Materiały źródłowe

• #1 Scarlet Fever – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507889/

  Epidemic scarlet fever, also known as scarlatina, is a cutaneous eruption caused by SPEs produced during GAS infections in humans and is most commonly associated with GAS pharyngitis. However, it can also arise from other GAS infections. Scarlet fever is a toxin-mediated disease that tends to occur in epidemics approximately every 5 to 6 years, likely due to type-specific herd immunity. Historically, it caused significant morbidity and mortality during the 19th and early 20th centuries. The prevalence of scarlet fever declined significantly in the latter half of the 20th century, likely due to the introduction of antibiotics, reducing its public health impact. […] GAS exclusively infects humans and can affect many areas of the body. Globally, GAS infections are increasing, contributing to significant morbidity and mortality rates. Transmission of GAS occurs through respiratory secretions, fomites, and contact with infected skin, such as in impetigo. While GAS infections can affect individuals of any age, children, older adults, and immunocompromised individuals are at higher risk.

• #1 Scarlet Fever – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507889/

  In 2011, a scarlet fever outbreak in Hong Kong documented a 10-fold increase in cases compared to the baseline and was associated with GAS types emm12 and emm1. […] Following the Hong Kong outbreak, WGS revealed an increase in scarlet fever cases in mainland China, with the expansion of emm12 clones contributing to the rise in infections. […] Epidemiological surveillance during the scarlet fever outbreak in 2014 in the United Kingdom revealed that regional outbreaks were caused by multiple emm types, including emm3, emm12, emm1, and emm4, as well as various phylogenetic lineages. A significant increase in the prevalence of the ssa gene was associated with scarlet fever cases. […] The incidence of scarlet fever declined during the COVID-19 pandemic. […] Following the COVID-19 pandemic, 3 emerging M1UK clades rapidly expanded across the United Kingdom, resulting in severe outcomes in children. The emergence of a new dominant clone within the emm1 genetic lineage, referred to as „M1UK,” was first reported in the United Kingdom in 2019. This clone was associated with seasonal outbreaks of scarlet fever and an increase in invasive infections, likely driven by a 10-fold overproduction of speA superantigen, also known as erythrogenic toxin.

• #1 Scarlet Fever – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507889/

  The epidemiology of GAS-related infections varies by infection type. GAS pharyngitis is most common in children aged 5 to 15 and is the most common bacterial cause of acute bacterial pharyngitis in this age group. This is commonly associated with contact with sick or asymptomatic children at school. […] The global prevalence of severe GAS infections is estimated at 18.1 million cases, with 1.78 million new cases of GAS and 616 million cases of GAS pharyngitis reported annually. Severe GAS infections are responsible for approximately 500,000 deaths globally each year, with most attributed to RHD and invasive infections. […] Epidemiological surveillance is crucial to monitor epidemics, particularly due to the increasing incidence and burden of GAS infections, especially iGAS, worldwide. WGS has a key role in this monitoring.

• #2 Scarlet Fever – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK507889/

  Epidemic scarlet fever, also known as scarlatina, is a cutaneous eruption caused by SPEs produced during GAS infections in humans and is most commonly associated with GAS pharyngitis. However, it can also arise from other GAS infections. Scarlet fever is a toxin-mediated disease that tends to occur in epidemics approximately every 5 to 6 years, likely due to type-specific herd immunity. Historically, it caused significant morbidity and mortality during the 19th and early 20th centuries. The prevalence of scarlet fever declined significantly in the latter half of the 20th century, likely due to the introduction of antibiotics, reducing its public health impact. Characteristic symptoms of scarlet fever include a coarse, papular erythematous rash, a strawberry tongue, and exudative pharyngitis.

• #3 Scarlet Fever – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK507889/

  In 2011, a scarlet fever outbreak in Hong Kong documented a 10-fold increase in cases compared to the baseline and was associated with GAS types emm12 and emm1. Among the isolates cultured during that year, emm12 was the dominant clone. GAS strains harboring these emm types had acquired mutations that enhanced their virulence and transmissibility. Following the Hong Kong outbreak, WGS revealed an increase in scarlet fever cases in mainland China, with the expansion of emm12 clones contributing to the rise in infections.

• #3 Scarlet Fever – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK507889/

  GAS exclusively infects humans and can affect many areas of the body. Globally, GAS infections are increasing, contributing to significant morbidity and mortality rates. Transmission of GAS occurs through respiratory secretions, fomites, and contact with infected skin, such as in impetigo. While GAS infections can affect individuals of any age, children, older adults, and immunocompromised individuals are at higher risk. The incubation period for GAS ranges from 1 to 5 days, during which patients remain infectious and can transmit the bacteria to others. Environmental factors and crowded settings, such as schools, households, and nursing homes, facilitate increased GAS transmission. GAS commonly causes a variety of infections in the upper respiratory tract and skin, ranging from mild to severe and from superficial to iGAS. Heavy shedding of GAS in classrooms or other crowded spaces, even in asymptomatic individuals, can lead to outbreaks.

