What should you know about start of scarlet fever?

Scarlet fever is linked to infection with group A streptococcal bacteria. A child may first have a sore throat, fever, headache, flushed cheeks or swollen glands in the neck. The rash commonly starts on the chest or tummy and can spread, while the area around the mouth may remain paler. The tongue may look red and bumpy.

Scarlet fever presents with this combination of throat symptoms and rash, but rashes have many causes. Strep throat can occur without the characteristic rash, so a clinician may need to assess the throat separately.

Arrange medical advice when scarlet fever is suspected, particularly for a child with fever, sore throat and a spreading rough rash. Encourage fluids and offer suitable fever or pain relief according to professional or label instructions. Wash hands, avoid sharing cups and utensils, and launder items that have been soiled with saliva or nasal discharge.

If a clinician prescribes antibiotic treatment, give it exactly as directed and complete the course unless the prescriber changes the plan. Improvement should be discussed if symptoms worsen or fail to settle.

Get urgent help if breathing or swallowing is difficult, the child is drooling because swallowing hurts, there is marked drowsiness, dehydration, a stiff neck, severe headache or a rapidly worsening rash. Seek prompt review for persistent fever, worsening throat pain or an illness that is not improving after treatment begins.

Ask whether testing is needed, when the child can return to school, how to protect household contacts, and what to do if the antibiotic causes a reaction or is difficult to take.