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Scarlet fever

The video shows a 3 year old boy with scarlet fever. Common symptoms of scarlet fever are a high fever, a sore throat, difficulty swallowing, a headache and swollen lymph nodes in the neck. The child will also have a distinctive rash.

scarlet fever

What is...
Symptoms
Complications
Home treatment
Prevention

What is...

What is scarlet fever?

Scarlet fever is a very common infectious disease in children.

Caused by group A streptococcus (strep) bacteria, scarlet fever means there is a throat infection with a rash all over the body.

The germ infects the throat and releases a toxin (poisonous substance) that causes a rash. In rare cases, scarlet fever can occur as a result of a skin infection (impetigo) caused by the same strep germ.

Although many children develop a strep throat infection, only a few develop scarlet fever.

Most children with strep throat do not develop the rash. This is because only certain types of group A Strep bacteria make the toxin that causes the rash. Contrary to popular belief, the infection is not more serious because someone has the rash, too.

This strep infection is spread by droplets during coughing and sneezing, and by direct contact with infected body fluids such as saliva.

The time from infection until the sore throat starts (incubation period) is less than one week. The rash usually breaks out on the second day of the throat infection.

Some individuals are chronic carriers of the strep bacteria, meaning that they always have the bacteria in their throats, but do not get sick with it. Carriers only rarely spread the infection to others.

Symptoms

Symptoms and signs

Scarlet fever usually starts with a red and sore throat, fever over 101 degrees Fahrenheit (38.3 degrees Celsius), headache, and swollen lymph nodes on the neck.

The tonsils in the back of the throat will often look larger than usual, have a white coating (exudates), and the child may complain that it hurts to swallow.

The child with strep throat usually feels quite ill, and often complains of a stomachache, nausea, and headache. The child may vomit, but diarrhea is uncommon, as are runny nose, cough and other cold symptoms. At the start of the infection, the tongue may be covered by a whitish or yellowish coating ("strawberry" tongue) that flakes off after a while and leaves a bright red colored tongue ("raspberry" tongue).

The rash starts on the body as an all-over pink rash (like a sunburn) with small bumps (like "goose bumps" or sandpaper).

The rash is most noticeable in the folds of the skin, such as the armpits, the groin, inside the elbow, and around the neck. The rash blanches (becomes paler when you press on it) and can be itchy.

It appears first on the neck and face, but the area around the mouth usually is not affected. The rash then spreads down the body.

After a few days, the rash disappears. As it does, the skin can flake off, especially in the groin area and on the fingertips; this can last up to 10 days.

Complications

If not treated, scarlet fever can lead to serious complications.

The throat infection can spread to other areas, including the ears, tonsils, and sinuses.

Infected tonsils can develop into a more serious infection called a peritonsillar abscess, which often requires drainage with surgery.

The strep bacteria can spread into the blood stream, causing blood poisoning (sepsis) and infection of other organs in the body.

Rheumatic fever and endocarditis are serious heart diseases that can be caused by untreated strep throat infections. Strep infections can also lead to arthritis, and a particular type of kidney infection called glomerulonephritis.

Always contact a doctor if you are concerned about the possibility of complications during the course of scarlet fever.

Home treatment

Treatment / What you should do

If you suspect that your child has scarlet fever, you should contact a doctor.

The doctor usually will take a throat swab from your child to see if streptococcus bacteria are there. If your child has the disease, he will receive an antibiotic treatment, usually some form of penicillin, unless he is allergic to it. It is important to take the medicine exactly as the doctor prescribed it and to complete the entire course, even if your child is feeling better.

Medicines that relieve pain or bring fever down, such as acetaminophen or ibuprofen, can be used when needed.

Give the child plenty to drink. This may soothe the throat and keep the child well hydrated.

Solid food can be difficult to swallow because of the throat infection. Soft, bland foods usually are best; cold things like popsicles and ice cream may be particularly comforting for your child.

Older children can gargle with warm salt water.

A humidifier, or vaporizer, may make the room more comfortable, especially in cold weather.

The rash needs no treatment.

Contact the doctor again if the child continues to have a sore throat or fever after the antibiotic treatment is finished. In some cases, it may be necessary to repeat the strep test because someone can get strep throat again.

Prevention

It is not easy to prevent your child from becoming infected by streptococci.

A sick child should be isolated from the rest of the family as much as possible, to avoid the spread of the infection.

Remember to wash your hands well every time you are near your child.

If other members of the family show signs of a sore throat, they should also be tested for strep.

Keep your child home from day care or school for at least one day after the antibiotic treatment has started.

After 24 hours on antibiotics, your child is no longer considered to be contagious.

Before your child goes back to school, he should be free of fever and feeling well. In the case of scarlet fever, this can take 4-5 days.

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About Child Health Guide

Child Health Guide (CHG) is a health web site for parents that uses actual video examples of how children look and act during illness and traumatic injuries.

The CHG helps parents by providing clear, easy-to-understand, accessible, actionable information about their child’s condition.

The Child Health Guide is a major advance in the delivery of healthcare information.

The CHG includes video clips of more than 100 of the most common childhood illnesses and injuries. Organized by symptoms and cross-referenced by disease, the CHG enables parents to easily find the information that is most useful to them.

It also has an important section about home-accidents and how to prevent them.

The video clips show children with symptoms at various stages of a disease – both more and less serious. The accompanying “narrative” explains the symptoms, the illness, and what a parent should do.

The CHG is not a substitute for a physician’s advice or a doctor’s office visit.

Rather, it is to help parents better understand and articulate their child’s condition, making visits to the doctor – and follow-up care -- more effective.

Both the videos and supporting text are vetted by physicians at the Harvard Medical School and Dartmouth Medical School.

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Scarlet fever

What is...

What is scarlet fever?

Symptoms

Symptoms and signs

Complications

Complications

Home treatment

Treatment / What you should do

Prevention

Prevention

Images

Related topics

Partners