• #3 Scarlet Fever – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK507889/

  The global prevalence of severe GAS infections is estimated at 18.1 million cases, with 1.78 million new cases of GAS and 616 million cases of GAS pharyngitis reported annually. Severe GAS infections are responsible for approximately 500,000 deaths globally each year, with most attributed to RHD and invasive infections. The burden of iGAS is significant, accounting for approximately 663,000 new cases and 163,000 deaths annually. Skin and soft tissue are the most common sites of infection, with 32% of patients presenting with cellulitis and 8% developing necrotizing fasciitis. […] Epidemiological surveillance is crucial to monitor epidemics, particularly due to the increasing incidence and burden of GAS infections, especially iGAS, worldwide. WGS has a key role in this monitoring. Since 2000, the dominant emm types in Europe and North America have been emm1 and emm3, with emm1 being the dominant type associated with invasive infections in high-income countries. The 7 emm types responsible for 50% to 70% of iGAS infections were emm1, emm28, emm89, emm3, emm12, emm4, and emm6. These emm types are collectively referred to as M1global.

• #4 Increased Incidence of Scarlet Fever — China, 1999−2018

  https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2019.019

  Scarlet fever had high incidence between the 1950s and 1980s, but during the 1980s and 1990s, the incidence of scarlet fever dropped to a relatively low and stable levels in China. […] Starting in 2011, scarlet fever incidence significantly increased in China. In the eight years between 2011 and 2018, 479,555 cases were reported, which exceeded the total number of 241,365 cases reported in the previous twelve years 1999-2010. […] Both patient and pathogen epidemiological surveillance need to be heightened to monitor serious cases of scarlet fever and to implement timely control measures. […] The data reported in this and a previous study indicate the incidence of scarlet fever in China is still increasing, which emphasizes the importance of national scarlet fever alerts. […] The reasons underlying the scarlet fever resurgence in China and other countries are still unclear.

• #4 Increased Incidence of Scarlet Fever — China, 1999−2018

  https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2019.019

  The findings in this report are subject to one limitation. The most accurate diagnosis of scarlet fever should be based on pathogen isolation. […] In summary, China is in a new period of high incidence of scarlet fever. […] The increasing disease burden caused by scarlet fever suggest that health facilities and the public health professionals should pay increasing attention to scarlet fever prevention and control. […] Scarlet fever GAS pathogen surveillance capabilities should be established where not available, and enhanced if limited to only a few dispersed centers within provinces of China, so as to closely monitor epidemic foci, spread, complications and severe cases, and identify any genetic changes related to bacterial drug resistance, virulence and epidemiology.

• #5 As scarlet fever cases rise, baffled researchers investigate

  https://www.wral.com/story/as-scarlet-fever-cases-rise-baffled-researchers-investigate/17145005/

  An outbreak then hit England, where cases tripled in one year, from 4,700 in 2013 to 15,637 in 2014. […] Infections continued to rise to nearly 20,000 in 2016, a 50-year high for the United Kingdom, according to the analysis. […] Hospital admissions during the outbreak in England are also high, the researchers said, nearly doubling between 2013 (703 cases) and 2016 (1,300 cases). […] Why the disease is making a resurgence today is also a mystery, according to the study. […] „Whilst there is no clear connection between the situation in the UK and East Asia, a link cannot be excluded without better understanding of the drivers behind these changes,” Lamagni said. […] „The hunt for further explanations for the rise in scarlet fever goes on.” […] „Guidance on management of outbreaks in schools and nurseries has just been updated, and research continues to further investigate the rise,” she said. […] „Scarlet fever epidemics have yet to abate in the UK and northeast Asia,” they wrote. „Thus, heightened global surveillance for the dissemination of scarlet fever is warranted.”

• #5 As scarlet fever cases rise, baffled researchers investigate

  https://www.wral.com/story/as-scarlet-fever-cases-rise-baffled-researchers-investigate/17145005/

  The age-old killer scarlet fever is on the rise in England and East Asia, according to research published Monday in The Lancet Infectious Diseases journal, and investigators don’t know why. […] „Whilst current rates (in England) are nowhere near those seen in the early 1900s, the magnitude of the recent upsurge is greater than any documented in the last century,” said study author Theresa Lamagni of Public Health England, the agency that funded the analysis. […] „Whilst notifications so far for 2017 suggest a slight decrease in numbers, we continue to monitor the situation carefully … and research continues to further investigate the rise.” […] But since 2009, cases have been steadily increasing in several East Asian countries, including Vietnam, South Korea, Hong Kong and mainland China.

• #6 Group A Strep Disease Surveillance and Trends | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/php/surveillance/index.html

  CDC tracks invasive group A Streptococcus (group A strep) disease using 2 surveillance systems. […] Rates of serious group A strep disease have been increasing since 2014. […] Preliminary 2023 data indicate the number of serious infections caused by group A strep reached a 20-year high. […] The U.S. rates of invasive group A strep disease began increasing in 2014. […] The increase was largest among adults aged 18 through 64 years old, but the rate also increased among older adults. […] Through ABCs, CDC tracks data on group A strep isolate resistance to certain antibiotics. […] Around 1 in 3 invasive group A strep infections are now caused by bacteria that are resistant to erythromycin and clindamycin. […] Experts estimate that several million cases of non-invasive group A strep infections occur in the United States each year.

