A rash on the skin of the body, a sore throat and a high fever are symptoms of many childhood infections. One of these infectious diseases is scarlet fever. It is very common in childhood and can cause serious complications. And therefore, many parents are concerned about the questions - how a child becomes infected with scarlet fever and what a rash looks like with this disease, how scarlet fever proceeds in children and how dangerous such an infection is, and many others.
What it is
Scarlet fever is called an acute infection, the causative agents of which are hemolytic streptococci belonging to group A. Such bacteria are capable of exerting toxic and septic, as well as allergic effects on the human body due to the production of a special poisonous substance - erythrotoxin.
It is this toxin that causes all the symptoms characteristic of scarlet fever. Due to the expansion of small vessels in children, a rash appears, and the death of the epidermis caused by the action of erythrotoxin causes severe skin peeling.
How is it transmitted
Group A streptococci from carriers and patients are transmitted to healthy children mainly by airborne droplets. The bacteria are spread by sneezing or coughing, so people who are near a sick child are especially at risk of infection. Transmission of the pathogen is also possible through clothing, contaminated toys, or food.
Who can you get infected from
Streptococci can cause scarlet fever by ingesting a child from:
- A person with scarlet fever, who is especially contagious in the early days of the infection.
- A person suffering from pharyngitis or sore throat, if these diseases are caused by group A streptococci.
- Recently recovered person, because bacteria continue to be released into the environment for up to three weeks after improvement.
- A carrier of hemolytic streptococcus who has no symptoms of the disease. The bacteria can live on the nasal and pharyngeal mucosa, and at the same time not cause scarlet fever in their host, but be dangerous to other people.
Incubation period
The first symptoms of the disease appear on average 3-7 days after infection. Most often, the incubation period in children lasts two to three days. Sometimes it shortens to one day or even several hours. In rare cases, the incubation period can be extended to twelve days.
How many days is a child contagious
A sick child begins to release the causative agent of scarlet fever into the environment from the moment the infection first appears. The contagious period can be of different duration - both several days and several weeks. If scarlet fever proceeds without complications and the child is started on antibiotic treatment, then after 7-10 days he ceases to be infectious to others.
Can an adult get infected from a child
Most often, scarlet fever is diagnosed in children from 2 to 10 years old. The disease in most cases causes lifelong immunity, therefore, if an adult has had such an infection in childhood, he often does not develop scarlet fever after contact with a sick child. Re-disease is possible with reduced immunity of an adult.
If an adult did not previously have scarlet fever, he can become infected from a sick child by airborne droplets. Moreover, the severity of scarlet fever in adulthood can be different. There are both erased forms and toxic scarlet fever with a very severe course.
Symptoms
The initial stage of scarlet fever in most children is short and lasts less than a day. The disease begins acutely with an increase in body temperature and the appearance of sore throat. The main signs of a typical form of scarlet fever in children are:
- Symptoms of general intoxication. The disease manifests itself as headaches, fever, general malaise, agitation (less often lethargy), vomiting, aching muscles and joints, tachycardia.
- Small-dot rash that appears on the first or third day of the disease.
- Angina, the course of which can be more severe than with ordinary tonsillitis.
- Changes in language, due to which it is called "crimson". The tongue with scarlet fever is at first covered with a whitish bloom, but on the second or fourth day from the onset of clinical manifestations it becomes bright red. It shows granularity, as the size of the papillae increases.
- Peeling of the skin, which appears about 1-2 weeks after the initial manifestations of the disease (it replaces the rash). On the feet and palms, the skin peels off in large parts, and on the trunk, ears and neck there is a small peeling, called pityriasis.
You can learn more about the symptoms that accompany the disease in the following video.
What does a rash look like?
The rash looks like numerous dots of red or bright pink. The localization of the rash is represented mainly by the face area (on the cheeks), the groin area, the flexor surfaces of the limbs, as well as the lateral sections of the trunk.
At the same time, in the area of the elbow bends, under the arms, and also under the knees, the rash thickens, forming dark red stripes (this is called the Pastia symptom). In the area called the "nasolabial triangle", there is no rash with scarlet fever, and the skin of this part of the face will be pale (this is how Filatov's symptom manifests itself).
