3 Things You Should Know About Scarlet Fever

Scarlet fever, also known as scarlatina, is a bacterial infection caused by group A Streptococcus or “group A strep.” This condition generally affects some people who have strep throat or skin infections caused by group A strep. Pharmacists can play an important role in counseling parents on prevention and treatment strategies for scarlet fever. Check out these 3 facts about scarlet fever.

• Scarlet fever is contagious.

Group A strep bacteria can spread from the droplets of an infected person through coughing and sneezing, drinking and eating from a contaminated glass or plate, or coming in contact with sores from skin infections. Anyone can develop scarlet fever, but it usually affects children 5 to 15 years of age.¹ Unfortunately, there is no vaccine to prevent scarlet fever. Counsel patients that prevention is key so they should wash their hands often with soap and water for at least 20 seconds and avoid sharing eating utensils, linens, towels, or other personal items. If soap and water are not available, then an alcohol-based hand sanitizer containing at least 60% alcohol should be used. Children with scarlet fever should stay home from school or daycare for at least 24 hours after starting antibiotics. Let patients know that they can become infected with scarlet fever more than once.

2. Red rash is a classic symptom. The classic symptom of scarlet fever is a red rash that feels like sandpaper which appears 1-2 days after the illness begins and generally lasts for 3-5 days.^1,2 The rash may first emerge on the neck, underarm, and groin regions and then spread over the body. Other symptoms also include a headache, fever, sore throat, swollen tonsils, chills, vomiting, and abdominal pain. The tongue may also have a “strawberry”-like appearance.^1,3 Let parents know to contact their pediatrician if their child has a fever, sore throat, and rash.

3. Treatment with antibiotics is important to prevent complications. Strep tests should be performed to determine whether group A strep is causing the illness. Penicillin or amoxicillin are the drugs of choice for treating group A streptococcal infections. Antibiotic therapy is recommended for 10 to 14 days. First-generation cephalosporins can be used as an alternative therapy as long as patients did not have an anaphylactic reaction to penicillin. Clindamycin or erythromycin are alternative treatments for patients unable to take penicillin or cephalosporins. Educate patients to complete the full antibiotic treatment to prevent resistance and the following long-term health problems:

• Rheumatic fever
• Kidney disease
• Otitis media
• Skin infections
• Throat abscesses
• Pneumonia
• Arthritis

Ibuprofen or acetaminophen can be used to treat fever and pain. Ibuprofen should only be used for children older than 6 months of age. Patients should drink plenty of fluids to keep the throat moist and prevent dehydration. Parents can prepare a saltwater gargle to help ameliorate throat pain. Cool mist humidifiers can help to eliminate dry air that may cause throat irritation.

References

• Scarlet fever: a group A streptococcal infection. CDC website. https://www.cdc.gov/features/scarletfever/index.html. Accessed January 20, 2017.
• Scarlet fever. AAP website. https://www.healthychildren.org/English/health-issues/conditions/skin/Pages/Scarlet-Fever.aspx. Accessed January 21, 2017.
• Scarlet fever. Mayo Clinic website. http://www.mayoclinic.org/diseases-conditions/scarlet-fever/basics/definition/con-20030976. Accessed January 21, 2017.