What you need to know about strep A and scarlet fever

An Irish pharmacist, Sheena Mitchell has advised parents to familiarise themselves with the symptoms of Strep A infection as the number of cases has increased.

In Ireland, Group A Streptococci (GAS) which we know is a cause of scarlet fever is not a notifiable disease to the relevant health authorities. However, cases of Invasive Group A Streptococci (iGAS) must be reported so that they can be investigated in order to prevent the spread of infection and to help identify potential outbreaks.

"I urge parents to be vigilant for the symptoms of both Scarlet Fever and iGAS," said the mother of three. "Prompt action will result in early medical intervention with readily available antibiotics which will reduce the risk of further complications.

"While many parents will know about a ‘Strep throat’, they may be less familiar with the term iGAS used to describe invasive Group A Streptococci and its symptoms. Simply put, the GAS is the Group A Streptococci bacteria which live on a person’s skin and in their throat. Usually this doesn’t cause any problems, however sometimes it can cause illness in the form of scarlet fever, a sore ‘strep throat’, or even a common skin infection in children called Impetigo.

"In a small number of cases, the GAS bacteria journeys into the blood or spinal fluid causing a very serious infection called invasive Group A Streptococci or iGAS. This can result in streptococcal toxic shock syndrome or necrotising fasciitis, both extremely serious conditions."

Symptoms of iGAS

· A high fever

· Severe muscle aches

· Redness or blisters at the site of a wound

· Localised muscle tenderness in one area

· Low blood pressure and dizziness

· Confusion

· Nausea and Vomiting

· Stomach Pain

Whilst iGAS does not always begin as a result of scarlet fever, due to their common origin from Group A Streptococci, the risk of iGAS is higher when levels of scarlet fever circulating are higher. Scarlet fever usually affects children between the ages of four and ten years. Children under two years have some immunity from their mothers, while children over ten years will have developed immunity themselves to the toxins from streptococcal bacteria. Infection normally occurs after exposure to someone with a skin infection or strep throat.

Symptoms of Scarlet Fever

A child can start to show symptoms of scarlet fever within one to seven days of exposure:

· High temperature

· Sore throat

· Headache

· A swollen tongue which can appear red and tender or thick with a white coating

· Nausea or loss of appetite

· Swollen neck glands

· A rash usually appears after 2-3 days of infection. The rash will start with red blotches and developing into a pink-red rash which feels like sandpaper. It normally starts on the torso and spreads to other areas like the legs, arms, and groin, lasting about a week.

· A flushed face is often a distinguishing feature of scarlet fever.

“If you suspect your child may have scarlet fever, you need to bring them to see your GP. Getting an antibiotic like penicillin, will not only speed up your child’s recovery but it will also reduce the length of time that they remain contagious. In fact, your child will be able to return to childcare after 24- hours of taking antibiotics, depending on how they are feeling. Without an antibiotic they will remain highly contagious for one to two weeks after they first developed symptoms,” says Pharmacist Sheena.

“Always trust your instinct and if you are in any way worried about your child’s health, don’t waste any time and bring them straight to hospital,” advises Pharmacist Sheena Mitchell.

Shenna Mitchell is an Irish Pharmacist and runs the Wonderbaba.ie website.