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Scarlet fever cases in England have been rising in recent years and hit a 50 year high in 2016, with more than 17,000 reported cases.

According to a report published in the Lancet medical journal, there has been an increase in reported cases since 2014, but health officials are unsure as to why scarlet fever is on the rise. Data for 2017 suggests the rate may be falling, but experts remain cautious, saying it is too early to tell.

Scarlet fever was a common illness in Victorian times, but cases had significantly dropped with improvements in sanitation, child nutrition and of course the advent of antibiotics so that scarlet fever is now generally a much less common disease. Scarlet fever is caused by bacteria known as group A streptococcus.

Symptoms include a sore throat, headache and fever, accompanied by a red rash that is rough to the touch the rash can appear on the body and typically appears on the face across the cheeks and is often described as having a sandpaper-like texture. The redness of the rash is what gives it the name scarlet fever. Doctors are urging the public to be aware of the symptoms and seek help from their GP if they suspect they or their child has scarlet fever.

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Why there has been a rise in cases of scarlet fever is unclear. A joint investigation by public health authorities from across England and Wales found that the incidence of scarlet fever tripled between 2013 and 2014, rising from 4,700 cases to 15,637 cases. This rose again and by 2016, there were 19,206 reported cases, the highest level since 1967.

Scarlet fever is most common in children under 10. The disease is spread by close contact with people carrying the bacteria usually in the throat, generally through coughing and sneezing and contamination of objects and surfaces with the bacteria.

Prompt diagnosis and treatment of scarlet fever are important, firstly to prevent the spread of the disease and patients are advised to stay at home for the first 24 hours after the start of treatment to avoid the spread of the infectious bacteria, and secondly to reduce the risk of further complications such as pneumonia.

Scarlet fever is a notifiable disease so doctors are required to report cases to their local health authority. Although unpleasant, with a sore throat and high temperatures, scarlet fever does not generally lead to serious complications and can be easily treated with antibiotics.

The reasons for the rise in cases in England are unclear. Other countries in East Asia have also reported an escalation over the past five years, including Vietnam, China, South Korea, and Hong Kong, however, there appears to be no other European country that has experienced a sudden rise.

A similar rise in cases of scarlet fever would be expected in other European countries if strains were spreading from Asia. So whilst a clear rise in cases has been confirmed in England we do not as yet know why.

Rachel Kayani