Talk:Scarlet fever

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This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Emb47. Peer reviewers: JSShin.

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i
i had it and it kills like crazy Article has below mentioned inconsistency issues and has almost no information on treatment or the history of this disease. As also mentioned below, the disease was very virulent prior to the invention of a vaccine and appeared in numerous works of literature, ie Frankenstein. Quality level dropped to C. 76.28.77.142 (talk) 15:47, 11 October 2010 (UTC)

Scarlet Fever != Rheumatic Fever
Scarlet Fever is the name for the rash that occurs due to released exotoxins from Group A strep.

Rheumatic Fever is the autoimmune disease that occurs after infection with Group A strep that causes damage to your heart valves.

--DocJohnny 22:40, 17 December 2005 (UTC)

It is not correct to state that Scarlet Fever used to be called Scarlatina. Scarlatina was believed to be a different, but similar, disease and even UK GPs believed, and diagnosed, on this basis. The 'symptoms' were much milder and recovery faster. It was later that they were identified as the same disease and the name Scarlatina dropped.

TigB (talk) 23:21, 1 April 2013 (UTC)

Virulence of Group A streps not decreasing!
The virulence of group A strep seems to be increasing lately. "Lately" is rather vague and is it true of the entire planet?

This is false. The virulence of Group A (beta Haemolytic) Streptococci seems to be decreasing globally. This is exemplified by the falling incidence of Rheumatic Fever. The theories as to why include: 1) better general sanitation and decreased infection from group A streps 2) improved management of strep infections resulting in the fever to rarely progress to either Rheumatic or Scarlet Fever 3) an unexplained decreased pathogenicity of group A streps

[Pathologic Basis of Disease, 7th Edition, Kumar, Cotran and Robbins. Chapter on Cardiovascular Pathology]

Rutigor
The edits you made are quite interesting and add some depth to the article, but they need to be sourced. I did remove the "They require reassurance..." sentence as it not very encyclopedic imo. --DocJohnny 06:49, 27 December 2005 (UTC)

Illness and Antibiotics.
Illness is too vague to belong on any symptom list.

Antibiotic treatment for streptococcal infections is not seriously criticized. While most people will recover without antibiotics from strep throat, antibiotics significantly reduce complications such as rheumatic fever. I can find no legitimate medical articles advocating against antibiotic usage.-- John DO | Speak your mind  05:10, 22 April 2006 (UTC)

"School age children are most likely to have scarlet Fever, but it goes for most ages." - begging the author's pardon, but this line was coming up with incorrect formatting, and the information is not written in a clear way. Reynardo 05:09, 29 October 2007 (UTC)

Scarlet Fever in Literature Section - Beth from Little Women
Doesn't Beth in Little Women die from Scarlet Fever? This article states she recovered. —The preceding unsigned comment was added by 12.150.14.227 (talk) 17:06, 11 December 2006 (UTC).

I thought she died of consumption [as it was known then] or TB later on - she did not die of scarlet fever although she was dangerously ill with it. I don't recall anything as specific as congestive heart failure. Vandenwyngaerde 13:47, 6 March 2007 (UTC)

The symptoms she had were the classic progression of scarlet fever to congestive heart failure. She never really recovers from the bout she has in "Little Women", and dies 5 years later in "Good Wives". Reynardo

More technical description: Should "Group A beta Hemolytic" be added to this description? Just thinking out-loud. sgs nola66.157.38.221 20:51, 15 March 2007 (UTC)

This article should be edited so it uses less jargon; it reads like a medical book. At the least some of this jargon should be linked to a definition.

reniam Reniam 00:31, 24 May 2007 (UTC)

Does anyone else have concerns about the MANY spoilers in the Literature/culture section? I definitely had a storyline ruined for me there. Maybe a warning?? Thanks! 149.101.1.134 (talk) 17:59, 13 November 2008 (UTC)

I don't see a Literature Section at all. I was looking at this article after reading THE VELVETEEN RABBIT by Marjorie Williams, to see whether burning all an infected child's belongings was actually an appropriate action to fight spread or recurrence of scarlet fever, but I didn't find that either. WordwizardW (talk) 16:23, 27 March 2022 (UTC)


 * Margery Williams, not Marjorie--sorry. WordwizardW (talk) 16:28, 27 March 2022 (UTC)

"Strawberry" tongue is not well described
One of the characterizing symptoms is given as "strawberry tongue" with the description of being bright red. The [| CDC description] says "The tongue itself looks like a strawberry because the normal bumps on the tongue look bigger. This is much more helpful to a worried parent.  (Like me Jsparkes 11:29, 12 June 2007 (UTC)


 * I agree. The description is not clear, though I nderstood what it meant when I looked at the photo.

