Scarlet fever is one of the most common bacterial infectious diseases in children of kindergarten and school age. Although transmission is still possible in adulthood, scarlet fever is considered a classic childhood illness. In this article, you’ll learn how to recognize the typical symptoms that may indicate your child has scarlet fever, how the disease progresses, and what treatment involves.

What is the transmission route of scarlet fever?

Every fifth to tenth person carries the scarlet fever pathogen (A-streptococci) without necessarily becoming ill. The bacteria spread quickly—usually via tiny saliva droplets when speaking, coughing, or sneezing ( Droplet infection ), and less frequently via contaminated objects that the pathogens stick to ( Smear infection ). Scarlet fever is highly contagious and occurs especially often in places where many people gather, such as kindergarten or school. Once transmitted, the infectious bacteria mainly settle in the throat area and penetrate the mucous membranes there.

What are the symptoms of scarlet fever in children?

Most of the time, there is a period between infection and the onset of the disease of one to three days . After this scarlet fever incubation period , the first symptoms appear very suddenly. At first, these mainly include the following flu-like signs:

• Headaches

• Fatigue

• Sore throat

• Difficulty swallowing

• Chills and rapidly rising fever

Especially in young children, it often leads to stomach pain and vomiting. Another characteristic feature of scarlet fever is that red spots on the palate and throat appear; the tonsils are inflamed and may be covered with white spots, and the lymph nodes in the neck are significantly swollen. Up to this point, it is referred to as Streptococcal Angina or Mandelentzündung .

How does the childhood disease progress?

Scarlet fever is only diagnosed when, after one or two days, a fine, velvety skin rash spreads across the entire body from the armpits, chest, and groin. Unlike measles or rubella, it causes no itching . Your little explorer’s cheeks are often very red, but the skin around the mouth remains pale.

Another typical scarlet fever symptom is the so-called raspberry tongue or strawberry tongue : At the beginning of the illness, the tongue is coated white; after a few days, it turns red and, with raised taste papillae, resembles a raspberry. After six to nine days, the rash and all other symptoms gradually subside. Shortly afterward, your child’s skin—especially on the palms of the hands and soles of the feet—may peel.

What can be done to treat scarlet fever?

If your child has a sore throat along with fever and a rash, you should definitely consult a doctor. go to the pediatrician : There, if necessary, a throat swab can clarify whether it is actually scarlet fever. Scarlet fever is usually treated with antibiotics , which children typically receive as a liquid or tablets. There is no risk of infection 24 hours after the first dose , and symptoms usually improve noticeably as well. However, if no antibiotics are taken, scarlet fever lasts about three weeks and remains contagious for the same duration.

If antibiotic treatment is not given or is stopped too early, more serious complications can occur, such as middle ear infections, sinus infections, or pneumonia. In the past, pneumonia was a particularly common and dangerous complication of scarlet fever. Thanks to improved treatment options and children’s generally better nutritional status, it has fortunately become very rare today. The so-called Rheumatic Fever —an inflammation that occurs as an autoimmune reaction following scarlet fever and can affect the skin, heart, joints, and brain—has also become extremely rare.

Immunity through scarlet fever?

A persistent rumor claims that children who recover without antibiotics are immune to scarlet fever —but that is not the case. While your child is immune to the specific pathogens that caused the illness after recovery, scarlet fever can be triggered by many different streptococcal bacteria. For that reason, complete immunity is never possible, and the infection can occur again at any time due to other pathogens. This misconception—and the idea of avoiding antibiotics because of it—can sometimes be very dangerous for your child. With scarlet fever, you should therefore strictly follow the pediatrician’s treatment plan and stick to the recommended duration of medication, even if symptoms improve earlier.

Additional measures

In addition to treatment by the pediatrician, there are a few things you can do to help your child feel better soon. With plenty of rest and love, recovery is ultimately the best medicine.

• As long as it is contagious, your child should have as little contact with others as possible to prevent further infections. Kindergarten, daycare, and co. are therefore initially tabu until the doctor decides when your little explorer can be around other children again. In addition, it’s important to inform the facility if your child has scarlet fever.

• At home, rest and convalescence are essential so your little patient can get back on their feet quickly.

• Hot beverages and soft foods like porridge or soup soothe a sore throat and ease swallowing difficulties. Especially with Fever , your favorite should also drink plenty. Water and herbal tea are best suited here. Be sure to wash your hands regularly and thoroughly to avoid infecting yourself.

After recovering from scarlet fever, it takes approximately four weeks until the immune system has recovered and is back to normal resilience. Even then, your child should take it easy at first and avoid physical overexertion: sports and wild play are only recommended again after six weeks (as far as that’s feasible with your toddler ;)).

Even if you probably can’t prevent your young child from catching scarlet fever—since there is currently no vaccine available—we want to reassure you: scarlet fever is treatable, and with the right measures, symptoms can be significantly relieved so your child will be healthy again soon. Until then, we wish you a speedy recovery!