Scarlet fever is caused by the bacteria known as streptococci. This was known as scarlatina until 1869. Streptococci are gram-positive and grow in chains. These are normally found in the nasal area and can cause pharyngitis, skin infections and pneumonia. Scarlet fever is associated with pharyngitis.
Only about 10 percent of streptococcal sore throats are known to develop into scarlet fevers. Person to person spread of the disease is through nasal droplets. Patients are contagious when the illness is acute and also during the initial subclinical stage.
Scarlet fever was a deadly epidemic in the 1800s, when the death rate due to this illness used to be as high as 150 in 100,000. The mortality rate and also the incidence of the disease have fallen considerably after the introduction of antibiotics and also improvement in socio economic conditions. The infection is known to occur largely in children in 3-8 years age group. Infection rate is known to increase with overcrowding and close contact. Schools are primary target area. The incidence of infection is known to be higher in spring and winter. Skin infections caused by streptococcal organisms are to be more common in warm climates and warm months.
The incidence of scarlet fever and the fatality rate data is available for Norway over a period of 100 years. There is a dramatic improvement in the fatality rate as per the figures given below.
Year Fatality rate per 1000
The similar data available for the United States and it is for an earlier period. This data is give below:
Year Fatality rate per 100,000
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