While “flesh-eating infections” caused by the group A streptococcus (Streptococcus pyogenes) may grab more headlines today, one hundred and fifty years ago, the best known and most dreaded form of streptococcal infection was scarlet fever. Simply hearing the name of this disease, and knowing that it was present in the community, was enough to strike fear into the hearts of those living in Victorian-era United States and Europe. This disease, even when not deadly, caused large amounts of suffering to those infected. In the worst cases, all of a family’s children were killed in a matter of a week or two. Indeed, up until early in the 20th century, scarlet fever was a common condition among children. The disease was so common that it was a central part of the popular children’s tale, The Velveteen Rabbit, written by Margery Williams in 1922.

Luckily, scarlet fever is much more uncommon today in developed countries than it was when Williams’ story was written, despite the fact that we still lack a vaccine for S. pyogenes. Is it gone for good, or is the current outbreak in Hong Kong and mainland China a harbinger of things to come? More below…

First, what are the symptoms of scarlet fever? Most often, this manifestation occurs during or following strep pharyngitis (“strep throat”). Rarely, scarlet fever occurs after the skin infection, impetigo. Children with scarlet fever develop chills, body aches, loss of appetite, nausea, and vomiting; these are symptoms may occur at the same time as or shortly following the onset of pharyngitis. When the rash emerges, it typically seems like an itchy sunburn with tiny bumps. After first becoming visible on the neck and face, it spreads to the chest and back, later spreading to the arms and the remainder of the body. Though initially consisting of separate bumps, these bumps tend to merge together, giving the entire torso a red appearance. Generally, the rash beings to fade by about the sixth day; and similarly to sunburn, the skin may peel afterwards. The tongue, typically very red and bumpy (“strawberry tongue”) may also peel.

Scarlet fever is nothing new to humanity, though the earliest case definition of scarlet fever is a matter of contention. Some researchers attest that descriptions of disease which match scarlet fever date back almost 2,500 years, to Hippocrates. Others believe the first conclusive diagnosis is found in the tenth century writings of Rhazes, who also worked to distinguish measles and smallpox as separate diseases. It is generally agreed upon that the first sufficiently detailed paper identifying scarlet fever as a disease distinct from other rashes appears in 1553. In that paper, the Italian physician Giovanni Ingrassia describes the disease and refers to it as “rossalia.” The term “febris scarlatina” appears in a 1676 publication by the British physician, Thomas Sydenham.

Historical data suggest at least three epidemiologic phases for scarlet fever. In the first, which appears to have begun in ancient times and lasted until the late eighteenth century, scarlet fever was either endemic (always present at a low level) or occurred in relatively benign outbreaks separated by long intervals. In the second phase (~1825-1885), scarlet fever suddenly began to recur in cyclic and often highly fatal urban epidemics. In the third phase (~1885 to the present), scarlet fever began to manifest as a milder disease in developed countries, with fatalities becoming quite rare by the middle of the 20th century. In both England and the United States, mortality from scarlet fever decreased beginning in the mid-1880s. By the middle of the twentieth century, the mortality rate from scarlet fever again fell to around 1%.

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Fig. 1. Boston 1840-1940. Severe streptococcal infections in historical perspective. Depicted in the insert are the recorded deaths in the United States from 1900 to 1960. From Krause RM, citation below.

During Sydenham’s life (1624-1689) and for more than a century afterwards, scarlet fever was considered by both parents and physicians to be a relatively mild childhood disease. Although several European cities experienced fatal epidemics of the disease, these epidemics were often short-lived, and it does not appear they were widespread.

In the early nineteenth century, the clinical presentation of the disease appears to have changed for the worse. Lethal epidemics were seen in Tours, France, in 1824; in Dublin, Ireland, in 1831; and in Augusta, Georgia, during 1832-33. Similarly, in Great Britain, the fatality rate from scarlet fever increased from between 1 and 2 % to more than 15% in 1834.

From 1840 until 1883, scarlet fever became one of the most common infectious childhood disease to cause death in most of the major metropolitan centers of Europe and the United States, with case fatality rates that reached or exceeded 30% in some areas–eclipsing even measles, diptheria, and pertussis.

