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What should I do if my child has scarlet fever?
Scarlet fever is a contagious bacterial infection that mostly affects young children and is easily treated with antibiotics.
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What it is
Scarlet fever is a contagious infection that mostly affects young children [1]. It is easily treated with antibiotics [1]. A rash of small, raised bumps that feels rough, like sandpaper, could be scarlet fever [8]. A GP can often diagnose scarlet fever by looking at your child’s tongue and rash [1]. Sometimes they may wipe a cotton bud around the back of the throat to test for bacteria or arrange a blood test [1].
Scarlet fever lasts for around 1 week [3]. Complications are rare but can happen during or in the weeks after the infection [2]. These can include ear infection, throat abscess, sinusitis, pneumonia, meningitis, and rheumatic fever [2]. Thanks to antibiotics, serious illness is less common than it used to be and easier to treat [2].
What you can do at home
If you think your child has scarlet fever, speak to a GP [8]. A GP will prescribe antibiotics [4]. Antibiotics will help your child get better quicker, reduce the chance of a serious illness such as pneumonia, and make it less likely that they will pass the infection on to someone else [4].
While taking antibiotics, you can help relieve symptoms by:
- Drinking cool fluids [5]
- Eating soft foods if there is a sore throat [5]
- Taking painkillers like paracetamol to bring down a high temperature (do not give aspirin to children under 16) [5]
- Using calamine lotion or antihistamine tablets to ease itching [5]
Keep giving the antibiotics until they are finished, even if your child feels better [4].
To avoid spreading scarlet fever:
- Stay off nursery or school until 24 hours after the first dose of antibiotics [6]
- Wash hands often with soap and water [6]
- Use tissues to trap germs from coughs or sneezes [6]
- Bin used tissues as quickly as possible [6]
- Do not share cutlery, cups, towels, clothes, bedding, or baths with anyone else [6]
If you do not take antibiotics, you can spread the infection for 2 to 3 weeks after symptoms start [3]. Stay away from nursery, school, or work for 24 hours after the first dose of antibiotics [3].
When to see a doctor or go to the emergency department
Trust your judgement if your child seems seriously unwell [9]. Call your emergency number or go to the emergency department now if your child is unwell with a rash and has any of these symptoms:
- A stiff neck [9]
- Bothered by light [9]
- They seem confused, agitated, or not responding like they usually do [9]
- Difficulty breathing, breathlessness, or breathing very fast (you may notice grunting noises or their tummy sucking under their ribs) [9]
- Their skin, lips, or tongue look pale, blue, grey, or blotchy [9]
- Sudden swelling of their lips, mouth, throat, or tongue [9]
- Their throat feels tight or they are struggling to swallow [9]
- The rash looks like small bruises or bleeding under the skin and does not fade when you press a glass against it [9]
On brown and black skin, it may be easier to see the rash or colour changes on the soles of the feet, palms, lips, tongue, and inside the eyelids [9]. Do not drive to the emergency department. Ask someone to drive you or call your emergency number for an ambulance [9]. Bring any medicines your child takes with you [9].
Common questions
Can scarlet fever harm my baby during pregnancy? There is no evidence to suggest that getting scarlet fever during pregnancy will harm your baby [7]. But it can make you feel unwell, so it is best to avoid close contact with anyone who has it [7]. Contact a GP if you get symptoms [7]. Many of the antibiotics used for scarlet fever can be taken during pregnancy [7].
How long is my child contagious? Your child can spread scarlet fever to other people until 24 hours after they take their first dose of antibiotics [3]. If they do not take antibiotics, they can spread the infection for 2 to 3 weeks after symptoms start [3].
Sources
[1] NHS — “Scarlet fever” (2024), section “Scarlet fever”, p. 1 — https://www.nhs.uk/conditions/scarlet-fever/ [2] NHS — “Scarlet fever” (2024), section “Complications of scarlet fever”, p. 1 — https://www.nhs.uk/conditions/scarlet-fever/ [3] NHS — “Scarlet fever” (2024), section “How long scarlet fever lasts”, p. 1 — https://www.nhs.uk/conditions/scarlet-fever/ [4] NHS — “Scarlet fever” (2024), section “Treating scarlet fever”, p. 1 — https://www.nhs.uk/conditions/scarlet-fever/ [5] NHS — “Scarlet fever” (2024), section “Things you can do yourself to help scarlet fever”, p. 1 — https://www.nhs.uk/conditions/scarlet-fever/ [6] NHS — “Scarlet fever” (2024), section “How to avoid spreading scarlet fever”, p. 1 — https://www.nhs.uk/conditions/scarlet-fever/ [7] NHS — “Scarlet fever” (2024), section “Pregnancy advice”, p. 1 — https://www.nhs.uk/conditions/scarlet-fever/ [8] NHS — “Rashes in babies and children” (2024), section “How to treat hand, foot and mouth disease yourself”, p. 1 — https://www.nhs.uk/conditions/rashes-babies-and-children/ [9] NHS — “Rashes in babies and children” (2024), section “Rashes in babies and children”, p. 1 — https://www.nhs.uk/conditions/rashes-babies-and-children/
This guide summarises published paediatric guidelines. It is not medical advice and does not replace your paediatrician. In an emergency, call your local emergency number.
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