Scarlet Fever

Scarlet fever, also known as scarlatina, is an infection caused by the same group A Streptococcus bacteria that gives you strep throat. This bacteria releases a toxin, like a poison, that triggers a bright red rash all over your body. That’s why it’s called scarlet fever! The rash is also bumpy, feeling rough like sandpaper.

One notable symptom of scarlet fever is the appearance of a swollen tongue that takes on a red and bumpy aspect. Some liken it to the appearance of a strawberry, hence the term “strawberry tongue.”

Who Gets Scarlet Fever?

While anyone can contract scarlet fever, it’s more common in children between the ages of 5 and 15. Parents and caregivers of children in this age group are also at a higher risk due to close contact. Babies and toddlers rarely get scarlet fever.

Causes

A bacteria called group A Streptococcus, also known as group A strep, is the villain behind scarlet fever. This same bacteria can cause strep throat and impetigo, a skin infection. Group A strep produces a toxin, a poisonous substance, that triggers the characteristic red rash of scarlet fever. In rare cases, untreated strep throat can lead to a more serious condition called rheumatic fever.

How Scarlet Fever Spreads

The group A strep bacteria lurk in your ears, nose, throat, and even on your skin. People infected with this bacteria can easily spread it through coughs or sneezes. These coughs and sneezes release tiny droplets containing the bacteria into the air. You can catch scarlet fever if you:

• Inhale these droplets.
• Touch a surface contaminated with the droplets and then touch your nose or mouth.
• Share utensils or drinks with someone who’s sick.
• Come into direct contact with sores caused by group A strep on someone’s skin.

While uncommon, scarlet fever can also spread through contaminated food that hasn’t been handled properly. The good news is that scientists believe pets and household items like toys are unlikely culprits in spreading the infection.

What the Rash Looks and Feels Like

The scarlet fever rash usually starts as small, flat red patches that gradually turn into fine bumps. It might resemble a sunburn or feel rough like sandpaper.

Is Scarlet Fever Contagious?

Absolutely. Scarlet fever is contagious and spreads through droplets expelled during coughs or sneezes.

Symptoms of scarlet fever

The initial signs of scarlet fever often include a fever and a sore throat. However, the telltale sign of this infection is a bright red, bumpy rash. It’s important to note that not everyone with strep throat develops the rash – in fact, less than 10% of strep cases present with the rash.

The Signature Rash:

• The rash typically appears first on the neck and chest.
• It then spreads to your back, arms, legs, and even your face.
• There may be a noticeable pale area around your mouth.
• Skin creases, especially under your arms, elbows, and groin, might become a deeper red than the rest of the rash (called Pastia’s lines).
• Peeling is common after the rash fades, particularly on your fingers.

Mouth and Throat Symptoms:

• Your tongue might have a white coating.
• It may also appear swollen, red, and bumpy, resembling a strawberry.
• Swollen, red, and sore tonsils and throat are common.
• White or yellow pus on your tonsils or throat might be present.
• Swallowing may become difficult.

Additional Symptoms:

• Chills
• Fever
• Stomach pain
• Nausea and vomiting
• Headache
• Body and muscle aches
• Swollen glands
• Loss of appetite
• Small red or purple bumps on the roof of your mouth

Risk Factors

While anyone can get scarlet fever, it’s more common in children between 5 and 15 years old. Parents and caregivers of young children are also at a higher risk due to frequent contact. It’s rare in babies and toddlers. Crowded environments like schools and daycare centers can increase the risk of outbreaks.

Complications of scarlet fever

Complications from scarlet fever are rare. They can occur if the Group A strep spreads to other parts of your body. Complications can include:

• Abscesses: Pockets of pus can develop around the tonsils or even the brain.
• Swollen Lymph Nodes: The lymph nodes in your neck might become enlarged and tender.
• Ear Infections: The bacteria can travel to the middle ear, causing an infection.
• Mastoiditis: This is a complication of an ear infection that affects the bone behind the ear.
• Sinus Infections: The strep bacteria can also invade the sinuses, leading to inflammation.
• Pneumonia: In severe cases, the infection can reach the lungs and cause pneumonia.
• Rheumatic Fever: This is a serious complication that can affect the heart, joints, skin, and brain.
• Kidney Damage: The bacteria can sometimes damage the kidneys.
• Septicemia: This is a life-threatening infection of the bloodstream.
• Joint and Bone Issues: Arthritis or osteomyelitis (bone infection) can develop.
• Skin Infections: Secondary skin infections may occur.
• Serious Blood or Brain Infections: Bacteremia (bloodstream infection) or meningitis (infection of the membranes surrounding the brain) are rare possibilities.
• Immune System Issues: PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus) is a rare condition that can develop after a strep infection.

Diagnosing Scarlet Fever

Doctors typically diagnose scarlet fever through a combination of:

• Physical Exam: The doctor will check for a rash, fever, and swollen throat.
• Rapid Strep Test: A quick swab of the throat can detect the presence of group A strep bacteria in most cases.
• Throat Culture: If the rapid test is negative but scarlet fever is suspected, a throat culture is done. It takes a day or two to grow bacteria and confirm the diagnosis.
• Rapid Molecular Strep Test: A newer option that provides quick results without the need for a culture.

Treatments

Treatment for scarlet fever typically involves antibiotics prescribed by your healthcare provider. These antibiotics target and eliminate the bacteria responsible for the infection, helping to alleviate symptoms and shorten the duration of illness. Additionally, antibiotics play a crucial role in preventing the spread of the infection and reducing the risk of complications.

Home Care Tips

• Soothing Sore Throats: A sore throat can make swallowing uncomfortable. Offer your child soft foods and cool liquids like soup, popsicles, and lukewarm tea. Staying hydrated is crucial.
• Gargling for Relief: Gargling with warm salt water can provide temporary relief from a sore throat.
• Pain Management: Over-the-counter pain relievers like acetaminophen (Tylenol®) or ibuprofen (Advil®) can help manage fever and discomfort.
• Itch Relief: If the rash is itchy, an anti-itch medication can help alleviate the discomfort.

Preventing the Spread of Scarlet Fever

Since there’s no vaccine, preventing scarlet fever relies on good hygiene practices:

• Avoid close contact with infected individuals.
• Wash hands frequently with soap and warm water for at least 20 seconds.
• When soap and water aren’t available, use an alcohol-based sanitizer.
• Cover your mouth and nose when coughing or sneezing.
• If you’re infected, keep your toothbrush separate from others.
• Stay home from school or work to prevent spreading the infection.

Recovery Timeline:

• Antibiotics quickly eliminate the bacteria causing scarlet fever.
• The rash typically fades within a week and may peel for a few weeks as the skin heals.
• Swollen glands might persist for a few weeks after the rash subsides.

Sources:

• Mayo Clinic or the
• Centers for Disease Control and Prevention (CDC)
• HealthyChildren.org
• Children’s Hospital of Philadelphia
• KidsHealth
• Boston Children’s Hospital