Symptoms of Strep A: London child seventh death in scarlet fever outbreak - warning signs to look out for

A 12 year old from Lewisham has become the latest death from complications of Strep A, known also as scarlet fever. The boy, understood to have attended Colfe’s School in the London borough, is the first secondary school pupil to have died after contracting the bacterial infection which usually only affects the throat and skin.

The outbreak has prompted a number of concerned parents in the London area to pull their children from schools to avoid the spread of the infection, including those schools that have yet to record a case of scarlet fever.

The UK Health Security Agency has reassured parents that they “should not be overly alarmed" and that children should still continue to go to school.

The UKHSA also confirmed that it was up to local health protection teams to decide whether parents of children at schools where there have been confirmed infections should be advised to keep them at home.

The assurance comes after the agency reported there have been 851 cases of scarlet fever per week since initial warnings about the outbreak were reported in November. That number has exploded from the average of 186 per week before covid restrictions were put in place.

The UK Health Security Agency released an update before the weekend regarding the current outbreak of scarlet fever among children, citing “social mixing” and high amounts of bacteria are to blame for the rise in cases. Official data from the agency states ”there have been five recorded deaths within seven days of an iGAS diagnosis in children under 10 in England. During the last high season for Group A Strep infection (2017 to 2018) there were 4 deaths in children under 10 in the equivalent period.”

Discussing the current outbreak, deputy director of the UK Health Security Agency Dr Colin Brown said: “The bacteria usually causes a mild infection producing sore throats or scarlet fever that can be easily treated with antibiotics [but] in very rare circumstances, this bacteria can get into the bloodstream and cause serious illness – called invasive Group A strep (iGAS).”

“This is still uncommon; however, it is important that parents are on the lookout for symptoms and see a doctor as quickly as possible so that their child can be treated and we can stop the infection becoming serious. Make sure you talk to a health professional if your child is showing signs of deteriorating after a bout of scarlet fever, a sore throat, or a respiratory infection.”

Symptoms of strep A

The NHS guidance has asked parents to keep an eye on their children suffering the following symptoms for scarlet fever, caused by strep A:

• Flu-like symptoms, including a high temperature. 
• Sore throat and swollen neck glands (a large lump on the side of your neck).
• A rash appearing 12 to 48 hours later (small, raised bumps starting on the chest and tummy, before spreading). 
• The rash makes the skin feel rough, like sandpaper.

Scarlet fever can be treated with a course of antibiotics and symptoms ahead of medical attention can be relieved by drinking cold fluids, eating soft foods, if your child has a sore throat, and using calamine lotion or antihistamine tablets to ease itching.

Scarlet fever can be spread to other people up to six days before symptoms develop and until 24 hours after a first dose of antibiotics is taken.