34):
same thing as chicken pox or measles, and that it
involved quote numerous spots, large and small, fiery and red
of universal distribution, so that the whole body appeared to
be on fire. In fifteen sixty five, Dutch physician Johann
Bayer described something similar and added another detail, which was
a severe sore throat. Then, in fifteen seventy eight, Jean
(05:57):
Katyer of Poitier described an illness causing quote general weariness, headache,
redness of the eyes, sore throat, and fever. Pirpura appeared
on the second or third day, accompanied by delirium and
soreness of the throat. Purpura is a rash that's caused
by the breaking of small blood vessels underneath the skin.
(06:18):
In sixteen thirty five, German physician Daniel Senner described an
epidemic in Viittenberg in which the skin later desquamated or peeled,
something that often happens in cases of scarlet fever. Centern
also described other complications that can follow scarlet fever, including edema,
fluid in the abdomen, and arthritis. Scarlet fever was showing
(06:40):
up in writings outside of the medical world as well.
Samuel Peeps, who comes up so often on the show
when we're talking about this period of history, wrote this
in his diary on November tenth, sixteen sixty four, quote
my little Girlie Susan is fallen, sick of the measles
we fear or at least of a scarlet fever. This
(07:00):
seemed to pass pretty quickly. The next day he wrote, quote,
our little girl is better than she was yesterday. Scarlet
fever as a term was in common use in English
at this point, as was the name scarletina. The first
use of the term scarlatina in medical literature is believed
to be in sixteen seventy four. English physician Thomas Sydenham
(07:21):
wrote Medical Observations on the History and Treatment of Acute Diseases,
which was published in Latin, and in it he described
febri scarlatina this way quote scarlet fever may appear at
any season. Nevertheless, it often breaks out toward the end
of summer, when it attacks whole families at once, and
(07:41):
more especially the infant part of them. The patient feel
riggers and shivering, just as they do in other fevers.
The symptoms, however, are moderate. Afterwards, however, the whole skin
becomes covered with small red maculae thicker than those of measles,
as well as broader and redder and uniform. These last
(08:02):
for two or three days and then disappear. The cuticle
peels off and branny scales remain lying on the surface
like meal. They appear and disappear two or three times.
So this was before the development of the germ theory
of disease, and Sydenham believed that this was caused by
quote a moderate effervescence of the blood arising from the
(08:24):
heat of the preceding summer or from some other exciting cause.
This made him cautious of using blood letting or enemas
to treat the patient, which is something that would have
happened with other illnesses. He believed that the blood needed
to be left to its own regulation in cases of
scarlet fever, and that blood letting or anemas could introduce
(08:46):
particles into the blood that were harmful to it. Instead,
he said it was quote sufficient for the patient to
abstain wholly from animal food and from fermented liquors, to
keep always indoors, and not to keep always in his bed.
When the desclamation is complete, and when the symptoms are departing,
I consider it proper to purge the patient with some
(09:07):
mild laxative accommodated to his age and strength. So at
the same time, he noted that if a child experienced
seizures or a coma, then they needed to be treated
immediately with a blister on the back of the neck
and a dose of opium tincture. Sydenham recommended repeating this
every night until the patient had recovered, and feeding them
(09:28):
diluted milk, but again not animal food. So these descriptions
of this illness don't sound really pleasant, and both Sydonym
and Center described complications and more serious cases, But like
none of this sounds nearly as frightening as scarlet fever became.
In the nineteenth century, Samuel Peeps made it sound like
scarlet fever was like a lesser illness than measles would
(09:51):
have been. Became much worse later on, and we'll get
to that after a sponsor break.
Speaker 1 (10:06):
Through.
Speaker 2 (10:07):
The seventeenth and eighteenth centuries, scarlet fever epidemics occurred regularly
in Europe, with the disease often striking a particular place
every four to six years. That same general pattern seems
to have been present in other places also. In the
eighteen twenties and thirties, though, the number of scarlet fever
cases really started to rise in a lot of places,
(10:29):
and so did their severity. There are several possible explanations
for why, and it's possible that all of them played
some kind of role. Nineteenth Century urbanization led to more
people living in closer quarters, often without sufficient facilities for hygiene,
which made it easier for a contagious illness like scarlet
(10:50):
fever to spread. But that can't account for everything, since
scarlet fever cases started increasing before this trend really started
to escalate. Some researchers have found a correlation between scarlet
fever and wheat prices. When wheat prices rose, there was
an increase in scarlet fever three years later, as though
malnutrition during pregnancy might make children more susceptible to it.
(11:15):
This is a correlation, though it's not necessarily a cause
and effect situation, and it is also possible that a
more virulent form of the disease evolved, which allowed it
to spread more easily and cause worse illnesses. Scarlet fever
was also introduced into parts of the world that had
never encountered it before during the nineteenth century. The first
(11:36):
case of scarlet fever in the archipelago of Madeira was
reported in eighteen oh six. They reached South America in
eighteen twenty nine, Greenland in eighteen forty seven, and both
Australia and New Zealand in eighteen forty eight. Although scarlet
fever had been reported in the northeastern United States for centuries,
the first case reported in California wasn't until eighteen forty nine.
(12:01):
Some sources will describe the nineteenth century spread of scarlet
fever as a pandemic stretching from about eighteen twenty five
to eighteen eighty five. Death rates could really vary from
place to place and from one outbreak to the next.
In places that had no experience with scarlet fever, the
mortality rate was often particularly high. As we said a
(12:22):
moment ago, the first cases reported in New Zealand were
in eighteen forty eight, and in Auckland that year one
out of every eight people who contracted scarlet fever died.
The vast majority of cases and deaths were in children
between the ages of two and ten, and no one
over the age of forty seemed to catch it at all.
The worst cases seemed to be in crowded or badly
(12:44):
ventilated homes. There's not a ton of exact data, though,
especially in the earlier decades of the eighteen hundreds, a
lot of places didn't have formal departments of health or
public health services. Widespread outbreaks of scarlet fef and other
contagious diseases were part of the motivation for those to
be established. In some places, there were laws in place
(13:07):
to try to control the spread of infectious diseases, and
a lot of those laws traced back to things like
the Black Death of the fourteenth century, but a lot
of the time there just wasn't a more systematic tracking
of diseases and their spread. However, it's generally agreed that
by eighteen forty, scarlet fever was a leading cause of
(13:28):
childhood death in the United States and parts of Europe,
possibly the leading cause of death and children during widespread outbreaks.
