More than 850 cases of scarlet fever were reported in Wales last week - nearly 35 times above the average for this time of year. Public Health Wales, which publishes a surveillance report each Monday, confirmed that 866 cases of the disease were identified between Monday, December 6, and Sunday, December 11 - way up on the 151 announced the previous week.
The average number of scarlet fever cases for the same week over the previous three years was around 25. However Dr Chris Williams, consultant epidemiologist for Public Health Wales, said the data should be treated with caution as GPs and the public are being urged to look out for the condition.
The spike in scarlet fever reporting comes following a rise in Strep A cases which can cause a wide variety of infections, but most commonly scarlet fever. According to PHW, scarlet fever mainly affects children aged two to eight, with most having built up an immunity to it by the age of 10. Most cases of scarlet fever cause no complications, especially if the condition is properly treated with antibiotics.
Read more: Strep A symptoms, how long it's contagious for and how it spreads
Symptoms of scarlet fever include a sore throat, headache, fever, nausea and vomiting. This is followed by a fine red rash which typically first appears on the chest and stomach, rapidly spreading to other parts of the body. Older children may not have the rash. On more darkly pigmented skin, the scarlet rash may be harder to spot, but it should feel like 'sandpaper'. The face can be flushed red but pale around the mouth.
Commenting on the latest figures, Dr Williams said: "We expect a surge in cases of scarlet fever every three or four years, but the figures reported are clearly higher than previous peaks in circulation. However, the data needs to be interpreted with caution.
"Over the last fortnight, Public Health Wales and other health authorities have been urging GPs to report cases of scarlet fever to us. Although cases are high at the moment, the reported rapid increase is likely to be in large part because of increased notifications by GPs, coupled with generally raised awareness. We can infer this because other signifiers, such as severe illness, have not increased at anything approaching the same rate."
He said the public should be reminded that cold and flu like symptoms are "very common" at this time of year, especially in children. "If your child has a sore throat or a headache, most will have a common seasonal virus, and there is no need to contact your doctor – simply treat them at home by keeping the child hydrated, and with paracetamol," he added.
"If your child develops a fever, nausea or vomiting, or fine pink-red rash that feels like sandpaper to touch, it may be a sign of scarlet fever. In this case, contact NHS 111 Wales or your GP for advice. Scarlet fever is usually a mild illness from which most children will recover without complications, especially if the condition is properly treated with antibiotics.
"In a very small number of cases, infection with Strep A can cause iGAS, a rare complication which usually affects fewer than 20 children in Wales each year. Although iGAS is a worrying condition, the majority of these children will recover with proper treatment. Contact your GP or get medical advice straight away if your child has a fever (a high temperature above 38°C) or if they have severe muscle aches.
"Catching flu increases the risk of becoming severely unwell with secondary infections. Help protect your child and vulnerable family members from Strep A infections by taking up the offer of a free flu vaccine for your child or eligible adult."
Since March the number of reported cases of scarlet fever has been above the previous three-year average. But towards the end of this year cases have soared, with 97 reported in week 46, 101 in week 47, 151 in week 48 and now a huge 866 in week 49 - by far the most reported in a single week in the last three years.
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