As we approach the last stretch of winter in the Northern Hemisphere, it’s important to be aware that we are still in a cold spell – and in the peak season for flu.
This year, countries such as the UK continue to see an increase in infections such as scarlet fever and Strep A. While the reason for this is not clear, some suggest it may be due to reduced immunity after the isolation of the pandemic.
Strep A (Group A Streptococcus) is a highly contagious bacterium that spreads via sneezing and coughing, or through close contact. This is particularly true in school settings where children are in close proximity to one another.
Early symptoms of Strep A (such as a sore throat and fever) can look similar to a range of other infections. This makes it a particularly difficult disease to contain during an indoor mixing season, and clinically it is also hard to diagnose strep A at an early stage when it is seen in primary care.
Strep A itself is also responsible for causing a wide array of infections – most commonly it causes a sore throat and general malaise that resolves by itself, but this can develop into an illness known as scarlet fever, marked by a bright red rash. This is a lot more common in children 5 to 15 years of age. In very rare cases the bacteria can cause a severe, life-threatening infection known as invasive group A streptococcal disease (iGAS).
At least five European countries have reported an increase in Strep A infections in recent months, and in some cases, scarlet fever. Reports show that children under ten have been the most affected age group.1 The UK, the worst affected country, reported more than 6,600 cases of scarlet fever and 652 cases of invasive group A strep infection over a period of only 12 weeks.
The UK government recently published a to highlight the sharp increase in scarlet fever early in the 2022 to 2023 season, which they say is ‘steeper’ than would be expected at this time of the year. The rate of iGAS infections is said to also be following a similar trend, with weekly incidence rates slightly above what would be expected.