Your child suddenly has a high fever, complains of a sore throat, and shortly afterwards a fine skin rash appears? Many parents then ask themselves: Is it scarlet fever? Does my child need antibiotics? And when can they go back to daycare?

Nowadays, scarlet fever can be treated well in the vast majority of cases. It is important to have the illness checked by a doctor and to watch out for warning signs.

What is scarlet fever?

Scarlet fever is a bacterial infection caused by group A streptococci. Children between 2 and 10 years are particularly often affected.

The bacteria are mainly spread through droplets when coughing, sneezing, or speaking. That is why scarlet fever often occurs in daycare centers and schools.

What symptoms are typical?

Scarlet fever usually starts suddenly.

Common symptoms are:

  • high fever
  • severe sore throat
  • difficulty swallowing
  • a red throat
  • swollen tonsils, often with a coating
  • swollen lymph nodes in the neck
  • headache or stomach pain
  • nausea or vomiting

After one to two days, many children also develop the typical skin rash.

What does the scarlet fever rash look like?

Common viral infections can also cause a combination of fever and a skin rash.

With scarlet fever, the rash often starts:

  • on the neck,
  • on the chest,
  • under the armpits,
  • or in the groin area.

It then spreads over the body and often feels fine and rough like sandpaper.

Also typical can be:

  • red cheeks with pale skin around the mouth
  • a “strawberry tongue” that is white-coated at first and later becomes intensely red

Not every child shows all the classic symptoms.

How is scarlet fever diagnosed?

The pediatric practice first assesses the symptoms and examines the throat.

Sometimes a rapid strep test is also done or a throat swab is sent to the lab.

How is scarlet fever treated?

Because scarlet fever is caused by bacteria, an antibiotic is often prescribed.

Treatment can:

  • shorten the duration of the illness,
  • help prevent complications,
  • and significantly shorten the time your child is contagious.

It is important to take the antibiotic exactly as prescribed by the doctor—even if your child is already feeling better.

In addition, these can help:

  • drinking enough fluids,
  • rest,
  • soft or cool foods for a sore throat,
  • age-appropriate pain or fever medicine as recommended by the doctor.

When is my child no longer contagious?

Without treatment, children can be contagious for several weeks.

After starting antibiotic treatment, the general rule is:

About 24 hours after the first dose of antibiotics, the risk of infection is usually much lower.

The key requirement is that your child feels better overall.

When can my child go back to daycare?

Most children can go back to daycare or kindergarten when:

  • antibiotic treatment has been going on for at least 24 hours,
  • they no longer have a fever,
  • and they feel fit again overall.

Also follow the rules of your daycare or the recommendations from your local health office.

When should you seek medical help right away?

A quick medical check is important if:

  • your child can hardly drink anymore,
  • they have severe pain or trouble swallowing,
  • they have breathing problems,
  • they have a very high fever or a fever that does not go away,
  • the rash looks unusual or gets worse quickly,
  • your child seems very sleepy or is hard to wake,
  • or their overall condition gets noticeably worse.

If symptoms do not improve after two to three days despite antibiotics, or if new symptoms appear, your child should be examined again.

What can help your child at home?

Alongside medical treatment, simple steps often help.

Helpful measures include:

  • drinking enough fluids,
  • lots of rest,
  • soft or cool foods,
  • regular handwashing,
  • using their own drinking glass or cutlery during the illness.

It’s also important that your child can fully recover before returning to the daycare routine.

What to remember

Scarlet fever usually starts with a sudden fever and a very sore throat. The typical skin rash often appears one to two days later. Because the illness is caused by bacteria, it is usually treated with antibiotics. About 24 hours after starting treatment, children are usually no longer contagious and can often return to daycare soon – as long as they feel well again.

Keep an eye on symptoms and how things are going

With the tio App, you can easily track fever, sore throat, rash, and other symptoms. This helps you notice changes more easily and, if you have questions for your pediatric practice, you’ll have all the important information ready.