Can you get scarlet fever more than once? What’s the difference to Strep A, are symptoms same, what’s the link

Cases of Strep A infection in children are on the rise in the UK. Strep A, which refers to Group A Streptococcus (GAS), is the name given to a type of bacteria sometimes found in the throat or on the skin.

It usually causes mild illnesses such as a sore throat, but can cause other infections such as pneumonia and scarlet fever. But what is scarlet fever and what are the symptoms to look out for? Here’s what you need to know.

How does Strep A differ from scarlet fever?

Strep A can cause other infections such as scarlet fever. Strep A can also cause throat infection or skin infections such as cellulitis or impetigo.

What are the symptoms of scarlet fever?

The first signs of scarlet fever can be flu-like symptoms, including a high temperature, a sore throat and swollen neck glands (a large lump on the side of your neck).

A rash then appears 12 to 48 hours later, which looks and feels like small, raised bumps and starts on the chest and tummy before spreading. The rash makes your skin feel rough, like sandpaper. The rash does not appear on the face, but the cheeks can look red.

A white coating also appears on the tongue, which then peels and leaves the tongue red, swollen and covered in little bumps. It’s sometimes referred to as “strawberry tongue”.

Complications from scarlet fever are rare, but they can happen during or in the weeks after the infection, and can include:

• ear infection
• throat abscess
• sinusitis
• pneumonia
• meningitis
• rheumatic fever

The NHS said the symptoms of scarlet fever are the same for children and adults, although “scarlet fever is less common in adults”. You can get scarlet fever more than once.

Strep A can cause throat infection, scarlet fever or skin infections which are usually treated with antibiotics, but very rarely it can cause severe illness when the bacteria get into parts of the body that are usually free from bacteria such as the lungs, blood or muscles. This is called invasive Group A Streptococcal disease.

The symptoms of invasive disease can include: :

• fever (a high temperature above 38°C (100.4°F)
• severe muscle aches
• localised muscle tenderness
• redness at the site of a wound

Does scarlet fever spread easily?

Scarlet fever is very infectious and can easily spread to other people. It lasts for around one week, but you can spread scarlet fever to other people up to six days before you get symptoms until 24 hours after you take your first dose of antibiotics.

If you do not take antibiotics, you can spread the infection for two to three weeks after your symptoms start. If you or your child has scarlet fever, you should stay away from nursery, school or work for 24 hours after you take the first dose of antibiotics.

When should I see a GP?

You should see a GP if you or your child:

• have scarlet fever symptoms
• do not get better in a week (after seeing a GP)
• have scarlet fever and chickenpox at the same time
• are ill again, weeks after scarlet fever got better – this can be a sign of a complication, such as rheumatic fever
• are feeling unwell and have been in contact with someone who has scarlet fever

Is scarlet fever easily spread?

Scarlet fever is very easily spread so you should check with a GP before you go in. They may suggest a phone consultation.

To reduce the chance of spreading scarlet fever you should:

• wash your hands often with soap and water
• use tissues to trap germs from coughs or sneezes
• bin used tissues as quickly as possible
• avoid sharing cutlery, cups, towels, clothes, bedding or baths with anyone who has symptoms of scarlet fever

How is scarlet fever diagnosed?

GPs can often diagnose scarlet fever by looking at your tongue and rash.

Sometimes they may:

• wipe a cotton bud around the back of your throat to test for bacteria
• arrange a blood test

How is scarlet fever treated?

A GP will prescribe antibiotics, which will:

• help you get better quicker
• reduce the chance of a serious illnesses, such as pneumonia
• make it less likely that you’ll pass the infection on to someone else

You can also relieve symptoms of scarlet fever by:

• drinking cool fluids
• eating soft foods if you have a sore throat
• taking painkillers like paracetamol to bring down a high temperature (do not give aspirin to children under 16)
• using calamine lotion or antihistamine tablets to ease itching