Scarlet fever is a bacterial infection that causes a sore throat, rash, and chills.
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"H:ow dark the days seemed now, how sad and lonely the house, and how heavy were the hearts of the sisters as they. worked and waited, while the shadow of death hovered over the once happy home." With these words, author Louisa May Alcott captures the fear and tragedy that scarlet fever spread in the 1800s.
Based on Alcott's own growing-up years, Little Women is the tale of Jo March and her sisters, Meg, Amy, and Beth. Immensely popular since its publication in 1869, it has been made into a movie at least four times. Beth, beloved by family and friends for her sweet nature and musical talent, develops scarlet fever when the girls' mother is away caring for their father, who has been injured in the Civil War. This sad part of the story never fails to bring tears to readers and movie audiences.
The words "scarlet fever" once struck fear in the hearts of people. The bacteria that cause scarlet fever are easy to spread, and in the 1800s there were epidemics. Children younger than 10 years old were especially at risk of death or serious complications, such as rheumatic fever. Scarlet fever also was a mysterious disease, because it would infect only some members of a family and not others. A good example of scarlet fever's effect can be found in the 1869 book Little Women (see sidebar).
Today, scarlet fever is not as deadly, because antibiotics are available to fight the streptococcal bacteria that cause the infection.
A Sore Throat That Gets Worse
Scarlet fever is caused by exposure to someone who is infected with streptococcal bacteria. People with the strep infection can spread it by sneezing or coughing. It also can be spread by sharing drinking glasses or eating utensils with people who are infected.
The first signs of scarlet fever usually start within a week of exposure to the strep bacteria. A sore throat develops, which is known as strep throat. But in some people, the particular kind of strep bacteria, known as Group A Streptococcus, causes a toxic reaction. A skin rash appears within 1 or 2 days of the sore throat. It looks like a sunburn on the neck, chest, and underarms. Less often the rash can appear on the face or the groin. The skin feels rough, like sandpaper. Within a week, the rash usually starts to fade, and flaking and peeling of the skin occur.
Scarlet fever also causes a fever with temperatures over 101 degrees Fahrenheit. Glands around the jaw and neck swell and are painful. Chills, nausea, and vomiting can result.
Scarlet fever body rash. © Biophoto Associates/Photo Researchers, Inc.
Scarlet Fever in History
The earliest concise description of scarlet fever and its symptoms was given by the German physiologist Daniel Sennert. In 1619 Sennert accurately observed and recorded the sequence of the disease's symptoms: the appearance of the associated rash, its decline, and scaling of the skin. In the eighteenth century, epidemics of scarlet fever were reported throughout Europe and America. During this time, physicians developed a clear clinical understanding of the disease. The first clinical standards for differentiating scarlet fever from similar diseases were established by Armand Trousseau. In 1887 the English physician Edmund Emmanuel Klein identified scarlet fever as being caused by Streptococcus bacteria that were observed to grow on the tonsils and secrete a rash-producing toxin. The American physician George E Dick and his wife Gladys R. H. Dick isolated the toxin in the 1920s. After World War II, penicillin became available as an effective means of curing the disease.
In rare cases, scarlet fever also can result from a skin infection known as impetigo.
Strep throat and scarlet fever can be serious without treatment from a physician. A doctor who suspects a strep infection will use a cotton swab to get a bit of the bacteria from the throat for laboratory testing to confirm that it is streptococcal bacteria. Treatment with antibiotics for 10 days usually kills the bacteria.