Facts you should know about scarlet fever

- Scarlet fever is a bacterial infection caused by group A Streptococcus bacteria that results in a rash and fever.
- Group beta-hemolytic streptococci produce an erythrogenic toxin that causes scarlet fever.
- The incubation period for scarlet fever is about 12 hours to seven days.
- Risk factors for scarlet fever include overcrowding, especially with children aged 5 to 15 years old, and the communal use of utensils, towels, or other substances.
- The contagious period for scarlet fever ranges from about 12 hours after exposure to the bacteria, even if the individual shows no symptoms, and during the acute phase when the person has a rash and fever; it ends after the fever has gone away for at least 12 hours.
- The signs and symptoms of scarlet fever include a fever of 101 F or higher, a sandpaper-like rash, strawberry-like tongue texture, and other features that are relatively nonspecific such as nausea and vomiting, headache, swollen glands, and body aches.
- The diagnosis of scarlet fever is usually preliminarily made by the patient's history and physical exam, especially if the person has the typical rash and fever; however, isolation of streptococci from the patient usually provides the definitive diagnosis.
- The treatment for scarlet fever is antibiotics that are effective against the infecting streptococci.
- Complications of scarlet fever can include rheumatic fever and kidney problems; other serious problems can occur rarely, including death.
- The prognosis of scarlet fever, if treated early and effectively, is very good; such treatment usually prevents complications. However, if complications develop, the prognosis decreases depending upon the involvement of other organ systems.
- It's possible to reduce or prevent the chance of getting scarlet fever by good hand-washing techniques and by not using others utensils, towels, or other personal grooming products. There is no vaccine for humans against scarlet fever.
What is the modern name for scarlet fever? Does scarlet fever still exist today?
Scarlet fever is also known as scarlatina in the older articles; group A Streptococcus (for example, Streptococcus pyogenes) is often shortened to read as "group A strep" or group A beta-hemolytic streptococci (GABHS).
Scarlet fever is a bacterial infection caused by group A Streptococcus bacteria. This illness usually occurs in a few people (about 10%) who have strep throat (streptococcal pharyngitis) and occasionally streptococcal skin infections or even wound infections. Scarlet fever is mainly known for its sunburned skin-colored sandpaper-like skin rash that is associated with fever.
Outbreaks do still occur. England reported a 50-year high number of individuals diagnosed with the disease (over 19,206) in 2016.
How do you catch scarlatina?
Group A beta-hemolytic streptococci (GABHS) bacteria are the cause of scarlet fever. These gram-positive coccus-shaped (elliptically shaped) organisms, while infecting a body site, can produce an erythrogenic (producing red-colored) toxin. This toxin is responsible for causing the sandpaper-like red-colored skin rash.
Researchers have shown that about 80% of children who reach age 10 have developed lifelong protective antibodies against Streptococcus exotoxin. These bacteria can cause other symptoms and/or diseases such as impetigo, skin desquamation, myositis, acute rheumatic fever, and necrotizing fasciitis.

SLIDESHOW
Infectious Disease: Are These Historical Illnesses Coming Back? See SlideshowWhat is the incubation period for scarlet fever?
The incubation period for scarlet fever has a fairly wide range from about 12 hours to seven days. Individuals are contagious during this first subclinical or incubation period and the acute illness. The primary strep infection is the contagious aspect. The rash itself is not contagious.
What are risk factors for scarlet fever?
Risk factors for scarlet fever are overcrowded conditions (schools, dormitories, institutional settings). Children 5-15 years of age are the population that is usually seen with scarlet fever, although it can occur in some older children and adults. Scarlet fever is rare in children younger than 2 years old because of maternal antibodies.
What is the contagious period for scarlet fever?
As stated previously, the contagious period for scarlet fever occurs during both the initial subclinical (before the development of symptoms) phase, about 12 hours to seven days after initial contact with the bacteria, and during the acute phase when the person has the rash and fever.
What are scarlet fever symptoms and signs?
Scarlet fever symptoms and signs may include a reddish sore throat, a fever (101 F or above), and a widespread red rash (exanthem) with a sandpaper-like texture, and a tongue that resembles a strawberry (red with small bumps also termed strawberry tongue).