If you press moderately on a scarlet fever rash with a spatula, the color of the specks becomes clearer, but with strong palm pressure, the rash disappears and the skin looks yellowish (this is called a "palm symptom"). To the touch, the skin of a baby with a rash resembles sandpaper.
After 3-7 days after the onset, the rash begins to disappear, leaving behind peeling. Peeling is especially pronounced on the hands - the skin is removed from the fingertips in large areas, like gloves. There is no pigmentation after such a rash.
How does angina manifest
A streptococcus caught on the mucous membranes of the nasopharynx settles on the tonsils and begins to secrete a toxin, which is the cause of sore throat with scarlet fever. The child's throat acquires a bright red color (due to severe inflammation, such a picture is called a "flaming pharynx"), and the tonsils become covered with a purulent bloom.
Here are some photos of the throat with scarlet fever in a child:
How long does the temperature last
Fever is one of the most common symptoms of the initial stage of scarlet fever. The temperature rises sharply to 38-40 ° C. Some children have febrile seizures due to this rise in temperature. A decrease in temperature in most children is noted from the third to fifth day of illness.
The severity of the disease
Depending on the age, the state of immunity and the clinical picture of scarlet fever, the child has:
- Lightweight. Symptoms of intoxication with this course are mild, the fever does not exceed + 38.5 ° C, the tonsils may be without plaque, and the rash is less bright and profuse. The mild form proceeds faster - by the fourth or fifth day, the temperature is normalized and all acute symptoms disappear. In our time, this form in children is diagnosed more often than others.
- Moderate. The disease begins acutely, the temperature rises to + 40 ° C, the child complains of headaches, weakness, vomiting and rapid pulse are noted. The rash with this form is quite abundant, its color is bright, and the pharynx and tonsils are covered with a purulent bloom. A decrease in temperature and the disappearance of acute symptoms are noted by the seventh to eighth day of the disease.
- Heavy. Nowadays, this form develops rarely. Due to severe intoxication, such scarlet fever is called septic or toxic. In addition, a severe form of scarlet fever is necrotic if a child develops necrotic inflammation of the tonsils, and the lymph nodes become inflamed and suppurate. In severe cases, children are necessarily hospitalized.
Atypical scarlet fever
In some children, the infection is atypical (a latent form develops)... Doctors distinguish such forms of scarlet fever in addition to the typical:
- Erased. With her, intoxication is weak, tonsillitis is catarrhal, and the rash is pale, scanty and disappears rather quickly.
- Extrabuccal. With such scarlet fever, streptococci enter the child's body through the affected skin.
- Scarlet fever without rash. With such an infection, all the symptoms of scarlet fever are present, but there are no skin rashes.
How many times get sick
In most cases, after suffering scarlet fever, a person develops immunity to the erythrotoxin produced by streptococci, so children often get this infection once in a lifetime. However, although it is very rare, cases of repeated disease occur.
The transfer of antitoxic immunity from a mother who had had scarlet fever to her baby after birth causes the rarity of cases of scarlet fever in newborns. A child within six months after giving birth is protected from such an infection by maternal immunity.
Treatment
Most children with scarlet fever are prescribed home treatment. Hospitalization is required only in severe cases or complications, as well as in some other situations (for example, if a child from a boarding school falls ill or there are people in the family of a sick child who work with children, but they cannot be isolated).
Mode
Until the temperature drops, the child should stay in bed. In addition, in the acute phase, it is important to adhere to a diet and increase the drinking regime. The child is given food in a semi-liquid or liquid form, and protein foods are limited. A child suffering from scarlet fever should drink a lot. It is best to give a warm drink such as tea.
Drug therapy
Medical treatment for scarlet fever certainly includes antibiotics. Often, children are prescribed penicillin drugs in tablet form or in syrup, for example, amoxicillin, augmentin, amoxiclav, retarpen. The duration of use and dosage is determined by the doctor, but usually the course of antibiotic therapy lasts 7-10 days.
