With so much about Group A Strep and Scarlet Fever circulating in the media, we understand the concerns many parents are facing. FTC Chief Medical Officer, Dr. Anna Cantlay, answers your questions about Group A Strep and outlines the signs and symptoms you should be looking out for.

Strep A is a common type of bacteria. An infection with Group A Strep can present in different ways. Most Infections are mild and can be easily treated with antibiotics, but some can be more serious. Common Strep A infections include:

• Tonsilitis
• Impetigo
• Scarlet Fever
• Cellulitis
• Chest infections

Rarely, the infection can be serious. This is called Invasive Group A Strep (iGAS)

Scarlet Fever is one of the infections that cause be caused by Group A Strep. For many, it causes a mild illness but it is very contagious. Symptoms to look out for include:

• Sore throat
• Headache 
• Fluey symptoms 
• Swollen neck glands 
• 12-48 hours later a pink/red rash appears that is small, raised bumps that have a sandpapery feel. It may look different on darker skin, but you will notice the rash which will feel like small bumps which will still have a sandpaper feel.
• Strawberry tongue – initially a white coating but then a red swollen tongue with small bumps 

Seek advice early if you are concerned that your child has Scarlet Fever or Group A Strep symptoms so that you can help reduce the risk of complications such as iGAS or pneumonia.

There were 851 cases of Scarlet Fever in week 46 (2023) compared to 186 for proceeding years.

There has also been an increase in iGAS although it is still uncommon – 0.5/100,000 cases in 1-4 years has risen to 2.3/100,000 cases. 

There is no evidence that a new strain is circulating. The increase likely related to more socializing and higher amounts of circulating bacteria. 

• Wash your hands regularly 
• Do not share utensils and glasses 
• Dispose of used tissues and wash handkerchiefs
• If your child is being treated for Scarlet Fever, keep them at home for 24 hours after starting antibiotics.  

If you are concerned that you or your child have Group A Strep, speak to your GP. In most cases, doctors diagnose it from symptoms alone, although a throat swab might sometimes be taken to confirm the diagnosis. 

Trust your instinct and speak to your GP or doctor if you are concerned your child is unwell. In particular, look out for:

• A child that is getting worse 
• A child that is feeding and eating much less than normal
• Dry nappies for 12 hours or other signs of dehydration
• A baby who is under 3 months old with a temperature of 38℃ or 3-6 months with a temperature of 39℃
• Your baby feels hotter than usual when you touch them
• Your child is very tired or irritable 

• Your child is having difficulty breathing 
• There are pauses when they breathe 
• Their skin, lips or tongue is blue 
• Your child is floppy and will not stay awake 

The key takeaway is to trust your instincts and seek advice early from your GP if you have any concerns that your child has Scarlet Fever or Group A Strep symptoms.

There is a great traffic light system for assessing an unwell child that can be found here.

You can read more about Strep A infections on the NHS website here and Scarlet Fever here. 

For the most accurate and up-to-date information, visit the UKSHA website here.