General information about pathology
Scarlet fever refers to a viral infectious pathology. Young children aged 2 to 10 years are at risk. However, adults can also get sick. In weakened people, the elderly, and pregnant women, the likelihood of contracting scarlet fever increases.
The main clinical manifestations of the disease are fever, characteristic lesions of the oropharynx and a pinpoint rash. The patient develops hyperemia of the mucous membrane of the pharynx, arches and soft palate. Sometimes lacunar or follicular tonsillitis and acute pharyngitis may appear. A purulent fibrinous or necrotic plaque appears on the tonsils.
The rash is evenly distributed throughout the body, with the exception of the nasolabial triangle. After 3-5 days it disappears, leaving fine-scaly or coarse-scaly peeling.
Cause of occurrence
The causative agent of scarlet fever is beta - hemolytic streptococcus of group A. The virus has a round spherical shape. Under a microscope you can see how these balls are connected into a long chain, forming the streptococcus itself.
The word “hemolytic” in the name of the microbe means that it is capable of destroying the formed elements of blood (red blood cells).
The main cause of scarlet fever is contact with an infected person. You can also become infected from a person with streptococcal pharyngitis or laryngitis.
Another cause of scarlet fever is being near a carrier of streptococcus. In this case, an apparently healthy person does not even suspect that he is a carrier of the disease. There are about 15% of people in whom streptococcus “lives” on the mucous membranes of the pharynx without causing any external manifestations.
Thus, knowing how scarlet fever is transmitted in children and adults, you can take measures to prevent diseases. This will prevent the person from becoming infected and prevent the development of dangerous complications.
Features of scarlet fever in adults
In total, three forms of the disease are known: erased, toxic-septic and extrabuccal. In adults, the disease occurs in most cases in a toxic-septic or erased form. The latter is characterized by vague manifestations that are easily confused with symptoms of other diseases or even not noticed at all. Thus, minor rashes may occur in small areas of the body. Many people experience swelling and redness of the throat, as well as pain in it, which occurs and intensifies when swallowing.
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The toxic-septic form does not occur so often (it is generally not observed in children), but it is considered the most severe. The symptoms are pronounced and affect not only the skin and mucous membranes, but also the cardiovascular system. A decrease in blood pressure, a slow heart rate, cold extremities, severe weakness, and faintness may be observed. But this form is dangerous not only due to its manifestations, but also to possible complications (they occur in approximately 5-6% of all cases), which include endocarditis, myocarditis, pneumonia, sinusitis, arthritis, otitis media, pyelonephritis and some others.
Main routes of infection
When asked whether scarlet fever is contagious to others, doctors answer unequivocally. This disease has a high contagious index in adults and children. This means that you can become infected in 90% of cases after communicating with a sick person.
The main routes of infection with scarlet fever include:
- Airborne.
- Contact and household.
There is also a possibility of developing the disease if streptococcus enters the extrapharyngeal route. In this case, the pathogen penetrates through the wound or burn surface. In this case, the rash is localized at the site of virus penetration.
In children
In children, scarlet fever is transmitted in several ways. You can become infected:
- When coughing, talking, sneezing.
- Through children's toys, household items, clothes.
Transmission of the virus through third parties is also possible. For example, if a child interacts on the playground with a child who has had contact with a person with scarlet fever.
The entry gates for beta-hemolytic streptococcus in children are the mucous membranes of the oropharynx and nasopharynx. Sometimes the pathogen can enter the child’s body through damaged skin.
It is extremely rare that the scarlet fever virus enters the body through food. Most often this occurs when consuming unboiled milk or other dairy products.
There is also an intrauterine route of transmission. A newborn can become infected when passing through the birth canal from a mother with scarlet fever.
In children, the risk of infection increases in the presence of the following unfavorable factors:
- Existing chronic diseases.
- Avitaminosis.
- Secondary immunodeficiency.
- Decrease in the body's defenses.
- Frequent hypothermia.
Strengthening the immune system, consuming vitamins, and daily exercise increase the body's resistance to scarlet fever.
In an adult
The question of how scarlet fever is transmitted in children interests many. This disease can be transmitted to others in different ways.
According to medical statistics, the likelihood of pathology occurring decreases with age. People under the age of 25–28 years are most often affected. In middle-aged and elderly people, this pathology occurs extremely rarely.
Scarlet fever can be transmitted to adults in the following ways:
- Aerosol route. In contact with a sick child. This can happen on the playground, in the kindergarten or in your own home.
- Contact-household way. In this case, it is necessary to use common household items: combs, dishes, clothes, towels.
- By nutritional route. Infection occurs through consumption of contaminated foods.
There are also atypical ways of transmitting scarlet fever. These include the extrabuccal route of infection. The gates of infection are extensive burns, large wounds, wounds, and the birth canal.
