Three Children in Washington DC Contract Scarlet Fever

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Officials in Washington DC have confirmed three cases of scarlet fever at Terrell Elementary school. Parents were alerted about two weeks ago as a precautionary measure, and many were unfamiliar with the condition that at one time was associated with a high death rate.

Scarlet fever, once more commonly known as scarlatina, is a disease caused by the same bacterium that causes strep throat – group A Streptococcus or “group A strep”. It is highly contagious, transmitted through contact with droplets from a person’s mouth or nose, especially when they cough or sneeze. It primarily occurs in children five to fifteen years old with a peak between ages four and eight.

In the 1800’s, scarlet fever was a feared epidemic because of the high complication and mortality (death) rate of those who were infected. Today, the infection follows a mostly benign course and is easily treated with common antibiotics.

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The first sign of scarlet fever is a rash that shows up as tiny red bumps primarily on the chest or stomach and then spreads all over the body except for on the palms of the hands or the soles of the feet. It is rough to the touch and usually lasts about one week. Fever of 101 degrees Fahrenheit or higher occurs, as well as a strawberry like appearance of the tongue and bright red color in the creases of the underarm and groin called Pastia’s lines. Other common symptoms include a flushed face that is pale around the lips, red and sore throat that may have white or yellow patches, and swollen glands in the neck.

Scarlet fever is treated with an antibiotic, most commonly penicillin, amoxicillin, azithromycin, clarithromycin, clindamycin, or a cephalosporin. Early treatment is essential to prevent the development of rheumatic fever, a serious complication of both strep throat and scarlet fever that can infect the heart, joints, skin and nervous system. Other possible complications include bone or joint problems, ear infection, inflammation of a gland, kidney or liver damage, or pneumonia.

Motrin or Advil can be given to treat fever and body aches, and adequate fluids are essential to prevent dehydration. Other helpful remedies are saltwater gargles or lozenges for sore throat and a cool-air humidifier. Clear liquids such as soups and popsicles are recommended for nutrition, with a focus on hydration as the most important factor.

The best prevention for contracting scarlet fever, or any contagious bacteria or virus, is to wash hands often with warm soapy water and to avoid sharing personal objects with others such as eating and drinking utensils.

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