Infectious Diseases

Scarlet Fever

What is scarlet fever?

Scarlet fever, also known as scarlatina, is an illness caused by group A ß hemolytic streptococcus (GABHS). This is the same bacteria that causes strep throat. The illness is characterized by a rash that is typically fine (feels like sandpaper) and consists of small red bumps. This rash may be seen in children with strep throat or who have GABHS infections elsewhere on the body.

Scarlet fever most often occurs in children who are under the age of 18. It is spread from direct contact with a child who is infected, usually through secretions from the mouth or nose.

What causes scarlet fever?

Scarlet fever is caused by toxins that are produced by bacteria. The most common bacterium is group A ß hemolytic streptococcus (GABHS). These bacteria release a toxin that travels through your child's bloodstream and causes a rash.

What are the symptoms of scarlet fever?

The following are the most common initial (before the rash develops) symptoms of scarlet fever. However, each child may experience symptoms differently. Symptoms may include:

• fever
• sore throat
• chills
• headache
• vomiting
• stomach ache
• coated white tongue

The rash begins approximately one to two days after the initial infection. The red, fine, sandpaper-like rash typically is noted on the neck, forehead, cheeks, and chest and then may spread to the arms and back. The rash usually begins to fade after three to four days.

The symptoms of scarlet fever may resemble other skin conditions or medical problems. Always consult your child's physician for a diagnosis.

How is scarlet fever diagnosed?

Your child's physician will make the diagnosis based on a complete medical history and physical examination. The rash of scarlet fever is unique and may be recognized by your child's physician. In addition, your child's physician may order a throat swab to confirm the diagnosis of strep throat as the source of the scarlet fever. Quick tests, called a rapid strep test, may be performed. This may immediately test positive for GABHS. However, if it is negative, part of the throat swab will be kept for a throat culture to further identify if there is any GABHS present.

Treatment for scarlet fever:

Specific treatment for scarlet fever will be determined by your child's physician based on:

• your child's age, overall health, and medical history
• extent of the condition
• your child's tolerance for specific medications, procedures, or therapies
• expectations for the course of the condition
• your opinion or preference

Treatment for scarlet fever is the same as for strep throat. Your child's physician will prescribe an appropriate antibiotic to treat the infection. Other treatment options may include:

• warm saline mouth gargles (to relieve the sore throat)
• acetaminophen (for fever)
• increased fluid intake

It is important to not send your child back to school or daycare until he/she has been on antibiotics for at least 24 hours. Also, be sure to notify others who may have been exposed.