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See Dr Morton’s diagnose skin rash soothe a fever and respect antibiotics
Scarlet fever (SF) is a highly infectious disease caused by a bacterium called group A streptococcus. This is the same bacterium that causes tonsillitis, and in the past in the UK, and now still in many parts of the world, rheumatic fever, which can damage the heart. Group A streptococcus is the bacterium that causes puerperal fever. Puerperal fever is infection in the uterus and bloodstream after childbirth. This is a very serious illness which claims mothers’ lives every year in the UK.
Scarlet fever mainly affects children between the ages of two and eight years (median age four years). It is sometimes known as scarletina. It is far less common than it was before the advent of antibiotics but there has been a recent peak in the number of reported cases this year. In spite of its rather scary sounding name it is usually a mild illness which is easily treated with a course of antibiotics. Scarlet fever is unusual in adults but they can catch it.
Scarlet fever usually starts with a sore throat< and headache accompanied by a high temperature often 38.5 degrees or higher. Within 12–48 hours a very fine, tiny red dot rash appears starting on the chest and then spreading over the body. The rash feels like sandpaper to the touch. Initially your child’s tongue will be white and coated but after a day or so it peels revealing a red, swollen so-called ‘strawberry tongue’.
If you think you or your child has scarlet fever you should get medical advice promptly.
Scarlet fever is highly infectious and if left untreated can lead to complications so antibiotic treatment is recommended. The group A streptococcus is highly sensitive to penicillin. Other antibiotics will be just as effective if you are allergic to penicillin. Serious complications such as pneumonia and meningitis are fortunately very rare. It usually takes 24 hours to start to feel better and to stop being infectious. The bacterium is found in the mucus in the nose and in saliva, so spread of the infection can be limited by careful hand hygiene and by using tissues to catch coughs and sneezes and binning them immediately afterwards. Don’t share forks and spoons.
As with all feverish illnesses, it is important to drink plenty and to keep temperature down by taking regular paracetamol (Calpol for children), and not overwrapping or wearing too many clothes. Use an electric fan if available.