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Streptococcal pharyngitis and scarlet fever

Streptococcal pharyngitis, or strep throat, is a bacterial infection caused by Group A streptococcus. It is more common in children than adults. If a characteristic rash appears, it is usually scarlet fever.

Incubation period and duration of the illness

The illness usually appears 1 to 5 days after exposure to the bacteria and rarely lasts more than 7 days.

Signs and symptoms

Symptoms include a very sore throat, fever, difficulty swallowing and tender, swollen nodes in the neck. A red throat, headaches, nausea and a sore stomach may also occur. Children do not usually have cold symptoms such as a cough and runny nose.

It may be scarlet fever if the individual's tongue has a strawberry-like appearance and a red rash with a sandpaper-like feel develops on the neck, chest, folds of the skin including the armpits, elbows, groin and knees. The rash usually lasts for 2 to 7 days, after which the skin may peel.


The bacteria is transmitted through direct contact with an infected person's saliva, nasal discharge or skin lesions. The illness can be spread through the air by droplets with coughing or sneezing, or through contact with contaminated objects or hands.

To prevent transmission, wash your hands often with soap and water, and when sneezing or coughing, do so into a tissue or into the crook of your elbow. Carefully disinfect toys, taps and door handles, preferably with an alcohol-based product.


An antibiotic may be prescribed to alleviate the sore throat, and to prevent transmission as well as complications. Patients are no longer infectious 24 hours after starting antibiotics. If the infection is not treated, the individual may be contagious for up to 2 to 3 weeks.

To avoid reinfection, dispose of your toothbrush 24 hours after starting the antibiotic.

Here are a few other tips that may also be of use:

  • Take acetaminophen or ibuprofen to relieve fever or pain, if necessary. Consult a health professional for more information.
  • Rest and drink plenty of fluids.
  • Gargle with salt water to soothe the sore throat.
  • Eat soft foods such as ice cream or yogurt.

For more information :

Canadian Paediatric Society

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