Nurse's News: Scarlet Fever

 

Scarlet Fever is one of the common contagious childhood diseases occurring in school aged children. It is caused by the bacteria known as Group A Streptococcus which is most often responsible for Strep Throat. This germ produces a toxin which causes the typical scarlatiniform rash. Most cases are mild, lasting a few days; however, left untreated severe cases with complications may occur.

Symptoms

• Sudden onset of fever 101 degrees or higher, orally, is most commonly present, although not always
• A flaming red throat, enlarged tonsils with a thin layer of pus
• Child complains of "painful swallowing" as well as nausea and vomiting in some cases
  a fine, lacy type rash more often felt than seen (like sandpaper) appears most often on neck, chest, folds under arms. elbow and groin. Usually, rash does not involve the face although there is a flushing of the cheeks.

Infectious Period
Children are most contagious one or two days before the rash breaks out and for an additional four to five days after- until fever subsides and treatment has been implemented. The incubation period is two to five days, but most commonly one to three days.

How Transmitted
Scarlet Fever is communicated through respiratory transmission between individuals in close contact. It occurs most frequently in winter and spring because of the close contact indoors and in schools.

Treatment
Throat Culture is the most satisfactory method of confirming streptoccal infection. The child will then be prescribed an antibiotic for 10 days. It is extremely important that all of the antibiotic be taken as directed regardless of how well the child feels. This will prevent relapse and/or complications. The physician will discuss with the parents the need to culture family members. Classmates without symptoms are not routinely cultured.

Returning to School
Children may return to school when they have completed at least 24 hours worth of medication and have been fever free (without needing Tylenol). Close contact with other children should be avoided until that time. Should parents have any further questions or specific concerns they are encouraged to contact their child's physician for personal advice.

Source: Red Book: Report of the Committee on Infectious Diseases, American Academy of Pediatrics