Is Scarlet fever contagious?

Is Scarlet Fever Contagious?

Yes, scarlet fever is highly contagious and spreads primarily through respiratory droplets and direct contact with infected individuals. 1

Transmission of Scarlet Fever

• Scarlet fever is caused by group A streptococcal bacteria (Streptococcus pyogenes) and is transmitted mainly through direct contact with saliva and nasal fluids of infected people 1
• The disease spreads through respiratory droplets when an infected person coughs or sneezes 2
• Transmission can also occur through contact with contaminated objects or surfaces 2
• Scarlet fever can spread easily in crowded settings such as schools, kindergartens, and other community environments 1
• The disease can also arise from streptococcal wound infections or burns in some cases 1

Contagious Period and Infection Control

• Patients with scarlet fever should be isolated for a minimum of 24 hours after beginning effective antibiotic therapy 2
• In healthcare settings, healthcare workers must use personal protective equipment including disposable gloves and aprons when in contact with infected patients 2
• Facial protection such as fluid-repellent surgical masks may be necessary when there is risk of droplet transmission 2
• Strict hand hygiene practices are essential for preventing the spread of infection 2

High-Risk Populations

• Scarlet fever most commonly affects children aged 5-15 years 1
• However, it can affect people of any age group, though it's primarily considered a pediatric illness 3
• Outbreaks can occur in schools, with transmission particularly high among younger pupils 4
• Significant transmission can also occur between siblings within households 4

Clinical Presentation and Diagnosis

• Classic symptoms include sore throat, high fever, and a distinctive sandpaper-like papular skin rash 1
• Oral manifestations include "strawberry tongue" or "raspberry tongue" which may be first noted by oral health professionals 5
• The disease can present with diverse symptoms, making diagnosis challenging in some cases 3
• Early diagnosis is crucial to prevent complications and limit spread 5

Prevention and Management

• No vaccine is currently available to prevent scarlet fever 1
• Prompt antibiotic treatment (typically phenoxymethylpenicillin/Penicillin V) is essential to:
  • Reduce the risk of complications 6
  • Prevent the spread of infection to others 6
  • Shorten the duration of illness 5
• Patients should be excluded from school or work for 24 hours after starting appropriate antibiotic treatment 2
• Environmental cleaning and proper handling of contaminated materials are important control measures 2

Potential Complications if Untreated

• Acute rheumatic fever 1
• Glomerulonephritis 1
• Bacteremia 1
• Pneumonia 1
• Endocarditis 1
• Meningitis 1

Important Considerations for Outbreak Management

• Outbreaks can be prolonged and difficult to control, as seen in a primary school outbreak where 45% of pupils were affected over a 4-week period 4
• Standard control measures such as hygiene advice and 24-hour exclusion while initiating antibiotic treatment may not always be effective in outbreak situations 4
• There is a need for evidence-based approaches to outbreak management 4