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Belfast Live
Belfast Live
National
Lauren Harte

NI GP on what symptoms to look out for amid rising Scarlet fever and Strep A cases among kids

A leading GP has urged parents to be alert after increased outbreaks of scarlet fever and Strep A have been reported across Northern Ireland.

It comes as a seventh child is reported to have died in the UK after developing the Strep A infection.

There has been a rise in rare invasive Group A strep this year, particularly in children under 10, the UK Health Security Agency has said. Group A strep bacteria can cause many different infections, ranging from minor illnesses to deadly diseases.

Read more: Co Down mum warning to parents after young daughter's Strep A diagnosis

The range of illnesses includes the skin infection impetigo, scarlet fever and strep throat. While the vast majority of infections are relatively mild, sometimes the bacteria cause a life-threatening illness called invasive Group A Streptococcal disease.

Last week, the Public Health Agency said there has been an increase in scarlet fever, above the levels usually seen at this time of year with clusters reported at schools and nurseries in Antrim, Belfast, Bangor and Craigavon.

To date, 104 cases of scarlet fever have been recorded in the last month. Parents and carers are being advised to be aware of the symptoms of scarlet fever, a bacterial illness that mainly affects children under 10 but people of any age can get it.

It is not usually a serious illness, but can result in serious complications, therefore treatment with antibiotics is recommended. This helps to reduce the risk of complications and spread to others.

Dr Ursula Mason, chair of the Royal College of General Practitioners and a GP Partner in Carryduff Surgery, explained the current picture.

"The two infections are caused by the same Streptococcus bacteria, which either causes a scarlet fever or it can cause the invasive Group A Strep disease. There are some situations where one might lead to the other but more than not it's two separate entities," Dr Mason told Belfast Live.

"The reality is that we're seeing an increasing number of children at the moment with lots of respiratory illnesses regardless, including sore throats and tonsillitis, and because Group A Strep is a bacteria, you can have them happening at the same time or in isolation of each other.

Dr Ursula Mason (RCGP Northern Ireland)

"We have circulating RSV and flu every year and scarlet fever and Group A Strep infections have also been increasing year-on-year to a larger degree so we're seeing this in the younger population anyway. But we are seeing increasing numbers who are developing this scarlet fever type picture and that is a tonsillitis but it's also associated with very specific features such as paler ring around the mouth, strawberry tongue and a sandpaper rash.

"Tonsillitis will present in a lot of children as a sore throat, puss in the tonsils and a high temperature but scarlet fever has those other additional features, more often than not. We are seeing more of that in our surgeries at the moment but we're also seeing the other respiratory illnesses and tonsillitis so it's trying to discern one from the other and make sure that parents and carers are getting the right advice about managing these conditions".

Dr Mason said Strep A is quite a common infection and some people will have it in their throats or the back of their noses without it causing any problems.

"A lot of these bacteria and viruses live quite happily in or on our bodies and don't cause us any problems but then from time to time you can become infected with a bacteria or virus. You could swab lots of people and find Strep A but it's not actually causing any disease or problems and you can have the situations where it is actually very florid and cause quite life-threatening infections," she added.

"The reality is that in the main, we are treating children who appear to have scarlet fever or Strep A infection with antibiotics. They won't all need a swab to check that they have that and if a child has clinical symptoms we will treat them with penicillin, which thankfully this particular bacteria is extremely sensitive to and parents can expect a 10-day course to treat their child's scarlet fever. They'll also be given advice on what to look out for in terms of a worsening condition and when to seek further medical help."

Dr Mason has this advice for parents and carers: "If you child is unwell with a high fever, sore throat or are eating and drinking much less than they would normally be, passing a lot less urine, more drowsy or sleepy than normal, those are the children we're more worried about and we would say to seek very early medical advice.

"For lots of children, they will get a temperature and sore throat and manage to fight off whatever infection they have without the need for intervention. If parents are seeing signs of scarlet fever like the rash, strawberry tongue or high temperature, it's entirely reasonable for them to contact their GP to seek advice.

"Because we're seeing lots and lots of these children on top of the already significant workload that we have, it has led to really long waits over the weekend and in out of hours because parents are worried about children with these particular symptoms.

"Apart from scarlet fever, it's important to remember that there are lots of children with other respiratory illnesses as well so parents need to be alert to the symptoms that suggest a more serious infection and to seek medical advice early."

The symptoms of scarlet fever are non-specific in early illness and may include:

  • sore throat;
  • headache;
  • high temperature;
  • nausea and vomiting.

After 12 to 48 hours the characteristic red, generalised pinhead rash develops, typically first appearing on the chest and stomach, then rapidly spreading to other parts of the body, giving the skin a sandpaper-like texture. On more darkly-pigmented skin, the scarlet fever rash may be harder to spot, although the sandpaper-feel should be present.

Further information about scarlet fever is available on the PHA website.

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