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There are currently high rates of Group A strep and scarlet fever in the UK. Scarlet fever, which is caused by the bacteria Group A streptococcus, is usually a mild illness but it is highly infectious. Scarlet fever is much more common in children than in adults and it is important that children with scarlet fever are seen by a healthcare professional so that they can be started on antibiotics.
The rash of scarlet fever often begins with small spots on the body that then spread to the neck, arms and legs over the next 1-2 days. It is often 'sand-paper' like to touch but is not itchy.
Your child may also have a:
If you think that you child has scarlet fever, you should let your GP practice or NHS 111 know the same day. If a healthcare professional thinks that your child has scarlet fever, they will prescribe your child antibiotics. This reduces the chance of their infection becoming more severe but more importantly also stops them spreading the infection to others (after 24 hours of starting antibiotics), especially to people at higher risk of severe infections such as the elderly and those with weakened immune systems. NOTE: there are many causes of rash in children - if your child does not have the other features above, they are unlikely to have scarlet fever.
Group A strep can also cause tonsillitis (Strep throat) - your child is likely to have a high fever, severe sore throat and you will see pus on their tonsils. Children with likely strep throat should also be seen by a healthcare professional within 24-48 hours for consideration of antibiotics. NOTE: if your child also has a runny nose with their tonsillitis, it makes a diagnosis of strep throat far less likely and if your child has none of the red or amber features below, they are unlikely to require treatment with antibiotics.
If your child has been in close contact with a case of scarlet fever or strep throat, they do not need to be treated with antibiotics unless they are showing signs of infection (severe tonsillitis with fever in the absence of a runny nose or signs of scarlet fever). Only in exceptional circumstances will the local public health team recommend for an entire school class to be treated with antibiotics.
Your child may continue to have a fever for a few days after starting antibiotics. Very rarely, Group A streptococcus can spread to other areas of the body (invasive Group A strep), causing infections in the neck (tonsillar abscesses or lymph node abscesses), behind the ear (mastoiditis), chest infections (pneumonia), bone and joint infections (septic arthritis) or sepsis. There is clear red / amber / green information below about what symptoms and signs to look our for to identify the child with possible invasive Group A strep or other complications of Group A strep.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
Please ring your GP surgery or call NHS 111 - dial 111
If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.
Continue providing your child’s care at home. If you are still concerned about your child, speak to your health visitor, local pharmacist or call NHS 111– dial 111
Children and young people who are unwell and have a high temperature should stay at home. They can go back to school, college or childcare when they no longer have a high temperature, and they are well enough to attend.
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Health visitors also provide advice, support and guidance in caring for your child, including:
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
You have a choice of service:
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
