Scarlet fever and Group A Streptococcal infections

We are currently seeing an increase in notifications of scarlet fever in the community. There has also been significant media attention relating to this which has naturally caused concern amongst parents and others.

We have been waiting for a national communication from UKHSA which we have now received.

Please see attached two letters from UKHSA – one for schools/early years providers and one for parents:

Further information from the UKHSA is provided below which you may find useful based on some of the queries that have been received.

Guidance and resources to support you:

Complications:

In very rare situations, GAS can cause a more serious infection (Invasive Group A Strep). This is when the bacteria get into parts of the body where it is not normally found, such as the lungs or bloodstream. Children who have flu or chickenpox at the same time as a GAS infection are more likely to develop this serious infection. However, you can reduce the spread of all infections by practicing good hand and respiratory hygiene and other standard infection control measures.

When to call the UKHSA South West Health Protection Team:

All of the infection control and prevention processes that you already have in place (e.g., good hygiene, ventilation and cleaning) will help reduce the spread of infection in your setting.

UKHSA have advised that schools/nurseries should contact them if:

  1. You have one or more cases of chickenpox or flu in the class that has scarlet fever at the same time. This is because infection with scarlet fever and either chickenpox or flu at the same time can result in more serious illness.
  2. You are experiencing an outbreak of scarlet fever in a setting / class that provides care or education to children who are clinically vulnerable.
  3. The outbreak continues for over 2 weeks, despite taking steps to control it.
  4. Any child or staff member is admitted to hospital with any Group A Strep (GAS) infection (or there is a death).
  5. Any issues that are making it difficult to manage the outbreak.

UKHSA South West Centre Health Protection Team:

Managing/preventing and outbreak or cluster of cases of scarlet fever (also useful in managing/preventing all infections in your setting):

1
  • Make sure that all children and employees that are ill go home. They cannot come back until it is safe to do so (As per national ‘Health protection in children and young people settings, including education’ guidance, children and adults with suspected scarlet fever should be excluded from nursery / school / work for 24 hours after the commencement of appropriate antibiotic treatment).
  • Any ill children need to keep away from others until they go home.
  • Employees supporting anyone ill should wear single use plastic gloves and aprons. Throw these away once they have left.
2
  • Tell parents and visitors about the cases of illness
  • Ask that any non-urgent visitors do not visit
  • Depending on the severity of the outbreak/cluster, you may want to consider postponing school gatherings e.g. discos or nativity plays
  • Make sure that any visitors that do come in wash their hands on arrival and before they leave
  • Anyone who is worried or think they may be ill with something else need to get medical advice.
3
  • Remind your employees to wash their hands throughout the day. Hand washing needs to be done after changing nappies and helping children use the toilet.
  • Handwashing should also be done after using the toilet and before helping with food. Help children to make sure they wash their hands. You could use rewards / points to encourage children to wash their hands during the day.
  • Respiratory hygiene is also important. Cover mouths when coughing or sneezing, making sure to wash hands afterwards. Use disposable tissues and throw away after use.
4 Make sure that all cuts, scrapes and wounds are cleaned and covered. This also applies to bites.
5

Cleaning:

Carry out regular cleaning throughout the day, especially hand contact surfaces. Use detergent followed by a chlorine containing disinfectant (any surface that may get touched by children) including:

  • light switches
  • door handles
  • hard toys
  • toilet cubicles
  • walls
  • tables

Potties or changing mats need to be cleaned after each use.

Carpets and soft furnishings should be vacuumed DAILY.

6 Until you are free of illness we recommend:

  • that you stop messy play (you can swap playdough with homemade dough that can be thrown out at the end of each day).
  • remove soft toys that are tricky to clean (or hot wash them each day)
  • you don’t go on any visits out of your setting
  • Do not allow children to share drinks between each other.
7 Once Cases have stopped:

  • When you have not had any new cases of illness for 10 days you must do a full clean of the building(s).
  • Clean surfaces, toys, floors etc where children and employees have been. You need to also steam clean carpets and any curtains need to be steam cleaned or washed on a hot wash.

Pregnancy advice:

  • There’s no evidence to suggest that getting scarlet fever during pregnancy will harm the baby. But it can make the person feel unwell, so it’s best to avoid close contact with anyone who has it.
  • Advise them to contact a GP if they get symptoms.
  • Many of the antibiotics used for scarlet fever are considered to be safe to take during pregnancy.
  • Further information can be found here: Scarlet fever – NHS (www.nhs.uk)