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Red alert: Scarlet fever hasn't gone away

It was once seen as a disease that died out decades ago, but cases of scarlet fever are at a 50-year high. Here's what you need to know

Scarlet fever is a bacterial illness most common among children under the age of 10

AS RECENT press reports have highlighted, scarlet fever has been making a comeback.

Like scurvy and rickets, it was once thought of as a Victorian-era concern, not something that anybody still needs to worry about, but cases have been steadily rising in Ireland over recent years and in Britain they are the highest they've been for five decades.

According to Public Health England, 6,157 children have been diagnosed since last September, while 17,586 cases were reported in England during 2015, compared to 1,678 in 2005.

In Northern Ireland, while there have been 61 cases reported so far this year, as opposed to 71 during the same period last year, Public Health Agency figures show an increase in reported cases between 2011 and 2015 – from 130 to 363 – with a spike in 2014, when there were 625 cases reported through the north's Notifications of Infectious Diseases arrangements.

Experts aren't entirely sure why the disease has returned at such a rate but the good news is a lot has changed since the Victorian age, when scarlet fever struck real fear.

So what do you need to know?

Scarlet fever, sometimes called scarletina, is an infection caused by group A streptococci bacteria. These are commonly found on the skin or in the throat where they can live without causing disease – however, under particular circumstances they can cause illness.

Anyone can get scarlet fever, but young children are most affected – most commonly, children under the age of 10, according to Dr Adam Simon, chief medical officer at PushDoctor.co.uk.

"Key symptoms include a sore throat, skin infection and the bright pink rash that gives the condition its name," says Dr Simon.

This usually starts as red blotches before turning into a fine pinky-red rash that feels like sandpaper. There might be a high temperature, headache and swollen tongue too, usually in the day or two before the rash develops, and nausea and vomiting.

"It's highly contagious," Dr Simon notes, "and can be passed on by coughing, sneezes, skin-to-skin contact and handling contaminated objects, like bath towels or bedding."

Most cases occur during winter and spring. Good hygiene – paying attention to hand-washing, and avoiding sharing potentially contaminated items – can help reduce spreading.

In the past, an outbreak of scarlet fever was a very serious concern and children and families affected were often quarantined. While things are different now, it's still important it's properly diagnosed and treated, and that necessary steps are taken to avoid passing it on further.

"In the majority of cases, scarlet fever will clear up of its own accord, but it's always recommended to see a GP if you think you or your child may have it," Dr Simon says.

"The usual course of treatment is antibiotics, which will help you to recover more quickly, lower the amount of time you're contagious for and reduce the risk of complications occurring."

It's usually a 10-day course and children should start feeling better after 24 hours, with symptoms clearing up completely after a few days (but it's still vital to complete the full course of treatment). Doctors generally advise that anybody infected stays home from nursery, school or work for at least 24 hours after starting on antibiotics too.

In the past, scarlet fever was a leading cause of infant death. Better hygiene, and treatments, means it generally isn't the terrifying illness it used to be and, in the vast majority of cases, will clear up quite quickly and cause little more than a few days of feeling poorly, especially if treated properly.

But as with many conditions, complications – ranging from mild to serious – can still potentially occur.

"Complications are rare and especially easy to avoid if symptoms are spotted and treatment begun early," Dr Simon says. "However, in some scarce cases, potential complications can occur, ranging from relatively simple issues like an ear infection, to blood poisoning and liver damage in more serious cases."

As ever, if you are concerned about your child's health, or if symptoms suddenly worsen or change, always get them checked with a doctor.

:: For more information about scarlet fever and the signs and symptoms see www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/ScarletFever.

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