Scarlet fever: what to know about symptoms and care

Scarlet fever is caused by toxins made by certain streptococcal bacteria, often alongside strep throat. The rash may begin on the chest or abdomen and spread, with a texture sometimes compared with fine sandpaper. The face can look flushed while the area around the mouth remains paler. A coated or strawberry-looking tongue, headache, nausea and tender neck glands may occur. Symptoms vary, and a rash is not enough to confirm the diagnosis; a clinician may assess the throat and overall illness.

Arrange a clinical assessment if scarlet fever is suspected, particularly when fever and sore throat occur with a spreading rough rash. Rest, drink fluids and use age-appropriate fever relief only as directed on the label or by a clinician. Wash hands, avoid sharing cups and cutlery, and keep close contacts informed if infection is confirmed. Antibiotic treatment may be prescribed after assessment; take it exactly as directed and complete the prescribed course. Do not give another person’s medicine.

Seek urgent help for difficulty breathing or swallowing, drooling, severe dehydration, unusual drowsiness, confusion, a rapidly worsening illness or a rash that does not fade when pressed. Contact a clinician promptly for persistent fever, worsening throat pain, reduced drinking, ear pain, joint swelling or symptoms that return after initial improvement. Children who seem significantly unwell need prompt assessment even when the rash appears mild.

Could this be scarlet fever or another rash illness? Does the throat need testing? Is antibiotic treatment appropriate, and when can the person return to school or work? How should household contacts reduce spread?