Scarlet fever and streptococcal infection

Dear Parents/Carers -

Download the letter Y Dwymyn Goch Scarlet Fever letter

Increase in scarlet fever and invasive streptococcal disease in 2022

As this subject has been in the national media over recent weeks, we have issued guidance to all schools based on advice from Public Health Wales and enclose some key information for you.

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 and streptococcal infection

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.

As the media have reported, there has been an increase in severe disease caused by this bacterium (invasive group A streptococcal infections) in late 2022, including some fatal cases in children. Invasive disease may occur without a person having had scarlet fever or sore throat first. Early signs of invasive disease include high fever, severe muscle aches, local muscle tenderness, or redness at the site of a wound. If there are any concerns about invasive disease, then urgent medical advice must be sought.

• • Schools and settings will be following the recommendations outlined by PHW, as per guidance below:
• • Staff will be aware of the possibility of this infection in children who become ill with a fever, sore throat or rash
• • Parents of unwell children will be advised to seek medical advice for diagnosis and treatment
• • A person with scarlet fever should withdraw from schools/setting for 24 hours after the commencement of appropriate antibiotic treatment
• • Where there are 2 or more cases of scarlet fever in a setting/school

• within the same 10-day period, schools/settings will inform PHW
• • 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

I hope that this provides reassurance that there is a consistent message amongst schools / settings and that the information above supports you, as parents/carers of the appropriate action to take should your child have symptoms or a diagnosis of scarlet fever or streptococcal infection.

Further details can be found at Scarlet Fever - Public Health Wales (nhs.wales)