Following media coverage of recent cases of death and serious illness from invasive Group A strep in young children, our paediatric emergency department team has seen an increase in parents/carers who are concerned about their children.
Scarlet fever is usually a mild illness, but it is highly infectious. Symptoms in children include a sore throat, headache, and fever, along with 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.
Parents/carers should contact NHS 111 or their GP if they suspect their child has scarlet fever, because early treatment of scarlet fever with antibiotics is important to reduce the risk of complications such as pneumonia or a bloodstream infection. If a child has scarlet fever, they should be kept at home until at least 24 hours after the start of antibiotic treatment to avoid spreading the infection to others.
Scarlet fever is caused by bacteria called group A streptococci. These bacteria also cause other respiratory and skin infections such as strep throat and impetigo. In very rare occasions, the bacteria can get into the bloodstream and cause an illness called invasive Group A strep (iGAS).
Parents should contact NHS 111 or their GP if:
- their child is getting worse
- their child is feeding or eating much less than normal
- their child has had a dry nappy for 12 hours or more or shows other signs of dehydration
- their baby is under three months old and has a temperature of 38°C, or is older than three months and has a temperature of 39°C or higher
- their baby feels hotter than usual when touching their back or chest, or feels sweaty
- their child is very tired or irritable
They should call 999 or go to A&E if:
- their child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs
- there are pauses when their child breathes
- their child’s skin, tongue or lips are blue
- their child is floppy and will not wake up or stay awake