Increase in cases of scarlet fever shows 49-year high - PHE

Public Health England (PHE) has warned that the cases of scarlet fever in England and Wales have risen to the highest level since the 1960s. There were 1,265 cases of scarlet fever in the first six weeks of 2016 compared to 762 for the same period last year. There were 17,586 diagnoses of scarlet fever in 2015 and 600 new cases are being recorded every week.

Scarlet fever has no vaccine and mostly affects children under the age of ten. Symptoms include fever, headaches, a sore throat and a rough red rash covering the arms, chest or back.

Analysts have to go as far back as the year 1967 - when 19,305 cases were reported to find a year when the numbers were higher. PHE is alerting all health practitioners to be mindful of the disease when assessing patients and more cases were expected as scarlet fever’s peak season is March and April. The body is urging GPs to be aware of the disease when diagnosing patients.

The number of cases of scarlet fever has soared in the last three years. In 2013 there were just 4,642 cases reported in England and Wales, but this then jumped by 236% to 15,625 cases in 2014. A PHE spokesman said the reason behind the increase in cases was unclear but said that it may reflect the long-term natural cycles in disease incidence seen in many types of infection.

Scarlet fever is caused by bacteria known as group A streptococcus, and it is spread through close contact with people carrying the organism often in the throat or through contact with objects and surfaces contaminated with the bacterium. In the early 1900s through to the 1930s the number of cases of scarlet fever in England and Wales regularly topped 100,000. Since then the numbers have, broadly speaking, been steadily declining, a trend spurred on by the introduction of antibiotics. This was until 2014 when health experts saw a significant spike in the figures and the answer has perplexed medical analysts, and cannot be explained through the general rises in population. Test samples have been collated from different parts of the country and experts believe no new strain of scarlet fever has appeared. In addition, initial tests suggest the infection has not become resistant to penicillin, but this is being watched closely.

Dr Theresa Lamagni of PHE head of streptococcal infection surveillance said that symptoms usually clear up after a week and the majority of cases will resolve without complication as long as the recommended course of antibiotics is completed. Potential complications include ear infection, throat abscess and pneumonia. Patients who do not show signs of improvement within a few days of starting treatment should seek urgent medical advice.

In Wales alone, the number of cases recorded in 2015 fell slightly by 10% on the previous year from 1,375 cases to 1,234. But these numbers are still high when compared to the figure for 2013 in Wales which was just 190 cases.

Dr Chris Williams, consultant epidemiologist for Public Health Wales said, we are monitoring an increase in scarlet fever in Wales, which is to be anticipated at this time of year. Meanwhile, Health Protection Scotland said, current data shows that cases have been rising through the early part of 2016 in Scotland, the number of laboratory reports is very similar to 2015 levels. In England, between September 2015 and March 2016, 6,157 cases were reported which is a 7% rise on the same period in the previous year. There were 363 cases in Northern Ireland  in 2015 which is a fall of 41% on 2014 when 625 cases were recorded. In 2013, Northern Ireland had 199 cases.