Scarlet fever pandemics of this and other eras also had a profound effect on history, in addition to providing a plot device for a beloved children’s story. Charles Darwin lost two of his children to scarlet fever. The first, his beloved daughter Annie, died at the age of 10 in 1851 (two sisters, also infected, recovered from this bout). In July 1858, Darwin also lost his 18-month-old son, Charles Waring, to scarlet fever. It is believed that a bout of scarlet fever at the age of 19 months caused Helen Keller to lose her senses of vision and hearing. Scarlet fever also led to the founding of The Rockefeller University by the world’s first billionaire and the founder of Standard Oil, John D. Rockefeller, whose 3-year-old grandson died of scarlet fever. Rockefeller remains a leader in biomedical research today, including research investigating various aspects of the biology of the group A streptococcus.

Why did scarlet fever, once a scourge of childhood, end up as a relatively rare infection in developed countries? While some of this can be attributed to antibiotics (particularly from the 1950s on), both the incidence of scarlet fever and mortality from the illness started to decline well before the antibiotic era (seen on the graph above)–a phenomenon that may be attributable to the emergence of novel strains of S. pyogenes in the population which were less likely to cause scarlet fever, but more likely to spread in the population. (A similar strain replacement may have occurred in the late 1970s/early 1980s, leading to the increase in the aforementioned “flesh eating” strains of strep). Other biological factors such as herd immunity to epidemic strains, as well as social factors including decreased crowding, improved hygiene, and even milk pasteurization (milk was responsible for several large group A strep outbreaks) also probably contributed to this decrease.

Scarlet fever still remains a threat today, particularly in developing countries, but nowhere today is it as severe a disease as it was during that frightening time in the middle of the nineteenth century. However, the current outbreak in China shows how quickly this situation can change, as they’ve seen a quadrupling in the number of cases in 2011 compared to previous years and several fatalities. News stories have suggested this is some kind of “mutant” strain and has increased resistance to antibiotics, though I haven’t seen much elaboration on either of those claims. (This story touts “the new strain has about 60 percent resistance to antibiotics used to treat it, compared with 10 percent to 30 percent in previous strains,” which doesn’t make much sense as written–maybe resistance to 60% of the antibiotics tested…?) Though still of relatively low mortality compared to Victorian era, the resurgence of this disease, and the potential for the emergence of a new strain shows how quickly this disease can make a comeback. Additionally, at least one article notes a simultaneous outbreak of chickenpox–and strep plus varicella zoster (the chickenpox virus) are a can be a nasty combination.

I also wonder if the current outbreak is really caused by a new strain as suggested, or by one that has been percolating throughout Asia for awhile and only recently hit the big time. I guess time–and hopefully sequencing data–will tell.

Further reading:

Katz SL, Morens DM. Severe streptococcal infections in historical perspective. Clin Infect
Dis 1992;14:298-307. Link.

Krause RM. Evolving microbes and re-emerging streptococcal disease. Clin Lab Med. 2002 Dec;22(4):835-48. Link.

Comments

  1. #1 IreneAdler
    July 6, 2011

    My 20-something sister had scarlet fever right here in the US of A just last year. Her doctor was completely bowled over — hadn’t seen a case in ages. Lab confirmed, though. I think that was the first time I actually knew someone who had it in my lifetime.

  2. #2 Mara
    July 6, 2011

    Scarlet fever is uncommon in the US? Wow. My 2-year-old son has had it three times! I just figured everybody got it at some point. Then again, my fully immunized son also managed to catch a mild case of chicken pox recently.

    Either my son’s doctor has lousy diagnostic skills (although the positive strep tests back him up) or my son has a real talent. Lemme see, so far: croup from RSV, croup from parainfluenza x3, scarlet fever x3, chicken pox, various colds, molluscum contagiosum, coxsackie virus…

  3. #3 Shanna
    July 6, 2011

    @Mara, I can’t speak about most of those conditions, but I personally had chicken pox twice. A very good case both times. My doctor said that in about 10% of the population, the immune system effectively “doesn’t remember” the first time, regardless of how bad you have it. The second time, I was 17 and they nearly hospitalized me (the doc wanted to, but my mom wouldn’t let them, so the doc gave her explicit instructions to follow in giving me liquids, etc…I still hate ginger ale to this day). It was pretty horrible, had them in my mouth, hair, and eyelids. When I got older and had my daughter, I had her vaccinated for chicken pox at the correct age, and she still developed it a couple of years later (which frankly didn’t surprise me a bit). The vaccine doesn’t give a 100% guarantee of never catching it for one thing, and I’m of the opinion (not medically certified, just my opinion) that my daughter inherited my tendency for the immune system to “forget” it. My sister’s son did the same thing.

