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What You Should Know About Scarlet Fever Rash
General facts about the disease
One of the most common diseases the human body has to fight especially during childhood is scarlet fever. The infection affects mainly children under the age of 10, especially during cold periods (autumn, winter and beginning of spring), and it is not very common among adults. Due to antibiotics treatment (i.e. penicillin), this infection is less severe than it was in the past, when it used to be a major cause of death. Currently, infection is benign and mortality occurs only in case of complications such as bronchopneumonia and meningitis.
Scarlet fever is an infectious and contagious disease, caused by the erythrogenic toxin (a bacterial exotoxin) which is released by Streptococcus pyogenesmore (group A beta-hemolytic streptococci). The disease normally transmits through respiratory infection, from the contaminated individual by means of: breathing, coughing, sneezing, laughing, talking, especially when the patient has fever. Infection rate is higher in crowded environments, like schools for instance, where a sick or even a healthy child can trigger an epidemic that may include most of the children of a large class. That is why infected persons should either be isolated at home, if conditions are appropriate, or hospitalized in the contagious diseases section. The incubation period, which is effectively the time elapsed between exposures to bacteria and the first apparent signs of disease, is between 2 to 5 days.
After the lengthy incubation period, the disease begins suddenly and it is manifested with fever symptoms over 38.5 ºC (101.3 ºF) and chills. In addition to the fever, there are also other symptoms that are indicators of the disease:
- Sore throat.
- Weakness and fatigue.
- Lack of appetite.
- Abdominal pain, nausea and even vomiting.
- Tongue covered with white or yellow deposits.
- Enlarged nodules in the neck region that are painful to touch.
Usually the rash appears within the next 24-48 hours after the fever and it is caused by the erythrogenic toxin secreted by the beta-hemolytic streptococci, which is released in the whole body. This kind of rash is specific to scarlet fever and it is called exanthema, other characteristics include, but are not limited to:
- Skin redness, stretched over a large area.
- Rough feeling and itching, especially in the incipient phase of the disease.
- In severe cases, the rash can be hemorrhagic.
- Exanthema first appears at: bending of the arms, elbows, armpits and other places and is rapidly expanding all over the body. Often the rash appears also over the face: checks turn into a red-glowing color with red stripes aspect, while lips, chin and nose remain bleak. Also palms and pads are not affected in the first phase, but afterwards these areas may peel.
- The maturity period for the rash is between 2 to 3 days, and then nothing changes for in the following 2 days and after that it diminishes in 2 days or so. Taking a total of 5-7 days until the skin on the face and neck starts to exfoliate.
Some parents question themselves which is the best treatment. Usually pediatricians recommend a penicillin based treatment for a period of 7-10 days, followed by benzathine penicillin, once a week for 3 consecutive weeks. If the child is allergic to penicillin, it can be replaced with a class of macrolide antibiotics, including here clarithromycin, azithromycin, which are administrated oral. In addition to antibiotics, it is necessary to administer drugs and also an adequate diet for the other symptoms of the scarlet fever and strep rash, like:
- Paracetamol or ibuprofen in order to relieve the fever.
- Menthol ointment to relieve the itching.
- Drinking a large amount of fluids, since sweating is common and can lead to severe dehydrating.
In the incipient phase of the scarlet fever, when the patient has high fever, complaining of sore throat and lack of appetite, a hydro-sweet and dairies rich diet is indicated. As appetite returns, the diet range should be extended by introducing some boiled meat and different kinds of flour products. Important to note is the fact that any salt – free diet is not recommended in this type of disease.
In cases of scarlet fever disease, it is very difficult to avoid infection of other family members, who are not immune at the disease. However, some precautions include:
- Keeping silverware and other personal items used by the infected child away from other members of the family and disinfecting them by washing with hot water and special soap.
- Isolation of the infected person, for the protection of the people with whom he or she might come into contact, and not only.
- Frequently venting the room where the child is staying. This is a measure that should be respected both at home and in the kindergarten.
- Hygiene measures, such as frequent hand washing that are recommended as one of the most effective preventive practices for contracting the disease.
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