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Guidance released following scarlet fever outbreak

Scarlet fever cases have continued to rise across England, leading the health protection agency to issue urgent guidance for health professionals. 

Close to 1,050 new cases of scarlet fever have been confirmed between 31 March and 6 April, Public Health England (PHE) has revealed. 

Since the season began in September 2013, there have been a total of 7,198 new cases.

The new guidance, for health protection teams, focuses on the public health management of scarlet fever outbreaks in schools, nurseries and other child care settings. 

Dr Vanessa Saliba, PHE consultant epidemiologist, said: “The guidelines include resources such as template letters for parents / guardians, staff and GPs highlighting the signs and symptoms of scarlet fever and the need for symptomatic children to stay off school and see their GP promptly.  If a diagnosis of scarlet fever is made, antibiotics should be given and the child must stay off school until they have received 24 hours of antibiotics.

“PHE strongly urge schools to embed good hand hygiene practices within daily routines for pupils and staff. Children and adults should be encouraged to cover their mouth and nose with a tissue when they cough and sneeze and to wash their hands after using or disposing of tissues.”

Dr Theresa Lamagni, PHE's head of streptococcal infection surveillance, said: “As scarlet fever cases continue to increase, PHE are working closely with healthcare professionals to assess the impact on the frequency of complications. We have a system in place to obtain a sample of strains from across the country to assess whether a new strain may have emerged.

“While we hope that the Easter school break will assist in breaking the chains of transmission in schools, reducing numbers of cases, we cannot assume or rely on this being the case.  As such, our investigations and assessment of the impact of this extraordinary rise in scarlet fever continue.”

Scarlet fever is mainly a childhood disease and is most common between the ages of two and eight years. It was once a very dangerous infection, but has now much less serious although complications can arise, particularly in those who remain untreated. 

There is currently no vaccine for scarlet fever.

The guidance is available to view on the Health Protection Agency website