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Researchers puzzled by upsurge in scarlet fever to 50-year high

Cases of scarlet fever in England have reached a 50-year high, with more than 19,000 infections reported last year, according to researchers who say identifying the reasons is a public health priority

Cases of scarlet fever in England have reached a 50-year high, with more than 19,000 infections reported last year.

Researchers from Public Health England analysed statutory scarlet fever notifications from 1911 onwards in England and Wales, comparing the frequency of complications and hospitalisations.

Scarlet fever is caused by bacteria known as streptococcus pyogenes (GAS) found on the skin or throat.

The findings, reported in The Lancet, show scarlet fever cases tripled between 2013 and 2014, rising from 8.2 per 100,000 people (4,700 cases) to 27.2 per 100,000 (15,637).

In 2016 there were 19,206 cases the highest number since 1967.

26,500

consultations with GPs for scarlet fever in 2014, around double the confirmed cases, suggesting underreporting, according

...
Strawberry_tongue_in_scarlet_fever_web_©SciencePhotoLibrary
Bumps on the tongue of a 4-year-old girl, known as ‘strawberry tongue’,
one of the symptoms of scarlet fever.Picture: Science Photo Library

Cases of scarlet fever in England have reached a 50-year high, with more than 19,000 infections reported last year.

Researchers from Public Health England analysed statutory scarlet fever notifications from 1911 onwards in England and Wales, comparing the frequency of complications and hospitalisations.

Scarlet fever is caused by bacteria known as streptococcus pyogenes (GAS) found on the skin or throat.

The findings, reported in The Lancet, show scarlet fever cases tripled between 2013 and 2014, rising from 8.2 per 100,000 people (4,700 cases) to 27.2 per 100,000 (15,637).

In 2016 there were 19,206 cases – the highest number since 1967.

26,500

consultations with GPs for scarlet fever in 2014, around double the confirmed cases, suggesting underreporting, according to an independent evaluation

Source: The Lancet

Children under ten made up 87% of cases.

The highest infection rates in 2015 and 2016 were recorded in the East Midlands, Yorkshire and Humber, and the north east.

Analyses showed the increase was not caused by spread of a single scarlet fever-causing GAS strain.

Instead, a genetically diverse range of established strain types were identified, meaning researchers could not explain the increase. The report said identifying the reasons remained a public health priority.

One of the study’s authors, Theresa Lamagni, said: ‘While current rates are nowhere near those seen in the early 1900s, the magnitude of the recent upsurge is greater than any documented in the past century.’


Lamagni T et al (2017) Resurgence of scarlet fever in England, 2014–16: a population-based surveillance study. The Lancet. doi: 10.1016/S1473-3099(17)30693-X

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