What is Scarlet Fever?

This page was reviewed or revised on Thursday, August 13, 2009.

Scarlet fever is a form of the streptococcal disease characterized by a skin rash. The streptococci secrete a toxin which causes a skin rash to appear. Ordinarily scarlet fever evolves from the initial illness of strep throat, although the rash only occurs in 10% of the cases of strep throat. Scarlet fever can also be present in those who are suffering from other infections caused by the streptococcal bacteria, such as a streptococcal infection of the skin and soft tissue, surgical wounds, or the uterus.

How does it spread?

Scarlet fever is spread by direct contact with respiratory droplets of infected person.

It is rarely spread by indirect contact through objects.

When is Scarlet Fever contagious?

Once a person has taken the appropriate antibiotics for 24 hours they are no longer contagious. Scarlet fever can be contagious for 10-21 days if untreated.

How long can Scarlet Fever incubate?

Scarlet fever can incubate for 1-4 days prior to the onset of the rash.

What are the symptoms of Scarlet Fever?

Scarlet fever is usually accompanied by symptoms of strep throat, such as sudden onset of fever, sore throat, headache, nausea, vomiting, abdominal pain, muscle pain, and fatigue. The rash that may appear in 12-48 hours after the onset of fever consists of scarlet red macules on reddened inflamed skin that is usually first noticed below the ears, on the chest and under the armpits. The rash will change in appearance to look like a sunburn with goose pimple and feel rough like a sandpaper-like texture. There may also be cicumoral pallor (pale skin area around the mouth). Peeling of the skin may also occur at the armpits, groin, and tips of fingers and toes.

Can Scarlet Fever have serious complications?

If scarlet fever is not treated rheumatic fever can occur in a small percentage of people. Rheumatic fever is an inflammatory disease that affects the joints and heart.

When is Scarlet Fever most prevalent?

The peak incidence of scarlet fever occurs in the 4-8 year of age range. By the time children have reached the age of 10, 80% have developed life-long protection against scarlet fever. There is an increase in the number of scarlet fever cases in the summer and early fall.

When can my child with Scarlet Fever return to school/ daycare?

Once the infected person has been treated with an appropriate antibiotic for 24 hours and is no longer feverish it is acceptable to return to school or daycare.