Scarlet fever

Scarlet fever is a bacterial infection that can cause a sore throat and sometimes a skin rash. Symptoms develop when the bacteria release toxins that spread throughout the bloodstream.

Signs and symptoms

• Fever
• Red, sore throat
• Rash which starts at the head and neck and spreads to the body, arms and legs. It appears within 24-48 hours and fades within 3-4 days.
• Skin feels rough, like sandpaper. It may peel (like a sunburn) when the rash is fading, and most commonly occurs on the hands, feet or in the nappy or groin areas.
• Skin looks red with red spots that turn white when pressed
• Red tongue with bumps, it may have a strawberry-like appearance
• White spots at the back of the throat
• Swollen lymph glands at the neck

Treatment

Scarlet fever is diagnosed by a GP after a physical examination. The GP may take a throat swab for testing and will let you know if more tests are needed.

Scarlet fever is treated with penicillin antibiotics (pills that are taken by mouth) for 10 days. It can take up to 48 hours for symptoms to get better.

If left untreated, scarlet fever can cause serious complications such as acute rheumatic fever – a disease that can affect the heart, joints, brain, and skin – which can lead to rheumatic heart disease (damage to the heart). This is an uncommon but serious complication so it’s important for your child to finish their recommended treatment from the GP.

Care at home

Make sure your child gets lots of rest and give them paracetamol (Panadol or Dymadon) and ibuprofen (Nurofen) to help manage any pain or fever. Follow the instructions on the bottle or package for the correct dosage. Do not give more than what is recommended for the day.

Give your child sugary drinks such as juice, milk or electrolytes (available from your local chemist). If your child is drinking enough, their wee will be light yellow in colour.

Your child will need to start their antibiotics more than 2 days before going back to school or childcare. When they feel well enough, they can go back to school or childcare.

It’s important to wash your/your child’s hands and anything your child uses for eating and drinking to stop the infection spreading.

For non-urgent medical advice, call 13 HEALTH (13 43 25 84) to speak to a registered nurse 24 hours a day, seven days a week for the cost of a local call.

Ask for an interpreter if you need one.

When to seek help

See your GP if your child:

• is in pain, even though they are taking paracetamol or ibuprofen
• does not want to drink anything
• is not weeing much
• is not getting any better.

In an emergency, call Triple Zero (000) and ask for an ambulance.

If you're not sure whether to go to an emergency department, call 13 HEALTH (13 43 25 84) and speak to a registered nurse.

Developed by Emergency Department, Queensland Children’s Hospital. We acknowledge the input of consumers and carers.

Resource ID: FS355. Reviewed: July 2022.

Disclaimer: This information has been produced by healthcare professionals as a guideline only and is intended to support, not replace, discussion with your child’s doctor or healthcare professionals. Information is updated regularly, so please check you are referring to the most recent version. Seek medical advice, as appropriate, for concerns regarding your child’s health.