SCARLET: contagion, incubation and symptoms in children, adults and pregnant women

There scarlet fever it is an acute infectious disease typical of the pediatric age. It is on average contagious and has quite important symptoms with temperature high and debilitating and a typical skin rash with red spots on the trunk and face, however if it is taken early it does not cause major complications or suffering to the child. It is caused by infection by a fairly common bacterium, lo Beta-hemolytic streptococcus of group TO, and its treatment involves taking a course of antibiotic therapy. Particular attention must be paid to women in pregnancy, given the possible development of malformations in the fetus.

Scarlet fever

What is scarlet fever? There scarlet fever it is an acute infectious disease typical of the pediatric age. It is on average contagious and has quite important symptoms with a high and debilitating fever, however if it is taken in time it does not cause major complications or suffering to the child. Although it is a exanthematous disease being part of the group of typical pathologies of childhood among which we remember for example chicken pox, rubella or measles, scarlet fever is the only one of this group not determined by a virus, but by a specific bacterium, the Streptococcus Group A beta-hemolytic (scientific name Streptococcus Pyogenes). Obviously, although it is widespread above all among children, as with other exanthematous diseases, this does not exclude that it is possible to take it even in adulthood, with symptoms certainly a little different but no less serious.

Lstreptococcal infection it also has considerable differences from the more common infections of viral origin. In fact, while these are usually taken only once in life (after taking them, the human body develops the antibodies necessary to fight them, thus avoiding a relapse), the scarlet fever (in English scarlet fever) can be taken several times during infancy. This happens because, although specific antibodies are activated in the child's body to fight streptococcal infection, the coverage they guarantee is not total. The most affected age group ranges from approximately three to ten years of age and unfortunately, also due to the possibility of relapses, there is no specific vaccine, even if it is a disease that responds very well to antibiotic treatments.

Cause of scarlet fever: incubation and contagion

How is scarlet fever taken? Although scarlet fever is definitely less contagious compared to other exanthematous diseases such as measles (and for this reason also a little less widespread), it is transmitted rather easily by air or by direct contact with the secretions of the sick person, or mucus or saliva. And mucus and saliva always determine the passage of the bacterium from one organism to another, since by air diffusion we mean breathing and the exchange of infected droplets emitted while talking, sneezing or coughing.

How do you get infected with scarlet fever? How is it transmitted? In order to transmit scarlet fever, it is not necessary to present the typical symptoms of the disease, nor does the infection need to be active: in fact, the so-called healthy carriers, or individuals who host the Streptococcus in their organism, are also transmitting the bacterium. Group A beta-hemolytic without this having triggered the disease and related symptoms. Hence the phenomenon of scarlet fever without fever, a condition that favors the uncertainty of the diagnosis, making it possible to confuse the infection with other pathologies with rather similar symptoms.

Picture of a newborn with scarlet fever

Photo of a child with skin affected by the typical exanthema secondary to scarlet fever

The contagion can occur as early as one or two days before the acute phase of the disease - that is when symptoms appear - and those who get sick remain contagious throughout the course of the infection, especially if it is not treated with the right antibiotics. Even for those who are treated, medical prophylaxis provides for the isolation of the patient for three days starting from the beginning of the treatment, since antibiotics require this period of time to be effective. Normally incubation of scarlet fever lasts a few days, from 2 to 5, after which you begin to see the first symptoms that appear suddenly within 24-48 hours.

Diagnosis: how to tell if it's really scarlet fever

In this regard, to diagnose scarlet fever without a shadow of a doubt, one does not rely exclusively on the symptoms, which to be honest as well as being quite generic are typical of almost all exanthematous diseases. The presence of group A Streptococcus in the child's throat can be easily ascertained thanks to a specific examination that takes place through a throat swab. It basically consists in taking mucus particles from the throat; examined under a microscope in the laboratory, they reveal the presence of the bacterium.

