Post by Joanna on Dec 9, 2017 0:02:42 GMT -5
The Return of Scarlet Fever
After decades of decline, scarlet fever is once again on the rise in the UK and other places around the world and doctors are scrambling to figure out why. Beginning in 2014, the infection began to steadily rise and in 2016, more than 19,000 cases from 620 outbreaks were reported, mostly in schools and nurseries. This represents a seven-fold increase since 2011.
Scarlet fever is a bacterial infection caused by a Group A Streptococcus. It is characterized by a sore throat, fever, headache, swollen lymph nodes, “strawberry tongue” and rash. It may not sound terrible based on those symptoms, but it was responsible for 36,000 registered deaths in the first decade of the 20th century in England and Wales and was a leading cause of child mortality.
There is no vaccine for scarlet fever. Once contracted, it id treated quite easily with a course of antibiotics, which – at least partially – contributed to the disease’s decline in developed countries after about 1945.
The most obvious reason for a resurgence in a bacterial infection would be a new strain of the disease that spreads more easily and is possibly antibiotic-resistant – but molecular genetic testing has ruled this out. Instead, tests showed a range of already established strains of the bacteria, leaving researchers still looking for a possible cause.
Meanwhile, the 2016 statistics placed incidence at 33.2 cases per 100,000 people, with 1 in 40 cases being hospitalized (although around half of these are discharged the same day). Overall, there were 19,206 reported cases – the highest number since 1967, and an astonishing rise from 2013, when there were just 4,643 cases reported.
Doctors are urging the public to be alert to the symptoms while they seek solutions. “Whilst current rates are nowhere near those seen in the early 1900s, the magnitude of the recent upsurge is greater than any documented in the last century,” said epidemiologist Theresa Lamagni of Public Health England, who led the study. “Whilst notifications so far for 2017 suggest a slight decrease in numbers, we continue to monitor the situation carefully. Guidance on management of outbreaks in schools and nurseries has just been updated and research continues to further investigate the rise,” she continued. “We encourage parents to be aware of the symptoms of scarlet fever and to contact their GP if they think their child might have it.”
Recent outbreaks have also occurred in China, Vietnam, South Korea and Hong Kong, but testing revealed only very minor genetic elements in common. There is, the researchers said, no clear link between the Asian outbreaks and those in the UK, but that doesn’t mean a link can be ruled out yet.
“Hypotheses that have been proposed include acquisition of scarlet fever-causing genes into the S pyogenes population, changes in immune status in the human population, environmental change, and an as yet unknown and potentially novel co-infective agent that predisposes the host to disease,” wrote microbiologists Mark Walker and Stephan Brouwer from the University of Queensland in a comment on the article. “Further research needs to be done to better understand the causes of scarlet fever resurgence,” he added. “Scarlet fever epidemics have yet to abate in the UK and northeast Asia. Thus, heightened global surveillance for the dissemination of scarlet fever is warranted."
The research has been published in the journal The Lancet.
What You Need to Know about Scarlet Fever. Cases of the highly contagious Victorian disease is on the rise in the UK, but what is the bacterial infection, what are the symptoms and who are those most at risk?
Like scurvy and rickets, scarlet fever was once thought of as a disease of the Victorian age that more or less died out years ago. But the disease is said to be on the rise and experts aren’t entirely sure why it has returned. However, the good news is a lot has changed since the Victorian era when scarlet fever struck real fear.
What is scarlet fever and who gets it? Anyone can get scarlet fever, but young children are most affected. It is a bacterial illness most common among children under the age of 10. Key symptoms include sore throat, skin infection and the bright pink rash that gives the condition its name. It usually starts as red blotches before turning into a fine pinky-red rash that feels like sandpaper. There might be a high temperature, headache and swollen tongue, too, usually in the day or two before the rash develops, as well as nausea and vomiting.
How do you catch it? Scarlet fever ids highly contagious and can be transmitted by coughing, sneezing, skin-to-skin contact and handling contaminated objects such as bath towels and bedding. Most cases occur during winter and spring. Good hygiene – paying attention to hand-washing and avoiding sharing potentially contaminated items – can reduce the spread of the disease.
What to do if you think your child has scarlet fever. In the past, an outbreak of scarlet fever was a very serious concern and children and families affected were often quarantined. While things are different now, it is still important that it is properly diagnosed and treated, and that necessary steps are taken to avoid passing it on further. In the majority of cases, scarlet fever will clear up of its own accord, but it is always recommended to see a doctor if you think you or your child may have it.
How is it treated? The usual course of treatment is antibiotics, which will help you recover more quickly, lower the amount of time you’re contagious and reduce the risk of complications. It is usually a 10-day course and children should begin feeling better after 24 hours, with symptoms clearing up completely after a few days – but it is still vital to complete the full course of treatment. Doctors generally advise that anyone infected avoid school or for at least 24 hours after beginning antibiotics.
Can it be serious? In the past, scarlet fever was a leading cause of infant death. Better hygiene and treatment means it generally isn’t the terrifying illness it used to be and in the vast majority of cases, it will clear up quickly and cause little more than a few days of feeling poorly, especially if treated properly. But as with many conditions, complications – ranging from mild to serious – can still occur. Complications are rare and especially easy to avoid if symptoms are spotted and treatment started early. Potential complications range from relatively simple issues such as an ear infection, to blood poisoning and liver damage in more serious cases.
If you are concerned about your child’s health, or if symptoms suddenly worsen or change, always contact a doctor.
Sources: Michelle Starr, ScienceAlert, November 29, 2017, and British Telecommunications, December 6, 2017.
