Scarlet fever is an infection caused by Streptococcus bacteria, characterised by a rash.
 
About scarlet fever
Symptoms of scarlet fever
Complications of scarlet fever
Causes of scarlet fever
Diagnosis of scarlet fever
Treatment of scarlet fever
 

About scarlet fever

 
Scarlet fever is usually a mild infection, which causes a rash. It’s most common in children and young adults.
 
A very mild form of the infection is sometimes referred to as scarletina.
 
If you have had scarlet fever once, you’re unlikely to get it again.
 

Symptoms of scarlet fever

 
The first symptoms of scarlet fever include:
 

  • sore throat
  • headache
  • high temperature
  • feeling sick
  • vomiting
  • tonsillitis
  • swollen glands in your neck
  • a flushed red face, but pale around your mouth
  • a white coating on your tongue – this will peel after a few days and your tongue will look red and swollen (known as ‘strawberry tongue’)
  • feeling tired and generally unwell

 
About 12 to 48 hours after these symptoms have appeared you will usually get a red rash on your skin. The rash will usually appear on your neck, chest and stomach to begin with and then spread to the rest of your body. The rash will feel like sandpaper to touch and will disappear when pressure is applied (blanch). It won’t usually be on your face, the palms of your hands or the soles of your feet.
 
The rash will usually last for about five days. After it has started to fade, the outer layer of your skin will usually shed, particularly on your fingertips, toes and groin area.
 
Your symptoms will usually clear up within one week.

 
 Complications of scarlet fever

 
Most people with scarlet fever won’t have any complications. However, there is a small chance that you may develop:
 

  • an ear infection
  • a throat abscess (a collection of pus in your throat)
  • sinusitis (inflammation of your sinuses)
  • pneumonia (inflammation of your lungs)

 
More rarely, meningitis can occur as a complication of scarlet fever. Meningitis is an infection of the meninges - the membranes that cover your brain and spinal cord.
 
Complications that may occur later on, sometimes after your scarlet fever symptoms have gone include:
 

  • joint or bone problems
  • liver damage
  • acute glomerulonephritis (inflammation of your kidneys)
  • rheumatic fever (a fever with painful, swollen or stiff joints)

 
Again, these complications are rare.
 

Causes of scarlet fever

 
Scarlet fever is caused by infection with Streptococcus bacteria. It can be passed from person to person. You may catch scarlet fever if you come into contact with the mucus or saliva of someone who is infected. This can happen if you inhale droplets when an infected person coughs or sneezes or if you come into contact with objects or surfaces that an infected person has touched. Your symptoms won’t usually start to show until between two and four days after you have become infected.
 

Diagnosis of scarlet fever

 
Your GP will ask about your symptoms and examine you. He or she may take a sample of cells from the back of your throat using a swab. A throat swab is similar to a small round cotton bud. The sample will be sent to a laboratory for testing.
 

Treatment of scarlet fever

 

Self-help

Try to rest and make sure you drink enough fluids.
 
You may find taking over-the-counter painkillers such as paracetamol or ibuprofen helps to relieve any pain. You can also suck over-the-counter throat lozenges to relieve your sore throat. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
 

Medicines

Your GP will usually prescribe you a course of antibiotics. You will usually be given an antibiotic called penicillin, which you will need to take four times a day for 10 days. Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.
 
If you’re allergic to penicillin, your GP may prescribe an antibiotic called erythromycin instead.
 
You shouldn’t go to work or school for five days after starting your antibiotics.

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email. See our answers to common questions about scarlet fever, including:
 
Can I get scarlet fever as an adult?
Is there a vaccine available for scarlet fever?
What is rheumatic fever and how can it affect me?

 
Can I get scarlet fever as an adult?

Yes, you can get scarlet fever as an adult, but it’s more common in children.
 

Explanation

Scarlet fever is most common in children aged between four and eight. It’s rare in children under two. This is because children this young still have some of their mother’s antibodies (proteins produced by your immune system that fight against bacteria and viruses) which help to protect them against infection.
 

Is there a vaccine available for scarlet fever?

No, there is no vaccine currently in use to protect you against scarlet fever.
 

Explanation

Scarlet fever is caused by infection with Streptococcus bacteria. It can be passed from person to person. You may catch scarlet fever if you come into contact with the mucus or saliva of someone who is infected. This can happen if you inhale droplets when an infected person coughs or sneezes or if you come into contact with objects or surfaces that an infected person has touched.
 
There is currently no vaccine in use to prevent you from catching scarlet fever. You can help to reduce your chances of getting it by washing your hands regularly.
 

What is rheumatic fever and how can it affect me?

Rheumatic fever is an inflammatory condition that can develop as a complication of scarlet fever, and other streptococcal throat infections. It happens when your immune system has an abnormal response to the Streptococcus infection. Rheumatic fever can affect your heart, skin, joints and central nervous system.
 

Explanation

Rheumatic fever sometimes develops after you have had scarlet fever. It’s most common in children aged between five and 15.
 
If you have rheumatic fever, you will have a fever (high temperature) and painful, swollen or stiff joints. Rheumatic fever can cause permanent damage to your heart valves. This is called chronic rheumatic heart disease, and it can increase your risk of endocarditis – infection of a heart valve.
 
If you think you have rheumatic fever, see your GP. You will usually need to rest and take antibiotics or painkillers. You may also be prescribed anti-inflammatory medicines.

Further information

 
Sources

  • Scarlet fever. Health Protection Agency. www.hpa.org.uk, accessed 3 December 2009
  • Haslett C, Chilvers ER, Hunter JAA, et al. Davidson's principles and practice of medicine. 18th ed. London: Churchill Livingstone, 1999:118-19
  • Kumar P and Clark M, Clinical medicine. 6th ed. London: Elsevier Saunders, 2005:65
  • Simon C, Everitt H, and Kendrick T, Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2005: 483
  • Scarlet fever. eMedicine. www.emedicine.medscape.com, accessed 10 December 2009

 

Related topics

  • Antibiotics
  • Meningitis and septicaemia in adults
  • Meningitis and septicaemia in children
  • Middle ear infection in children
  • Pharyngitis
  • Pneumonia
  • Tonsillitis

 
This information was published by Bupa’s Health Information Team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
 
Publication date: March 2010.
 
 
 
 
 
 

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