Scarlet Fever In Children

Key points about scarlet fever

• scarlet fever is common in tamariki
• it causes fever and a very red rash over the body
• scarlet fever can happen when a child has a throat or skin infection caused by the bacteria Streptococcus pyogenes (group A strep)
• if you think your child has scarlet fever - see a health professional
• tamariki with scarlet fever need treatment with antibiotics

What is scarlet fever?

Scarlet fever is an illness that mostly affects tamariki. It happens in tamariki who have had a recent throat or skin infection caused by the bacteria Streptococcus pyogenes (group A strep). Scarlet fever causes a very red rash, which is why it's called ‘scarlet’ fever.

Causes of scarlet fever

Scarlet fever is caused by bacteria called Streptococcus pyogenes (group A strep). A toxin released by the Streptococcal bacteria causes the rash of scarlet fever. 

Symptoms of scarlet fever

Rash

The main symptom of scarlet fever is a bumpy red rash. It can feel like sandpaper to touch. The rash usually starts on the chest and tummy and then spreads to the rest of the body. The rash can appear at the time of infection or 1 to 2 weeks later. The rash can sometimes be itchy.

The rash looks blotchy at first and then over time, looks more like sunburn. The area around your child’s mouth is usually clear.

The rash may look more obvious around the:

• underarms
• elbows
• groin area

Once the infection has gone away, your child’s skin may peel on the tips of their fingers and toes.

Other symptoms

Other symptoms of scarlet fever include:

• fever
• sore throat
• sore swollen neck glands
• vomiting
• a bright red, bumpy tongue (often called ‘strawberry tongue’)

Who gets scarlet fever

Young tamariki aged around 4 to 10 are most likely to get scarlet fever. Scarlet fever affects tamariki who have recently had a throat infection or skin infection caused by group A strep.

Group A strep bacteria can spread from person to person through sneezing, coughing or touching the sores of someone with a skin infection.

Diagnosing scarlet fever

If you think your child has scarlet fever, take them to a health professional. The health professional will examine your child and talk to you about their symptoms. They may also do a throat swab to check for group A strep.

Managing scarlet fever

Antibiotics

Scarlet fever is treated with antibiotics. Antibiotics treat group A strep bacteria. It's important to make sure your child takes all the medicine as prescribed. This lowers the chance of complications. Your child should start feeling better a day or two after starting the medicine.

Medicine to relieve itch

A health professional may give your child some creams to put on their skin to ease itching. They may also give your child antihistamines if their rash is very itchy. 

Caring for your child with scarlet fever at home

Paracetamol if needed

You can give paracetamol if your child is in discomfort or miserable with a fever. You must follow the dosage instructions on the bottle or packet. It is dangerous to give more than the recommended dose.

Never give your child aspirin, as this may increase the risk of Reye syndrome, which is a rare and serious illness.

Rest

Encourage your child to rest as much as possible. They will need to take a break from sports and exercise while they have scarlet fever.

Food and fluid

Encourage your child to drink plenty of fluids. Offer them small amounts of water, often. Your child may not feel like eating much when they have scarlet fever. Offer them soft foods like soup and yoghurt if their throat hurts. They may prefer chilled food and fluids.

Keep fingernails short

The scarlet fever rash can sometimes be itchy. Keep your child’s fingernails trimmed to prevent them from damaging the skin. 

Possible complications from scarlet fever

It’s very rare for tamariki to have complications from scarlet fever. But if the infection caused by Streptococcus bacteria is left untreated or treatment doesn’t work, a complication may happen.

Complications from scarlet fever include the following.

Rheumatic Fever

Poststreptococcal Glomerulonephritis (PSGN)

Pneumonia

Ear Infections

Preventing the spread of scarlet fever

To prevent the spread of the Streptococcus bacteria that causes scarlet fever, make sure your child doesn’t share cups, drink bottles or utensils with others. Frequent hand washing helps decrease the chance of spreading the infection.

Keep tamariki home from school or kura until they have had at least 24 hours of antibiotics and they are showing signs that they are feeling better.