Group A Strep (Streptococcus) Infection and Scarlet Fever

The most common infections caused by Group A Streptococcus are mild and include:

  • sore throats (strep throat)  
  • fever  
  • Scarlet Fever

There has been a recent increase in notifications of Scarlet Fever to the UK Health Security Agency (UKHSA), above seasonal expected levels at both local and national levels. We would like to take this opportunity to remind you of the signs, symptoms and the actions to be taken if you think that you or your child might have Scarlet Fever. 

Signs and symptoms of Scarlet Fever

Scarlet Fever is a common childhood infection caused by Streptococcus pyogenes, or group A Streptococcus (GAS). It is not usually serious, but should be treated with antibiotics to reduce the risk of complications (such as pneumonia) and spread to others. There is no evidence that the bacteria is a new strain, or that the bacteria is showing any resistance to anti-biotics. The early symptoms of Scarlet Fever include sore throat, headache, fever, nausea and vomiting. After 12 to 48 hours, the characteristic red, pinhead rash develops, typically first appearing on the chest and stomach, then rapidly spreading to other parts of the body, and giving the skin a sandpaper-like texture. The scarlet rash may be harder to spot on darker skin, although the 'sandpaper' feel should be present. Patients typically have flushed cheeks and be pale around the mouth. This may be accompanied by a bright red red ‘strawberry’ tongue.

If you think you, or your child, might have Scarlet Fever: 

  • contact your GP or NHS 111 as soon as possible 
  • make sure that you or your child take(s) the full course of any antibiotics prescribed. Although you or your child will feel better soon after starting the course of antibiotics, you must complete the course to ensure that you do not carry the bacteria in your throat after you have recovered 
  • stay at home, away from nursery, school or work for at least 24 hours after starting the antibiotic treatment, to avoid spreading the infection 

Prevention of infection

Group A Streptococcus infections are spread by close contact with an infected person and can be passed on through coughs and sneezes or from a wound. Good infection control is essential at home, in schools, and in healthcare - wash hands for at least 20 seconds, cover faces when coughing or sneezing.

Invasive Group A Streptococcus

The most serious infections linked to GAS come from invasive group A strep, known as iGAS. These infections are caused by the bacteria getting into parts of the body where it is not normally found, such as the lungs or bloodstream. In rare cases an iGAS infection can be fatal. Whilst iGAS infections are still uncommon, there has been an increase in cases this year, particularly in children under 10 and sadly, a small number of deaths

As a parent or carer, if you feel the person you are caring for seems seriously unwell, you should trust your own judgement. 

Contact NHS 111 or your GP if: 

  • your child is getting worse •your child is feeding or eating much less than normal 
  • your child has had a dry nappy for 12 hours or more or shows other signs of dehydration 
  • your baby is under 3 months and has a temperature of 38 °C, or is older than 3 months and has a temperature of 39 °C or higher 
  • your baby feels hotter than usual when you touch their back or chest, or feels sweaty 
  • your child is very tired or irritable 

Call 999 or go to A&E if:

  • your child is having difficulty breathing 
  • you may notice grunting noises or their tummy sucking under their ribs 
  • there are pauses when your child breathes 
  • your child’s skin, tongue or lips are blue 
  • your child is floppy and will not wake up or stay awake

Further resources: