Scarlet Fever Cases Continue Accelerating Across England

There continues to be a steep increase in scarlet fever and invasive GAS (iGAS) notifications among children in the United Kingdom (U.K.), with higher numbers than would be expected at this time of the year.

While the rate of iGAS infection is elevated in all age groups, the incidence in children under ten has been exceptionally high compared to levels reported in the last peak season preceding the COVID-19 pandemic and substantially higher than in the past two years.

A total of 6,601 notifications of scarlet fever were received from weeks 37 to 48 this season (2022 to 2023) in England.

This data compares with an average of 1,774 for this same period in the previous five years.

Infections such as tonsilitis, scarlet fever, and invasive disease caused by group A streptococcus (GAS; also known as Streptococcus pyogenes) have strong seasonality, typically increasing in winter and peaking in spring, wrote The Lancet Infections Disease on December 22, 2022.

The U.K. Health Security Agency published Research and Analysis on December 22, 2022, stating medical practitioners have been alerted to this early increase in incidence and elevated iGAS infection in children.

Given the potential for severe presentations, it remains vital that scarlet fever cases are treated promptly with antibiotics to limit the further spread and reduce the risk of potential complications in patients and their close contacts.

Clinicians should remain alert to the severe complications of GAS and maintain a high degree of clinical suspicion when assessing patients, particularly those with preceding viral infection (including chickenpox) or close contacts with scarlet fever.

In the U.S., the Centers for Disease Control and Prevention (CDC) says while there is no vaccine to prevent scarlet fever, there are things people can do to protect themselves and others.

The best way to keep from getting or spreading group A strep bacteria is to wash your hands often. This is especially important after coughing or sneezing and before preparing foods or eating.

Unfortunately, people can get scarlet fever more than once.

Having scarlet fever does not protect someone from getting it again in the future, says the CDC.

If a child has scarlet fever, antibiotics can help your child feel better faster and prevent long-term health problems. Antibiotics can also help protect others from getting sick.

If you have questions, speak with your doctors, nurse, or pharmacists.

Disclosures: Data published by the CDC, UKHSA, and The Lancet. No industry conflicts of interest were reported.