Streptococcal Sore Throat and Scarlet Fever

Clinical Explanation
Streptococcal sore throat is an acute condition with fever, exudative tonsillitis or possibly pharyngitis, and tender cervical lymph nodes; however, it may possibly manifest with a small number of signs or symptoms. More than a few sore throats resembling "strep throat" are not caused by strep and could possibly be a virus-like infection. Scarlet fever is a mixing of a streptococcal sore throat and a skin rash caused by a toxin produced by Group A Streptococcus bacteria (Streptococcus pyogenes). The health probem is characterized by a fine, red rash that can feel almost like sand-paper. It appears first on the upper body, then widely spreads to cover almost all of the body. In serious cases, this may manifest during a period of a couple of hours to four or five days. The rash fades on tension and leads to the flaking of the skin. With few exceptions, it might be no more severe or dangerous than a strep throat without the rash. The main reason for consideration with a streptococcal infection is the risk of developing rheumatic fever, which is markedly reduced by prompt treatment with appropriate medications.

Incubation Period
The incubation period ranges from 1 to 3 days, rarely longer.

Mode of Transmission
The major mode of transmission is by large respiratory droplets or straight contact with individuals who have strep throat or with holders of the bacteria. Strep throat and scarlet fever are rarely transmitted through direct contact with objects. Those with acute respiratory tract (especially nasal) infections are becoming likely to transmit infection.

Period of Communicability
One who is untreated can spread the disease as long as he or she is symptomatic, normally 10-21 days. Affected individuals can no longer transmit the infection within 24 to 48 hours after the initiation of antibiotic therapy.

Exclusion/Attendance
Children should not settle for school until at least 24 hours after beginning antibiotic treatment when sick with noninvasive Group A Streptococcus infections. Asymptomatic teenager should not be excluded from school.

Prevention/Care
Children with a sore throat and fever, and children with an unexplained fever over 101 degrees Fahrenheit should be referred for pharmaceutical evaluation.