A century ago, scarlet fever was a common infectious childhood disease. It thrived in conditions of overcrowding and poor hygiene, and those affected were at risk of potentially serious complications.
Today, thanks to the introduction of antibiotics and also better living conditions, the incidence of scarlet fever has reduced dramatically and when it does occur it’s often in a mild form.
However, there are still roughly 4,000 cases of scarlet fever in the UK every year. It is most common in children between the ages of four and eight – it’s unusual in the under twos. It is worth knowing what to look out for, and what action to take if you suspect your child has scarlet fever.
Scarlet fever, also in its milder form known as scarlatina, is caused by a bacterium known as beta-haemolytic group A streptococcus. It usually occurs after a child has had a throat or skin infection with group A streptococcus, commonly called a ‘strep’ throat. These bacteria make a number of toxins (poisons) which cause a rash to appear on the body.
It is rare today in the UK because of the regular use of antibiotics, which curb strep infections.
Scarlet fever can be passed on through bacteria in airborne droplets from coughs and sneezes. In some cases it can follow infection from other sites, including wounds and burns.
It takes around two to four days to develop symptoms after being infected. It often starts with a sore throat or skin infection.
The characteristic symptom of scarlet fever is a fine pinkish-red rash on the body that feels slightly rough to touch. It appears first on the chest and stomach, spreading rapidly to other parts of the body. The rash doesn’t usually cover the face but your child may have flushed cheeks, while the area around their mouth stays pale. The rash will blanche (turn white) if you press a glass on it.
Other symptoms may include:
The rash usually lasts for about six days then fades. If symptoms are not treated, the outer layers of the skin may peel (usually on the hands and feet). This may last for up to six weeks after the original rash has faded.
A doctor will usually be able to diagnose scarlet fever by the characteristic signs and symptoms. A throat swab may be taken to identify the bacteria involved, confirming the diagnosis.
Scarlet fever is a notifiable disease. This means your GP must report each case to the local health authorities, so the spread of the disease can be monitored. It‘s best to call the surgery beforehand to warn them your child might have scarlet fever, as there may be a separate waiting area for people with infectious diseases.
Most children with a mild case of scarlet fever will recover within a week or so. However treatment can speed up your child’s recovery. Your child’s GP will probably prescribe a course of antibiotics which should clear up the infection within a couple of days. You’ll need to make sure the course is finished to make sure the infection clears effectively.
Make sure your child is drinking plenty of fluids, especially if they aren’t eating much. You can also give liquid paracetamol to bring down your child’s fever, and relieve any discomfort.
Complications are rare. Most children recover fully with no lasting effects. Occasionally though, scarlet fever can lead to an ear or throat infection, pneumonia, or rheumatic fever.
If your child has scarlet fever, keep them off school and away from other people until they have been on a course of antibiotics for three days.
Make sure you dispose of any tissues your child has used immediately, and wash your hands if you have touched them yourself.
One episode of scarlet fever will usually mean you child will be immune from the disease in the future. However, it is occasionally possible for scarlet fever to recur due to different forms of bacteria causing the infection.
Last reviewed by Great Ormond Street Hospital: 19 November 2008
This information has been written by Great Ormond Street Hospital specialists and has also appeared in a different format on the website of The Times newspaper.
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