Scarlet Fever In Babies And Toddlers: 9 Answers You Must Know

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My 13-month boy is always healthy and happy. He is in the active mode throughout the day and has been gaining good weight. But one day while undressing him for a bath, to my dismay I found red rashes on his chest! Scores of doubts flooded my mind at once. After a while, I gathered myself and went to seek medical advice. The doctor suspected it to be scarlet fever and prescribed medication.

We returned home. Still many doubts kept haunting me! ‘Is scarlet fever common in babies?’ ‘Is it dangerous?’ And so on. If you, too, want answers for every question on scarlet fever in babies and toddlers, this post at MomJunction is a must-read.

We tell you the reasons for the condition to occur, the ways you can identify the fever, and the treatments your doctor could recommend. Also, do not miss the tips we have to prevent the fever from spreading. But first, we’ll allay your fears.

1. Is scarlet fever common in infants?

No. Scarlet fever is rare in infants as they are protected by the immune system components transferred from the mother at birth. However, children between the ages 2 and 10 years are susceptible to this fever. Thankfully, it is not dangerous given the availability of antibiotic medications.

2. What causes scarlet fever in babies and toddlers?

Scarlet fever is an upper respiratory tract infection. The bacterium called group A streptococcus or Streptococcus pyogenes bacteria, causes the condition (1).

The streptococcal bacteria release poisons (toxins), which enter the blood from the infected throat and cause characteristic red rashes. They feel like sandpaper when touched. However, some babies may not develop rashes to Streptococcal infections, as they are not sensitive to the toxin.

It is rare but possible for a strep skin infection like impetigo to develop scarlet fever. But in such a case, the toddler may not have a sore throat.

The milder form of scarlet fever is Scarlatina.

[ Read: Symptoms Of Glandular Fever In Babies ]

3. Is scarlet fever contagious?

Scarlet fever is contagious. But it is the strep throat that is contagious and not the rash. Fluids, including saliva, cough, and mucus of the infected person, spread the disease through the air. The infection could spread even through the sharing of towels, bed linen, and bath clothes or skin-to-skin touch.

If older children in the family are infected, take every possible care to avoid spreading it to your baby. Look out for any symptoms to act quickly.

4. What are the symptoms of scarlet fever?

Scarlet fever results in the rise of body temperature. The rashes show up a day or two after the onset of the first typical symptoms such as fever above 101°F (38.3°C), and sore throat (2).

  • Initially, the tongue gets a white coating and has ‘white-strawberry’ appearance. It gradually turns into ‘bright red strawberry tongue’.
  • Rashes of 1-2mm and bumps emerge, beginning from the throat and spreading downwards. They move to the trunk and legs and arms (extremities).
  • Rashes appear throughout the body except for the face. The face could look flushed, and the skin turns white (blanch) when you press the rashes.
  • These rashes can be itchy.
  • Red streaks may appear if rashes develop on the creases of the body like elbow folds and armpits. These red streaks are called Pastia’s lines.
  • Tonsils enlarge and turn tender and red. Other lymph nodes may swell as well.
  • Other symptoms are appetite loss, vomiting, nausea, chills, body aches, and fever.

The tell-tale rash breaks out on the second day and lasts for almost five days. As the rash begins to disappear (sometime between third and fifth day), the skin begins to peel in a way similar to that of a sunburn. The fever comes down within three to five days, but a sore throat continues.

[ Read: Heat Rash On Babies ]

5. How can you diagnose scarlet fever in babies and toddlers?

The fever, rashes, and sore throat indicate that something is wrong with the baby. Take him immediately to the doctor, who will initially examine the skin and throat culture. A rapid strep test or blood test could be performed to diagnose the disease. If the tests confirm the condition to be scarlet fever, then the treatment begins.

6. What is the treatment for scarlet fever?

The scarlet fever is treated with a 10-day course of antibiotics. However, tonsils and swollen glands can take a few weeks to come to normal.

Antibiotics: The treatment for scarlet fever would include prescribed antibiotic administration for nearly 10 days. After 24-hour antibiotic treatment, the infected person is no more contagious.

The symptoms may subside earlier but complete the course of antibiotics to avoid possible complications (3). You need to call the doctor if his fever does not subside even after 48 hours of starting the antibiotics.

7. What are the complications associated with scarlet fever?

Though rare, early complications such as sinus, ear and throat infections, pneumonia, brain abscess and meningitis are associated with scarlet fever. Other serious but rare complications that could occur a few weeks later include kidney damage, chicken pox, and rheumatic fever.

8. How to take care of your baby when he has scarlet fever?

  • Maintain normal room temperature to prevent shivering or overheating.
  • Do not wrap up the feverish baby with extra layers.
  • Keep him hydrated by offering a lot of fluids.
  • Do not use a fan to cool the baby; just a gentle air-flow in the room would be helpful.
  • Also, avoid cold-water sponging. If the water is too cold, the blood vessels under the skin constrict. This would lock the heat inside the deeper body parts, making it difficult to escape from the body. Moreover, cold-sponging may be uncomfortable for a few babies.
  • Use a cool-mist humidifier for a dry, sore throat.
  • Offer your baby soft foods and plenty of fluids as a sore throat can make swallowing painful.

[ Read: How To Treat Dehydration In Babies ]

9. How to prevent scarlet fever from spreading?

As the scarlet fever is a contagious infection, the baby’s caretaker should follow some guidelines to avoid its spread among the family and friends.

  • Keep clothing and bathing objects and cutlery of the baby separately. Wash them thoroughly before and after use.
  • Do not send your toddler to nursery or school if he has scarlet fever.
  • Cover the nose and mouth with a tissue or cloth while sneezing to prevent the spread. Frequent hand-wash with soap is advisable.
  • Trim his fingernails short to prevent him from scratching the itchy rash.

Take enough care to prevent the infection from spreading as there is no vaccine available to prevent scarlet fever.

The good news is it is not very common to get scarlet fever more than once, even though your baby might get strep throat several times. Scarlet fever is not as dreadful as it was earlier. Prescribed antibiotic course would help in subsiding the infection. So, if you suspect scarlet fever in your little one, seek immediate medical advice.

Moms, what did you do to alleviate discomforts of your baby when he was down with scarlet fever? Let us know in the comment section below.

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Dr. Anuradha Bansal

Dr. Anuradha Bansal is a pediatrician and neonatologist working as assistant professor in the Department of Paediatrics at PIMS Jalandhar. She has done her MBBS and MD Pediatrics at GMCH, Chandigarh. Thereafter, she polished her skills as senior resident at MAMC, Delhi. She has also done IAP Fellowship in Neonatology at GMCH, Chandigarh and obtained the membership of the prestigious... more

Dr Bisny T. Joseph

Dr. Bisny T. Joseph is a Georgian Board-certified physician. She has completed her professional graduate degree as a medical doctor from Tbilisi State Medical University, Georgia. She has 3+ years of experience in various sectors of medical affairs as a physician, medical reviewer, medical writer, health coach, and Q&A expert. Her interest in digital medical education and patient education made... more