Scarlet fever once feared as a serious childhood illness is making a quiet comeback in many countries. While less dangerous today thanks to antibiotics, it remains a highly contagious bacterial infection that should never be underestimated.

With its telltale red rash, sore throat, and fever, scarlet fever often strikes quickly and spreads fast especially in schools and daycares. But with early recognition and the right care, children recover fully and quickly.

What Is Scarlet Fever?

Scarlet fever is a bacterial infection caused by group A Streptococcus, the same bacteria responsible for strep throat. It mostly affects children between the ages of 3 and 12, and spreads through droplets from coughing, sneezing, or sharing utensils.

The condition gets its name from the bright red rash that usually appears after a sore throat. Though rare in adults, they can still carry and transmit the bacteria.

While scarlet fever sounds old-fashioned, cases have increased in recent years across Europe and elsewhere reminding us that classic childhood illnesses can still pose modern risks.

How Does Scarlet Fever Start?

The illness usually begins 2 to 5 days after exposure with symptoms similar to strep throat:

• Sudden sore throat 
• Fever (often above 38.5°C / 101.3°F) 
• Headache 
• Swollen lymph nodes in the neck 
• Nausea, vomiting, or abdominal pain (especially in younger children) 

Within 12 to 48 hours, the signature fine, red rash begins starting on the chest or neck and spreading to the rest of the body. It may feel like sandpaper and be accompanied by:

• Flushed cheeks with a pale ring around the mouth 
• A “strawberry tongue” red and bumpy, sometimes coated white 
• Peeling skin on the fingers or toes during recovery 

The rash typically fades within a week, but peeling may continue for several days afterward.

How Is Scarlet Fever Diagnosed?

Diagnosis is typically made through clinical examination, supported by:

• A throat swab to confirm the presence of Streptococcus A 
• A rapid strep test, which delivers results within minutes 
• In rare or complicated cases, additional blood tests may be needed 

Because scarlet fever is bacterial, early treatment is essential to avoid complications.

Is Scarlet Fever Dangerous?

With timely antibiotic treatment, scarlet fever is very manageable. However, if left untreated, it can lead to more serious complications such as:

• Otitis media (middle ear infection) 
• Sinusitis or pneumonia 
• Rheumatic fever, which can affect the heart, joints, and brain 
• Post-streptococcal glomerulonephritis, a kidney inflammation 
• Abscess formation around the tonsils 

That’s why early recognition and completing the full course of antibiotics is critical even if your child starts feeling better after a day or two.

How Is Scarlet Fever Treated?

Standard treatment includes:

• Oral antibiotics, usually penicillin or amoxicillin, taken for 7–10 days 
• Fever and pain relief using paracetamol or ibuprofen 
• Plenty of fluids to soothe the throat and prevent dehydration 
• Soft foods and rest during the acute phase 

Children are usually no longer contagious 24 hours after starting antibiotics, but should still stay home from school or daycare for at least a full day.

How to Protect Other Children

Since scarlet fever spreads easily in group settings, it’s important to take preventive steps:

• Keep your child home until they’ve been on antibiotics for at least 24 hours 
• Wash hands frequently, especially after sneezing or coughing 
• Avoid sharing cups, spoons, or towels during illness 
• Disinfect toys and high-touch surfaces 
• Notify your child’s school or daycare if a diagnosis is confirmed, so they can alert other families 

In some countries, scarlet fever is still a reportable illness especially during outbreaks.

Can You Get Scarlet Fever More Than Once?

Yes. Although many children build immunity after infection, it’s possible to get scarlet fever more than once. Immunity develops only against the specific strain, and there are many variants of group A streptococcus.

If symptoms return after recent infection or a sibling begins to show signs it’s best to see a pediatrician promptly.

Recovery and Reassurance for Parents

For most children, scarlet fever resolves fully with antibiotics and rest. After about a week, energy levels return, the rash fades, and peeling skin may be the last lingering sign. Most kids bounce back quickly and are soon back to their usual routines.

As a parent, it’s natural to feel concerned but with today’s treatment options, scarlet fever is no longer the threat it once was. Still, vigilance is key, especially during flu season or when strep throat is circulating in schools.

Because Some Illnesses Still Deserve Respect

Scarlet fever may not make headlines like it used to, but that doesn’t mean it should be ignored. Prompt recognition, appropriate treatment, and community awareness all play a role in keeping your child and others safe.

If your child develops a sudden sore throat, high fever, or a red rash, the pediatric team at Erdem Hospital is here with fast diagnostics, child-friendly care, and guidance tailored to your family’s needs so you can face classic childhood illnesses with confidence.