Scarlet fever: The warning signs parents need to know

After becoming very rare previously, cases of scarlet fever have been increasing again over recent years with outbreaks at a 50 year high.

Around 600 cases are currently being recorded each week with April thought to be ‘peak season’ for the illness. Doctors are now being told to look out scarlet fever by Public Health England and parents are being informed about the symptoms.

The NHS say, ‘figures published by Public Health England show that from September 2013 to March 2014 there were 2,830 cases of scarlet fever. For the same period in 2014/15 a total of 5,746 cases were recorded. The reason for recent increase is unclear.’

It’s very unlikely that you’ll get scarlet fever twice, because once you’ve had it, you build up immunity to it. Most cases are relatively mild and usually clear up after a week but you should keep an eye on the symptoms in case it becomes more serious.

Here’s all you need to know about the condition so you can spot the symptoms and start to get help.

What is scarlet fever?

It’s an illness caused by a bacteria called streptococcus which is found on the skin and in the throat. This is similar to what causes meningitis but it’s a different strain of the bacteria, and considered not as dangerous. This however doesn’t mean that it isn’t dangerous at all, with some cases becoming very serious if left untreated.

Who can get it?

Anyone, but it’s most common in children aged 3-15 with 80% of the cases occurring in children under 10, with the most common age being 4 years old – so it’s important to be vigilant if you think your child might have caught scarlet fever.

What are the symptoms?

Symptoms usually start to appear between two and five days after infection, although this varies from case to case. Scarlet fever causes a red-pink (scarlet) rash (see above) which feels a bit like sandpaper to the touch.

Other symptoms include:

  • A headache
  • High temperature (38.3C/101F or above)
  • Swollen neck glands
  • Sore throat
  • White coating with red spots on the tongue often called ‘strawberry tongue’.
  • The fever lasts a few days and the rash typically about 6 days which can cause skin peeling when it disappears.

    Are there any potential complications?

    In most cases, when treated properly, there shouldn’t be any further complications. In minimal cases there is a risk of the infection spreading to other parts of the body so you should monitor children carefully if they do contract scarlet fever. Possible further complications include an ear infection, a throat abscess, sinusitis and pneumonia.

    It is advised to seek medical help if you or your child develops any symptoms of the above within a few weeks of after you have had scarlet fever.

    How is it spread?

    It’s spread through mucus and saliva, which is why it’s more common in the winter months as coughing and sneezing is more prevalent. Early spring is also a key time for the illness to spread. Scarlet fever is very contagious so it’s advised to stay indoors once you’ve contracted it, to minimise the risk of passing it on to others.

    How to minimise scarlet fever spreading

    If you suspect your child has scarlet fever then the NHS advise keeping them off school and nursery. Even once antibiotics have started to treat the condition they advise staying off for at least a further 24 hour following the first dose of antibiotics, to minimise risk of spreading.

    Children should be encouraged to over their mouth and nose when sneezing and wash their hands thoroughly with warm water and soap after disposing of their tissue.

    It is also a good idea to avoid sharing things which could be contaminated; like cups, glasses and cutlery, as well as bed linen and towels.

    How is it confirmed?

    Many doctors confirm a scarlet fever diagnosis just from the symptoms, but sometimes a swab is taken from the throat and sent to be tested for streptococcus.

    What’s the treatment?

    Most cases are mild and will and can be easily treated with a course of liquid antibiotics, like penicillin or amoxicillin. Doctors advise children and adults staying at home until at least 24 hours after they’ve started their antibiotics to make sure they don’t spread scarlet fever among their peers. So no work, school or nursery until then.

    Most people will appear recovered within 4-5 days of treatment, but antibiotics must be taken for 10 days.

    If not treated with antibiotics children will be infectious for 1-2 weeks and should be kept at home, away from peers, to minimise spreading scarlet fever amongst friends.

    Can you get scarlet fever more than once?

    It’s very rare to get scarlet fever a second time, so usually once you’ve had it you’re immune. It’s worth keeping an eye out for subsequent infections, however, as these do happen occasionally.