Health officials are urging parents to look out for symptoms of scarlet fever in their children following a surge in cases driven by a recent increase in Strep A infections.
According to the most recent data from the UK Health Security Agency (UKHSA), the number of scarlet fever cases remains higher than would typically be expected at this time of year. There were 851 cases reported in week 46 compared with an average of 186 in the preceding years, the agency said.
The illness is caused by a species of bacteria called Group A Streptococcus. These bacteria also cause other respiratory and skin infections, such as Strep throat and impetigo.
On rare occasions, the bacteria can get into the bloodstream and cause an illness called invasive Group A Strep (iGAS). While still uncommon, there has been an increase in invasive Strep A cases this year, particularly in children under 10.
The warning comes after a sixth child died after contracting a Strep A infection. The UKHSA says investigations are under way following the increase in cases, though there is no evidence that a new strain is circulating.
While scarlet fever is usually a mild illness, it is highly infectious. But what are the signs to look out for? And how worried should parents be? Our guide below may help to answer some of your questions.
How many cases of Strep A are there?
The UKHSA has confirmed an increase in invasive Group A Strep cases this year, particularly in children under 10, which it says is likely to have been caused by a high level of circulating bacteria combined with social mixing.
The data shows a rate of 2.3 cases per 100,000 children aged between one and four, compared with an average of 0.5 cases in the three seasons prior to the pandemic (2017 to 2019), and 1.1 cases per 100,000 children aged five to nine, compared with a pre-pandemic average of 0.3.
So far this season there have been five recorded deaths within seven days of a diagnosis in children under 10 in England. There has been a further death in Wales in that age group.
During the last high season for Group A Strep infection (2017-18), there were four deaths in children under 10 in the equivalent period.
What are the symptoms of scarlet fever?
Health officials say that the symptoms to look out for in your child include a sore throat, headache and fever, along with a fine, pinkish or red body rash with a sandpapery feel. On darker skin, the rash can be more difficult to detect visually but will still have a sandpapery feel.
The UKHSA advises contacting NHS 111 or your GP if you suspect your child has scarlet fever, because early treatment of the illness with antibiotics is important in reducing the risk of complications such as pneumonia or a bloodstream infection.
If your child has scarlet fever, keep them at home until at least 24 hours after the start of antibiotic treatment to avoid spreading the infection to others.
When should you seek medical help?
Though in most cases scarlet fever will resolve without medical intervention, children can on occasion develop a bacterial infection on top of the virus, and that can make them more unwell. As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement, said the UKHSA.
Health officials say you should contact NHS 111 or your GP if:
- Your child is getting worse
- Your child is feeding or eating much less than normal
- Your child has had a dry nappy for 12 hours or more, or shows other signs of dehydration
- Your baby is under 3 months old and has a temperature of 38C, or is older than 3 months and has a temperature of 39C or higher
- Your baby feels hotter than usual when you touch their back or chest, or feels sweaty
- Your child is very tired or irritable
In more serious cases, you should call 999 or go to A&E if:
- Your child is having difficulty breathing – you may notice grunting noises or their tummy sucking in under their ribs
- There are pauses when your child breathes
- Your child’s skin, tongue or lips are blue
- Your child is floppy and will not wake up or stay awake
How to ward off potential infection
Good hand and respiratory hygiene are important for stopping the spread of many bugs. By teaching your child how to wash their hands properly with soap for 20 seconds, use a tissue to catch coughs and sneezes, and keep away from others when feeling unwell, they will be able to reduce the risk of picking up, or spreading, infections.
Dr Colin Brown, deputy director at the UKHSA, said: “We are seeing a higher number of cases of Group A Strep this year than usual. The bacteria usually causes a mild infection, producing sore throats or scarlet fever, which can be easily treated with antibiotics. In very rare circumstances, this bacteria can get into the bloodstream and cause serious illness – called invasive Group A Strep (iGAS).
“This is still uncommon, however it is important that parents are on the lookout for symptoms and see a doctor as quickly as possible so that their child can be treated and we can stop the infection becoming serious.
“Make sure you talk to a health professional if your child is showing signs of deteriorating after a bout of scarlet fever, a sore throat, or a respiratory infection.”
