Scarlet fever in children: symptoms and treatment

recognize scarlet fever

Scarlet fever is a bacterial infection that is particularly common in children between the ages of four and twelve. Since babies often have immune protection through their mother’s milk and the antibodies it contains, scarlet fever rarely occurs in them. However, it is not entirely out of the question. According to the Robert Koch Institute (RKI), 1 to 1.5 million people in Germany contract scarlet fever every year. Most often this happens in the cold season, that is, between October and March. During this period, the immune system is particularly susceptible to viruses and bacteria due to the prevailing cold.

Causes of Scarlet Fever

Scarlet fever is caused by streptococci. These are spherical bacteria that form long chains and penetrate the mucous membranes. But by no means all streptococci cause scarlet fever, only a certain subgroup, namely only type A streptococci. These form toxins, so-called toxins, which can trigger the typical scarlet fever symptoms.

Transmission routes of scarlet fever

Due to the high risk of infection, scarlet fever occurs particularly frequently in community facilities such as kindergartens or schools. The period between infection and outbreak of the disease, the so-called incubation period, is two to four days for scarlet fever. This means that the sick person is contagious to others even before the actual onset of the disease. Scarlet fever can basically be transmitted in two ways:

• Droplet infection: Type A streptococci can be transmitted by droplet infection. By sneezing, coughing or speaking, droplets containing bacteria are released into the air, which can enter the human organism via the respiratory tract and settle on the mucous membranes.
• Smear infection: Since type A streptococci can survive outside the body, they can also be transmitted through a smear infection. At this point, a basic distinction is made between primary and secondary smear infection. In a primary smear infection, the bacterium is transmitted through contact with contaminated people or animals. In the case of a secondary smear infection, on the other hand, the streptococci are transmitted through contact with contaminated objects. These can be keyboards, toys or doorknobs, for example.

Symptoms of Scarlet Fever

The toxins contained in the streptococci trigger the classic symptoms of scarlet fever. The most common symptoms are:

• High fever
• Mostly severe sore throat and difficulty swallowing
• Dark Red Revenge
• First whitish coated tongue, later raspberry red (“raspberry tongue”)
• Red, patchy, slightly raised skin rash
• Noticeable pallor around the mouth

course of scarlet fever

Scarlet fever begins with a sore throat, difficulty swallowing, and rapidly rising fever. Some children vomit. The throat is fiery red, sometimes there are yellowish-white dots on the tonsils. The lymph nodes in the neck are severely swollen. The tongue is initially whitish and then takes on a raspberry reddening. Two to three days after the first signs of illness, a skin rash forms with small, closely spaced, slightly raised reddenings reminiscent of velvet. Gradually, the rash spreads all over the body. Since the cheeks are very red, the area around the mouth looks noticeably pale. The rash disappears within a few days. One to three weeks later, the skin peels off, especially on the palms and soles. This can even last up to eight weeks. But don’t let this irritate you: Sometimes the rash from scarlet fever is only mildly pronounced or does not appear even though your child is ill. A child who is not treated with antibiotics or not treated long enough can develop serious heart, kidney or joint diseases two to three weeks after scarlet fever. Caution: Even people who are not sick can pass the bacteria that causes scarlet fever on to others.

Scarlet Fever: When to the doctor?

If your child is suspected of having scarlet fever, you should call a doctor immediately because of the risk of infection. Only take your child to his practice if the doctor explicitly asks you to do so over the phone.

In order to find out whether your child really has scarlet fever, the doctor usually first orders a rapid test to detect type A streptococci. Because other viruses can cause the same symptoms, physical signs alone are not enough to diagnose scarlet fever. If the rapid test is negative, a bacterial culture is usually created. For this purpose, the doctor takes a swab of the tonsils, breeds the bacteria that are on the tonsils and then identifies them under a microscope.

If the doctor really diagnoses scarlet fever in your child, he will prescribe an antibiotic, usually penicillin. Both experts from the Robert Koch Institute (RKI) and the German Society for Pediatric Infectious Diseases (DGPI) generally recommend treating scarlet fever quickly with antibiotics. In this way, possible complications, secondary diseases and the risk of infection are reduced. Because while the risk of infection after treatment with antibiotics is just 48 hours, children whose scarlet fever is not treated with antibiotics are contagious for up to three weeks. But keep in mind that just because your child is on antibiotics and is no longer contagious after 48 hours, that doesn’t mean he’s cured his illness.

