Scarlet fever

What is scarlet fever?

Scarlet fever is an infection which produces a red rash on the body and flu-like symptoms. It is quite rare in the Canada, but it is most likely to occur amongst children, particularly four- to eight-years-old.

What are the symptoms of scarlet fever?

If your child has scarlet fever, his first symptoms are likely to be:

• sore throat
• headache
• fever
• nausea or vomiting (HPA 2008a)

A red rash with a sandpapery texture normally develops 12 to 48 hours after this, starting in one place, and then spreading over the body. The rash is unlikely to spread to your child’s face, but his cheeks may become flushed with the skin around his mouth remaining pale.

Always use the "glass test" to check suspicious rashes. Press the side of a clear drinking glass to your child’s skin – a scarlet fever rash will "blanch" (fade to white) under pressure. If this doesn’t happen, tell your doctor, as it could be a sign of meningitis (NHS 2008a).

Other symptoms of scarlet fever may include:

• swollen neck glands
• loss of appetite
• abdominal pain
• pastia lines – broken blood vessels in the folds of the body, such as in the armpit
• white coating on the tongue – this normally peels away after a few days leaving the tongue red and swollen (strawberry tongue)

There is a milder form of scarlet fever, often known as scarletina. If your child has a rash but none of the other symptoms of scarlet fever, he may have scarletina.

I think my child has scarlet fever. Do I need to see the doctor?

Yes. Your doctor should be able to make a diagnosis based on your child’s symptoms. In some cases he may take a throat swab to confirm the diagnosis. Your child may also need a blood test to check for other infections. If he has scarlet fever your doctor will prescribe antibiotics to speed his recovery and prevent any complications.

How can I help my child to recover?

• Make sure your child drinks plenty of cool fluids, particularly if he doesn’t have much of an appetite.
• Keep his bedroom at a cool temperature.
• Give him acetametophin or ibuprofen to bring down his temperature and to relieve aches and pains.

Once your child has started his course of antibiotics his fever should disappear within 12 to 24 hours. The rest of his symptoms will go in a few days. Make sure that your child finishes the whole course of treatment to ensure the infection clears fully.

Can scarlet fever cause any complications?

Most cases of scarlet fever have no complications at all, and once your child has had scarlet fever he is unlikely to catch it again (NHS 2008a). Very occasionally it can lead to other infections:

• throat abscess
• ear infection
• otitis media
• sinusitis
• pneumonia
• kidney inflammation
• rheumatic fever

In extremely rare cases it can lead to these infections:

• meningitis
• kidney failure
• septicaemia (blood poisoning)
• bronchopneumonia
• osteomyelitis (infection of the bone and bone marrow)(NHS 2008a)

Contact your doctor for advice if your child’s symptoms don’t subside 24 hours after starting antibiotic treatment, or if new symptoms develop. He could have developed a complication.

How does scarlet fever spread?

Scarlet fever is passed on by bacteria from an infected person. These bacteria can spread to other people in the following ways:

• through airborne droplets from coughs and sneezes
• by touching drinking glasses, plates, utensils and other items an infected person has used, and then touching your mouth, nose or eyes
• from contaminated foodstuffs
• by coming into contact with the broken skin of an infected person.

What can I do to prevent my child from passing it on?

Keep your child away from daycare or preschool and away from other people until he has been on a course of antibiotics for at least five days.

Wash any kitchen utensils, bed linen or clothes your child has used and dispose of any tissues. Make sure you wash your hands thoroughly after touching them.

I’m pregnant – will catching scarlet fever harm my baby?

There is no evidence that having scarlet fever will harm your unborn baby (NHS 2008b). However, it will make you feel feverish and uncomfortable so it is wise to stay away from anyone you know is infected. If your child has scarlet fever then try to take preventative measures at home (see above What can I do to prevent my child from passing it on?). If you do contract scarlet fever, see your doctor for treatment – antibiotics are safe to take during pregnancy (NHS 2008b).

Created January 2009