Speaker 1 (13:37):
Throughout the nineteenth century.
Speaker 2 (13:39):
Scarlet fever was terrifying. Communities often used isolation and quarantined
to try to control the diseases spread, along with things
like canceling school and public gatherings, recommending ventilation and disinfection procedures,
and urging people to keep children at home and away
from other people, especially other children. The increasing spread of
(14:02):
scarlet fever also led to researchers learning more about it.
English physician Richard Bright made the connection between streptococcus infections
and kidney disease in eighteen thirty six. Bright was one
of the first people to describe nephritis or kidney inflammation,
which came to be known as Bright's disease, and he
wrote of it quote scarletina has apparently laid the foundation
(14:25):
for the future mischief, so Scarlatina later causing nephritis, although
his next sentence went on to say, quote exertion and
childish plays has done the same. So just some questions
about that. Don't let your kids play too hard.
Speaker 1 (14:40):
Yeah, they might have kidney disease later.
Speaker 2 (14:43):
Although people didn't know exactly what caused scarlet fever yet,
they did know that it spread easily from person to person,
so much so that people thought that the disease could
linger on things like clothing, bedding, and toys for a
long period of time. And in eighteen six, doctor Michael Taylor,
who was a local physician in northwestern England, connected a
(15:05):
scarlet fever outbreak to milk. At this point, Louis Pester
had done groundbreaking work on what would come to be
known as pasteurization, but he was doing this work in
the context of fermentation. The idea that milk should be
pasteurized that was still decades away. Taylor knew about the
work of doctor John Snow, who had identified a water
(15:27):
pump as the source of a cholera outbreak in eighteen
fifty four. Taylor had thought that if water could carry
a disease, then surely milk could as well, and he
had later traced a typhoid outbreak to contaminated milk. In
eighteen sixty seven, people started reporting cases of scarlet fever
in and around the town of Penrith, which had not
(15:49):
seen a case of scarlet fever in more than a year.
It turned out that the people who got sick had
all bought milk from the same milk dealer whose child
had got in scarlet fever and died. In eighteen seventy four,
Theeodor Bilroth of Austria identified and named the Streptococcus bacterium,
which he had found in infected wounds and in a
(16:11):
case of a skin infection called erysipellus. He had observed
quote small organisms as found in either isolated or arranged
in pairs, sometimes in chains, and he named them for
the Greek terms strepto or chain and caucus or barry.
Five years later, Louis Paster isolated the same organism in
(16:33):
the uterus and bloodstream of a number of patients with
child bed fever. Then, in eighteen eighty four, microbiologist Friedrich
Julius Rosenbach refined the organism's name to Streptococcus pyogenes, with
pyogenes from Greek words meaning pus forming. It did not
take long for the connections to be made between Streptococcus
(16:56):
piogenes and scarlet fever. In eighteen eighty seven, doctor Emmanual
Klein published a report in the Proceedings of the Royal
Society of London saying that he had identified the Streptococcus
organism in both people with acute scarletina in London and
cows at a milk farm in Hendon, so he believed
(17:16):
that the milk from the Hendon farm had caused the
scarlet fever outbreak in London. This report was the result
of years of work. Klein was a bacteriologist who had
been born in Hungary and studied in Austria before moving
to England to work as a researcher at the Brown
Institution of the University of London. His scarlet fever research
(17:37):
had included post mortem examinations of children who had died
of it, and he had spotted similar pathological changes in
cows that he examined at the Hendon farm. This wasn't
just a matter of observing the similarities in the sick cows,
and the sick children. He followed the criteria that at
that point had been outlined by Robert Koch now known
(17:58):
as Coke's postulates, to show that the same bacteria were
causing both the illness in the cows and in the
people who had drank their milk. He also had shown
that the bacteria he cultured from the sick cows could
grow and survive and basically thrive in milk. They called
this organism Micrococcus scarletine. Although it was indistinguishable from the
(18:23):
one previously named Streptococcus pyogenes. This was an important discovery,
although he was using a different name for it. Klein
was the first person to connect Streptococcus pyogenes to scarlet fever,
but his results were not widely accepted. Since Michael Taylor's
discovery in eighteen sixty seven, there had been other scarlet
(18:44):
fever outbreaks traced to milk, and most of the time
milk from the affected dairy had been destroyed, but most
people had thought these outbreaks had a human source, like
a child who lived on the farm, or a dairy worker,
or a delivery world who had cared for a child
with scarlet fever or someone who had it themselves. Taylor
(19:06):
had showed that the cows could carry the disease, which
could mean that destroying the milk was not enough to
stop an outbreak, that the cows themselves might have to
be culled. Destroying potentially contaminated milk was a financial hardship
for dairy farms, but destroying their cows was far worse,
and people resisted the idea that cows could be a
(19:26):
source of infection, although a few people had tried applying
Louis Passenger's heat treatment process to milk almost twenty more
years past before German agricultural chemists Franz von Suchslet suggested
that milk be routinely treated with pastorization, and a big
reason for that was that so many diseases were being
(19:48):
transmitted through milk, not just scarlet fever, but also typhoid, diphtheria, tuberculosis,
and various gastrointestinal illnesses. It still took a while for
pastorization to catch on, though there were concerns that pasteurizing
milk destroyed the nutrients in it, or affected the flavor,
or made it harder to digest, but by that point
(20:09):
scarlet fever rates were on the decline, and we'll talk
more about that after a sponsor break. Although the number
of scarlet fever cases was declining at the end of
the nineteenth century and the disease didn't seem to be
(20:30):
as deadly as it had been in the early twentieth century,
it was still seen as a major public health concern.
Speaker 1 (20:38):
In England.
