Scarlet Fever


Scarlet fever is a very contagious infectious disease in children. It is caused by bacteria. The infection can go away by itself, but sometimes treatment is needed.

Scarlet fever is most common in children between the ages of five and fifteen. Children under six months are usually protected by antibodies transmitted during pregnancy.

Older children and adults rarely get scarlet fever. They get throat flux instead.

Symptoms of scarlet fever

The child gets symptoms of scarlet fever two to four days after being infected.

It is common with one or more of the following symptoms of scarlet fever:

  • The child gets a fever which is usually moderate, but which can be high. The fever lasts from a few days up to a week if left untreated.
  • It hurts the neck, stomach, and head.
  • The child feels sick and sick.
  • The lymph nodes on the outside of the throat can become swollen and feel sore.
  • The tonsils become larger and red. White-yellow warps are formed on the surface of the tonsils.
  • At the beginning of the disease, the tongue gets a yellow-white film. The coating disappears after someday and the tongue instead becomes shiny red, with swollen small raises. It is similar to the surface of a strawberry and is therefore usually called a strawberry tongue. 

Children who have scarlet fever also have symptoms that are clearly visible on the body.

Knotty rashes

Some day after a child gets sick, they get small rashes on the skin. The rash often starts at the armpits and groins and spreads to the stomach and back. Finally, they can cover most of the body, which then turns red. The red tone may be clearer to look at light skin. On darker skin, red skin changes may be more difficult to see.

The rash is like small raises in the skin. It feels stiff when you stroke your hand over your skin.

It is also common with ulcers in the mouth pipes and on the fingers, at the nails.

Red cheeks

The face turns slightly pink, but the skin around the mouth remains pale.

Late symptoms of scarlet fever

Some symptoms of scarlet fever do not appear until a few weeks after scarlet fever erupts.

  • The child may get sore in large joints such as knees and elbows. The pain will disappear by itself within a week.
  • The skin of palms, soles of the feet, fingers, and toes begin to peel. Even the skin on the stomach, chest, and back can start to peel.

When should I seek care?

If you think a child has scarlet fever, contact a  health center or on-call reception. 

If you suspect that a child has had complications due to scarlet fever, contact a health care center or an on-call clinic immediately. Seek care at an emergency room if it is closed at the health center or on-call reception.

How can I prevent scarlet fever?

Weather and wash your hands carefully to prevent the spread of the infection. Figure 1

So does scarlet fever

Scarlet fever is caused by streptococci, which is a highly contagious bacterium. There is no vaccine against scarlet fever.

When a person with scarlet fever sneezes or coughs, droplets containing infectious substances are collected in the air. Then the person who is close can get infected. It’s called drip contamination.

Scarlet fever can also be transmitted through direct contact, for example, through the hands or through hugs and kisses. Children can also be infected if they take in things that the sick person has taken in or turned in. It can be, for example, towels, handkerchiefs, toys, and toys.

Scarlet fever infects from a day before the child becomes ill and several weeks afterward if the child does not receive treatment of scarlet fever. The child does not usually become infected after two days of antibiotic treatment.

Scarlet fever is spread mainly from people who are themselves sick. A child can also carry streptococci and be contagious without being sick. Up to half of the students in a class where scarlet fever occurs can be healthy carriers of infection. 

Children should stay at home

Children who attend school, preschool or open preschool should stay at home until they are fever-free and feel good. They should stay at home for at least two days after starting antibiotic treatment of scarlet fever.


The doctor looks at the throat, tongue, and rash to determine if a child has scarlet fever. The child will usually be told how she feels about herself if she can.

You can also do a so-called quick test, which shows if there are streptococci in the throat. The doctor takes the sample from the pharynx with a small swab of cotton on top and will be ready in minutes. The rapid test is performed at the doctor’s office.

Influence and participate in your care

In order to be able to participate in your care and make decisions, it is important that you understand the information you receive from the healthcare staff. Ask questions if you don’t understand. You can also ask to have the information printed to read it peacefully.

Children should be able to participate 

There is no age limit for when a child can have influence over their care. The child’s ability to participate in related to the child’s maturity.

The older the child, the more important it is for them to be involved in their care. In order to be active in the care and to make decisions, it is important that you as an adult and the child understand the information you receive from the care staff.

Treatment of scarlet fever

Children who have a streptococcal infection are treated with antibiotics. It is important not to stop before the treatment of scarlet fever is complete, even if the child is healthy.

You can give non-prescription drugs if your child has a fever and pain

  • You can give medicines containing paracetamol to children from three months of age. 
  • You can give medicines containing ibuprofen from the age of six months. 

The drugs are available in several different forms that are suitable for children, for example, tablets that melt in the mouth and in liquid form. Ask a pharmacy what is right for your child.

Follow the instructions on the package carefully and do not combine different medicines. Here you can read about combining paracetamol and ibuprofen. 

You can read more about medicine in the package leaflet that comes with the package. You can also look up the drug at and read the package leaflet there.

What happens in the body?

The streptococcus bacteria enter the body through the inhalation air and through contact with infected persons or objects. The bacteria then reach the mucous membranes of the pharynx. They multiply and form a bacterial toxin, which spreads throughout the body with the blood.

The bacteria cause an infection in the tonsils. Then a poison is formed that produces red skin rashes on the body. The tongue also becomes red and bumpy. Antibodies are formed against this bacterial toxin. They prevent you from getting the rash again in a new streptococcal infection. At the next streptococcal infection, throat flux instead.


Most people become healthy when treated with antibiotics. It is unusual to have any complications.


In some single children, the throat infection develops into a more severe infection on one side of the neck. The child can then get more hurt and it becomes harder to swallow and gape. In the end, a collar is formed. Throat needs to be treated by a doctor.


It is unusual but some children may get kidney inflammation. Symptoms of renal inflammation are swollen legs and feet. The symptoms usually come after a week. Kidney inflammation can also be detected by a doctor taking a blood test or a urine test. Renal inflammation usually goes by itself.

Rheumatic fever

An unusual complication of scarlet fever is rheumatic fever. Rheumatic fever shows up a week after the scarlet fever is over and causes the child to have pain in the joints and inflammation of the heart. It can affect the heart valves and cause the child to become tired, short of breath and feel sick. 

The child is treated with antibiotics against the remaining streptococci, and with cortisone to counteract inflammation of the joints and heart. Most people who are treated for rheumatic fever get well in the joints but about half get a heart valve disease in the form of a  constricted mitral valve. 

Leave a Reply