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Scarlet Fever and Strep A guidance

Date updated: 21/12/2022

Scarlet fever cases are higher than we would typically see at this time of year, with some very serious infections requiring hospital admission.

Scarlet fever is caused by the common bacteria called group A streptococcus (commonly referred to as Strep A). It is not usually serious, but should be treated with antibiotics to reduce the risk of complications and spread to others. In very rare occasions, the bacteria can get into the bloodstream and cause a more serious illness called invasive group A strep (iGAS). Whilst iGAS. infections are still uncommon, there has been an increase in cases this year, particularly in children under ten and sadly, a small number of deaths. It is very rare for children with scarlet fever to develop iGAS infection.

Signs and symptoms

  • Sore throat
  • Headache
  • Fever
  • A fine, pinkish or red body rash with a sandpapery feel. On darker skin, the rash can be more difficult to detect visually but will have a sandpapery feel.
  • Patients typically have flushed cheeks and be pale around the mouth. This may be accompanied by a bright red red ‘strawberry’ tongue.

What you should do

Contact NHS 111 or your GP if you suspect your child has scarlet fever. Early treatment with antibiotics is important to reduce the risk of complications, such as pneumonia or a bloodstream infection.

If your child has scarlet fever, keep them at home until at least 24 hours after the start of antibiotic treatment to avoid spreading the infection to others.

Contact NHS 111 if or your GP 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 three months and has a temperature of 38C, or is older than three months and has a temperature of 39C 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

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

Good hand and respiratory hygiene are important for stopping the spread of many bugs. 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.

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