Speaker 2 (20:39):
For example, isolation hospitals were established for people with contagious
illnesses who could not effectively be isolated at home. During
outbreaks of scarlet fever. There could be house to house
visits to find sick people so they could be isolated
in the hospital. Unfortunately, it is really not clear how
much or whether this really helped slow the spread of
(21:00):
the disease. And also people with different contagious diseases were
all being housed in the same hospitals, and this led
people to say that the isolation hospital was where you
went when you caught one disease, so that you could
come out with all the rest. Welcome to Petri dish Arms.
You'll get a bed and probably seven different things. That's
(21:23):
not great, no good. Other efforts to control the spread
of scarlet fever also did not help a nineteen fifteen
article in the American Journal of Nursing described it this way,
quote it seems to cling to whatever object it encounters.
In no other disease has the infection been apparently conveyed
with such frequency by objects which have come in contact
(21:44):
with those ill as clothes, books, toys, and the like.
This article recommended that quote all hangings, carpets, and upholstered
furniture are to be taken from the room before the
patient is brought in. The furniture left should be of
a kind readily clem. There should be no such fancied
attempts at purifying the air as by hanging up sheets
(22:05):
wet with disinfectants. Such measures are not only useless, but
tend to give a false sense of security. Needless to say,
the patient should be provided with bedclothing, nightgown towels, eating utensils,
and drinking vessels for his exclusive use. Yeah, it is
no longer believed that scarlet fever is just transmitted readily
(22:27):
and for a long period of time in things like curtains.
This article also recommended disinfecting anything that the sick person
had used, using either a five percent solution of carbolic
acid or a two percent solution of creosol, and anything
that had been used for coughing or sneezing into was
to be burned. Also, the recommended treatment for patients themselves
(22:51):
was at least three weeks in bed, even if they
only had a mild case. Around this same time, people
were making more discoveries about scarlet fever, something that really
escalated during the nineteen teens and twenties. In nineteen fifteen,
English bacteriologists Frederick William Twart and his brother were using
colonies of bacteria as part of an effort to find
(23:12):
a way to grow smallpox vaccine in a lab. Twart
discovered areas where the bacteria couldn't grow, and found that
a substance from these areas was capable of passing through
a porcelain filter that trapped most bacteria. He published an
article in The Lancet about what he described as a
filter passing virus that attacked bacteria. His work didn't get
(23:35):
a lot of attention, but this was the first known
description of a bacteria phase. French microbiologists Feligues Derrell made
the same discovery independently of torte about two years later
in the nineteen twenties, husband and wife researchers George and
Gladys Dick, made a series of discoveries about scarlet fever
and its cause. While working in Chicago. They confirmed the
(23:59):
link between the disease and Streptococcus bacteria, and they identified
a toxin produced by the bacteria that was the cause
of scarlet fever. They also developed a skin test known
as the Dick test to show whether a person was
susceptible to scarlet.
Speaker 1 (24:15):
Fever or not.
Speaker 2 (24:17):
They were nominated for the Nobel Prize in Medicine for
the sork in nineteen twenty five in nineteen twenty six.
In nineteen twenty seven, two different pairs of researchers discovered
a bacteria phase that could change a non toxogenic strain
of strap into a toxogenic one. In other words, to
turn a variety of strap that did not cause scarlet
(24:38):
fever into one that did. Various researchers started trying to
develop an inoculation for scarlet fever using either the bacteria
or various modifications of the toxin that it produced. In
nineteen twenty eight, American microbiologist Rebecca Craighill Lancefield developed a
system for classifying strep bacteria into groups based on the
(25:00):
antigens found on the bacteria. Initially, she proposed two groups,
group A and group B. As we said earlier, scarlet
fever is group A. Today there are many more groups.
She was also one of the first people to demonstrate
that strep infections could lead to rheumatic fever. The first
SULFA drugs were developed in the nineteen thirties and were
(25:23):
used as a treatment for strep infections, including scarlet fever.
But the big medical breakthrough was penicillin. We did a
whole episode on penicillins development back in September. Today, penicillin
and amoxicillin are the antibiotics most often used to treat
scarlet fever, with other antibiotics recommended for people who are
allergic to those. Today, in most children, scarlet fever clears
(25:47):
up quickly as long as antibiotic treatment begins promptly, and
that made the amoxicillin shortages that were happening at the
end of last year in a lot of places particularly
scary for folks. Penicillin is often credited with turning scarlet
fever from a terrifying and deadly disease to one that's
considered to be a relatively mild childhood illness most of
(26:09):
the time. As we said earlier, though deaths from scarlet
fever were becoming less and less common decades before penicillin
was introduced, we don't totally know why. Starting in the
nineteen eighties, though, the opposite started to happen, as invasive
strep infections started to become more common in spite of
(26:30):
the existence of antibiotics to treat them. Scarlet fever specifically
started to become more prevalent in a lot of parts
of the world starting in about two thousand and eight.
Increased rates of scarlet fever were first reported in parts
of Asia, and then in the UK and other parts
of Europe, and then in the US. The UK, for example,
saw a sudden spike in scarlet fever cases starting in
(26:53):
twenty fifteen, and soon the rate of scarlet fever was
higher there than it had been in almost fifty years.
At first, it seemed like this wasn't leading to a
similar increase in fatalities, but a year later, invasive strep
infection started to increase there as well.
Speaker 1 (27:10):
Worldwide, there was a five.
Speaker 2 (27:11):
Fold increase in the number of scarlet fever cases between
twenty eleven and twenty twenty, with a drop in twenty
twenty after the start of the COVID nineteen pandemic. Yeah
and a lot of places, the general trend of when
scarlet fever cases are the highest was like sort of
nearing its end when the COVID nineteen pandemic really started.
(27:34):
Although health officials thought there might be some more dangerous
strain of Strep. Bacteria that was causing this increase, some
whole genome sequencing of samples from a lot of different
sick children found that there was not one strain that
was responsible for most of the illnesses. Some researchers have
suggested that the bacteria may have started producing a more
(27:54):
aggressive form of the toxin that causes the disease. It's
also not clear what has caused this most recent spike
in scarlet fever cases that started toward the end of
twenty twenty two in the northern Hemisphere. Scarlet fever cases
usually peak in the late winter or early spring, so
this outbreak happened out of season. At this point, this
(28:16):
is all really speculative, with some of those speculations being
more baseless than others. Like the measures put in place
to try to control the spread of the COVID nineteen
pandemic led to people not being exposed to other diseases.
