Over the past few years, doctors have been witnessing a steep and unexpected increase in scarlet fever – with more than 19,000 children reported to have been diagnosed with the infection in England and Wales in 2016.1 While the disease itself isn’t usually serious, the type of bacteria behind it (Group A streptococcus – or “strep A”) can also cause more life-threatening conditions. Professor Shiranee Sriskandan at Imperial College London, together with experts at Public Health England, is carrying out an important new programme of work to find ways to slow down the spread of scarlet fever – with the hope of saving children’s lives from invasive strep A infections.
How are children’s lives affected now?
Scarlet fever, a highly infectious disease, is experiencing a worrying comeback. Thankfully, it is usually not serious – with symptoms including a blotchy rash, sore throat and a high temperature usually clearing up with antibiotics.
But the strep A bacteria that cause scarlet fever can also have a much darker side – in rare cases, they can trigger more dangerous illnesses - such as pneumonia, meningitis, toxic shock, necrotising fasciitis (sometimes called the ‘flesh-eating’ disease) and sepsis.
“Strep A infections can affect different children in very different ways – usually causing a sore throat or occasionally scarlet fever – but rarely, they can develop into something more life-threatening,” says Professor Sriskandan. “And although complications are very rare, sadly some children will die – or have long-term problems such as scarring, organ dysfunction and limb loss.”
“Given the current magnitude of scarlet fever outbreaks each year, it’s really important that we find out how we can control it better.” says Professor Sriskandan.
How could this research help?
“We aim to build our understanding of how scarlet fever infects children and spreads so we can identify the best ways to slow down transmission in future outbreaks,” says Professor Sriskandan. “We hope that this will, in turn, save children’s lives from more dangerous conditions caused by the same bacteria.”
The team plan to identify key attributes of the bacteria that help them to spread and find out which antibiotics are most effective at slowing them down. They will also test whether current hygiene interventions and recommendations for disease control – such as hand washing, classroom cleaning, antibiotic treatment and staying away from school or nursery – are enough to reduce the risk of the spread of scarlet fever during an outbreak.
“Our results will help inform public health strategy, as surveillance could be used to monitor which strains are circulating in a season and highlight what is needed to prevent an outbreak,” says Professor Sriskandan. “Should our study suggest that the current guidelines need adjusting, our team is well-placed to ensure this happens as quickly as possible.”
Public Health England. NOIDS weekly report. Statutory notification of infectious diseases in England and Wales. Week 2016/52 ending 01/01/2017. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/581408/NOIDS-weekly-report-week_52-2016.pdf
|Project Leader||Professor Shiranee Sriskandan, FRCP PhD|
|Project Team||Dr Theresa L Lamagni, MSc PhD HonMFPHDr Rebecca J Cordery, BSc MBBS MRCP MD MPH FFPH|
|Project Location||Department of Medicine, Imperial College London|
|Project Location Other||National Infection Service, Public Health EnglandSouth London Health Protection Team, Public Health England|
|Project duration||Two years|
|Date awarded||20 July 2017|
|Project start date||1 August 2017|
|Project end date||31 January 2020|