  4. #4 Tara C. Smith
    July 6, 2011

    Yeah, it’s rare but can happen, and some kids tend to be more susceptible to various manifestations of strep infections than others. My daughter gets strep throat roughly twice/year like clockwork, and my son’s never had it, despite being exposed and occasionally sharing drinks, utensils, etc. before we knew she was sick. No scarlet fever to date, though.

  5. #5 Sarah
    July 6, 2011

    I’m in my mid 20s, and I had scarlet fever when I was 3 years old. I have vague memories of a really high fever, and being really uncomfortable. I’m the only one I’ve ever met to have had it. It impresses the heck out of people when I tell them.

  6. #6 Mara
    July 6, 2011

    We have friends whose son had scarlet fever back when I was pregnant with my older child. I had no idea what it was and got it confused with rubella, so I ran around like a chicken with its head cut off, convinced I’d been exposed to something that would kill my baby.

    (Mind you, I’d had my immunity to rubella confirmed before I even got pregnant. But I’d be the last person to claim that pregnant women were rational.)

    Now that I think about it, though, that’s the only other case I can think of! My son is so talented :)

  7. #7 wheatdogg
    July 8, 2011

    My dad had scarlet fever as a child ca. 1920, if I remember it correctly. He acquired a heart murmur as a result of some childhood illness, in any event, and it made him 4F during World War II. (He was also my grandma’s sole means of support, so he probably would not have seen combat, anyway.) On the downside, it weakened one of his heart valves, which many years later had to be replaced with a porcine valve when his blood pressure got too high and damaged the valve further.

    However, I could be confusing scarlet fever with rheumatic fever.

  8. #8 stripey_cat
    July 8, 2011

    I got scarlet fever in about 1990. I was well enough in the morning to send into school, and after lunch I collapsed from a high fever. The next thing I remember was nearly a week later. Apparently, my grandmother, born in about 1918, had kittens when she saw me (she beat the doctor to the diagnosis); the teacher tried to treat it as an ordinary fainting fit (she’d never seen scarlet fever nor realised fevers could get high enough for loss of consciousness); my unfortunate mother had to deal with a procession of army medical personnel trooping up to my room to see the clinical case of something they’d only read about. Luckily I didn’t spread it to anyone, and they didn’t know where I’d managed to pick it up.

  9. #9 Tara C. Smith
    July 8, 2011

    However, I could be confusing scarlet fever with rheumatic fever.

    It’s quite possible the latter came as a result of the former–rheumatic fever/rheumatic heart disease are sequelae of strep infections, so the scarlet fever could have led to RF/RHD. That was fairly common in the pre-antibiotic era.

  10. #10 wheatdogg
    July 12, 2011

    Thanks, Tara.

    @stripey_cat: my daughter, who’s now 25, was sick with what we thought was a bad cold when she was around 4. Her fever suddenly spiked to 104, she passed out and started convulsing. Scared us shitless. After a trip to the ER and some meds, she was fine and recovered in a few days.

    Maybe this kind of thing can run in families?

  11. #11 FloridaJudy
    July 13, 2011

    My son got scarlet fever at age two. He must have had the more benign “modern” type, since he never acted particularly sick, just turned some interesting colors and peeled like a post-it a week later. Of course taking the kid to the pediatrician as soon as he started resembling a boiled lobster may have had something to do with it!

  12. #12 malnwah
    July 19, 2011

    I myself, had scarlet fever at age 5 in 1970 with a temp of 105. I don’t remember any of it except what was told to me by my parents. During my teens, I suffered with mono and recently was diagnosed with EBV. I am now 45 and have been suffering with neurological problems and a heart murmer. Could Scarlet Fever cause this after 40+ years??

  13. #13 Rahul
    July 30, 2011

    It is quite scary to think that scarlet fever can still strike at will. This is especially true in the case of developing countries as correctly stated as they do not have the mechanism to prevent it completely. The increases resistance to antibiotics is something to be worried about.

  14. #14 tayfun
    August 5, 2011

    Araştırmalarınızı takip ediyorum hizmetleriniz için teşekkürler.

  15. #15 RP
    August 12, 2011

    My brother had scarlet fever twice in the 1970s – I remember quite distinctly because we both had to have the nasty penicillin syrup for 10 days each time. I didn’t have it until the early 80s, when I was a teenager: came home from a babysitting job and my fever went up around 103-104 F as soon as I got home. It stayed there for several days until my parents finally took me to the doctor for a diagnosis and some penicillin (pill form, fortunately).

