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Medical Author:

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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In this Article

• Scarlet fever facts
• What is scarlet fever?
• What is the history of scarlet fever?
• What causes scarlet fever?
• What are scarlet fever symptoms and signs?
• How long is scarlet fever contagious?
• How is scarlet fever diagnosed?
• What is the treatment for scarlet fever?
• Can scarlet fever be prevented?
• What is the prognosis for scarlet fever?
• Find a local Doctor in your town
• Scarlet Fever Index

In the 19th century, scarlet fever, measles, roseola, impetigo, fifth disease, yellow fever, chickenpox, and rubella were among the many diseases that caused rash and fever in children. Scarlet fever was among the most common of these diseases, and the phrase scarlatina was used to describe the mildest form of the disease. Unfortunately, scarlet fever was often severe, and in the 19th century, it was a leading cause of death among children in the United States. Malnutrition, in either childhood or prenatally during pregnancy, was a risk factor for more severe disease. In the 1870s, streptococcal bacteria were first identified by Theodor Billroth and Louis Pasteur. However, it was not until the early 20th century that GAS was effectively identified in routine culture. In the 1920s, studies showed that GAS was the cause of scarlet fever and identified the fact that a toxin was associated with scarlet fever strains of the bacteria. With the advent of the antibiotic era, mortality rates from scarlet fever declined.

Outbreaks of scarlet fever continue to emerge periodically, although the disease is less common now than it was in the 19th century. This is due to many factors, including the widespread use of antibiotics and a decline in the strains of GAS that produce the toxin. People have also become more resistant to infection as nutrition has improved. Also, people who have been exposed to the toxin in the past may produce antibodies that protect them against scarlet fever.