Can an adult get scarlet fever? A complete guide


Written by tapGP Clinical Team

10 November 2023

Scarlet fever is a bacterial infection resulting from group A streptococcus, which is the the same bacteria that causes strep throat. Scarlet fever usually causes a red rash, sore throat, fever, and a ‘strawberry’ tongue. Scarlet fever is not just a childhood disease and although it is less common, adults can also develop symptoms.

What are the symptoms of scarlet fever in adults?

As an adult, you might have the following symptoms and signs that could suggest scarlet fever:

  • A ‘scarlet’ rash, which feels like sandpaper to the touch, starts on your chest and stomach and spreads to other parts of your body.
  • Red lines in the folds of your skin, especially around the groin, elbows, and armpits.
  • A flushed face, with the area around the mouth appearing paler than the rest.
  • A strawberry-like appearance of the tongue, which may start with a white coating before becoming red and swollen.
  • High fever, often over 38.3°C that starts suddenly.
  • A sore throat that can be severe and you usually have swollen glands.
  • Difficulty swallowing due to throat pain.
  • Headaches, nausea, vomiting, and body aches.

These symptoms usually develop within one to four days after coming into contact with someone with the infection and often require urgent medical assessment by a doctor.

How does scarlet fever spread?

Understanding how scarlet fever spreads is essential in preventing its transmission. This bacterial infection is primarily caused by Group A Streptococcus (GAS), the same bacteria responsible for strep throat. The bacteria can be transmitted through respiratory droplets when an infected person coughs or sneezes. Touching a surface or object contaminated with the bacteria and then touching your face, especially your mouth or nose, can also lead to infection.

Understanding how scarlet fever spreads is crucial to protect yourself and those around you from this bacterial infection. Scarlet fever is mainly caused by Group A Streptococcus (GAS), which is the same bacteria responsible for strep throat. Here’s how it can be transmitted:

  • Respiratory Droplets: When an infected person coughs or sneezes, tiny droplets containing the bacteria can be released into the air. If you inhale these droplets, you can become infected.
  • Contaminated Surfaces: The bacteria can also survive on surfaces or objects touched by an infected person. If you touch these contaminated surfaces and then touch your face, especially your mouth or nose, you can introduce the bacteria into your body.

It’s important to note that scarlet fever is highly contagious, which means it can easily spread in crowded places where people are in close proximity to each other. To protect yourself and others, follow these simple yet effective hygiene practices:

  • Frequent Handwashing: Regularly wash your hands with soap and water for at least 20 seconds, especially before eating and after being in public spaces.
  • Cover Your Mouth and Nose: When you cough or sneeze, use a tissue or your elbow to cover your mouth and nose. Dispose of used tissues properly.
  • Avoid Close Contact: Try to maintain physical distance from individuals who are known to be infected with scarlet fever. This can help reduce the risk of transmission.

By practicing good hygiene and taking preventive measures, you can significantly lower the chances of contracting scarlet fever and help prevent its spread within your community.

Who’s at risk of scarlet fever?

Adults who are in close contact with young children, either at home or in settings like schools, are at a higher risk of catching scarlet fever. Other risk factors include having a weakened immune system and living in crowded conditions.

How is scarlet fever diagnosed in adults?

If you think you have symptoms of scarlet fever, speak to a doctor. They will likely perform a physical examination, discuss your medical history, and may perform a throat swab or a rapid strep test to confirm the infection.

How is scarlet fever in adults treated?

A GP will usually prescribe antibiotics to treat the infection. It’s important to take the full course, even if you feel better after a few days. In addition to antibiotics, rest and drinking plenty of water are important for recovery. Over-the-counter pain-killers can help reduce fever and throat pain. You can also try the following home treatments:

  • Use a cool-mist humidifier to add moisture to the air and soothe a sore throat.
  • Drink warm liquids like tea with honey or broth to ease throat pain.
  • Avoid acidic or spicy foods that may further irritate your throat.
  • Gargle with salt water to reduce throat discomfort.
  • Apply calamine lotion to the rash to relieve itching.

While recovering from scarlet fever, you’ll need to take steps to care for yourself and protect others:

  • Rest until the fever is better and you feel ready to restart normal activities.
  • Stay at home and avoid going to work or social activities for at least 24 hours after starting antibiotics to avoid spreading the infection.
  • Replace your toothbrush after you’ve been on antibiotics for 24 hours to prevent re-infection.

How can I prevent getting scarlet fever?

Prevention is often the best defence. Wash your hands frequently, especially after coughing or sneezing, before preparing foods, and before eating. If someone in your household is diagnosed with scarlet fever, disinfect surfaces and do not share towels, bedding or eating utensils.

What are the signs of severe scarlet fever infection?

Monitor for signs of complications, such as worsening symptoms, difficulty breathing, or persistent fever. If these occur, see a doctor immediately or call 999.

Without proper treatment, scarlet fever can lead to severe conditions, such as rheumatic fever, kidney disease, and other infections. It’s essential to be aware of these risks and to manage your condition carefully to avoid them.

Recovery and follow-up

If you are not feeling better after 48 hours of completing antibiotics you speak to a doctor immediately.

If you have scarlet fever, you may need to rest for a longer period of time. Support from family and friends can be helpful, as well as understanding from your workplace. Remember, your health is the priority, and ensuring a full recovery is important before returning to your full daily routine.

FAQs on scarlet fever in adults

Is scarlet fever in adults serious? 
Yes, it can be, especially if not treated correctly. Adults may experience more severe symptoms and are at a higher risk for complications.

How can I tell if it’s scarlet fever or just a rash? 
Look for other symptoms like a high fever and sore throat. A doctor can provide a definitive diagnosis.

What should I do if I’ve been exposed to scarlet fever?
Monitor for symptoms and seek medical advice if they develop.

Can I get scarlet fever if I’ve had it before?
Yes, previous infection with scarlet fever doesn’t provide lifelong immunity.

How long is the recovery period?
Most symptoms of scarlet fever resolve within a week with proper treatment, though full recovery may take longer.

While scarlet fever is uncommon in adults, it’s important to be educated about the infection. If you have symptoms, speak to a GP immediately and follow through with prescribed treatments. With the right care, most people make a complete recovery. Remember to prioritise your wellbeing and allow yourself the time needed to recover fully.

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