By NewsDesk  @bactiman63

The UK Health Security Agency (UKHSA) continues to report  an out of season increase in scarlet fever and group A strep infections. Cases usually show steepest rises in the new year, but have increased sharply in recent weeks.

This patient revealed a scarlet fever rash on the volar surface of the forearm due to group A Streptococcus bacteria

So far this season (from 12 September to 4 December) there have been 6,601 notifications of scarlet fever. This compares to a total of 2,538 at the same point in the year during the last comparably high season in 2017 to 2018.

In addition, there have been 85 iGAS cases in children aged 1 to 4 compared to 194 cases in that age group across the whole of the last comparably high season in 2017 to 2018. There have been 60 cases in children aged 5 to 9 compared to 117 across the whole of the last comparably high season in 2017 to 2018. The majority of cases continue to be in those over 45.

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Sadly, so far this season there have been 60 deaths across all age groups in England. This figure includes 13 children under 18. In the 2017 to 2018 season, there were 355 deaths in total across the season, including 27 deaths in children under 18.

Cases of GAS usually increase during the winter and the last time significant numbers of cases were reported was in the 2017 to 2018 season. Seasons with high cases can occur every 3 to 4 years but social distancing measures implemented during the coronavirus (COVID-19) pandemic may have interrupted this cycle and explain the current increase being observed.

Currently, there is no evidence that a new strain of GAS is circulating or any increase in antibiotic resistance. Antibiotics are the best treatment and work well against the circulating strains. The increase is likely to reflect increased susceptibility to these infections in children due to low numbers of cases during the pandemic, along with current circulation of respiratory viruses, which may increase the chances of children becoming seriously unwell. However, investigations are under way to understand if there are other factors that could be contributing to the increase this season and to better understand who is currently most affected.

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