The Rycote Practice

Thame Health Centre
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Strep A and Scarlet Fever

You will have heard a lot about Strep A in the media recently. Streptococcus A is a very common bacteria that usually causes a mild infection producing sore throats or scarlet fever. It can be easily treated with antibiotics to reduce the risk of complications such as pneumonia and spread to others. It can however be highly infectious and we are seeing a higher number of Group A strep this year than usual.

Symptoms to watch out for include:

  • Sore throat
  • Headache and muscle aches
  • Fever (temperature above 39 or 38.3 in children under 3 months)
  • Pinkish/red body rash with a sandpapery feel (that often starts on the stomach or chest a day or two after other symptoms)
  • Flushed cheeks
  • Swollen glands and tongue. A white coating also appears on the tongue. This peels, leaving the tongue red, swollen and covered in little bumps (called “strawberry tongue”)
Sandpapery rashFlushed Cheeks“Strawberry” Tongue

Currently there is no evidence that a new, more infectious strain, is circulating. The age group most affected is 1 – 4 years where cases have increased from about 0.5 per 100,000 children to approximately 2.3 per 100,000 children This increase is most likely related to high amounts of circulating bacteria and social mixing following a period of pandemic lockdowns.

Most cases of scarlet fever clear up after about a week without treatment. Treatment reduces the length of time you’re contagious, speeds up recovery and lowers the risk of complications of scarlet fever.With treatment, most people recover in about 4 to 5 days and can return to nursery, school or work 24 hours after starting antibiotic treatment. Without treatment, you’ll be contagious for one to two weeks after symptoms appear

In extremely rare occasions (less than 1% of Scarlet Fever cases) these bacteria can get into the bloodstream and cause an illness called invasive Group A strep (iGAS). Please do not panic but remain vigilant. Lots of viruses cause the same symptoms as Strep A. Learn more about Scarlet Fever at Scarlet fever – NHS (

Further advice for parents, guardians and carers

We understand that this is an anxious time for patients with young children but our team our here to help you. You can take the following actions to ensure that you keep your children safe:

  1. Do not panic and remain vigilant.
  2. Watch out for visible signs including flushed cheeks, a pinkish red rash with a sandpapery feel and a white or strawberry tongue
  3. Use a thermometer to check whether your child has a temperature of 39 or over (38.3 if your child is under 3 months)
  4. Be aware of symptoms including a sore throat, headache and muscle aches
  • Take steps to stop the spread of this infection including
  • Teaching your children how to wash their hands properly with soap for 20 seconds
  • Teaching your children to use a tissue to catch coughs and sneezes
  • Washing contaminated items such as clothes and bedding
  • Keeping your children away from others when they are feeling unwell

  • Seek help from your GP or NHS 111 if
  • Your child has symptoms – especially if they are getting worse
  • Your child is eating less than normal
  • Your child has a dry nappy or shows signs of dehydration
  • Your child has a high temperature

If your child is having difficulty breathing, has blue lips or tongue or is floppy or hard to wake up you should call 999.

Please be kind to our team as they work to meet current high levels of demand – This week we have seen a 65% increase in children aged 7 or under this week as a result of media coverage of Strep A.

Thank you for your cooperation and assistance. Read more at Group A Strep – What you need to know – UK Health Security Agency (