Tonsillitis

High rates of group A streptococcus infection in England

In a UK Health Security Agency (UKHSA) report, notifications of scarlet fever and invasive group A streptococcus (iGAS) disease in England are higher than expected for this time of year.

Prompt treatment of children with scarlet fever with antibiotics is recommended to reduce risk of possible complications and limit onward transmission. If there is uncertainty about the diagnosis, obtain a throat swab prior to commencing antibiotics. Children with scarlet fever should stay at home until 24 hours of antibiotic treatment has been received.

The Centers for Disease Control and Prevention (CDC) is looking into an increase in iGAS infections among children in the US.

Scarlet fever:

• Around 90% of cases occur in children under 10 years

• Usually a mild illness, but is highly infectious

• Presents with a generalized, erythematous rash, which feels like sandpaper

• Often preceded by sore throat (pharyngitis, tonsillitis)

• Pharyngeal erythema with exudates, palatal petechiae, and a red, swollen (strawberry) tongue are suggestive features.

Invasive group A streptococcal infection:

• The relatively higher rates of iGAS in children this season may reflect increased rates of a preceding viral infection (including respiratory viruses and chickenpox)

• Clinicians are advised to maintain a high index of suspicion, as early recognition and prompt initiation of specific and supportive therapy for patients with iGAS infection can be life-saving.

Further information from CDC:

• CDC: Increase in pediatric invasive group A streptococcal infections Opens in new window

Original source of update