Scarlet fever / Streptococcus A


National data is showing that scarlet fever cases continue to remain higher than we would typically see at this time of year, with some very serious infections requiring hospital admissions / paediatric intensive care.

Scarlet fever is caused by bacteria called group A streptococci. It is usually a mild illness, but is highly infectious. In very rare occasions, the bacteria can get into the bloodstream and cause an illness called invasive Group A Strep (iGAS). So far this season there have been six recorded deaths associated with an iGAS infection in children under 10 in England.

Currently, there is no evidence that a new strain is circulating. The increase is most likely related to high amounts of circulating bacteria and social mixing.

Be extra vigilant of the signs and symptoms of scarlet fever which include sore throat, headache and fever, along with a fine, pinkish or red body rash with a sandpapery feel. On darker skin, the rash can be more difficult to detect visually but will have a sandpapery feel. 

What to do if you feel your child is unwell

As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement. Contact NHS 111 or your GP if:

  • your child is getting worse
  • your child is feeding or eating much less than normal
  • your child has had a dry nappy for 12 hours or more or shows other signs of dehydration
  • your baby is under 3 months and has a temperature of 38°C, or is older than 3 months and has a temperature of 39°C or higher
  • your baby feels hotter than usual when you touch their back or chest, or feels sweaty
  • your child is very tired or irritable

Call 999 or go to A&E if:

  • your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs
  • there are pauses when your child breathes
  • your child’s skin, tongue or lips are blue
  • your child is floppy and will not wake up or stay awake

Good hand and respiratory hygiene are important for stopping the spread of many bugs. By teaching your child how to wash their hands properly with soap for 20 seconds, using a tissue to catch coughs and sneezes, and keeping away from others when feeling unwell, they will be able to reduce the risk of picking up or spreading infections.

Guidance and further information

View the most up-to-date national scarlet fever guidance.

The UKHSA blog gives useful advice, in an accessible way (and is much shorter than the guidance) and the principles can be applied to children over 5, as well.

This page was last modified on: 6 Dec 2022