Symptoms of scarlet fever: how does it manifest itself?

What does scarlet fever look like? Although some symptoms are non-specific (for example temperature), others symptoms I'm typical of the scarlet fever and therefore easily recognizable. The incubation of this pathology is relatively short; it lasts three days, after which the first, characteristic symptoms appear which include among others the presence of strange red dots on the skin.

Other symptoms are generally a high fever (up to 39.5 ° C), chills, a throbbing sensation of headache and above all a sore throat (as well as aching, the child's throat is also significantly red, and should be examined immediately in cases of suspected scarlet fever) and not least the enlargement of the tonsils, which in many cases are literally studded with white spots. Another obvious symptom of an ongoing streptococcal infection is the altered condition of the tongue, which is no longer a healthy pink and red color, but covered with a sort of whitish patina on which the red papillae visibly stand out. . However, this only happens in the first days of the infection, because after a few days the tongue begins to peel, taking on a bright red color.

It is no coincidence that in these circumstances we speak of red strawberry tongue or of raspberry tongue. The rash (rash) main of the disease - i Red dots that storm the skin of the whole body, sometimes concentrating in some areas, sometimes in others - it appears after a day or two; it starts from the armpits, neck and groin, and then spreads like wildfire over the rest of the child's body.

Scarlet fever strawberry tongue photo

Image of a strawberry or raspberry tongue in a child with scarlet fever.

An oddity typical exclusively of scarlet fever, then, is that the patient's face appears very red, except for the area around the mouth, which instead remains white. Precisely this symptom has determined the expression of a scarlet mask that distinguishes the sick child.

L'rash, which often causes an intense and annoying itch, it slowly tends to fade three days after reaching its peak, and then disappears definitively within a week or a couple of days earlier. Even the disappearance of the red dots follows a very specific process: the skin, in fact, begins to peel into thin lamellae starting from the face, and then continue with the trunk, then with the hands and feet. In total, the course of scarlet fever can take from ten to fourteen days, during which it is good for the child to stay at home, both to have time to recover, and not to infect other children and consequently trigger a real epidemic.

Which antibiotic to use to fight scarlet fever?

How is scarlet fever treated? As already mentioned, since scarlet fever is a bacterial infection, the cure is represented by a course of specific antibiotics which must last approximately ten days. It should be emphasized, however, that starting from the three days of treatment the child is no longer contagious, so siblings and schoolmates can safely stay in contact with him, although in almost all cases it is a good rule to postpone the return to school. If the temperature exceeds 39 ° C, in addition to the antibiotic, the pediatrician of reference could give the little patient a paracetamol-based antifebril so as to soothe the most debilitating symptoms caused by the exponential increase in temperature. But which antibiotic is really effective in case of scarlet fever? The amoxicillin / clavulanic acid combination (Augmentin, Neoduplamox) represents the most used combination, and is an excellent antibiotic, one of the most prescribed by pediatricians for both children and adults.

Other antibiotics normally prescribed are others pennicillins such as ampicillin (Amplital), cephalosphorins or macrolides such as erythromycin (Erythrocin) or clarithromycin (Macladin, Klacid, Veclam) in patients allergic to pennicilins. In the face of side effects, drug interactions and almost non-existent - or at least very rare - contraindications, these antibiotics quickly and effectively fight both scarlet fever and a whole series of infections including those of the ear and nasal sinuses, respiratory and urinary tract , skin, teeth, soft tissues and finally also bones and joints. Obviously, the methods of administration and dosage must be decided by the attending physician.

Scarlet fever in adults, children and pregnant women

As mentioned several times, although it falls into the group of childhood exanthematous diseases, like all other diseases in this group, scarlet fever can also affect adults. Symptoms, methods of transmission and treatment are essentially the same (they vary rather from subject to subject, than in relation to age), however particular attention should be paid to pregnant adult women. Like other exanthematous diseases, scarlet fever is also associated with the risk of fetal malformations.


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