Scarlet Fever Risk Factors, Prevention And Treatment


Some patients with strep throat go on to acquire the bacterial disease known as scarlet fever. Scarlatina, another name for scarlet fever, is distinguished by an extensive, vivid red rash. A painful throat and a high fever are symptoms of scarlet fever.

Children aged 5 to 15 are most susceptible to developing scarlet fever. Scarlet fever has become less dangerous because of antibiotic treatments, despite formerly being thought of as a devastating pediatric ailment. Scarlet fever can nonetheless lead to more severe problems that impact the heart, kidneys, and other body organs if left untreated.


Group A streptococcus, often known as group A strep, is the same type of bacterium that causes strep throat and is the cause of scarlet fever. The bacteria that cause scarlet fever secrete a toxin that results in the rash and crimson tongue.

When an infected individual coughs or sneezes, droplets are generated that allow the virus to transmit from one person to another. The duration between exposure and disease, or the incubation period, typically lasts 2 to 4 days.

How to check if you have Scarlet Fever?

If your child gets a sore throat, consult your doctor about the following:

  • A temperature of at least 100.4 F (38.0 C)
  • Neck glands that be enlarged or painful
  • An acute rash

Any of the following signs or symptoms in children or teenagers requires immediate evaluation:

  • New breathlessness when at rest
  • Difficulty breathing
  • Breathing that is noisy, wheezy, or raspy that does not go away when you cough
  • Quickly breathing
  • Chest discomfort
  • The difficulty to swallow liquids or saliva, to speak clearly, or to completely open one's mouth
  • Confusion, a lack of willpower, or trouble staying awake and aware
  • Dizziness whether sitting or standing
  • Drooling (if age 3 years or older)
  • Severe or ongoing vomiting
  • Diarrhea
  • Dehydration

Other signs that require urgent attention in infants younger than two months old include:

  • Unable to find comfort
  • Breathing that begins and pauses frequently
  • Between 100.4 °F and 96.0 °F (35.5 °C) in temperature

Risk Factors

Compared to other age groups, children between the ages of 5 and 15 are more likely to contract scarlet fever. 

Those in close contacts, such as family members, child care groups, or classmates, are more likely to contract the scarlet fever virus.

Scarlet fever most usually appears after strep throat. On rare occasions, scarlet fever can follow a skin condition like impetigo. A person may experience scarlet fever more than once.


Scarlet fever is named after the signs and symptoms that include:

A red rash. The rash feels like sandpaper and has a sunburn-like appearance. Usually, it starts on the face or neck and moves to the body's trunk, arms, and legs. The reddish skin turns pale when pushed.

Lines in red. Typically, the skin folds around the groin, armpits, elbows, knees, and neck turning a darker shade of red than the other rash-affected locations.

The face is flushed. A pale ring around the mouth and a flush to the cheeks may be seen.

Tongue with strawberry. Early in the condition, the tongue is frequently coated in a white covering and typically has a reddish, lumpy appearance.

Other indications and symptoms of scarlet fever include:

  • A fever of at least 100.4 F (38.0 C),
  • Usually with chills
  • A throat that is quite painful and red, perhaps with white or yellowish spots.
  • Having trouble swallowing
  • Lymph nodes, which are enlarged glands in the neck, are painful to the touch.
  • Nausea or diarrhoea
  • Abdomen (tummy) discomfort
  • Body pains and headaches
  • Usually, the rash and the redness on the tongue and cheeks remain for a week. The skin affected by the rash frequently peels after these symptoms and indications have subsided.


Scarlet fever cannot be prevented with a vaccination. The same actions used to avoid infections are also the most effective approaches to prevent scarlet fever:

Sanitize your hands. Teach your child to wash their hands thoroughly for at least 20 seconds in warm, soapy water. If soap and water are not available, alcohol-based hand sanitiser can be used instead.

Never exchange food or utensils at the table. Generally speaking, your child should not let friends or classmates use their drinking cups or dining utensils. Shared meals are also subject to this restriction.

Put your mouth and nose covered. While coughing and sneezing, instruct your kid to cover their mouth and nose to help stop the possible transmission of germs.

If your child has scarlet fever, wash mugs and other items in hot, soapy water.

Once your child uses them, wash them with water or a dishwasher.


Your healthcare professional will recommend an antibiotic for scarlet fever. Ensure that your youngster takes all of the prescribed medication. Your child may experience issues if they do not adhere to the treatment instructions since the virus may not be entirely eradicated.

To reduce throat discomfort and moderate the temperature, use acetaminophen (Tylenol, Advil, Children's Motrin, etc.) or ibuprofen (Advil, Children's Motrin, etc.). Consult your child's doctor about the appropriate dosage.

After taking antibiotics for at least 12 hours and no longer experiencing a fever, your child is eligible to return to school.

Complications of Scarlet Fever

The bacterium that causes scarlet fever might spread to:

  • Tonsils
  • Skin
  • Blood
  • Central ear 
  • Sinuses
  • Lungs
  • Heart
  •  Kidneys
  • Joints
  • Muscles

Occasionally, rheumatic fever, a deadly inflammatory condition that can harm the heart, joints, nervous system, and skin, can develop from scarlet fever.

Pediatric autoimmune neuropsychiatric illness associated with group A streptococcus is an uncommon syndrome that has been linked to a strep infection. In children who have this disease, strep can exacerbate the symptoms of neuropsychiatric illnesses including obsessive-compulsive disorder or tic disorders. The validity of this connection is still up for debate.


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Page last reviewed: Apr 17, 2023

Next review due: Apr 17, 2025

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