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Scarlet fever at unseasonably high levels

Dec 3, 2022 | Awareness | 0 comments

You may or may not have seen the recent news relating to some small outbreaks of Scarlet fever throughout the UK and affecting young children (typically 10 years and below). Sadly, some of these cases have led to the death of infected children.

As an organisation we are dedicated to educating about any disease that is related to necrotising fasciitis, so we wanted to create a post about this highly infectious infection, which is on the rise.

What is Scarlet fever

Scarlet fever is a bacterial infection. Once dubbed a ‘victorian disease’ by some, it has been on the rise now for the last decade. This winter, GPs are sending out warnings of higher levels than normal of this bacterial infection.

It’s a highly infectious disease and, while not usually serious, recent evidence has shown that in some rare cases it triggers more dangerous conditions, such as necrotising fasciitis. Early diagnosis and treatment can help prevent such complications and preventing the spread of Strep A in the community will help reduce the risk on a whole.

What causes scarlet fever

Scarlet fever is related to necrotising fasciitis in that both can be caused by a group A Streptococcus (group A strep or Strep A) bacterial infection (scarlet fever is always caused by Strep A, but NF can be caused by other bacterial infections as well).

Strep throat – what’s the link

Group A strep is also the cause of strep throat. The same bacteria sometimes release a toxin into the body. This toxin (or poison) is what leads to the red rash that gives scarlet fever its name.

What are the symptoms of scarlet fever

The infection usually begins with a sore throat and a fever and are usually followed by a bumpy scarlet rash on the body. The rash does not appear on the face, but cheeks can be flushed red.

Other common symptoms include:

  • Very red throat
  • Fever and chills
  • White coating on the tongue early in the illness
  • The white coating sheds to reveal a red bumpy tongue often called “strawberry tongue”
  • Bright red skin at the underarms, elbows and groin
  • Swollen glands in the neck
  • Headache and body aches
  • Nausea, vomiting
  • abdominal pains

The scarlet fever rash

The scarlet fever rash usually appears a day or two after the onset of general illness. However, it can take up to 7 days to appear and has been known to appear before the sore throat in some cases. It commonly starts at the groin, underarms and neck. Although the red blotches appear under the skin initially, they usually progress to small bumbs on top of the skin.

The rash usually lasts around a week, but skin may begin peeling as it heals. This peeling can last a few weeks.

Who is at risk of catching scarlet fever

Scarlet fever most commonly affects children under the age of 10, although it can be caught at any age.

Children are more likely to pass bacteria between one another due to their behaviour – such as playing and sitting together in a close group setting.

Adults at a higher risk of contracting the infection are those that spend a lot of time with children, such as teachers and parents or child minders.

Treatment of scarlet fever

Although scarlet fever has the potential to be quite serious, modern medicine means that it can be easily treated with antibiotics. This has helped control the spread of scarlet fever compared to before antibiotics.

Home remedies

Although it’s important to get antibiotics to treat scarlet fever, some home remedies will help relieve the symptoms. The NHS website suggests:

  • drinking cool fluids
  • eating soft foods if you have a sore throat
  • taking painkillers like paracetamol to bring down a high temperature (do not give aspirin to children under 16)
  • using calamine lotion or antihistamine tablets to ease itching

Diagnosis

the NHS website recommends you go see a GP if you or your child:

  • have scarlet fever symptoms (see above)
  • do not get better in a week (after seeing a GP)
  • have scarlet fever and chickenpox at the same time
  • are ill again, weeks after scarlet fever got better – this can be a sign of a complication, such as rheumatic fever
  • are feeling unwell and have been in contact with someone who has scarlet fever

Scarlet fever is very easily spread. Check with a GP before you go in. They may suggest a phone consultation.

Your GP will be in a better position to diagnose scarlet fever on inspection of the mouth and rash. They may perform a throat swap to test for Strep A or arrange blood tests.

Prevent the spread of scarlet fever

If you or your child has scarlet fever, stay away from nursery, school or work for 24 hours after you take the 1st dose of antibiotics.

Unfortunately, you can spread the infection to other people up to 6 days before you get symptoms until 24 hours after you take your 1st dose of antibiotics.

If you do not take antibiotics, you can spread the infection for 2 to 3 weeks after your symptoms start.

Complications of scarlet fever

Although rare, complications can occur if the bacteria spreads to other parts of the body. According to the Center for Disease Control and Prevention (CDC), these complications include:

  • Abscesses (pockets of pus) around the tonsils
  • Swollen lymph nodes in the neck
  • Ear, sinus, and skin infections
  • Pneumonia (lung infection)
  • Rheumatic fever (a disease that can affect the heart, joints, brain, and skin)
  • Post-streptococcal glomerulonephritis (a kidney disease)
  • Arthritis (joint inflammation)
  • Necrotising Fasciitis (very rare)

Can I get a vaccine?

Unfortunately there is no vaccine for scarlet fever. Iif you do get scarlet you will build up antibodies to Strep A in your body, however these do fade over time. Having scarlet fever once, does not prevent you from getting it again.

How can I prevent scarlet fever

The answer to this is good hygiene – you will all know the drill by now following the Covid-19 pandemic. But here’s a reminder from the CDC:

“The best way to keep from getting or spreading group A strep bacteria is to wash your hands often. This is especially important after coughing or sneezing and before preparing foods or eating.

To prevent group A strep infections, you should:

  • Cover your mouth and nose with a tissue when you cough or sneeze.
  • Put your used tissue in the waste basket.
  • Cough or sneeze into your upper sleeve or elbow, not your hands, if you don’t have a tissue.
  • Wash your hands often with soap and water for at least 20 seconds.
  • Use an alcohol-based hand rub if soap and water are not available.

You should also wash glasses, utensils, and plates after someone who is sick uses them. These items are safe for others to use once washed.”

And of course, if you’ve been in contact with anyone who is diagnosed with scarlet fever and feel unwell. Please stay home and stay safe.

You can find out more about Strep A and the other bacterial infections that could lead to necrotising fasciitis here.

Information sources:

Scarlet Fever: All You Need to Know | CDC

Scarlet fever – NHS (www.nhs.uk)

Scarlet Fever In Children | Action Medical Research

UKHSA update on scarlet fever and invasive Group A strep – GOV.UK (www.gov.uk)

Strep A: Parents warned to look out for these symptoms as scarlet fever cases rise | The Independent

TB and scarlet fever: why Victorian diseases are making a comeback | Health & wellbeing | The Guardian

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