Scarlet fever

Key points about scarlet fever 

  • Scarlet fever is caused by Streptococcus A bacteria. Although it affects mostly children under the age of 10 years, anyone can get it.
  • Symptoms usually start with a fever and sore throat, then a pink rash that starts on your chest and tummy and spreads across your whole body.
  • It can be diagnosed with a throat swab or a blood test and is treated with antibiotics.
  • People with scarlet fever should stay home from school, preschool or work for at least 24 hours after starting antibiotics.
  • Careful handwashing is key to preventing the spread of scarlet fever.
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Symptoms usually start 1–3 days after contact with the bacteria.

  • The illness usually begins with fever and a sore throat. There may also be vomiting and tummy pain.
  • A rash usually starts 1–2 days after the illness begins. It may first appear on your neck, underarms and groin, then spread over your body. It usually starts as small, flat, red blotches that gradually become small bumps with a rough surface. A child often gets a pink or red face, with a pale area around their mouth.
  • The tongue may get a white coating with red spots, often called 'strawberry tongue'. Once this coating comes off the tongue is bright red.
  • The scarlet fever rash usually fades in 7 days, and there is usually some skin peeling as the rash fades. 

Scarlet fever is usually mild; however, it can cause serious complications such as rheumatic fever and kidney problems. Read more about rheumatic fever in children

Scarlet fever mostly affects children, especially those aged under 10 years old. Adults can also get it, although that is rare.

Scarlet fever can be spread by:

  • breathing in air droplets coughed or sneezed by a person with scarlet fever
  • touching contaminated surfaces, hands or objects (such as cups, plates, and eating utensils ) used by a person with scarlet fever.

People with scarlet fever should stay home from school, preschool or work for at least 24 hours after starting antibiotics.

Your doctor will take a history and do a physical examination. Scarlet fever can be diagnosed through:

  • a blood test to test for the presence of Streptococcus A antibodies
  • a throat swab to test for the presence of Streptococcus A bacteria.

See your doctor if you think you or your child may have scarlet fever. Early treatment can prevent the illness from getting severe.

Antibiotics are the treatment for scarlet fever. If your illness is mild, you will be given oral antibiotics. If severe, you will need to go to hospital for antibiotics through your vein and for closer monitoring.

There is no vaccine available to prevent scarlet fever.

Careful handwashing is key to preventing the spread of scarlet fever. Wash your hands thoroughly with soap. It is especially important for anyone with a sore throat to wash your hands often. Avoid sharing towels, eating utensils such as spoons, forks, knives, plates and cups or other personal items. There is no vaccine to prevent scarlet fever.

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust. Content adapted with permission from the Hawkes Bay Public Health Unit

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