An adult can also become infected with scarlet fever through kissing, hugging, shaking hands, or tactile contact.
How does the disease manifest itself?
The incubation period is characterized by the time from the moment the pathogen enters the human body until the onset of the first symptoms of the disease.
How many days does it last?
With scarlet fever, you can see the duration of the incubation period from a couple of days to one and a half weeks . But most often it lasts no more than five days.
You can get sick if you come into contact with a person in the last couple of days of the incubation period.
The incubation period stops from the moment the first symptoms of the disease appear. Scarlet fever always begins with signs of severe intoxication, the onset is abrupt and acute.
The symptoms of the disease increase very quickly. Patients begin to complain of:
- [high temperature], which is poorly reduced by taking antipyretics;
- aches throughout the body;
- intense headache;
- chills;
- sweating;
- nausea, vomiting;
- pain in the abdominal area;
- pronounced general weakness.
The patient may be in an excited state or, conversely, in a depressed state. This can be explained by the action of hemolytic streptococcus toxin.
Following the intoxication syndrome, the patient begins [symptoms of acute tonsillitis]:
- severe pain in the throat;
- tonsils swell and turn red;
- later purulent plaques appear;
- hyperemia may also occur in nearby mucous membranes.
The pathogen spreads through the lymphatic tract, causing inflammation.
In this case, the patient can see slight swelling in the submandibular area, due to enlarged [lymph nodes].
When they are palpated, the patient experiences pain.
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Towards the end of the first day of the disease, or the beginning of the second day, skin changes begin to appear in a patient with scarlet fever.
Skin manifestations are expressed in the appearance of small pinpoint rashes on the skin of the face, which gradually descend and spread over all skin integuments.
A distinctive feature of skin changes with scarlet fever is that there are no changes in the area of the nasolabial triangle.
Also, if you rub a hard object over the rashes, with scarlet fever the rashes completely disappear. After five days , the skin changes completely disappear, and they do not cause any traces after disappearance.
But after seven to fourteen days, patients note the beginning of peeling of the skin; the skin peels off the palms and soles in lamellar peeling.
Also, with scarlet fever, plaque appears on the tongue in the first days of the disease. Later, the plaque disappears, but inflammation of the papillae of the tongue occurs; as a result of inflammation, they swell and acquire a crimson color.
Duration and features of the incubation period
The incubation period for scarlet fever lasts from 1 to 7 days. Its duration depends on the body’s defenses and the individual characteristics of the person. With good immunity, a child or adult does not get sick, but becomes a carrier of the infection. A person is contagious the day before the rash appears. Children who are in organized groups (kindergartens, schools) are most at risk of infection.
Thus, it is necessary to remember that to the question whether scarlet fever is contagious during the incubation period, the answer will be positive. An infected person is a source of infection for the 2nd day from the onset of the disease.
Quarantine during scarlet fever: what happens in kindergarten at this time?
Quarantine measures are taken after the first case of the disease, even if the parents immediately took the infected baby home. For at least a day, he released bacteria into the environment and probably managed to “inoculate” all the premises of the preschool institution with them. During quarantine the following is carried out:
- No new pupils are accepted into kindergarten for 21 days.
- All children presenting on the day of detection of scarlet fever are examined by a nurse. Children's temperature is measured, their throat, tongue, and skin are examined. All children noticed with redness and rashes are sent home with their parents.
- Teachers, nannies, and kitchen workers also undergo a medical examination.
- Furniture, floors, window sills and other surfaces in the kindergarten are washed with water in which a disinfectant is dissolved. A similar composition is used to treat dishes, toys, carpets, and textiles. Floor coverings are generally removed from premises during quarantine.
- Every day, the rooms are ventilated and disinfected with a quartz lamp several times. At the same time, the children are taken to the next room.
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Diagnostics
If scarlet fever is suspected, the following diagnostic measures are carried out:
- Interviewing the patient, collecting an epidemiological history. The doctor finds out whether the person has previously had this disease. Finds out whether there have been contacts with sick children or adults.
- General blood and urine analysis. There are no changes in urine analysis. A blood test reveals an increased ESR, leukocytosis, and an increase in the number of eosinophils.
- Electrocardiography. It is carried out because hemolytic streptococcus has an affinity for the myocardium. Consequently, with scarlet fever, the risk of developing myocarditis and endocarditis increases.
- Taking swabs from the mucous membranes of the mouth and nose. When a disease occurs, the corresponding pathogen is isolated from them.
The main diagnostic method for determining scarlet fever is bacteriological culture. With its help, you can determine the type of pathogenic microorganism and identify sensitivity to various antibacterial drugs.
With scarlet fever, it is necessary to carry out a differential. diagnosis of measles, rubella, allergic reaction, enterovirus infection and pseudotuberculosis.
