Increase in cases of Scarlet Fever and Group A Strep



Attwaters are concerned to hear about the recent national increase in notifications of scarlet fever and Group A Strep to the UK Health Security Agency (UKHSA), which is above expected levels for the time of year.

Most cases of scarlet fever occur in children under 10 (usually between 2 and 8 years of age). However, people of any age can get the illness. This is an opportunity to remind ourselves of the signs and symptoms of scarlet fever.

Scarlet fever is usually a mild illness, but it is highly infectious. Therefore, look out for symptoms, which include 

  • a sore throat, headache, and fever, along with 
  • a fine, pinkish or red body rash with a sandpapery feel which is rough to the touch 
  • On darker skin, the rash can be more difficult to detect visually but will still have a rough, sandpapery feel. 

Please Contact NHS 111 or your GP if you suspect you or someone you know has scarlet fever. Early treatment of scarlet fever with antibiotics is important to reduce the risk of complications such as pneumonia or a bloodstream infection. If you have scarlet fever, stay at home until at least 24 hours after the start of antibiotic treatment to avoid spreading the infection to others. 

Scarlet fever is caused by bacteria called group A streptococci. These bacteria also cause other respiratory and skin infections such as strep throat and impetigo. 

In very 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 Group A strep cases this year, particularly in children under 10 and you may have seen the recent media reports of some tragic deaths as a result of iGAS.

Sadly, Deaths do occur each year due to iGAS however this year has seen a slight increase which could be related to the increase in scarlet fever cases.

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. 

There are lots of viruses that cause sore throats, colds and coughs circulating. These should resolve without medical intervention. However, children can on occasion develop a bacterial infection on top of a virus and that can make them more unwell. 

If you’re a parent and you feel that your child seems seriously unwell, you should trust your own judgement. 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 and has a temperature of 38°C, or is older than 3 months and has a temperature of 39°C 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 

Remember the earlier you seek treatment and the more alert you are to the symptoms these illnesses can generally not be too serious and can be swiftly and effectively treated.

As medical negligence lawyers we know all too well that misdiagnosis can be fatal and we would urge everyone to do their utmost to avoid this.

More information about scarlet fever can be found here.

Attwaters Accidents is the Medical Negligence department of the trusted, long-established firm Attwaters Jameson Hill.