• #6 Group A Strep Disease Surveillance and Trends | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/php/surveillance/index.html

  Group A strep infections can occur any time during the year. However, some infections are more common in the United States in certain seasons: Strep throat and scarlet fever: Winter and spring. […] The World Health Organization estimates that each year over 600 million have pharyngitis due to group A strep.

• #7 Scarlet Fever: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1053253-overview

  Scarlet fever predominantly occurs in children aged 5-15 years, although it can also occur in older children and adults. It is uncommon in children aged 3 years or younger. […] By the time children are 10 years old, 80% have developed lifelong protective antibodies against streptococcal pyrogenic exotoxins, which prevent future disease manifestation. Scarlet fever is rare in children younger than 1 year because of the presence of maternal antiexotoxin antibodies and lack of prior sensitization. […] Males and females are affected equally. No racial or ethnic predilection is reported for group A streptococcal infection.

• #7 Scarlet Fever: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1053253-overview

  As many as 10% of the population contracts group A streptococcal pharyngitis. Of this group, as many as 10% then develop scarlet fever. […] In the past century, the number of cases of scarlet fever has remained high, with marked decrease in case-mortality rates secondary to widespread use of antibiotics. Transmission usually occurs via airborne respiratory particles that can be spread from infected patients and asymptomatic carriers. […] The infection rate increases in overcrowded situations (eg, schools, institutional settings) and it peaks during late fall, winter, and spring in temperate environments. Immunity, which is type specific, may be induced by a carrier state or overt infection. In adulthood, incidence decreases markedly as immunity develops to the most prevalent serotypes. Complications (eg, rheumatic fever) are more common in recent immigrants to the United States.

• #8 Epidemiological study of scarlet fever in Shenyang, China | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4705-9

  Since 2011, there has been an increase in the incidence of scarlet fever across China. The main objective of this study was to depict the spatiotemporal epidemiological characteristics of the incidence of scarlet fever in Shenyang, China, in 2018 so as to provide the scientific basis for effective strategies of scarlet control and prevention. […] A total of 2314 scarlet fever cases were reported in Shenyang in 2018 with an annual incidence of 31.24 per 100,000. The incidence among males was higher than that among females (p<0.001). A vast majority of the cases (96.89%) were among children aged 3 to 11 years. The highest incidence was 625.34/100,000 in children aged 5-9 years. [...] The incidence of scarlet fever in urban areas was significantly higher than that in rural areas (p<0.001). [...] Urban areas are the hot spots of scarlet fever and joint prevention and control measures between districts should be applied. Children aged 3-11 are the main source of scarlet fever and therefore the introduction of prevention and control into kindergarten and primary schools may be key to the control of scarlet fever epidemics.

• #8 Epidemiological study of scarlet fever in Shenyang, China | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4705-9

  The incidence of scarlet fever was higher among males than among females, which is consistent with other findings. The number of scarlet fever cases was the highest among children aged 3-11 years and accounted for 96.89%. […] The spatial distribution showed that scarlet fever cases were concentrated in urban areas with high population density, and the incidence of scarlet fever in urban areas was significantly higher than that in rural areas. […] The autocorrelation analysis of Global Morans I value demonstrated that the spatial distribution of scarlet fever was randomly distributed in Shenyang in 2018. […] Hotspot analysis of Getis-Ord (Gi*) Z values revealed that the hotspot area with a high-high positive spatial association of scarlet fever incidence was located around the urban districts (Heping, Shenhe, Dadong, Huanggu, Sujiatun, Hunnan and Yuhong).

• #8 Epidemiological study of scarlet fever in Shenyang, China | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4705-9

  The monthly distribution of scarlet fever cases is obviously seasonal in Shenyang. The time distribution of scarlet fever is highly consistent with school and vacation time. The incidence of scarlet fever in urban areas with dense population and convenient transportation is significantly higher than that in rural areas.

• #9 Scarlet fever ( infectious diseases ) | PPT

  https://www.slideshare.net/slideshow/scarlet-fever-infectious-diseases/91610056

  Scarlet fever occurs mostly in children aged 4-8 years. Scarlet fever generally has a 3-6 day incubation period (1-7 days). Common in late winter and early spring. By 10 years old, up to 80% of children have developed lifelong protective antibodies against streptococcal toxins, whilst children younger than 2 years still have acquired maternal anti-exotoxin antibodies. Males and females are affected equally. […] Group A streptococcal infections that cause scarlet fever are contagious. Streptococcal bacteria can spread from person to person by breathing in airborne droplets from an infected person’s coughing or sneezing. Bacteria can also be passed by touching the infected skin of someone with a streptococcal skin infection, or by sharing contaminated clothes, towels or bed linen. Scarlet fever can also be spread by infected individuals who are carriers of streptococcal bacteria but do not show any symptoms.

