Scarlet Fever (Scarlatina) – Symptoms, Treatment and Prevention

scarler fever symptoms treatment
Scarlet fever (also known as scarlatina)  is a bacterial infection which can affect anyone, but it is particularly common in children aged 5 to 15 years old. Scarlet fever is a condition that should be taken seriously, as it can lead to severe complications if left untreated. In this article, we will provide information about the causes, symptoms, treatment, prevention, and care of scarlet fever in kids.

Scarlet fever causes

Scarlet fever is caused by the same bacteria that cause strep throat. The bacteria produce a toxin that causes a rash and a high fever. The infection is contagious and can be spread through contact with an infected person’s saliva or nasal secretions.

Symptoms of Scarlet fever (Scarlatina)

The symptoms usually appear within 1 to 3 days of exposure and can include:
  1. Sore throat: A sore throat is usually one of the first symptoms of scarlet fever. It can be mild to severe, and may cause difficulty swallowing or talking.
  2. High fever: A fever is another common symptom of scarlet fever. It can be as high as 101 to 104 degrees Fahrenheit (38.3 to 40 degrees Celsius) and may last for several days.
  3. Rash: A characteristic rash is one of the hallmark symptoms of scarlet fever. The rash usually starts on the chest and stomach and then spreads to other parts of the body, including the arms, legs, and face. The rash is typically red and has a sandpaper-like texture. It may be itchy and can last for up to a week.
  4. Swollen glands: Scarlet fever can cause swelling of the lymph nodes, especially in the neck, which can be painful to the touch.
  5. Headache: A headache is a common symptom of scarlet fever and may be caused by the high fever or the infection itself.
  6. Nausea and vomiting: Some people with scarlet fever may experience nausea and vomiting, especially if the infection is severe.
  7. Tonsils and throat: In some cases, scarlet fever can cause white or yellow patches on the tonsils, a red or swollen throat, and difficulty swallowing.
  8. Raspberry-colored coated tongue: another specific symptom is a coated tongue, which is initially covered with a white coating, then it separates and underneath it looks very red and swollen, the so-called “raspberry tongue”.

Not every  child scarlet fever will experience all of these symptoms, and some kids may have no symptoms at all. If you or your child is experiencing any of these symptoms, especially if they are accompanied by a fever, it is important to see a healthcare provider for diagnosis and treatment.


The diagnosis of scarlet fever in children is typically based on a combination of clinical symptoms and laboratory testing. Here are some key details about the diagnostic process:

  1. Clinical symptoms: Scarlet fever is characterized by a combination of symptoms, including fever, sore throat, and a rash. The rash typically starts on the chest and stomach and spreads to other areas of the body, including the arms, legs, and face. The rash is usually described as “sandpaper-like” and may feel rough to the touch. Other symptoms may include headache, nausea, vomiting, and swollen glands.
  2. Throat culture: A throat culture is a laboratory test in which a swab is taken from the back of the child’s throat to check for the presence of group A streptococcus bacteria, which is the bacterial infection that causes scarlet fever. The test takes just a few seconds and is usually painless, although some children may find it uncomfortable.
  3. Rapid strep test: A rapid strep test is a quick diagnostic test that can be done in the doctor’s office to check for the presence of strep bacteria. The test involves taking a swab from the back of the child’s throat and testing the sample for the presence of the bacteria. The results are available within a few minutes.
  4. Blood tests: In some cases, blood tests may be done to check for the presence of antibodies to the strep bacteria, which can indicate a recent or current infection.

Note that not all children with scarlet fever will test positive for strep bacteria, especially if they have already started taking antibiotics. Therefore, the diagnosis of scarlet fever is usually made based on a combination of clinical symptoms and laboratory testing. If you suspect that your child may have scarlet fever, it is important to seek medical attention promptly to receive a proper diagnosis and treatment.

Incubation period of scarlet fever

The incubation period for scarlet fever is the time between exposure to the bacteria and the onset of symptoms. In children, the incubation period for scarlet fever is typically between 1 and 7 days, although it some cases it can range from 12 hours to 10 days. During this time, the bacteria are multiplying in the child’s body and the child may not yet show any symptoms.

According to the Centers for Disease Control and Prevention (CDC), kids who are diagnosed with and treated for scarlet fever are no longer contagious after 24 hours of starting antibiotic treatment. It is important to note that completing the full course of antibiotics is essential to prevent relapse and reduce the risk of spreading the infection to others.

Treatment of scarlet fever (Scarlatina)

  1. Antibiotics: The most common antibiotics used to treat scarlet fever are penicillin and amoxicillin. These antibiotics are usually given as an oral medication and are taken for 10 days. In some cases, if the person is allergic to penicillin, alternative antibiotics may be used.
  2. Pain relief: Over-the-counter pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), can be used to relieve pain and reduce fever.
  3. Comfort measures: Rest, plenty of fluids, and a healthy diet can help support the body’s natural healing process. In addition, a cool compress or bath may help to reduce fever and provide comfort.
  4. Monitoring: Children with scarlet fever should be monitored closely for signs of complications, such as dehydration, difficulty breathing, or worsening of symptoms.
  5. Follow-up: After completing the course of antibiotics, the child should be reevaluated by a healthcare provider to ensure that the infection has been fully treated and that there are no complications.