It's also possible that kids who might have gotten strap
or scarlet fever over the last couple of years didn't
and are instead just getting it now. But there have
(28:39):
also been totally baseless claims pointing to either COVID nineteen
vaccines or the flu vaccine as somehow causing a rise
in strep infections. There is no credible evidence for either.
There were not doctors, so we cannot possibly comment on
every conceivable thing that has been postulated about the spike
and scarlet fever cases. Like it does seem possible that
(29:03):
it is an extension of the spike that was happening
before the pandemic started that kind of paused during the
pandemic peak, when so many places were taking a lot
of mitigation measures.
Speaker 1 (29:15):
As we said at.
Speaker 2 (29:16):
The top of the show, though a lot of folks
experience with scarlet fever is not from their own illness
or the illness of their children.
Speaker 1 (29:22):
It's literature.
Speaker 2 (29:23):
So we'll close out with just a few of the
most famous examples. First, there is Little Women by L. M. Alcott,
in which Beth gets scarlet fever and is extremely sick.
She dies years later, and while the book doesn't give
a specific cause, it's usually interpreted that she had developed
rheumatic fever after that scarlet fever case. Alcott's real life sister,
(29:46):
Elizabeth Sewell Alcott, died at the age of twenty two,
two years after having had scarlet fever, and then Alcott
published Little Women ten years later in eighteen sixty eight.
Another past podcast subject with a scarlet fef connection is
Laura Ingles Wilder, whose real sister Mary became blind after
what the family described as brain fever, probably some form
(30:09):
of meningitis or encephalitis. In the book The Shores of
Silver Lake, set in eighteen seventy nine, the fictional version
of Mary becomes blind after she and the rest of
the family contract scarlet fever. And yet another example that
incorporates both fiction and reality. Several of the von Trapp
family contracted scarlet fever in the early nineteen twenties, and
(30:31):
their mother, Agatha contracted it while caring for them and
died in nineteen twenty two. This led to a young
woman named Maria being hired from a convent to work
as a tutor with the convalescing children, and the family
later became a performing group called the Trap Family Singers
that of course inspired the musical The Sound of Music. Lastly,
(30:52):
of course, there's The Velveteen Rabbit or How Toys Become
Real by Marjorie Williams, which was published in nineteen twenty two,
and in the book, a little boy gets a velveteen
rabbit as a Christmas present, and then there's a whole
story about how nursery magic can make a toy real
through the strength of a child's love.
Speaker 1 (31:09):
This little boy then gets.
Speaker 2 (31:11):
Scarlet fever and it's very sick for a long time,
and once he's better, there's a plan to take him
to the seaside while his room is disinfected, and all
of his toys and books and everything he has played
with is going to be burned, which, as we talked about,
it is a real thing that people would do. So
the doctor then describes the velveteen rabbit as quote, a
(31:31):
mass of scarlet fever germs. Fortunately, the nursery magic theory
appears and makes the velveteen rabbit real, so he is
not burned, but Honestly, this story is kind of horrifying.
It's the meanest thing ever. I remembered it being sad
from like my own childhood, Like I remembered feeling sad
about it. And I'm pretty sure I have like a
copy of the book with its original illustrations and all that,
(31:54):
like in the house somewhere. But I read it at
my desk while working on this episode, and I mean,
maybe it was my emotional stated. There was a lot
of just weeping over this story, and I was like,
why did they give this to children?
Speaker 1 (32:14):
I will tell you a velveteen rabbit story on Friday. Okay,
that'll be great.
Speaker 2 (32:20):
We can talk more about our literature experiences with Scarlet Fevers.
Thanks so much for joining us on this Saturday. If
you'd like to send us a note, our email addresses
History Podcast at iHeartRadio dot com, and you can subscribe
to the show on the iHeartRadio app, Apple Podcasts, or
(32:41):
wherever you listen to your favorite shows.
Happy Saturday.
Speaker 2 (00:03):
Since one of the updates we talked about in this
week's installment of Unearthed was about scarlet fever, we thought
we would replay our episode on it as the day's
Saturday Classic. This originally came out on February eighth, twenty
twenty three. Enjoy Welcome to Stuff You Missed in History Class,
(00:24):
a production of iHeartRadio. Hello, and welcome to the podcast.
I'm Tracy V. Wilson and I'm Holly Frye. So some
of my friends' kids got scarlet fever late last year,
and their response to this was kind of like, what
(00:44):
is this the nineteenth century? And I remember having a
really similar feeling when I got scarlet fever as a
kid back in the nineteen eighties, because I really associated
scarlet fever with old timey children's books to me, like
The Velveteen Rabbit and Little Women, and this sort of
(01:05):
response to scarlet fever, like what century is it?
Speaker 1 (01:08):
That's not unique to me or my friends.
Speaker 2 (01:11):
When I started working on this episode, the very initial
research just turned up a ton of news articles going
back many years, all of them reporting on scarlet fever outbreaks,
and all of this with a tone of like.
Speaker 1 (01:26):
The return of an old disease.
Speaker 2 (01:29):
They all made it sound like this was like a
unique thing, and it was really just year after year
after year, a new headline of a new scarlet fever
outbreak with a new like an old disease has returned.
So scarlet fever is caused by Group A Streptococcus, and
over the last few months there's been a big spike
in Group A Strep infections in many parts of the world,
(01:52):
sometimes causing relatively minor illnesses, but also sometimes much more
dangerous and even deadly invasive infections, usually in places where
people have prompt access to medical care. Scarlet fever specifically
is pretty treatable with antibiotics, but in the middle of
the nineteenth century it was the leading cause of death
(02:15):
and children in some parts of the world. A lot
of times antibiotics get the credit from turning that trend around,
but it wasn't just because of antibiotics, which is one
of several kind of mysteries about this disease. Scarlet fever
usually starts with symptoms like a fever, sore throat, headache,
and sometimes nausea or vomiting. A rash usually forms a
(02:38):
day or two after the fever starts. The appearance and
texture of this rash can vary based on a person's
skin color, At least in the US and Europe, most
descriptions in pictures of this are of white children, and
in people with lighter skin, the rashes red and bumpy
and often has this texture that's described as sand papery.
