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Scarlet fever is a disease caused by infection with the group A Streptococcus bacteria.  This is the same bacteria that causes strep throat infections.
Causes, incidence, and risk factors
Scarlet fever is easily treatable although it was once a very serious childhood disease.  The cause of the illness is the streptococcal bacteria, which produces a toxin that leads to the red rash of the illness.
A history of strep throat infections or scarlet fever in schools or community increases the risk of infection.
Generally, it is only one to two days between becoming infected and showing symptoms. Typically the illness will begin with a sore throat and fever.
The rash usually appears first on the chest and neck and then spreads over the body.  It is described as feeling like sand paper when touched and looking like sun burn.  It is this texture of the rash that is more important than how it looks in confirming the illness. The rash can last for more than a week and as it fades, there may be skin peeling around the toes, fingertips and groin area.
Other symptoms include:
  • Abdominal pain
  • Bright red color in the creases of the groin and underarm
  • Fever of 101 degrees Fahrenheit or 38.3 degrees Celsius or higher
  • Chills
  • General discomfort and malaise
  • Headache
  • Muscle aches
  • Sore throat
  • Swollen, red tongue  and sometimes, a whitish coating (strawberry tongue)
  • Vomiting
Signs and tests
  • Physical examination
  • Throat swab to be used for a throat culture or a rapid antigen test to see if there is a group A step infection.
Antibiotics are used to kill the bacteria that causes the throat infection - this is crucial to prevent rheumatic fever which is a serious complication of strep throat and scarlet fever.
With proper antibiotic treatment, the symptoms of scarlet fever should get better quickly however, the rash can last for up to two to three weeks before it fully goes away.
Complications are rare with the right treatment, but can include:
  • Acute rheumatic fever
  • Bone or joint problems (osteomyelitis or arthritis)
  • Ear infection
  • Inflammation of a gland or abcess
  • Kidney damage
  • Liver damage (hepatitis)
  • Meningitis
  • Pneumonia
  • Sinusitis
When should a doctor be consulted?
  • You develop symptoms of scarlet fever
  • Your symptoms do not go away 24 hours after beginning antibiotic treatment
  • You develop new symptoms
Bacteria are spread by by droplets exhaled by an infected person or by direct contact with infected people. It is best to avoid contact with infected people where possible.
Do not share cups, straws, cutlery, toothbrushes etc and wash hands after blowing/touching nose.
Is there anything else I can do to make my child feel better?
Warm liquids like soups or cold foods like ice pops or milkshakes help to ease the pain of the sore throat.  
You should offer these to your child often especially when they have a fever as the body needs a lot of fluid when it is sick with a fever.  
A cool mist humidifier will help to keep the air in your child's room moist which will keep the throat from getting too dry and sore.
Your child also needs plenty of rest.



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