What you can do personally with scarlet fever

If your child has scarlet fever, the following tips can help you gently relieve symptoms:

• Bed rest: If your child has scarlet fever, it belongs in bed. It should rest physically and not overexert itself so that it can cure the disease. Sleep is fundamentally important to the recovery process. The following applies: the more sleep, the stronger the immune system. Stress and lack of sleep, on the other hand, only prevent a quick recovery. If your child refuses because he or she may not be able or willing to sleep, at least make sure that their daily routine is as calm and relaxed as possible.
• Drink a lot: Because high fever is a common symptom of scarlet fever, your child should drink as much as possible. The fluid loss caused by the fever should be compensated for by drinking enough water. This is particularly important for babies and children, as their fluid balance is not as stable as that of adults. In addition, the dried-out mucous membranes can be moistened and pathogens can be “washed out”. In general, water, tea, unsweetened juices or chicken soup are particularly suitable for children with scarlet fever.
• Humidity: Scarlet fever occurs mainly in the cold season. Poorly ventilated or overheated rooms can quickly become a problem. Low humidity causes the mucous membranes to dry out quickly. This gives pathogens the best conditions for penetrating the human organism and settling on the mucous membranes there. You can counteract this, for example, by setting up humidifiers or placing a damp towel on the warming radiator.

Home remedies for sore throat in scarlet fever

A sore throat is a common symptom of scarlet fever. If the throat is red, it hurts to swallow. Find out here which home remedies you can use to combat inflammation in the throat.

• Gargling: Gargling can be an effective home remedy for a sore throat. It disinfects the pharynx by dissolving pathogens and flushing them out together with the pharyngeal mucus. Inflammation of the mucous membranes and the associated pain are thus alleviated. In order for your child to gargle, they need a saline solution. You can either buy these at the pharmacy or make them yourself. Simply dissolve half a teaspoon of salt in a cup of warm water. As a first step, your child should take a sip of this solution in their mouth, tilt their head back and gargle for a while. It should then spit out the solution. The application can be repeated three times a day without hesitation.
• Neck wrap: A neck wrap made of quark has a disinfecting and cooling effect and can quickly help your child with a sore throat. To do this, first spread a one centimeter thick layer of quark on the middle of a gauze bandage. Fold the blank sides of the gauze bandage over it and place the gauze bandage around your child’s neck. It is best to secure the wrap with a towel or scarf afterwards. Now let it work overnight.
• Chicken Soup: Chicken soup can be very effective for a sore throat. Due to its healthy ingredients, such as zinc or iron, it has a disinfecting and anti-inflammatory effect on the throat. Apart from that, it keeps your child warm, his mucous membranes moist and can also serve as a hydration to compensate for the dehydration caused by scarlet fever. Find a recipe for chicken soup here and learn how to prepare it step by step.

Home remedies for scarlet fever

Scarlet fever can be accompanied by a high fever. Fever is the body’s natural response to pathogens. Increased temperature activates the body’s own defense cells and kills pathogens. However, it is important to bring the fever down. You can treat your child’s fever with appropriate home remedies.

• Calf wraps: Calf wraps are a tried and tested home remedy for fever. Wet and cool cloths are placed around your child’s lower legs. They are beneficial in case of fever, especially as they achieve a refreshing and cooling effect. The warmth of the body caused by the fever is successfully dissipated by calf wraps. Calf wraps are therefore among the so-called heat-dissipating home remedies. Find out more about using a calf wrap here .
• Vinegar socks: Vinegar socks, also known as vinegar slippers, are basically just a modification of the calf wrap. They have a cooling and heat-dissipating effect on fever. Before actually using the vinegar socks, you should lay out a pad to protect the lying surface. Then mix one liter of water with five tablespoons of vinegar essence. Soak a pair of your child’s cotton socks in it, wring them out and put them on your child. Then you slip another, dry pair of socks over it. The application continues until the inner socks, i.e. the actual vinegar socks, are dry.

prevent scarlet fever

Scarlet fever is caused by type A streptococci. Since there are many subgroups of this type, your child can also get scarlet fever more than once. There is no specific vaccination against scarlet fever. However, a healthy lifestyle and a few hygiene rules can prevent droplet or smear infection with type A streptococci. Find out more in our article “ Hygiene protects your child from infection ”.