What is Scarlet Fever?

Scarlet fever is characterized by high fever and a bright, red rash covering the entire body. Scarlet fever occurs in conjunction with about 10 percent of cases of streptococcal respiratory infection, or strep throat. In general, the widespread use of antibiotics to treat strep throat has made scarlet fever less common than it was in the past, but occasional outbreaks still occur. Like strep throat, scarlet fever is most common among children over the age of four. It generally spreads in school and household settings.

What Causes Scarlet Fever?

Scarlet fever is caused by a toxin that certain strains of streptococcal bacteria release when they infect the upper respiratory tract. It passes from person to person the same way strep throat does—through close contact between an infected and a noninfected person. When a child with the infection coughs or sneezes, bacteria-laden droplets are expelled. Children playing face to face, eating together, and sharing toys and eating utensils can easily pass strep infections back and forth.

Signs and Symptoms of Scarlet Fever

The first symptoms, which may develop suddenly, include a high fever, headache, abdominal pain, nausea and vomiting. Occasionally, abdominal pain and vomiting develop one or two days before the rash appears.

The rash, which consists of tiny, red bumps, begins on the trunk and spreads outward, covering the body in a matter of hours or days, giving the skin a rough sandpaper-like texture. Application of pressure makes the bumps disappear momentarily.

The typical rash of Scarlet Feer

The rash generally spares the area around the mouth, although the lips (as well as the palms and the soles) frequently turn bright red. The tongue, too, undergoes characteristic changes, turning white (with small flecks of red) early in the course of the illness, then becoming swollen and red (strawberry tongue). In addition, deep, red streaks may appear in creases formed by joints—in the armpits and elbow crooks, as well as in the groin and behind the knees. Evidence of strep throat (sore, swollen tonsils covered by whitish-yellow material) is usually part of the picture.

Should I Seek Medical Attention for My Child?

Yes. It is important to get an accurate diagnosis of strep infections and scarlet fever, since many other conditions can cause similar symptoms. If a strep infection is present, antibiotic therapy is necessary to prevent complications, such as rheumatic fever.

Never delay in seeking professional medical help for your child. 

Treatment for Scarlet Fever

Penicillin is the drug of choice for children with scarlet fever. Once the bacteria are wiped out, the toxin that causes scarlet fever will be eliminated as well. Children who are allergic to penicillin may be given erythromycin instead. Treatment is continued for 10 to 14 days even if the symptoms disappear earlier.


John Furst

JOHN FURST is an experienced emergency medical technician and qualified first aid and CPR instructor. John is passionate about first aid and believes everyone should have the skills and confidence to take action in an emergency situation.

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