(02:59):
In people with brown or black skin, the rash is
often the same color as the skin or slightly darker,
and while it's usually still raised in bumpy, it sometimes
doesn't have quite the same texture. Scarlet fever can also
cause something called strawberry tone that's a white coating that
can progress to a red, bumpy appearance. If you google this,
(03:20):
which I'm not necessarily recommending that you do, it's obvious
why they call it that. If left untreated, scarlet fever
and other strep infections can cause some really serious complications,
including organ damage and an inflammatory disease called rheumatic fever.
There's also a possible connection between strap infections and autoimmune
(03:41):
disease and neurological disorders and children. And again, there are
also invasive strep infections that themselves can be like really
dangerous Streptococcus bacteria can cause a wide range of diseases,
and while strep is believed to have been one of
the most frequent causes of infectious diseases in prehistoric times,
it's not clear when exactly it started causing scarlet fever.
(04:04):
This is because strap only causes scarlet fever when it's
been infected with a bacteria phage that's a virus that
infects bacteria. The bacteria phage causes the bacteria to produce
a toxin, and scarlet fever is the body's response to
that toxin. It's likely that there were strains of Streptococcus
present in much of the world prior to the fifteenth century,
(04:26):
but that scarlet fever specifically was introduced to some places
during colonization, including the Americas, Australia, and New Zealand. Scarlet
fever is most common in children, and there are just
a lot of childhood diseases that can cause similar symptoms,
so a lot of the time it's not really possible
to tell whether an early medical text or other writing
(04:49):
is referencing scarlet fever or some other disease that causes
some combination of like a fever, sore, throat, rash, and
other symptoms. There are references to various childhood fevers and rashes,
and medical texts from the Mediterranean, the Middle East, and Asia,
going all the way back to Hippocrates in the fourth
century BCE. We don't really have a way of knowing
(05:10):
whether any of them were talking about scarlet fever, or
even if scarlet fever really existed. Yet accounts describing scarlet
fever as a distinct illness started to develop in the
sixteenth century. Giovanni Philippo Ingracias was a physician born in Sicily,
and in fifteen fifty three he described an illness that
he called rosalia. He specified that this was not the
(05:34):
same thing as chicken pox or measles, and that it
involved quote numerous spots, large and small, fiery and red
of universal distribution, so that the whole body appeared to
be on fire. In fifteen sixty five, Dutch physician Johann
Bayer described something similar and added another detail, which was
a severe sore throat. Then, in fifteen seventy eight, Jean
(05:57):
Katyer of Poitier described an illness causing quote general weariness, headache,
redness of the eyes, sore throat, and fever. Pirpura appeared
on the second or third day, accompanied by delirium and
soreness of the throat. Purpura is a rash that's caused
by the breaking of small blood vessels underneath the skin.
(06:18):
In sixteen thirty five, German physician Daniel Senner described an
epidemic in Viittenberg in which the skin later desquamated or peeled,
something that often happens in cases of scarlet fever. Centern
also described other complications that can follow scarlet fever, including edema,
fluid in the abdomen, and arthritis. Scarlet fever was showing
(06:40):
up in writings outside of the medical world as well.
Samuel Peeps, who comes up so often on the show
when we're talking about this period of history, wrote this
in his diary on November tenth, sixteen sixty four, quote
my little Girlie Susan is fallen, sick of the measles
we fear or at least of a scarlet fever. This
(07:00):
seemed to pass pretty quickly. The next day he wrote, quote,
our little girl is better than she was yesterday. Scarlet
fever as a term was in common use in English
at this point, as was the name scarletina. The first
use of the term scarlatina in medical literature is believed
to be in sixteen seventy four. English physician Thomas Sydenham
(07:21):
wrote Medical Observations on the History and Treatment of Acute Diseases,
which was published in Latin, and in it he described
febri scarlatina this way quote scarlet fever may appear at
any season. Nevertheless, it often breaks out toward the end
of summer, when it attacks whole families at once, and
(07:41):
more especially the infant part of them. The patient feel
riggers and shivering, just as they do in other fevers.
The symptoms, however, are moderate. Afterwards, however, the whole skin
becomes covered with small red maculae thicker than those of measles,
as well as broader and redder and uniform. These last
(08:02):
for two or three days and then disappear. The cuticle
peels off and branny scales remain lying on the surface
like meal. They appear and disappear two or three times.
So this was before the development of the germ theory
of disease, and Sydenham believed that this was caused by
quote a moderate effervescence of the blood arising from the
(08:24):
heat of the preceding summer or from some other exciting cause.
This made him cautious of using blood letting or enemas
to treat the patient, which is something that would have
happened with other illnesses. He believed that the blood needed
to be left to its own regulation in cases of
scarlet fever, and that blood letting or anemas could introduce
(08:46):
particles into the blood that were harmful to it. Instead,
he said it was quote sufficient for the patient to
abstain wholly from animal food and from fermented liquors, to
keep always indoors, and not to keep always in his bed.
When the desclamation is complete, and when the symptoms are departing,
I consider it proper to purge the patient with some
(09:07):
mild laxative accommodated to his age and strength. So at
the same time, he noted that if a child experienced
seizures or a coma, then they needed to be treated
immediately with a blister on the back of the neck
and a dose of opium tincture. Sydenham recommended repeating this
every night until the patient had recovered, and feeding them
(09:28):
diluted milk, but again not animal food. So these descriptions
of this illness don't sound really pleasant, and both Sydonym
and Center described complications and more serious cases, But like
none of this sounds nearly as frightening as scarlet fever became.
In the nineteenth century, Samuel Peeps made it sound like
scarlet fever was like a lesser illness than measles would
(09:51):
have been. Became much worse later on, and we'll get
to that after a sponsor break.
Speaker 1 (10:06):
Through.
