Scarlet Fever - History

History

The first description of this disease is uncertain. It is possible that Hippocrates in c. 400 BC described this in a case with a sore throat and skin ulcers, but the diagnosis is not entirely clear from the description. In the 10th/11th century, the physicians Rhazes, Ali Abbas and Avicenna described a measles-like illness that had a more vivid colour and was more dangerous. Again it is not certain that these descriptions refer to scarlet fever.

The disease appears to have been first described in the medical literature in the 1553 book De Tumoribus praeter Naturam by the Sicilian anatomist and physician Giovanni Filippo Ingrassia, where he referred to it as rossalia or rosania. It was redescribed by Johann Weyer during an epidemic in lower Germany between 1564 and 1565 who referred to it as scalatina anginosa. The first unequivocal description of scarlet fever was published by Jean Cottyar of Poieters in his book De febre purpura epidemiale et contagiosa libri duo published in 1578 in Paris. Daniel Sennert of Wittenberg described the classical 'scarlatinal desquamation' in 1572 and was also the first to describe the early arthritis, scarlatinal dropsy and ascites associated with the disease.

Bright in 1827 first recognised the involvement of the renal system in scarlet fever.

The association of streptococci and disease was first described in 1874 by Billroth in patients with wound infections. Billroth also coined the genus name Streptococcus. The organism was first cultured in 1883 by the German surgeon Friedrich Fehleisen who cultured it from perierysipelas lesions. It received its current name (Streptococcus pyogenes) in 1884 from Rosenbach.

The German physician Friedrich Loeffler was the first in 1884 to show the presence of streptococci in the throats of patients with scarlet fever. Because not all patients with pharyngeal streptococci developed scarlet fever, these findings remained controversial for some time. The association between streptocci and scarlet fever was confirmed by Dochez, George, and Dick in the early 1900s.

Scarlet fever serum from horses was used in the treatment of children beginning in 1900 and reduced mortality rates significantly.

In 1906 the Austrian pediatrician Clemens von Pirquet postulated that disease-causing immune complexes were responsible for the nephritis that followed scarlet fever.

Bacteriophages were discovered in 1915 by Frederick Twort. His work was overlooked and phages were later rediscovered by Felix d'Herelle in 1917. The specific association of scarlet fever with the Group A streptococcus had to await the development of Lancefield's streptococcal grouping scheme in the 1920s. The Dicks showed that cell-free filtrates could induce the erythematous reaction characteristic of scarlet fever, proving that this reaction was due to a toxin. Karelitz and Stempien discovered that extracts from human serum globulin and placental globulin can be used as lightening agents for scarlet fever and this was used later as the basis for the Dick test. The association of scarlet fever and bacteriophages was described in 1926 by Cantucuzene and Boncieu.

The discovery of penicillin and its subsequent widespread use has significantly reduced the mortality of this once feared disease.

The first toxin that causes this disease was cloned and sequenced in 1986 by Weeks and Ferretti.