By Dr Quince Mwabu

A 10-YEAR-OLD boy brought his mother to the outpatient department with a complaint of sore throats, fever, abdominal pain and nausea.
Her general health has been fine until two days ago. Initially, she noticed pain on swallowing and had a temperature of 38 °C.
Her mother noticed the red rash on her trunk and the inside of her knees. Upon examining her tongue, the enlarged papillae showed “strawberry” like appearance. Her anterior-cervical nodes noted swollen and tender.
Immediately, a rapid streptococcal antigen test was done and results showed a strain of group A Streptococcus
What is Scarlet fever?

Scarlet fever is an illness caused by a bacteria called group A Streptococcus or group A strep. It is also known as scarlatina.
Scarlet fever is almost always accompanied by a sore throat and a high fever and it is common in young ones. Streptococcal bacteria can sometime be toxic; a toxin released by the streptococcal bacteria causes the rash of scarlet fever.

What are signs and symptoms?

The following are some of signs and symptoms;

  1. Dysphagia (difficulty swallowing)
  2. High fever
  3. Red rash
  4. Severe sore throat
  5. Enlarged neck lymph nodes that are tender to the touch

What causes scarlet fever?
Scarlet fever is caused by a group A Streptococcus, the same type of bacteria that cause strep throat. The bacteria release a toxin that produces the rash and red tongue.

How do you get scarlet fever?
The infection is spread from one person to another through breathing in airborne droplets expelled when someone with infection coughs or sneezes, by touching droplets and then touch their mouth or nose, by drinking from the same glass or eat from the same plate as a sick person and by touching sores on the skin caused by group A Streptococcus.
Scarlet fever can also be spread by infected individuals who are carriers of streptococcal bacteria but do not show any symptoms. Research shows that up to 15-20 percent of school-age children are thought to be asymptomatic carriers.
To contract scarlet fever you must still be susceptible to the toxin produced by the streptococcal bacteria. Therefore, it can happen that two children of the same family may both have streptococcal infections, but only one – who is still susceptible to the toxin develops scarlet fever. The incubation period is usually noted between two to four days.

How scarlet fever is

When a doctor takes history and examines you physically and suspects scarlet fever, he/she will request for throat swab culture or rapid streptococcal antigen test to rule out strep infection.

Risk factors
Scarlet fever is more common in children than adults. It is most common in children 5 to 15 years of age. Scarlet fever infection spread more easily among people in close contact, such as family members or classmates.

Scarlet fever if left untreated can cause complications such as Rheumatic fever, Septicemia, Otitis media, Pneumonia, Glomerulonephritis etc.

Once a streptococcal infection is confirmed, a physician will prescribe antibiotics to treat the disease. Take the prescription exactly as the doctor prescribes.
Don’t stop taking the medicine, even if you or your child feels better, unless the doctor says to stop.
Early treatment of scarlet fever is important, both to rectify symptoms and to prevent further spread of infection

Having scarlet fever more than once does not protect you from getting it again in the future. To prevent scarlet fever, practice good hygiene by washing your hands often, especially before eating and before preparing food.
Cover your mouth and nose when coughing and sneezing.

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