Derbyshire health leaders have offered reassurance and advice to parents and guardians concerned about the ongoing spread of scarlet fever and an invasive form of Strep A.
To date, Government health officials have not confirmed any cases or deaths relating to the bacterial infection Strep A in Derbyshire, including Derby.
Eight children are known to have died in the UK as a result of Strep A, an invasive form of what is a very common bacteria which can cause serious harm and death if it reaches further into the body – such as the lungs.
One of the core issues linked to Strep A is the development of scarlet fever, with a key symptom being a pink or red rash which feels like sandpaper.
Cases of scarlet fever in Derbyshire are currently high for the time of year, but level with what health chiefs expect to see when there is a spread.
They confirm the disease is not typically seen in the winter and is usually seen in the spring, and that it is now hitting children when they are already susceptible to other winter bugs such as the flu and norovirus, with respiratory syncytial virus also now spreading out of season.
This introduction of illnesses being seen out of season is being linked to children not socialising as much in the past couple of years and, as a result, not gaining immunity to common bugs, say public health leaders.
In the past week there have been 28 cases of scarlet fever in Derbyshire, with six of those in Derby, and 95 cases in the past four weeks, Government data shows.
The data shows that there have been no reported cases of “invasive group A Streptococcal disease” in Derbyshire, with 10 cases across the UK in the most recent week.
However, there was a case recorded in Stafford in the week to December 4, a case in Oadby and Wigston, in Leicestershire, in the week to November 13 and a case in Nottingham in the week to November 6.
Dr Robyn Dewis, Derby’s public health director, speaking to the Local Democracy Reporting Service, said data for a low level of cases relies on children being taken to a doctor and the doctor filing a report, saying the current level “does not feel out of kilter”.
She said: “It is increasing nationally at the moment and it is increasing at a time of year when we wouldn’t normally expect to see that and that has happened with a number of other infections as well.
“The Strep A activity has been slightly different. In 17/18 we had the last high-normal levels, it tends to wax and wane, we tend to get higher levels every few years as immunity in the population decreases.
“Children catch it and gain immunity and then we have a few years we have it a little less and then there is a whole batch of new children born we get it again, so it waxes and wanes with scarlet fever.
“This year it is coming higher and earlier than we would expect for the time of year but it is still not at the peak we had in 17/18.”
For example, Derbyshire saw a spike in scarlet fever cases in June, with 53 cases over the course of four weeks and 103 over eight weeks. This was also attributed to low background immunity among children.
Dr Dewis said: “It is usually around spring when we get scarlet fever. It is coming earlier than we anticipate and we are seeing that with a lot of diseases as a result of our change in our behaviour over Covid.
“Things have come slightly unpredictable following that.”
Dr Dewis said this comes down to “exposure” of young children to illnesses, particularly the “Covid babies” born during lockdown restrictions and who have had much less social contact.
She said: “There is a combination of children not being exposed to many things, it’s as if everything is now coming at them at once, and our behaviour over that time… (during lockdown restrictions) we showed brilliantly how we can stop the spread of infectious diseases, there was hardly any flu circulating, really minimal levels, low levels of scarlet fever and low levels or RSV – which also came at an unusual time last winter.”
Dr Dewis detailed that the UK Health Security Agency was looking into the impact of several viruses circulating at the same time and if that is one of the reasons for the “significant impact” of scarlet fever.
She said our immune systems are less able to fight a second infectious disease while recovering from an initial illness, which is what often happens in the winter but is happening to a larger extent this winter due to infections being spread out of season – including scarlet fever.
This can in effect create a domino effect of illnesses which can be “more challenging”.
She said scarlet fever, which can lead to Strep A, is not an unusual bug and that it is seen every year and that experts feel it is not a new strain.
Concern, she says, relates to it spreading at the same time as other illnesses.
Symptoms include a sore throat, headache and fever and a rash which is very rough and feels like sandpaper – which can be pink or red on people with lighter skin.
Parents are encouraged to contact their GP if they have these symptoms and Dr Dewis says antibiotics are the easy solution for the illness, only requiring children to have one day off school.
She said if children start to get worse rather than better, and if parents and guardians are worried about their child deteriorating further, using their understanding of what their child is usually like when they are ill, they should contact NHS111 or their GP for advice.
Iain Little, assistant public health director for Derbyshire, told the LDRS that parents and guardians should adopt the practices that became commonplace during the pandemic, including regular handwashing with soap and water, catching coughs and sneezes in a tissue and then throwing it away, keeping away from friends and family if you are ill, and to get available vaccinations.
Mr Little said: “We know there are higher cases of scarlet fever being reported at the moment, and Strep A is a very common bacteria so lots of us will have it but for most of us it will not cause any illness.
“It does cause a number of other illnesses including scarlet fever. There are high numbers of cases of scarlet fever being reported at the moment and we also seeing across the country a small number of children being made ill by Group A Streptococcal, which enters parts of the body where it is not normally found and that can cause much more serious illness.
“The message we want to share is that even though there are lots of infections around at the moment, including Strep A, most will only cause mild illness within children.
“We understand that some parents might be worried and if a parent is concerned they should contact NHS111 and if they feel their child has scarlet fever they should ring NHS111 or contact their GP.”
He reiterated that scarlet fever can be treated with antibiotics and that early treatment can reduce the risk of complications and infections to others.
Mr Little said warning signs can include their child not eating, getting more ill instead of better, not eating, signs of dehydration and a high temperature.
Dr Colin Brown, Deputy Director, UKHSA, said: “We are seeing a higher number of cases of Group A strep this year than usual. The bacteria usually causes a mild infection producing sore throats or scarlet fever that can be easily treated with antibiotics.
“In very rare circumstances, this bacteria can get into the bloodstream and cause serious illness – called invasive Group A strep (iGAS).
“This is still uncommon; however, it is important that parents are on the lookout for symptoms and see a doctor as quickly as possible so that their child can be treated and we can stop the infection becoming serious.
“Make sure you talk to a health professional if your child is showing signs of deteriorating after a bout of scarlet fever, a sore throat, or a respiratory infection.”