Speaker 2 (10:07):
The seventeenth and eighteenth centuries, scarlet fever epidemics occurred regularly
in Europe, with the disease often striking a particular place
every four to six years. That same general pattern seems
to have been present in other places also. In the
eighteen twenties and thirties, though, the number of scarlet fever
cases really started to rise in a lot of places,
(10:29):
and so did their severity. There are several possible explanations
for why, and it's possible that all of them played
some kind of role. Nineteenth Century urbanization led to more
people living in closer quarters, often without sufficient facilities for hygiene,
which made it easier for a contagious illness like scarlet
(10:50):
fever to spread. But that can't account for everything, since
scarlet fever cases started increasing before this trend really started
to escalate. Some researchers have found a correlation between scarlet
fever and wheat prices. When wheat prices rose, there was
an increase in scarlet fever three years later, as though
malnutrition during pregnancy might make children more susceptible to it.
(11:15):
This is a correlation, though it's not necessarily a cause
and effect situation, and it is also possible that a
more virulent form of the disease evolved, which allowed it
to spread more easily and cause worse illnesses. Scarlet fever
was also introduced into parts of the world that had
never encountered it before during the nineteenth century. The first
(11:36):
case of scarlet fever in the archipelago of Madeira was
reported in eighteen oh six. They reached South America in
eighteen twenty nine, Greenland in eighteen forty seven, and both
Australia and New Zealand in eighteen forty eight. Although scarlet
fever had been reported in the northeastern United States for centuries,
the first case reported in California wasn't until eighteen forty nine.
(12:01):
Some sources will describe the nineteenth century spread of scarlet
fever as a pandemic stretching from about eighteen twenty five
to eighteen eighty five. Death rates could really vary from
place to place and from one outbreak to the next.
In places that had no experience with scarlet fever, the
mortality rate was often particularly high. As we said a
(12:22):
moment ago, the first cases reported in New Zealand were
in eighteen forty eight, and in Auckland that year one
out of every eight people who contracted scarlet fever died.
The vast majority of cases and deaths were in children
between the ages of two and ten, and no one
over the age of forty seemed to catch it at all.
The worst cases seemed to be in crowded or badly
(12:44):
ventilated homes. There's not a ton of exact data, though,
especially in the earlier decades of the eighteen hundreds, a
lot of places didn't have formal departments of health or
public health services. Widespread outbreaks of scarlet fef and other
contagious diseases were part of the motivation for those to
be established. In some places, there were laws in place
(13:07):
to try to control the spread of infectious diseases, and
a lot of those laws traced back to things like
the Black Death of the fourteenth century, but a lot
of the time there just wasn't a more systematic tracking
of diseases and their spread. However, it's generally agreed that
by eighteen forty, scarlet fever was a leading cause of
(13:28):
childhood death in the United States and parts of Europe,
possibly the leading cause of death and children during widespread outbreaks.
Speaker 1 (13:37):
Throughout the nineteenth century.
Speaker 2 (13:39):
Scarlet fever was terrifying. Communities often used isolation and quarantined
to try to control the diseases spread, along with things
like canceling school and public gatherings, recommending ventilation and disinfection procedures,
and urging people to keep children at home and away
from other people, especially other children. The increasing spread of
(14:02):
scarlet fever also led to researchers learning more about it.
English physician Richard Bright made the connection between streptococcus infections
and kidney disease in eighteen thirty six. Bright was one
of the first people to describe nephritis or kidney inflammation,
which came to be known as Bright's disease, and he
wrote of it quote scarletina has apparently laid the foundation
(14:25):
for the future mischief, so Scarlatina later causing nephritis, although
his next sentence went on to say, quote exertion and
childish plays has done the same. So just some questions
about that. Don't let your kids play too hard.
Speaker 1 (14:40):
Yeah, they might have kidney disease later.
Speaker 2 (14:43):
Although people didn't know exactly what caused scarlet fever yet,
they did know that it spread easily from person to person,
so much so that people thought that the disease could
linger on things like clothing, bedding, and toys for a
long period of time. And in eighteen six, doctor Michael Taylor,
who was a local physician in northwestern England, connected a
(15:05):
scarlet fever outbreak to milk. At this point, Louis Pester
had done groundbreaking work on what would come to be
known as pasteurization, but he was doing this work in
the context of fermentation. The idea that milk should be
pasteurized that was still decades away. Taylor knew about the
work of doctor John Snow, who had identified a water
(15:27):
pump as the source of a cholera outbreak in eighteen
fifty four. Taylor had thought that if water could carry
a disease, then surely milk could as well, and he
had later traced a typhoid outbreak to contaminated milk. In
eighteen sixty seven, people started reporting cases of scarlet fever
in and around the town of Penrith, which had not
(15:49):
seen a case of scarlet fever in more than a year.
It turned out that the people who got sick had
all bought milk from the same milk dealer whose child
had got in scarlet fever and died. In eighteen seventy four,
Theeodor Bilroth of Austria identified and named the Streptococcus bacterium,
which he had found in infected wounds and in a
(16:11):
case of a skin infection called erysipellus. He had observed
quote small organisms as found in either isolated or arranged
in pairs, sometimes in chains, and he named them for
the Greek terms strepto or chain and caucus or barry.
