Scarlet on the tongue

Scarlet fever is an infectious disease that mainly affects children between the ages of four and seven years. However, it can also occur in adulthood. There is no vaccination against scarlet fever and the disease can occur more than once in a lifetime.

The infection is caused by bacteria called beta-hemolysing streptococci, which belong to the Lancefield group A. If these bacteria possess specialized viruses, so-called bacteriophages, the full clinical picture occurs because the bacteriophages produce a scarlet toxin. If the bacteria have no specialized viruses, the full clinical picture does not occur, but “only” a purulent tonsillitis.

The specialized viruses alone have no disease value. The infection occurs via droplet infection, smear infection, mouth and throat contact. The bacteria can therefore be transmitted by sneezing, coughing and speaking.

However, they can also enter the body through open wounds and cause wound scarlet fever. There are also carriers who do not fall ill themselves, but can transmit the disease. The disease can occur several times in life because there are different types of specialized viruses.

Since scarlet fever is a disease caused by bacteria (streptococci), a sick child is treated with an antibiotic. The antibiotic penicillin is most effective against streptococci. This antibiotic damages the cell wall of the streptococci and thus destroys them.

If, for example, there is an intolerance to penicillin, there are other effective antibiotics (cephalosporins, macrolides). The therapy of scarlet fever with penicillin lasts 10 days and should not be terminated earlier either, otherwise the risk that the child develops a secondary disease (rheumatic fever, glomerulonephritis) is increased. After 1-2 days of medication the fever should have dropped and the child should feel much better. If this is the case, the child can go back to public institutions such as kindergarten or school 48 hours after the beginning of the therapy, as it is no longer contagious now.

Incubation period

Scarlet fever is a highly contagious but not dangerous disease. It is hardly possible to protect siblings from the disease, as the incubation period is a few days. The incubation period is the time between infection and outbreak of a disease.

The incubation period of scarlet fever is about two to four days, depending on the literature. After that the first symptoms appear. These include fever, chills, sore throat and skin rashes.

Most commonly affected are children of kindergarten and school age, i.e. between four and seven years of age. Without treatment, children and adults are contagious for up to three weeks. In the case of severe scarlet fever, the risk of infection can increase or even last longer.

If antibiotic therapy begins shortly after the onset of the disease, the risk of infection is reduced to about one to two days. There is no vaccination against scarlet fever because the bacteria that causes it (Streptococcus pyogenes) occurs in too many different variants. Long-term medication to prevent a new illness (reinfection prophylaxis) is only necessary if the child has developed rheumatic fever. The affected child must then take penicillin in low doses over a period of at least 5 years. In order not to overlook a late pathological change in the kidneys (glomerulonephritis), the urine of a child with scarlet fever should be checked by a pediatrician 2 weeks after the onset of the disease.