Increased outbreaks of Strep A and scarlet fever have been reported across Northern Ireland and is causing concern. There has been a huge increase in the numbers of people being diagnosed across the UK with hundreds more cases reported this year than in previous ones. On Tuesday morning, it was revealed that a five-year-old girl at a Belfast primary school, which last week reported a severe case of Strep A, has died.

Eight children in Great Britain have died with a form of Strep A. Strep A infections are usually mild and can be easily treated with antibiotics.

Illnesses caused by the Group A strep bacteria include skin infection impetigo, scarlet fever and strep throat.

There has also been a big leap in the number of scarlet fever cases. 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.

Symptoms of scarlet fever include 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 harder to see but will still be "sandpapery".

Strep A infections can develop into a more serious invasive Group A Strep (iGAS) infection - though this is rare.

Last week, the Public Health Agency in Northern Ireland urged parents and carers to be aware of scarlet fever symptoms after an increase in the number of cases at schools and nurseries across the region.

It said this follows two years during the coronavirus pandemic when reported cases were lower than usual.

It said clusters of scarlet fever have been reported at schools and nurseries in Antrim, Belfast, Bangor and Craigavon.

How do you check if you have scarlet fever?
The first signs of scarlet fever can be flu-like symptoms, including a high temperature, a sore throat and swollen neck glands (a large lump on the side of your neck).

A rash appears 12 to 48 hours later. It looks looks like small, raised bumps and starts on the chest and tummy, then spreads. The rash makes your skin feel rough, like sandpaper.

On white skin the rash looks pink or red. It may be harder to see on brown and black skin, but you can still feel it

A white coating also appears on the tongue. This peels, leaving the tongue red, swollen and covered in little bumps, known as strawberry tongue.

The rash does not appear on the face, but the cheeks can look red. The redness may be harder to see on brown and black skin.

The symptoms are the same for children and adults, although scarlet fever is less common in adults.

When should I see a GP?
See a GP if you or your child:

have scarlet fever symptoms
do not get better in a week after seeing a GP
have scarlet fever and chickenpox at the same time
feel ill again, weeks after scarlet fever got better – this can be a sign of a complication, such as rheumatic fever
are feeling unwell and have been in contact with someone who has scarlet fever
Scarlet fever is very easily spread. Check with a GP before you go in. They may suggest a phone consultation.

What happens at the GP appointment?
GPs can often diagnose scarlet fever by looking at your tongue and rash.

Sometimes they may:

wipe a cotton bud around the back of your throat to test for bacteria
arrange a blood test
How is scarlet fever treated?
A GP will prescribe antibiotics. These will:

help you get better quicker
reduce the chance of a serious illnesses, such as pneumonia
make it less likely that you'll pass the infection on to someone else
Keep taking the antibiotics until they're finished, even if you feel better.

You can relieve symptoms of scarlet fever yourself by:

drinking cool fluids
eating soft foods if you have a sore throat
taking painkillers like paracetamol to bring down a high temperature (do not give aspirin to children under 16)
using calamine lotion or antihistamine tablets to ease itching
How long does scarlet fever last?
Scarlet fever lasts for around one week. You can spread scarlet fever to other people up to 6 days before you get symptoms until 24 hours after you take your first dose of antibiotics.

If you do not take antibiotics, you can spread the infection for 2-3 weeks after your symptoms start. If you or your child has scarlet fever, stay away from nursery, school or work for 24 hours after you take the first dose of antibiotics.

Is scarlet fever dangerous?
Scarlet fever can be a serious illness, but thanks to antibiotics, it's less common than it used to be and easier to treat. But cases of scarlet fever have increased in recent years.

Complications from scarlet fever are rare. They can happen during or in the weeks after the infection, and can include:

ear infection
throat abscess
sinusitis
pneumonia
meningitis
rheumatic fever
What is the advice for pregnant women?
There's no evidence to suggest that getting scarlet fever during pregnancy will harm your baby. But it can make you feel unwell, so it's best to avoid close contact with anyone who has it. Contact a GP if you get symptoms.

Many of the antibiotics used for scarlet fever are considered to be safe to take during pregnancy.

How can I avoid spreading scarlet fever?
Scarlet fever is very infectious and can easily spread to other people. To reduce the chance of spreading scarlet fever:

Do:

wash your hands often with soap and water
use tissues to trap germs from coughs or sneezes
bin used tissues as quickly as possible
Don’t:

share cutlery, cups, towels, clothes, bedding or baths with anyone who has symptoms of scarlet fever
What is Strep A?
Group A streptococcus (GAS) is a common bacteria. Lots of us carry it in our throats and on our skin and it doesn’t always result in illness. But it does cause a number of infections, some mild and others more serious.

The most serious infections linked to GAS come from invasive group A strep, known as iGAS.

This can happen when a person has sores or open wounds that allow the bacteria to get into the tissue, breaches in their respiratory tract after a viral illness, or in a person who has a health condition that decreases their immunity to infection. When the immune system is compromised, a person is more vulnerable to invasive disease.

How is it spread?
GAS is spread by close contact with an infected person and can be passed on through coughs and sneezes or from a wound.

Some people can have the bacteria present in their body without feeling unwell or showing any symptoms of infections and while they can pass it on, the risk of spread is much greater when a person is unwell.

Which infections does GAS cause?
GAS causes infections in the skin, soft tissue and respiratory tract. It’s responsible for infections such as tonsillitis, pharyngitis, scarlet fever, impetigo and cellulitis among others.

While infections like these can be unpleasant, they rarely become serious. When treated with antibiotics, an unwell person with a mild illness like tonsillitis stops being contagious around 24 hours after starting their medication.

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