Scarlet Fever

 

Case definition:

Clinical symptoms of pharyngitis and fever and at least one characteristic sign of scarlet fever:

 

• Blanching punctate erythemathous rash giving a sand paper like texture to the touch and predominantly truncal indistribution. The rash spares the palms and soles. Rash develops within 1-2 days of onset of symptoms and may include the axillae and groins.
• Strawberry tongue;
• Flushing of the cheeks with pallor around the mouth;
• Desquamation of the skin in convalescence including feet and hands.

 

Headache, nausea, vomiting, abdominal pain, lymphadenopathy (neck) and an initial white coating of the tongue may also be present.

 

Susceptible age group: mostly affects 4 – 8year olds.

 

Transmission: respiratory droplet spread by sneezing and coughing. Salivary transmission is an important mode of spread including, spread through inanimate objects such as toys, rulers, pencils and pens contaminated with mouth secretions.

 

Incubation period: 1-5 days

 

Transmissibility: untreated 10 – 21 days. Treated within 24-48 hours.

 

Tests: throat swab prior to starting antibiotics.

 

Treatment: penicillin or equivalent for 10 days.

 

Preventive measures:

 

• Keep child at home for 5 days from the start of antibiotics;
• Kindergarten schools are advised to wash toys with soap and water and dry well;
• Desks should be cleaned in a similar manner or with disposable alcohol wipes;
• Eating and drinking utensils should not be shared!
• Frequent and proper hand washing is the single most important preventive measure, including after coughing and sneezing.