Information about Scarlet Fever

scarlet fever scarlatina information about

Scarlet fever, or scarlatina as some might know it, is a bacterial illness, a group A Streptococcus (group A Strep) infection that can develop in some people who have strep throat. Scarlet fever mainly affects children between the ages of 5 and 15 and it features a bright red rash that covers most of the body, accompanied by a high fever, a sore throat, headaches and swollen lymph nodes.  The rash is red and feels like sandpaper and the tongue may be red and bumpy. The same bacteria that causes strep throat also causes scarlet fever. It used to be a common and serious childhood illness, but it’s rare today. Antibiotic treatments have reduced the severity of the symptoms and the prevalence of the disease. Researchers aren’t sure why cases of scarlet fever have decreased while cases of strep throat remain common.
Scarlet fever affects a small number of people who have either strep throat or streptococcal skin infections. The bacteria are usually spread by people coughing or sneezing. It can also be spread when a person touches an object that has the bacteria on it and then touches their mouth or nose. The characteristic rash is due to the erythrogenic toxin, a substance produced by some types of the bacterium. The diagnosis is typically confirmed by culturing the throat.

The infection spreads from person to person via droplets expelled when an infected person coughs or sneezes. The incubation period — the time between exposure and illness — is usually two to four days.
Although scarlet fever was once considered a serious childhood illness, antibiotic treatments have made it less threatening. Still, if left untreated, scarlet fever can result in more-serious conditions that affect the heart, kidneys and other parts of the body.

scarlet fever scarlatina information about

Description and distribution of the bacteria

Scarlet fever is caused by  A Streptococcus bacteria, or streptococcus pyogenes which comprises the vast majority of the Lancefield group A streptococci, and is often used as a synonym for GAS. S. pyogenes (GAS) is the causative agent in a wide range of group A streptococcal infections. These infections may be noninvasive or invasive. The noninvasive infections tend to be more common and less severe. The most common of these infections include streptococcal pharyngitis (strep throat) and impetigo. Scarlet fever is also a noninvasive infection, but has not been as common in recent years.
The invasive infections caused by group A β-hemolytic streptococci tend to be more severe and less common. This occurs when the bacterium is able to infect areas where it is not usually found, such as the blood and the organs. The diseases that may be caused include streptococcal toxic shock syndrome, necrotizing fasciitis, pneumonia, and bacteremia. Globally, GAS has been estimated to cause more than 500,000 deaths every year, making it one of the world’s leading pathogens.

Additional complications may be caused by GAS, namely acute rheumatic fever and acute glomerulonephritis. Rheumatic fever, a disease that affects the joints, kidneys, and heart valves, is a consequence of untreated strep A infection caused not by the bacterium itself. Rheumatic fever is caused by the antibodies created by the immune system to fight off the infection cross-reacting with other proteins in the body. This “cross-reaction” causes the body to essentially attack itself and leads to the damage above. A similar autoimmune mechanism initiated by Group A beta-hemolytic streptococcal (GABHS) infection is hypothesized to cause pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), wherein autoimmune antibodies affect the basal ganglia, causing rapid onset of psychiatric, motor, sleep, and other symptoms in pediatric patients.

Group A Streptococcus infection is generally diagnosed with a rapid strep test or by culture.

Symptoms of Scarlet Fever

There are a few major symptoms that give Scarlet Fever its name:

A quite disturbing red rash
This looks like a sunburn and feels like sandpaper to touch. At first, if begins of the face and neck and then spreads to the trunk, arms and legs. As any sunburn, if any pressure if applied to the reddened skin, it will turn pale.

Red Lines
The folds of skin around the groin, armpits , elbows , knees and neck  usually become a deeper than the surrounding rash.

Flushed Face
The face may appear flushed, with a pale ring around the mouth

Strawberry tongue
The tongue generally looks red and bumpy, and it’s often covered with a white coating early in the disease.

The rash and the redness in the face and tongue usually last about a week. After these signs and symptoms have subsided, the skin affected by the rash often peels. Other signs and symptoms associated with scarlet fever include:

  • Fever of 101 F (38.3 C) or higher, often with chills
  • Very sore and red throat, sometimes with white or yellowish patches
  • Difficulty swallowing
  • Enlarged glands in the neck (lymph nodes) that are tender to the touch
  • Nausea or vomiting
  • Headache


If scarlet fever goes untreated, the bacteria may spread to the:

  • Tonsils
  • Lungs
  • Skin
  • Kidneys
  • Blood
  • Middle ear

Rarely, scarlet fever can lead to rheumatic fever, a serious condition that can affect the:

  • Heart
  • Joints
  • Nervous system
  • Skin

How to prevent this

There is no vaccine. Prevention is by frequent hand-washing, not sharing personal items, and staying away from other people when sick. The disease is treatable with antibiotics, which prevent most complications. Outcomes with scarlet fever are typically good. Long-term complications as a result of scarlet fever include kidney disease, rheumatic heart disease, and arthritis. It was a leading cause of death in children in the early 20th century.
For more information regarding how this can be prevented, read our next article detailing how to Prevent Infestation with Scarlet Fever.

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