Current invasive Group A streptococcus (iGAS) infection notifications remain unusually high for this time of year, particularly in children. Marked increases in scarlet fever notifications are also being seen. Important links from the UK Health Security Agency are available at:
Group A streptococcal infections: report on seasonal activity in England, 2022 to 2023 and
UKHSA update on scarlet fever and invasive Group A strep 2 Dec 2022.
The advice and guidance is likely to change as more data becomes available and updates will be provides through NHSE and the health security agency.
There has been an increase in lower respiratory tract GAS infections in children over the past few weeks in some cases causing severe illness. A high burden of co-circulating viral infections may be contributing to the increased severity and complications through co-infection. Clinicians should continue to be mindful of potential increases in invasive disease and maintain a high index of suspicion in relevant patients as early recognition and prompt initiation of specific and supportive therapy for patients with iGAS infection can be life-saving.
Urgent notification to UKHSA Health Protection Teams of iGAS infection is essential to facilitate immediate public health actions including assessment of contacts.
There are no specific recommendations for children and adults with congenital heart disease. Although an autoimmune inflammatory reaction to group A streptococcus can lead in very rare cases to rheumatic fever, to our knowledge, group A streptococcus does not cause a more severe illness in children with congenital heart disease.
Recommendations for primary care:
Recommendations for secondary care:
Advice for parents:
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.
Scarlet fever is usually a mild illness, but it is highly infectious. Therefore, look out for symptoms in your child, which 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. Contact NHS 111 or your GP if you suspect your 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 your child has scarlet fever, keep them at home until at least 24 hours after the start of antibiotic treatment to avoid spreading the infection to others.
In very rare occasions, the bacteria can get into the bloodstream and cause an illness called invasive Group A strep (iGAS).
There are lots of viruses that cause sore throats, colds and coughs circulating. These should resolve without medical intervention. However, children can on occasion develop a bacterial infection on top of a virus and that can make them more unwell.
As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement. Contact NHS 111 or your GP if:
Call 999 or go to A&E if:
Healthier Together website: This includes an excellent traffic light guideline and graphics of strep A infection
Health Security Agency website.
06 December 2022