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NHS Info Strep A

The following information has been sent to all schools. Please be vigilant for signs of Scarlet Fever/Strep A infection and seek medical advice if you are concerned. Please inform school if your child is diagnosed with Scarlet Fever. They should not attend school until at least 24 hours after starting antibiotics and only then if they are well enough.

Group Strep (GAS) / Streptococcus pyogenes

What is Group A Strep (GAS)?

Group A Strep is the name of a bacteria that most commonly causes throat infections, skin infections / Scarlet Fever. It is also able to cause more serious infections, but this does not happen very often. Across the country we are seeing four times more Scarlet Fever cases than we usually do for this time of so it important to be able to recognise the signs and symptoms of Scarlet Fever.

Signs & Symptoms of Scarlet Fever

The symptoms are the same for children and adults, although scarlet fever is less common in adults. Scarlet Fever most commonly happens in children aged under 10 years old and it can be treated with antibiotics.

The first symptoms of Scarlet Fever are the same as those caused by viruses that commonly cause infection at this time of year and they include: sore throat, headache, fever (may be 38.3?C (101?F) or higher), nausea & vomiting. At this stage of the infection Scarlet Fever is hard to diagnose unless your child had been in contact with another child who has already been diagnosed with Scarlet Fever. And not every child will get all the symptoms, some people don’t get any symptoms.

12-48 hours after the initial symptoms a fine rash may appear first on the chest and tummy and then it spreads quickly to the rest of the body. When you feel the rash, it feels rough like sandpaper.


This rash appears pink or red on white skin and may not be as obvious on someone with brown / black skin.




It is common for children with Scarlet Fever to have a white coating on their tongue that peels off and then the tongue appears red and swollen. If your child’s skin is pale, they may also have red cheeks. Symptoms can also include swollen lymph glands.



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When should I contact my GP / NHS 111?

Scarlet fever is very easily spread. Check with a GP before you go in. They may suggest a phone consultation.

· Contact your GP as soon as possible if your child has symptoms of Scarlet Fever or are feeling unwell and have been in contact with someone who has scarlet fever.

· Let your GP know if your child does not get better in a week (after seeing a GP), are ill again, weeks after scarlet fever got better as this can be a sign of a complication, such as rheumatic fever.

· It is also important that you let your GP know if your child gets chickenpox at the same time as Scarlet Fever

You should also contact your GP / NHS 111 if as a parent, you feel that your child seems seriously unwell. You should trust your own judgement.


Contact your GP / NHS 111 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 38C, or is older than 3 months and has a temperature of 39C 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

If it is Scarlett Fever your GP may prescribe antibiotics. Antibiotics will shorten the length of time your child is infectious (can pass the bacteria unto someone else) and can help toreduce the chance of them developing a more serious infection. Your child can return to school 24 hours after starting antibiotic treatment for Scarlet Fever if they are well enough and their temperature has settled. It is important that they continue to take all their antibiotic treatment even if they start to feel better.

When should I call 999 / go to A & E?

  • 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


Should I let anyone else know if my child has Scarlet Fever?

You can spread scarlet fever to other people up to 6 days before you get symptoms until 24 hours after you take your 1st dose of antibiotics. If you do not take antibiotics, you can spread the infection for 2 to 3 weeks after your symptoms start.

If your child attends a baby-sitter with other children, a nursery / school it would be helpful to tell them that your child has Scarlet Fever.

Scarlet fever is a notifiable disease in England and Wales. This means health professionals must inform local health protection teams of suspected cases.

If me or my child is diagnosed with Scarlet Fever, what can I do to stop spreading the infection?



Encourage them to wash their hands often with soap & water

Share Towels, bedding /cups & cutlery before washing them

Use tissues when they cough and sneeze and bin it afterwards

Allow them to mix with other children if possible until 24 hours after they have started their antibiotics.


What can I do relieve the symptoms?

You can relieve symptoms of scarlet fever by:

· drinking cool fluids

· eating soft foods if you have a sore throat

· taking painkillers like paracetamol to bring down a high temperature (do not give aspirin to children under 16)

· using calamine lotion or antihistamine tablets to ease itching


Where to get more information? NHS: Scarlet Fever