Scarlet Fever

Scarlet Fever

What is Scarlet Fever?

Scarlet fever is a condition in which a distinct rash develops. It is caused by group A streptococcus bacteria.

The bacteria make a toxin, which when released, causes the 'scarlet' rash to develop, along with other common symptoms, such as a high fever and sore throat.

While the illness can affect people of all ages, it most commonly affects young children. Cases of scarlet fever in people over the age of 18 are rare.

Scarlet fever is contagious.

What are the symptoms?

People usually get sick two to five days after being exposed to the illness. Symptoms include:

-A high fever. This usually peaks at 103 or 104 degrees Fahrenheit on the second day.

-A sore throat.


-Nausea or vomiting.

-Body aches and pain.

-A general feeling of unwell.

-Loss of appetite.

-Swollen neck glands.

-A 'strawberry' tongue - this is when the tongue develops a thick, white coating that peels off after four or five days, producing a strawberry-like appearance.

However the scarlet fever rash is the most distinctive symptom. It usually appears 12 - 48 hours after the person becomes ill. The rash generally starts below the ears, neck, chest, armpits and groin, before spreading to the rest of the body after 24 hours. The face is spared, although it does appear flushed, except around the area of the mouth.

The rash is usually scarlet in colour and can feel quite rough - like sandpaper. It eventually fades and begins to peel, like sunburned skin. Peeling usually begins after six days and can last up to six weeks.

How is scarlet fever contracted?

Scarlet fever is contagious. A person can contract it by breathing in the airborne droplets from an infected person's coughing or sneezing.

It can also be contracted by sharing contaminated clothes, towels or bed linen, or by touching the skin of someone infected.

It should be noted that in order to get scarlet fever, you must be susceptible to the toxin produced by the group A streptococcus bacteria. It can happen that two children in the same family may both have streptococcal infections, such as strep throat, but only one - the one susceptible to the toxin - will develop scarlet fever.

How is scarlet fever diagnosed and treated?

A GP may suspect scarlet fever based on a physical examination and symptoms history. This diagnosis can be confirmed by taking a throat swab sample - a painless procedure - and testing it for bacterial growth.

Once scarlet fever is confirmed, a course of antibiotics will usually be prescribed. These are generally taken for up to 10 days. It is essential that the patient finishes the prescribed course of antibiotics.

Additional treatments and advice can include:

-Paracetamol for fever, headache or throat pain.

-Oral antihistamines or calamine lotion to relieve the itch of the rash.

-Eating soft foods and drinking cool liquids, as the throat may be very sore.

-Keep fingernails on young children short, as they may scratch and damage the skin.

With treatment, most patients recover after four to five days, although it may take up to six weeks for skin symptoms to clear fully.

If left untreated or if treatment is unsuccessful, complications can occur, including rheumatic fever, pneumonia and septicaemia. However this is rare.

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