Scarlet Fever – What every parent needs to know 

Scarlet Fever – What every parent needs to know 

What is Scarlet Fever? 

Many people think of Scarlet fever as a disease of the past, however in the UK there were 15,500 cases in the first 3 months of this year, with the overall number of reported cases at a level not seen since 1982. 

Scarlet fever, or it’s milder form Scarlatina, is an illness caused by a bacteria called Streptococcus, usually Streptococcus A. Scarlet fever is typically an illness of childhood and is most commonly seen in children under 10 years old. Adults can also get Scarlet fever however this is unusual. The symptoms and treatment are the same for both adults and children.  

Symptoms of Scarlet fever 

  • Fever  
  • Sore throat 
  • ‘Strawberry tongue’ – where the tongue is very red and looks like a strawberry  
  • Flushed face 
  • A rough-feeling, red rash, that usually starts on the neck and chest before spreading to the tummy and cheeks. The rash will feel like sandpaper when you rub over it with your fingers. The rash can last between 2-5 days and once it resolves, the skin often begins to peel 

What is the treatment of Scarlet fever?

Because Scarlet fever is caused by a bacterium, the best treatment is antibiotics, with the antibiotic of choice typically penicillin. The dose of the penicillin depends on your child’s age and weight and is usually a ten-day course. There are, however, alternate options for those allergic to penicillin. The duration of treatment with penicillin is long (10 days) and it needs to be taken 4 times per day so often an antibiotic called azithromycin is used instead as this can be given once a day for 5 days.   

It is also important, as well taking antibiotics, to give general symptomatic treatment whilst waiting on the antibiotics to work. Effective treatments include anti-pyretics for fever or if your child is in pain – Paracetamol is safe to use in Scarlet fever.  It is generally important for anyone who is unwell to keep their fluid levels up. Eating soft foods can help ease the throat. Using an emollient (moisturising cream) or calamine lotion can help with the symptoms of itch, as can anti-histamine medication like Piriton.   

How long does Scarlet fever last and does my child need to stay away from school?  

Scarlet fever lasts for around one week. You are infectious up to 7 days before the symptoms start until 24 hours after you take the first dose of antibiotics. As such, your child can return to school 24 hours after commencing antibiotic therapy.  

Is Scarlet Fever infectious? 

It is estimated that 1 in 5 people carry Strep bacteria in their throats without becoming ill. The bacteria can be spread from person to person through air droplets via sneezing, coughing or kissing. Scarlet fever is most common in winter months due to increased coughing and sneezing. Outbreaks are commonest in group settings like nurseries and schools.  

There is no evidence that catching Scarlet fever when pregnant will put your baby at risk.   

Is Scarlet fever dangerous?

In the past, Scarlet fever was a serious illness. Fortunately, for most cases, Scarlet fever is a mild illness that can be fully treated. Deaths from scarlet fever are now extremely rare in the Western world. Whilst complications can occur, they are now very rare with current antibiotic treatment.  

What can be done to reduce the spread of Scarlet fever? 

As people carry the causative bacteria in their throats, it is impossible to completely eradicate Scarlet fever. There are tips to reduce risk, however. These include thorough hand hygiene. If you or someone close to you has Scarlet fever, you should wash your hands thoroughly and regularly, as well as avoiding sharing bath towels. Tissues should be used for coughing and sneezing and disposed of straight away. Changing toothbrushes after a bout of scarlet fever may help reduce the risk of spread and recurrance.   

Dr Emma Crawley

Dr Emma is a newest member of Coyne Medical, a family focused private GP Surgery in heart of Parsons Green, Fulham