What is scarlet fever?

Scarlet fever is a type of bacterial throat infection that also features a red (scarlet) rash. It is also known as 'scarlatina'. It usually affects young and primary school-aged children.

It is caused by group A streptococci bacteria — the same type of bacteria that cause 'strep throat', impetigo, wound infections and rheumatic fever.

Treatment with antibiotics means most people recover in about a week, but if left untreated scarlet fever can spread to other parts of the body and cause serious health problems.

What are the symptoms of scarlet fever?

Symptoms of scarlet fever usually appear between 1 and 3 days after catching the infection, and include a very red sore throat, swollen glands and fever.

About 12 to 48 hours after symptoms start, red blotches appear on the skin, usually on the head and neck and then spread to the body, including arms and legs. It can look like sunburn and feel like sandpaper. The rash lasts about 2 to 5 days. After the rash is gone, the skin on the fingers and toes may begin to peel.

Scarlet fever may also cause:

• red bumps on the tongue (this can look like a strawberry) or a whitish coating on the tongue
• headache
• abdominal pain, nausea and vomiting
• very sore throat and tonsils — swallowing can be difficult
• swollen glands in the neck
• muscle aches and chills

What causes scarlet fever?

Scarlet fever is caused by group A streptococcal bacteria. These bacteria are found in the nose and throat and are spread by:

• coughing and sneezing
• contact with contaminated surfaces, such as cutlery or drink bottles
• touching or kissing an infected person

Children can also catch it by touching the sores of someone who has a streptococcal skin infection.

Read more about streptococcal infections.

When should I see my doctor?

You should see a doctor if your child has a very sore throat, red rash or fever. You should also see your doctor if your child is in pain, not drinking or not urinating (weeing) much.

When should I seek urgent medical care?

You should seek urgent medical care if your child has:

• persistent high fevers
• joint pain and swelling
• signs of skin infection (cellulitis)

These could suggest that there are complications of scarlet fever.

You know your child best. If your child seems seriously unwell, you are worried about their health and they have symptoms of scarlet fever, call triple zero (000) and ask for an ambulance or take them to the nearest emergency department.

How is scarlet fever diagnosed?

To diagnose scarlet fever your doctor will ask about your symptoms and do a physical examination. They may take a swab from your throat to check for the bacteria.

How is scarlet fever treated?

Scarlet fever is treated with antibiotics (usually penicillin). If left untreated, the bacteria might spread to the tonsils, lungs, skin, kidneys, blood or middle ear. Antibiotics can help prevent serious health problems, including rheumatic fever, kidney disease, pneumonia and joint pain.

The doctor may also recommend rest, pain relief and that your child drinks a lot of water.

Your child will stop being infectious 24 hours after they start antibiotics. If they don't take antibiotics, they can still be infectious for 2 to 3 weeks.

How can scarlet fever be prevented?

The best way for your child to avoid scarlet fever is by washing their hands often, and not sharing cups, bottles or utensils with others.

To avoid giving it to other people they should:

• cover their nose and mouth when coughing or sneezing
• throw away used tissues immediately
• wash their hands after blowing their nose

Children with scarlet fever should stay home while they are unwell and for at least 24 hours after starting antibiotics.

What are the complications of scarlet fever?

Infection with group A strep which causes scarlet fever can lead to several complications, including:

• an abscess (collection of pus) that develops next to the tonsils.
• rheumatic fever — an immune condition that can affect your heart, joints, skin and other body organs
• inflammation and reduced kidney function
• meningitis — an infection of the membranes around the brain
• sepsis — damage to body tissues in response to an infection
• toxic shock syndrome — a type of infection caused by bacteria

These complications can be prevented by treating early with antibiotics.

Resources and support

For more information about the symptoms, diagnosis and treatment of scarlet fever, see the following websites:

• Healthy WA provides advice on treatment and where to get help.
• The Sydney Children's Hospitals Network, for information on group A streptococcus infection and how to prevent the spread.
• The Kids Research Institute Australia and Perth Children's Hospital have information on symptoms, as well as research initiatives in the fight against strep A.
• NT Health has information about risk groups for streptococcus infection and treatment advice.
• SA Health has a factsheet on streptococcal sore throat, including symptoms, treatment and prevention.
• SA Health offers tips on reducing spread through hand hygiene, including 'wash, wipe, cover' advice.

Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.

Pregnancy, Birth and Baby's video call service allows you to speak face-to-face with a maternal child health nurse. Video call is a free service and is available from 7am to midnight (AET), 7 days a week (including public holidays).

Languages other than English

Scarlet fever information is available in other languages, with resources from Children's Health Queensland.