It is essential for the child to take the full course of antibiotics as prescribed by the healthcare provider, even if the symptoms start to improve before the medication is finished. This is crucial to ensure that the infection is fully treated and to prevent the development of antibiotic-resistant bacteria, which can make future infections more difficult to treat.


Preventing the spread of scarlet fever is crucial to protect individuals from the bacterial infection. Children diagnosed with scarlet fever should be isolated from others until they have completed their course of antibiotics to prevent transmission. Additionally, family members and close contacts should be tested and treated if they have been exposed to the infected individual. Practicing good hygiene, such as washing hands frequently, covering the mouth and nose when coughing or sneezing, avoiding sharing eating utensils or drinking cups, and disinfecting frequently touched surfaces, can help reduce the risk of infection.

Moreover, maintaining a healthy lifestyle with a balanced diet, adequate sleep, and regular exercise can strengthen the immune system and reduce the risk of infection. It’s also important to ensure that living spaces have adequate ventilation to provide fresh air and reduce the risk of transmission. By following these preventive measures, individuals can significantly reduce their risk of contracting and spreading scarlet fever.

Natural remedies to support the treatment of Scarlet Feaver

While natural remedies may be used to complement conventional medical treatment for scarlet fever, it is important to note that they should not be used as a replacement for conventional medical treatment, such as antibiotics, which are essential for treating the bacterial infection that causes scarlet fever. If your child has been diagnosed with scarlet fever, it is important to seek medical treatment from a healthcare provider.

  1. Vitamin C: Vitamin C is a powerful antioxidant that helps support the immune system. Increasing vitamin C intake through diet or supplementation may help boost the body’s ability to fight off the infection.
  2. Honey: Honey has natural antibacterial properties and can help soothe a sore throat. Adding honey to warm tea or water may provide relief from symptoms.
  3. Echinacea: Echinacea is a herb that is commonly used to support the immune system. It can be taken as a tea or supplement.
  4. Homeopathy: Homeopathic remedies, such as Belladonna, Apis mellifica, and Mercurius solubilis, have been used to treat scarlet fever. These remedies are chosen based on the individual’s specific symptoms and constitution, and should only be used under the guidance of a trained homeopathic practitioner.
  5. Ginger: Drinking ginger tea can help to soothe a sore throat and ease nausea. To make ginger tea, peel and slice a piece of fresh ginger root and steep it in hot water for several minutes. Add honey to taste, if desired.

Scarlet fever and immunity

Scarlet fever is caused by group A Streptococcus bacteria, and like other bacterial infections, once the body has been infected, the immune system produces antibodies that recognize and fight against the specific type of bacteria that caused the infection. These antibodies can provide some level of protection against future infections by the same type of bacteria.

However, it is important to note that the immunity to scarlet fever is not permanent, and a child can become infected again if they are exposed to the bacteria. Additionally, there are many strains of group A Streptococcus bacteria, and the antibodies produced in response to one strain may not provide protection against another strain.


In some cases, a child may develop a complication of scarlet fever, such as rheumatic fever or post-streptococcal glomerulonephritis, which can affect the immune system and lead to long-term health problems. These complications can occur when the body’s immune response to the bacterial infection becomes overactive and attacks healthy tissues in the body.

Other potential complications of scarlet fever include:

  1. Rheumatic fever: This is a serious complication that can occur several weeks after a strep infection, including scarlet fever. Rheumatic fever can cause inflammation and damage to the heart, joints, and other organs.
  2. Kidney damage: In some cases, the strep bacteria can cause inflammation and damage to the kidneys, leading to a condition called acute glomerulonephritis. This can cause symptoms such as blood in the urine, swelling of the hands and feet, and high blood pressure.
  3. Ear infections: Scarlet fever can lead to ear infections, which can cause symptoms such as ear pain, hearing loss, and fever.
  4. Abscesses: In rare cases, scarlet fever can lead to the development of abscesses, which are pockets of pus that form in the body.
  5. Pneumonia: Scarlet fever can also increase the risk of developing pneumonia, which is a serious infection of the lungs that can cause symptoms such as cough, fever, and difficulty breathing.

To help prevent complications and protect your child’s immune system, it is important to ensure that they receive prompt and appropriate medical treatment. Along with antibiotics to treat the bacterial infection, supportive care can also be important for managing symptoms and preventing complications. Additionally, good hygiene practices, such as washing hands frequently and avoiding close contact with others who are sick, can help reduce the risk of exposure to group A Streptococcus bacteria.

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