Scarlet Fever / Streptococcus

Re: increase in scarlet fever and invasive group A streptococcus above seasonally expected levels

We are writing to inform you of a national increase in notifications of scarlet fever and invasive group A streptococcus (iGAS) to the UK Health Security Agency (UKHSA), above seasonally expected levels.

We would like to take this opportunity to remind you of the signs and symptoms and the actions to be taken:

Signs and symptoms of scarlet fever

Scarlet fever is a common childhood infection caused by Streptococcus pyogenes, or group A streptococcus (GAS). The early symptoms of scarlet fever include sore throat, headache, fever, nausea and vomiting. After 12 to 48 hours the characteristic red, pinhead rash develops, typically first appearing on the chest and stomach, then rapidly spreading to other parts of the body, and giving the skin a sandpaper-like texture. The scarlet rash may be harder to spot on darker skin, although the 'sandpaper' feel should be present. Patients typically have flushed cheeks and pallor around the mouth. This may be accompanied by a ‘strawberry tongue’. As the child improves peeling of the skin can occur.

Infection control advice

In schools and nurseries it is recognised that infections can be spread through direct physical contact between children and staff and through shared contact with surfaces such as table tops, taps, toys and handles. During periods of high incidence of scarlet fever there may also be an increase in outbreaks in schools, nurseries and other child care settings.

As per national Health Protection in Schools and Other Child Care Facilities guidance, children and adults with suspected scarlet fever should be excluded from nursery / school / work for 24 hours after the commencement of appropriate antibiotic treatment. Good hygiene practice such as hand washing remains the most important step in preventing and controlling spread of infection.