Cases of scarlet fever increase dramatically throughout England

Cases of scarlet fever among children in England have increased to the highest levels observed since the 1960s, while the reason for re-emergence of the disease remains unknown, according to Public Health England.

Public health officials reported that approximately 600 new cases of scarlet fever are being detected weekly in England since September. In 2014, cases of scarlet fever suddenly reached levels higher than those observed since 1969, according to a news release. Since then, there have been noted increases in all 3 years.

“The reasons behind this increase are unclear but may reflect the long-term natural cycles in disease incidence seen in many types of infection,” officials wrote in a news release. “Assessment of bacteria obtained from patients has excluded the possibility of a newly emerging strain of group A Streptococcus with increased ability to spread between patients causing the increase in disease incidence.”

Officials wrote that since September, there have been 6,157 new cases reported, compared with 5,061 and 2,416 cases in the two preceding seasons. Peak scarlet fever season is typically marked by an elevation in incidence between March and mid-April.

“As scarlet fever is highly contagious, children or adults diagnosed with scarlet fever are advised to stay off school or work until at least 24 hours after the start of antibiotic treatment to avoid passing on the infection,” Theresa L. Lamagni, MSc, PhD, of Imperial College London and head of streptococcal infection surveillance at Public Health England, said in the release. “Early signs to look out for are sore throat, headache and fever with the characteristic pinkish/red sandpapery rash appearing within a day or two, typically on the chest and stomach but then spreading to other parts of the body.”

According to the release, scarlet fever is an infectious disease caused by group A Streptococcus, which mainly affects children aged 2 to 8 years. Antibiotic treatment is recommended to reduce the risk for complications, which are rare.

“Potential complications include ear infection, throat abscess and pneumonia,” Lamagni said “Patients who do not show signs of improvement within a few days of starting treatment should seek urgent medical advice.”

UK health officials wrote that the age distribution of recent scarlet fever cases remains in line with previous years, with 91% of cases reported in children aged younger than 10 years. The incidence rate among children ranged from 9.1 cases per 100,000 population among children aged 10 to 14 years to 121.5 per 100,000 among children aged 1 to 4 years.