Scarlet Fever: Signs, Symptoms And Treatment


Scarlet fever is a disease known to be widespread during the Victorian era, and there has been a significant decrease in recorded cases over the years. However, this illness seems to be making a comeback as recent years show a rapid increase in recorded cases.

Scarlet fever outbreaks have been tracked in Asia and Europe. There have been more than 100,000 cases in China over the past five years, and in the UK, there have been at least 12,000 cases since 2014.

The numbers of cases are staggering. In the data published by Public Health England (PHE), there were 2,830 cases from September 2013 to March 2014 and 5,746 cases from September 2014 to March 2015. In 2015 alone, there were 17,586 cases recorded in England and Wales.

The cause of this sudden increase in the number of cases is still unclear. Some experts believe that it could be due to a new strain.

PHE expects that there would be a significant increase in the number of cases in the coming weeks as the illness is likely to occur in late March to mid-April.

Medical practitioners are pushing toward educating primary caregivers and health professionals alike about how to detect early signs and symptoms so proper treatment can be initiated.

What We Know About Scarlet Fever

Scarlet fever affects children, about 80 percent of whom are less than 10 years old, but anyone can get the illness when highly exposed to an infected individual.

Scarlet fever is highly contagious and is spread through airborne droplets when an infected person sneezes and coughs. It can also be spread when one is in contact with an infected skin infection or sharing baths, towels, clothes or bed sheets with an infected person.

It is also important to note that it may also be transmitted via carriers, or asymptomatic patients who have the bacteria on their skin or on their throat. Schools and nurseries are often affected by outbreaks because the children are often in close contact with one another.

Signs And Symptoms Of Scarlet Fever

Patients with scarlet fever would initially complain of sore throat or a skin rash, particularly impetigo, caused by streptococcus bacteria. Patients would also complain of headache, swollen tongue (strawberry tongue), and high fever (38.3C/101F or higher).

About two days into the illness, a characteristic pinkish rash on the chest and stomach becomes visible. It later spreads to the other areas, such as the neck and ears. Symptoms are commonly seen within two to five days after the onset of the infection. The incubation period (time of exposure to appearance of symptoms) is one to seven days. The skin rash is itchy and feels like sandpaper to the touch.

The cheeks may also become noticeably flushed, with areas around the mouth appearing pale. Pastia's lines, or rashes that are brighter red compared to other rashes, are common in elbows, underarms and skin creases.

As the rashes start to heal, peeling may occur and may last for a few weeks.

Diagnosis, Treatment And Prognosis

Group A streptococcus (GAS) infections can be easily diagnosed by a thorough history and physical exam. Laboratory tests, such as microbiological culture of the skin infection, may also be helpful. Some doctors may also request for serology. Public Health England recommends storing isolates from health care-associated infections for a minimum of six months.

Scarlet fever lasts for a week and patients should be seen by a medical doctor for proper diagnosis and treatment. Doctors may prescribe caregivers to give liquid antibiotics, like amoxicillin. Recovery may be noted after four to five days of antibiotics but the recommended course of antibiotic treatment must be completed.

Those with scarlet fever are still highly contagious 24 hours after the first antibiotic administration and they are advised against interacting with playmates, schoolmates or other young children at this time. Infected children will still be contagious for one to two weeks after the initial appearance of symptoms if they are not given the proper antibiotic treatment.

Complications Of Scarlet Fever

Once infected children are on antibiotics, complications are highly unlikely but one should note that there is still the risk of the spread of infection other body parts that may lead to infections. Some patients develop sinusitis, ear infection, or pneumonia.

Other notable health problems associated with scarlet fever include post-streptococcal glomerulonephritis, arthritis, throat abscess and rheumatic fever.

At present, no vaccine is available for scarlet fever. To avoid spreading the disease, infected school children should not attend school 24 hours after antibiotic treatment. Infected adults are also advised to call in sick a day after the initial antibiotic treatment.

Proper hygiene should also be emphasized to school children. Covering the mouth and nose while coughing or sneezing and washing their hands thoroughly with soap and water can significantly curb the spread of the bacteria.

Infected individuals are also advised to refrain from sharing utensils, cups, towels, bed sheets and clothes.

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