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27 November 2009
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Scarlet fever

Dr Rob Hicks

Scarlet fever (also referred to as scarlatina) is caused by a bacterial infection that causes a sore throat and a characteristic red rash. It's highly infectious.


Who's affected?

Scarlet fever is caused by group A streptococcal bacteria and can affect people of any age. However, it's most common between the ages of six and 12.

What are the symptoms?

The main symptoms include a sore throat and headache, fever, vomiting and swollen neck glands.

The tongue develops a thick, white coating, which peels after four or five days leaving it swollen with a red, 'strawberry' appearance.

The rash usually develops around the second day of infection

The rash usually develops around the second day of infection. It's caused by toxins released during the condition and tends to look like bad sunburn. It may itch and feels like sandpaper with tiny bumps.

It first appears on the neck, before spreading to the chest and back, then to the rest of the body.

It fades around six days after the onset of sore throat symptoms. The skin affected by the rash may peel, particularly around the fingertips, toes and groin.

Complications are rare, but they can include:

  • Acute rheumatic fever
  • Ear infection (otitis media)
  • Adenitis or abscess
  • Pneumonia
  • Kidney damage
  • Meningitis

Early treatment will reduce the risk of complications.

How can I prevent it?

A person can become infected with streptococcus by touch or through airborne droplets. Not all streptococci produce this toxin, however, and not everyone is sensitive to it. Only those who are sensitive to the toxin are likely to develop the rash.

To minimise your risk, avoid contact with the infected person. If this can't be avoided, wash your hands regularly.

What's the treatment?

Get plenty of rest and take fluids, painkillers and medication to reduce the fever. You may also prefer to eat soft foods if you have a sore throat. Treatment is with antibiotics, usually penicillin.

This article was last medically reviewed by Dr Orlena Kerek in March 2009


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