Slapped cheeks?
Image states "Slapped Cheek". I think this is incorrect and may be confusing to the medical community (esp medical students). Slapped cheek is typically attribured to "Erythema infectiosum (fifth disease), not Scarlet fever. Scarlet fever normally is said to be associated with sandpaper rash on the abdomen and circumoral palor.  —Preceding unsigned comment added by Ksaraf (talk • contribs) 20:30, 20 November 2007 (UTC)
 * I agree with this contribution.It is erroneous to describe the red face of scarlet fever as "slapped cheek" as this has a different,far less serious, cause -B19 parvovirus.86.128.182.232 (talk) 13:18, 1 February 2008 (UTC)
 * I've adjusted caption to match description as given in the article text and remove the highly confusing mention of "slapped cheek" which of course would be mistaken for descirption of fifth disease (aka "slapped cheek syndrome"). I've also asked image author to review their image's caption.David Ruben Talk 17:58, 1 February 2008 (UTC)

I'm adding back in my image of the slapped cheeks as this was the definitive diagnostic symptom in my daughter's case. As I said in response to David's request: I think I'll leave my wording, but thanks for the discussion! At The Skin Disease Archive, when talking about Fifth Disease, they reference both rashes as being quite similar: "It is called slapped cheek syndrome because the children suffering from this disease show rosy slapped-like cheeks....It is the fifth of five common child diseases that cause similar skin rashes (measles, rubella, scarlet fever, Filatov-Dukes disease and slapped cheek syndrome)." I believe this supports the wording that both diseases have a slapped-cheek look as a possible symptom. In my daughters case, it was *the* symptom (along with the white mustache) that allowed a positive diagnosis. Estreya (talk) 21:32, 16 February 2008 (UTC)" Estreya (talk) 18:52, 10 October 2008 (UTC)
 * Estreya, in that case, your physician may have misdiagnosed your child. The picture shows slapped cheeks, a sign of fifth disease.  Perioral pallor is seen with scarlet fever, but no pallor is seen -- that is your daughter's natural skin color.  The rash of scarlet fever spares the face.  The "definitive test" for scarlet fever isn't the facial appearance, it's a confirmed culture of Group A strep from the strep throat preceeding the rash.  For these reasons, I am removing the picture.  It is misleading to have it here, regardless of what your personal physician has told you.Danierrr (talk) 05:43, 24 May 2009 (UTC)

Eurocentric article
The article mentions "slapped cheeks" and the "white mustache" as symptoms of scarlet fever. What about symptoms on people of non-European descent? Do people with dark skin still get a "white mustache" when struck by scarlet fever? Or does the disease only attack white people? — Morganfitzp (talk) 17:05, 18 January 2008 (UTC)


 * I'll be the first to admit that much medical and first aid literature is deficient in this regard. It may not be entirely the fault of the authors of the article, but more a reflection on the lack of good documented medical knowledge for treating certain conditions in non-white persons. --Waterspyder (talk) 15:31, 5 January 2009 (UTC)

"Very Deadly"? gotta be incorrect
Try comparing 02:05, 31 March 2008 with 23:45, 31 March 2008. That "very deadly" thing is almost certainly wrong. --24.46.164.83 (talk) 05:52, 4 April 2008 (UTC)


 * uncited and I've removed it. I've add a ref to history section which sets out some info on mortality in prior centuaries and why this might be so. David Ruben Talk 18:47, 4 April 2008 (UTC)

Epidemiology
It may be helpful to have some epidemiological information, for example, what age groups does it strike, is it a problem in the developing/developed world, what % of people experience this at some point, etc. If I come across this info I'll add it. Imogenne (talk) 00:00, 27 August 2008 (UTC)

*Some* popular references.
Oh, I agree that the list had got out of hand. However, some reference to the frequency in which it appears, and tying that in with how prevalent it was before modern antibiotics, should be there in my opinion. A line or two such as "Scarlet fever was often used as a plot point in novels such as the Little Women series, and the Little House stories." Yes? No? Reynardo

Historical significance
Given the prevalence and morbidity of SF before the 1950s, a section on the treatment and outcome of this disease in the pre-antibiotic era would improve the article. I don't have enough expertise in the history of medicine to do this myself. Growing up in the 50s and 60s my parents still had a dread of this awful disease. --80.176.142.11 (talk) 19:45, 5 August 2009 (UTC)

Diarrhea
Shouldn't the possibility of diarrhea be mentioned before the "Treatment" section?

