If the attack
is very mild the throat symptoms may not cause any distress. Frequently,
about the third day, there are patches on the tonsils. Prostration may
be profound if the fever is very high. Convulsions and diarrhea are
sometimes present in very young patients. It takes from two to six days
to develop scarlet fever from the time the child is exposed to it. The
disease may be caught at any time, but it is most contagious during the
time the patient is scaling. It is not as contagious as measles. Some
children seem to escape even though directly exposed to it. It is more
frequent in the fall and during the winter, and it is more severe during
the latter months.

Eruption.--The eruption appears at any time after twelve hours. It may
not, however, appear before the third or fourth day. It lasts from three
to seven days, and only takes a few hours to cover the whole body after
it is first seen. The rash is first seen on the neck or chest; it
appears as a red, uniform blush, but, when examined closely, small
reddish spots may be seen all over it. If the rash is very faint and of
a doubtful character a hot bath may bring it out. A bright red,
well-developed rash is a sign of good heart action. In the event of
heart failure, the rash fades quickly. Itching is a constant symptom
after the rash is fully out.

About the eighth day the rash begins to scale or desquamate. It begins
on the neck and chest. It takes from one to three weeks to scale
completely, from the time it begins to peel. The hands and feet are the
last spots to scale.

It must always be kept in mind that mild cases are just as contagious as
severe cases, and that a mild case may cause in another person a very
severe attack.

The throat may be mildly affected or it may be the most troublesome
feature of the case. It is red and swollen and the child complains of
pain during the act of swallowing. Patches may be seen on the tonsils on
the third day. There is usually a discharge from the nose and this
discharge may be contagious. While the fever is high, the child is
restless, complains of thirst, and may be slightly delirious.

One attack is usually all a child has during life, though there are
exceptions to this rule. Complications are quite frequent with scarlet
fever. Inflammation of the ears and kidneys is most often met.

Measures to be Taken to Prevent Spread of Disease.--Every case, no
matter how mild, should be isolated for four weeks. Many cases