Scarlet Fever

Symptoms and Causes

What causes scarlet fever?

A bacteria called group A beta-hemolytic Streptococcus or group A strep causes scarlet fever. The bacteria produce a toxin that leads to the red rash the infection is named for. Group A strep causes strep throat and impetigo and can result in rheumatic fever.

How do you get scarlet fever?

The bacteria group A strep lives in your ears, nose, throat and on your skin. People who are infected can easily spread it by coughing or sneezing. Coughing or sneezing creates tiny droplets that contain the bacteria. These droplets are sent out into the air. You can get sick if you:

• Breathe in the tiny droplets.
• Touch a surface containing the droplets and then touch your nose or mouth.
• Eat from the same plate or drink from the same glass as someone who is sick.
• Touch sores on the skin caused by group A Streptococcus.

Very rarely, people can get group A strep by eating food that hasn’t been handled properly. Scientists don’t believe Group A strep can be spread by touching pets or household items like toys.

What are the symptoms of scarlet fever?

The first symptoms to appear are usually fever and sore throat. The most obvious sign of scarlet fever is a red, bumpy rash. However, fewer than 10% of strep cases have an accompanying rash.

Rash symptoms:

• A red rash may first appear around your neck and chest.
• The rash may spread to your back, arms, legs and face.
• There may be a pale area around your mouth.
• Skin creases and petechiae (small red or purple bumps) in your underarms, elbows and groin may become brighter red than the rest of the rash (pastia lines).
• Peeling may be prevalent seven to 10 days after the rash fades, especially on your fingers.

Mouth and throat symptoms:

• Your tongue may develop a white-colored coating.
• Your tongue may appear swollen, red and bumpy and look like a strawberry.
• Your tonsils and throat may be swollen, red and sore.
• Your tonsils and throat may have a white or yellow coating or dots of white or yellow pus.
• You may have difficulty swallowing.

Other symptoms you may experience include:

• Chills.
• Fever.
• Stomach pain.
• Nausea and vomiting.
• Headache.
• Body and muscle aches.
• Swollen glands.
• Decreased appetite.
• Small red or purple bumps on the roof of your mouth.

What does scarlet fever rash look like?

Scarlet fever rash typically starts as small, flat splotches on your skin. The splotches will slowly turn into fine bumps. The rash may look like a bad sunburn. Others describe the rash as looking and feeling rough like sandpaper.

Is scarlet fever contagious?

Scarlet fever is contagious. It spreads through droplets in the air that people pass on when coughing or sneezing.

Who is at risk for scarlet fever?

Anyone can get scarlet fever. It's more common in children ages 5 to 15 than in adults. Parents of children in this age range and other adults who frequently come into contact with children in this age range are more at risk. Scarlet fever is rare in babies and toddlers.

Your risk increases if you’re in close contact with a person who has scarlet fever. Scarlet fever spreads quicker in large group settings. Outbreaks in schools, daycares, communities and neighborhoods can increase your risk.

What are the complications of scarlet fever?

Complications from scarlet fever are rare. They can occur if the Group A strep spreads to other parts of your body. Complications can include:

• Abscesses (pockets of pus) around your tonsils or brain.
• Swollen lymph nodes in your neck.
• Ear infections.
• Mastoiditis.
• Sinus infections.
• Pneumonia.
• Rheumatic fever.
• Kidney damage.
• Septicemia.
• Arthritis or osteomyelitis.
• Skin infections.
• Bacteremia or meningitis.
• Immune issues, such as PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus).