Scarlet Fever, by Cinnamon Worth

Scarlet Fever, by Cinnamon Worth

As I continue to work on my next book, I found I wanted to know a little more about the history of scarlet fever. You see, I needed to use a disease that would keep Elizabeth away from Longbourn so she would be forced to interact with Darcy at Netherfield, but I didn’t want a sickness that would cause permanent scarring like smallpox. I also wanted the sick to have a strong chance to survive and was looking for something common for the period.

The ancient Greeks described a disease that was believed to be scarlet fever, so it has been around for a very long time. By 1675, the disease was called scarlatina. As you may know, it is a bacterial infection that can now be easily treated, but before society had antibiotics, the illness had a mortality rate between 15 and 20 percent. They isolated and quarantined those who caught the disease to control the spread. Sometimes, damp sheets were hung over the doorways of the rooms containing the sick to contain the illness. There were, of course, several ineffective and potentially dangerous “treatments,” but an ounce of prevention was the only true defense.

Historically, the disease affects more children than adults, since children have less built-up immunity. It could, however, impact adults as well. Though having survived scarlet fever in the past did not guarantee immunity, it certainly helped. By age 10, up to 80% of children would have developed lifelong immunity because of repeated exposure.

Yes, in my story, older teens and adults become ill. I also leave poor Kitty behind to nurse the group, reasoning that she has had the illness and therefore has immunity. While the scenario I am creating is possible, I am a little disappointed with it. I imagine some readers will question my choice of disease, reasoning that these adults should already have built-up immunity. If you’d like to suggest a different illness that required a quarantine, was around during that era, and was more common in adults, I am open to suggestions.

There were many outbreaks between 1770 and 1800, and between 1820 and 1880, there was a world pandemic of scarlet fever. One thing I found interesting was that researchers found a correlation between the wheat prices and outbreaks but with a three-year lag. In years with dry spring and summer seasons, wheat productions would fall and prices would go up. This led to more malnutrition among pregnant women. Babies get antibodies for pathogens from their mothers, but by age two, most of these antibodies have cleared their systems. Three years after periods of high wheat prices, data showed a rise in the number of scarlet fever patients, suggesting that malnourishment during pregnancy resulted in the subsequent children having greater susceptibility to the bacteria that leads to this illness.

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Marie H
Marie H
January 7, 2022 7:45 AM

Congratulations on your new release! Franchise and Follies was my first read of 2022 and I loved it! I thought your scarlatini scenario was very credible and well done. It is a 5-star book for me and my favourite of yours to date.

August 18, 2021 3:02 PM

I also contracted scarletina as a child. I don’t remember much about it except that I had to stay home from school and couldn’t see friends for a few weeks, and had to sleep on the living room sofa so my sister, with whom I shared a bedroom, wouldn’t catch it (she didn’t). The only thing I specifically recall is that I had a very high fever and when I was allowed to go out again I could not keep my balance well, especially on my roller skates. I never skated again, phooey. Have had balance problems ever since. And no, yoga does not help. Being allergic to penicillin I took some other antibiotic. Curiously, about a year ago I went to a new dentist and on the health checklist was scarlet fever — along with cancer, diabetes, and other serious conditions. When I was filling it out I asked the hygienist why the question about scarlet fever and no other disease esp childhood disease? She said she’d ask the doc but didn’t get around to it and I never got an answer. So I’m not sure what the connection is or what the long-term effects are other than fever-related inner ear balance problems.Good luck with your story… forward to seeing it!

August 13, 2021 5:20 PM

I had scarlet fever several times growing up. I think the last time was when I was twelve. I remember the terrible sore throat with the accompany rash and high fever. I think we were quarantined, but I developed an allergy to penicillin, so I didn’t take anything. The nightmares were awful as well. No one else in the family got it from me. I think it is plausible that Kitty could be the nurse and not get it.

August 11, 2021 7:10 PM

If you are looking for other alternatives, you might consider diphtheria or typhoid fever.

In the early 1800s diphtheria was known as “putrid fever” and typhoid was sometimes called “burning fever”.

Of the two, typhoid was more likely to infect adults and children equally.

August 11, 2021 10:21 PM
Reply to  MB

Typhoid fever was also lumped with other similar diseases and called “bilious fever” if you like that name better.

August 10, 2021 2:34 PM

I’ve read books that featured this disease before and think it will work for your story. At least you’ll get no criticism over it from me:)

Linda A.
Linda A.
August 10, 2021 1:51 PM

I had scarlatina when I was in first grade. I don’t remember much other than missing school for two weeks, and having to get a blood test (of some kind) before I could go back. I’m told I had a really high fever, but that is all I know. I don’t think anyone else in the family was quarantined, in fact, I believe I still shared a double-bed with my sister at the time. I’ll have to ask my mom.

Linda A.
Linda A.
August 11, 2021 9:44 AM
Reply to  Cinnamon Worth

You got me thinking, so called mom. She said she picked me up from school, watched my temperature climb, and took me to our doctor. Said he knew immediately what it was, gave her a prescription to fill, and took me home. She figured it was penicillin (but with a different name). My temperature was around 103 and she said I was talking but didn’t make any sense. I had the red rash on my chest and back. The rest of my family was not quarantined. She thought maybe because it was a “minor” case? Plus having antibiotics. I often wondered if the scarlatina messed with my heart. I’ve heard it can cause blindness, heart problems, and other issues.

Good luck with the story!

Gianna Thomas
August 10, 2021 1:35 PM

Thank you for the interesting post, Cinnamon. Disease back then, I’m sure, was very hard to deal with without having a knowledge of what would fight them. I don’t know how well known natural remedies were, but antibiotics helped in the war against disease as well. Both have been helpful in lowering the rates over time. Offhand, I don’t know of another disease you might consider. Probably be okay with this one as it seems to fit your story.

cindie snyder
cindie snyder
August 10, 2021 7:42 AM

I don’t know if anyone in our family ever had Scarletina but it looks gross! I see where it gets it’s name! I am glad we harness now it must have been hard in Austen’s time.

Regina Jeffers
August 10, 2021 6:01 AM

My youngest cousin had scarlatina when she was young. I shan’t say how she contracted the disease, for it was quite gross and very stupid as most childhood adventures are. All of us who lived in the house had to quarantined. My mother was especially upset for I had rheumatic fever and was on bed rest for a couple of years. I still catch strep throat easily and must be pretreated with antibiotics for dental procedures, etc. For me, I was mad at my cousin, for such meant my perfect attendance at church was broken, and I would not receive my “attendance” pin.

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