Five years later, Louis Paster isolated the same organism in
(16:33):
the uterus and bloodstream of a number of patients with
child bed fever. Then, in eighteen eighty four, microbiologist Friedrich
Julius Rosenbach refined the organism's name to Streptococcus pyogenes, with
pyogenes from Greek words meaning pus forming. It did not
take long for the connections to be made between Streptococcus
(16:56):
piogenes and scarlet fever. In eighteen eighty seven, doctor Emmanual
Klein published a report in the Proceedings of the Royal
Society of London saying that he had identified the Streptococcus
organism in both people with acute scarletina in London and
cows at a milk farm in Hendon, so he believed
(17:16):
that the milk from the Hendon farm had caused the
scarlet fever outbreak in London. This report was the result
of years of work. Klein was a bacteriologist who had
been born in Hungary and studied in Austria before moving
to England to work as a researcher at the Brown
Institution of the University of London. His scarlet fever research
(17:37):
had included post mortem examinations of children who had died
of it, and he had spotted similar pathological changes in
cows that he examined at the Hendon farm. This wasn't
just a matter of observing the similarities in the sick cows,
and the sick children. He followed the criteria that at
that point had been outlined by Robert Koch now known
(17:58):
as Coke's postulates, to show that the same bacteria were
causing both the illness in the cows and in the
people who had drank their milk. He also had shown
that the bacteria he cultured from the sick cows could
grow and survive and basically thrive in milk. They called
this organism Micrococcus scarletine. Although it was indistinguishable from the
(18:23):
one previously named Streptococcus pyogenes. This was an important discovery,
although he was using a different name for it. Klein
was the first person to connect Streptococcus pyogenes to scarlet fever,
but his results were not widely accepted. Since Michael Taylor's
discovery in eighteen sixty seven, there had been other scarlet
(18:44):
fever outbreaks traced to milk, and most of the time
milk from the affected dairy had been destroyed, but most
people had thought these outbreaks had a human source, like
a child who lived on the farm, or a dairy worker,
or a delivery world who had cared for a child
with scarlet fever or someone who had it themselves. Taylor
(19:06):
had showed that the cows could carry the disease, which
could mean that destroying the milk was not enough to
stop an outbreak, that the cows themselves might have to
be culled. Destroying potentially contaminated milk was a financial hardship
for dairy farms, but destroying their cows was far worse,
and people resisted the idea that cows could be a
(19:26):
source of infection, although a few people had tried applying
Louis Passenger's heat treatment process to milk almost twenty more
years past before German agricultural chemists Franz von Suchslet suggested
that milk be routinely treated with pastorization, and a big
reason for that was that so many diseases were being
(19:48):
transmitted through milk, not just scarlet fever, but also typhoid, diphtheria, tuberculosis,
and various gastrointestinal illnesses. It still took a while for
pastorization to catch on, though there were concerns that pasteurizing
milk destroyed the nutrients in it, or affected the flavor,
or made it harder to digest, but by that point
(20:09):
scarlet fever rates were on the decline, and we'll talk
more about that after a sponsor break. Although the number
of scarlet fever cases was declining at the end of
the nineteenth century and the disease didn't seem to be
(20:30):
as deadly as it had been in the early twentieth century,
it was still seen as a major public health concern.
Speaker 1 (20:38):
In England.
Speaker 2 (20:39):
For example, isolation hospitals were established for people with contagious
illnesses who could not effectively be isolated at home. During
outbreaks of scarlet fever. There could be house to house
visits to find sick people so they could be isolated
in the hospital. Unfortunately, it is really not clear how
much or whether this really helped slow the spread of
(21:00):
the disease. And also people with different contagious diseases were
all being housed in the same hospitals, and this led
people to say that the isolation hospital was where you
went when you caught one disease, so that you could
come out with all the rest. Welcome to Petri dish Arms.
You'll get a bed and probably seven different things. That's
(21:23):
not great, no good. Other efforts to control the spread
of scarlet fever also did not help a nineteen fifteen
article in the American Journal of Nursing described it this way,
quote it seems to cling to whatever object it encounters.
In no other disease has the infection been apparently conveyed
with such frequency by objects which have come in contact
(21:44):
with those ill as clothes, books, toys, and the like.
This article recommended that quote all hangings, carpets, and upholstered
furniture are to be taken from the room before the
patient is brought in. The furniture left should be of
a kind readily clem. There should be no such fancied
attempts at purifying the air as by hanging up sheets
(22:05):
wet with disinfectants. Such measures are not only useless, but
tend to give a false sense of security. Needless to say,
the patient should be provided with bedclothing, nightgown towels, eating utensils,
and drinking vessels for his exclusive use. Yeah, it is
no longer believed that scarlet fever is just transmitted readily
(22:27):
and for a long period of time in things like curtains.
This article also recommended disinfecting anything that the sick person
had used, using either a five percent solution of carbolic
acid or a two percent solution of creosol, and anything
that had been used for coughing or sneezing into was
to be burned. Also, the recommended treatment for patients themselves
(22:51):
was at least three weeks in bed, even if they
only had a mild case. Around this same time, people
were making more discoveries about scarlet fever, something that really
escalated during the nineteen teens and twenties. In nineteen fifteen,
English bacteriologists Frederick William Twart and his brother were using
colonies of bacteria as part of an effort to find
(23:12):
a way to grow smallpox vaccine in a lab. Twart
discovered areas where the bacteria couldn't grow, and found that
a substance from these areas was capable of passing through
a porcelain filter that trapped most bacteria. He published an
article in The Lancet about what he described as a
filter passing virus that attacked bacteria. His work didn't get
(23:35):
a lot of attention, but this was the first known
description of a bacteria phase. French microbiologists Feligues Derrell made
the same discovery independently of torte about two years later
in the nineteen twenties, husband and wife researchers George and
Gladys Dick, made a series of discoveries about scarlet fever
and its cause. While working in Chicago. They confirmed the
(23:59):
link between the disease and Streptococcus bacteria, and they identified
a toxin produced by the bacteria that was the cause
of scarlet fever. They also developed a skin test known
as the Dick test to show whether a person was
susceptible to scarlet.
Speaker 1 (24:15):
Fever or not.
Speaker 2 (24:17):
They were nominated for the Nobel Prize in Medicine for
the sork in nineteen twenty five in nineteen twenty six.
In nineteen twenty seven, two different pairs of researchers discovered
a bacteria phase that could change a non toxogenic strain
of strap into a toxogenic one. In other words, to
turn a variety of strap that did not cause scarlet
(24:38):
fever into one that did. Various researchers started trying to
develop an inoculation for scarlet fever using either the bacteria
or various modifications of the toxin that it produced. In
nineteen twenty eight, American microbiologist Rebecca Craighill Lancefield developed a
system for classifying strep bacteria into groups based on the
(25:00):
antigens found on the bacteria. Initially, she proposed two groups,
group A and group B. As we said earlier, scarlet
fever is group A. Today there are many more groups.
She was also one of the first people to demonstrate
that strep infections could lead to rheumatic fever. The first
SULFA drugs were developed in the nineteen thirties and were
(25:23):
used as a treatment for strep infections, including scarlet fever.
