Sick childScarlet fever, a leading killer of children in the 19th and early 20th centuries, is making a comeback in parts of the world — catching parents in the U.S. by surprise.

In February, the mother of a sicken 1 year old from Kentucky told FOX19, “I just didn’t know that was a thing that was still around. I thought it was well in the past. I don’t know anyone who’s had it.”

In the 1800s and well into the 1900s, scarlet fever was commonplace. Readers of the children’s novel “Little Women” will remember the tragic death of Beth March, who succumbed to scarlet fever – a fate she shared with the author Louisa May Alcott’s real-life sister, Elizabeth.

Earlier this year, the U.S. Centers for Disease Control and Prevention (CDC) identified scarlet fever as its “Disease of the Week” with the purpose of educating the public about the disease, following confirmed cases in the U.S. in 2018 and 2019. Scarlet fever has been sweeping England, with an estimated 12,000 new cases since September — a 50-year high.

How Do You Get Scarlet Fever?

Scarlet fever is highly contagious and caused by bacteria known as “group A strep.” Group A strep live in the nose and throat and the infection spreads in the saliva droplets coughed and sneezed out by infected individuals. People can get sick if they:

  • Breathe in the droplets
  • Touch something with droplets on it and then touch their mouth or nose
  • Drink from the same glass or eat from the same plate as a sick person
  • Touch sores on the skin caused by group A strep (impetigo)

What to Expect

Scarlet fever is generally a mild infection. It usually takes two to five days for someone exposed to group A strep to become sick. Scarlet fever presents these common symptoms:

  • Very red, sore throat
  • Fever (101 or higher)
  • Whitish coating on the tongue, early in the illness
  • “Strawberry” (red and bumpy) tongue
  • Red skin rash that has a sandpaper feel
  • Bright red skin in the creases of the underarm, elbow, and groin
  • Swollen glands in the neck
  • Other general symptoms may include a headache, body aches, nausea, vomiting, or abdominal pain

The rash (excluding open sores) is not dangerous or contagious and the infection is treated with antibiotics the same way as strep throat. Usually the redness appears on the face, neck and trunk first, but it can also be on the arms and legs and often in the creases of the groin. The rash is caused by a skin toxin from the strep bacteria, but the rash does not need any special treatment.

Once antibiotics are started, the fever and sore throat should resolve within 48 hours, but the rash can take days to fade away. As the rash fades, the skin may peel around the fingertips, toes, and groin area. This peeling can last up to several weeks.

Who is at Risk of Contracting Scarlet Fever?

Anyone can get scarlet fever, but it is most common in children five to 15 years of age. Adults who are at increased risk for scarlet fever include: parents of school-aged children; and adults who are often in contact with children.

If someone has scarlet fever, it often spreads to other people in their household.


Doctors Can Test for and Treat Scarlet Fever

If you notice your child is suffering from these symptoms, call to speak to a doctor right away. Doctors treat scarlet fever with antibiotics, commonly penicillin or amoxicillin. Long-term health problems and complications are rare but can occur after having scarlet fever. Treatment with antibiotics can prevent most of these health problems.

Protect Yourself and Others

People can get scarlet fever more than once. Having scarlet fever does not protect someone from getting it again. There is no vaccine to prevent scarlet fever. But there are things people can do to protect themselves and others.

The best way to keep from getting or spreading group A strep is to wash your hands often. This is especially important after coughing or sneezing, and before preparing or eating foods.

People with scarlet fever should stay home from work, school, or daycare until they no longer have a fever and have taken antibiotics for at least 24 hours. Take the prescriptions exactly as the doctor says. Don’t stop taking the medicine, even if you or your child feels better.


The information on this blog is provided for general information purposes and is not a substitute for professional medical advice, care, treatment or evaluation; nor should it be used in diagnosing a health condition. You are encouraged to consult your health care provider if you or a family member has or suspect you have a medical problem.