The European office of the World Health Organization states that several European countries (including France, Ireland, the Netherlands, Spain, Sweden and the United Kingdom) have recorded an upsurge in infections since September 2022. invasive type A streptococcal infections in children under 10 years of age. Indeed, this bacterium, also called “pyogenic streptococcus”, is the cause of certain widespread benign and non-invasive infections: scarlet fever.
What is scarlet fever?
Scarlet fever is a bacterial infection that usually manifests as typical skin rashes consisting of reddish-pink spots covering the entire body. It affects people who have recently suffered from a sore throat (strep throat) or school sores (impetigo) caused by certain strains of group A strep bacteria.
How common is scarlet fever and who gets it?
Scarlet fever is not as common as it was a century ago, when it was associated with deadly epidemics. The development of antibiotics and their early use in the treatment of streptococcal infections has prevented many cases of scarlet fever and the long-term complication of rheumatic fever.
Scarlet fever mainly appears in children aged 4 to 8 years. By the age of 10, up to 80% of children have developed lifelong protective antibodies against streptococcal toxins, while children under the age of 2 still have acquired maternal anti-xotoxin antibodies.
How do you get scarlet fever?
Group A streptococcal infections that cause scarlet fever are contagious. Strep bacteria can be passed from person to person by breathing in airborne droplets from an infected person’s cough or sneeze. Bacteria can also be passed on by touching the infected skin of someone with a streptococcal skin infection, or by sharing contaminated clothes, towels, or bedding.
To contract scarlet fever, you must still be sensitive to the toxin produced by the streptococcus bacteria. It may therefore happen that two children in the same family both have a streptococcal infection, but only one (who is still sensitive to the toxin) develops scarlet fever. Scarlet fever usually has an incubation period of 1 to 4 days.
Who is at risk for scarlet fever?
People most at risk for scarlet fever are:
- People living in a crowded environment such as boarding schools, day care centers or military camps.
- Children over 3 years old
- people in close contact with someone with angina or a skin infection.
What are the symptoms of scarlet fever?
Scarlet fever often starts with:
- A sudden fever associated with a sore throat.
- Swelling of the neck glands.
- Headaches.
- Nausea.
- Vomitings.
- A loss of appetite.
- A swollen, strawberry-red tongue.
- Abdominal pain.
- Body aches.
- A faintness.
The characteristic rash appears 12 to 48 hours after the onset of fever. The rash usually begins under the ears, neck, chest, armpits and groin before spreading to the rest of the body within 24 hours.
Scarlet spots or pimples, giving the appearance of boiled lobster, are often the first sign of a rash. As the skin lesions progress and spread, they begin to look like sunburn with goosebumps. Skin may feel like rough sandpaper.
In the folds of the body, especially the armpits and elbows, fragile blood vessels (capillaries) can rupture and cause classic red streaks called lines of Pastia. These may persist for 1-2 days after the generalized rash has disappeared.
In the untreated patient, the fever peaks on the second day and gradually returns to normal over 5 to 7 days. When treated with appropriate antibiotics, the fever usually subsides within 12-24 hours.
Around the sixth day of infection, the rash begins to fade and peeling, similar to that of sunburned skin, occurs. Flaking of the skin is most prominent in the armpits, groin and fingertips and/or toes and may continue for up to 6 weeks.
What are the complications of scarlet fever?
Today, scarlet fever infection usually follows a mild course when diagnosed and treated appropriately. However, if left untreated or if treatment fails, the following complications caused by strep infection may occur.
- Rheumatic fever
- otitis media
- Pneumonia
- Sepsis
- Glomerulonephritis
- Osteomyelitis
- Death
Rheumatic fever, which affects the heart, and glomerulonephritis, which affects the kidneys, can cause permanent damage to the body and require long-term treatment.