But the big medical breakthrough was penicillin. We did a
whole episode on penicillins development back in September. Today, penicillin
and amoxicillin are the antibiotics most often used to treat
scarlet fever, with other antibiotics recommended for people who are
allergic to those. Today, in most children, scarlet fever clears
(25:47):
up quickly as long as antibiotic treatment begins promptly, and
that made the amoxicillin shortages that were happening at the
end of last year in a lot of places particularly
scary for folks. Penicillin is often credited with turning scarlet
fever from a terrifying and deadly disease to one that's
considered to be a relatively mild childhood illness most of
(26:09):
the time. As we said earlier, though deaths from scarlet
fever were becoming less and less common decades before penicillin
was introduced, we don't totally know why. Starting in the
nineteen eighties, though, the opposite started to happen, as invasive
strep infections started to become more common in spite of
(26:30):
the existence of antibiotics to treat them. Scarlet fever specifically
started to become more prevalent in a lot of parts
of the world starting in about two thousand and eight.
Increased rates of scarlet fever were first reported in parts
of Asia, and then in the UK and other parts
of Europe, and then in the US. The UK, for example,
saw a sudden spike in scarlet fever cases starting in
(26:53):
twenty fifteen, and soon the rate of scarlet fever was
higher there than it had been in almost fifty years.
At first, it seemed like this wasn't leading to a
similar increase in fatalities, but a year later, invasive strep
infection started to increase there as well.
Speaker 1 (27:10):
Worldwide, there was a five.
Speaker 2 (27:11):
Fold increase in the number of scarlet fever cases between
twenty eleven and twenty twenty, with a drop in twenty
twenty after the start of the COVID nineteen pandemic. Yeah
and a lot of places, the general trend of when
scarlet fever cases are the highest was like sort of
nearing its end when the COVID nineteen pandemic really started.
(27:34):
Although health officials thought there might be some more dangerous
strain of Strep. Bacteria that was causing this increase, some
whole genome sequencing of samples from a lot of different
sick children found that there was not one strain that
was responsible for most of the illnesses. Some researchers have
suggested that the bacteria may have started producing a more
(27:54):
aggressive form of the toxin that causes the disease. It's
also not clear what has caused this most recent spike
in scarlet fever cases that started toward the end of
twenty twenty two in the northern Hemisphere. Scarlet fever cases
usually peak in the late winter or early spring, so
this outbreak happened out of season. At this point, this
(28:16):
is all really speculative, with some of those speculations being
more baseless than others. Like the measures put in place
to try to control the spread of the COVID nineteen
pandemic led to people not being exposed to other diseases.
It's also possible that kids who might have gotten strap
or scarlet fever over the last couple of years didn't
and are instead just getting it now. But there have
(28:39):
also been totally baseless claims pointing to either COVID nineteen
vaccines or the flu vaccine as somehow causing a rise
in strep infections. There is no credible evidence for either.
There were not doctors, so we cannot possibly comment on
every conceivable thing that has been postulated about the spike
and scarlet fever cases. Like it does seem possible that
(29:03):
it is an extension of the spike that was happening
before the pandemic started that kind of paused during the
pandemic peak, when so many places were taking a lot
of mitigation measures.
Speaker 1 (29:15):
As we said at.
Speaker 2 (29:16):
The top of the show, though a lot of folks
experience with scarlet fever is not from their own illness
or the illness of their children.
Speaker 1 (29:22):
It's literature.
Speaker 2 (29:23):
So we'll close out with just a few of the
most famous examples. First, there is Little Women by L. M. Alcott,
in which Beth gets scarlet fever and is extremely sick.
She dies years later, and while the book doesn't give
a specific cause, it's usually interpreted that she had developed
rheumatic fever after that scarlet fever case. Alcott's real life sister,
(29:46):
Elizabeth Sewell Alcott, died at the age of twenty two,
two years after having had scarlet fever, and then Alcott
published Little Women ten years later in eighteen sixty eight.
Another past podcast subject with a scarlet fef connection is
Laura Ingles Wilder, whose real sister Mary became blind after
what the family described as brain fever, probably some form
(30:09):
of meningitis or encephalitis. In the book The Shores of
Silver Lake, set in eighteen seventy nine, the fictional version
of Mary becomes blind after she and the rest of
the family contract scarlet fever. And yet another example that
incorporates both fiction and reality. Several of the von Trapp
family contracted scarlet fever in the early nineteen twenties, and
(30:31):
their mother, Agatha contracted it while caring for them and
died in nineteen twenty two. This led to a young
woman named Maria being hired from a convent to work
as a tutor with the convalescing children, and the family
later became a performing group called the Trap Family Singers
that of course inspired the musical The Sound of Music. Lastly,
(30:52):
of course, there's The Velveteen Rabbit or How Toys Become
Real by Marjorie Williams, which was published in nineteen twenty two,
and in the book, a little boy gets a velveteen
rabbit as a Christmas present, and then there's a whole
story about how nursery magic can make a toy real
through the strength of a child's love.
Speaker 1 (31:09):
This little boy then gets.
Speaker 2 (31:11):
Scarlet fever and it's very sick for a long time,
and once he's better, there's a plan to take him
to the seaside while his room is disinfected, and all
of his toys and books and everything he has played
with is going to be burned, which, as we talked about,
it is a real thing that people would do. So
the doctor then describes the velveteen rabbit as quote, a
(31:31):
mass of scarlet fever germs. Fortunately, the nursery magic theory
appears and makes the velveteen rabbit real, so he is
not burned, but Honestly, this story is kind of horrifying.
It's the meanest thing ever. I remembered it being sad
from like my own childhood, Like I remembered feeling sad
about it. And I'm pretty sure I have like a
copy of the book with its original illustrations and all that,
(31:54):
like in the house somewhere. But I read it at
my desk while working on this episode, and I mean,
maybe it was my emotional stated. There was a lot
of just weeping over this story, and I was like,
why did they give this to children?
Speaker 1 (32:14):
I will tell you a velveteen rabbit story on Friday. Okay,
that'll be great.
Speaker 2 (32:20):
We can talk more about our literature experiences with Scarlet Fevers.
Thanks so much for joining us on this Saturday. If
you'd like to send us a note, our email addresses
History Podcast at iHeartRadio dot com, and you can subscribe
to the show on the iHeartRadio app, Apple Podcasts, or
(32:41):
wherever you listen to your favorite shows.
Stuff You Missed in History Class News
Hosts And Creators
Holly Frey
Tracy Wilson
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