Scarlet fever is a common, usually mild, childhood infection caused by the bacteria known as group A Streptococcus (GAS). These bacteria may be found on the skin, throat (“strep throat”) and other sites where they live without causing any problems. Under some circumstances GAS can cause non-invasive infections such as pharyngitis, impetigo and scarlet fever.
The symptoms of scarlet fever can be flu-like including a high temperature, sore throat, and swollen neck glands. It is then characterised by a red, generalised pinhead rash, typically beginning on the chest and stomach 12-48 hours after first symptoms, which then rapidly spreading to other parts of the body. On more darkly pigmented skin, the scarlet rash may be harder to spot, but it should feel like 'sandpaper'. The face can be flushed red but pale around the mouth.
Cases of scarlet fever should be treated with antibiotics to reduce the risk of complications and onward transmission. If a child has symptoms of scarlet fever, it is important that they see their GP. Children can return to their setting 24 hours after commencing antibiotic treatment (so long as they are well enough to do so). If no antibiotics are administered, they will be infectious to others for 2-3 weeks and so will require an extended isolation period.
Advice on how to manage scarlet fever is available here: https://www.nhs.uk/conditions/scarlet-fever/
In any situation, if parents are concerned about how unwell a child or adult is, they should seek advice from their pharmacy, GP or NHS 111. In an emergency, call 999 or go to A&E.
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