Scarlet fever
Scarlet fever
Scarlet fever is an illness caused by bacteria, and it mostly affects children. Its most recognisable sign is a distinctive pink-red rash.
The bacteria behind it are called Streptococcus pyogenes, also known as Group A Streptococcus. These bacteria live on the skin and in the throat.
Common Symptoms
⚠️ This symptom list is for educational purposes. Having these symptoms does not mean you have this condition. See a doctor for proper diagnosis.
Medicines Commonly Used
⚠️ These medicines are commonly used for confirmed diagnoses of this condition. This is NOT a recommendation or prescription. Treatment must be determined by your doctor.
No medicines have been linked to this condition yet.
When to See a Doctor
If you think you or your child may have scarlet fever, see a doctor so it can be properly diagnosed and treated. It usually clears up after about a week.
A doctor can usually tell it is scarlet fever by looking at the distinctive rash and asking about the other symptoms. Sometimes they will also take a swab from the back of the throat and send it to a laboratory to confirm the diagnosis.
There is no evidence that catching scarlet fever during pregnancy puts your baby at risk. Even so, if you are in the later stages of pregnancy, let the doctors or midwives looking after you know if you have been in contact with someone who has scarlet fever.
How scarlet fever spreads
Scarlet fever is very infectious. You can catch it by:
- breathing in droplets carrying the bacteria when an infected person coughs or sneezes
- touching the skin of someone with a Streptococcal skin infection, such as impetigo
- sharing contaminated towels, baths, clothes or bed linen
It can also be passed on by people who carry the bacteria in their throat or on their skin without having any symptoms themselves.
Who is affected by scarlet fever
Most cases occur in children under 10, usually between the ages of 2 and 8. Still, people of any age can get it.
Because it spreads so easily, scarlet fever is most likely to affect someone in close contact with a person who has a sore throat or skin infection caused by Streptococcus bacteria. Outbreaks can happen in nurseries and schools, where children are in close contact with one another.
Only people who are susceptible to the toxins produced by the Streptococcus bacteria will develop the symptoms. Most children over 10 have already built up immunity to these toxins.
It is possible to have scarlet fever more than once, but this is rare.
Treatment
Most cases of scarlet fever clear up on their own after about a week. Even so, your doctor may recommend treatment because it:
- shortens the time you are infectious to others
- helps you recover faster
- lowers the risk of complications from scarlet fever
With treatment, most people recover in about 4 to 5 days and can go back to nursery, school or work 24 hours after starting antibiotics.
Without treatment, you stay infectious for 1 to 2 weeks after symptoms appear.
Antibiotics
Scarlet fever is usually treated with a 10-day course of antibiotics. This is often penicillin or amoxicillin in tablet form, though a liquid form may be given to young children.
If you are allergic to penicillin, another antibiotic such as erythromycin can be used instead.
Symptoms usually start to improve within 24 hours of the first dose, and the rest settle within a few days. It is important to finish the whole course, even once you feel better. This makes sure the infection is fully cleared and helps prevent antibiotic resistance.
Keep your child away from nursery or school for at least 24 hours after starting antibiotics.
Adults with scarlet fever should also stay home from work for at least 24 hours after starting treatment.
Self care
Many symptoms of scarlet fever can be eased with some simple steps at home.
Do
- drink plenty of cool fluids
- eat soft foods if your throat is painful
- take paracetamol to bring down a high temperature
- use calamine lotion or antihistamines to relieve itching
- cover your mouth and nose with a tissue when coughing or sneezing
- wash your hands with soap and water after using or throwing away tissues.
Prevention
There is currently no vaccine that protects against scarlet fever.
If your child has scarlet fever, keep them home from school or nursery for at least 24 hours after they start their antibiotics. Adults who have the illness should also stay home from work for at least 24 hours after starting treatment.
Doctors, schools and nurseries should be aware that scarlet fever is currently circulating at high levels, and should inform the local health protection team if they come across cases, especially when more than one child is affected.
Don't
- Do not share contaminated utensils, cups and glasses, clothes, baths, bed linen or towels.
Complications
Most people who get scarlet fever do not develop complications, especially when the illness is treated properly and on time.
Even so, there is a small chance that the infection can spread to other parts of the body and cause more serious problems, such as:
- an ear infection
- a throat abscess (a painful collection of pus)
- sinusitis (inflammation of the sinuses)
- pneumonia (inflammation of the lungs)
Some very rare complications can appear later on. These include:
- bacteraemia (an infection of the bloodstream)
- septic arthritis (infection in a joint)
- meningitis
- necrotising fasciitis (a severe infection in which areas of soft tissue under the skin die)
- streptococcal toxic shock syndrome (symptoms that worsen very quickly, with low blood pressure and failure of several organs)
See a doctor straight away if you or your child develop any of the following in the first few weeks after the main infection has cleared up:
- feeling very unwell
- severe pain
- severe headaches
- vomiting
- diarrhoea
If your usual doctor or clinic is closed, go to the nearest hospital emergency department or call the national health helpline on 16263.