More than 30 cases of scarlet fever have been discovered in Nottinghamshire over the last week as at least 16 children were confirmed to have died of invasive Strep A across the UK. The latest figures by the UK Health Security Agency (UKHSA) show that 1,131 people in England and Wales have been infected with scarlet fever in the week ending December 4, which is up 991 infections from the previous week.
Official figures show that there has been a post-Covid surge in cases of scarlet fever this year, which is a manifestation of a Strep A infection. Between July and December 2022, there were 11,089 cases of scarlet fever, which is almost a 10-fold increase from 1,338 cases over the same period of 2021.
Additionally this is nearly 20 times higher than the 577 cases in 2020. Covid-19 restrictions have had a knock-on effect of reducing the prevalence of many other contagious illnesses and infections, but the number of cases in 2022 is also more than double than those reported in the three years prior to the pandemic.
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There were 31 cases of scarlet fever included in the latest Notifications of Infectious Diseases report for Nottinghamshire. That includes five cases in Broxtowe, five cases in Gedling, five cases in Mansfield, five cases in Rushcliffe, four cases in Nottingham, three cases in Newark and Sherwood, two cases in Ashfield, and two in Bassetlaw.
The figures were released in the UKHSA’s weekly NOIDS report and have increased from 991 infections last week. Strep A bacteria can cause many different infections, ranging from minor illnesses to serious and deadly diseases, including scarlet fever as well as strep throat, and the skin infection impetigo.
Scarlet fever is a contagious infection that mostly affects young children. It can begin with flu-like symptoms including a high temperature, sore throat, and swollen neck glands, and then a rash appears 12 to 48 hours later.
The rash usually looks like small, raised bumps and starts on the chest and stomach before spreading. It is easily treated with antibiotics, but monitoring scarlet fever levels can give health authorities an indication of how much Strep A bacteria is in circulation.
This is important because in extremely rare cases Strep A can cause invasive group A streptococcal infection or iGAS. This happens when bacteria gets into parts of the body it is not normally found, such as the lungs or the bloodstream. Warning signs include fever and severe muscle aches.
The UKHSA says the rate of iGAS infection in children under the age of 10 has been “higher than levels reported in the years preceding the Covid-19 pandemic but substantially higher than the past two years”. In a report to the government, the UKHSA said: “Notifications and GP consultations of scarlet fever in England are higher than normal for this point in the season, after remaining elevated later in the previous season than expected.
“Notifications of invasive group A streptococcus (iGAS) disease are following a similar trend and are slightly higher than expected for this time of year. The relatively higher rates of iGAS in children are noted and may reflect increases in respiratory viruses.
“Given the potential for severe presentations in children, it remains important that scarlet fever cases are treated promptly with antibiotics to limit further spread and reduce risk of potential complications in cases and their close contacts. Due to these uncommon but potentially severe complications, clinicians and health protection teams (HPTs) should continue to be mindful of potential increases in invasive disease and maintain a high degree of clinical suspicion when assessing patients, particularly those with preceding viral infection (including chickenpox) or close contacts of scarlet fever.”
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