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Scarlet Fever

14 March 2018 (by Mark Letman (admin))

Important Information from the NHS...

Increase in scarlet fever notifications 2018

We are writing to inform you of a recent increase in notifications of scarlet fever to Public Health Wales. There were 476 notifications in the first 8 weeks of 2018, compared to 295 in the same period in 2017.

We are notifying schools and nurseries as this infection mostly affects children aged under 10 years, and outbreaks can occur in schools and nurseries. Older children are also susceptible to streptococcal sore throats, but may not have the rash of scarlet fever.

Signs and symptoms of scarlet fever

Scarlet fever, sometimes called scarlatina, is an infectious disease caused by group A streptococcus (GAS) bacteria (also known as Streptococcus Pyogenes).

It is highly infectious and can be caught through direct contact with an infected person or through the air via droplets from coughs or sneezes.

The characteristic symptom of scarlet fever is a widespread, fine pink-red rash that feels like sandpaper to touch. Other symptoms include a high temperature, a flushed face and a red, swollen tongue.

Treatment is straightforward and usually involves a course of penicillin antibiotics.

Complications of scarlet fever

Most cases of scarlet fever cause no complications, especially if the condition is properly treated. However, complications in the early stages of the disease can include ear infection, throat abscess, sinusitis, pneumonia and meningitis.

Very rare complications include rheumatic fever, kidney damage, liver damage, bone infection, blood poisoning and toxic shock syndrome which can be life-threatening.

Recommended actions

 Staff should be aware of the possibility of this infection in children who become ill with a fever, sore throat or rash

 Parents of unwell children should be advised to seek medical advice for diagnosis and treatment

 Where there are 2 or more cases of scarlet fever in the institution within the same 10 day period, please notify the Health Protection Team on 0300 00 300 32 for further guidance

 Scarlet fever circulating with chickenpox or influenza can be particularly dangerous- please report this to the Health Protection Team as above

 Advise exclusion from nursery / school / work for 24 hours after the commencement of appropriate antibiotic treatment

 Good hand hygiene and avoidance of spread of respiratory secretions (as per influenza- “catch it, bin it, kill it”) can help to prevent the spread of infection

Yours sincerely,

Dr Gwen Lowe
Consultant in Communicable Disease Control

References:
NHS Direct Wales website information on scarlet fever https://www.nhsdirect.wales.nhs.uk/encyclopaedia/s/article/scarletfever

Public Health Wales information on scarlet fever
http://howis.wales.nhs.uk/sitesplus/888/page/63112

Infection prevention and control for childcare settings and schools
http://www.wales.nhs.uk/sitesplus/888/page/75726

Public Health England guidance on outbreaks of scarlet fever in schools and nurseries
https://www.gov.uk/government/publications/scarlet-fever-managing-outbreaks-in-schools-and-nurseries