Pharmacist publishes guide to Strep A and Scarlet Fever symptoms in children

Pharmacist, Sheena Mitchell, says parents need to know the signs as the number of cases of Strep A infection continues to increase.

Pharmacist, Sheena Mitchell, says parents need to know the signs as the number of cases of Strep A infection continues to increase.

Pharmacist, Sheena Mitchell, says parents need to know the signs as the number of cases of Strep A infection continues to increase.

“We have already seen how various strains of Covid-19 spread here in Ireland following their arrival on UK shores, so it is logical to assume that the high levels of Scarlet Fever in the UK are now being replicated here. However, because it is not a notifiable disease here in Ireland, we have no way of confirming this hypothesis.

“It is possible to conclude that due to the inherent link between both the GAS and iGAS conditions borne through Strep A bacterial infection, it is highly likely that if incidences of one rises so will the other. As both a medical professional and a mother of young children, I urge parents to be vigilant for the symptoms of both Scarlet Fever and iGAS. Prompt action will result in early medical intervention with readily available antibiotics which will reduce the risk of further complications,” Ms Mitchell said.

While many parents will know about a ‘strep throat’, they may be less familiar with the term iGAS used to describe invasive Group A Streptococci and its symptoms. Simply put, the GAS is the Group A Streptococci bacteria which live on a person’s skin and in their throat. Usually this doesn’t cause any problems, however sometimes it can cause illness in the form of Scarlet Fever, a sore ‘strep throat’, or even a common skin infection in children called Impetigo.

In a small number of cases, the GAS bacteria journeys into the blood or spinal fluid causing a very serious infection called invasive Group A Streptococci or iGAS. This can result in streptococcal toxic shock syndrome or necrotising fasciitis, both extremely serious conditions.

The Pharmacist and mum of three highlights the importance remaining vigilant for the symptoms of GAS and more importantly iGAS.

“Parents are already worried about their children’s ability to fight infection due to their relatively immature immune systems post Covid, and GP surgeries are at capacity. I want to empower parents across Ireland as best I can, so that they know the symptoms to watch out for and feel confident making a call to their doctor for treatment. This is a bacterial infection so antibiotics will be effective if given in time,” Ms Mitchell added.

Symptoms of iGAS

· A high fever

· evere muscle aches

· Redness or blisters at the site of a wound

·Localised muscle tenderness in one area

· Low blood pressure and dizziness

· Confusion

· Nausea and Vomiting

· Stomach Pain

Whilst iGAS does not always begin as a result of Scarlet Fever, due to their common origin from Group A Streptococci, the risk of iGAS is higher when levels of Scarlet Fever circulating are higher. Scarlet Fever usually affects children between the ages of four and ten years. Children under two years have some immunity from their mothers, while children over ten years will have developed immunity themselves to the toxins from streptococcal bacteria. Infection normally occurs after exposure to someone with a skin infection or strep throat.

Symptoms of Scarlet Fever

A child can start to show symptoms of scarlet fever within one to seven days of exposure:

· High temperature

· Sore throat

· Headache

· A swollen tongue which can appear red and tender or thick with a white coating

· Nausea or loss of appetite

· Swollen neck glands

· A rash usually appears after 2-3 days of infection. The rash will start with red blotches and developing into a pink-red rash which feels like sandpaper. It normally starts on the torso and spreads to other areas like the legs, arms, and groin, lasting about a week.

· A flushed face is often a distinguishing feature of Scarlet Fever.

“If you suspect your child may have Scarlet Fever, you need to bring them to see your GP. Getting an antibiotic like penicillin, will not only speed up your child’s recovery but it will also reduce the length of time that they remain contagious. In fact, your child will be able to return to childcare after 24 hours of taking antibiotics, depending on how they are feeling. Without an antibiotic they will remain highly contagious for one to two weeks after they first developed symptoms.

“Very rarely untreated Scarlet Fever can result in complications such as blood poisoning, toxic shock syndrome and damage to the kidneys. It is important to seek medical attention if your child’s condition is not improving with treatment of antibiotics. Always trust your instinct and if you are in any way worried about your child’s health, don’t waste any time and bring them straight to hospital,” Ms Mitchell concluded.


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