Strep A - General Health Information
doctor looking in boys mouth

Strep A & Scarlet Fever


Scarlet fever, which is sometimes called scarlatina, is an infection caused by

Streptococcus pyogenes or ‘Group A Streptococci’ bacteria (Strep A).


This is often abbreviated to ‘GAS’, the term used throughout this page.



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What is Group A Streptococci (Strep A)?

GAS often presents as a sore throat, it can also cause skin infections and impetigo.


GAS is highly infectious spreading easily & quickly.


Prompt treatment is important to minimise the spread.


It is a ‘notifiable’ infection, meaning that it must be reported so that effective monitoring and protection can be put in place to reduce the risk of it spreading.


In rare cases GAS bacteria can spread & get into the bloodstream & cause invasive disease such as septicaemia, called ‘invasive Group A Streptococci infection’, abbreviated to ‘iGAS’.


GAS infections are relatively rare, although in England there are on average 30,000 cases per year with the main peaks occurring in the winter and spring.


GAS usually affects children, but it can affect any one at any age.




Symptoms

Symptoms can develop as quickly as 24 hours & up to 7 days after being infected. In general, it takes between 2

to 5 days for symptoms to show: this is called the incubation period.


Symptoms and their severity can vary considerably from person to person:

  • Initial symptoms: sore or red throat, headache, fever, nausea and vomiting.
  • Rash: small, raised bumps, which feel rough like sandpaper to touch, is very characteristic of GAS. The rash generally develops over 48 hours. The skin looks red which is sometimes difficult to see on dark or black skin.
  • Flushed cheeks and face, which may look more like sun burn on darker skin, & pale around the mouth.
  • Swollen red tongue: the tongue may initially have a white coating which peels away leaving the tongue looking red & swollen (known as ‘strawberry tongue’).
  • Difficulty in swallowing: enlarged glands in the neck (lymph nodes) that are tender to touch.
  • Irritability, tiredness & generally feeling unwell.
  • As people recover they may get skin peeling from the tips of fingers & toes &, less often over the trunk & limbs.

Treatments

If you or your child is showing symptoms as described you need to consult your general practice or pharmacist.


Diagnosis is normally made from the symptoms alone but may be confirmed from a throat swab which will show the presence of the GAS bacteria. In some cases a blood test may be required to confirm infection.


If a diagnosis of GAS is made, a course of antibiotics will be prescribed.


You do not need antibiotics unless you have a GAS infection & you have symptoms. Antibiotics reduce the time one is infectious & able to pass on the disease.


The symptoms will generally subside very quickly after starting the course, it is important to complete the full course. Speak to a member of your community pharmacy team for symptom relief.


If scarlet fever is not treated the symptoms can persist for 2 – 3 weeks & people will remain infectious. Most people will no longer be infectious after 24 hours from starting the antibiotics.


To minimise the spread of infection, you should keep away from school or work for at least 24 hours after starting the antibiotics.


Those who decline treatment with antibiotics will need to stay away from school or work until their symptoms have gone.

What can I do now?

Minimise the spread of infection in schools & workplaces

Children & adults can continue to attend school or work as normal unless they are feeling unwell & have a high temperature.


Good infection prevention & control

Infection is spread through contact with an infected person or any contaminated objects.


Measures to reduce the spread

The following measures are essential to reduce the risk of infection to yourself & protect those around you.

  • Ventilation: avoid being in confined spaces ensuring good air circulation & having windows open where possible.
  • Respiratory hygiene: you should cover nose & mouth with a tissue when coughing and sneezing & throw the tissue away in a waste bin, & clean your hands. If there is no tissue, cough or sneeze into the inner elbow (upper sleeve), rather than into the hand.
  • Avoid touching your eyes, mouth & nose with contaminated hands, this risks re-infection.
  • Hand hygiene, hand washing or use of alcohol gel. Wash hands before & after eating, after going to the toilet or after touching any infected areas such as skin rash, after coughing or touching the face.
  • General cleaning of plates cups and toys etc & careful handling of soiled household linens such as bedding and towels will reduce the risk of cross-infection.


Get prompt treatment and complete the course.

If you or your child is showing symptoms as described you need to consult your GP practice or pharmacist & get antibiotics as soon as possible. The full course of antibiotics must be taken to reduce the risk of reinfection or different strains of GAS developing.

When to seek urgent help

For most people GAS infection does not cause complications but they can occur in the early stages of infection:

• Local infections; ear infection, throat abscess, inflammation of the sinuses (sinusitis), skin or soft tissue infection (cellulitis).

• Invasive disease; pneumonia, joint inflammation (arthritis), septicaemia, meningitis


Late effects of Scarlet fever

• Very rarely people can develop complications at a later stage such as: bone or joint problems, liver damage, kidney damage and heart damage.

• It is important therefore to keep an eye out for any symptoms which might suggest these complications in the first few weeks after the main infection has cleared up.

• For any persistent severe symptoms: joint pain, palpitations breathlessness, seek medical help immediately.


Invasive Group A streptococcal disease (iGAS)

• Early signs and symptoms of iGAS disease include: High fever, severe muscle aches, localised muscle tenderness, increasing pain, swelling & redness at the site of the wound & unexplained diarrhoea or vomiting.

• People need to seek urgent help and advice if these symptoms occur & household contacts who are also at risk of infection should also say they have been exposed to GAS infection.

Your health is a priority

Could it be Covid-19?

The most common symptoms of coronavirus include:

  • A sore throat
  • A new and continuous cough
  • A high temperature
  • A loss or change to your sense of smell or taste
  • Feeling tired, or exhausted
  • A headache
  • Loss of appetite


It's important to rest and stay at home if you think you may have Covid or Flu. Call 111 for support if you're struggling with your symptoms.

No need to see your doctor. See a pharmacist!

Get advice and treatment from a medically trained member of staff at Prestwich Pharmacy, without an appointment. You must come to Prestwich Pharmacy in person (or take the child with you if that is the patient), so a full assessment can be carried out. 

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