    Neither my brother nor I had long term consequences from this, but I certainly heard horror stories once I got back to high school about aunts and uncles who died or lost all their hair to scarlet fever.

  16. #16 BlondMaggie
    August 15, 2011

    Scarlet Fever makes one thank God for scientists and modern medicine. My son had the disease about 5 years ago, and I’ve never seen him so miserable. The doctor was unalarmed but fascinated, and called in every doctor and nurse in the clinic to observe an actual case and feel the sandpaper rash. Which, once I realized the disease wouldn’t kill him, I was happy to allow. What floored me more was that all it took was a short course of antibiotics to knock it out.

    I am profoundly grateful to all the scientists who turned this deadly and scarring disease into just another inconvenient childhood malady.

  17. #17 jre
    November 8, 2011

    Hiçbir şey, Tayfun düşünün. Bir fincan kahve ister misiniz?

  18. #18 Deborah
    February 7, 2012

    I am 50 years old and had Strep Throat which progressed into Scarlet Fever when I was 2, with my temperature reaching as high as 107.4 degrees. I was initially misdiagnosed, though my mother cannot recall what the wrong diagnoses were. I now have RA and Arrythmia and wonder if these might be related to having the disease as a child. I have heard they could be. I would love to hear from anyone with knowledge, especially medical knowledge about this. Thanks!

  19. #19 Sheryl
    April 13, 2012

    10 years ago, I had Strep that went undiagnosed even though I visited the Doctor. He lost my culture results. As a result Strep turned into Scarlet Fever and a week in the hospital. They told me to monitor for heart problems. . Just recently I have noticed waking up with a very high heartbeat multiple times each night. I initially thought this was my thyroid gone a little crazy. But now I realize this occurs primarily when I lay a certain way on my left side. Upon researching Scarlet Fever and heart valves, I realize I should get this checked out quickly. Thanks for scaring me into it!

  20. #20 Lisa
    October 29, 2012

    I had Scarlet Fever in 1966…am now 50 yrs. old. I have never had a fever since then. Even with getting the normal flu and a few bouts of Strep throat over the years, my body just never fevers. My best friends mom is 80, and she’s the only person I know who has said her body doesn’t fever either. She too had Scarlet Fever as a child. Doctors look at me like I’m a nut when I tell them this. Has anyone experienced or heard of this?

  21. #21 Lori
    January 4, 2013

    @ Lisa..I had scarlet fever as a child with strep throat. I was about 6. I’m now 36 and have never had a fever since even with cold and flu symptoms.

  22. #22 Jean
    England
    January 11, 2013

    I had Scarlet Fever when I was 5 in 1959. I remember being taken to hospital and seemed to be there for weeks but arnt sure how long exactly. It was over Christmas and my mum came to see me on Christmas day but wasnt allowed in my room. She had to look at me playing with my presents through the glass door. I had injections in my bottom every day and my skin peeled off on my hands. I have four brothers and it was expected that they would get it too but they didnt.

  23. #23 Jenny
    Frinton-on-Sea, Essex
    January 15, 2013

    I am 64 and remember when I developed Scarlet Fever back in the 50’s,. I was 4 or 5 and recall being sent to an isolation hospital. It must have about Christmas time, the nurses toured the wards with candles, singing carols round the christmas tree. Like Jean I remember seeing my parents through the window only. I also remember my fav toy, my hollowing, had to be sterilised and was returned to me, an awful grey colour, when he had been boiled I guess. That upset me more than anything else!

  24. #24 Jenny
    January 15, 2013

    My fav toy was golliwog, sorry for mistake.

  25. #25 MadamXAnon
    January 15, 2013

    I have a mitral valve heart defect after surviving scarlet fever in 1958. I missed a month of school. It caused me to be a sickly child for years. I couldn’t run or get upset or my heart would get out of rhythm. At age 51, I had a stroke from a blood clot in my brain that migrated from my heart. It took several years to be able to stand up on my own. I have permanent memory problems and I can’t drive anymore. We should be very concerned that this blight on childhood ever takes a foothold again.

