Rise in scarlet fever


Scarlet fever is back. The same disease your parents were scared you might catch as a child. In the UK, it reached the highest incidence in 50 years, with 19,026 cases in 2016. It has now spread to East Asia, and the likelihood that the US will experience it soon is great. (Conspiracy theorists are wondering whether it’s been weaponized.)

Scarlet fever is a bacterial infection caused by Strep Group A, and mainly affects children aged between five and fifteen, although adults can catch it too.

It used to come with a one-in-three chance of infantile death as complications  can include rheumatic fever and kidney problems. Nowadays, the prognosis of scarlet fever, if treated early and effectively, is very good; such treatment usually prevents complications.

Next time your child or grandchild has a sore throat or rash, remember to ask the doctor to check for scarlet fever when they do the strep test.

Common Symptoms of Scarlet Fever

  • A very red, sore throat
  • A fever (101° F or above)
  • A red rash with a sandpaper feel
  • Bright red skin in the creases of the underarm, elbow, and groin
  • A whitish coating on the tongue
  • A “strawberry” (red and bumpy) tongue
  • Swollen glands in the neck

Other general symptoms include

  • Headache or body aches
  • Nausea, vomiting, or abdominal pain

Usually the characteristic red rash appears one or two days after the illness begins. However, the rash can appear before illness or up to 7 days later. The rash usually appears first on the neck, underarm, and groin. Over time, the rash spreads over the body. Typically, the rash begins as small, flat red blotches that gradually become fine bumps and feel like sandpaper. The disease can manifest into long-term problems, such as kidney disease and rheumatic fever.

Thankfully, doctors can check for scarlet fever with a quick strep test, and it can be treated with antibiotics.

The WHO says the disease transmits through “respiratory droplets or through direct contact with mucus, saliva or the skin of infected people”, so be aware that the disease is contagious. The best thing to do is to keep away from people who have the disease, but if you are unable to, be sure to wash your hands frequently and thoroughly.

Medical treatment is aimed at providing adequate antistreptococcal antibiotic levels for at least 10 days. Patients who have scarlet fever are usually treated with a standard 10-day course of oral penicillin VK or erythromycin. Patients can also be treated with a single intramuscular injection of penicillin G benzathine.

After 24 hours of properly taken antibiotics, the CDC says people with the disease should no longer be contagious to others. It is much less dangerous than it was fifty years ago, thanks to advances in medicine – even so, we should all be wary.