Scarlet fever in pregnant women: should you worry and what to do if you’ve been exposed

It's natural to worry about being poorly when you're pregnant and how that might affect your baby. And if there's one infection that's likely to worry you more than others, it's scarlet fever. This contagious infection generally affects young children so if you have children already and you're pregnant, scarlet fever could be something you're concerned about.

So, before we get into what scarlet fever is and what you need to know about scarlet fever in pregnant women, let's set your mind at ease. It's generally thought that catching scarlet fever when pregnant doesn't pose a risk to your baby. But it can make you feel unwell, so it's certainly best to avoid it, if you can. To help, we've taken a look at the signs and symptoms of scarlet fever, how you can catch it and what you should do if you're pregnant and exposed to scarlet fever.

What is scarlet fever?

Scarlet fever is a contagious bacterial infection that's caused by group A streptococcus bacteria, the same type of bacteria that causes strep throat. It's most common in children between the age of 2 and 8, but as it's highly infectious, it can be passed on to adults as well. While it was once considered serious, it's now easily treated, but there can be complications in rare cases, so it's worth knowing the signs and symptoms of scarlet fever as well as how you can avoid it if you're pregnant.

Scarlet fever: Signs and Symptoms

Scarlet fever symptoms generally develop around 2 to 5 days after infection, but it can be anywhere from 1 to 7 days. One of the first symptoms is likely to be a sore throat and other flu-like symptoms, followed by a pink-red rash around 12 to 48 hours later. This rash is rough and bumpy - often described as like sandpaper - and is likely to start on the chest or stomach and spread from there. On white skin, it will be pink-red, but on brown or black skin, the colour may be harder to see but will still feel rough. The tongue may develop a white film that peels off to leave it red and swollen - this is referred to as 'Strawberry Tongue'. The cheeks won't have a rash but may be red.

Symptoms of scarlet fever

• Sore throat

• Flu-like symptoms: headache, a temperature of over 38C (100.4F), swollen glands

• A rough rash that starts on the torso and spreads

• White coating on the tongue that peels off to leave it red and swollen

• Red cheeks

How do you catch scarlet fever?

Scarlet fever is highly contagious. According to UK Government guidance, the scarlet fever bacteria is in the mouth, nose or throat of the infected person so it can be passed on through contact with that person's mucus or saliva. This could be through surfaces they've touched or items like cutlery. It can also be passed on through airborne droplets, for instance by sneezing, coughing or breathing.

If you're a pregnant woman and exposed to scarlet fever, or have scarlet fever symptoms, contact your midwife or GP. They'll be able to talk to you about your treatment options.

How to avoid catching scarlet fever

While it's unlikely to harm your baby, scarlet fever can make you feel very unwell, so if you're pregnant, you should try to avoid being exposed to it. This can mean keeping your distance from people you know have been infected - remember the incubation period can be up to 7 days, so they may not show symptoms until a week after they were infected.

To avoid catching or spreading scarlet fever:

• Encourage good hygiene, including washing hands regularly with soap and water

• Use tissues to catch germs from coughs or sneezes

• Put used tissues in the bin as quickly as possible

• Don't share cutlery, plates, towels, bedding or clothes

Scarlet fever: Treatment

Scarlet fever is treated with antibiotics and the NHS guidance notes that many of the antibiotics used are safe to take in pregnancy. If you or your child has scarlet fever, you'll need to stay off school, nursery or work for 24 hours after you take the first dose of antibiotics to avoid passing it on to other people.

In addition, you can also look after yourself by staying hydrated, eating soft foods that ease your throat, taking paracetamol to bring down a temperature (it's best to check your pain relief options with your midwife if you're pregnant), and using calamine lotion to ease itching.

Scarlet fever: Complications

Complications caused by scarlet fever are rare but there is a small risk of the infection moving to other parts of the body, especially if you don't seek treatment.

According to NHS Inform, complications caused by scarlet fever can be:

• Ear infections

• Assess in the throat

• Sinusitis

• Pneumonia

Very rare complications include:

• Bacteraemia (an infection of the bloodstream)

• Septic arthritis

• Meningitis

• Necrotising fasciitis

• Streptococcal toxic shock syndrome

Scarlet fever in pregnant women: the takeaways

The main point to remember if you're concerned about the risks of scarlet fever and pregnancy, or you're pregnant and your child has scarlet fever, is that there's no evidence that scarlet fever can hurt your baby. So try not to let it cause you too much anxiety while you're pregnant. However, you can feel very unwell if you catch scarlet fever as an adult, so practising good hygiene and encouraging children to wash their hands and use tissues can help protect you. If you think you have been exposed to scarlet fever when pregnant, speak to your GP or midwife so they can assess you and prescribe antibiotics if needed.

About the author

Rebecca Lancaster is a Digital Writer for Mother&Baby, drawing on ten years of parenting her two children to help others navigating their own parenting journey. As a freelance writer, she spent ten years working with leading lifestyle brands, from travel companies to food and drink start-ups, and writing everything from hotel reviews to guides to the best British cheeses. She’s particularly interested in travel and introducing her children to the excitement of visiting new places, trying different foods (less successfully) and experiencing different cultures.