Scarlet fever is a bacterial infection caused by streptococci, group A beta-hemolytic streptococcus. It is mostly seen in children aged 3 to 10 years. Once it enters the body, these bacteria produce toxins that are harmful to the body, causing a series of specific symptoms for one to two weeks.
Scarlet fever long remained a fatal childhood disease, declining and almost disappearing in Europe in the 1940s due to the widespread use of antibiotic treatment. But in the last twenty years, a resurgence of cases has been reported in some countries. In 2018, the United Kingdom was concerned about 31,000 sick people. Last year, France reported the highest number of cases in six years.
Several hypotheses are put forward by doctors to explain this revival. Among them, the chronic shortage of amoxicillin (the most effective antibiotic treatment for treating scarlet fever). This lack sometimes forces patients to be treated with alternative molecules, which will not slow down the infection as much. Faced with an increase in cases last year, Public Health France noted that the exacerbation of other viral epidemics (flu, gastro, etc.) could also “result in the risk of invasive bacterial infections” in children.
The concept of “immune debt” is sometimes mentioned. These include delayed immunity in children who have experienced successive confinements linked to the Covid-19 pandemic, who have not developed sufficient antibodies during this period, and who have become more ill. But this theory has not been tested and is widely debated, even questioned, by part of the scientific community.
Scarlet fever, a smooth throat with rash? In fact, it is a little more than that… Generally, the symptoms of scarlet fever are as follows:
Angina, yes. The throat becomes red and swollen, it becomes difficult to swallow, the tonsils and lymph nodes in the throat are swollen.
high fever Scarlet fever is usually accompanied by a fever above 38.5 degrees Celsius, causing extreme fatigue and chills.
rashes. Red, rough patches appear on the body, usually 24 to 48 hours after the onset of angina symptoms. They may be more obvious in skin folds.
Raspberry tongue. One of the typical symptoms of scarlet fever is damage to the tongue. After being covered with a white coating, it becomes painful, rough and raspberry colored.
Headache, stomach ache and nausea can also occur along with this illness.
Scarlet fever is contagious. It can be transmitted through direct contact with an infected person, through respiratory droplets expelled by coughing or sneezing, but also through contact with contaminated objects (door handles, toys or utensils) and then touching their face, especially the mouth, nose or the eyes
Some people can carry the bacteria without showing obvious symptoms, but can still pass scarlet fever to others.
The incubation period for scarlet fever, the period between exposure to the bacteria and the appearance of the first symptoms, is usually 2 to 4 days, although it can vary. During this period, the sick person is already contagious.
Since scarlet fever is a bacterial disease, it can be treated with antibiotic treatment. If scarlet fever is suspected, the doctor may perform a rapid diagnostic test for angina (trod angina), to confirm the bacterial origin. The test involves taking a small sample of saliva from the tonsils, and results are available within seconds.
If the diagnosis is confirmed, the doctor will usually prescribe amoxicillin (penicillin family) for 6 days. In case of allergy or shortage (the amoxicillin market is regularly under pressure in recent years), some other molecules can replace it. In all cases, carefully observe the rules regarding taking the drugs and the recommended duration of treatment.
Additionally, the doctor may prescribe an analgesic or antipyretic, usually paracetamol, for fever and pain to limit symptoms.
In addition to these medications, to limit your sick child’s discomfort, you can:
Encourage him to rest and stay indoors
Drink it regularly to avoid dehydration (but beware of acidic fruit juices that aggravate sore throats
Feed him soft food several times a day, especially cold (compotes, yogurt, ice cream) in small amounts.
Keep the ambient air slightly moist as dry air irritates the throat
Avoid loading the air with various pollutants (cigarettes, perfumes, household products, candles) as they irritate the throat.
Finally, if the rash is itchy, always consult a healthcare professional before applying any cream to the skin, especially on a baby.
Preventive gestures and simple hygiene measures can help prevent the transmission of scarlet fever, but also many other diseases. Wash your hands frequently, avoid close contact with sick people, cover your mouth and nose when sneezing, and regularly clean frequently touched surfaces such as kitchen handles to reduce the risk of transmission through objects. Doors, toys and switches, contamination to reduce risk.
Yes. Scarlet fever is one of the infectious diseases for which evacuation from the community is officially requested (according to the Inter-Ministerial Decree of May 3, 1989). If your child has scarlet fever, he or she may not attend school or daycare for at least two days after starting treatment, the duration of the infection period. And if the law does not systematically require prolonged expulsion, symptoms, especially high fever and difficulty swallowing (and therefore eating), sometimes require a child to remain at home for a longer period of time.
Scarlet fever most commonly occurs in children between the ages of 5 and 10, with the youngest children receiving antibodies from their mothers transmitted during pregnancy. When they are exposed to scarlet fever streptococcus, they develop the disease by making their own antibodies.
According to Health Insurance, in France, by age 10, about 80% of individuals have produced antibodies that will make them immune to scarlet fever in the future. So this disease rarely affects adults, but it is not impossible. Indeed, the disease often results from infection with a specific strain, so if a person is infected with another strain, they can potentially develop scarlet fever again.
And be careful, even if a person is already infected with scarlet fever, they are not necessarily immune to other types of infections caused by group A streptococcus, including streptococcal pharyngitis (throat infection). Scarlet fever is only one manifestation of streptococcal infection, but this bacteria can cause many other illnesses.
Most of the time, people infected as adults are professionals working in communities (nurseries, schools, hospitals) or medical laboratories, often exposed to the bacteria.
While scarlet fever has long been a fatal childhood illness, today, with proper treatment, it usually resolves within a few days, and complications are rare.
The usual symptoms (pain and fever) usually disappear after a week, as does the unusual color of the tongue. The skin rash is followed by desquamation (the peeling of the skin in large pieces), before disappearing after a fortnight.
However, if normal symptoms persist, fever disappears or new symptoms appear, health insurance advises to consult a doctor again.
Complications from scarlet fever are rare but possible. They are mostly seen in patients with a mild form, which are not detected, or late, but in fragile people, suffering from a chronic illness or undergoing treatment. The infection can then spread to the lymph nodes (cervical lymphadenitis), ears (otitis), sinuses (sinusitis), lungs (pneumonia) or kidneys (acute glomerulonephritis). These patients can also be affected by joint pain and arthritis, which can affect the heart, so it is important to consult a doctor as soon as unusual symptoms appear.
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