Scarlet fever

What is scarlet fever?

Scarlet fever is a type of bacterial throat infection that also features a red (scarlet) rash. It is also known as ‘scarlatina’. It usually affects young and primary school-aged children.

It is caused by group A streptococci bacteria — the same type of bacteria that cause a ‘strep throat’, impetigo, wound infections or rheumatic fever.

Treatment with antibiotics means most people recover in about a week, but left untreated scarlet fever can spread to other parts of the body and cause serious health problems.

What are the symptoms of scarlet fever?

Symptoms of scarlet fever usually appear between 1 and 3 days after catching the infection, and include a very red sore throat, swollen glands and fever.

About 12 to 48 hours after symptoms start, red blotches appear on the skin, usually the head and neck and then spread to the body, including arms and legs. It can look like sunburn and feel like sandpaper. The rash lasts about 2 to 5 days. After the rash is gone, the skin on the fingers and toes may begin to peel.

Scarlet fever may also cause:

• red bumps on the tongue — this can look like a strawberry, or a whitish coating on the tongue
• headache
• abdominal pain, nausea and vomiting
• very sore throat and tonsils — swallowing can be difficult
• swollen glands in the neck
• muscle aches and chills

What causes scarlet fever?

Scarlet fever is caused by group A streptococcal bacteria. These bacteria are found in the nose and throat and are spread by:

• coughing and sneezing
• contact with a contaminated surface, such as a plate or glass
• touching or kissing an infected person

Children can also catch it by touching the sores of someone who has a streptococcal skin infection.

Read more about streptococcal infections.

When should I see my doctor?

You should see a doctor if your child has a very sore throat, red rash or fever. You should also see your doctor if your child is in pain, not drinking or not urinating (weeing) very much.

How is scarlet fever diagnosed?

To diagnose scarlet fever your doctor will do a physical examination and take a swab from your throat to check for the bacteria.

How is scarlet fever treated?

Scarlet fever is treated with antibiotics (usually penicillin). If left untreated, the bacteria might spread to the tonsils, lungs, skin, kidneys, blood or middle ear. Antibiotics will prevent serious health problems including rheumatic fever, kidney disease, pneumonia and joint pains.

The doctor may also recommend rest, pain relief and that your child drinks a lot of water.

Your child will stop being infectious 24 hours after they start antibiotics. If they don’t have antibiotics, they can still be infectious for 2 to 3 weeks.

How can scarlet fever be prevented?

The best way for your child to avoid scarlet fever is by washing their hands often, and to not share plates or utensils with other people.

To avoid giving it to other people, they should cover their nose and mouth when coughing or sneezing.

Children with scarlet fever should stay home while they are unwell, and for at least 24 hours after starting antibiotics.

Complications of scarlet fever

Infection with group A strep which causes scarlet fever can lead to several complications.

Complications include:

• an abscess (collection of pus) that develops next to the tonsils.
• rheumatic fever
• inflammation and reduced function of the kidneys

These complications can be prevented by treating early with antibiotics.