Scarlet fever is a bacterial-mediated infectious disease that mainly affects children aged three and over. In principle, however, there is a risk of developing scarlet fever at any age.
Typical of a scarlet fever infection is the small speckled rash, which usually appears one to two days after the onset of the disease and spreads from the upper body over the entire body, except for the palms of the feet and palms. In addition, sick people show a so-called raspberry tongue (reddened tongue) and paleness around the mouth.

How often can you get scarlet fever?

Basically, you can get scarlet fever more than once. However, it is often not that easy to distinguish a scarlet fever infection from other infections.
According to the current state of science, infection with scarlet fever is possible three times. Nevertheless, there are often cases in which, according to the pediatrician, children would have contracted the infectious disease ten to 15 times. Something like this is rather unlikely, because any infections with the bacterium Streptococcus Pyogenes are often referred to as scarlet fever. Although this bacterium is also responsible for scarlet fever, it also causes a number of other infections of the upper respiratory tract.

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Streptococcal angina in particular, an infection of the throat and tonsils caused by the bacterium, is often equated with scarlet fever. However, the typical reddened tongue (“raspberry tongue”) and the paleness around the mouth are missing.

A scarlet-like rash can also occur with streptococcal angina. Since there is usually no difference between the therapy of scarlet fever and streptococcal angina, it is often not decisive which of the two forms the child has. In both cases the disease is treated with antibiotics.

Streptococci are already sensitive to penicillins, so-called macrolide antibiotics (e.g. erythromycin) can also be given in the case of allergies. In retrospect, it is therefore often no longer possible to prove whether a child actually had scarlet fever or just streptococcal angina. Incidentally, a person can contract this form of streptococcal infection much more frequently than the actual scarlet fever infection.
But even a more harmless viral tonsillitis, the most common form of tonsillitis in adults, is a possible differential diagnosis to scarlet fever. However, this should not be confused with scarlet fever, as therapy with antibiotics does not bring about any improvement in viral infections.

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How often does it relate to scarlet fever?

Scarlet fever is caused by the bacterium Streptococcus pyogenes. However, this only happens under certain conditions. If a person is infected with the bacterium, then normally only streptococcal angina, i.e. a sore throat and tonsillitis, occurs. However, it can happen that the bacterium itself is infected by a special virus. Such viruses, which can only attack bacteria, are called bacteriophages. Contact with this virus is not necessarily bad for the bacterium, because the virus can incorporate part of its genetic material into the bacterium's genetic material.

This results in new abilities for the bacterium. In the case of streptococci, this results in the ability to form toxins, i.e. poisonous substances. If a streptococcus previously infected with a bacteriophage now infects a person, this person will develop scarlet fever due to the toxin. Since there are three different bacteriophages that can affect a streptococcus, there are also three different toxins that can trigger scarlet fever.
Because a person develops antibodies against the toxin involved after a scarlet fever infection, according to the current state of science, one can get scarlet fever exactly three times.

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You might also be interested in this topic: How contagious is scarlet fever?

If you've had scarlet fever before, is next time less bad?

Since scarlet fever is caused by streptococci, as described above, which can contain three different toxins, the immune system is only familiar with one of the three toxins after the first infection.
If there is a renewed infection with exactly this type of streptococcus, an outbreak of the disease no longer occurs. The other toxins are not yet known to the immune system. Therefore an infection with another type is still possible and usually not much less bad than with the first scarlet fever infection.

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Find out more about the topic: Complications of scarlet fever

How quickly in a row can you get scarlet fever?

Theoretically, the first scarlet fever infection can follow immediately after infection with a different type of streptococcus. Frequently, infections that follow one another very quickly have another reason.
If the antibiotic is not taken long enough, individual streptococci can survive and symptoms return after initial improvement once the antibiotic is stopped.

However, this is not an infection with another type of streptococcus. If you are unsure, it is worth going to the doctor again after stopping the antibiotic and having a smear taken for streptococci. If no more bacteria are found, there is a high chance that the infection was over.
In addition, the antibiotic should not be discontinued independently after the symptoms have improved, but should be taken for the entire prescribed period in order to prevent a new outbreak.

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Also read the article on the topic: Treatment of scarlet fever

Is there a vaccination against scarlet fever?

Unfortunately, there is no vaccination against scarlet fever infection.
However, it is important to prevent infection. Healthy people should have as little direct contact with infected people as possible. If this cannot be avoided, you should then wash your hands thoroughly, possibly also disinfecting them with hand disinfectant.
It can also be useful to wash bed linen, stuffed animals and clothing thoroughly after an infection and to use hygiene items such as replace the toothbrush.

Read more on the topic: Vaccination against scarlet fever

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