Wanderer57 (talk) 20:03, 15 September 2009 (UTC)

Rash On Face
The description at the top says the rash spares the face, and then the article later goes on to say the rash first appears on the face but not around the mouth. Please be consistent. --38.98.177.132 (talk) 17:58, 12 October 2009 (UTC)

wow, what happened to this article?
Scarlet fever has had quite a cultural significance in the history of the world. Why has all that information been extracted from the article? Wickedjacob (talk) 06:58, 17 October 2011 (UTC)

Yes, I couldn't find a section on literary mentions, even though such a section is referred to on this Talk page. I came to this article after reading THE VELVETEEN RABBIT by Marjorie Williams, so I'd imagine that's worth a mention. WordwizardW (talk) 16:26, 27 March 2022 (UTC)
 * Margery Williams, not Marjorie--sorry. WordwizardW (talk) 16:27, 27 March 2022 (UTC)

Vaccine
DrMicro is continually adding in results from a primary study 50 years ago as what I believe is WP:OR conclusion about vaccines. I would like him to justify using this source as a commentary on vaccines, when at least from the abstract, vaccines aren't even mentioned. Yobol (talk) 16:43, 22 June 2012 (UTC)
 * The logic is simple. A vaccine cannot work unless there is a persistent immune response either cell mediated or antibody mediated. A vaccine to strepococci is not possible unless there is a persistent immune response. The Dick vaccine was developed in the 1920s and was used for about a decade. Since this has not been used in decades we have no idea if an immune response to this or any other streptococal vaccine is possible. There are very few published studies that have been done to confirm the persistence of an Ab or other response to streptococci over several decades. Because immunity to some vaccines or infections seem to wane over time repeated vaccinations are recommended for some vaccines. The hepatitis B vaccine is a case in point: rechecking the Ab levels is recommended at least once every ten years. Without this evidence in this paper suggesting that a vaccine - other than the Dick vaccine which has been proven to work - is even possible is at best misleading. This study suggests that a vaccine may be possible. Concerning the OR suggestion: this statement is misleading at best. By definition restating the significant findings of a published study is not OR. Aside from the OR statement the basis for this edit warring which has been referred is not clear. DrMicro (talk) 08:51, 25 June 2012 (UTC)
 * Stating that the source discusses this implication in the context of vaccine is OR. If the source doesn't we don't.  Also, per WP:MEDRS, we should be using secondary sources, to establish WP:WEIGHT. Find a better source. Yobol (talk) 14:12, 25 June 2012 (UTC)
 * Firstly at the moment there are NO references in the section at all. There is no cited evidence to support the claim that there is on going research into a vaccine. There is no cited evidence that there are difficulties due to the number of strains. In accordance with WP policy given this lack of cited evidence I would move that this section be stricken from the article unless published sources to support these remarks can be provided.
 * Secondly the material relating to the patented and clinically used Dick vaccine is not mentioned in this section. Its omission from this section is curious.
 * Thirdly the source simply states that an immune response persists. As an persistent immune response is the sine qua non for any vaccine. Because of this any discussion of a potential vaccine development should cite evidence of a persistent immune response. Failure to cite evidence of a persistent immune response is tantamount to building an edifice on sand.
 * Finally "Stating that the source discusses this implication in the context of vaccine is OR." Im afraid this statement is simply wrong because it is not what I wrote. Accordingly the logic behind it seems circuitous at best. DrMicro (talk) 22:37, 25 June 2012 (UTC)
 * You apparently need to read the section again, because there is clearly a source at the end of it. If you want to add a discussion about the immune response and antibody persistence as it relates to vaccine, you need to find a source that explictly discusses all parts of that, with appropriate weight compared to the source, that complies with WP:MEDRS. Otherwise, there is nothing left to discuss. Yobol (talk) 23:20, 25 June 2012 (UTC)

Prognosis
This article needs a "Prognosis" section, like "Measles" and other infectious disease articles.--Solomonfromfinland (talk) 22:56, 14 October 2012 (UTC)

Testing section (9.1)
Could someone with more expertise in this area find out what the test is called referred to in the section in the middle of the article? I've been browsing page history for a while and it's unclear what is the correct name, as its been altered several times.74.96.70.179 (talk) 12:11, 7 June 2013 (UTC)

Regarding what I percieve to be a fallacy in the article.
The sentence below implies that plummeting deaths from scarlet fever were due to antibiotics which does not appear to be correct.

