Just hearing the term “scarlet fever” may make many people pause — it sounds like a disease from centuries past, something that shouldn’t exist in our modern world. Yet the truth is, this so-called “old-fashioned illness” is still very much around. In fact, the number of reported cases has been rising both in Thailand and abroad. And the most affected group? School-aged children, who are considered the most at-risk.
Scarlet fever, caused by the bacterium Group A Streptococcus — the same germ responsible for strep throat — occurs when the bacteria release toxins that trigger a distinctive rash across the body. This rash feels rough, like sandpaper, and is often accompanied by another hallmark symptom: a bright red “strawberry tongue,” giving the illness an almost storybook-like description.
Children aged 5 to 15 years are the most commonly affected because they spend time in close contact with others at school, daycare centers, and playgrounds. The bacteria spread easily through droplets from coughing or sneezing, or by sharing personal items such as cups, utensils, or handkerchiefs. Even touching a contaminated surface — like a doorknob or handrail — and then touching one’s face can unknowingly introduce the bacteria into the body.
The resurgence of scarlet fever in recent years has been partly linked to the post-COVID-19 era. As mask mandates were lifted and people resumed social activities, opportunities for bacterial transmission increased, while children’s immune systems — less exposed during lockdowns — may not have been as strong. Symptoms usually appear 1–4 days after infection, beginning with high fever, sore throat, swollen tonsils with pus, and difficulty swallowing, followed by the telltale red rash that often starts on the neck or chest and spreads outward. The tongue turns bright red and bumpy like a strawberry. Some children may also experience nausea, vomiting, muscle pain, or fatigue. If your child or a young family member shows these symptoms, it’s crucial to see a doctor promptly.
Treatment for scarlet fever is straightforward — antibiotics are highly effective, and most patients recover within a few days. However, if left untreated or if the medication course is not completed, serious complications can occur, such as middle ear infections, abscesses around the tonsils, deep neck tissue infections, or even bloodstream infections. More concerning are post-infection complications like rheumatic fever, which can affect the heart, or acute glomerulonephritis, an inflammation of the kidneys that, while rare, can lead to kidney failure.
Although there’s no vaccine yet for scarlet fever, prevention is simple. Practice good hygiene: wash hands thoroughly, avoid sharing cups or utensils, and wear a mask when coughing or having a sore throat — especially during outbreak seasons.
If someone in your household shows symptoms, seek medical care immediately. Once diagnosed, the patient should stay home from school or work until they have completed the antibiotic course and symptoms have clearly improved, to prevent spreading the infection to others.
Scarlet fever may not be a “new” disease, but its return is a reminder that health awareness and preventive care are timeless essentials. A little extra caution — particularly in households with children or crowded environments — can go a long way in keeping both families and schools safe from this resurging illness.
