Scarlet fever & Invasive Group A strep (iGAS)

Monday 05 December 2022

The latest data from the UK Health Security Agency (UKHSA) shows that scarlet fever cases continue to remain higher than we would typically see at this time of year.

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.

Scarlet fever is usually a mild illness, but it is highly infectious. Therefore, look out for symptoms in your child, which 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 have a sandpapery feel.

Contact 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.

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 in the UK this year, particularly in children under 10.

The number of reported cases of scarlet fever in the Bailiwick has remained stable with no significant increase so far this year, and to date we have seen no cases of iGAS in individuals aged under 18.

Alex Hawkins-Drew, Associate Director Public Health said:

It is very important that parents and carers of children are aware of the signs and symptoms of iGAS and where to obtain help.

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.

I understand that parents must be very anxious but Strep A is something that we have all dealt with and I want to reassure parents that that GPs, Emergency Department and the paediatric department will be extra vigilant

As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement.'

So far this season there have been 5 recorded deaths within 7 days of an iGAS diagnosis in children under 10 in England. During the last high season for Group A Strep infection (2017 to 2018) there were 4 deaths in children under 10 in the equivalent period. This suggests that this outbreak is no different from a usual strep A season.

Contact 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 the Emergency Department 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
• your child has a non-blanching rash (doesn't go with the glass test)

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