SCARLET FEVER

General Information

DEFINITION--A childhood disorder characterized by a bright red rash. Scarlet fever is preceded by a streptococcal throat infection. Both are very contagious for 2 to 3 weeks. Scarlet fever is far less common and less dangerous than it once was.

BODY PARTS INVOLVED--Throat; tonsils; skin.

SEX OR AGE MOST AFFECTED--Children and adolescents, especially between ages 2 and 10.

SIGNS & SYMPTOMS--

Symptoms may vary from person to person. Following is the usual course of the disease:

• Day 1--Fever as high as 104F (40C); a red sore throat; swollen tonsils (tonsils may have a whitish coating); enlarged lymph glands in the neck; cough; vomiting.
• Day 2--Bright red rash on the face, except around the mouth.
• Day 3--Reddened tongue and rash in body creases, spreading to the neck, chest, back, then the entire body. The rash resembles a sunburn with bumps.
• Day 6--Faded rash and skin that begins peeling, continuing for 10 to 14 days.

CAUSES

• Streptococcal infection caused by a specific type of germ that manufactures a scarlet-fever toxin (poison). The bacteria are spread in droplets coughed or breathed into the air.
• Very few strep infections progress to scarlet fever, because everyone is not susceptible to the rash-producing toxin. In one family, one child may contract scarlet fever, another may have a strep throat only, and a third may carry the germ and transmit it to others without being sick.

RISK INCREASES WITH

• Family history of recurrent strep infections.
• Recent impetigo.
• Crowded or unsanitary living conditions.
• Exposure to others in public places.
• Age (2-10).

HOW TO PREVENT--

Cannot be prevented completely, because some healthy persons are carriers of the strep germ without being ill. However, partial preventive measures include:

• Antibiotic treatment for at least 10 days for any strep infection.
• Avoidance of persons with sore throats.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory throat culture.

APPROPRIATE HEALTH CARE

• Home care after diagnosis.
• Doctor's treatment.

POSSIBLE COMPLICATIONS--

Without treatment:

• Rheumatic fever.
• Impaired hearing.
• Glomerulonephritis.
• Meningitis.
• Pneumonia.
• Encephalitis.

PROBABLE OUTCOME--Usually curable in 10 days or more with treatment. Scarlet fever is not as prevalent as it once was, and it is rarely fatal. With antibiotic treatment, the severity and likelihood of complications decrease.

How To Treat

GENERAL MEASURES--

• Care may be given at home.
• Use a cool-mist, ultrasonic humidifier to relieve the dry, tight feeling in the throat. Clean humidifier daily.
• Use moist, warm soaks to relieve tender, enlarged glands in the neck.
• Isolate the ill person from other people, including family members.

MEDICATION--

• Your doctor may prescribe penicillin to shorten the course of scarlet fever and prevent complications. If the patient is allergic to penicillin, other antibiotics, such as erythromycin, are also effective. Finish the entire course of the medicine, even if the symptoms disappear.
• Use acetaminophen for pain relief and fever.

ACTIVITY--Bed rest is necessary until all signs of illness have disappeared.

DIET--No special diet. Drink plenty of fluids.

Call Your Doctor If

• You or your child have symptoms of strep throat or scarlet fever.
• The following occurs during treatment: Temperature becomes normal for 2 days, then fever develops again. New symptoms begin, such as: nausea; vomiting; earache; cough; headache; thick, colored, nasal drainage; chest pain; or labored breathing.