News story

PHE publish guidance for managing the continuing increase in scarlet fever cases

PHE reports 1,049 new cases of scarlet fever across England.

Public Health England (PHE) has reported a continued substantial increase in scarlet fever notifications across England with 1,049 new cases reported from 31 March to 6 April. A total of 7,198 new cases have now been reported since the season began in September 2013. Scarlet fever is a seasonal disease and this is the time of year when the highest numbers of cases are typically seen. As such, a decline in numbers of cases should become evident over the coming weeks.

PHE has this week published new guidance on the public health management of scarlet fever outbreaks in schools, nurseries and other child care settings. The guidance will support Health Protection Teams, working closely with schools, nurseries and colleagues in local authorities, to control outbreaks of scarlet fever in child care settings and protect vulnerable children and adults.

Dr Vanessa Saliba, PHE Consultant Epidemiologist, said:

The guidance has been developed in response to the current high levels of scarlet fever to assist local health protection teams in controlling the spread of infection in schools and nurseries when an outbreak is identified. The guidelines are based on a rapid review of the evidence and expert advice and will be kept under review as new evidence emerges.

The guidelines also include resources such as template letters for parents / guardians, staff and GPs highlighting the signs and symptoms of scarlet fever and the need for symptomatic children to stay off school and see their GP promptly. If a diagnosis of scarlet fever is made, antibiotics should be given and the child must stay off school until they have received 24 hours of antibiotics.

PHE strongly urge schools to embed good hand hygiene practices within daily routines for pupils and staff. Children and adults should be encouraged to cover their mouth and nose with a tissue when they cough and sneeze and to wash their hands after using or disposing of tissues.

Dr Theresa Lamagni, PHE’s head of streptococcal infection surveillance, said:

As scarlet fever cases continue to increase, PHE are working closely with healthcare professionals to assess the impact on the frequency of complications. We have a system in place to obtain a sample of strains from across the country to assess whether a new strain may have emerged.

While we hope that the Easter school break will assist in breaking the chains of transmission in schools, reducing numbers of cases, we cannot assume or rely on this being the case. As such, our investigations and assessment of the impact of this extraordinary rise in scarlet fever continue.

Scarlet fever is mainly a childhood disease and is most common between the ages of 2 and 8 years. It was once a very dangerous infection, but has now much less serious although complications can arise, particularly in those who remain untreated. There is currently no vaccine for scarlet fever.

Notes to editors

  • An average of 1,836 cases of scarlet fever, have been reported for the same period (September to April) in the previous 10 years (range 964 to 3,214).
  • Regional breakdowns for scarlet fever seasonal activity in England:cases from weeks 37 in 2013 to weeks 15 in 2014.
PHE Centre Name Cases from Sept to April
Anglia and Essex 319
Avon, Gloucestershire and Wiltshire 557
Cheshire and Merseyside 340
Cumbria and Lancashire 307
Devon, Cornwall and Somerset 239
East Midlands 1181
Greater Manchester 318
Kent, Surrey and Sussex 478
London 685
North East 464
South Midlands and Hertfordshire 380
Thames Valley 404
Wessex 341
West Midlands 530
Yorkshire and the Humber 655
England 7198

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