Scarlet fever is pretty rare these days, but it hasn't been completely eradicated. It's easily identifiable by its rough and itchy rash...
What is it?
Scarlet fever is a bacterial infection that is spread around via coughs and sneezes, as well as by touching infected surfaces (utensils, towels, toys and so on). Although relatively uncommon, it is incredibly infectious – and although anyone can get it, it most commonly affects children between the ages of four and eight. If your child hasn't had scarlet fever by the age of 10, the chances are they never will, because they might well have developed an immunity to it by then.
The culprit is the streptococcus bacteria, which usually causes sore throats and skin infections. Scarlet fever occurs when someone is sensitive to the toxins caused by that bacteria, so your child might have become infected by someone who didn't have scarlet fever themselves.
Often the first symptoms of scarlet fever are a sore throat or a skin infection, accompanied by a high temperature (link to fever page). The rash will appear up to 48 hours after the onset of the fever, and it is identifiable by its pinkish-red colour and sandpaper like texture. It commonly appears around the ears and neck, elbows, inner thighs and groin and, while it's unlikely to show up on the face, your child might look a little flushed.
The rash is unpleasant and it might feel very uncomfortable and itchy. What's more it'll be joined by some other nasty symptoms, including a headache and swollen neck glands, nausea or vomiting, tummy and muscle pains, and 'strawberry tongue' (a white coating, which peels to leave the tongue red, swollen and sore). Your child might also get some red streaks in various folds (in their armpits, for example) which are actually broken blood vessels and, wherever the rash appears, the skin might peel for weeks afterwards.
What can I do?
Although it's not serious, scarlet fever is very horrid indeed, not to mention highly contagious, which is why it's an identifiable disease. So, as soon as you suspect your child may have it, take them along to your GP.
Often a doctor will diagnose scarlet fever on sight, but occasionally a swab from the throat (to identify the streptococcus bacteria) might be taken.
The good news is, because scarlet fever is a bacterial infection, the recovery process can be sped along by a 10-day course of antibiotics (probably penicillin, unless your child has a problem with it).
Ensure you follow the instructions for taking the medicine to the letter and be sure to complete the course, even if your child feels better half way through. The fever should have disappeared within 24 hours of beginning the course and hopefully the rest of the nasty symptoms will follow within a few days (although the peeling skin might last for a couple of weeks or more).
As well as the antibiotics, the correct dosage of liquid paracetamol or ibuprofen can be given to ease your child's fever and aches and pains.
Calamine lotion might help with their itching (or if not, then some liquid antihistamine might help), and keeping them cool will reduce their desire to claw at their rash, too.
It's highly likely, with tummy pains and a sore tongue, your little one will be right off their food. Don't worry too much about that – it's much more important they keep sipping at cool drinks to stave off dehydration, which can cause problems of its own.
Because scarlet fever is so contagious, there are some practical measures you can take to prevent spreading it to anyone who's not immune. Keep your child indoors and away from school or nursery until they have completed at least the first 24 hours of their antibiotics course.
At home, wash your child's towels and bed linen on a high heat, don't share cups and utensils, and dispose of used tissues in a bin straight away. And, of course, everyone in the house should keep up the hand washing!
Usually scarlet fever will clear up nicely, especially with the help of some penicillin, but very rarely it can lead to some complications. If your child doesn't seem to be improving after the first 24 hours of taking antibiotics, or if they have a severe headache, vomiting or diarrhoea in the few weeks after the infection seems to have cleared, go back to your GP.
What else could it be?
Scarlet fever is recognisable by its sandpaper-like rash, but if your child seemed to have a cold, then developed red spots around their ears and neck, followed by spots elsewhere on their body, they might have measles.