What is it?

Scarlet fever is a streptococcal infection that is caused by the same bacteria that causes strep throat. Scarlet fever is more likely to affect children under the age of 18. The onset of scarlet fever may be quite sudden and symptoms include:

  • Sore throat.
  • High temperature.
  • Vomiting.
  • Headache.
  • A fine red rash.
  • The face is often flushed except for a pale area around the lips.
  • A whitish coating can appear on the surface of the tongue. The tongue itself can look like a strawberry because the normal bumps on the tongue look bigger.
  • The rash shows up as tiny red bumps starting on the neck/chest and then spreading to other areas of the body. It looks like sunburn, but is usually rough to touch.
  • The rash may last for two to seven days. After the rash is gone there may be some peeling on the tips of the fingers and the toes.

How does it spread?

Scarlet fever spreads when someone with the illness coughs or sneezes, spraying droplets of fluid from the nose or throat. It can also spread through contact with contaminated hands, food, food utensils and other items.

A child may have been infected by the bacteria one to three days before any symptoms appear.

Infectious period

A child is infectious during the early stages of the illness and usually until 24 hours after treatment begins. A child who is untreated will remain infectious for as long as they are sick, which is usually between three to seven days.

Exclusion period

A child can return to the centre 24 hours after treatment on antibiotics begins.

Responsibilities of staff

  • Tell parents there is scarlet fever in the centre.
  • Display information about scarlet fever on your notice board.
  • Make sure staff and children’s hands are washed often with soap and warm water and thoroughly dried. This will help prevent the spread of the bacteria.
  • Clean all toys and surfaces with detergent, then disinfect by wiping with or soaking in 1:10 dilute bleach (1 teaspoon bleach to 500ml water). Disinfecting toys and general surfaces such as tables is a precaution for outbreaks, not a ‘normal’ procedure. Pay particular attention to resources that children put in their mouths such as pretend food, cups, etc.
  • Remove all shared play resources such as play dough, water play and painting.
  • Remove shared food, drink and utensils.

Responsibilities of parents

  • Keep your unwell child home until treatment has been provided for 24 hours.


Penicillin or other effective antibiotics will be prescribed by a GP.


Download printable factsheet

Last updated 14 July 2022.