Scarlet Fever

Scarlet fever is a bacterial infection that causes a sore throat, rash, and chills.

A scarlet fever rash on the forearm dueto group A streptococcus. The scarlet fever rash first appears as tiny red bumps on the chest and abdomen that may spread all over the body.

A scarlet fever rash on the forearm dueto group A streptococcus. The scarlet fever rash first appears as tiny red bumps on the chest and abdomen that may spread all over the body. Looking like a sunburn, it feels like a rough piece of sandpaper, and lasts about 2-5 days. CDC.

What Is Scarlet Fever?

Scarlet fever once was dreaded by many people. The bacteria that cause scarlet fever are easy to spread, and in the 1800s there were epidemics. Children younger than 10 years of age were especially at risk of serious complications, such as rheumatic (roo-MAH-tik) fever or death. Scarlet fever was also a mysterious disease because it would infect only some members of a family and not others. A good example of scarlet fever's effect can be found in Louisa May Alcott's 1868 novel Little Women.

By the early 2000s scarlet fever was far less common and easier to treat with modern antibiotics * available to fight the streptococcal (strep-toe-KOK-al) bacteria that causes the infection.

What Are the Symptoms of Scarlet Fever?

Scarlet fever is caused by exposure to someone who is infected with streptococcal, or strep, bacteria. People with strep infection can spread it by sneezing or coughing. It can also be spread by sharing drinking glasses or eating utensils with people who are infected.

Louisa May Alcott's novel Little Women is based on the author's own childhood. It is the story of Jo March and her sisters, Meg, Amy, and Beth. Immensely popular since its publication in 1868, the novel bas been made into a movie at least five times.

In the book, Beth, beloved by family and friends for her sweet nature and musical talent, develops scarlet fever when the girls’ mother is away caring for their father, who has been injured in the Civil War. Alcott captures the fear and tragedy that scarlet fever caused in the 1800s in her description of the dark days in the March household. Although at first Beth seems to recover, her illness progresses to rheumatic fever and she dies of congestive heart failure.

Scarlet fever also causes a fever with temperatures of more than 101°F (38°C). Glands around the jaw and neck swell and are painful. Other symptoms can include chills, nausea, and vomiting.

In rare cases, scarlet fever also can result from a skin infection known as impetigo * .


The earliest description of scarlet fever and its symptoms was given by the German physiologist Daniel Sennert (1572–1637). In 1619 Sennert accurately observed and recorded the sequence of the disease's symptoms: the appearance of the rash, its decline, and scaling of the skin.

In the 18th century, epidemics of scarlet fever were reported throughout Europe and the United States. During this time, physicians developed their clinical understanding of the disease. The first clinical standards for differentiating scarlet fever from similar diseases were established by Armand Trousseau (1801–1867).

In 1887 the English physician Edmund Emmanuel Klein identified scarlet fever as being caused by streptococcus bacteria that were observed to grow on the tonsils and secrete a rash-producing toxin.

The American physician George Frederick Dick (1881–1967) and his wife Gladys R. H. Dick (1881–1963) isolated the toxin in the 1920s. After World War II, penicillin became available as an effective means of treating the disease.

Without medical treatment, strep throat and scarlet fever can be serious. A doctor who suspects a strep infection uses a cotton swab to get some of the bacteria from the throat for laboratory testing to confirm that they are streptococcal bacteria. Treatment with antibiotics for 10 days usually kills the bacteria.

See also Impetigo • Rheumatic Fever • Sore Throat/Strep Throat • Streptococcal Infections


Books and Articles

Alcott, Louisa May. Little Women, or, Meg, Jo, Beth, and Amy. Boston: Roberts Brothers, 1868.

Sotoodian, Bahman. “Scarlet Fever.” Medscape, March 7, 2016. Available at: (accessed July 6, 2016).


MedlinePlus. “Scarlet Fever.” U.S. National Library of Medicine. (accessed July 6, 2016).


Centers for Disease Control and Prevention. 1600 Clifton Rd., Atlanta, GA 30329-4027. Toll-free: 888-674-6854. Website: (accessed July 6, 2016).

World Health Organization. Avenue Appia 20, 1211 Geneva 27, Switzerland. Telephone: 41 22 791 21 11. Website: (accessed July 6, 2016).

* antibiotics (an-tie-by-AH-tiks) are drugs that kill or slow the growth of bacteria.

* impetigo (im-pih-TEE-go) is a bacterial skin infection that usually occurs around the nose and mouth. It causes itching and fluid-filled blisters that often burst and form yellowish crusts.

  This information is not a tool for self-diagnosis or a substitute for professional care.