Scarlet fever and immunodeficiency

Scarlet fever (sometimes called scarlatina) is a bacterial illness that causes a distinctive pink-red rash. It is uncommon in the UK but recently there has been an increase in the number of cases reported.

Scarlet fever is caused by bacteria called Streptococcus pyogenes, or group A streptococcus (GAS).

Symptoms of scarlet fever

You can read about scarlet fever from this Public Health England information sheet here.

The characteristic symptom of scarlet fever is a widespread, fine pink-red rash that feels like sandpaper to touch. It may start in one area, but soon spreads to many parts of the body, such as the ears, neck and chest. The rash may be itchy and may be accompanied by a sore throat.

Other symptoms include a high temperature, a flushed face and a red, swollen tongue.

Symptoms of scarlet fever usually develop two to five days after infection, although people are contagious before showing signs of the illness.

Advice for people with immunodeficiency

The Public Health England (PHE) advice for outbreak management in schools and nurseries is centred around good hygiene and infection control. You can find out more about this on the PHE information sheet.

People with PID and other people whose immune systems are compromised (either children at the school or adults working in a school) should seek specific advice from their immunology team.

If there is an outbreak of chickenpox and scarlet fever at school then exclusion or antibiotic prophylaxis may be suggested by their team.

For any patient who has a household contact exposed to an outbreak, the advice is the same – seek advice from your immunology team.

This page was reviewed by Dr Matthew Buckland, Chair of our Medical Advisory Panel, August 2022.