There are currently high rates of Group A strep and scarlet fever in the UK. Scarlet fever, which is caused by the bacteria Group A streptococcus, is usually a mild illness but it is highly infectious.
It much more common in children than in adults; it is important that parents of children with suspected scarlet fever contact NHS 111 or their GP (doctor’s surgery) as they may need antibiotics.
This is not only to reduce the chance of their infection becoming more severe but also to stop them spreading the infection to others, especially people at higher risk of severe infections such as the elderly and those with weakened immune systems.
Whilst severe complications of the infection are still uncommon, there has been an increase in cases this year, particularly in children under 10 and sadly, a small number of deaths.
Information for parents on Strep A
Dr Ranj Singh explains what to look for:
Symptoms
The rash of scarlet fever often begins with small spots on the body that then spread to the neck, arms and legs over the next 1-2 days. On darker skin it may be more difficult to see but is often described like ‘sandpaper’ to touch but is not itchy.
Your child may also have a:
- Sore throat/tonsillitis
- Fever (temperature of 38°C (100.4°F) or above)
- Painful, swollen glands in the neck
- A red tongue (strawberry tongue)
If your child also has a runny nose with their tonsillitis, it makes a diagnosis of scarlet fever / Group A strep less likely.
Occasionally, the infection can spread to other areas of the body and very rarely, in the most serious cases cause sepsis.
When should I worry?
Seek urgent help if your child has any of the following:
- Is pale, mottled and feels abnormally cold to touch
- Has blue lips
- Too breathless to talk/eat or drink
- Has a fit/seizure
- Is extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
- Has dark green vomit
- Has a rash that does not disappear with pressure (the ‘Glass Test‘)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
Contact NHS 111 or a healthcare professional if your child has any of the following:
- Is finding it hard to breathe
- Has laboured/rapid breathing or they are working hard to breathe – drawing in of the muscles below their lower ribs, at their neck or between their ribs (recession).
- Unable to swallow saliva
- Has features suggestive of scarlet fever (see above)
- Seems dehydrated (sunken eyes, drowsy or not passed urine for 12 hours)
- Is drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
- Has extreme shivering or complains of muscle pain
- Has a painful, red swollen gland in their neck which is increasing in size
- Is 3-6 months of age with a temperature of 39°C/102.2°F or above (but fever is common in babies up to two days after they receive vaccinations)
- Continues to have a fever of 38°C or above for more than 5 days
- If your child has recently had scarlet fever but now appears to have a puffy face/eyelids, tea or ‘Coca-Cola’ coloured urine (pee), or a swollen, painful joint(s)
- Is getting worse or if you are worried
You need to contact a doctor or nurse today.
If none of the above symptoms are present, continue with self-care.
Additional information is available about infant crying and how to cope – visit ICON for more details.
Children and young people who are unwell and have a high temperature should stay at home. They can go back to school, college or childcare when they no longer have a high temperature, and they are well enough to attend.
Further Information
There are a number of useful resources that provide more information on Strep A and Scarlet Fever
