Scarlet fever
Scarlet fever, also known as scarlatina, is an acute contagious disease primarily affecting children, caused by a bacterial infection from group A Streptococcus. It typically spreads through respiratory droplets from an infected person's cough or sneeze, with an incubation period of two to four days. Symptoms include a red, sore throat, fever, swollen lymph nodes, and a distinctive red rash that often begins on the chest and spreads to other areas. The face may appear flushed, with a pale area around the mouth, and the tongue often takes on a strawberry-like appearance.
Treatment primarily involves antibiotics, which have significantly reduced the complications associated with the disease. Alongside antibiotics, supportive measures such as hydration and pain relief can aid recovery, which generally occurs within about seven days. Although rare, potential complications can include ear infections and rheumatic fever. While the incidence of scarlet fever declined towards the end of the 20th century, a notable resurgence has been observed since September 2022, prompting discussions among experts regarding possible contributing factors such as environmental influences and herd immunity. Understanding these dynamics is crucial for managing outbreaks and safeguarding children's health.
Scarlet fever
ALSO KNOWN AS: Scarlatina
ANATOMY OR SYSTEM AFFECTED: Immune system, skin
DEFINITION: An acute, contagious childhood disease caused by bacterial infection
CAUSES: Bacterial infection
SYMPTOMS: Sore throat, fever, rash, flushed face (resembling sunburn with goosebumps), pale area around mouth
DURATION: Acute
TREATMENTS: Antibiotics, alleviation of symptoms
Causes and Symptoms
Scarlet fever is caused by a bacterial infection with group A Streptococcus. The bacteria are spread by inhalation of air that has been contaminated by the coughing or sneezing of an infected person. After exposure, the incubation period is between two and four days.
The disease is characterized by a red, sore throat; fever; swollen lymph nodes; and a red, rough rash; it may follow throat infections and, occasionally, wound infection and septicemia (blood poisoning). The face is flushed, resembling sunburn with goosebumps, with a pale area around the mouth. The mucous membranes of the mouth, throat, and tongue become strawberry red. The irritation usually appears first on the upper chest but quickly spreads to the neck, abdomen, legs, and arms.
Treatment and Therapy
Antibiotics have reduced the complications of scarlet fever to a minimum. A strep test, involving a simple swab of the throat, is used to confirm the diagnosis. In mild cases, recovery takes about seven days. To decrease its contagious effect, isolation for the patient for the first twenty-four hours starting antibiotics is recommended. A few days after the body temperature returns to normal, peeling off of the skin takes place at the site of the rash, especially on the hands and feet. The rare complications that might arise include ear infections, rheumatic fever, pneumonia, and kidney inflammation (nephritis). A child with scarlet fever should rest and be given plenty of fluids and antipyretics (fever-reducing agents), such as acetaminophen, to reduce discomfort. A saltwater gargle, lozenges (for children over the age of four), and using a humidifier can help to alleviate the pain of a sore throat. The spread of infection can be greatly reduced with frequent and thorough handwashing and avoiding the shared use of utensils, drinking glasses, and linens.
Perspective and Prospects
Scarlet fever was first clearly distinguished from measles and other rash-producing diseases in 1860. Fifty years later, Russian scientists associated its cause to streptococcus, a hemolytic microorganism (one that destroys red blood cells). In 1924, George and Gladys Dick isolated the rash-causing substance in the medium used to grow hemolytic streptococci. They applied it to susceptible individuals in an attempt to establish immunity in them. Deaths as a result of scarlet fever continued until the development of antibiotics in the 1940s. For an unknown reason, the incidence of the disease had declined drastically by the end of the twentieth century. However, since September 2022, there has been a significant outbreak of scarlet fever among children in Europe as well as documented cases in the United States. Experts are unsure of why this resurgence occurred but theorize that it may have to do with environmental factors, herd immunity, and a lack of a vaccine for group A strep, which causes the disease.
Bibliography
Kliegman, Robert, et al., eds. Nelson Textbook of Pediatrics. 20th ed. 2 vols. Philadelphia: Elsevier, 2015. Print.
Kimball, Chad T. Childhood Diseases and Disorders Sourcebook: Basic Consumer Health Information About Medical Problems Often Encountered in Pre-adolescent Children. Detroit: Omnigraphics, 2003. Print.
Leikin, Jerrold B., and Martin S. Lipsky, eds. American Medical Association Complete Medical Encyclopedia. New York: Random House Reference, 2003. Print.
Papadopol, Raluca. "Scarlet Fever." KidsHealth. Nemours Foundation, Dec. 2014. Web. 2 May 2016.
Prinzi, Andrea. "Scarlet Fever: A Deadly History and How It Prevails." American Society for Microbiology, 24 Jan. 2023, asm.org/Articles/2023/January/Scarlet-Fever-A-Deadly-History-and-How-it-Prevails. Accessed 8 Apr. 2024.
Professional Guide to Diseases. 10th ed. Philadelphia: Lippincott Williams & Wilkins, 2012. Print.
"Scarlet Fever: A Group A Streptococcal Infection." Centers for Disease Control and Prevention. US Dept. of Health and Human Services, 19 Jan. 2016. Web. 2 May 2016.
Woolf, Alan D., et al., eds. The Children’s Hospital Guide to Your Child’s Health and Development. Cambridge, Mass.: Perseus, 2002.