Overview
Scarlet fever cases are higher than we would typically see at this time of year, with some very serious infections requiring hospital admission.
Scarlet fever is caused by the common bacteria called group A streptococcus (group A strep). It is not usually serious, but should be treated with antibiotics to reduce the risk of complications and spread to others. In very rare occasions, the bacteria can get into the bloodstream and cause a more serious illness called invasive group A strep (iGAS). Whilst iGAS. infections are still uncommon, there has been an increase in cases this year, particularly in children under 10 and sadly, a small number of deaths. It is very rare for children with scarlet fever to develop iGAS infection.
Currently, there is no evidence that a new strain is circulating. The increase is most likely related to high amounts of circulating bacteria and social mixing
Key messages for schools and early years settings
Be extra vigilant of the signs and symptoms of scarlet fever which include 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 have a sandpapery feel.
Schools and early years settings should ensure that all children with confirmed or suspected group A strep infections (mainly scarlet fever and also tonsillitis) are kept away from school until they've been treated with antibiotics for 24 hours.
There is no vaccine against group A strep, the main preventive measures are good hand and respiratory hygiene. Children should 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.
Suspected scarlet fever outbreaks (2 or more cases within 10 days of each other) should be reported to the North East North Central London Health Protection Team on 020 3837 7084 or necl.team@ukhsa.gov.uk. Any co-circulating scarlet fever and chickenpox outbreaks must be reported urgently as chickenpox is the most common risk factor for iGAS disease in children.
Please read the national scarlet fever guidance for schools and early years settings.
Key messages for parents and carers
Be extra vigilant of the signs and symptoms of scarlet fever which include 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 have a sandpapery feel.
Contact NHS 111 or your GP if you suspect your child has scarlet fever, because early treatment of scarlet fever with antibiotics is important to reduce 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.
There is no vaccine against group A strep, the main preventive measures are good hand and respiratory hygiene. By teaching your child how to wash their hands properly with soap for 20 seconds, using a tissue to catch coughs and sneezes, and keeping away from others when feeling unwell, they will be able to reduce the risk of picking up, or spreading, infections.
As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement. Contact NHS 111 if 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 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
Call 999 or go to A&E if:
- your child is having difficulty breathing – you may notice grunting noises or their tummy sucking 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