Medicine: Itchy Town

All the school kids in the Ontario city of Sault Ste. Marie (pop. 32,000) were having their heads examined last week. And with good reason: the Soo had been hit by a raging epidemic of tinea capitis (ringworm of the scalp). Of 5,712 elementary schoolchildren, 1,300 had ringworm; so had 150 preschool moppets and 64 youths and adults. On streets and playgrounds, every bobbing head was topped with a white cotton skullcap, compulsory for schoolchildren, strongly recommended for all others. It was the severest ringworm epidemic ever recorded in Canada or the U.S.

Hour after hour, every day, hundreds of itchy victims trooped into the nine treatment centers set up by the city’s brisk, go-getting health officer, Dr. Joseph Gimby. Each child’s head was examined under a special ultraviolet lamp which makes infected areas show up fluorescent. Where the fungus* had a foothold, the patches were marked and, down the line, were clipped. Many boys and a few girls were completely shaved.

Loud Screams. The scalp was scrubbed, and then began the most painful part of the treatment: under the revealing lamp, infected hairs were pulled out with tweezers. In spite of loud screams echoing down the halls, this Spartan procedure was necessary because the fungus penetrates the follicle clear down to the hair root. After a hot salt compress to open up the pores, the children had a detergent solution (Bacticide) rubbed into their scalps.

In such a rampant epidemic, the schools might have been closed. But Dr. Gimby’s skullcaps virtually checked the spread. Even if roughhousing boys bump heads, the caps prevent the transfer of broken, infected hairs. Each child has to have three clean caps a day. Mother has to boil them every night.

Pesky Problem. The source of Sault Ste. Marie’s epidemic was plain. Last March five youngsters with ringworm were allowed back in school too soon after routine treatment by their family doctors. All summer the disease spread (encouraged by a long damp spell and barbers’ unsterilized clippers). Not until school opened did authorities realize how far it had got out of hand.

Dr. Gimby promptly cut out all home medication and treatment by family doctors, insisted that every victim go through the city’s treatment centers. “I believe a new deal will come out of this epidemic here,” he said. “Too many people, and even too many doctors, don’t know enough about this pesky disease.” Main plank in Dr. Gimby’s new deal for ringworm : changes in health laws to make the disease reportable and handled as a public health problem.

* Misnamed more than 500 years ago, ringworm is caused not by a worm but by a fungus, usually Microsporon audouini. In North America the commonest fungus disease is popularly called “athlete’s foot.”