Scarlet fever

"Scarlet fever" is also a term denoting the condition of having strong love for or attraction to red hair.

Scarlatina is an exotoxin-mediated disease caused by Group A streptococcal infection that occurs most often in association with a sore throat and rarely with impetigo or other streptococcal infections. It is characterized by sore throat, fever and a rash over the upper body that may spread to cover almost the entire body. Scarlet fever is not rheumatic fever. Rheumatic fever is the autoimmune disease that occurs after infection with Group A strep that causes damage to the heart valves.

History

This disease was also once known as Scarlatina (from the Italian scarlattina). Many novels depicting life prior to the nineteenth century (see Scarlet fever in literature below) describe scarlet fever as an acute disease being followed by many months spent in convalescence. The convalescence was probably due to complications with rheumatic fever. It was also not uncommon to destroy or burn the personal effects of a person afflicted with scarlet fever to prevent transmission to other people.

The disease was once greatly feared and killed many thousands of people. Today, however, it is fairly easy to treat with modern antibiotics.

Signs and symptoms

The disease is typically preceded by:

There is a characteristic rash:

fine, red, rough-textured and blanches upon pressure
appears 12–48 hours after the fever
generally starts on the chest, axilla (armpits), and behind the ears
worse in the skin folds
Pastia lines (small linear petechiae) appear and persist after the rash is gone

Scarlet fever also produces a bright red tongue with a "strawberry" appearance.
The area around the mouth is usually pale (circumoral pallor)
After about a week, the skin often desquamates or peels, usually in the groin, axilla, and on tips of fingers and toes

Transmission

The illness is spread by the same means as strep throat.

Treatment

Other than the occurrence of the rash, the treatment and course of scarlet fever are no different from those of any strep throat.

Antibiotic treatment is considered necessary to prevent rheumatic fever.

Scarlet fever in literature

Little Women by Louisa May Alcott (1868) - Beth contracts scarlet fever and, after a long convalescence, succumbs to the illness.
The Velveteen Rabbit by Margery Williams (1922) - The main protagonist, a small boy, contracts scarlet fever and his toys are all burned.
By the Shores of Silver Lake by Laura Ingalls Wilder (1939) - Prior to the start of the book, Laura's older sister Mary has been left blind by a bout with scarlet fever.

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