The signs and symptoms that give scarlet fever its name include:

• Red rash. The rash looks like a sunburn and feels like sandpaper. It typically begins on the face or neck and spreads to the trunk, arms and legs. If pressure is applied to the reddened skin, it will turn pale.
• Red lines. The folds of skin around the groin, armpits, elbows, knees and neck usually become a deeper red than the surrounding rash.
• Flushed face. The face may appear flushed with a pale ring around the mouth.
• Strawberry tongue. The tongue generally looks red and bumpy, and it's often covered with a white coating early in the disease.

The rash and the redness in the face and tongue usually last about a week. After these signs and symptoms have subsided, the skin affected by the rash often peels. Other signs and symptoms associated with scarlet fever include:

• Fever of 101 F (38.3 C) or higher, often with chills
• Very sore and red throat, sometimes with white or yellowish patches
• Difficulty swallowing
• Enlarged glands in the neck (lymph nodes) that are tender to the touch
• Nausea or vomiting
• Headache

• A fever of 102 F (38.9 C) or higher
• Swollen or tender glands in the neck
• A red rash

Scarlet fever is caused by the same type of bacteria that cause strep throat. In scarlet fever, the bacteria release a toxin that produces the rash and red tongue.

The infection spreads from person to person via droplets expelled when an infected person coughs or sneezes. The incubation period — the time between exposure and illness — is usually two to four days.

Children 5 to 15 years of age are more likely than are other people to get scarlet fever. Scarlet fever germs spread more easily among people in close contact, such as family members or classmates.

If scarlet fever goes untreated, the bacteria may spread to the:

• Tonsils
• Lungs
• Skin
• Kidneys
• Blood
• Middle ear

Rarely, scarlet fever can lead to rheumatic fever, a serious condition that can affect the:

• Heart
• Joints
• Nervous system
• Skin