Everything you need to know about scarlet fever, a rash accompanied by a sore throat caused by the streptococcus bacteria.
Reviewed by John Pillinger
Concerned you or your child might have scarlet fever? Here’s everything you need to know about the contagious infection which mostly affects young children.
What is scarlet fever?
Scarlet fever is a rash accompanied by a sore throat caused by the streptococcus bacteria.
The disease most commonly affects children, but can occur in any age group. The characteristic symptoms are a rash and a ‘strawberry tongue’. The disease is treated with antibiotics and it is usually resolved without complications.
How is scarlet fever contracted?
A person can become infected with streptococcus either by touching or through airborne droplets.
Scarlet fever appears together with a streptococcal sore throat. The incubation period – the time that passes from infection until the outbreak of the disease – is three to eight days.
What are the symptoms of scarlet fever?
Scarlet fever is usually accompanied by the following symptoms:
✔️ A sore throat.
✔️ A temperature.
✔️ Headache.
✔️ Feeling generally unwell.
✔️ A rash that develops within 12 hours of the onset and rapidly becomes generalised. In the creases of the skin, especially around the elbows and under the arm pits, it can cause classical red streaks.
✔️ The cheeks and neck are flushed, and the child looks ‘scarlet’ except for the area around the mouth, which is spared.
✔️ The rash fades after a few days, or sooner if treatment with antibiotics is given, following which the skin undergoes peeling.
✔️ The tongue has a thick, white coating that peels after four or five days, producing a red strawberry appearance.
When should you be concerned?
If your child has any of the symptoms associated with scarlet fever, try the following:
- When the symptoms appear consult a GP.
- The GP will make a diagnosis by assessing the symptoms and examining the throat.
- Pain on swallowing may be eased by hot drinks and soft food.
- Give the patient plenty of fluids.
- Treat the fever with paracetamol, eg calpol and/or Junifen.
⚠️ Scarlet fever is a notifiable disease in the UK. This means that cases are required by law to be reported to a health officer or local government authority.
How is scarlet fever treated?
With treatment, the disease normally disappears within a week without any problems, but can be contagious for between 10 days and three weeks if left untreated.
The rash may last for a very short time particularly if the patient is treated quickly with antibiotics. Children should be excluded from school for at least 24 hours after starting antibiotic treatment.
If the patient is allergic to penicillin they are usually treated with erythromycin (eg Erythroped).
Scarlet fever complications
Very rarely, particularly if the condition remains untreated, the following complications may occur:
- Pneumonia
- Sinusitis
- Inflammation of middle ear (otitis media)
- Rheumatic fever. Luckily, this seldom happens and is the exception rather than the rule
- Luckily, this seldom happens and is the exception rather than the rule.