Scarlet fever in Children

Scarlet fever is a bacterial illness that has a distinctive pink-red rash which feels like sandpaper to the touch. It is most common in children between the ages of 2-8, although it can affect people of any age.

Thankfully, scarlet fever is now less common in the UK than it used to be. When scarlet fever does occur, if treated appropriately with antibiotics it should usually be resolved without any further complications.

Catching scarlet fever more than once is possible, but rare.

The most recognisable symptom of scarlet fever is a rash that feels like sandpaper and starts on the chest and tummy. On lighter skin it looks pink or red, on darker skin it can be more difficult to see, but you can still feel it. It does not usually spread to a child’s face although they may give the appearance of having flushed cheeks.
The first signs of scarlet fever can be flu-like symptoms, including a high temperature of 38C or above, a sore throat, and swollen neck glands (a large lump on the side of your neck). The rash appears a few days later.

Other symptoms of scarlet fever include:

• A white coating on the tongue, which peels several days later resulting in the tongue becoming red and swollen (as such it is often referred to as ‘strawberry tongue’)
• High temperature – 38C or above
• A sore throat, sometimes with white or yellow spots or patches
• Swollen glands in the neck
• Feelings of nausea and/or vomiting
• White or yellow spots or coating on the tonsils and throat

Scarlet fever lasts about a week, but your child will be infectious up to 7 days before symptoms appear, until 24 hours after the first antibiotic tablets are taken.

Scarlet fever is caused by specific strains of streptococcus bacteria, the same type which also causes strep throat. The bacteria make toxins (poisons) which cause the distinctive rash to appear, and the red tongue.

Scarlet fever is very contagious and can be caught by breathing in bacteria from an infected person’s coughs and sneezes. It can also spread by being in contact with the skin of a person who has a streptococcal skin infection, or using contaminated fabrics and surfaces such as towels, clothes and bed linen.

Scarlet Fever and Pregnancy
Dr Ellie Canon says: “Fortunately, there is no evidence to suggest that catching scarlet fever during pregnancy poses any risk to your baby. However, if a mother is infected when they give birth then there is a risk that the baby will also become infected. For pregnant women who do contract scarlet fever, the treatment consists of antibiotics.

This content was written by Dr Ellie Cannon on 8th September 2015. She was paid for her time but does not endorse CALPOL^® Products.

It is important to get an accurate diagnosis and correct treatment if you suspect that your child has scarlet fever. A diagnosis will usually be made through physical examination of the characteristic rash and other symptoms associated with the disease. To confirm the disease, your family doctor may need to take a sample of saliva with a swab from the back of your child’s throat or arrange a blood test.

Dr Ellie Canon says: “Your family doctor will probably prescribe a course of antibiotics. As well as making sure the course is completed to ensure the infection is effectively cleared, there are also several other measures that can be taken to aid recovery. It is important that your child takes on board regular fluids, and tries eating soft foods if they have a sore throat. To bring down a fever, liquid paracetamol can also be used to reduce your little one’s temperature if they are distressed and ease their discomfort. Calamine lotion or antihistamine tablets can also be used to stop any itching.”

This content was written by Dr Ellie Cannon on 8th September 2015. She was paid for her time but does not endorse CALPOL^® Products.

Visit your GP if your child has scarlet fever symptoms, and if these symptoms do not go within a week after seeing your GP (especially if your child has recently had chickenpox). If your child falls ill soon after having scarlet fever, or if they feel unwell after being in contact with someone who has scarlet fever, it is also important to speak to your GP.

As scarlet fever is highly infectious, it is good to ring your GP first as they may advise a phone consultation rather than visiting the surgery.

Are there any complications associated with scarlet fever?

If properly treated, most cases of scarlet fever will result in no further complications. However, there are a number of possible complications that rarely occur in the weeks after the infection as well as during it. There is a small risk of sinusitis, ear infection (otitis) and a throat abscess. There is also a small risk of pneumonia, meningitis, or rheumatic fever.