What is Scarlet Fever?

Q: I was shocked when my child was recently diagnosed with scarlet fever. What is that?

A: Scarlet fever is an illness that develops in some people who have strep throat. It is often accompanied by a sore throat and a high fever and features a bright red rash that, if untreated, can cover most of the body.

Scarlet fever, which is most common in school-age children, was once considered a serious childhood illness. But antibiotic use has revolutionized treatment. Still, if left untreated, scarlet fever can result in serious conditions that can affect the heart, kidney and other parts of the body.

Signs and symptoms include red rash that looks like a sunburn and feels like sandpaper on the face or neck and spreading to the trunk, arms and legs; red lines around the folds of skin; flushed face with a pale ring around the mouth; and a tongue that is red, bumpy and covered with a white coating early in the disease.

The rash and the redness in the face and tongue usually last about a week. Scarlet fever is caused by the same type of bacteria that cause strep throat. In scarlet fever, the bacteria release a toxin that produces the rash and red tongue.

Other signs and symptoms include a fever of 101 F or higher, often with chills; very sore and red throat, sometimes with white or yellowish patches; difficulty swallowing; enlarged or swollen lymph nodes in the neck that are tender to the touch; nausea or vomiting; and headache.

The infection can spread from person to person through droplets expelled when an infected person coughs or sneezes. The time between exposure and illness is typically two to four days.

The doctor will take a throat swab to test for strep bacteria. Antibiotics are prescribed and should be taken for the full course. The affected child should not go to school until he or she has been on antibiotics for at least 24 hours and no longer has a fever. 

Treat pain and fever with ibuprofen or acetaminophen. Give your child plenty of fluids to keep the throat moist and prevent dehydration. Humidify the air to eliminate dry air that may further irritate the throat. Offer lozenges to relieve a sore throat. Provide comforting foods like warm liquids and popsicles.

Teach your child to wash hands often, cover mouth and nose when coughing or sneezing and not to share food or drinking or eating utensils.

Today’s expert is Paul Schleitwiler, PA-C, ThedaCare Physicians-New London.