Strep A Advice

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For parents and carers from the Royal College of Paediatrics and Child Health

Strep A is a very treatable infection that is well researched and widely recognised by the medical community.

The early symptoms of scarlet fever include:

  • sore throat, headache, fever, nausea and vomiting
  • after 12 to 48 hours, the characteristic red rash develops, usually first on the chest and stomach, then rapidly spreading to other parts of the body, making the skin have a sandpaper like feel to it. The scarlet rash may be harder to spot on darker skin, although the ‘sandpaper’ feel should be present 
  • patients usually have flushed red cheeks. They may also have a bright red ‘strawberry’ tongue.

We’d like to reassure parents and carers that Strep A is a common infection in children and most cases are mild or asymptomatic. In very rare occasions, the bacteria can get into the bloodstream or enclosed parts of the body like the chest and cause an illness called invasive Group A strep (iGAS).

The rising numbers of infections have understandably caused anxiety among parents. As with any winter period, there are lots of viruses that cause sore throats, colds and coughs and these should generally resolve without medical intervention. 
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.

Good hand and respiratory hygiene are important for stopping the spread of many bugs. By teaching your child how to wash their hands properly with soap for 20 seconds, using a tissue to catch coughs and sneezes, and keeping away from others when feeling unwell, they will be able to reduce the risk of picking up or spreading infection.