Scarlet Fever - Causes, Symptoms and Treatment

Philippines has been alarmed about this Scarlet Fever which recently Hong Kong declared its outbreak after two children died and cases have reached 459. China and Macau have also reported 9,000 and 49 scarlet fever cases, respectively

The Department of Health (DOH) is reminding pediatricians in the country to be on alert for scarlet fever. "Para sa mga pedia, inaabisuhan namin sila na mag-report agad kung kayo po ay tumitingin ng 10 taong gulang pababa na may sintomas ng scarlet fever," said Dr. Eric Tayag, director of the DOH's National Epidemiology Center.

The DOH has not received any reports of any Filipino infected with scarlet fever so far.  Despite the scarlet fever outbreak in the former Crown colony, the DOH is not issuing any travel advisory telling Filipinos not to go to Hong Kong.

Scarlet fever is a disease caused by infection with the group A Streptococcus bacteria (the same bacteria that causes strep throat).


Scarlet fever was once a very serious childhood disease, but now is easily treatable. It is caused by the streptococcal bacteria, which produce a toxin that leads to the hallmark red rash of the illness.
The main risk factor is infection with the bacteria that causes strep throat. A history of strep throat or scarlet fever in the community, neighborhood, or school may increase the risk of infection.


The time between becoming infected and having symptoms is short, generally 1 - 2 days. The illness typically begins with a fever and sore throat.
The rash usually first appears on the neck and chest, then spreads over the body. It is described as "sandpapery" in feel. The texture of the rash is more important than the appearance in confirming the diagnosis. The rash can last for more than a week. As the rash fades, peeling (desquamation) may occur around the fingertips, toes, and groin area.
Other symptoms include:
  • Abdominal pain
  • Bright red color in the creases of the underarm and groin (Pastia's lines)
  • Chills
  • Fever
  • General discomfort (malaise)
  • Headache
  • Muscle aches
  • Sore throat
  • Swollen, red tongue (strawberry tongue)
  • Vomiting

Exams and Tests

  • Physical examination
  • Throat culture positive for group A strep
  • Rapid antigen detection (throat swab)


Antibiotics are used to kill the bacteria that causes the throat infection. This is crucial to prevent rheumatic fever, a serious complication of strep throat and scarlet fever.

Outlook (Prognosis)

With proper antibiotic treatment, the symptoms of scarlet fever should get better quickly. However, the rash can last for up to 2 - 3 weeks before it fully goes away.

Possible Complications

Complications are rare with the right treatment, but can include:
  • Acute rheumatic fever
  • Bone or joint problems (osteomyelitis or arthritis)
  • Ear infection (otitis media)
  • Inflammation of a gland (adenitis) or abscess
  • Kidney damage (glomerulonephritis)
  • Liver damage (hepatitis)
  • Meningitis
  • Pneumonia
  • Sinusitis

When to Contact a Medical Professional

Call your health care provider if:
  • You develop symptoms of scarlet fever
  • Your symptoms do not go away 24 hours after beginning antibiotic treatment
  • You develop new symptoms


Bacteria are spread by direct contact with infected people, or by droplets exhaled by an infected person. Avoid contact with infected people.

Alternative Names



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