Scarlet fever: an overview and more

Scarlet fever is an infection caused by group A strep (group A strep), the same bacteria that cause pharyngitis . Also known as scarlet fever, it is characterized by a rash and a red tongue. It most often affects children between the ages of 5 and 15 and rarely, if ever, affects adults. Although scarlet fever used to be a dangerous childhood disease, it now responds well to treatment and is rare in most parts of the world.

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The symptoms of scarlet fever

Scarlet fever usually begins with a fever, sore throat, and other familiar symptoms of strep infection , such as a headache and chills.

After two days, a rash appears on the skin, which helps distinguish scarlet fever from strep throat. The rash will persist for some time after the initial symptoms of scarlet fever respond to treatment. Sometimes the skin in certain areas of the body is shed over a period of several weeks.

Although scarlet fever is rare, it can develop after a strep skin infection such as impetigo . Scarlet fever does not start with a throat infection, but rather with signs of infection around the burn or wound.

In very rare cases, scarlet fever can lead to serious long-term health problems, such as rheumatism and kidney problems. But it is important to know that such complications are very rare and can be easily prevented by quickly curing scarlet fever (and other strep infections) with a full course of antibiotics.


Group A strep bacteria is responsible for many types of infections, including strep throat and some skin infections. Bacteria belonging to the group A strain of streptococcus that causes scarlet fever produce the toxin responsible for the red rash and 'strawberry tongue', which are unique characteristics of the disease.

Group A strep bacteria are spread through droplets of infected fluid that are carried through the air when an infected person coughs or sneezes. Touching something that has been exposed to bacteria and then touching your mouth, eyes, or nose can lead to infection.

The disease spreads more in crowded conditions. Washing your hands and covering for coughs and sneezes can help prevent the spread. A child remains contagious after just two days of taking antibiotics.


Scarlet fever is diagnosed in the same way as pharyngitis. A throat swab is taken and a rapid strep test is performed or the sample is cultured to see if strep bacteria are present. The rapid test can show a positive result in 5 to 10 minutes, but culture results can take up to two days. Both tests will run frequently because the quick tests may not be reliable.

Watch out

There are two important aspects of treating scarlet fever: killing bacteria and relieving symptoms .

A full course of antibiotic treatment is essential. The most commonly used drugs are penicillin and amoxicillin. There are many safe alternatives for people allergic to penicillin.

There are many over-the-counter and home remedies available to help manage the unpleasant and sometimes painful symptoms of scarlet fever. These include simple methods to relieve a sore throat, such as eating cold foods, drinking hot liquids, and using the bedroom to keep the air moist. Nonsteroidal anti-inflammatory drugs (NSAIDs) can lower fever and relieve body aches and pains.

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Scarlet fever was once a very dangerous and common childhood disease. In the 19th century it caused the death of many children. Now that it can be easily and effectively treated, it is no longer the threat it once was. However, there have been a few outbreaks in recent years. Since 2014, the incidence of scarlet fever has been on the rise in England and East Asia, for example, according to a 2018 report by The Lancet .

Researchers are not sure what is behind the rise in scarlet fever in these countries, although resistance to certain antibiotics is believed to have played a role in Asia . But despite the resurgence of scarlet fever in certain regions of the world, it's important to note that the disease is no longer the common childhood scourge that it once was.

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