Scarlet fever is a bacterial illness that mainly affects children. It causes a distinctive pink-red rash. Generally, scarlet fever is much less common than it used to be but in recent years there have been a number of significant outbreaks.
The illness is caused by Streptococcus pyogenes bacteria, also known as group A streptococcus, which are found on the skin and in the throat.
It’s important to be aware of the signs and symptoms of scarlet fever so that early treatment with antibiotics can be given.
Scarlet fever symptoms
Initial symptoms usually include a sore throat, headache and a high temperature, flushed cheeks and a swollen tongue. A day or two later the characteristic pink-red rash appears. It usually occurs on the chest and stomach before spreading to other areas of the body.
The symptoms of scarlet fever usually develop two to five days after infection, although the incubation period (the period between exposure to the infection and symptoms appearing) can be as short as one day or as long as seven days.
The rash feels like sandpaper to touch and it may be itchy. On darker skin the rash may be more difficult to see although its rough texture should be apparent.
When to seek medical advice
Scarlet fever usually clears up after about a week, but if you think you or your child may have it, see your GP for a proper diagnosis and appropriate treatment.
Your GP should be able to diagnose scarlet fever by examining the distinctive rash and asking about other symptoms. They may also decide to take a sample of saliva from the back of the throat so it can be tested to confirm the diagnosis.
There's no evidence to suggest that catching scarlet fever when pregnant will put your baby at risk. However, if you're heavily pregnant, tell the doctors and midwives in charge of your care if you've been in contact with someone who has scarlet fever.
How scarlet fever spreads
Scarlet fever is very contagious and can be caught by:
- breathing in bacteria from an infected person's coughs and sneezes
- touching the skin of a person with a streptococcal skin infection, such as impetigo
- sharing contaminated towels, baths, clothes or bed linen
It can also be caught from carriers – people who have the bacteria in their throat or on their skin but don't have any symptoms.
Who's affected by scarlet fever?
Most cases (about 80%) of scarlet fever occur in children under 10 (usually between two and eight years of age). However, people of any age can get the illness.
Outbreaks often occur in nurseries and schools where children are in close contact with one another.
The symptoms of scarlet fever will only develop in people susceptible to toxins produced by the streptococcus bacteria. Most children over 10 years of age will have developed immunity to these toxins.
It's possible to catch scarlet fever more than once, but this is rare.
Treating scarlet fever
Scarlet fever used to be a very serious illness, but nowadays most cases tend to be mild.
It can easily be treated with antibiotics. Liquid antibiotics, such as penicillin or amoxicillin, are often used to treat children. These must be taken for 10 days, even though most people recover after four to five days.
It's important to be aware that your child will still be infectious for 24 hours after antibiotic treatment has begun, and therefore they shouldn't attend nursery or school during this period.
Without antibiotic treatment, your child will be infectious for 1-2 weeks after symptoms appear.
Preventing scarlet fever from spreading
There’s currently no vaccine for scarlet fever. If your child has scarlet fever, keep them away from nursery or school for at least 24 hours after starting treatment with antibiotics. Adults with the illness should also stay off work for at least 24 hours after starting treatment.
Avoid sharing contaminated utensils, cups and glasses, clothes, baths, bed linen or towels.