• #10 Online Journal of Public Health Informatics – Assessing scarlet fever re-emergence from notifiable disease surveillance in Hong Kong

  https://ojphi.jmir.org/2018/1/e62213

  Objective: This study examined the epidemiology of scarlet fever in Hong Kong based on notifiable disease surveillance data, in a period where a 10-fold upsurge in scarlet fever incidence occurred. High risk groups and important factors associated with scarlet fever transmission were identified. […] Scarlet fever is a notifiable disease in Hong Kong for over 40 years. There was relatively low activity of scarlet fever until an outbreak in mid-2011 which resulted in two deaths and more than 1,500 cases. Scarlet fever incidence remained elevated since then with gt;10-fold increase comparing to that before the upsurge. […] We analyzed the patterns in scarlet fever incidence in Hong Kong using the notifiable disease surveillance data from 2005-2015. […] We found that the most affected groups were kindergarten students (3-5y), followed by primary school students (6-11y). Comparing to girls aged 0-2y, boys had significantly higher risk than girls except for the 0-2y age group, and boys aged 3-5y had the highest risk.

• #10 Online Journal of Public Health Informatics – Assessing scarlet fever re-emergence from notifiable disease surveillance in Hong Kong

  https://ojphi.jmir.org/2018/1/e62213

  Our study showed that elevated activity of scarlet fever was sustained for more than 5 years after the upsurge in 2011. We found that younger children who started schools, especially for boys aged 3-5 years, had a higher risk of scarlet fever, and there was significant effect of school holidays in reducing scarlet fever incidence. Sustained and consistent surveillance of scarlet fever allows continued monitoring of potential change in high risk group to drive updated and effective control strategy.

• #11 Forecasting the monthly incidence of scarlet fever in Chongqing, China using the SARIMA model | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/forecasting-the-monthly-incidence-of-scarlet-fever-in-chongqing-china-using-the-sarima-model/843AEDEA49C5E0B74E7D08D651B25C9A

  Since scarlet fever presents typical seasonal characteristics, a SARIMA model may be more effective than ARIMA model in predicting the scarlet fever epidemic. […] Therefore, in this study, we aimed to develop a prediction model using SARIMA model for scarlet fever in Chongqing, China. […] The time series of scarlet fever exhibited semiannual peaks in Chongqing, with a large peak during April to June and a small peak during October to December. […] Therefore, it is crucial to enhance scarlet fever control and prevention measures in schools. […] In this study, we found that the SARIMA (3, 1, 3) (3, 1, 0)12 model was the best-fitted mathematical model for forecasting monthly scarlet fever incidence based on the surveillance data from January 2011 to December 2018 in Chongqing, China. […] The results showed that the actual monthly incidence was within 95% CI of the predicted values, and the RMSE and MAPE between the predicted values and the actual values was 19.40 and 0.25 respectively, indicating that the model has reasonable accuracy in predicting the incidence of scarlet fever in Chongqing. […] The prediction model could be helpful in developing timely disease control and prevention strategies for scarlet fever in Chongqing, such as properly allocating health resources.

• #11 Forecasting the monthly incidence of scarlet fever in Chongqing, China using the SARIMA model | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/forecasting-the-monthly-incidence-of-scarlet-fever-in-chongqing-china-using-the-sarima-model/843AEDEA49C5E0B74E7D08D651B25C9A

  The incidence of scarlet fever has increased dramatically in recent years in Chongqing, China, but there has no effective method to forecast it. […] This study aimed to develop a forecasting model of the incidence of scarlet fever using a seasonal autoregressive integrated moving average (SARIMA) model. […] The data from 2011 to 2018 were used to fit a SARIMA model and data in 2019 were used to validate the model. […] The optimal SARIMA model was identified as (3, 1, 3) (3, 1, 0)12. […] The SARIMA model could be employed to forecast scarlet fever incidence trend, providing support for scarlet fever control and prevention. […] Accurately modelling and forecasting the scarlet fever epidemic holds great importance as it helps the authorities make the necessary arrangements and allows a timely response.

• #12 Exposure to air pollution and scarlet fever resurgence in China: a six-year surveillance study | Nature Communications

  https://www.nature.com/articles/s41467-020-17987-8

  Statistical examinations of 6-year nationwide data suggested long-term exposure to ambient NO2 and O3 is associated with the scarlet fever upsurge. Scarlet fever incidence also appeared to be associated with school breaks such that lower incidence rates were observed in the summer and winter holidays compared with when school was in session. […] This study revealed that among the various air pollutants examined, the risk estimates for NO2 and O3 were the most robust in the DLNM model. The concentrations of NO2 and O3, traffic-related pollutants, had low to moderate positive correlations with the risk of scarlet fever, and a ten-unit increment of NO2 and O3 concentration was associated with an increase in scarlet fever. […] In conclusion, our research shows scarlet fever cases continued to occur in China at elevated incidence rates for 8 consecutive years after a resurgence in 2011, but with decreased incidence in summer and winter school holidays each year. Based on 6 years of ecological data, we found that long-term exposure to NO2 and O3 is associated with scarlet fever resurgence in China, even at concentration ranges well below Chinas present annual mean limit.

