Scarlet Fever - Strep A - Symptoms & treatment

UK hospitals have received an alert from Public Health England regarding the rise in cases of scarlet fever. This has also caused a lot of concern amongst parents.

Scarlet fever is an infection caused by Group A Strep. Strep A is the most common bacterial cause of acute sore throat, accounting for 15 - 30% of cases in children and 5-10% of cases in adults. During the winter and spring in temperate climates, up to 20% of asymptomatic school-aged children may be group A streptococcus carriers.

Scarlet fever is characterised by a scarlatiniform rash that blanches with pressure. It is highly contagious and has an incubation period of two to five days. Symptoms of scarlet fever:

• Children usually start with a fever over 38.3 degrees

• Headache

• Sore throat

• Fatigue

• Nausea

• 12-48 hours later a rash will appear on the abdomen spreading to the neck and extremities. The rash is like sandpaper and is often worse in folds of skin such as the armpit area. The rash usually fades within one week.

You can also get:

• White coat on tongue which peels

• Flushed face

• Lymph nodes in neck

• After the symptoms have resolved, it is common to get peeling skin that can last for several weeks.

Key facts about scarlet fever:

• A high fever is a normal response to fighting infection

• Most children with scarlet fever recover quickly, symptoms of scarlet fever usually resolve after one week.

It is important to know when to call 111 or to go and see your GP. If your child:

• Is not drinking

• Not passing urine regularly

• Extremely drowsy

• Under 3 months old

Take your child to A&E if they have any of the following symptoms:

• Blue lips

• Extremely drowsy

• skin is cold/mottled

• They are agitated or confused

• Difficulty breathing

• Has a rash that does not disappear with the glass test.

Complications can arise from Group A strep however are very rare. Antibiotics are often prescribed to prevent complications and to prevent transmission. It is important to exclude children from schools and nursery until they have received at least 24 hours treatment of antibiotics. If your child isn't receiving treatment for scarlet fever, they need to be excluded for two weeks.