Scarlet Fever

What is scarlet fever?

Scarlet fever, also known as scarlatina, is an infection that can develop in people who have strep throat. It’s characterized by a bright red rash on the body, usually accompanied by a high fever and sore throat. The same bacteria that cause strep throat also cause scarlet fever.

Scarlet fever mainly affects children between the ages of 5 and 15 years. It used to be a serious childhood illness, but it’s often less dangerous today. Antibiotic treatments used early on in the illness have helped speed recovery and reduce the severity of the symptoms.

Strep throat rash

A rash is the most common sign of scarlet fever in both adults and children. It usually begins as a red blotchy rash and becomes fine and rough like sandpaper. The scarlet-colored rash is what gives scarlet fever its name. The rash can begin up to two to three days before a person feels ill or up to seven days after.

The rash typically begins on the neck, groin, and under the arms. It then spreads to the rest of the body. The folds of skin in the armpits, elbows, and knees can also become a deeper red than the surrounding skin.

After the rash has subsided, about seven days, the skin on the tips of the fingers and toes and in the groin may peel. This can last for several weeks.

Other symptoms of scarlet fever

Other common symptoms of scarlet fever include:

  • red creases in the armpits, elbows, and knees (Pastia’s lines)
  • flushed face
  • strawberry tongue, or a white tongue with red dots on the surface
  • red, sore throat with white or yellow patches
  • fever above 101°F (38.3°C)
  • chills
  • headaches
  • swollen tonsils
  • nausea and vomiting
  • abdominal pain
  • swollen glands along the neck
  • pale skin around the lips

Cause of scarlet fever

Scarlet fever is caused by group A Streptococcus, or Streptococcus pyogenes bacteria, which are bacteria that can live in your mouth and nasal passages. Humans are the main source of these bacteria. These bacteria can produce a toxin, or poison, that causes the bright red rash on the body.

Is scarlet fever contagious?

The infection can spread two to five days before a person feels ill and may be spread through contact with droplets from an infected person’s saliva, nasal secretions, sneeze, or cough. This means that any person can contract scarlet fever if they come into direct contact with these infected droplets and then touch their own mouth, nose, or eyes.

You may also get scarlet fever if you drink from the same glass or eat off of the same utensils as a person with the infection. In some cases, group A strep infections have been spread through contaminated food.

Group A strep can cause a skin infection in some people. These skin infections, known as cellulitis, can spread the bacteria to others. However, touching the rash of scarlet fever will not spread the bacteria since the rash is a result of the toxin not the bacteria itself.

Risk factors for scarlet fever

Scarlet fever mainly affects children between the ages of 5 and 15 years. You catch scarlet fever from being in close contact with others who are infected.

Complications associated with scarlet fever

In most cases, the rash and other symptoms of scarlet fever will be gone in about 10 days to 2 weeks with antibiotic treatment. However, scarlet fever can cause serious complications. These can include:

  • rheumatic fever
  • kidney disease (glomerulonephritis)
  • ear infections
  • throat abscesses
  • pneumonia
  • arthritis

Ear infections, throat abscesses, and pneumonia can best be avoided if scarlet fever is treated promptly with the proper antibiotics. Other complications are known to be the result of the body’s immune response to the infection rather than the bacteria themselves.

Diagnosing scarlet fever

Your child’s doctor will first perform a physical exam to check for signs of scarlet fever. During the exam, the doctor will particularly check the condition of your child’s tongue, throat, and tonsils. They’ll also look for enlarged lymph nodes and examine the appearance and texture of the rash.

If the doctor suspects your child has scarlet fever, they’ll likely swab the back of your child’s throat to collect a sample of their cells for analysis. This is called a throat swab and is used to create a throat culture.

The sample will then be sent to a laboratory to determine whether group A Streptococcus is present. There’s also a rapid throat swab test that can be performed in the office. This may help identify a group A strep infection while you wait.

Treatment for scarlet fever

Scarlet fever is treated with antibiotics. Antibiotics kill bacteria and help the body’s immune system fight off the bacteria causing the infection. Make sure you or your child complete the entire course of the prescribed medication. This will help prevent the infection from causing complications or continuing further.

You can also give certain over-the-counter (OTC) medications, such as acetaminophen (Tylenol), for fever and pain. Check with your doctor to see if your child is old enough to receive ibuprofen (Advil, Motrin). Adults may use acetaminophen or ibuprofen.

Aspirin should never be used at any age during an illness with fever due to the increased risk of developing Reye’s syndrome.

Your child’s doctor might also prescribe other medication to help ease the pain of a sore throat. Other remedies include eating ice pops, ice cream, or warm soup. Gargling with salt water and using a cool air humidifier can also decrease the severity and pain of a sore throat.

It’s also important that your child drink plenty of water to avoid dehydration.

Your child can return to school after they’ve taken antibiotics for at least 24 hours and no longer have a fever.

There’s currently no vaccine for scarlet fever or group A strep, although many potential vaccines are in clinical development.

Preventing scarlet fever

Practicing good hygiene is the best way to prevent scarlet fever. Here are some prevention tips to follow and to teach your children:

  • Wash your hands before meals and after using the restroom.
  • Wash your hands anytime you cough or sneeze.
  • Cover your mouth and nose when sneezing or coughing.
  • Don’t share utensils and drinking glasses with others, especially in group settings.

Managing your symptoms

Scarlet fever needs to be treated with antibiotics. However, there are things you can do to help ease the symptoms and discomfort that come with scarlet fever. Here are a few remedies to try:

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