• #12 Exposure to air pollution and scarlet fever resurgence in China: a six-year surveillance study | Nature Communications

  https://www.nature.com/articles/s41467-020-17987-8

  Scarlet fever has resurged in China starting in 2011, and the environment is one of the potential reasons. Nationwide data on 655,039 scarlet fever cases and six air pollutants were retrieved. We show that the average incidence in 20112018 was twice that in 20042010 [RR=2.30 (4.40 vs. 1.91), 95% CI: 2.292.31; p0.001] and generally lower in the summer and winter holiday (p=0.005). A low to moderate correlation was seen between scarlet fever and monthly NO2 (r=0.21) and O3 (r=0.11). A 10g/m3 increase of NO2 and O3 was significantly associated with scarlet fever, with a cumulative RR of 1.06 (95% CI: 1.021.10) and 1.04 (95% CI: 1.011.07), respectively, at a lag of 0 to 15 months. In conclusion, long-term exposure to ambient NO2 and O3 may be associated with an increased risk of scarlet fever incidence, but direct causality is not established.

• #13 Epidemiological changes of scarlet fever before, during and after the COVID-19 pandemic in Chongqing, China: a 19-year surveillance and prediction study | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-20116-5

  This study aimed to investigate the epidemiological changes in scarlet fever before, during and after the COVID-19 pandemic (2005-2023) and predict the incidence of the disease in 2024 and 2025 in Chongqing Municipality, Southwest China. […] Between 2005 and 2023, 9,593 scarlet fever cases were reported in Chongqing, which resulted in an annual average incidence of 1.6694 per 100,000 people. […] The incidence of scarlet fever increased by 106.54% and 39.33% in the post-upsurge period (2015-2019) and the dynamic zero-COVID period (2020-2022), respectively, compared to the pre-upsurge period (2005-2014) (P<0.001). [...] During the dynamic zero-COVID period, the incidence of scarlet fever decreased by 68.61%, 25.66%, and 10.59% (P<0.001) in 2020, 2021, and 2022, respectively, compared to the predicted incidence.

• #13 Epidemiological changes of scarlet fever before, during and after the COVID-19 pandemic in Chongqing, China: a 19-year surveillance and prediction study | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-20116-5

  The reported cases decreased to 1.5168 per 100,000 people unexpectedly instead of increasing. […] It is predicted that the high incidence of scarlet fever in Chongqing will persist in 2024 and 2025, and the outer districts (counties) beyond urban zone would bear the brunt of the impact. […] Scarlet fever is one of the main respiratory infectious diseases in Chongqing Municipality. […] The incidence of scarlet fever in Chongqing ranked 23rd among Chinese Mainland (including 31 provinces, municipalities and autonomous regions) in 2019, 9th in 2022 and 22nd in 2023. […] The spatial autocorrelation analysis revealed that scarlet fever cases were markedly clustered; the areas with higher incidence were mainly concentrated in Chongqing’s urban areas and its adjacent districts, and gradually spreading to remote areas after 2020.

• #13 Epidemiological changes of scarlet fever before, during and after the COVID-19 pandemic in Chongqing, China: a 19-year surveillance and prediction study | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-20116-5

  The annual incidence of scarlet fever in Chongqing was visually presented on a district (county)-level map utilizing various hues, where darker shades signify higher rates of incidence. […] The global Morans I value ranged between 0 and 1, indicating the presence of some degree of spatial autocorrelation among the observed cases of scarlet fever during the study period. […] The results of LISA clustering diagram indicated that there was an evident spatial correlation blinding the cases of scarlet fever diseases. […] The incidence had a significant positive spatial correlation at the county scale in the two stages in Chongqing and that the distribution of the cases was not random.

• #14 Scarlet Fever: A Deadly History and How it Prevails

  https://asm.org/articles/2023/january/scarlet-fever-a-deadly-history-and-how-it-prevails

  Scarlet fever is a disease that has significantly evolved in definition and management over the last several hundred years. […] However, recent outbreaks demonstrate the need to keep the disease front-of-mind to successfully identify and track the pathogen, treat patients and prevent poor outcomes. […] Since September 2022, there has been a significant outbreak of scarlet fever in children in Europe, and more recently, there have been documented increases in cases in the U.S. This outbreak has been unique in that it first appeared out of sync with typical seasonality and has come with higher mortality rates than normal. […] Importantly, antimicrobial susceptibility test results from routine laboratory surveillance in England did not demonstrate any increased antibiotic resistance among S. pyogenes organisms, indicating that drug resistance is not responsible for increased virulence or spread of the organism in the current outbreak.

• #14 Scarlet Fever: A Deadly History and How it Prevails

  https://asm.org/articles/2023/january/scarlet-fever-a-deadly-history-and-how-it-prevails

  Expanded surveillance and research are needed to understand these outbreaks, but the pathogenesis and epidemiology of the disease provide additional context clues. […] The Centers for Disease Control (CDC) estimates that in the last 5 years, 14,000 to 25,000 cases of invasive group A strep disease have occurred in the U.S. and that 1,500-3,000 people die yearly from these infections. It is imperative that data on the prevalence of disease are reported to public health agencies regularly and surveillance is performed at the public health level. […] WHO recommends continued surveillance and advises healthcare providers to maintain a high level of suspicion for group A strep-related diseases, as identifying and treating these infections early may prevent invasive Streptococcal disease and other serious downstream outcomes.

