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Scarlet fever, also known as scarlatina, is an infection that can develop in people who have strep throat. It results when the bacteria release a toxin that causes a rash.

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Scarlet fever usually causes a sore throat and a bright red rash that may be harder to see in people with darker skin.

It typically affects children, but anyone can contract the illness. You can contract it directly with an ill person or in crowded areas like schools or daycares.

In the past, scarlet fever could cause complications and even lead to death. These days, when treated with antibiotics, it is typically a mild infection that clears within a few days.

Keep reading to learn more information on scarlet fever.

Scarlet fever is an infection by the bacteria Group A streptococcus (Group A strep). This is the same bacteria that causes strep throat.

A bright red rash usually develops on the body, often accompanied by a high fever and sore throat.

Scarlet fever mainly affects children ages 5-15 years. It used to be a serious childhood illness but is less dangerous today.

Antibiotic treatments used early on in the illness can help speed recovery and reduce the severity of the symptoms.

A rash is the most common sign of scarlet fever in adults and children. It usually begins as a red blotchy rash and becomes fine and rough like sandpaper.

The scarlet-colored rash is what gives scarlet fever its name. The rash can begin up to two to three days before a person feels ill or up to seven days later.

The rash may be less obvious on darker skin, though you would still be able to feel the bumpy, raised rash.

The rash typically begins on the neck, groin, and under the arms. It then spreads to the rest of the body. The folds of skin in the armpits, elbows, and knees can also become a deeper red than the surrounding skin.

After the rash has subsided, usually in about seven days, the skin on the tips of the fingers and toes and in the groin may peel. This can last for several weeks.

In addition to the tell-tale rash, scarlet fever may also cause:

Here is what scarlet fever may look like on different skin tones.

Group A Streptococcus or Streptococcus pyogenes bacteria causes scarlet fever. Normally, Group A strep causes the typical sore throat or, in some cases, fever.

However, the bacteria can sometimes produce a toxin that causes a bright red rash on the body. This is an endotoxin, which means that it is a toxin released when the bacterial cell disintegrates. This is when the disease becomes scarlet fever.

Not everyone who gets group A strep will get scarlet fever. Some people are more susceptible to the toxin than others.

The infection can spread up to 6 days before a person feels ill and may be spread through contact with droplets from a person’s saliva, nasal secretions, sneeze, or cough. This means that any person can contract scarlet fever if they come into direct contact with these infected droplets and then touch their own mouth, nose, or eyes.

You may also get scarlet fever if you drink from the same glass or eat with the same utensils as a person with the infection. In some rare cases, group A strep infections have spread through food.

Group A strep can cause a skin infection in some people. However, this is different from scarlet fever. These skin infections, known as cellulitis, can spread the bacteria to others. However, touching the rash of scarlet fever will not spread the bacteria since the rash is a result of the toxin and not the bacteria itself.

A doctor, nurse practitioner, or physician’s assistant will perform a physical exam to check for signs of scarlet fever. During the exam, the doctor will check the condition of your child’s tongue, throat, and tonsils. They’ll also look for enlarged lymph nodes and examine the appearance and texture of the rash.

If the medical professional suspects your child has scarlet fever, they’ll likely swab the back of your child’s throat to collect a sample of their cells for analysis. This is called a throat swab and is used to create a throat culture.

They will then send the sample to a laboratory to determine whether group A strep is present.

They may also order a rapid antigen detection test that they can perform in the office. This may help identify a group A strep infection while you wait.

Medical professionals treat scarlet fever with antibiotics. Antibiotics kill bacteria and help the body’s immune system fight off the bacteria causing the infection.

Make sure you or your child complete the entire course of the prescribed medication. This will help prevent the infection from causing complications or continuing further.

For fever and pain, you can also give certain over-the-counter (OTC) medications, such as acetaminophen (Tylenol). Check with the medical team you’re working with to see if your child is old enough to receive ibuprofen (Advil, Motrin). Adults may use acetaminophen or ibuprofen.

You should not give aspirin to any child under the age of 16 during an illness with a fever due to the increased risk of developing Reye’s syndrome.

A medical professional might also prescribe other medication to help ease the pain of a sore throat.

Home remedies

Other remedies that may help your child feel better include:

It’s also important that your child drink plenty of water to avoid dehydration.

Other steps you can take to treat scarlet fever at home include:

Your child can return to school after they’ve taken antibiotics for at least 12-24 hours and no longer have a fever.

There’s currently no vaccine for scarlet fever or group A strep yet, although researchers are currently looking into potential vaccines.

You can get scarlet fever if you encounter someone ill with the infection. Since it is more common in children, risk factors include being in a school, preschool, or another place where many children are present.

In theory, you are at an increased risk of catching scarlet fever in crowded areas, especially in closed-off facilities with many people.

In most cases, the rash and other symptoms of scarlet fever will be gone in about seven days with antibiotic treatment. However, scarlet fever can cause serious complications. These can include:

A person has a higher chance of avoiding ear infections, throat abscesses, and pneumonia through prompt antibiotic treatment. Other complications occur due to the body’s immune response to the infection rather than the bacteria. This is called poststreptococcal disorder.

Practicing good hygiene is the best way to prevent scarlet fever. Here are some prevention tips to follow and teach your children:

  • wash your hands before meals and after using the restroom or after coughing or sneezing
  • cover your mouth and nose when sneezing or coughing
  • avoid sharing utensils and drinking glasses with others, especially in group settings
  • stay away or keep your distance from a person you know has scarlet fever

The following sections answer some of your frequently asked questions about scarlet fever.

How fatal is scarlet fever?

In the past, scarlet fever had a relatively high mortality rate due to potential complications. Since the development of antibiotics, it has become a much more mild infection that clears within a few days.

How common is scarlet fever?

About 15-30% of children who get scarlet fever are ages 5-15-years. It rarely affects children under the age of three. About 5-15% of adults will get the illness.

There is research showing that infections could be rising. According to a 2019 study, 2018 saw the highest number of reported scarlet fever cases in china in 20 years. It is similarly reemerging in other parts of the world.

Can scarlet fever be cured?

Antibiotics can clear the infection. You can still get infected again in the future, and there is currently no vaccination against it.

Scarlet fever occurs due to a toxin released by the Group A bacteria. Though it is most common in children, anyone can develop the infection.

Scarlet fever gets its name from the red, bumpy rash that appears on the skin. People with darker skin may not have a color change but will likely feel a bumpy rash.

Treatment consists of antibiotics, but you can help ease discomfort with home remedies and over-the-counter medications. Early treatment is the best way to prevent complications. Once treated, the infection should clear within seven days.