Health conditions

Scarlet fever

What is scarlet fever?

Scarlet fever is an infection of the throat caused by group A streptococci bacteria.

This group of bacteria can cause a range of other conditions, including throat infections and tonsillitis, skin infections (impetigo), wound infections, and acute rheumatic fever.

The disease most commonly starts in children or adults with a ‘strep throat‘ infection or tonsillitis, followed by the development of a skin rash. It is not very contagious and the infection is easily treated with antibiotics. Most children will recover fully within a week or so. Deaths from scarlet fever are now extremely rare.

How do you get scarlet fever?

The bacteria are found in the nose and/or throat of infected people and can be spread to other people by:

  • coughing or sneezing (by breathing in droplets containing the bacteria)
  • direct contact with an infected person, where bacteria may be transferred by kissing or on hands
  • direct contact with contaminated surfaces
  • using the same eating utensils when sharing food or drink with an infectious person.

Who is most at risk?

Anyone can be infected with group A streptococci, but scarlet fever is more likely to occur in young and primary school-aged children.

People living in the same household or coming into close contact with an infected person who is coughing or sneezing are at risk.

Signs and symptoms

Signs and symptoms appear around 1 to 3 days after exposure to an infectious person. 

  • Sore throat, fever (high temperature) and swollen tonsils and neck glands are the typical first symptoms.
  • A fine red (scarlet) rash develops 12 to 48 hours after symptoms begin. It appears on the trunk and limbs and looks like sunburn and feels like sandpaper. The rash lasts 2 to 5 days.
  • During recovery, the skin may peel off the fingers and toes.
  • The tongue becomes very red (known as ‘strawberry tongue’). Other common symptoms include headaches, nausea (feeling sick) and vomiting, not feeling hungry, and feeling generally unwell.

Infected children should be kept away from child care or school until they are well, and at least 24 hours after starting antibiotic treatment.

How do I know I have scarlet fever?

A medical professional will diagnose scarlet fever by taking a throat swab and sending it to a laboratory for confirmation.

How long is it infectious?

You are no longer infectious 24 hours after you start taking antibiotics.

However, people who do not get treated and who have the symptom of a sore throat can still be infectious 2 to 3 weeks after becoming ill.

Treatment of scarlet fever

Treatment consists of a course of antibiotics (usually penicillin) to kill the bacteria and prevent serious complications that can sometimes occur, including heart (rheumatic fever) and kidney disease.

It is important to take all of the antibiotics your doctor prescribes.

While you have the infection

  • Paracetamol may reduce high temperature (fever) and relieve a sore throat. Talk to your doctor about pain relief.
  • Drink plenty of water.
  • Get lots of rest.

How can scarlet fever be prevented?

You can prevent the spread of scarlet fever and ‘strep throat’ by following this advice:

  • Cover your mouth and nose with a tissue when you cough or sneeze.
  • Throw tissues in the bin after you use them.
  • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
  • Wash your hands before preparing food.
  • See your doctor if you or your child has symptoms of sore throat and fever.

Where to get help

  • See your doctor
  • Visit a GP after hours
  • Ring healthdirect on 1800 022 222

Remember

  • Scarlet fever is an uncommon infection.
  • The first symptom is usually a 'strep throat' or tonsillitis, followed by a rash.
  • Antibiotics will kill the bacteria and prevent complications.

Acknowledgements
Public Health

This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.

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