Pharmacist and founder of the family healthcare advice platform Wonderbaba.ie, Sheena Mitchell, guides parents on the Strep A bacteria and its relationship with Scarlet Fever.
With the number of Strep A infections increasing significantly across the UK, and now cases appearing here on Irish shores, parents need to know the signs and symptoms to watch out for.
What is iGAS?
While many parents will know about strep throat, they may be less familiar with the term iGAS used to describe invasive Group A Streptococci and its symptoms.
Simply put, the GAS is the Group A Streptococci bacteria that live on a person’s skin and in their throat. Usually, this doesn’t cause any problems, however, sometimes it can cause illness in the form of Scarlet Fever, a sore ‘strep throat’, or even a common skin infection in children called Impetigo.
In a small number of cases, the GAS bacteria journeys into the blood or spinal fluid causing a very serious infection called invasive Group A Streptococci or iGAS. This can result in streptococcal toxic shock syndrome or necrotising fasciitis, both extremely serious conditions.
Symptoms of iGAS
- A high fever
- Severe muscle aches
- Redness or blisters at the site of a wound
- Localised muscle tenderness in one area
- Low blood pressure and dizziness
- Confusion
- Nausea and Vomiting
- Stomach Pain
Whilst iGAS does not always begin as a result of Scarlet Fever, due to their common origin from Group A Streptococci, the risk of iGAS is higher when levels of Scarlet Fever circulating are higher.
What is Scarlet Fever?
Scarlet Fever usually affects children between the ages of four and ten years. Children under two years have some immunity from their mothers, while children over ten years will have developed immunity themselves to the toxins from streptococcal bacteria. Infection normally occurs after exposure to someone with a skin infection or strep throat.
Symptoms of Scarlet Fever
A child can start to show symptoms of scarlet fever within one to seven days of exposure:
- High temperature
- Sore throat
- Headache
- A swollen tongue which can appear red and tender or thick with a white coating
- Nausea or loss of appetite
- Swollen neck glands
- A rash usually appears after 2-3 days of infection. The rash will start with red blotches and developing into a pink-red rash that feels like sandpaper. It normally starts on the torso and spreads to other areas like the legs, arms, and groin, lasting about a week.
- A flushed face is often a distinguishing feature of Scarlet Fever.
Treatment
If you suspect that your child has a case of Scarlet Fever, you need to bring them to see your GP so that they can prescribe antibiotics. This will reduce the risk of any further complications.
Your doctor will most likely prescribe a 10-day course of an antibiotic called penicillin, or an alternative if your child has an allergy. These antibiotics are readily available and there is no shortage of supply.
Using an antibiotic is important in treating Scarlet Fever, not only to speed up your child’s recovery and avoid any rare complications, but also to reduce the length of time that they remain contagious. If your child is being treated with an antibiotic, they will be able to return to childcare after 24-hours of use, however some childcare and schools may have their own policies and rules.
If a child with Scarlet Fever does not receive an antibiotic, they will remain contagious for up to two-weeks from the time they first developed symptoms. Your child may appear better within a day or two of starting treatment, but as with all infections it is important to finish the course of antibiotics. If Scarlet Fever is untreated there is the risk of developing complications such as a throat abscess, ear infection, or pneumonia.
Provide frequent fluids, little and often if necessary, and watch out for signs of dehydration, such as lethargy and drowsiness. If your child has a sore throat, provide soft foods and cold yoghurts or ice pops which will also help with dehydration.
Very rarely untreated Scarlet Fever can result in complications such as blood poisoning, toxic shock syndrome and damage to the kidneys. It is important to seek medical attention if your child’s condition is not improving with treatment of antibiotics. Always trust your instinct and if you are in any way worried about your child’s health, don’t waste any time and bring them straight to hospital.
Seeking help
A parent’s gut instinct will usually steer them right, remember nobody knows your child better than you. If you are in any doubt about your child’s health or you are seeing any of the following warning symptoms, please seek urgent medical attention.
- If your child is lethargic, not eating, has a rash, shows signs of dehydration, or has a seizure.
- If your child has a swollen fontanelle.
- If your child’s colouring is ashen, or blue. This is easiest to see around the lips, earlobes, and fingers.
- If your child is crying constantly, particularly a weak or high pitched cry.
- If your child is not responding to you in their normal way.
- If you have difficulty waking your child or keeping them awake.
