What are the symptoms of scarlet fever?
Scarlet fever starts with a very sore throat and a high temperature (fever). It is often initially put down to tonsillitis. Sometimes at roughly the same time as the sore throat comes on, the tongue goes red, with tiny white spots. This makes it look like a strawberry, hence the name: strawberry tongue. This is pretty typical of scarlet fever.
After the sore throat and whitish tongue comes a red rash on the cheeks, chest and tummy. If you run your hands over the rash on the tummy and chest it feels slightly rough, like fine sandpaper. This is the typical rash of scarlet fever.
By www.badobadop.co.uk (own work) via Wikimedia Commons
After a couple of days the tongue, previously only slightly red with white spots, goes very red and a bit bigger than usual. Some people call this a 'beef tongue'.
By Afag Azizova (own work) via Wikimedia Commons
By this stage, the combination of a sore throat, rough-feeling rash and red tongue makes the diagnosis of scarlet fever fairly obvious to doctors. If left untreated, the rash and sore throat will fade over about 10 days, but the skin sometimes peels (like with sunburn). Not all people with streptococcal infections develop the rash, as some people are not sensitive to the poison (toxin). A mild form of scarlet fever may occur; this is often called scarlatina.
Further reading and references
Scarlet fever: guidance and data; Public Health England
Interim guidelines for the public health management of scarlet fever outbreaks in schools, nurseries and other childcare settings; Public Health England, 2014 (archived content)
Wong S et al; Emerging Microbes and Infections, Nature.com, 2012
Feverish illness in children - Assessment and initial management in children younger than 5 years; NICE Guideline (Updated August 2017)
Scarlet fever; NICE CKS, May 2010
No authors listed; Varicella, herpes zoster and nonsteroidal anti-inflammatory drugs: serious Prescrire Int. 2010 Apr19(106):72-3.
No authors listed; Sixty seconds on . . . scarlet fever. BMJ. 2016 Mar 23352:i1658. doi: 10.1136/bmj.i1658.
My son who will be 3 in April has been on antibiotics (not penicillin as his allergic). He also has asthma. His diagnosis GP- after noticing the rash 2 days prior is German measles. He however has...c30262
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