Scarlet Fever In Children: Causes, Symptoms And Treatment

scarlet fever in children

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Scarlet fever is strep throat (bacterial infection causing a scratchy sore throat) with an accompanying rash. It was once a severe and fatal disease in children but is now treatable with antibiotics.

MomJunction tells you about the causes of scarlet fever in children, and how it can be identified and addressed. We also share measures to prevent its spread.

What Causes Scarlet Fever In Children?

Scarlet fever is caused by type A Streptococcal (Group A Strep) bacteria, which also causes a strep throat. This bacteria release a toxin that causes the red itchy rashes.

The contagious disease spreads from one child to the other through (1):

  • Respiratory discharges such as sneeze and cough of an infected child.
  • Close contact like sharing the same utensils, towel or toothbrush or having skin contact with an infected child.
  • Skin sores that occur due to Group A strep infections.

Though scarlet fever can occur in any person, children in a particular age group are at a higher risk.

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Who Is At A Higher Risk Of Getting Scarlet Fever?

Children who are in close physical contact with affected children are at a greater risk of contracting scarlet fever.

Those aged between 5 and 12 years are the most vulnerable (2). Boys are more prone to it than girls.

Children below three years of age are not likely to get scarlet fever due to the presence of antibodies from the mother’s body.

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What Are The Symptoms Of Scarlet Fever?

The following symptoms indicate scarlet fever (3):

  • A red rash first appears in the groin and spreads up the torso. The rashes feel like sandpaper and often itch. These scarlet-color rashes give scarlet fever its name.
  • The rashes may result in a white area around the mouth.
  • Early in the infection, the tongue may be coated with a whitish or yellowish layer.
  • The tonsils and the back of the throat may appear red, swollen and marked with several rashes with little white specks of pus.
  • Red streaks or scars appear around the creases of armpits, elbows, knees, groin, and neck. This condition is known as Pastia’s lines.
  • The face might look flushed.
  • The child may have a strawberry tongue, wherein the tongue becomes bright red and white with bumpy sores on the surface.

Other nonspecific signs and symptoms of scarlet fever include:

  • Fever of 101o F or higher, sometimes accompanied by chills
  • A sore, scratchy throat that is red and painful
  • Difficulty and pain while swallowing due to sores and rashes
  • Inflammation of glands in the neck, such as the lymph nodes
  • Nausea
  • Loss of appetite
  • A headache
  • After these initial symptoms subside, the skin often starts to peel

Scarlet fever is usually mild and is not problematic. However, in some cases, the fever can lead to other complications.

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What Are The Complications Associated With Scarlet Fever?

Scarlet fever can lead to some other health complications, such as (4):

  1. Rheumatic fever: Inadequate treatment of scarlet fever can cause the inflammatory disease rheumatic fever. The joints and organs such as heart and kidneys get inflamed.
  1. Kidney disease: Post-streptococcal Glomerulonephritis, a kidney disease, is often caused following a strep infection with symptoms like blood in the urine, and swollen or puffy eyes and ankles. It happens as the body’s immune system tries to fight the strep bacteria from the body.
  1. Other complications: Improper or inadequate treatment of strep A bacteria or scarlet fever can lead to the swelling of tonsils with abscesses of pus, sinus and ear infections, arthritis, and pneumonia.

Such complications can be avoided with prompt treatment.

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When To Call The Doctor?

Call for a doctor’s appointment if:

  • The rashes have spread widely and the fever is not subsiding.
  • Your child doesn’t feel better even after a week.
  • Is sick even after all the symptoms of scarlet fever are cleared. This can be a sign of a complication.

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How Is Scarlet Fever Diagnosed?

Your child’s doctor will conduct a physical examination to determine if your child is affected by scarlet fever (5).

  1. Examination of tongue, throat, and tonsils: The doctor will examine the child’s tongue, tonsils, and throat to see if the tongue has a yellowish or white coating along with a sore throat and rashes in the tonsils.
  1. Examine the neck: The doctor will look for enlarged lymph nodes as inflammation of the glands in the neck is one of the significant symptoms of scarlet fever.
  1. Examine the rashes: If the rashes look like a sunburn and feel like fine sandpaper, they are signs of scarlet fever. The doctor will also determine the condition by checking where the rashes have appeared in the body.
  1. A throat swab or throat culture: If the doctor suspects that your kid has scarlet fever, he or she will get the throat swab tested. The swab is collected from the back of the child’s throat and sent for laboratory testing to determine the presence of group A Streptococcus.

The doctor will initiate treatment depending on the severity of the condition.

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Treatment For Scarlet Fever

Doctors usually prescribe antibiotics, mostly pencilin, to treat scarlet fever (6). Make sure that your child is completing the entire course of the antibiotics. Otherwise, it increases the risk of a returning infection.

The doctor may prescribe topical ointments for the rashes or medicines to ease a sore throat.

You may give paracetamol to control fever. But talk to the doctor before doing that.

With treatment, your child should be able to recover quickly. Your child can return to school once the fever is gone and 24 hours after taking the first dose of antibiotics.

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How To Take Care Of Your Child At Home?

Scarlet fever is treated with antibiotics, but you can use homecare measures to relieve the symptoms of the condition:

  • Have your child gargle with lukewarm salt water to soothe a sore throat.
  • An air humidifier helps in decreasing the pain from a sore throat.
  • Because of a sore throat, your child may find it painful and difficult to drink water often, and that can lead to dehydration. Therefore, make your child consume warm beverages or soupy foods.
  • To relieve itching, you may use over-the-counter anti-itching ointments.
  • Sucking on throat lozenges can relieve a sore throat.
  • Offer soft foods like noodles or soups to your kid.
  • Keep your child’s nails trimmed to avoid scratching.
  • Keep your child away from irritants in the air, like smoke or pollution.

While taking care of your child, you should also make sure that the infection is not spreading to the other kids in the house.

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How To Stop Scarlet Fever From Spreading?

Maintaining good hygiene is the most effective way to prevent scarlet fever. Some of the preventive measures are:

  • Wash hands before eating meals and after using the washroom or restroom.
  • Cover your mouth while sneezing or coughing.
  • Keep the utensils, toys and other personal objects separate from others while the infection is on.
  • Keep your child away from an infected person as it can get transmitted through sneezing or a cough.
  • All utensils, glasses, and cups should be washed with soap and water.
  • If you are taking care of a child with a strep infection, you must wash your hands frequently with soap and water.

Next, we answer some more commonly asked questions about scarlet fever.

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Frequently Asked Questions

1. Can adults get scarlet fever from a child?

Adults can get scarlet fever while being around or treating a child suffering from the condition. To prevent catching the infection, wash your hands with soap and water thoroughly.

2. Can a child get scarlet fever twice?

Although rare, scarlet fever can occur more than once. Getting the illness once does not provide immunity for a lifetime.

3. How long does scarlet fever last?

The infection will stay for one to two weeks without antibiotics. Once the child begins taking antibiotics, the infection is active for the first 24 hours (7).

The symptoms and fever will go away soon after the medication is started, and your child will get well soon. The initial days may be a little challenging to manage, but it is not a threat to your child. Take care of the child at home, and they will be alright soon.

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Do you have any experiences or tips to share? Let us know in the comment section below.

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Sudipta Jana

BA, MASudipta is an English Major from the University of Hyderabad. Has considerable medical research writing experience, but also enjoys creative writing and the arts. Her writings aim to make highly scientific/ health material easy to understand for a common reader.She is also a National Novel Writing Month awardee. Sudipta loves to hit the roads to find stories and motivation to fill up her canvases and the pages of her diary.
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