Symptoms of scarlet fever 

The symptoms of scarlet fever usually take two to five days to appear after infection.

However, the incubation period (the time between exposure to the infection and symptoms starting) can be as short as one day or as long as seven days.

The symptoms of scarlet fever include a sore throat, headache, high temperature (38.3C/101F) or above), flushed face and swollen tongue. The distinctive pink-red rash develops 12 to 48 hours later.

Rash

Red blotches are the first sign of the rash. These turn into a fine pink-red rash that feels like sandpaper to touch and looks like sunburn. It may also be itchy.

The rash usually starts on the chest and stomach, but soon spreads to other parts of the body, such as the ears, neck, elbows, inner thighs and groin.

The rash doesn't usually spread to the face. However, the cheeks become flushed and the area just around the mouth stays quite pale. The rash will turn white if you press a glass on it.

The rash usually fades after about a week, but the outer layers of skin, usually on the hands and feet, may peel for several weeks afterwards.

In milder cases, sometimes called scarlatina, the rash may be the only symptom.

Other symptoms

Other symptoms may include:

• swollen neck glands
• loss of appetite
• nausea or vomiting
• red lines in the folds of the body, such as the armpit, which may last a couple of days after the rash has gone
• a white coating on the tongue, which peels a few days later leaving the tongue red and swollen (this is known as strawberry tongue)
• a general feeling of being unwell

When to seek medical advice

See your GP as soon as possible if you think you or your child has scarlet fever. Although the illness usually clears up after about a week, your GP will be able to confirm a diagnosis and recommend appropriate treatment.