Scarlet fever: Symptoms, diagnosis and treatment
What is scarlet fever?
Scarlet fever is a rare bacterial illness causing a pink-red rash that feels like sandpaper.
A child thought to have scarlet fever should receive medical advice as soon as possible.
Scarlet fever mostly affects children aged between 2 and 10. It's caused by infection with group A streptococcal bacteria - the same bacteria that causes strep throat.
Symptoms of scarlet fever typically appear three days after exposure to another person with the illness, although this incubation period can be anywhere from one to seven days.
Symptoms of scarlet fever typically include a very high temperature over 38C and a red, sore throat.
Other symptoms may include nausea, vomiting, headache and abdominal pain. A distinctive scarlet rash appears - first on the neck and chest and then all over the body. In areas of skin folds - the armpits and the creases at the elbows and the groin - the rash has a bright red colour.
The tongue also becomes swollen and turns bright red. After two to seven days the rash usually disappears, but the tongue may remain swollen for several more days.
As the rash fades, there may be skin peeling around the tips of the fingers and toes and in the groin area.
What are the symptoms of scarlet fever?
Scarlet fever most often occurs in children. Its symptoms may include:
- Bright red or scarlet spotty rash, usually beginning on the neck or chest (often excludes face, palms and soles)
- High temperature
- Sore throat (although half of patients will not have this symptom)
- Painful swallowing
- Tongue with white coating and red bumps - referred to as strawberry tongue
- Swollen glands in neck
Seek medical advice if:
Your child develops symptoms of scarlet fever, especially if the child has recently had strep throat. Left untreated, scarlet fever may have serious complications affecting the heart, kidneys, and other organs.
How do I know if my child has scarlet fever?
Your GP will examine your child, looking for the characteristic rash, characteristic changes on the tongue called "strawberry tongue", and at the throat. The doctor will swab the throat and send the swab to the lab to examine it for the presence of streptococcal bacteria.
What are the treatments for scarlet fever?
Seek medical advice immediately if you think your child has the disease. Treatment with antibiotics is recommended to speed up recovery and reduce the risk of complications developing. Along with taking antibiotics, your child should get plenty of bed rest and drink enough fluid. Paracetamol and calamine lotion may be advised.
Never give aspirin to anyone under the age of 16 years who has an infection. It can cause Reye's syndrome, a rare but possibly deadly disease of the liver.
Your GP will prescribe an antibiotic, such as penicillin. If your child is allergic to penicillin, he or she will be given an alternative, such as erythromycin. The medication must be taken for its entire course, even if the symptoms disappear sooner.
Children should stay away from school or other children for at least 24 hours after starting antibiotic treatment. Other family members should also be examined and treated if necessary. Before the advent of antibiotics, households were quarantined because of scarlet fever, but this is no longer necessary.
How can I prevent scarlet fever?
Avoid people who have a strep infection. Wash your hands often and avoid sharing eating utensils or drinks.