Latest figures showed that 94 people in England have died (from any cause) within 7 days of an invasive group A streptococcus (iGAS) diagnosis in the current season. Of the deaths, 39 (41%) were in people aged 75 years and over, 17 in those aged 65 to 74, and 16 in children aged between 1 and 9 years, the UK Health Security Agency (UKHSA) reported.
Rates of iGAS disease remain higher than expected for this time of year, and notifications of scarlet fever in England are at "exceptional" levels for early in the season, it said, citing data up to 18 December.
A total of 960 notifications of iGAS disease were received through laboratory surveillance in England, with a weekly high of 116 notifications in the week up to 11 December. Laboratory notifications of iGAS infection were higher than recorded over the same period in the last five seasons.
So far this season there have been 126 iGAS cases in children aged 1 to 4 years compared with 194 cases in that age group across the whole season for the last comparably high season in 2017 to 2018. The high rates of iGAS in children might reflect increases in respiratory viruses and high levels of group A streptococcus (GAS) circulating in children, the Agency said.
Investigations were underway into reports of an increase in lower respiratory tract GAS infections, particularly empyema, in children over the past few weeks. Whilst the current M protein gene (emm) types responsible for virulence had been in circulation for many years, it remained unclear whether a relatively new strain of emm1 (M1UK) that had emerged in the last decade was driving the current high rates of iGAS in children.
The highest rates of iGAS so far this season – between 12 September and 18 December – have been recorded in the Yorkshire and Humber region (2.5 per 100,000 population), followed by the South West region (2.0 per 100,000), and the South East and North East regions (1.9 per 100,000).
'Steep Rise' in Scarlet Fever Activity
The last 2 weeks had seen a steep increase in scarlet fever notifications and GP consultations. The UKHSA said there had been 27,486 notifications of scarlet fever from weeks 37 to 50 of the current season in England, compared with an average of 2318 (range 406 to 4,039) over the previous 5 years. The last peak season for scarlet fever notifications was 2017 to 2018 when 30,768 reports were received across the entire season, the Agency noted. A total of 9977 notifications for scarlet fever were logged for the week ending 11 December.
It attributed some of the increases in the current season to people seeking advice following national alerts.
Dr Colin Brown, the UKHSA's deputy director, said: "I understand how this large rise in scarlet fever and 'strep throat' may be concerning to parents; however, the condition can be easily treated with antibiotics and it is very rare that a child will go on to become more seriously ill.
"Most winter illnesses can be managed at home and NHS.UK has information to help parents look after children with mild illness. NHS services are under huge pressure this winter, but please visit NHS.UK, contact 111 online or your GP surgery if your child has symptoms of scarlet fever or 'strep throat' so they can be assessed for treatment.
"At this time of year, there are lots of winter illnesses circulating that can make children unwell and I would urge all those eligible for free winter vaccines to take advantage of these."