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Mary from Little House Didn't Get Scarlet Fever

It was viral meningoencephalitis (a viral brain infection) that caused Mary’s illness and subsequent blindness—not scarlet fever, according to the current edition of Pediatrics.

In Laura Ingalls Wilder’s semi-autobiographical Little House book series, her sister Mary became ill with fever and severe headache. “Far worst of all, [scarlet] fever had settled in Mary’s eyes, and Mary was blind,” the author wrote.

Yet it was viral meningoencephalitis (a viral brain infection) that caused Mary’s illness and subsequent blindness—not scarlet fever, according to the current edition of Pediatrics. The authors based their conclusion on archival records and medical information.

The new diagnosis is reasonable, based on Mary’s symptoms. Encephalitis commonly causes fever and severe headache, and weakness of the face can be the result of inflammation of nerves from the brain (cranial nerves) related to encephalitis. The outcome of viral encephalitis varies widely, ranging from complete recovery to fatality. Patients may recover, but with an isolated long-term injury to the nervous system that causes deafness or blindness.

As the authors of the Pediatrics study point out, scarlet fever in children today is much milder than it was in the 1800’s. Scarlet fever is caused by the bacterium Group A Streptococcus, which causes strep throat. Certain strains produce a toxin that causes the red, rough rash that characterizes scarlet fever. 

Generally, children with scarlet fever are no more ill than children who have strep throat without a rash. But in the 1800’s, scarlet fever was frequently fatal. The availability of antibiotics doesn’t explain the change in the disease’s severity because scarlet fever became milder even before that. The reasons for the change in severity remain unknown.

This post is contributed by a community member. The views expressed in this blog are those of the author and do not necessarily reflect those of Patch Media Corporation. Everyone is welcome to submit a post to Patch. If you'd like to post a blog, go here to get started.

North Shore-LIJ Health System February 06, 2013 at 01:44 PM
This post was written by Lorry Rubin, MD, director of pediatric infectious diseases at Cohen Children's Medical Center of New York and professor of pediatrics at Hofstra North Shore-LIJ School of Medicine. Contents of the health blog are the property of North Shore-LIJ Health System and are provided as a health resource for consumers, health care professionals and members of the media. The medical content on the North Shore-LIJ Health Blog is for informational purposes only and should not be considered a substitute for consultation with your physician regarding diagnosis, treatment or any other form of specific medical advice. These materials may be reprinted for noncommercial personal use only. "North Shore-LIJ Health System," "North Shore-LIJ," "northshorelij.com," "VivoHealth," their related entities and logos are trademarks of the North Shore-LIJ Health System. Copyright © 2011 North Shore-LIJ Health System. All rights reserved.

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