  26. #26 Belinda
    Smithtown ny
    February 28, 2013

    My daughter was just diagnosed today with scarlet fever. She was cold and tired 1st day, headache 2nd day , rash 3rd day. No other symptoms. Dr said 2nd case in her practice this week. She’s seen it about 2 yrs ago. I was very surprised but she’s ok thank goodness

  27. #27 Brittany
    March 12, 2013

    If you have had scarlet fever as a child.. what can you expect as an adult? I am 27 years old, and had scarlet fever at 11 or 12. I don’t remember much, however remember being carried to a few different doctor offices to get other opinions. My ankles were very swollen and I was very week. After taking a skin biopsy they confirmed that it was Scarlet Fever. Since then, I’ve only ever gotten sick (serious sick) a couple of times. I never catch a cold and I’m not an extremely healthy person. I did used to get horrible migraines a year or so after Scarlet Fever. And caffeine makes my heart race. I may sound naive, but could this be at all linked to Scarlet Fever?

  28. #28 X marks the spot
    March 25, 2013

    My 18 year old daughter suffers from chronic strep throat, all last week high fever sore throat, by friday she was “feeling better” Saturday she came upstairs looking like a boiled lobster. Ran to the clinic yup SCARLET FEVER, which I happened to find hilarious, as I recognized it immediatly.. I had it when I was 20, my younger sister had it at 16… it is actually an allergic reaction to the poisinous toxins that Strep A passes through the body and only certain people are allergic… which is why not everyone who gets strep throat gets scarlet fever.

  29. #29 Kristiy
    March 28, 2013

    My four year old son was diagnosed with scarlett fever and strep throat yesterday. He had a fever with vomitting and diahhrea for three days. We thought he seemed to be doing better and the fourth day he woke up with almost all of his face except below the mouth and his upper chest and the back of his neck was pinkish red and part of his face slightly swollen. I took him straight to the dr where they tested and confirmed strep and scarlett fever. Hes been on amoxicillin since yesterday morning and he hasnt vommited once, his fever is slight

  30. #30 Kristiy
    March 28, 2013

    The doctor said theyd not seen a strep case get that bad.The day before he got sick he was fine, running around and playing with his cousins.

  31. #31 Andrea
    March 31, 2013

    My daughter, who just turned one, got diagnosed with strep throat and scarlet fever today. I really thought scarlet fever was a thing of the past! How wrong was I! She does have a slight rash but nothing as bad as what it sounds like it could be. Yet……

  32. #32 Kimmi
    Middlands
    April 1, 2013

    I had Scarlet Fever at the age of 6 which turned out real bad and had to be rushed to hospital for weeks. My Mother asked the Doctor if I could get Heart problems later on in life and he replied no. This does worry me as most of you have pointed this out.. I am only 25 but do feel all stressed out sometimes and notice my heart does have a kind of dull ache at times but I hope this is nothing :/

  33. #33 Claudia
    Georgia, USA
    April 3, 2013

    My son is almost five and he had Scarlet Fever twice in the last year. He has had strep throat before but the Scarlet Fever only developed on his last 2 times. He did not complain about any symptoms but that red rash freaked me out the first time.

    Just yesterday, my almost 4 year old daughter got Scarlet Fever for the first time (2 weeks after my son had finished his round of antibiotics). It may run in the family.

    Although this might be a modern version of the Middle Ages Scarlet Fever because the children are definitively not suffering (thank God). And I do not think Scarlet Fever is so uncommon.

  34. #34 Harley
    new York
    April 5, 2013

    I’m 13 years of age and I have scarlet fever… It took the doctors about two months to figure out what was wrong. They had diagnosed me with so many different things before my mother demanded a blood test and it showed that it’s in my blood stream… Out really sucks and is not something you want to get. The meds I have to take are super strong but might not work so I’m a bit on the scared side

  35. #35 cortney
    Michigan
    May 12, 2013

    I am 28 years of age and have had Scarlett fever when i was about 7 or 8? I don’t remember a whole lot except for laying on my grand fathers couch with a high fever and pinkish red cheeks. Thank fully we have the technology today to help with this kind of stuff.

  36. #36 amanda
    ohio
    May 22, 2013

    My two year old son has this right now it has caused a side effect not listed on any site. The roof of his mouth is bloody. Its a very scary diease i have only heard of in talks with my history teacher an my great grandma. Its something everyone told me was nothing more than a simple heat rash an sore throat. I trusted my gut an took him to the hospital good thing to because it could cause him to have kidney liver heart and breathing problems if left untreated. Hope the antibiotics do the trick. If not i was told he will be kept in the hospital in a completly setrial room untill they can figure out what to do.

