Scarlet Fever (Strep A)




Parent and Carer Advice

There are currently high rates of Scarlet Fever (caused by Group A Strep) in the UK. Scarlet Fever is much more common in children than in adults and it is important that children with Scarlet Fever are seen by their GP so that they can be started on antibiotics.

The rash of Scarlet Fever often begins with small spots on the body that then spread to the neck, arms and legs over the next 1 to 2 days. It is often ‘sandpaper’ like to touch and is sometimes itchy.

Your child may also have a:

  • Sore throat/tonsillitis
  • Fever (temperature of 38°C (100.4°F or above))
  • Painful, swollen glands in the neck
  • A red tongue (strawberry tongue)

Occasionally, the bacteria causing Scarlet Fever can spread to other areas of the body, causing infections in the neck (tonsillar abscesses or lymph node abscesses), chest infections (pneumonia) or sepsis.


How long will your child’s symptoms last?

The sore throat and fever often last for about 3-6 days and the rash usually improves within a week. Antibiotics reduce the length of fever/sore throat by about 1 day.

Children commonly experience peeling of their fingers or toes after Scarlet Fever.

Your child is no longer infectious to others (contagious) after 24 hours of starting antibiotics and can go back to school/nursery if they feel well enough.


What should you do?

If you think your child has Scarlet Fever, they should be seen their GP. They may need treatment with antibiotics.


Contact Emergency Services 999 / attend your local hospital if your child has any of the following:

  • Is pale, mottled and feels abnormally cold to touch
  • Has blue lips
  • Too breathless to talk/eat or drink
  • Has a fit/seizure
  • Is extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
  • Has a rash that does not disappear with pressure (use the glass test)

Contact 111 or visit a GP or Nurse today if your child has any of the following:

  • Is finding it hard to breathe
  • Unable to swallow saliva
  • Seems dehydrated (sunken eyes, drowsy or not passed urine for 12 hours
  • Is drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) + especially if they remain drowsy or irritable despite their fever coming down
  • Has extreme shivering or complains of muscle pain
  • Has a painful, red swollen gland in their neck which is increasing in size
  • Is 3-6 months of age with a temperature of 39°C /102.2°F or above (but fever is common in babies up to two days after they receive vaccinations)
  • Continue to have a fever of 38°C or above for more than 5 days
  • If your child has recently had scarlet fever but now appears to have a puffy face/eyelids, tea ‘Coca-Cola’ coloured urine or a swollen, painful joint (s)
  • Is getting worse or if you are worried

You need to contact a doctor or nurse today Please ring your GP surgery or call NHS 111 – dial 111

If symptoms persist for more than 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features as above.


If none of the above features are present:

Additional information is available about infant crying and how to cope see QR code guides and self-care as below.

Children and young people who are unwell and have a high temperature should stay at home. They can go back to school, college or childcare when they no longer have a high temperature, and they are well enough to attend.

Continue providing your child’s care at home. If you are still concerned about your child, speak to your health visitor, local pharmacist or call NHS 111 – dial 111.


Useful Information and Official NHS / Government Advice


Parent & Carer advice on Group A Strep & Scarlet Fever video

Published: Dec 9, 2022