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When Your Child Has Scarlet Fever

Scarlet fever is an illness that appears as a red (“scarlet”) rash on the body. It is caused by the same bacteria that causes strep throat. Scarlet fever was once a serious childhood illness. Now, it can be treated with medication and home care. Children generally recover from scarlet fever within a week after starting treatment.

Close up of hands giving liquid medicine to girl lying in bed.

What causes scarlet fever?

Scarlet fever is caused by Streptococcus (strep) bacteria. This is the same bacteria that causes strep throat.

How is scarlet fever spread?

Scarlet fever can be spread in the following ways:

  • Breathing infected air (the germs can enter the air when an infected person coughs or sneezes)

  • Contact with fluids (such as nasal fluids) from an infected person

  • Contact with items (such as cups, toothbrushes, or towels) that have been contaminated by an infected person

What are the symptoms of scarlet fever?

Symptoms usually appear 24 to 48 hours after exposure. These include:

  • A red rash that appears most often on the chest, back, or abdomen (also called “sandpaper rash” because it raises the skin and makes it feel like sandpaper)

  • Sore throat (strep throat)

  • Fever

Other symptoms that may occur include:

  • Red cheeks

  • Paleness around the mouth

  • Strawberry tongue (white coating and red spots appear on the tongue causing it to look like a strawberry)  

  • Muscle aches

  • Abdominal pain

  • Neck pain

  • Red eyes

How is scarlet fever diagnosed?

The doctor asks about your child’s symptoms and health history. Your child is examined. If scarlet fever is suspected, the doctor will swab the back of your child’s throat to check for the presence of bacteria.

How is scarlet fever treated?

  • Scarlet fever generally lasts about 7 to 10 days. The fever and sore throat go away within 48 to 72 hours of starting treatment. The rash may take 7 days to go away. Some peeling or flaking of the skin is normal.

  • Antibiotics are prescribed by the health care provider. These can be given by injection or by mouth. Make sure your child takes ALL of the medication, even if he or she feels better.

  • Your child is no longer contagious 24 hours after starting treatment. Your child can go back to school or daycare following full recovery.

Call the health care provider if your otherwise healthy child has any of the following:

  • Fever

    • In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher

    • In a child of any age who has a repeated temperature of 104°F (40.0°C) or higher

    • A fever that lasts more than 24-hours in a child under 2 years, or for 3 days in a child 2 years or older

    • A seizure caused by the fever

  • Symptoms that do not improve within 48 hours of starting treatment

  • A rash that worsens

  • Trouble swallowing

What are the long-term concerns?

There are usually no further problems once your child receives treatment. If untreated, scarlet fever can cause other serious health problems. Be sure to contact your child’s health care provider right away if your child ever has a sore throat with a rash.


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