Some patients will have a whitish coating on the tongue or the throat and may have swollen lymph nodes glands, headache, abdominal pain or discomfort resulting in nausea and vomiting, and/or body aches.
The classic description of the rash of scarlet fever has been described as "goose bumps (papule) on sunburned skin" or "boiled-lobster" skin.
Health News
- Attachment Theory: What It Is, Stages & the Different Attachment Styles
- Gentle Parenting: What It Is, Techniques & Discipline
- U.S. Nursing Homes Fail to Report Many Serious Falls, Bedsores: Study
- The Younger You Get Diabetes, the Higher Your Risk for Dementia Later
- FDA Grants Full Approval to Paxlovid to Treat COVID-19
More Health News »
How do physicians diagnose scarlet fever?
In most cases, the patient's history and physical exam will result in a presumptive diagnosis of scarlet fever. For example, the physical exam may reveal Pastia's signs or Thompson's signs where pink or red lines form in skin creases of the armpits and groin. The lines may form before the rash develops and may remain as pigmented lines after desquamation (skin peeling off). However, a healthcare professional may obtain a throat culture or swab (or rarely, swabs from a wound or other sites of infection) to determine if GABHS are present.
Unfortunately, there are many other infections, like measles, that can cause both a skin rash and a fever. Isolation of GABHS usually is enough to confirm the diagnosis of scarlet fever. An infectious disease specialist may be consulted if complications develop. If GABHS is not identified, the symptoms and signs are likely due to another underlying problem.
What is the treatment for scarlet fever?
The treatment for scarlet fever is antibiotics that are effective against GABHS. Usually, about 10 days of oral penicillin medication (for example, amoxicillin) is effective early treatment. Rarely, some patients may need to be treated with a single injection of penicillin G benzathine (Bicillin L-A). This is most commonly indicated for a patient who is unable to retain oral antibiotics. Other effective antibiotics are members of the cephalosporin family (for example, cephalexin [Keflex]).
A recent outbreak in China showed GABHS resistance to the common antibiotics used to treat scarlet fever. Antibiotics may prevent complications of scarlet fever such as rheumatic fever.
What are the long-term effects of scarlet fever?
Complications from scarlet fever may include kidney disease (termed post-streptococcal glomerulonephritis) and rheumatic fever (an inflammatory disease caused by antibody cross-reactivity that affects the heart, joints, skin, and brain).
- Rheumatic complications can begin about two to three weeks after the initial infection; children between the ages of 6 and 15 are most susceptible to rheumatic fever development.
- Glomerular complications may begin about one to two weeks after throat infection or about three to six weeks after skin infection and usually cause more problems in adults than children.
Is scarlet fever fatal?
The prognosis for scarlet fever, when treated appropriately with antibiotics, is usually excellent. Patients recover completely and the skin symptoms progressively decrease over several weeks. Untreated scarlet fever has a worse prognosis and before the use of antibiotics, scarlet fever had a mortality (death) rate of about 15%-20%.
Currently, the mortality rate is less than 1% because of early recognition and early treatment with antibiotics. In general, appropriately diagnosed and treated scarlet fever results in few if any long-term effects. However, if complications develop for whatever reason, problems that include kidney damage, hepatitis, vasculitis, septicemia, congestive heart failure, and even death may occur.
Is it possible to prevent scarlet fever? Is there a scarlet fever vaccine?
The best way to prevent or lessen the chance of getting a scarlet fever is hand washing. In addition, avoiding communal use of utensils, towels, or other personal items should be avoided. Transmission of the disease is from person to person, usually by droplets, so direct contact with infected individuals should be avoided. Patients who are treated with antibiotics and have had no fever for about 24 hours are considered to be noncontagious. No vaccine is available for humans to prevent scarlet fever.
Subscribe to MedicineNet's General Health Newsletter
By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.
