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How to tell if a child has scarlet fever: symptoms and how to act

2023-06-06T09:21:38.557Z

Highlights: scarlet fever is a mild infection that causes fever and a rash on the skin. It is caused by a bacterium called streptococcus pyogenes. This bacterium, "sometimes, can cause invasive and life-threatening infections," says a pediatrician. The more cases there are of non-invasive disease, it is logical to think that there are more cases of more severe disease, says Jesús Saavedra Lozano, member of the Spanish Society of Pediatric Infectology.


If the child is infected with this bacterium, he may have: skin or tongue rash, fever and pain to swallow. Within 24 hours of starting antibiotic treatment, if your child is well, he or she can go back to school.


One night, my seven-year-old son told us that his tongue stinged while eating and that he had discomfort when swallowing. When he opened his mouth, the tongue resembled a strawberry, it was inflamed, red, and each papilla had a very well-defined white color. In addition, the skin on his back was rough. It was scarlet fever. "A mild infection that causes fever and a rash on the skin, caused by a bacterium called streptococcus pyogenes that produces, above all, mild infections, such as scarlet fever, pharyngotonsillitis or other skin infections," explains Ángela Manzanares Casteleiro, pediatrician at the 12 de Octubre University Hospital.

However, this bacterium, "sometimes, can cause invasive and life-threatening infections, such as necrotizing fasciitis or streptococcal toxic shock syndrome," adds this pediatrician. This fact seems to be the cause behind the statement issued last December by the World Health Organization (WHO). In its note, the agency reported that at least five European Union member States had reported an increase in cases of invasive group A streptococcal infection and, in some cases, scarlet fever as well. An increase that, as they explained, in some of these countries had meant the notification of deaths, with children under 10 years of age being the most affected group.

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The journal The Lancet has recently published the articleIncrease in the incidence and severity of invasive group A streptococcal disease in Spanish children in 2019-2022. In this research, carried out by the PedGAS-net Working Group, a national network that for four years has been monitoring the disease in children, they have been able to verify the significant increase in cases, according to Jesús Saavedra Lozano, member of the Spanish Society of Pediatric Infectology (SEIP) and coordinator of the PedGas network. "Especially pneumonia, which was also more clinically serious compared to the pre-pandemic era," he adds. "This network does not monitor non-invasive infection, such as scarlet fever or acute pharyngotonsillitis, but there is an impression that the increase in both infections has been very significant," he continues. Saavedra explains that, in fact, the more cases there are of non-invasive disease, it is logical to think that there are more cases of more severe disease.

One of the factors that has been able to influence the increase in this type of infection could be related to the abandonment of the use of the mask, implemented with covid19. "Now that we have stopped using it widely, all those microorganisms that a couple of seasons ago were not transmitted have done it again. And the child population, which is where there is more transmission, has not developed in the last two years the immunity necessary to deal with all these viruses and bacteria, "says Anna Gamell, pediatrician at the Hospital Sant Joan de Dèu, in Barcelona.

The reason why this disease sometimes occurs with a greater aggravation is still unknown. "It probably depends on several factors, although there is no known immunological deficit associated with this infection. What is known is that once it passes the initial barrier of the organism (skin, pharynx), and reaches the blood, it has many virulent mechanisms that facilitate the rapid dissemination of the bacteria, and increase inflammation in a very serious way, which can go against the patient himself, "argues Saavedra.

It is advisable not to be in close contact with the child who has the infection, since it is transmitted by droplets of saliva. blackjake (Getty Images)

In the case of children, who are generally prone to infections caused by both viruses and bacteria, their greatest predisposition lies in the fact that "the immune system is developing and most of the time it faces a new microorganism for the first time," Manzanares resumes. "Contrary to what happens with adults, whose immune system is already trained," adds Saavedra, "theirs in development favors superinfection by bacteria such as streptococcus pyogenes." This expert clarifies that scarlet fever is a rash or rash that is associated with streptococcus pyogenes infection, almost always an acute pharyngotonsillitis or a skin infection (impetigo), "but scarlet fever is produced by a substance that releases this bacterium and not by a direct infection of the skin".

My child has scarlet fever

When a child has scarlet fever, he or she most often has a fever and sore throat when swallowing. When these symptoms appear, you have to go to the health center. Once in consultation, apart from doing a physical examination, where very large, red tonsils will be observed and, sometimes, with white plaques, a rapid test is done and in 5 or 10 minutes you have the result that confirms if it is this bacterium. "If so, you have to prescribe an antibiotic treatment with penicillin or amoxicillin and maintain it for 10 days. After 24 hours of starting antibiotic treatment, the patient is no longer contagious," says Gamell. So, as he continues, if the child is well he could go to class from that moment.

Most of the time, the contagion by streptococcus pyogenes presents as a pharyngotonsillitis. So it is convenient not to be in close contact with the child who has the infection, since it is transmitted by droplets of saliva to be at a distance of less than one meter, or use a mask if you have to approach.

It is important not to forget hand hygiene, both for this infection and for all in general. Finally, this infection can be spread quite easily. So for a few days you have to be more aware of it, and go to the pediatrician if you have symptoms such as: fever without catarrhal picture, sore throat or generalized bright red rash. "Being the most frequent age of presentation between 4-15 years," says Saavedra. Generally, although it is a disease associated with childhood, adults are also susceptible to suffering from it as a pharyngotonsillitis. "Sometimes, it can happen, especially in those over 50, in women who have just given birth, and in people with risk factors. Therefore, adults should take the same precautions as children to avoid infection, "says Manzanares.

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Source: elparis

All news articles on 2023-06-06

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