The Treatment of Scarlet Fever with Immune Human Serum

Abstract

All efforts to identify and isolate the specific cause of scarlet fever having failed, it has been impossible to produce an immune serum for therapeutic purposes in this disease similar to that employed in the treatment of tetanus, diphtheria, epidemic meningitis and pneumonia. However, it was naturally inferred that persons who had recently passed through an attack of scarlet fever would have specific antibodies in their blood and, should the antibodies be in sufficient concentration, that the serum of such blood might be of curative value when introduced into patients acutely sick with the disease. Acting on this presumption, Weisbecker,1 in 1897, treated 5 cases of scarlet fever with the blood serum of convalescents, but with little success. From 1897 to 1903, scarlet fever cases were treated by injections of convalescent serum by Huber and Blumenthal,2 von Leyden,3 Rumpel4 and Scholz.5 They did not reach any certain conclusion as to the value of the procedure. The serum was injected subcutaneously and in relatively small doses. Because of the absence of any decided advantage from this treatment and from the fear of transmitting syphilis and other infections the use of convalescent serum was abandoned for about 10 years. By this time the Wassermann test made it possible to exclude syphilis from the donor of the serum, and a large experience in the administration of large quantities of serums had been acquired. Intravenous injections of serum had also been successfully employed in various cases. In 1912, Reiss and Jungmann treated 12 cases of severe scarlet fever by intravenous injections of 40 to 100 c.c. of convalescent serum with marked benefit in 10 cases. They drew the blood from convalescents about the end of the 3rd or beginning of the 4th week of the disease, tested each serum for syphilis and sterility,