Health Solutions From Our Sponsors
Top Scarlet Fever (Scarlatina) Related Articles
Abdominal Pain
Abdominal pain can have many causes that range from mild to severe. Some of these causes include bloating, gas, colitis, endometriosis, food poisoning, GERD, IBS (irritable bowel syndrome), ovarian cysts, abdominal adhesions, diverticulitis, Crohn's disease, ulcerative colitis, gallbladder disease, liver disease, and cancers. Signs and symptoms of the more serious causes include dehydration, bloody or black tarry stools, severe abdominal pain, pain with no urination or painful urination. Treatment for abdominal pain depends upon the cause.Tonsillitis (Adenoiditis)
Tonsillitis is a contagious infection with symptoms of bad breath, snoring, congestion, headache, hoarseness, laryngitis, and coughing up blood. Tonsillitis can be caused by acute infection of the tonsils, and several types of bacteria or viruses (for example, strep throat or mononucleosis). There are two types of tonsillitis, acute and chronic. Acute tonsillitis lasts from 1-2 weeks while chronic tonsillitis can last from months to years. Treatment of tonsillitis and adenoids include antibiotics, over-the-counter medications, and home remedies to relieve pain and inflammation, for example, saltwater gargle, slippery elm throat lozenges, sipping warm beverages and eating frozen foods (ice cream, popsicles), serrapeptase, papain, and andrographism Some people with chronic tonsillitis may need surgery (tonsillectomy or adenoidectomy).Congestive Heart Failure (CHF): Symptoms, Causes, Stages, Treatment
Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.Is Strep Throat Contagious?
Strep throat is caused by group A streptococcus bacteria. Incubation period for strep throat is 1-5 days after exposure. If strep throat is treated with antibiotics, it is no longer contagious after 24 hours; if it is not treated with antibiotics, it is contagious for 2-3 weeks. Symptoms include fever, sore throat, tonsillitis, white spots or patches on the tonsils, and nausea and vomiting. Diagnosis of strep throat is performed through a rapid strep test.Rapid Strep Test
A rapid strep test is an easy and accurate test performed to diagnose strep bacteria, causing strep throat. A rapid strep test is performed in the health care practitioner's office. A rapid strep test can assist in ruling out other causes of sore throat, for example, flu, common cold, or mononucleosis. Treatment of strep throat is generally antibiotics.
Skin Rash
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.Scarlet Fever Picture
A skin condition that is due to a streptococcal sore throat or any other streptococcal infection. The group A streptococcal bacteria produce a toxin that causes a scarlet rash that initially appears on the neck and chest, then spreads over the body, and lasts around 3 days. As the rash fades, desquamation (peeling) may occur around the fingertips, toes, and groin area. Scarlet fever is usually not a serious illness when treated promptly with antibiotics such as penicillin. However, untreated streptococcal infection can cause kidney inflammation (glomerulonephritis) and rheumatic fever. Also known as scarlatina. Shown is desquamation of skin from hands: a symptom of scarlet fever. Desquamation also called skin peeling, is the shedding of the outermost membrane or layer of a tissue, such as the skin.Sore Throat
Sore throat (throat pain) usually is described as pain or discomfort in the throat area. A sore throat may be caused by bacterial infections, viral infections, toxins, irritants, trauma, or injury to the throat area. Common symptoms of a sore throat include a fever, cough, runny nose, hoarseness, earaches, sneezing, and body aches. Home remedies for a sore throat include warm soothing liquids and throat lozenges. OTC remedies for a sore throat include OTC pain relievers such as ibuprofen or acetaminophen. Antibiotics may be necessary for some cases of sore throat.
Swollen Lymph Nodes (Lymphadenopathy)
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly, but may include fever, night sweats, toothache, sore throat, or weight loss. Causes of swollen lymph nodes also vary, but may include cancer, the common cold, mono, chickenox, HIV, and herpes. The treatment of swollen lymph nodes depends upon the cause.Tongue Problems
There are a variety of diseases and conditions that can cause tongue problems, discoloration, and soreness. Though most tongue problems are not serious. Conditions such as leukoplakia, oral thrush, and oral lichen planus may cause a white tongue while Kawasaki syndrome, scarlet fever, and geographic tongue may cause the tongue to appear red. A black hairy tongue may be caused by overgrown papillae on the tongue. Canker sores, smoking, and trauma may cause soreness of the tongue.What Are the 5 Types of Fever?
Fever is a sign that your body is fighting an infection or illness. Learn the five types of fever, signs, what causes fever, how doctors diagnose fever, and what you can do to treat fever.