Scarlet fever is a contagious infection that more commonly affects children.
Caused by strep A bacteria, which is often found in the nose or mouth, it is typically spread through respiratory droplets containing the bacteria.
This means infected people can spread the infection by talking, coughing or sneezing.
It is also possible to catch scarlet fever by drinking from the same glass or eating from the same plate as an infected person, or touching the droplets and then touching their nose or mouth.
Although most people will start to feel better after a week, symptoms can linger for longer.
If you have scarlet fever it is likely you will need to be treated with antibiotics.
Therefore, spotting the symptoms as soon as possible is vital.
According to the Centres for Disease Control and Prevention (CDC) there are six warning signs of infection that appear in the mouth.
- Whitish coating on the tongue, early in the illness
- “Strawberry” (red and bumpy) tongue
- Very red throat
- Red and swollen tonsils
- White patches or streaks of pus on the tonsils
- Tiny, red spots on the roof of the mouth, called petechiae.
Typically the tongue will appear white first before becoming red and bumpy later in the illness.
Patients may also have swollen lymph nodes at the front of the neck.
This, along with other symptoms in the mouth, can make it difficult or painful to swallow.
There are some more general symptoms of scarlet fever that are common among many types of infection.
- Fever or chills
- Sore throat and pain when swallowing
- Headache or body aches
- Stomach pain
- Nausea or vomiting.
A rash is also a common sign of scarlet fever that “usually” appears one or two days after infection.
This can be distinguished by the following traits:
- Red rash that feels rough like sandpaper
- Brighter red skin in the creases of the underarm, elbow, and groin
- A pale area around the mouth
- Skin peeling as the rash fades.
The CDC explains: “The rash may first appear on the neck, underarm, and groin (the area where your stomach meets your thighs).
“Over time, the rash spreads over the body. The rash usually begins as small, flat blotches that slowly become fine bumps that feel like sandpaper.
“Although the cheeks might look flushed (rosy), there may be a pale area around the mouth. Underarm, elbow, and groin skin creases may become brighter red than the rest of the rash.
“The rash from scarlet fever fades in about seven days. As the rash fades, the skin may peel around the fingertips, toes, and groin area. This peeling can last up to several weeks.”
If you or your child experiences symptoms of scarlet fever you should speak to your GP as they may need to prescribe antibiotics.
The NHS advises seeing a GP if you or your child:
- Have scarlet fever symptoms
- Do not get better in a week (after seeing a GP)
- Have scarlet fever and chickenpox at the same time
- Are ill again, weeks after scarlet fever got better – this can be a sign of a complication, such as rheumatic fever
- Are feeling unwell and have been in contact with someone who has scarlet fever.