User:Mr. Ibrahem/Scarlet fever

Scarlet fever is a widespread rash that occurs during a group A strep (GAS) infection. It typically begins with a sore throat, fever, headache, body ache, nausea, and abdominal pain. In addition to large tonsils and a red throat, small red spots on the roof of the mouth may be visible. Glands in the neck may be enlarged and tender. The rash is generally first noticed on the neck and torso before spread to the arms and legs. It generally looks red on white skin; though, might be difficult to see on dark skin. It typically feels like sandpaper and can be itchy. The palms and soles are typically not involved. A more intense redness may be noticed in skin folds. The tongue may be red and bumpy and the cheeks flushed. It takes around a week for the main rash to disappear, following which the skin sheds in fine flakes. Symptoms begin 2 to 5 days after contact with the infection.

It typically follows strep throat and less frequently from streptococcal skin infections, such as following an infected burn or surgical wound. The bacteria are usually spread by coughing or sneezing. It can also be spread when a person touches a contaminated object then touches their mouth or nose. The rash occurs as a result of capillary damage by erythrogenic toxin-producing GAS. Diagnosis may be confirmed by a throat swab or by rapid streptococcal antigen test. A blood test showing a raised anti-streptolysin O confirms recent infection. It may appear similar to Kawasaki disease, toxic shock syndrome, impetigo, erysipelas, measles, chickenpox, and hand-foot-and-mouth disease. Scarlet fever during pregnancy is not known to harm the baby.

There is no vaccine. Prevention is by handwashing, not sharing personal items, and staying away from people who are sick. Up to 80% of children develop lifelong immunity by the age of 10 years. Treatment is with antibiotics, which prevent most complications. Generally, 10 days of penicillin is the first choice of treatment. Alternatives include amoxicillin, first-generation cephalosporin, clindamycin, or erythromycin. Drinking cool water, eating soft foods, taking medications for fever, and applying calamine lotion to the skin may help with symptoms. Outcomes are good if treated. Long-term complications may include rheumatic heart disease, kidney disease, or arthritis.

Scarlet fever most commonly affects children age 1 to 15 years. Low and middle income countries see a greater number of cases. It is seen more frequently when children are in school and in the winter. Males and females are affected equally frequently. Since 2011, mainland China, Hong Kong, South Korea, Taiwan, Singapore, Vietnam, and the United Kingdom have seen outbreaks. It was possibly described as early as 400BC by Hippocrates. In the early 20th century it was a leading cause of death in children, but its severity was already declining before the Second World War and the introduction of antibiotics, possibly as a result of better living conditions, introduction of control measures, and a lower virulence of the bacteria.