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Scarlet fever
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What is scarlet fever?
Scarlet fever is an infection caused by a germ called ‘streptococcus pyogenes’. The
scarlet fever rash usually occurs after a throat or skin infection, such as streptococcal
sore throat.
The germ produces toxins that cause the characteristic scarlet fever rash and can also
cause strawberry tongue, when the tongue can become swollen and red.
What are the symptoms of scarlet fever?
Symptoms include:
• Sore throat and fever
• Pink or red rash on the neck and chest, which may spread to the rest of the body
- the skin may feel rough, like sandpaper. When pressed, the rash turns white. The
rash appears 12 to 48 hours after the onset of fever and may last seven to ten days.
• Once the rash has cleared, the skin may peel. This is more noticeable in the
armpits, groin and tips of the fingers and toes.
• White coating on the tongue, which peels after a few days leaving the tongue red
and swollen
• Headache
• Swollen glands
• Loss of appetite
• Nausea and / or vomiting
• Abdominal pain
• General feeling of being unwell
The incubation period for scarlet fever is one to four days, and starts with a throat or
skin infection.
Who can it affect?
Scarlet fever usually affects children - it is most common in children between the ages
of four and eight years. However, people of all ages can catch it. It is rarely found in
children less than two years old.
How is it spread?
The bacteria (germs) are carried in saliva in the mouth and in mucus from a runny
nose. Scarlet fever is spread by touching the mucus or saliva of an infected person,
and then touching your mouth, nose, eyes. You can also get the disease by inhaling
infected airborne droplets produced by a person with scarlet fever coughing or
sneezing near you.
It can also be spread through close physical contact with a person who has a
streptococcal skin infection.
How is it diagnosed?
Your family doctor (GP) can diagnose scarlet fever from the characteristic signs and
symptoms alone. You may need a throat swab, to be tested in the laboratory. This
helps to identify the bacteria causing the infection.
How can you prevent the infection being spread?
• Wash or dispose of all used handkerchiefs and tissues of someone with scarlet fever
• Always use a handkerchief or tissue when coughing and sneezing.
• Wash your hands after handling tissues or handkerchiefs.
• Ensure the infected person has their own towels for personal use.
• Do not share eating utensils.
What is the treatment for scarlet fever?
Scarlet fever is treated with a course of antibiotics. Symptoms will improve after a few
days. However, you should always take the full course to ensure the infection is fully
If you have a high temperature, drink plenty of fluids. You can take paracetamol to
relieve discomfort and bring down temperature.
Are there any complications?
Complications are rare. However, they can occur. Complications include:
• throat abscess
• ear infection
• sinusitis
• pneumonia
• meningitis
• bone and joint problems
• kidney damage
• liver damage
• rheumatic fever
If you have had scarlet fever you are unlikely to get it again.
When can I go back to nursery/school/work?
You should stay away from nursery, school or work until you are well and have
completed five days of the antibiotic course.
Further information
To find out more about scarlet fever, contact:
Health Protection Nurse Specialist
Department of Public Health - NHS Ayrshire & Arran
01292 885 858
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Compiled by: Public Health department
Review date: May 2010
Leaflet reference: PHD09-003-GD_A4 VERSION