More than 1,000 cases of scarlet fever have been discovered in the last week as 15 children were confirmed to have died of invasive Strep A in the UK. The latest figures released by the UK Health Security Agency (UKHSA) show that 1,131 people in England and Wales have been infected with scarlet fever, a manifestation of Strep A infection, in the week ending December 4. That is up from 991 infections the previous week.
Official figures show that there has been a post-Covid surge in cases of scarlet fever this year. In total between July and December, there have been 11,089 cases of scarlet fever, almost a 10-fold increase from 1,338 cases over the same period of 2021, and nearly 20 times higher than the 577 cases in 2020. Covid-19 restrictions had a knock-on effect of reducing the prevalence of many other contagious illnesses and infections. However, the number of cases in 2022 is also more than double those reported in the three years prior to the pandemic.
The highest number of infections were in the South East, with 189, followed by the North West (182), and then London (156). There were also 150 cases in the East of England, 134 in Wales, 122 in East Midlands, 69 in West Midlands, 66 in Yorkshire and the Humber, 59 in the North East, and just three in the South West. The figures were released in the UKHSA’s weekly NOIDS (Notifications of Infectious Diseases) 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.
A rash then appears 12 to 48 hours later, which looks like small, raised bumps and starts on the chest and stomach, and then spreads. 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.”
