Strep A scarlet fever alert to all parents in Northern Ireland: symptoms and what to look out for

The Public Health Agency (PHA) is advising parents and carers to be aware of the symptoms of scarlet fever following an increase in the number of cases at schools and nurseries across Northern Ireland.

The warning was issued prior to reports that a young girl has died in Belfast with an illness linked to Strep A, which can cause scarlet fever.

The PHA said it has seen an increase in notifications of scarlet fever which is “above the levels we usually see at this time of year”.

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Records show that there have been 104 cases reported in November alone this year, compared to just 13 cases in November 2021.

People have been urged to be vigilant over potential scarlet fever infections.People have been urged to be vigilant over potential scarlet fever infections.
People have been urged to be vigilant over potential scarlet fever infections.

The figures for last month are more than double the number of cases for the entire year in 2021.

A PHA spokesperson said: "This follows two years during the pandemic when notifications were lower than usual. Other parts of the UK have also reported increases.

"Clusters have been reported at schools and nurseries in Antrim, Belfast, Bangor and Craigavon.

Scarlet fever is a bacterial illness that mainly affects children under 10 but people of any age can get it. It is not usually a serious illness, but can result in serious complications, therefore treatment with antibiotics is recommended. This helps to reduce the risk of complications and spread to others.”

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Symptoms are non-specific in early illness and may include: sore throat; headache; high temperature; nausea and vomiting.

After 12 to 48 hours the characteristic red, generalised pinhead rash develops, typically first appearing on the chest and stomach, then rapidly spreading to other parts of the body, giving the skin a sandpaper-like texture. On more darkly-pigmented skin, the scarlet fever rash may be harder to spot, although the sandpaper-feel should be present.

Speaking recently Dr David Cromie, Consultant in Health Protection at the PHA, said: “It’s not uncommon to see a rise in cases of scarlet fever at this time of year and we are continuing to monitor rates of infection across the Northern Ireland.

“Scarlet fever is contagious but not usually serious. Early treatment with antibiotics reduces the risk of complications and spread to others.

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“Scarlet fever usually clears up after about a week, but anyone who thinks they or a child may have it should contact a GP for a diagnosis and appropriate treatment.

"It is important to take antibiotics as instructed by your GP, to minimise the risk of complications.”

Dr Cromie said that to limit the spread of scarlet fever it is also important to practise good hygiene by washing hands with warm water and soap, not sharing drinking glasses or utensils, and covering the nose and mouth when coughing or sneezing.

"People should also stay away from nursery, school or work for 24 hours after taking the first dose of antibiotics.”

What is Scarlet Fever?

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Scarlet fever is a common childhood infection caused by Streptococcus pyogenes (also known as Group A Streptococcus (GAS). These bacteria may be found on the skin, throat and other sites where they can live without causing problems.

Under some circumstances GAS can cause ‘non-invasive infections’ such as pharyngitis, impetigo and scarlet fever.

On rare occasions, they can cause ‘invasive infections’ such as streptococcal toxic shock syndrome, necrotising fasciitis (a life-threatening skin infection), and blood poisoning/sepsis.

The number of cases of scarlet fever reported to the PHA has been rising in the past few months.