Scarlet Fever

Born in the US in the late 20th century, there are many things about life that I take for granted.  Vaccinations, for example.  Antibiotics.  Health.  And a distinct lack of the illnesses that people die of in some of my favorite 19th century novels.

All of which is why I was utterly floored when my daughter was diagnosed with scarlet fever at the beginning of this week.

To me, it seemed like such an outdated illness to contract, though of course as soon as you open your mouth about it you find a dozen people saying their child had it, they had it, their first cousin's second wife's rabbi's son had it, etcetera.  But my daughter?  Now, in 2015?  She hadn't even seemed so ill, just a very slight fever of 37.5C and then a rash on her chest and back.  It's really the rash that made me take her to the doctor.

I try to imagine what would have happened to her had she contracted it a century ago.  Today it seems very minor; within 24 hours of the rash first appearing she was on antiobiotics, and 24 hours after that she was more or less her usual self.  How would it have progressed had antibiotics not been discovered yet?  What would happen if we were in an area with limited access to healthcare - or none at all?

Reading through the literature you find that the potential side effects and outcomes of untreated scarlet fever are actually quite scary.  With our family's easy and cheap access to healthcare, aside from the "scary" name of the illness, it just seemed like one of the run-of-the-mill things that kids catch and get over just as quickly.  There was never any fear for her survival or the potential future side effects for her.

Then I wonder about the large parts of the world where such health and access to doctors and medicines are not something that can be taken for granted.  When their child develops scarlet fever, what do they do?  What do they think?  How do they get through it?  The fatality rates of scarlet fever are around 1% nowadays, down from 15-20% pre-antibiotics.  But I can't help but wonder if the 99% / 1% split is 99 children in first-world countries who survive and 1 child in a third-world country who dies.

A century ago, scarlet fever would have spelled death for 1 in 5 children.  Such a diagnosis could strike fear into a parent's heart.  Now we're so cocky with our medical advancements that my daughter was diagnosed with it and I got home and laughed for an hour and the sheer absurdity.

I'm the parent of one of the 99, so I can laugh and be relaxed about it.  But who's the parent of the 1?