Thousands of pupils could be kept out of schools in Britain after an eighth child died from a strep A illness that is now spreading at "higher than usual" rates, medical chiefs have said.
The number of cases of scarlet fever is currently almost five times the average in infants. In some rare cases, scarlet fever leads to an illness called invasive Group A strep.
In the past few weeks, seven children have died of complications from strep A, caused by a relatively common bacteria that normally results in a sore throat.
The recent deaths from strep A have included a four-year-old from High Wycombe, Hertfordshire, and a six-year-old from Surrey. Another four-year-old is fighting for her life in Alder Hey Children’s Hospital in Liverpool.
The UK Health Security Agency has reported that there were 851 cases of scarlet fever in the week starting November 14, compared to an average of 186 a week in pre-Covid years.
Colin Brown, deputy director of the agency, said there was “a higher number of cases of Group A strep this year than usual”.
“In very rare circumstances, this bacteria can get into the bloodstream and cause serious illness — called invasive Group A strep," he said.
"Make sure you talk to a health professional if your child is showing signs of deteriorating after a bout of scarlet fever, a sore throat or a respiratory infection.”
The National Health Service says the Group A Streptococcus type of bacteria "usually causes mild illness like sore throats and skin infections".
"Rarely these bacteria can cause severe and life threatening illness called invasive Group A Streptococcal disease," it adds.
The illness is highly infectious with symptoms including a sore throat, headache and fever, along with a red body rash.
“On darker skin, the rash can be more difficult to detect visually but will have a sandpapery feel,” the UKHSA said.
Although strep A is uncommon, “there has been an increase in invasive Group A strep cases this year, particularly in children under 10”, the UKHSA said.
There were 2.3 cases for every 100,000 children aged one to four compared to an average of 0.5 in pre-pandemic seasons.
“Currently, there is no evidence that a new strain is circulating,” the UKHSA said. “The increase is most likely related to high amounts of circulating bacteria and social mixing.”
Parents at a primary school in Ashford, Kent, where two children have strep A, told the Mail on Sunday that they would be keeping their children at home this week. Others are expected to follow if the illnesses continue.
Beate Kampmann, an infectious diseases paediatrician, told the BBC that children with a fever should be kept out of school.
“It starts off with a high fever, very sore throat and very red tongue,” she added. “Eventually developing a rash which feels a bit like sandpaper.
“The rash starts in the elbows and behind the neck. It tends to then peel after about 10 days.”
Most children will recover of their own accord but if a child deteriorates to the point where they are "not eating, drinking, being quite flat and lethargic" parents should a doctor, Dr Kampmann said.
Antibiotics given early enough almost always help clear the infection.
No affected school in Britain has yet said healthy children should stay at home but the UKHSA said those with scarlet fever should not attend class.
“Exclusion [from school] is recommended,” it added.
There is currently no government advice on keeping pupils with a sore throat away from schools.