A Comparison of the Effects of Hospital Isolation and Home Isolation in Cases of Scarlet Fever.

The question whether a scarlet fever patient, to prevent the spread of infection, ought to be isolated in hospital or whether one can be content with isolation at home, which in many cases is equivalent to no isolation at all, has long been a subject of much dispute. Whereas it was formerly usual to isolate scarlatina patients in hospital, great opposition to this procedure has been raised in recent years. The arguments advanced against it are: Firstly, that it has not been possible to establish with certainty that hospital isolation has any influence on the spread of the disease, scarlet fever being not less prevalent in places where such isolation is strictly practised than in places where it is not. Secondly, that patients with manifest scarlatina constitute only a small fraction of those infected and it therefore is unreasonable to isolate them. Thirdly, that isolation in hospital is an expensive measure which entails great outlay for the community, without yielding corresponding advantages. And fourthly, that hospital isolation in certain cases may have injurious effects, the patients being infected during their stay in the hospital by other types of streptococci than those they originally possessed and being therefore more liable to complications and recurrences.