Scarlet fever in children: clinical and stomatological impact after the pandemic

Abstract

Introduction. Scarlet fever, caused by Streptococcus pyogenes, has re-emerged globally following the COVID-19 pandemic, mainly affecting the pediatric population. This reemergence has been related to the decrease in herd immunity and the emergence of more virulent strains, such as the M1UK lineage. In Mexico, molecular data on circulating strains are limited, which complicates their epidemiological control. Objective. To analyze the resurgence of scarlet fever from clinical and epidemiological perspectives, highlighting its impact on children's health and the role of the dental professional in early detection. Review. A narrative review was conducted by searching scientific articles in databases such as PubMed, Scopus, and Google Scholar, selecting publications between 2002 and 2023 related to scarlet fever, oral manifestations, and public health in pediatric contexts. Among the most relevant findings is the role of dental personnel in the early identification of signs such as strawberry tongue, rashes, and pharyngitis, which may precede systemic manifestations. Recent literature has also linked the increase in cases to the relaxation of post-pandemic health measures, as well as to the emergence of more virulent strains. In Mexico, the circulation of strains with genetic diversity and variable resistance to antibiotics has been documented, underscoring the need for continuous microbiological surveillance. Conclusions. Scarlet fever has re-emerged as a public health concern. Early detection by dental personnel is key, as oral manifestations may present before other systemic symptoms. Recommendations. Train dental health personnel in clinical recognition, apply infection control measures and immediately refer the patient for medical treatment with appropriate antibiotics.