In addition, the child is given vitamin preparations and antiallergic drugs, and if intoxication is pronounced, infusion therapy is recommended (glucose and other drugs are injected intravenously). For gargling, use chamomile infusion, furacilin solution, soda solution, calendula infusion and other antiseptics.
Homeopathy and folk remedies can be used in the treatment of scarlet fever, as auxiliary methods, but only after consulting a doctor.
Is it possible to bathe the child
Washing with scarlet fever is not prohibited. On the contrary, bathing children should be done, as this will reduce itching of the skin and prevent rash from scratching. However, it is important to follow some rules:
- The bath water should not be too hot or very cool.
- If the child has a fever, replace the bath with a rubdown.
- The skin should not be rubbed with a washcloth or sponge.
- To rinse off the soap suds, instead of a shower, it is better to douche from a ladle.
- It is not advised to dry the child with a towel after bathing. It is better to get the water wet by wrapping the baby in a sheet or diaper.
Complications
With scarlet fever in children, the following complications are possible:
- Glomerulonephritis.
- Purulent otitis media.
- Inflammation of the paranasal sinuses.
- Inflammation of the lymph nodes.
- Arthritis.
- Myocarditis.
- Pneumonia.
The risk of complications is significantly reduced with timely antibiotic therapy. In the development of lesions of the heart, joints and kidneys, the sensitization of the child's body (its increased allergic sensitivity to erythrotoxin) is of great importance.
Komarovsky's opinion
A well-known pediatrician quite often encountered scarlet fever in his practice. Komarovsky focuses the attention of parents on such nuances:
- Streptococci are highly sensitive to penicillin antibiotics, therefore, after several doses of the drug, the condition of babies with scarlet fever clearly improves.
- If a child has a penicillin intolerance, this will not be a problem either, since streptococci are sensitive to many other antimicrobial drugs.
- Scarlet fever can be called a disease in which the timely administration of antibiotics ensures a successful outcome. If the infection is not treated, serious complications (kidney and heart damage) are possible.
- Treatment should not be stopped as soon as the child's condition has improved. It is important to complete the course of the antimicrobial drug prescribed by your doctor.
- Due to the timely appointment of antimicrobial agents, sometimes streptococci die in a child's body very quickly, and there is no time to develop immunity to their toxins. This is the reason for repeated diseases, which, according to Komarovsky, are easier than the first infection.
- Streptococcus can enter the child's body not only through the throat. There are cases of infection through wounds on the skin. In this case, the child has all the signs of scarlet fever (there will be no only angina). Treatment is the same as for ordinary scarlet fever.
- A child who has had scarlet fever should not contact other people for some time after the illness, since a repeated exposure to streptococcus threatens with allergies and other complications. Komarovsky recommends starting attending school or kindergarten after scarlet fever no earlier than 3 weeks later.
Mild forms and most moderate forms of scarlet fever in children are safely treated at home. The kids are isolated for 10 days, after which they are allowed to walk in a satisfactory condition.
Effects
At the present time, the prognosis for a child with scarlet fever is in most cases favorable. When the child has recovered, it is important to monitor his well-being in order to timely identify possible complications. Close attention should be paid to the color of urine (it changes with kidney damage, becoming like "meat slops") and complaints of pain in the joints.
Doctors should monitor the condition after moderate to severe scarlet fever for one month. If, 3 weeks after recovery, the child is examined, blood and urine tests do not show abnormalities, dispensary observation is stopped. Having identified any alarming symptoms in a child who has had scarlet fever, he is sent for examination to a nephrologist or rheumatologist.
Prevention
It is known that there are no vaccines that protect against scarlet fever. To protect children and adults who have not been sick before from infection, you can take the following measures:
- In order to prevent infection of family members, it is important to carry out regular ventilation and wet cleaning in the room where the sick child is staying.
- A single person should be involved in caring for a child with scarlet fever, who is advised to use dedicated clothing and a gauze mask.
- A sick child should be given a separate towel, their own dishes, a handkerchief, toys and other items with which healthy family members should not come into contact.
If the child has been in contact with a person who has been sick with scarlet fever and has not previously had such an infection, he should be isolated from the children's team for 7 days. After staying at home for a week, such a child can return to school (we are talking about primary grades) or to kindergarten.
