Text_Files/Strep_Throat_and_Scarlet_Fever.txt

Division of Public Health Services  Disease Handbook for Childcare Providers 
Bureau of Infectious Disease Control   REVISED –January 2018 
STREP THROAT & SCARLET FEVER 
 
Group-A Streptococci are bacteria that can cause 
a variety of illnesses, the most common of which 
are strep throat, scarlet fever and impetigo. 
 
Strep Throat is a sore throat caused by this 
bacterium.  Cold viruses, not stre p bacteria, cause 
the vast majority of sore throats in both children 
and adults.  Strep sore throats tend to be 
accompanied by fever, tender swollen neck 
glands, headache and stomach ache but can also 
occur with cough, runny nose, or other cold 
symptoms. 
 
Scarlet Fever is a form of strep infection caused 
by bacteria that produce a substance, which 
causes a skin rash.  The rash is usually red with 
fine bumps that feel like sand paper and is most 
noticeable on the neck, chest, groin, or on the 
inner surface o f the knees, thighs and elbows.  
The rash does not usually involve the face, but 
cheeks are flushed and there is paleness around 
the mouth.  The tongue may be reddish and look 
like the surface of a strawberry.  The rash may 
only last a few hours.  Scarlet fever is no more 
serious then strep throat.   
 
Treatment of strep infections with antibiotics may 
not dramatically change the length or severity of 
the sore throat symptoms or rash.  It is important 
to treat strep infections in children to prevent its 
spread to others and the possible development of 
rheumatic fever. 
 
Note:  Rheumatic Fever (i.e., abnormalities of the 
heart valves and inflammation of the joints) is 
very rare in the United States today, but can 
develop five to six weeks after any type of 
untreated strep infection.  In rare instances, 
kidney disease can also occur following a strep 
infection. 
 
Who can get this disease? 
Anyone can get strep throat or scarlet fever, but it 
is uncommon in children under three years of age 
(as is rheumatic fever).  It is most common in 
school-aged children, in winter months and in 
crowded situations (e.g., schools, childcare 
centers).  Often if one person in a family gets it, 
other do also, especially brothers and sisters. 
 
How is it spread? 
During infections, strep  is in nose and mouth 
secretions so it can be coughed, sneezed or 
smeared around on hands, dishes, food, toys and 
similar objects.  The incubation period is two to 
five days.  Unlike colds, children are probably not 
infectious during this incubation period.  Children 
are most likely to pass strep to others when they 
have symptoms and until they have been on 
antibiotic treatment for 24 hours. 
 
How soon do symptoms appear? 
The symptoms generally appear within one to 
three days. Because of a possible associati on with 
Reye’s Syndrome (i.e., vomiting, liver problems 
and coma), salicylate -containing products (i.e., 
aspirin) are not recommended for control of fever. 
 
How are they diagnosed and treated? 
The diagnosis of strep throat is made by a throat 
culture.  It usually takes 24- 48 hours to grow the 
bacteria.  There are several recently developed 
rapid tests, which can diagnose a strep infection in 
less time.  Strep infections are treated with an oral 
antibiotic for 10 days.  Occasionally a healthcare 
provider may give a single long -lasting injection.  
Depending on the symptoms, the healthcare 
provider may give antibiotics immediately or wait 
for the throat culture results. 


STREP THROAT & SCARLET FEVER 
(cont.) 
Division of Public Health Services  Disease Handbook for Childcare Providers 
Bureau of Infectious Disease Control   REVISED –January 2018 
 
How can the spread of this disease be 
prevented? 
1. Enforce handwashing and general 
cleanliness in the childcare facility.  If a 
case of strep throat has been diagnosed, it 
is particularly important to remember that: 
a. Staff and children should wash 
their hands after wiping/blowing 
noses and before eating or 
preparing food. 
b. Toys and surfaces should be 
washed and disinfected daily. 
c. Each child should have his/her 
own cup; preferably, disposable 
cups should be used. 
d. Food should not be shared. 
e. All eating utensils should be 
carefully washed in hot, soapy 
water, disinfected and air -dried.  A 
dishwasher is best. 
2. Keep children’s noses clean and dry; wash 
hands immediately after wiping noses. 
3 Teach children to cough/sneeze to one side 
toward the floor and into a tissue.  They 
need to wash their hands afterward. 
4 If there is a case of strep throat in the 
facility, children and staff who develop 
sore throat symptoms should be seen by 
their healthcare provider to be tested for 
strep.  Generally, children and staff who 
do not have symptoms do not need to be 
cultured. 
 
Who should be excluded? 
Children and staff shoul d be excluded until 24 
hours after beginning antibiotic therapy and until 
there is no fever present. 
 
Reportable? 
No, this type of Streptococcal infection is not 
reportable by New Hampshire law to the Division 
of Public Health Services, Bureau of Infectio us 
Disease Control .  However, Public Health 
Professionals are available for consultation at 
(603) 271-4496.