We hear so little about scarlet fever these days that when we do hear about it, it arouses instant fear. That’s because it used to be a serious illness, and usually involved isolating the patient and stringent cleaning - sometimes to the point of burning all of the patients’ personal items.
Surely everyone remembers when, in “Little Women,” Beth contracted scarlet fever and seemed to recover, but it progressed to rheumatic fever and finally, she succumbed to congestive heart failure. Or, in another famous tale, “The Velveteen Rabbit,” the main character, a small boy, developed scarlet fever and his toys were all going to be burned, along with his favorite toy, the velveteen rabbit. Just before the burning took place, the rabbit came alive and joined the “real” rabbits outside in the garden.
Scarlet Fever is a disease many people thought disappeared a century ago, but it is still around and doctors say it needs to be treated quickly. Some pediatricians say even though scarlet fever never went away, it has become much easier to treat because of antibiotics.
The other day, my daughter called to say that my grandbaby was sick and that scarlet fever was going around in the daycare she attended. After a visit to the doctor, she found that she didn’t have scarlet fever, but she did have strep throat and an ear infection. The doctor gave her a shot of antibiotics (which produced quite a hullabaloo), but she was fine within a few days.
Scarlet fever, also once known as scarlatina (from the Italian scarlattina) is a red, bumpy rash caused by toxins released by Group A Streptococcus (“strep”) bacteria. Along with symptoms such as fever, swollen lymph nodes, loss of appetite, nausea, vomiting and fatigue, it causes a finely textured rash similar to sandpaper, which appears 12-48 hours after the strep infection.
The scarlet fever rash looks like a sunburn on the cheeks, and often has a sandpaper-like texture or goosebumps. It usually starts in the underarm area, groin and neck, and then spreads to the trunk, back, arms and legs. Other symptoms include: a pale area around the mouth; white strawberry tongue, a white coating with red dots on the tongue’s surface; and Pastia’s lines, a darkening of the normal skin creases, especially in the crook of the arms.
Occasionally, scarlet fever follows a streptococcal skin infection, such as an infection of burns or wounds, or impetigo. When this happens, the rash and related skin symptoms appear, but there are no symptoms related to strep throat.
When scarlet fever occurs because of a throat infection, the fever typically stops within three to five days, and the sore throat passes soon afterward. The scarlet fever rash usually fades on the sixth day after sore throat symptoms began, but skin that was covered by rash might begin to peel.
The bacterial infection that causes scarlet fever is contagious. A child who has scarlet fever can spread the bacteria to others through nasal and throat fluids by sneezing and coughing. If a child has a skin infection caused by strep bacteria, like impetigo, it can be passed through contact with the skin.
Unfortunately, there’s no way to prevent spreading scarlet fever because it spreads so easily and usually occurs before a mother even knows her child has it. However, if not treated quickly, scarlet fever can turn into rheumatic fever, which can cause more serious health issues including rheumatic heart disease.