  37. #37 Julie Davis
    IL
    May 26, 2013

    My 7 year old daughter was diagnosed with Scarlet fever yesterday. Her temp got up to 104. She only threw up one time. Her rash has been really itchy. This really surprised me because i didnt think anyone got it anymore. My 2 older kids never had it, i just hope there arent any long term effects.

  38. #38 Nick
    Escondido
    August 12, 2013

    I had scarlet fever at about 6, and I remember being itchy… VERY ITCHY… With red bumps everywhere. It was very scary. But my brother, with his high immunity to infections, didn’t catch it. He also evaded catching strep throat when I would get it every year like clockwork in January-February. I’ve been getting panic attacks lately and am wondering if the two might be related? Thanks.

  39. #39 heather Reynolds
    United States
    September 26, 2013

    my 11month son was diagnosed with scarlet fever/strep he has had it for about 4 days now he is feeling much better but it is a scary site seeing your lil boy spred it looks like he sat in straight sunlight for days he started with just a small fever then 30 min later a rash started the another 30 mins after that he was just as red as can be i took his temp it was 102.8 hurried and rushed him to the docs and by time we got there it was a 105.3 thise was all in a 20 min time spand is how high his fever got and was riseing the did test and when it came back they where stuned how his blood count was and they transported him to a childrens hospital it took untill the next day for the complete results to come back but iam glad and i think god i cought it in time

  40. #40 Jim
    IL
    September 29, 2013

    I had scarlet fever when I was five. I am 52 now. The only thing I remember is waking up feeling horrible and my parents taking me home and how happy I was to be going home. For the life of me, I cannot remember where I was apparently quarantined but I must have been because I distinctly remember the ride home. Now I suffer from psoriatic arthritis. I wonder if there is any link between the two.

  41. #41 Jrsgel
    USA
    October 10, 2013

    My 12 year old son went to school Monday morning feeling fine. School nurse called at 10:30 with him in her office with sore throat but mild low fever. She gave him Tylenol and some mints. Within a few hours he was back again but fever was a little higher …99.7. Came to get him and went to doctor. Confirmed it was strep throat and given amoxicillin. Tuesday afternoon he said that he had bites all over him, but when I looked I could tell it was a rash. I thought it was an allergy to the medicine. Took him back to doc and she said its no allergy…..it’s scarlett fever. I nearly fainted! She calmed me down and told me that it’s not like it used to be and that it’s treated with normal antibiotics which he was already on. She said he should be better by Friday. I see a marked improvement today, in that he’s not nauseous or running a high fever. It got up to over 103 Tuesday night. He was miserable. Labored breathing, high fever and nauseated. Plus, he complained about the top of his head being extremely sore. Aches and chills, night sweats too. The rash is still spreading today, but everything else is much better.

  42. #42 Myra Berger
    Wenatchee, WA
    November 8, 2013

    My daughter had Scarlet Fever when she was 9. She is now 59 and her hands started peeling recently, just like when she was ill at age 9. I have been searching for a reason for this peeling but cannot fine anything.

  43. #43 Laura
    July 31, 2014

    I had scarlet fever for several weeks when I was 14. My parents thought it was just the flu or something. We went on vacation instead of cancelling because I said I’d be fine and didn’t want to ruin their trip. I wish I had. I have never been so miserable. I couldn’t eat and my throat was so swollen I could barely swallow tylenol. We didn’t know what it was but I got a red rash and my throat kept getting worse my grandmother kept saying it reminded her of when her uncle had scarlet fever but no one got that anymore so that couldn’t be it. I went to the doctor when we got home even though I was feing better pretty much but sure enough that’s what it was. They said I was lucky to have lived because it was really severe and my throat is still damaged from it. I never had any antibiotics for it though. My immune system hasn’t been nearly as stable since then. I get sick at least once a month now.

  44. #44 Christina
    Arkansas
    October 8, 2014

    My son had scarlet fever maybe 6 years ago; he was 5. Since then, he has complained of chest pains and shortness of breath with exertion. I’m kinda freaking out now. I’m certain the symptoms are related. Oh and my son showed no symptoms days before he got the rash. The morning of the “boiled lobster” rash he did complain of a sore throat and I made him an appointment at his Dr office. By the early afternoon he had developed the full red rash. Can’t recall if he had a high fever, don’t think so. But he always reacts runny when seriously ill.

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