• #15

  https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON429

  As of 8 December 2022, at least five Member States in the European Region, reported to WHO an increase in cases of invasive group A streptococcus (iGAS) disease and in some cases also scarlet fever. […] During 2022, France, Ireland, the Netherlands, Sweden, and the United Kingdom of Great Britain and Northern Ireland, have been observing an increase in cases of invasive group A streptococcus disease and scarlet fever, mostly affecting children under 10 years of age. […] SpF also detected an increase in cases of scarlet fever reported in outpatient clinics in the country since September 2022. […] According to the UK Health Security Agency, following a higher-than-expected scarlet fever activity in the summer in England, with a decrease during August 2022, notifications from mid-September to early December have increased again, remaining above what is normally seen at this time of year.

• #15

  https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON429

  GAS infection commonly causes mild illnesses such as tonsillitis, pharyngitis, impetigo, cellulitis and scarlet fever. […] However, in rare instances, GAS infection can lead to invasive GAS, which can cause life-threatening conditions, such as necrotizing fasciitis, streptococcal toxic shock syndrome and other severe infections, as well as post-immune mediated diseases, such as poststreptococcal glomerulonephritis, acute rheumatic fever and rheumatic heart disease. […] Enhanced surveillance activities have been implemented in the countries reporting an increase in iGAS cases, together with public health messages addressing the general population and clinicians, in order to enhance early recognition, reporting and prompt treatment initiation of GAS cases. […] WHO currently assesses the risk for the general population posed by the reported increase in iGAS infections in some European countries as low, considering the moderate rise in iGAS cases, GAS endemicity, no newly emerging emm gene sequence types identified, and no observed increases in antibiotic resistance.

• #16 Clinical Guidance for Scarlet Fever | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/scarlet-fever.html

  Scarlet fever, also called scarlatina, is caused by pyrogenic exotoxin-producing Streptococcus pyogenes (group A strep bacteria). […] The incubation period of scarlet fever is approximately 2 to 5 days. […] Anyone can get scarlet fever, but age and close contact can increase someone’s risk of infection. […] Scarlet fever is most common among children 5 through 15 years of age. It’s rare in children younger than 3 years of age. […] Close contact with another person with scarlet fever is the most common risk factor for illness. […] Crowded settings can increase the risk for spreading the bacteria. […] The differential diagnosis of scarlet fever with pharyngitis includes multiple viral pathogens that can cause acute pharyngitis with a viral exanthema. […] To confirm scarlet fever with pharyngitis, healthcare providers need to use either a rapid antigen detection test (RADT) or throat culture.

• #16 Clinical Guidance for Scarlet Fever | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/scarlet-fever.html

  RADTs have high specificity for group A strep bacteria but varying sensitivities when compared to throat culture. Throat culture is the gold standard diagnostic test. […] Healthcare providers can use a positive RADT or throat culture as confirmation of scarlet fever with pharyngitis. […] Children older than 3 years: Healthcare providers should follow up a negative RADT with a throat culture. […] Patients with scarlet fever, regardless of age, who have a positive RADT or throat culture need antibiotics. […] Using a recommended antibiotic regimen to treat scarlet fever shortens the duration of symptoms, reduces the likelihood of transmission to close contacts, and prevents the development of complications. […] There’s never been a report of a clinical isolate of group A strep bacteria that’s resistant to penicillin. However, resistance to azithromycin, clarithromycin, and clindamycin can occur and varies geographically and temporally.

• #16 Clinical Guidance for Scarlet Fever | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/scarlet-fever.html

  Good hand hygiene and respiratory etiquette can reduce the spread of group A strep bacteria. […] After at least 12 hours of treatment with an appropriate antibiotic, someone’s ability to transmit group A strep bacteria is reduced. […] Prevention of invasive group A streptococcal disease among household contacts of case patients and among postpartum and postsurgical patients.

• #17 Scarlet fever and IGAS | HSC Public Health Agency

  https://www.publichealth.hscni.net/directorates/directorate-public-health/health-protection/surveillance-data/scarlet-fever-and-igas

  Group A Streptococcus (GAS) are common bacteria. GAS can be present on or in the human body, without causing infection which is known as colonisation. However these bacteria can cause skin, soft tissue and respiratory infections, including scarlet fever. GAS infections range from mild to very severe. Invasive GAS (IGAS) occurs when the bacteria proliferate in a normally sterile body site, such as the blood, soft tissues or joints. Streptococcal toxic shock syndrome (STSS) can be a severe complication of IGAS, caused by toxins that are produced by GAS, which act on host cells or tissues. […] GAS is spread by close contact between individuals, through respiratory droplets and direct skin contact. GAS can also be transmitted indirectly through contact with inanimate objects, such as towels or bedding. GAS is usually diagnosed by microbiological culture of a specimen from the affected site or by a characteristic illness, such as scarlet fever.

