Still around today, this strep infection that cruses a rash has terrible effects in “Little Women’ & “Little Town on the Prairie”

On the February 17, 2025, episode of Jeopardy!, the Final Jeopardy category was “Literature & Sickness.” Contestants faced the following clue:

“Still around today, this strep infection that causes a rash has terrible effects in ‘Little Women’ & ‘Little Town on the Prairie’.”

What is Scarlet Fever?

Scarlet fever, a bacterial infection caused by Streptococcus pyogenes, has appeared in several works of classic literature, particularly in the 19th century, when outbreaks were common. In Little Women by Louisa May Alcott, Beth March, the shy and gentle sister, contracts scarlet fever after caring for a sick child in a poor family. Though she initially recovers, her health is permanently weakened, and she eventually succumbs to complications from the illness, marking one of the most emotional moments in the novel.

In Little Town on the Prairie, part of Laura Ingalls Wilder’s Little House series, scarlet fever is responsible for Mary Ingalls’ blindness. Although modern medical research suggests that her blindness was likely caused by viral meningoencephalitis rather than scarlet fever, Wilder’s books attribute her condition to the bacterial infection, reflecting the fears and medical knowledge of the time.

The Reality of Scarlet Fever in the 19th Century

During the 19th century, scarlet fever was a major health threat, particularly to children. The disease spreads through respiratory droplets and close contact, with symptoms including a high fever, sore throat, and a distinctive red rash that gives it its name. Without antibiotics, complications such as rheumatic fever and organ damage were common, making it a feared illness in households across Europe and North America.

Medical treatments at the time were limited to isolation, rest, and home remedies, as antibiotics had not yet been discovered. Many children who survived scarlet fever experienced lasting health effects, including heart and kidney damage. The disease frequently appeared in literature as authors drew from personal experiences or societal concerns about the epidemic.

Modern Advances in Treating Scarlet Fever

Unlike in the 19th century, scarlet fever is no longer a deadly disease in most developed countries. The discovery of penicillin in the 20th century made treating streptococcal infections much safer and more effective. Today, early diagnosis and antibiotic treatment prevent serious complications, and the disease is far less common than it once was. However, outbreaks still occur, particularly in school settings, and global health organizations continue to monitor its spread.

Interestingly, while scarlet fever has declined in many parts of the world, recent years have seen an increase in cases in some regions, including the United Kingdom and parts of Asia. Scientists believe factors such as bacterial evolution and changing immunity patterns may contribute to this resurgence.

Scarlet Fever’s Lasting Impact in Literature and Medicine

The portrayal of scarlet fever in Little Women and Little Town on the Prairie reflects the historical reality of the disease’s dangers in the 19th century. It served as a narrative device to highlight the fragility of life, the sacrifices of caregivers, and the limitations of medicine at the time. Beth March’s tragic fate remains one of the most poignant moments in American literature, while Mary Ingalls’ blindness shaped the direction of the Little House series.

Though scarlet fever is no longer the severe threat it once was, its legacy lives on in literature, medical history, and ongoing public health discussions. The inclusion of this disease in Final Jeopardy! is a reminder of how illnesses once feared and misunderstood have shaped both fictional and real-world narratives.