An outbreak of scarlet fever in a primary school

Abstract

Scarlet fever, due to infection with an erythrogenic toxin-producing Group A streptococcus, is an uncommon and generally mild illness, although serious sequelae do occur. In March 2009, 57 of the 126 (45%) pupils in a primary school in Lancashire, UK developed scarlet fever over a 4-week period. Infection was transmitted via direct contact between pupils, particularly among the youngest pupils. A significant degree of transmission also occurred between siblings. The median number of days absent from school was 3 (range 1-10 days). No children were hospitalised. Control measures, including hygiene advice to the school and exclusion of pupils for 24h while initiating penicillin treatment, were ineffective. The outbreak occurred against a background of an unusually high incidence of invasive Group A streptococcal infection. While there are national guidelines for the control of invasive disease, none exist for the control of scarlet fever outbreaks. This prolonged outbreak of scarlet fever highlights the need for an evidence based approach to outbreak management.

Orbital cellulitis in Scotland: current incidence, aetiology, management and outcomes: Table 1

“…There are a few historic reports of subperiosteal abscess in patients with Scarlet Fever; however, a thorough PubMed search revealed no recent associations 17 18. The last recorded outbreak of Scarlet Fever in the UK was in Lancashire in 2009 also with no cases of orbital cellulitis 19. Prior to the introduction of the Haemophilus influenzae type B (Hib) vaccine, Hib was the most common organism causing orbital cellulitis 1 2 9 11.…”

Epidemiological and molecular characteristics of clinical isolates of Streptococcus pyogenes collected between 2005 and 2008 from Chinese children

“…After the late 1990s, the prevalence of erythromycin-resistant S. pyogenes increased significantly in several European countries (Grivea et al, 2006). An unusual increase in invasive S. pyogenes diseases was observed in [2008][2009] and was projected by an increase in incidences of scarlet fever (Czarkowski & Kondej, 2010;Lamden, 2011). The type-specific M protein, encoded by the emm gene, is the surface protein of the cell wall and is an important virulence factor of S. pyogenes.…”

Common Bacterial Skin Infections in Children

“…Tanı, tipik klinik bulgular ve grup A streptokokların izole edilmesi ile konur. ASO titresi yardımcı başka bir parametredir 13,14 . Ilımlı bir seyir izlese de, akut renal yetersizliğe yol açabilen glomerülonefrit ve romatizmal ateş en önemli komplikasyonlarındandır.…”

“…Ilımlı bir seyir izlese de, akut renal yetersizliğe yol açabilen glomerülonefrit ve romatizmal ateş en önemli komplikasyonlarındandır. Kızıl tedavisinde 10 günlük penisilin uygulaması yeterli sağaltımı sağlar 14 .…”