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Strep A & Scarlet Fever

We are hearing of some mild cases of Strep A locally, which given the time of year isn't that surprising.


There have been a number of reports in the media which have understandably upset many parents with young children. Please read Dr Brown's statement below and remember that serious illness is very rare indeed.


Dr Colin Brown, Deputy Director, UKHSA, said:

Scarlet fever and ‘strep throat’ will make children feel unwell, but can be easily treated with antibiotics. Symptoms to look out for include fever, sore throat, swollen glands, difficulty swallowing, and headache. Scarlet fever causes a sandpapery rash on the body and a swollen tongue. NHS services are under huge pressure this winter, but please visit NHS.UK, contact 111 online or your GP surgery if your child has symptoms of scarlet fever or ‘strep throat’ so they can be assessed for treatment.At this time of year, there are lots of winter illnesses circulating that can make children unwell. Most of these can be managed at home and NHS.UK has information to help parents look after children with mild illness.It is very rare that a child will go on to become more seriously ill, but parents know better than anyone else what your child is usually like, so you’ll know when they are not responding as they would normally. Make sure you speak to a healthcare professional if your child is getting worse after a bout of scarlet fever, a sore throator respiratory infection – look out for signs such as a fever that won’t go down, dehydration, extreme tiredness, intense muscle pains, difficulty breathing or breathing very fast.

Good hand and respiratory hygiene are important for stopping the spread of many germs. By teaching your child how to wash their hands properly with soap for 20 seconds, using a tissue to catch coughs and sneezes, and keeping away from others when feeling unwell, they will be able to reduce the risk of picking up or spreading infections.

The first symptoms of scarlet fever include flu-like symptoms, including a high temperature, a sore throat and swollen neck glands (a large lump on the side of your neck).

A rash appears 12 to 48 hours later. It looks like small, raised bumps and starts on the chest and tummy, then spreads. The rash makes your skin feel rough, like sandpaper.

On white skin the rash looks pink or red. On brown and black skin it might be harder to see a change in colour, but you can still feel the rash and see the raised bumps.

Contact 111 (online if child over 5) or GP surgery if your child has scarlet fever symptoms.

Symptoms can include nausea and vomiting.

The symptoms of ‘strep’ throat include:

Contact 111 (online if child over 5) or GP surgery if your child has ‘strep’ throat symptoms.

The symptoms of iGAS include:

  • high fever

  • severe muscle aches

  • localised muscle tenderness

  • increasing pain, swelling and redness at site of wound

  • unexplained diarrhoea or vomiting

There are several viruses circulating that cause sore throats, colds and coughs. These should resolve without needing medical attention. Antibiotics are not needed for viral infections. However, children can on occasion develop a bacterial infection at the same time as a virus and that can make them more unwell.

As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement. Contact NHS 111 (online if child over 5) or your GP surgery if:

  • your child is getting worse

  • your child is feeding or eating much less than normal

  • your child has had a dry nappy for 12 hours or more or shows other signs of dehydration

  • your baby is under 3 months and has a temperature of 38°C, or is 3 to 6 months and has a temperature of 39°C or higher

  • your baby feels hotter than usual when you touch their back or chest, or feels sweaty

  • your child is very tired or irritable


Only Call 999 or go to A&E if:

  • your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs

  • there are pauses when your child breathes

  • your child’s skin, tongue or lips are blue

  • your child is floppy and will not wake up or stay awake

Cases of GAS usually increase during the winter and the last time significant numbers of cases were reported was in the 2017 to 2018 season. Seasons with high cases can occur every 3 to 4 years but social distancing measures implemented during the coronavirus (COVID-19) pandemic may have interrupted this cycle and may explain the current increase being observed.

While invasive group A strep is rare, close contacts of cases are at greater risk of developing the infection. Health protection teams follow national guidance to manage the contacts of iGAS cases and advise preventative treatment if necessary.

Following an evidence review of individuals who are at greater risk of invasive group A strep, UKHSA has updated guidance to expand the number of vulnerable groups who would be potentially eligible for prophylactic antibiotics following a risk assessment by health protection teams. This evidence review was underway before the current rise in cases, and is now being implemented

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