What is
scarlet fever?
Scarlet fever is a strep throat infection
with a rash. Your child will have a sore throat and fever
before the rash (usually 18 to 24 hours before). Once your
child gets the rash, it will cover all areas within 24
hours.
Your child will have:
- Reddened, sunburned-looking skin
(especially on the chest and abdomen) that feels rough,
somewhat like sandpaper. On close inspection, the
redness is speckled (tiny pink dots).
- Increased redness in skin folds
(especially the groin, armpits, and elbow creases).
- Flushed face with paleness around the
mouth.
What is the cause?
Scarlet fever is caused by the strep
bacteria. The rash is caused by a toxin that is produced by
some strep bacteria. The complication rate is no different
than the complication rate for strep throat alone.
How long does
it last?
The red rash usually clears in 4 or 5 days.
Sometimes the skin peels in 1 to 2 weeks where the rash was
most prominent (for example, the groin). The skin on the
fingertips also commonly peels. Your child will stop having
a sore throat and fever after taking an antibiotic for 1 or
2 days.
How can I
take care of my child?
- Antibiotics
Try not to forget any of the doses. Give
the medicine until all the pills are gone or the bottle
is empty. Even though your child will feel better in a
few days, give the antibiotic for 10 days to keep the
strep throat from flaring up again.
If the medicine is a liquid, store it in
the refrigerator. Use a measuring spoon to be sure that
you give the right amount.
A long-acting penicillin (Bicillin)
injection can be given if your child will not take oral
medicines or if it will be impossible for you to give
the medicine regularly. (Note: If given correctly, the
oral antibiotic works just as rapidly and effectively as
a shot.)
- Relief of sore
throat or fever
Acetaminophen or ibuprofen is very
helpful for throat pain. Children over 1 year old can
sip warm chicken broth or apple juice. Children over 4
years old can suck on hard candy or lollipops. Also give
acetaminophen (Tylenol) or ibuprofen (Advil) for fevers
over 102°F (39°F).
- The rash
The rash itself needs no treatment. It
generally clears in 4 to 5 days.
- Contagiousness
Your child is no longer contagious after
he or she has been on an antibiotic for 24 hours.
Therefore, your child can return to school after 1 day
if he or she is feeling better. The rash itself is not
contagious.
- Throat
cultures for the family
Scarlet fever and strep throat can
spread to others in the family. Any child or adult who
lives in your home and has a fever, sore throat, runny
nose, headache, vomiting, or sores; or who doesn't want
to eat; or who develops these symptoms in the next 5
days should have a throat culture. Usually, your health
care provider needs to culture only those who are sick.
(EXCEPTION: In families where relatives have had
rheumatic fever or frequent strep infections, everyone
should come in for a throat culture.) Your health care
provider will call you if any of the cultures are
positive for strep.
- Recurrent
strep throat and repeat cultures
Usually repeat throat cultures are not
necessary if your child takes all of the antibiotic.
However, about 10% of children with strep throat don't
respond to initial antibiotic treatment. Therefore, if
your child continues to have a sore throat or mild fever
after treatment is completed, return for a second throat
culture. If it is positive, your child will be retreated
with a different antibiotic.
When should I call my child's health care provider?
Call IMMEDIATELY if:
- Your child starts acting very sick.
Call during office hours if:
- The fever lasts over 48 hours after
your child starts taking the antibiotic.
- You have other concerns or questions.
