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If your child has a sore throat and a rash, it may be scarlet fever (also called scarlatina). Your child's doctor can do a quick strep test to find out.

If your child has scarlet fever, antibiotics can help your child feel better faster and prevent long-term health problems. Antibiotics can also help protect others from getting sick.

Bacteria cause scarlet fever

Bacteria called group A Streptococcus (group A strep) cause scarlet fever. These bacteria are also the cause of strep throat. The bacteria sometimes make a toxin (poison), which causes a rash - the "scarlet" of scarlet fever.

How you get scarlet fever

Group A strep bacteria are very contagious. Generally, people spread the bacteria to others through

Respiratory droplets

Direct contact

Rarely, people can spread group A strep bacteria through food that is not handled properly (visit CDC's food safety page).

It usually takes two to five days for someone exposed to group A strep bacteria to become sick with strep throat or scarlet fever.

Respiratory droplets

Group A strep bacteria often live in the nose and throat. People who are infected spread the bacteria by talking, coughing, or sneezing, which creates respiratory droplets that contain the bacteria.

People can get sick if they:

Breathe in respiratory droplets that contain the bacteria

Touch something with those droplets on it and then touch their mouth or nose

Drink from the same glass or eat from the same plate as a person infected with group A strep

Direct contact

People can also spread group A strep bacteria from infected sores on their skin. Other people can get sick if they:

Touch sores on the skin caused by group A strep (impetigo) or come into contact with fluid from the sores

People are contagious even with no symptoms

Some people infected with group A strep do not have symptoms or seem sick. People who are sick with strep throat are more contagious than those who do not have symptoms.

Rash and fever are common symptoms

In general, scarlet fever is a mild disease. Illness usually begins with a fever and sore throat.
General symptoms
Some symptoms of scarlet fever are common to other infections, too. These may include:

Fever (101°F or higher) or chills

Sore throat and pain when swallowing

Headache or body aches

Stomach pain

Nausea or vomiting

Physical signs
Some physical signs are typical of scarlet fever. These show in the following areas:

Physical signs

Tongue, throat, and neck

Signs in these areas:

Whitish coating on the tongue, early in the illness

"Strawberry" (red and bumpy) tongue

Very red throat

Red and swollen tonsils

White patches or streaks of pus on the tonsils

Tiny, red spots on the roof of the mouth, called petechiae

Swollen lymph nodes in the front of the neck

The illustrations below show what these physical signs usually look like.

Skin rash

Signs of scarlet fever rash:

Red rash that feels rough like sandpaper

Brighter red skin in the creases of the underarm, elbow, and groin

A pale area around the mouth

Skin peeling as the rash fades

One to 2 days after the illness begins, a red rash usually appears. However, the rash can appear before illness or up to 7 days later.

The rash may first appear on the neck, underarm, and groin (the area where your stomach meets your thighs). Over time, the rash spreads over the body. The rash usually begins as small, flat blotches that slowly become fine bumps that feel like sandpaper.

Although the cheeks might look flushed (rosy), there may be a pale area around the mouth. Underarm, elbow, and groin skin creases may become brighter red than the rest of the rash.

The rash from scarlet fever fades in about 7 days. As the rash fades, the skin may peel around the fingertips, toes, and groin area. This peeling can last up to several weeks.

Some people are at increased risk

Anyone can get scarlet fever, but there are some factors that can increase the risk of getting this infection.

Age

Scarlet fever, like strep throat, is more common in children than adults. It is most common in children 5 through 15 years old. It is rare in children younger than 3 years old. Adults who are at increased risk for scarlet fever include:

Parents of school-aged children

Adults who are often in contact with children

Group settings

Close contact with another person with scarlet fever is the most common risk factor for illness. For example, if someone has scarlet fever, the bacteria often spread to other people in their household.

Infectious illnesses tend to spread wherever large groups of people gather. Crowded settings can increase the risk of getting a group A strep infection. These settings include:

Schools

Daycare centers

Military training facilities

Doctors can test for and treat scarlet fever

Many viruses and bacteria can cause an illness that includes a red rash and sore throat. A doctor will determine what type of illness you have by asking about symptoms and doing a physical exam. If they think you might have scarlet fever, they will swab your throat to test for strep throat. There are two types of tests for strep throat: a rapid strep test and throat culture.

Rapid strep test

A rapid strep test involves swabbing the throat and running a test on the swab. The test quickly shows if group A strep bacteria are causing the illness.

If the test is positive, doctors can prescribe antibiotics.

If the test is negative, but a doctor still suspects scarlet fever, then the doctor can take a throat culture swab.

Throat culture

A throat culture takes time to see if group A strep bacteria grow from the swab. While it takes more time, a throat culture sometimes finds infections that the rapid strep test misses.

Culture is important to use in children and teens since they can get rheumatic fever from an untreated scarlet fever infection. For adults, it is usually not necessary to do a throat culture following a negative rapid strep test. Adults are generally not at risk of getting rheumatic fever following scarlet fever.

Antibiotics are used for treatment

Doctors treat scarlet fever with antibiotics. Benefits of antibiotics include:

Decreasing how long someone is sick

Decreasing symptoms (feeling better)

Preventing the bacteria from spreading to others

Preventing serious complications like rheumatic fever

When to return to work, school after illness
People with scarlet fever should stay home from work, school, or daycare until they:

AND

Have taken antibiotics for at least 12 to 24 hours; ask the doctor how long you should stay home after starting antibiotics

Antibiotic dos and don'ts

1. Do take the prescription exactly as the doctor says to.

2. Don't stop taking the medicine, even if you or your child feels better, unless the doctor says to stop.

You can find more guidance on taking antibiotics on CDC's Antibiotic Do's & Don'ts Page.

