What should you know about scarlet fever untreated?

Scarlet fever is an illness caused by toxin-producing group A streptococcal bacteria, often alongside a sore throat, fever and a fine rough rash. Without treatment, the infection may remain active and spread to other people through respiratory droplets and close contact. Rarely, an untreated infection can be followed by problems affecting the ears, skin, joints, kidneys or heart. A rash alone cannot confirm the diagnosis, because several childhood illnesses can look similar.

Contact a doctor or paediatric clinician promptly, especially when fever and a sore throat occur with a sandpaper-like rash. The clinician may examine the throat and decide whether testing is needed. If antibiotics are prescribed, give every dose as directed and complete the course unless the prescriber changes the plan. Encourage fluids, rest and soft foods; avoid sharing cups, utensils or towels. Ask when the child can return to school or nursery, and keep close contacts informed if advised.

Seek urgent help for trouble breathing, inability to swallow fluids, severe drowsiness, confusion, a rapidly worsening illness, very little urine, repeated vomiting, or signs of an allergic reaction after medicine such as facial swelling or wheezing. Arrange prompt review if fever persists, the rash becomes painful, or symptoms return after treatment.

Ask: Does this look like scarlet fever or another rash illness? Is a throat test useful? Which medicine and schedule are appropriate? When is the illness no longer readily spread? What symptoms should trigger a same-day review?