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Scarlett Fever
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Scarlett Fever

Scarlett Fever in the UK

Scarlett Fever also is known as scarlatina is a bacterial infection caused by Group A Streptococcus pyogenes. Throughout the 20th century incidence was declining; however, the past decade has seen an increase in outbreaks. In November 2017, it was reported that Scarlett Fever cases had reached a 50-year high in England 19,000 cases were reported in 2016 with a recent outbreak identified in East Sussex in December 2017.

Symptoms of Scarlett Fever

Typical presentation of Scarlett Fever includes a blotchy rash on the trunk of the body that turns white when pressed with a glass and feels rough, like sandpaper, a sore throat with visibly enlarged red and white papillae on the tongue ‘strawberry tongue’ and a rash on the soft palate, abdominal pain, prolonged fever, swollen neck glands, tachycardia high heart rate, nausea and vomiting.

The rash tends to spread to the extremities and can result in peeling skin on the palms of the hands. Patients present with varying severity. The key differentiating factor from other diseases with a rash such as measles and rubella is the lack of upper respiratory inflammation.

How long will Scarlett fever last?

Scarlett Fever generally lasts for a week. It is a notifiable disease as it is highly contagious; patients are infectious from up to seven days before symptoms appear it is spread via coughs and sneezes. Actions can be taken to reduce the spread of the disease such as the following.

1. Regular and vigorous handwashing

2. Discard used tissues

3. Avoiding sharing bedding, baths or cutlery

It is also advisable for those diagnosed with Scarlett Fever to minimise contact with vulnerable individuals such as those who are immunocompromised.

What age can you develop Scarlett Fever?

People can develop Scarlett Fever at any age, however, incidence tends to be higher in children from 3 to 8 years of age. Incidence is also higher in males and during the winter and spring seasons. Common risk factors for the development of Scarlett Fever include chickenpox and influenza.

Treatment for Scarlet Fever

As treatment involves administration of a course of antibiotics, it is important to ensure accurate diagnosis, usually by an oral swab to confirm the presence of bacteria and avoid misdiagnosis of other viral conditions such as roseola. The recommended treatment is Penicillin as a 10-day course, however, other options are available for patients who are allergic to penicillin for example Azithromycin as a 5-day course. The dose is determined by age.

Scarlett Fever in Adults and Children


The first signs of Scarlett fever with adults can be flu-like symptoms including a high temperature of 38C or above and swollen neck glands such as having a large lump on the side of your neck. Symptoms in adults can be managed by over-the-counter medication such as paracetamol and ibuprofen.


In children, calamine lotion may soothe itching and drinking cool fluids may relieve their discomfort. Early diagnosis and treatment are important to prevent the development of complications such as throat abscesses, ear infection and sinusitis ore more serious complications that may require hospital admissions such as rheumatic fever, pneumonia and meningitis. Patients with impetigo are more likely to suffer from complications of Scarlett Fever.

Scarlett Fever is contagious the is currently no vaccine for scarlet fever, although many are in clinical development. It is contagious so it is important to prevent passing it on through skin contact.

Sources: Nhs, NCBI, Gov. UK