A century ago—or even less—a scarlet fever outbreak was news that frightened parents. Normally a sore throat is something children shake off in a few days or a week. In the case of scarlet fever, which is caused by the streptococcus A bacteria, the illness can cause such complications as ear infections, sinusitis, skin infections, throat abcesses, pneumonia, kidney disease and arthritis if the bacteria spreads. In rare cases, scarlet fever progresses to rheumatic fever, an inflammatory condition that may affect major organs including the brain and heart.
Fever and a sore throat, often very painful and bright red, usually are the first symptoms in a child with scarlet fever. Your child may experience other flu-like symptoms (nausea, vomiting, headache and more general aches and pains). Scarlet fever, however, has two distinguishing symptoms that make it stand out from other childhood diseases.
The first is a red, flat rash that appears a few days after the first symptoms and eventually becomes a rash of small bumps that give the skin the texture of sandpaper. On darker skin, the rash may not appear red, but the rough texture is an indicator of strep. The rash may spread over most of the body.
Scarlet fever also causes changes to the tongue. It’s often very swollen, red and covered in a whitish film with a bumpy appearance like a strawberry.
Other reddish discolorations of the skin may occur, and when the infection clears, the skin of your child’s toes, fingertips and groin area may peel for as long as several weeks.
Children with scarlet fever may be quite uncomfortable for some days. Because the throat and tonsils may be very red and swollen, swallowing can be very painful and difficult. Some families find that cold drinks or even ice cream can numb the pain and make swallowing easier. Fever and achiness may be treated with paracetamol as with other illnesses.
Fortunately, scarlet fever is easily cured with antibiotics, but testing and diagnosing the strep infection is key. This is done quickly via a simple throat swab and culture to identify the streptococcus A bacteria. Antibiotic treatment is required in the case of a positive strep culture. Children usually are prescribed a 10-day course of treatment in syrup form. Antibiotics will help to alleviate uncomfortable symptoms and also reduce spread of the illness to others. Because of resistance problems, you should never attempt to treat your child with antibiotics without visiting and obtaining a prescription from your paediatrician.
Strep germs spread easily via droplets (from sneezing and coughing), sharing of glasses, plates and implements, or occasionally from contact with someone else’s streptococcal skin infection (impetigo). A simple way to stop the spread of scarlet fever is to insist that schoolmates, friends and family members use individual dining implements, baths, towels, clothes and bedding. Washing hands thoroughly with soap, particularly when there is an outbreak, is also important to prevent others getting sick.