Patient discussions
Advise patients, or their parents/guardians, to:
Stay home from work or school for at least 24 hours after the initiation of appropriate antibiotic treatment, or until symptoms have resolved if they do not wish to take antibiotics.[25] This is to minimise the potential spread of scarlet fever-causing strains of Streptococcus pyogenes to other people.[25][26] There is evidence that most patients who are being treated with an antibiotic for 24 hours or longer are generally no longer infectious after this time.[26] In the US, the Centers for Disease Control and Prevention recommends patients to stay at home until they are afebrile AND at least 12 hours have passed after starting appropriate antibiotic therapy.[13] Note that individual schools and nurseries may have their own policies.
Complete the fully prescribed course of antibiotics, currently recommended for 10 days for oral phenoxymethylpenicillin.[2][25][49]
Keep their nails cut short to minimise the risk of scratching and introducing a secondary bacterial infection.
Expect the skin affected by the rash to start peeling (called desquamation) starting 3-4 days after scarlatiniform rash. This is part of the natural course and evolution of the illness and does not represent a worsening or relapse of the infection.
Watch out for any symptoms that might suggest complications (e.g., persistent high fever, cellulitis, joint pain and swelling) and to seek medical help immediately.[53]
Advise close contacts to be vigilant of scarlet fever symptoms and its complications.[53]
Be aware that household contacts have been found to have an increased risk of invasive group A streptococcal infection in the 2 months after scarlet fever onset, although the risk is relatively low (35.3 cases/100,000 person-years).[19] See Complications.
Use of this content is subject to our disclaimer