For starters, it’s not the reason Mary Ingalls from Little House on The Prairie went blind, according to research published in March 2013 in the journal Pediatrics. Scarlet fever, also referred to as scarlatina, is a relatively mild illness that can be brought on by a streptococcal (strep) A infection. Most cases of strep begin in the throat and sometimes can develop into scarlet fever. Certain strains of strep can produce a toxin that causes the rash associated with scarlet fever, explains Camille Sabella, MD, director of the Center for Pediatric Infectious Diseases at the Cleveland Clinic in Ohio. In other words, if someone is sick with strep throat, there is a chance they can also get scarlet fever and should know the signs. Scarlet fever is characterized by:
a very red, sore throata bright red rash on the body that has a sandpaper feela “strawberry,” or red and bumpy, tongue
Other symptoms can include fever, swollen glands in the neck, a whitish coating on the tongue, and bright red skin in the underarm, elbow, or groin.
Scarlet Fever Spreads in Droplets Through the Air
Scarlet fever, like strep throat, is highly contagious and is more common in children than adults, particularly those between the ages of 5 and 15. It’s spread from person to person when someone who is infected coughs or sneezes, through small droplets in the air. You can get sick by breathing in those droplets or by touching something that the droplets have landed on and then touching your nose or mouth. Drinking from the same glass or eating off the same plate as someone who has scarlet fever can also spread the illness. It’s also possible to get scarlet fever sores on the skin caused by a strep infection. Close contact with someone who has the infection is the biggest risk factor for getting the illness. “Certainly among family members and in schools it’s usually very contagious because of close contact among children,” Dr. Sabella says. “There are lots of outbreaks usually in the winter and springtime.”
How Common Is Scarlet Fever in the United States?
A study published November 2017 in the journal The Lancet Infectious Diseases found dramatic increases in scarlet fever in certain parts of the world. The research found that England in particular has seen a sharp rise in cases since 2014, with a 50-year high of 620 outbreaks totalling more than 19,000 cases in 2016. Countries in East Asia, including China, Vietnam, and South Korea, have also reported recent surges. In the United States, the Centers for Disease Control and Prevention (CDC) does not track the number of scarlet fever cases, so the exact number and whether cases are increasing or decreasing is not known. But Sabella says scarlet fever is more common than most people probably think. “Think of all the strep throat infections kids get each year. Pediatricians see lots of cases of scarlet fever, too,” he says.
Doctors Can Easily Diagnose and Treat Scarlet Fever
Scarlet fever typically begins with a fever and sore throat followed by a rash, which usually appears a day or two later. But the rash can also begin before the other symptoms begin to manifest, or even up to seven days after the onset of symptoms. Doctors diagnose scarlet fever based on the appearance of symptoms, most notably the sandpaper-like rash and strawberry tongue in addition to sore throat. “It’s pretty easy to recognize clinically,” Sabella says. “It’s usually not a mystery.” Scarlet fever is easily treated with antibiotics. But it’s important to complete the entire course of the medication prescribed by your healthcare provider to reduce the spread of infection as well as your risk for developing complications. Over-the-counter medicines, including Advil (ibuprofen) and Tylenol (acetaminophen), can be used to help reduce fever and relieve pain associated with the illness. RELATED: How To Keep Antibiotics From Causing Diarrhea
Complications Are Rare but Can Occur
Complications from scarlet fever are very rare but sometimes happen. They include:
Abscesses around the tonsilsSwollen lymph nodes in the neckPneumoniaSkin infectionArthritisSinus and ear infections
Other, more serious complications are even rarer and can include include rheumatic fever, which causes inflammation, especially of the heart, blood vessels, and joints. “Some people confuse scarlet fever with rheumatic fever but they are totally different entities,” Sabella says. Scarlet fever may also lead to long-term problems with the kidneys, including kidney disease. Still, “the overwhelming majority of scarlet fever cases are fully treated and have no complications,” Sabella says. RELATED: Pneumonia Treatment and Prevention
How to Prevent Scarlet Fever
There is no vaccine for scarlet fever, but people can protect themselves by practicing good hygiene. This includes using a tissue to cover your mouth when sneezing or coughing, frequent hand washing, using alcohol-based hand sanitizer if soap and water are unavailable, and coughing or sneezing into your upper sleeve or elbow rather than your hands if a tissue isn’t available. Additionally, Sabella says that “probably the best way to avoid scarlet fever is if you treat strep throat quickly and adequately. A lot of times you can prevent scarlet fever this way.” If your child develops any of the symptoms of scarlet fever — especially if they have been around someone else who is sick — get them to a pediatrician right away for treatment.