• #17 Scarlet fever and IGAS | HSC Public Health Agency

  https://www.publichealth.hscni.net/directorates/directorate-public-health/health-protection/surveillance-data/scarlet-fever-and-igas

  There was an increase in scarlet fever incidence during January 2023, this increase was also observed in other European nations. There has been an increase in the number of IGAS infections compared to the pandemic period. While IGAS incidence has steadily fallen since December 2022 and January 2023, the monthly incidence remains at levels in keeping with previous moderate seasons. […] Scarlet fever notifications and IGAS cases are reported by clinicians to the Public Health Agency and were extracted from the case management database. Laboratory reports of IGAS are also reported and validated with those reported by clinicians. Scarlet fever is notifiable in Northern Ireland under the Public Health Act (1967) Northern Ireland and IGAS is not notifiable.

• #17 Scarlet fever and IGAS | HSC Public Health Agency

  https://www.publichealth.hscni.net/directorates/directorate-public-health/health-protection/surveillance-data/scarlet-fever-and-igas

  During December 2022, there was a substantial increase in GAS and Scarlet fever cases across the UK, with the highest number of notifications in Northern Ireland recorded in January 2023. Notifications for GAS and Scarlet fever remained higher than usual between December 2022 to March 2023 before returning to usual seasonal levels towards the end of Spring 2023. […] Public and clinician awareness of GAS infections has changed over time, especially during December 2022, which may contribute to changes in trends. IGAS, being more severe, is likely more consistent over time. […] Annual figures for Scarlet fever cases from 2022 onwards are shown in (Table 2.1). Reported cases of IGAS during the same time period are shown in (Table 2.2). […] Scarlet fever notifications in Northern Ireland slightly increased in December 2024 but have since steadily declined. Scarlet fever notifications during January to March 2025 remain lower than what was observed during the same period last year.

• #18 Revista de Pediatría de Atención Primaria – Unusual clinical findings in an outbreak of scarlet fever

  https://pap.es/article/12403/unusual-clinical-findings-in-an-outbreak-of-scarlet-fever

  Scarlet fever is an infectious disease caused by Streptococcus pyogenes that manifests as a typical pharyngoamigdalitis and exanthema. […] We define the epidemiology, clinical characteristics, microbiological tests, treatment and appearance of relapses. […] The rapid test on primary care units allows diagnosis on doubtful cases. […] Scarlet fever is a disease that results from infection group A Streptococcus pyogenes (GAS) strains producing pyrogenic exotoxins in individuals that do not have antibodies against the toxin. […] Transmission is facilitated by close contact, and thus nurseries, schools and the home are significant settings for transmission. […] The incubation period lasts between two and five days. […] Its incidence is cyclical and depends on the prevalence of toxin-producing strains and the immune health of the population, and it is higher in children aged 5 to 15 years, especially the younger set, although it is not rare in other ages.

• #18 Revista de Pediatría de Atención Primaria – Unusual clinical findings in an outbreak of scarlet fever

  https://pap.es/article/12403/unusual-clinical-findings-in-an-outbreak-of-scarlet-fever

  In Spain, the reporting of scarlet fever cases stopped being mandatory in 1996, so at present we do not have reliable epidemiological data that would serve as a reference. […] In the United Kingdom, where there is epidemiological surveillance of scarlet fever, the data has shown a cyclical pattern with incidence peaks every four years. […] Given the possibility of a future increase in the incidence of invasive disease by streptococcus, we think that epidemiologic surveillance by means of mandated reporting is necessary.

• #19 Scarlet Fever | Health Knowledge

  https://www.healthknowledge.org.uk/public-health-textbook/disease-causation-diagnostic/2b-epidemiology-diseases-phs/infectious-diseases/scarlet-fever

  Occurs worldwide though less commonly in the tropics. […] Via respiratory droplets or direct contact with infected person. […] Untreated – 10-21 days. […] Treated – communicability generally ends within 24 hours of antibiotic treatment.

• #20 Scarlet fever – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000301

  Scarlet fever can occur at any age but mainly affects children aged 1 to 10 years, and it is most common in those aged 3 to 6 years. It is uncommon in children 1 year old and in adults. […] Scarlet fever is a notifiable disease in China, South Korea, and many European countries including England, Wales, Northern Ireland, Austria, and Poland. […] GAS pharyngitis and scarlet fever have similar epidemiology, evaluation, and treatment.

• #21

  https://www.gov.uk/government/collections/scarlet-fever-guidance-and-data

  Scarlet fever occurs most often in the winter and spring. […] Scarlet fever is a notifiable disease in England and Wales. This means health professionals must inform local health protection teams of suspected cases. […] Added current season’s report page, under epidemiology, and removed direct links to historical reports. […] Latest seasonal activity document inserted into the Epidemiology subgroup (2017/2018 season).

