Scarlet Fever

What are the symptoms?

Scarlet fever generally starts off with a sore throat, headache, and fever of 101 degrees Fahrenheit (38.3 degrees Centigrade) or higher. The other symptoms that a child with scarlet fever may exhibit include:

• A white or yellowish coating tongue which may later turn red. These bumps may appear quite large, giving the condition the name ‘strawberry tongue’.
• A coating on their tonsils and back of their throat may also be coated, or red and swollen tonsils.
• A flushed face with a pale mouth area
• Chills, shivers, aches, swollen glands, lethargy
• Loss of appetite, nausea and vomiting.
• A rash, which usually begins as a mass of tiny red spots in the armpits, neck, chest and groin area. These commonly appear on the second day and typically last about two to five days, spreading progressively to other parts of the body. The bumps feel like fine sandpaper and may itch. In the creases of the body, such as around the underarms, the inside of the elbows, and the groin, the rash can form red streaks, which are called ‘Pastia’s lines’ As the rash fades, skin peeling may occur, especially on the hands, feet and in the groin area.

Is scarlet fever serious?

Scarlet fever is serious if undiagnosed or left untreated with antibiotics, as any infection involving the streptococcus bacteria can have serious complications. These include abscesses on the tonsils and rheumatic fever, which can affect the valves of the heart (the condition was feared in the pre-antibiotic era because of these complications).

Making a child with scarlet fever comfortable

A child with scarlet fever will probably have a high temperature so it’s important that they have a good fluid intake, as they will be more prone to becoming dehydrated. Eating may well be painful for them because of their strep throat, so soft foods and soups will probably be easier to manage than more solid meals.

When should I call the doctor?

You should call for an immediate appointment with your doctor if your child has a sore throat, a rash, fever, swollen glands, a white coating on the tonsils or the back of the throat, or any of the other symptoms of scarlet fever or strep throat. If your child has already been diagnosed with scarlet fever and has commenced antibiotics, you should call the doctor if they still have a fever or other symptoms 48 hours after starting them.

Reducing the risk of spreading the infection

Twenty-four hours after your child has been diagnosed with scarlet fever and has started their course of antibiotics, they won’t be infectious. Within that first 24 hours you should take sensible precautions by separating their drinking glasses, cups, utensils, sheets, towels, toys and other shared objects from those of other family members. These items should be thoroughly washed in hot water with detergent and anyone handling them should wash their hands frequently. Any family members exhibiting symptoms such as a sore throat (with or without a rash) should be tested for strep infection.