Long-term health problems are not common

Complications can occur after having scarlet fever. This can happen if the bacteria spread to other parts of the body. Complications can include:

Treatment with antibiotics can prevent most of these health problems.

Protect yourself and others

People can get scarlet fever more than once. Having scarlet fever does not protect someone from getting it again in the future. While there is no vaccine to prevent scarlet fever, there are things people can do to protect themselves and others.

Good hygiene

The best way to keep from getting or spreading group A strep is to wash your hands often. This is especially important after coughing or sneezing and before preparing foods or eating.

To prevent group A strep infections, you should:

Cover your mouth and nose with a tissue when you cough or sneeze.

Put your used tissue in the waste basket.

Cough or sneeze into your upper sleeve or elbow, not your hands, if you don't have a tissue.

Wash your hands often with soap and water for at least 20 seconds.

Use an alcohol-based hand rub if soap and water are not available.

You should also wash glasses, utensils, and plates after someone who is sick uses them. These items are safe for others to use once washed.

Antibiotics

Antibiotics help prevent someone with strep throat from spreading the bacteria to others.

Related diseases

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If your child has a sore throat and rash, it may be scarlet fever, a group A strep infection. Do you know the symptoms of this contagious illness and treatment options?

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The group A Streptococcus bacteria is scarlet fever. This bacteria can make toxins poisonous to the body, and create a bright red rash. The rash can cover most of the body and comes with a high fever and sore throat.

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1. Very red sore throat
2. Fever of 101 or higher
3. Whitish coating on the tongue when first infected
4. Red and bumpy tongue- called a strawberry tongue
5. Bright red skin in the underarm, elbow, and groin area (sandpaper rash)
6. Swollen glands in the neck
7. Headache or body aches
8. Nausea, vomiting, or abdominal pain

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Prevention- Make sure to wash your hands often, try not to touch your mouth or nose, cover your mouth if coughing or sneezing, and if you are sick do not go around people.
Treatment- Doctors will prescribe antibiotics to get a patient healthy fast. Either penicillin or amoxicillin are a recommended antibiotic for scarlet fever.

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This is the Scarlet Fever cycle that ends with antibiotics as the healing agent.  

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Video: https://www.youtube.com/watch?v=XU1Bm2acTqo

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A rapid strep test or a throat culture test can determined if the cause of your illness is from the A strep bacteria. First doctors will do the rapid test and If the patient is negative for Strep, then the doctors can start to assume scarlet fever as a possibility. The throat culture test is used to test scarlet fever, but will take more time and throughly find bacteria the strep test will miss.

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If an infected person does not get the treatment they need it could lead to
1. Abscesses (pus) around the tonsils
2. Swollen lymph nodes
3. Ear, sinus, and skin infections
4. Pneumonia- infection in the lungs
5. Rheumatic Fever- infection in the heart
6. Arthritis- joint inflammation

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Causative agent- What causes Scarlet fever?

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Causative agent- What causes Scarlet fever?

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The bacteria group A strep exists around the nose and throat and is easily spread. The infected may cough or sneeze allowing small respiratory droplets of scarlet fever bacteria to get out.
sickness can be caused if
1. Breathe in the droplets
2. Touch droplets and then rub your nose or mouth
3. Drink or eat from the infected person
4. Touch sores on the skin that have the strep bacteria

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In the paper I found on Pubmed, written by Jian-Yun Lu, Zong-Qiu Chen, Yan-Hui Liu, Wen-Hui Liu, Yu Ma, Tie-Gang Li, Zhou-Bin Zhang, Zhi-Cong Yang, compared the effect of whether on scarlet fever. The conclusion was that higher temperatures, higher atmospheric pressure, and low rainfall all helped in reducing the scarlet fever bacteria. The extreme meteorological trends correlated with scarlet fever incidences, the only one that wasn't highly statistically significant was wind velocity. This information can help in the further understanding of why there may be a scarlet fever outbreak, and can work as an early warning system for the disease spread and control.

https://pubmed.ncbi.nlm.nih.gov/30711589/

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Wen- Hui Liu's research is affiliated with Guangzhou medical university

Other Works: https://www.researchgate.net/scientific-contributions/Wen-Hui-Liu-2156102500

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1. Scarlet fever is most common among children 5 to 15 years of age.
2. Most common locations for the spread of Scarlet fever are schools, daycare centers, military training facilities.
3. It takes around five days for a person to know they have been infected.
4. Occurs in 10% of the people with strep throat
5. About 80% of children who reach age 10 have developed lifelong antibodies against the Streptococcus exotoxin

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- https://www.mayoclinic.org/diseases-conditions/scarlet-fever/symptoms-causes/syc-20377406

- https://www.medicinenet.com/scarlet_fever_scarlatina/article.htm

- https://www.ncbi.nlm.nih.gov/books/NBK333430/

- Infographic: https://www.verywellhealth.com/thmb/7aEZ1MN9PidD4uphpkgjMGA-LZQ=/614x0/filters:no_upscale():max_bytes(150000):strip_icc()/scarlet-fever-overview-1958805_fin-b03dd028ce63461c8bbdecef8eff4ff5.png

- https://pubmed.ncbi.nlm.nih.gov/30711589/

- Scarlet fever photo: https://www.google.com/url?sa=i&url=https%3A%2F%2Fwhat0-18.nhs.uk%2Fnational%2Fworried-your-child-unwell%2Fscarlet-fever&psig=AOvVaw0CHQF_qbVkADZeyUM2FiMn&ust=1637853429997000&source=images&cd=vfe&ved=0CAsQjRxqFwoTCJDwqdGlsfQCFQAAAAAdAAAAABAP