Recrudescence of Scarlet Fever and Its Implications for Dental Professionals

A significant increase in the incidence of scarlet fever, mainly in Europe, has been noted during the COVID-19 postpandemic period. Scarlet fever is caused by a pyrogenic exotoxinproducing streptococcus-Streptococcus pyogenes-responsible for more than 500,000 deaths annually worldwide. Superantigens (SAgs) secreted by this Group A streptococcus (GAS) usually overstimulate the human immune system, causing an amplified hypersensitivity reaction leading to initial symptoms such as sore throat, high fever, and a sandpaper-like skin rash. There could be concurrent oral manifestations known as strawberry tongue or raspberry tongue, which may be first noted by oral health professionals. The early diagnosis and treatment of this disease is critical to obviate the development of local and systemic sequelae such as acute rheumatic fever, endocarditis, and glomerulonephritis. Antibiotics should be prescribed early to mitigate its duration, sequelae, and community spread. Dental practitioners should be aware of the early symptoms of scarlet fever for infection detection, emergency patient management, and appropriate referral. This concise review outlines the prevalence, pathogenicity, oral and systemic manifestations, as well as the dental implications of scarlet fever. (c) 2023 The Authors. Published by Elsevier Inc. on behalf of FDI World Dental Federation. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Automated summary

There has been a significant increase in the incidence of scarlet fever, especially in Europe, after the COVID-19 pandemic. Scarlet fever is caused by streptococcus pyogenes, which produces pyrogenic exotoxin and is responsible for over 500,000 deaths annually worldwide. Superantigens secreted by this bacteria can overstimulate the immune system, leading to symptoms such as sore throat, high fever, and a sandpaper-like rash. Dental practitioners should be aware of the early symptoms for timely diagnosis, treatment, and referral.