Scarlet fever: symptoms and treatment

Overview: what is scarlet fever?

Scarlet fever – also known as scarlatina – is an infectious disease caused by bacteria (streptococci). Typical indications of scarlet fever are a severe sore throat and a reddish rash of slightly raised bumps.

Is scarlet fever contagious?

The disease is highly contagious. If untreated, the patient can be contagious for up to two weeks. Taking antibiotics will reduce the risk of the patient infecting others.

Scarlet fever symptoms

The children’s disease scarlet fever presents with high fever, severe sore throat and headache as well as coughing. The patient’s throat is reddened and swallowing is painful. The lymph nodes in the neck are severely swollen.

Main symptoms

Scarlet fever is accompanied by a bumpy rash with pale red patches. This appears on the torso and neck, but can spread to the legs and arms as the disease progresses. There’s often no rash around the mouth and chin. After a few days, the skin may peel on the reddened areas, especially on the palms of the hands and the soles of the feet.

Further symptoms of scarlet fever

The severe coughing can cause other symptoms such as stomach pain and vomiting . The peeling skin can itch and the inflammation in the mouth can lead to bad breath. Also common is a bright red tongue with conspicuous, small bumps (strawberry or raspberry tongue).

Symptoms in adults

Adults can also contract scarlet fever. The symptoms are similar: a sore throat and headache, or abdominal and joint pain. However, adults are less likely to have fever, the classic symptom of the disease. Initial diagnoses often suggest a flu-like infection before scarlet fever is recognised. As a rule, the course of scarlet fever is no worse in adults than in children. 

Possible complications

In individual cases, scarlet fever can lead to complications:

• Abscess of palatine tonsils (formation of pus)
• Sinus infection and middle ear infection
• Very rarely, blood poisoning (sepsis)
• Rheumatic fever
  • Inflammation of the heart muscle and heart valves
    
  • Kidney inflammation

Causes – how does scarlet fever develop?

Scarlet fever is caused by group A streptococcus bacteria. It’s transmitted from person to person, for example when sneezing or coughing through droplet infection. Scarlet fever and angina come from the same pathogen. In scarlet fever, however, certain strains produce toxins (exotoxins), which lead to the added symptom of a skin rash.

Diagnosis – how is scarlet fever diagnosed?

To determine if the patient has scarlet fever, a rapid test or a blood test can be carried out at a medical practice or in hospital. A rapid test shows whether the infection is caused by streptococcus bacteria. The blood test checks the patient’s inflammation levels.

Treatment – how is scarlet fever treated?

Scarlet fever is treated with antibiotics (penicillin). The antibiotic shortens the course of the illness and minimises the risk of infecting other people. Fever-reducing painkillers are also prescribed.

Household remedies: What can I do myself?

Only antibiotics can help prevent transmission. However, the following tips can help alleviate symptoms:

• Gargling, for example with sage tea or camomile tea
• Cold throat compresses (e.g. quark, lemon, onion poultices)
• Honey milk for a sore throat
• Hot lemon for a cough
• Bed rest

When to see a doctor?

Antibiotics are recommended for treating scarlet fever with symptoms. Patients taking antibiotics usually stop being contagious after the first day of treatment. Without antibiotics, the condition remains infectious for around 3 weeks.

It is generally recommended to reduce social contact until the main symptoms subside (stay home from work, keep children home from nursery or school).

Patients without symptoms and in good general health are not considered to be contagious and do not need to take antibiotics. Children may go to nursery or school (consult the school or family doctor if uncertain).

Antibiotics are prescribed by a doctor. Be sure to consult a doctor if any of the following symptoms occur:

• Fever of higher than 40 degrees
• Light-headedness, cramps, stiff neck
• Bleeding into the skin (dark red spots)