Scarlet fever is the name given to an illness that occurs with a bacterial infection by streptococcus pyogenes bacteria (also known as group A strep). The most common features are a rash, fever and sore throat. Scarlet fever used to cause many deaths in the 1800s but in modern times is has become a milder illness and far less common. However, there have been recent outbreaks in the UK.
Children under 10 are most commonly affected by scarlet fever, with a peak in the number of cases around age 4. Children with scarlet fever typically have a high temperature and a rash. The rash is red, and fades with pressure. It may be blotchy and patchy initially (with dark red pinprick spots sometimes noticeable) but patches join up to create large areas of redness. It affects the chest, tummy and cheeks, and feels rough and dry to touch. Your child may also have a sore throat and be reluctant to eat or drink. The tongue can develop a thick white coating which disappears after a few days leaving the tongue looking dark pink or red – this is known as “strawberry tongue.”
The illness is typically quite mild, but if your child has recently had chickenpox they are at risk of having a more serious infection with scarlet fever.
If you think your child might have scarlet fever you should have them assessed by a doctor or pharmacist. Although scarlet fever is rarely a severe illness nowadays, the bacteria can cause very serious complications including damage to the sepsis, joint infections and rheumatic fever. In order to prevent these problems, a course of antibiotics is usually prescribed to those diagnosed with scarlet fever. This significantly reduces the risk of complications and the chances of passing on the infection. Treatment is usually with penicillin for 10 days, but other antibiotics may be used in the case of penicillin allergy.
Pain and fever may be treated with paracetamol and/or ibuprofen if needed.
Without antibiotic treatment, scarlet fever is highly infectious and is spread from person to person in the air, by coughing and sneezing. However, once your child has completed 24 hours of antibiotics they may return to school as the likelihood of passing on the infection becomes very small. It is very unusual for adults to develop scarlet fever and the infection doesn’t pose any specific risks to pregnant women.