"Before the availability of antibiotics, scarlet fever was a major cause of death."

Deaths from scarlet fever were plummeting way before antibiotics were available to treat it. This decreased mortality rate was most likely due to the Sanitation Revolution from the mid-1800s into the early 1900s.

I have viewed statistics on England and Wales scarlet fever mortality rates from 1838 to 1978 from the record of mortality in England and Wales for 95 years as provided by the Office of National Statistics.

I have never edited wikipedia before and I don't want to step on anyones toes so to say, so I would appreciate any advice on the "correct" way to go about this.

Dora79 (talk) 14:47, 21 February 2014 (UTC)

Can you sequence a toxin
"The first toxin that causes this disease was cloned and sequenced in 1986 by Weeks and Ferrett" I thought you could only sequence DNA - of an organism. Surely a toxin is not an organism and does not have DNA?Billlion (talk) 17:46, 4 April 2014 (UTC)

wrong redirect
The link in the microbiology section to SpeA actually redirected to Pseudomonas exotoxin. Fixed it to go to erythrogenic toxins (streptococcal pyrogenic exotoxins). Rrcopley12 (talk) 00:29, 5 March 2016 (UTC)

Work Plan for the next month
I plan on prioritizing the signs and symptoms section. I think there is room for improvement in the organization and descriptions. The presentation can also vary based on the person’s race so I can add a section to focus on different populations. The differential diagnosis is an important focus that should be located right after the signs and symptoms since those things listed in the differential diagnosis will share some of them. I also think it will be important to expand upon the complications that can occur from scarlet fever if left untreated and why those complications arise. Overall I think the general organization of the sections can be changed as well.

I intend to use a variety of resources over the next few weeks. I am most familiar with PubMed and Clinical Key so I will likely start with those two however am interested in searching on Medline Plus. Scopus will be a great resource since it indicates how many times an article has been sited which will help in determining the value of articles.

As I research information about Scarlet Fever I will gain a better idea about what will be most important to include however I think that clinical diagnosis is a very important topic to focus on as many cases will be found in pediatric primary care offices. As I mentioned above I think the complications section will be important since there are serious consequences that can arise from untreated streptococcal infections. With that, the pathophysiology section will be important since that will also give the reader a better idea as to why those complications can arise. I will also definitely be including a history section since it is likely that that is the way many of the readers have heard about the illness.

I will embed links to descriptive terms that will be used in the signs and symptoms portion in addition to describing them. Embedding the terms to pages with more in depth description, examples and pictures will allow for easy clarification. I will also embed links to the other possible diseases that will be talked about in the differential diagnosis section.

To avoid using medical jargon when editing this article I am going to look on websites that are directed more towards parents worried about their kids or people using google to get medical advice. I will definitely not be using the information from these articles however I think they will be a good resource for the kind of vocabulary I should use.

Update to the work plan: So far in the editing of the article I have done a thorough literature review for the signs and symptoms section so as to create the most accurate and concise list. I decided to go into more detail with the Rash description and the Oropharyngeal findings description since those are the two most prominent findings in scarlet fever. I added a picture of an oropharyngeal exam of a child with a positive strep throat culture from the wikipedia commons. It shows an exudative pharyngitis really well. I still need to add in the special populations part of this section as I addressed earlier.

I am currently updating the complications portion since there are many and working to break it into two major categories for organization purposes. I then plan on re-doing the history and pathophysiology section of the article. After I have completed updating all of the sections that I think were lacking I will address the opening statement because at that point I should have a better knowledge base to do so.

