How to Spot Scarlet Fever | Symptoms to look out for

Scarlet fever is a type of infection, most common in children, caused by a bacteria called Group A Streptococci (Strep A).

What do parents need to look out for?

Scarlet fever usually starts with symptoms commonly related to a cold or the flu; a sore throat, headache, fever and nausea and vomiting. 

After the initial onset of these symptoms, a distinctive rash that has a sandpaper texture usually develops around 12 to 48 hours later.  On white skin the rash looks pink or red, on brown and black skin it may be harder to see a change in colour, but you can still feel the texture of the rash and see raised bumps.

Another characteristic symptom of scarlet fever which may appear is ‘strawberry tongue’. A white coating appears on the tongue, which peels off, and leaves behind a red swollen tongue covered in little bumps.

If your child is experiencing symptoms of scarlet fever, contact 111 or your GP as soon as you can, because early treatment with antibiotics is important to reduce the risk of a more serious infection.

Despite the increase in cases, the risk of this bacteria causing a serious infection remains very low. 

As a parent, if you believe your child is seriously unwell, trust your own judgement and contact your GP straight away, as you know your child better than anyone.

Call 111 or contact your GP if your child:

  • Is getting worse
  • Is not eating as much as normal.
  • Has a dry nappy for more than 12 hours (sign of dehydration).
  • Is hotter than usual to the touch or sweaty.
  • Is very tired or irritable.
  • Is under 3 months old and has a temperature of 38C, or is 3-6 months old and has a temperature of 39C or higher.

Call 999 or go to A&E if your child:

  • Has difficulty breathing or is breathing irregularly
  • Has skin, tongue or lips that are blue/grey - on black or brown skin this may be easier to see on the palms of the hands or soles of the feet.
  • Is floppy and will not wake up or stay awake.


Spread of scarlet fever

Scarlet fever usually lasts around a week, however it is highly contagious and you can spread the bacteria to other people for up to 4 weeks from the initial infection (this can be before symptoms appear). Since it is so contagious, it is important to keep your child away from nursery, school or work, until they have started their course of antibiotics, and for at least 24 hours after you take the first dose. After this time, you are less likely to spread the bacteria to others.

Strep A bacteria is generally passed on through the air, via coughs and sneezes. Some people can carry the bacteria in their body without experiencing any symptoms, but they can still spread the infection.

You can reduce the chance of catching or spreading the infection by:

  • Coughing and sneezing into tissues, and quickly disposing of them.
  • Frequently washing your hands with soap and water.

Written by Charlotte Broadbent. Reviewed by Conor McSorley (2223070)