Scarlet fever is a bacterial illness that mainly affects children. It causes a distinctive pink-red rash. The illness is caused by Streptococcus pyogenes bacteria, also known as group A streptococcus, which are found on the skin and in the throat. Generally, scarlet fever is much less common than it used to be but in recent years there have been a number of significant outbreaks. It’s important to be aware of the signs and symptoms of scarlet fever so that early treatment with antibiotics can be given.
Scarlet fever
symptoms: Scarlet fever usually follows a sore throat or
a skin infection, such as impetigo, caused by
particular strains of streptococcus bacteria.
Initial symptoms usually include a sore throat, headache and a high temperature (38.3C/101F or above), flushed cheeks, and a swollen tongue. A day or two later the characteristic pinkish rash appears. It usually occurs on the chest and stomach before spreading to other body areas, such as the ears and neck. The symptoms of scarlet fever usually develop two to five days after infection. However, the incubation period (the period between exposure to the infection and symptoms appearing) can be as short as one day or as long as seven days. The rash feels like sandpaper to touch and it may be itchy. On darker skin, the rash may be more difficult to see although its rough texture should be apparent.
When to seek
medical advice: Scarlet fever usually clears up after about a
week, but if you think you or your child may have it, see your GP (General
physician) for a proper diagnosis and appropriate treatment. Your GP should be
able to diagnose scarlet fever by examining the distinctive rash and asking
about other symptoms. They may also decide to take a sample of saliva from the
back of the throat so it can be tested in a laboratory to confirm the
diagnosis. There's no evidence to suggest that catching scarlet fever when
pregnant will put your baby at risk. However, if you're heavily pregnant, tell
the doctors and midwives in charge of your care if you've been in contact with
someone who has scarlet fever.
How scarlet fever spreads: Scarlet fever is very contagious and can be
caught by:
·
breathing in bacteria in airborne droplets from an infected
person's coughs and sneezes
·
touching the skin of a person with a streptococcal skin infection,
such as impetigo
·
sharing contaminated towels, baths, clothes, or bed linen
·
It can also be caught from carriers – people who have the bacteria
in their throat or on their skin but don't have any symptoms.
Who's affected by
scarlet fever: Most cases (about 80%) of scarlet fever occur in
children under 10 (usually between two and eight years of age). However, people
of any age can get the illness. As it's so contagious, scarlet fever is likely
to affect someone in close contact with a person with a sore throat or skin
infection caused by streptococcus bacteria. Outbreaks often occur in nurseries
and schools where children are in close contact with one another. The symptoms
of scarlet fever will only develop in people susceptible to toxins produced by
the streptococcus bacteria. Most children over 10 years of age will have
developed immunity to these toxins. It's possible to catch scarlet fever more
than once, but this is rare.
Treating scarlet
fever: Scarlet
fever used to be a very serious illness, but nowadays most cases tend to be
mild. It can easily be treated with antibiotics. Liquid antibiotics, such as
penicillin or amoxicillin, are often used to treat children. These must be
taken for 10 days, even though most people recover after four to five days.
It's important to be
aware that your child will still be infectious for 24 hours after antibiotic
treatment has begun, and therefore they shouldn't attend nursery or school
during this period. Without antibiotic treatment, your child will be
infectious for 1-2 weeks after symptoms appear.
Complications of
scarlet fever:
With the right
treatment, further problems are unlikely. However, there's a small risk
of the infection spreading to other parts of the body and causing more
serious infections, such as an ear infection, sinusitis, or pneumonia.
Preventing
scarlet fever from spreading: There’s currently no
vaccine for scarlet fever. If your child has scarlet fever, keep them
away from nursery or school for at least 24 hours after starting
treatment with antibiotics. Adults with the illness should also stay off
work for at least 24 hours after starting treatment. GPs, schools, and
nurseries should be aware of the current high levels of scarlet fever and
inform local health protection teams if they become aware of cases,
particularly if more than one child is affected. Children and adults
should cover their mouth and nose with a tissue when they cough or sneeze and
wash their hands with soap and water after using or disposing of tissues. Avoid
sharing contaminated utensils, cups and glasses, clothes, baths, bed linen, or
towels.
Rash: Red blotches are the first sign of the
rash. These turn into a fine pink-red rash that feels like
sandpaper to touch and looks like sunburn. It may also be
itchy. The rash usually starts on the chest and stomach, but soon
spreads to other parts of the body, such as the ears, neck, elbows, inner
thighs, and groin. The rash doesn't usually spread to the face. However,
the cheeks become flushed and the area just around the mouth stays quite pale.
The rash will turn white if you press a glass on it. The rash usually fades
after about a week, but the outer layers of skin, usually on the hands and
feet, may peel for several weeks afterward. In milder cases, sometimes called
scarlatina, the rash may be the only symptom.
Other symptoms:
Other symptoms may
include:
- swollen neck glands
- loss of appetite
- nausea or vomiting
- red lines in the folds of
the body, such as the armpit, which may last a couple of days after
the rash has gone
- a white coating on the tongue,
which peels a few days later leaving the tongue red and swollen (this is
known as strawberry tongue)
- a
general feeling of being unwell
Self-care: Many
of the symptoms of scarlet fever can be relieved using some simple self-care
measures, such as:
- drinking plenty of cool fluids
- eating soft foods (if your
throat is painful)
- taking paracetamol to
bring down a high temperature
- using
calamine lotion or antihistamine tablets to relieve itching
Complications of
scarlet fever: Most cases of scarlet fever don't cause complications,
mainly if the condition is properly treated.
In
the early stages, there's a small risk of:
- An ear
infection
- A throat abscess (a painful
collection of pus)
- sinusitis (inflammation
of the sinuses)
- pneumonia (inflammation
of the lungs)
Very rare complications
that can occur at a later stage include:
·
Rheumatic fever, which can cause joint pain, chest pain, and shortness of breath
·
Glomerulonephritis (damage to the tiny filters inside the kidneys)
- Liver damage
- Osteomyelitis (infection of the
bone)
- blood
poisoning
- Necrotizing fasciitis (a
flesh-eating disease)
- Toxic
shock syndrome (a rare, life-threatening bacterial infection)
You may have one of
these rare complications if you're very unwell, in severe pain, and have a
severe headache, vomiting, or diarrhea. See your GP
immediately if any of these symptoms appear in the first few weeks after the
main infection has cleared up.
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