Scarlet Fever and Group Strep A Infections
Various government departments, including the DfE and UK Health Security Agency (UKHSA), are monitoring the increased cases of Group A streptococcus (Strep A) and scarlet fever.
UKHSA is reporting an increased number of cases of Group A streptococcus (Strep A) compared to normal at this time of year. There is no evidence that a new strain is circulating, and the increase is most likely related to high amounts of circulating bacteria and social mixing. However, as guidance is issued, we will attempt to distil the important points and keep everyone informed.
What are scarlet fever and Strep A?
Scarlet fever is caused by bacteria called Group A streptococci (Strep A). The bacteria usually cause a mild infection that can be easily treated with antibiotics. In very rare occasions, the bacteria can get into the bloodstream and cause an illness called invasive Group A strep (iGAS).
What are the symptoms of Strep A/scarlet fever?
Strep A infections can cause a range of symptoms that parents should be aware of, including:
Sore throat
Headache
Fever
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
If a child becomes unwell with these symptoms, the advice is to contact your GP practice or contact NHS 111 (which operates a 24/7 service) to seek advice. If a child has scarlet fever, he/she should stay at home until at least 24 hours after the start of antibiotic treatment to avoid spreading the infection to others.
In what appears to be a policy U-turn, the government is at last encouraging parents to trust their own judgement, which is very welcome. The guidance is that, if your child seems seriously unwell, call 999; or go to A&E if:
a child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs
there are pauses when a child breathes
a child’s skin, tongue or lips are blue
a child is floppy and will not wake up or stay awake.
Managing confirmed cases
The protocols we will follow if needed are common sense and fairly low-key. We will contact UKHSA if we have a school outbreak of two or more scarlet fever cases within ten days of each other. Please note that the official guidance is clear: “If there are confirmed or suspected cases in an education or childcare setting, there is no reason for children to be kept at home if they are well”.
How to help prevent Strep A
To prevent the spread of Strep A, UKHSA advises children, young people and staff to implement good hand and respiratory hygiene practices. Where have we heard that before? We will increase our focus on those issues – hopefully when we all return after Christmas, things will have settled down.
I await further guidance on how to deal with staff who go floppy and will not wake up or stay awake. This is quite common at this time of year.