Should you be worried about Scarlet Fever?

The contagious Victorian illness is making a puzzling comeback across the world, but should you be concerned here in South Africa? By Kim Bell


When you hear the words scarlet fever, you can be forgiven for associating it with Louisa May Alcott’s Little Women, and the cause of death of young Beth March, the protagonist’s sister. After all, it was a disease that was commonplace in the 1800s and 1900s – not today’s modern world.

According to a study published in the Lancet in November 2017, this infectious condition started to steadily rise in the UK in recent years. The report shares that in 2013, 4 643 cases were reported. This number rapidly increased to 19 000 cases from 620 outbreaks reported in 2016, predominately in schools and nurseries. It’s continuing unabated, with 15 500 confirmed cases in the UK this year alone – twice the number as for this time last year, according to Public Health England. Doctors are completely baffled as to why.

Researchers have a number of hypotheses, which include changes in the immune status in the human population and environmental changes. According to the report, the reason for the ongoing rise remains unidentified. “Molecular genetic testing has ruled out a newly emerged strain of the infection with increased ability to spread between individuals. Research is underway to understand the possible cause and prevention strategies.”

Lead author and epidemiologist, Theresa Lamagni, of Public Health England, adds that 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 last century.”

Recent outbreaks have also been recorded in China, Vietnam and South Korea. The researchers said there is no clear link between the UK and Asian outbreaks, but that doesn’t mean a link can be ruled out as yet.

What is Scarlet Fever?

Scarlet fever is a bacterial infection. Specifically, it’s a group A streptococcal infectious disease, otherwise known as A Strep. This same bug can cause strep throat, pneumonia and necrotising fasciitis or flesh-eating disease. The World Health Organization (WHO) shares that most cases of scarlet fever are mild, but complications can develop, which include acute rheumatic fever or acute kidney disease.

ALSO SEE: Group B Streptococcus – why you should get tested for this during pregnancy

According to WHO, symptoms include:

  • A high fever
  • A sore throat
  • Skin infection or rash around the neck, underarms or groin, which spreads around the body. After about two to seven days, the skin slowly peels off.
  • Telltale signs include the red rash, a whitish coating on the tongue and swollen glands in the neck.

Incubation is between two and six days. The disease is contagious and spreads from person to person through “respiratory droplets” or through direct contact with mucus, saliva or the skin of those infected. It tends to be more common in children under the age of 10 and is treatable – especially when detected early.

The South African story

South Africa seems to be safe from scarlet fever for now, with research revealing only two publicised cases in the last year. A 10-month-old baby girl in Howick, KwaZulu-Natal was diagnosed in March 2017, while a three-year-old girl from Rietfontein in Gauteng was diagnosed in December 2017. Treasurer of the Federation of Infectious Disease Societies of Southern Africa, Dr Gary Reubenson, adds: “I am not aware of an increase in scarlet fever cases in South Africa, it remains a very rare but serious condition.”

scroll to top
Send this to a friend