Health protection

Group A streptococcus (GAS)

Group A streptococcus (GAS) is a common bacteria, which causes a range of infections including scarlet fever. These infections are usually mild.

Invasive group A streptococcus (iGAS)

GAS can also cause a rare, more serious infection called invasive group A strep (iGAS). This occurs when GAS bacteria get into parts of the body such as the lungs or bloodstream, where they cause serious disease. iGAS is a form of sepsis and you should take immediate action by calling 999 if your child shows any of the symptoms listed under the ‘Call 999 or go to A&E’ section below.

What is scarlet fever?

Scarlet fever is an illness that mainly affects children. We are used to seeing cases in the Spring, what we are seeing at the moment is unseasonably higher cases for this time of year. it usually follows a sore throat or a skin infection, such as impetigo, caused by particular strains of streptococcus bacteria. It’s important to be aware of the signs and symptoms of scarlet fever so that early treatment with antibiotics can be given quickly:

• sore throat
• headache
• a high temperature (38.3C/101F or above), flushed cheeks and a swollen tongue.
• a fine, pinkish or red body rash with a sandpapery feel – on darker skin, the rash can be more difficult to detect visually but will have a sandpapery feel.
• The rash may be itchy. It usually occurs on the chest and stomach before spreading to other areas of the body, such as the ears and neck.

Contact NHS 111 or your GP if you suspect your child has scarlet fever, because early treatment with antibiotics is important to reduce the risk of complications, such as pneumonia or a bloodstream infection.

If your child has scarlet fever, keep them at home until at least 24 hours after the start of antibiotic treatment to avoid spreading the infection to others.

What to do if you’re worried

As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement.

Contact NHS 111 or your GP if:

• your child is getting worse
• your child is feeding or eating much less than normal
• your child has had a dry nappy for 12 hours or more or shows other signs of dehydration
• your baby is under 3 months and has a temperature of 38°C, or is older than 3 months and has a temperature of 39°C or higher
• your baby feels hotter than usual when you touch their back or chest, or feels sweaty
• your child is very tired or irritable

Call 999 or go to A&E if:

• your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs
• there are pauses when your child breathes
• your child’s skin, tongue or lips are blue
• your child is floppy and will not wake up or stay awake

How to prevent GAS bacteria spreading

GAS is spread by close contact with an infected person and can be passed on through coughs and sneezes or from a wound.

Good hygiene practice such as hand washing remains the most important step in preventing and controlling spread of infection.

• Wash your hands thoroughly and teach your child how to wash their hands properly with soap and warm water for 20 seconds
• Use a tissue to catch coughs and sneezes, then throw it away and wash your hands
• Keep away from others when feeling unwell
• If diagnosed, follow advice on keeping your child at home

A negative throat swab is not required for children to attend childcare, however children and adults with suspected scarlet fever should be excluded from nursery / school / work for 24 hours after the commencement of appropriate antibiotic treatment.

Find out more from UKHSA.