--Emb47 (talk) 20:13, 20 November 2017 (UTC)
 * Hi, Thanks for your work so far on this article and your efforts to improve it. We greatly appreciate this!
 * I changed Scarlet_fever to past tense. Can you please check the two citations used in this paragraph to make sure that they fit WP:MEDRS. The first citation (from 1925 I think) looks primary to me. I cannot open the second one from my library. They would be exempt from WP:MEDDATE because this is in a historical context and in the history section of the article. If they are the primary research papers for this test, please search for a review article that summarizes this information. There is a good chance that the review article will not have as much information, but that is ok. Only leave in the article information that you can cite from a high-quality secondary (or tertiary) source. If you have any questions, please let me know.
 * Thanks again for helping with this article!
 * JenOttawa (talk) 02:07, 9 December 2017 (UTC)

Peer Review
Below is my peer review as part of the WikiEd Course: Is the article clear and understandable? -Overall the article was very clearly written and easy to understand. One suggestion is to try and clean up the prevention section. The discussion of the vaccine approach is hard to follow, which I think that is mostly due to sentence structure so it should be an easy fix. (i.e. "The vaccine approach has more potential to do so since vaccine formulations can target multiple subtypes of the bacteria.")

Is everything in the article relevant to the article topic? -All sections of the article seem equally and appropriately weighted, except for the history section. The history section is one of the longest sections and the level of detail included is probably beyond the scope of the article.

Is there anything that distracted you? -I did not find anything in particular to be distracting in this article.

Would it be understandable to a non-medical person? -Overall I thought that the article was well written for the intended audience of laypersons and the images of the different rashes are great. There are a couple of sections in the article that I think would be difficult to understand for a non-medical person. -A few examples: In the signs and symptoms section, the dermatology nomenclature may be hard to follow (i.e. petechiae). In the same section instead of saying "inguinal and axillary regions" maybe just use groin and armpit. -The pathophysiology/microbiology section is super technical but I think that is largely unavoidable. -Differential diagnosis section. The dermatology terms (i.e. exanthem, morbiliform, maculopapular) would be hard to understand, but the wikilinks provided gives the reader the ability to easily clarify.

Is the article neutral and balanced? -the article does appear to be neutral and well balanced

Are there any claims that appear heavily biased toward a particular position? -No

Is the supporting evidence from unbiased sources? -Yes

Are there viewpoints that are overrepresented, or underrepresented? -none

Is the article supported by reliable evidence? -Yes, all reference appear to be from well known journals or publishers

Is each fact referenced with an appropriate, reliable reference? - Antibiotic resistance section: "Previously, observed resistance rates had been 10–30%; the increase is likely the result of overuse of macrolide antibiotics in recent years." -History section: there are entire paragraphs that don't have a single reference cited.

Are the citations from publicly available sources? -A number of the books cited don't include an ISBN or other clickable link or easier reference but they could be accessed if the general public was so inclined.

Does the article paraphrase or plagiarize? -None that I am aware of

Is the cited evidence current? -Yes, a majority of the references are from within the last 5 years.

Other -I made a handful of minor spelling/grammar changes and added internal wiki links for some of the technical words used. JSShin (talk) 15:23, 10 December 2017 (UTC)


 * Thanks so much for the review! I definitely spent some time this week researching the historical information about scarlet fever to fix that part of the article, especially all of the paragraphs that had no references listed. I also went back and re-worded the section on vaccines because you were definitely correct in that it was hard to follow. Thanks again! --Emb47 (talk) 01:16, 15 December 2017 (UTC)

A Commons file used on this page or its Wikidata item has been nominated for deletion
The following Wikimedia Commons file used on this page or its Wikidata item has been nominated for deletion: Participate in the deletion discussion at the. —Community Tech bot (talk) 22:06, 29 January 2020 (UTC)
 * Scarlet fever 2.jpg

Removed mention of the Ingalls and Nelson families.
I removed the following statement:
 * "In 1879, The Ingalls and Nelson family contracted Scarlet Fever, making Mary Ingalls blind."

For the following reasons: MagnoliaSouth (talk) 06:12, 15 February 2021 (UTC)
 * 1) It does not have a source at all.
 * 2) Mary Ingalls actually did not have Scarlet fever, but instead it was probably meningoencephalitis. I know this because it's on the Mary Ingalls Wikipedia page, which is sourced by several articles. Very likely, many did refer to it as scarlet fever before, but new evidence suggests it's untrue. If you can cite a source where originally all those years ago people believed it was scarlet fever and you have sources for that, then please return to it and rewrite it but it's important to note that it probably is untrue. How to find out is beyond my personal knowledge.

Wiki Education assignment: Plagues and People
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