A Nova Scotia mother is raising new concerns about an illness often thought to be a thing of the past.

Melissa Pepper’s seven-year-old daughter Katelyn appeared to have a nasty case of the flu last week. A trip to the emergency room revealed it was actually scarlet fever.

The infectious bacterial illness is a historically common cause of childhood death. Symptoms include a red sore throat, fever, a red sandpaper-like rash, swollen neck glands and a tell-tale strawberry-like red, bumpy tongue.

According to Health Canada, symptoms typically present one to four days after exposure to Group A streptococcus bacteria. If left untreated, complications can result in rheumatic heart disease and kidney damage. The illness is most common among children aged five to 18 years old, but adults can also become infected.

“I was a bit panicky,” Pepper told CTV Atlantic on Tuesday. “I was shocked.”

Scarlet fever has been in decline for the past two centuries, according to research published in The Lancet Infectious Disease Journal last November. However, cases have been rising since 2009 in some East Asian nations. The U.K. saw a spike in the contagious illness in 2016.

Pepper, who works as a nurse, said the illness caught her off guard.

“Had I have known, I would never have waited past two days of a fever,” she said.

Nova Scotia Chief Medical Officer of Health Dr. Robert Strang said parents should be on the lookout for symptoms, and not wait to seek medical attention.

“A combination of fever, sore throat, (and a) rash like that, that is not getting better after a day or so, that really should be seen,” he said.

With a report from CTV Atlantic’s Sarah Ritchie