Scarlet Fever
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Scarlet Fever

What is scarlet fever?

Scarlet fever, known in Maltese as “Skarlatina”, is a disease caused by a bacterium called group A Streptococcus. This bacterium also causes the common sore throat known as “strep throat”. Children who are infected with the bacterium for the first time can sometimes also develop a rash and the illness is then called Scarlet fever. People with scarlet fever typically also have a high fever and a strawberry-like appearance of the tongue. The rash of scarlet fever is usually seen in children under the age of 18.

Why are we having so many cases of scarlet fever in Malta?
We have a few cases of scarlet fever regularly, especially in winter time. This year, there has been an increase in the number of cases as has happened in some other countries (such as Scotland). This could be because a slightly different strain has reached Malta, and many Maltese children have never been infected with this particular strain. This does not mean that the strain causes more severe disease, only that more children might get a rash together with their sore throat.

How do you get scarlet fever?
The illness can be caught from contact with the sick person. The germ is carried in the mouth and nasal fluids and is transmitted through contact with droplets when the infected person sneezes or coughs. If you touch your mouth, nose, or eyes after touching something that has these fluids on them, you may become ill. The best way to keep from getting sick is to wash your hands often and avoid sharing eating utensils. It is especially important for anyone with a sore throat to wash his or her hands often and not share eating or drinking utensils.

What are the symptoms of scarlet fever?
Scarlet fever begins with a rash that shows up as tiny red bumps. It most often begins on the chest and stomach but can then spread all over the body. It looks like a sunburn and feels like a rough piece of sandpaper. Most of the time it is redder in the creases of the elbows, arm pits, and groin areas. The rash lasts about 2-7 days. After the rash is gone, the skin on the tips of the fingers and toes begins to peel. Some other common signs of scarlet fever are:
  • A flush face with a pale area around the lips;
  • A red and sore throat that can have white or yellow patches;
  • A fever of 101 degrees Fahrenheit (38.3 degrees Celsius) or higher;
  • Swollen glands in the neck; and
  • A whitish coating can appear on the surface of the tongue. The tongue itself looks like a strawberry because the normal bumps on the tongue look bigger.

Other less common signs of illness include:

  • Feeling sick to your stomach (nausea) and throwing up (vomiting);
  • Having a headache; and
  • Having body aches.

 How is scarlet fever diagnosed?
To diagnose the cause of your child’s rash or sore throat, your doctor will examine your child and might swab the back of the throat with a cotton swab. The swab will be then used for a throat culture to see if there is a group A strep infection.

What is the treatment for scarlet fever?
If your doctor diagnoses you or your child with scarlet fever, the doctor will give you a drug that fight germs (antibiotic) for your child. Be sure to give your child the drug as the doctor tells you. Never share any of the drug with anyone else. Also, be sure to ask your doctor about drugs you can buy in the store for sore throat pain.

Is there anything else I can do to make my child feel better?
Warm liquids like soup or cold foods/drinks like milkshakes help to ease the pain of the sore throat. Offer these to your child often, especially when he/she has a fever since the body needs a lot of fluid when it is sick with a fever. A cool mist humidifier will help to keep the air in your child's room moist which will keep the throat from getting too dry and more sore. Your child needs plenty of rest.

What should I do if I think my child has scarlet fever?
If you think your child has scarlet fever, take your child to his or her doctor right away. The doctor may give your child drugs that fight germs (antibiotics). The department of health recommends that your child stays away from school until he or she has been taking antibiotics for five days.

Is scarlet fever a dangerous disease?
Before the availability of antibiotics, around 3% of untreated cases of scarlet fever resulted in complications such as rheumatic fever. Nowadays, with basic antibiotics, the risk of developing complications is very much smaller; however you should make sure that if your child is sick, he/she should be seen by a doctor. 

Adapted from the Centres for Disease Control website​

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