Managing scarlet fever

Scarlet fever, an infection caused by toxin-producing strains of Streptococcus pyogenes, was associated with high levels of morbidity and mortality when epidemics were common in the 18^th and 19^th centuries throughout Europe and the USA.¹ Although this disease nearly disappeared during the 20^th century, several countries, including the UK, have recently experienced a re-emergence of scarlet fever.^1-3 However, the reason for these new outbreaks remains unclear.^1,4 Despite a general move to reduce the use of antibiotics for many mild self-limiting infections (e.g. tonsillitis, sinusitis), national guidance recommends treating people with scarlet fever with antibiotics regardless of severity of illness to speed recovery, to reduce the length of time the infection is contagious and to reduce the risk of complications.^5,6 Here, we discuss the management of scarlet fever in the UK.