School and health officials worked Friday to ease parents' fears after three classmates at George Washington Elementary in Southwest Baltimore were diagnosed with scarlet fever — an ailment with a scary history, but one that is easily treated and usually not life-threatening.
Principal Amanda Rice and a school liaison official from the Baltimore City Department of Health met with about 50 parents Friday morning to reassure them that students were safe. The school's facilities team spent the previous evening wiping down desks, bathroom stalls and stair rails with antibacterial agents, paying special attention to the classroom shared by the students.
"Our school is fine," Rice said. "There is no reason for parents to worry."
But she said teachers and parents were asked to take precautions and watch for symptoms of the disease in students. Symptoms include chills, sore throat, muscle aches and a swollen red tongue.
"We told teachers that if a kid looks sick or says they feel sick, to take it seriously and send them to the nurse," Rice said.
The school learned of the outbreak after being contacted by parents of the three students Thursday. The school then sent a letter to parents that detailed the symptoms and explained steps the staff was taking to prevent further spread of the disease.
The school received many calls from parents who were concerned for their children's safety after receiving the letter, so school staff decided to hold the morning meeting. Although school officials assured parents that children could attend school, about 11 of the school's 279 students didn't come to class Friday, Rice said.
School officials were trying to determine Friday whether a fourth child had also contracted the disease.
When cases of scarlet fever arise, some may think of the disease from a 19th-century perspective, when widespread outbreaks took lives. People may have heard of the disease from the book "The Velveteen Rabbit" and from "The Little House on the Prairie" series. The name of the disease itself sounds scary to some people, said Judith DeBose, medical director of the Bureau of Schools for the city health department. But DeBose said that those stories of dangerous outbreaks come from an era when little was known about the disease and it was often caught too late to treat.
DeBose, who spoke with parents at Washington Elementary, said that scarlet fever is fairly common and can be treated with antibiotics. It is spread like any other bacterial disease: by contact with someone who has it, through touching, sneezing or coughing. She said children in particular are liable to pass on colds and other illnesses like scarlet fever because they touch so many things.
Scarlet fever is considered a complication of strep throat, a common childhood malady, though it can occur on its own. Both diseases are caused by the same bacteria. DeBose describes scarlet fever as strep throat with a very red rash.
Once introduced into the body, the bacteria produce different toxins. Some cause only the typical sore throat and fever associated with strep throat, and others add the red sandpaper-like rash starting on the neck that is associated with scarlet fever.
"Group A strep can cause a variety of difference clinical scenarios," said Lucy Wilson, an infectious disease physician at the state Department of Health and Mental Hygiene. "Most commonly we see strep throat, with fever, sore throat and swollen glands, in the winter and spring."
Wilson said scarlet fever is far less common than strep, but there are likely cases every year in Maryland. The state, however, does not collect data on the number of cases.
About 15 percent of the population are thought to be carriers of the bacteria in their throats at any time, though it only makes some people sick.
Charlotte Watson, who has grandchildren who attend the school, said she was concerned at first, but felt better after talking with officials.
"I was worried about the health of my family," she said.
Candy Rottman who has a daughter in prekindergarten at the school, said she also wasn't worried after hearing more about scarlet fever. But she said some parents had reservations.
'I think it's just fear," she said. "People hear the word and they don't have a lot of knowledge about the disease, and they don't know what to think."
Baltimore Sun reporter Meredith Cohn contributed to this article.
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