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Scarlet Fever

By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

Scarlet fever consists of tonsillitis, a rash and raspberry tongue. The child can only have the rash once in a lifetime. Scarlet fever begins with sudden high fever, sharp pains in the throat and a rash. The rash is red and starts in the face later spreading down onto the rest of the body. Scarlet fever can be treated with penicillin. If the child is drowsy or its general condition is affected you must contact a doctor immediately.

Scarlet fever consists of tonsillitis, a rash and raspberry tongue.

The inflammation in the throat is caused by a certain bacteria (streptococcus) that forms a certain poison. It is this poison that causes the rash. Because the body forms its own antibodies against the poison you only have the rash once in a lifetime, but the child may have repeating cases of tonsillitis.

The tonsillitis strikes like a bolt from the blue with sharp pains in the throat, fever (39-40ºC), headache and general discomfort – the child feels very ill. Several swollen and sore glands appear– right below the jaw – on the neck at first. If you look down the throat you will find the tonsils enhanced in size and crimson red with a grey-white coating.

The rash begins in the face. The skin turns red, except from the area surrounding the mouth which is entirely pale. After a few hours the rash will spread to the neck, chest, back, arms and legs. The rash is most visible in the groin area, on the elbows and in the hollow of the knee and is very red. At closer inspection, small, wide red spots appears that are more easily felt than seen. If you move your hand over the rash it will feel like ‘goose bumps’. When the temperature gets closer to normal – in the course of a week – the skin will flake off in large flakes.

The raspberry tongue is typical for scarlet fever. The tongue is red with swollen spots and looks like the surface of a raspberry. Raspberry tongue appears four days after the illness has begun.

In the old days scarlet fever was a serious illness, but not anymore. In very rare cases damage to the kidneys or rheumatic fever can follow scarlet fever – but it is very rare.

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Scarlet fever infects through the air via saliva, but also through objects the child has touched like toys and doorknobs.

Day Care:
The child can attend day care when it has been treated with penicillin for 2 days. The child must be free of fever,


Scarlet fever must be treated with penicillin.

What can you do?

If the child does not want to eat because of the pains in the throat it should not be forced. Cold and warm drinks can soothe the pain. It can also help to raise the bedhead 15-20cm with bricks or books so the child’s head will be elevated when it sleeps.

You can minister painkillers to ease the pain in the throat – remember that children under two years of age should not be medicated without the directions of a doctor. In the case of high fever, the child should be undressed and encouraged to intake lots of fluid.

Contact the doctor tomorrow

If you suspect scarlet fever.

Contact the doctor immediately

If the child is drowsy (lies completely still in bed and does not want to hear stories or play).