• #22 Brief Report: Diagnoses of Scarlet Fever in Military Health System (MHS) Beneficiaries Under 17 Years of Age Across the MHS and in England, 2013–2018 | Health.mil

  https://staging-mobile.health.mil/sitecore/content/MHSHome/News/Articles/2020/02/01/Scarlet-Fever-MSMR-Pubmed-2020?type=All&page=9

  Because scarlet fever is a reportable disease in England, a large increase in incident cases was identified in 2014. This increase has continued to persist throughout the country. Public health surveillance identified a 3- to 4-fold increase in incidence of scarlet fever, which has significantly impacted schools and nurseries in the country. Strains of S. pyogenes that were emm typed during this time period demonstrated a wide variety of M-protein gene sequences, but a new emm1 strain (M1UK) that is genotypically distinct from other pandemic emm1 isolates has increased in prevalence in England as invasive streptococcal disease has also risen. Although increased incidence of scarlet fever had been described in parts of Asia since 2008, England was the first European country to detect a sudden large-scale increase in cases, and this discovery has led to concern about similar widespread outbreaks occurring in other areas of the world.

• #23 Factsheet – Health Protection Surveillance Centre

  https://www.hpsc.ie/a-z/other/scarletfever/factsheet/

  Scarlet fever and the other milder infections caused by GAS bacteria are not notifiable in Ireland meaning that healthcare professional do not have to report cases to the national surveillance centre. Because of this the number of cases in Ireland is not known. […] In England, there were 58,972 notified cases of scarlet fever between September 2022 and June 2023. […] More severe, iGAS diseases are notifiable in Ireland. As of June 2023, there has been an increase in notified iGAS infections in Ireland since October 2022, with data from 2023 suggesting that it continues to remain at a higher level than expected.

• #24 Strep Throat/Scarlet Fever | Disease Outbreak Control Division

  https://health.hawaii.gov/docd/disease_listing/strep-throatscarlet-fever/

  Strep throat and scarlet fever are diseases caused by infection with group A streptococci (GAS). […] Group A Streptococcus is found in Hawaii and is a reportable disease. […] Streptococcal diseases, Group A are considered Routine reporting to Hawaii Department of Health. Reporting by mail, telephone, or FAX to the Disease Outbreak and Control Division on Oahu, or to the District Health Offices on the neighbor islands.

• #25 Scarlet fever, a disease of yore, is making a comeback in parts of the world

  https://www.statnews.com/2017/11/27/scarlet-fever-cases/

  Scarlet fever, a disease that struck fear into the heart of parents when cases surged in the days of yore, appears to be making an unexpected and puzzling comeback in parts of the world. […] England and Wales have seen a substantial rise in scarlet fever cases starting in 2014. […] Similar and in some cases even larger surges of scarlet fever have been reported in recent years in South Korea, Vietnam, China, and Hong Kong. […] The reason for the sudden and surprising increase is a mystery. […] Thus, heightened global surveillance for the dissemination of scarlet fever is warranted, wrote Mark Walker and Stephan Brouwer, of the University of Queensland in Australia. […] Scarlet fever is not a reportable disease in the U.S., and the Centers for Disease Control and Prevention does not track the condition.

• #25 Scarlet fever, a disease of yore, is making a comeback in parts of the world

  https://www.statnews.com/2017/11/27/scarlet-fever-cases/

  Lamagni noted that in 2013 scarlet fever cases in England and Wales were seen at a rate of about 8 per 100,000 children. That soared to 27 per 100,000 in 2014 and 33 per 100,000 in 2016. […] Even though scarlet fever does not have to be reported to the CDC, Lamagni said a surge in the United States would be hard to miss.

• #26 Detecting spatio-temporal hotspots of scarlet fever in Taiwan with spatio-temporal Gi* statistic | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0215434

  A resurgence of scarlet fever has caused many pediatric infections in East Asia and the United Kingdom. Although scarlet fever in Taiwan has not been a notifiable infectious disease since 2007, the comprehensive national health insurance data can still track its trend. […] Understanding the distribution of a disease in time and space is a foundation of public health. One of the most relevant analyses is related to analyzing the aggregation of disease cases in space, in time, or in both space and time. […] The mapping of disease incidence and prevalence has long been a part of public health, epidemiology, and the study of disease in human populations. […] Local spatial statistics, such as local Morans I, the Getis-Ord Gi* statistic and the score statistic, may assist with the identification of disease clusters.

• #27 :: IC :: Infection & Chemotherapy

  https://icjournal.org/DOIx.php?id=10.3947/ic.2018.50.1.38

  Here, an epidemiological analysis was conducted to identify the possible route of transmission and to recommend appropriate control measures to prevent future outbreaks of scarlet fever. […] Scarlet fever has been designated as a notifiable disease with a case defined by the Korean Centers for Disease Control and Prevention. […] The overall attack rate was 13.3%; attack rates based on the kindergarten class were 45.1% in Leaf A, 14.3% in Leaf B, 13.3% in Dew C, and 4.2% in Petal A. […] The staff’s delayed identification and notification of this outbreak were considered as the major causes of the large number of cases, which can be avoided by immediately reporting the occurrence of an outbreak and implementing appropriate control measures. […] Several studies have reported an increasing rate of scarlet fever in countries including the Republic of Korea in the recent years, prompting increased attention to the epidemiological factors that caused the spread of GAS particularly in young children. […] Previous studies suggest that monitoring GAS strain with antibiotic susceptibility is critical to prevent future outbreaks of scarlet fever.

• #27 :: IC :: Infection & Chemotherapy

  https://icjournal.org/DOIx.php?id=10.3947/ic.2018.50.1.38

  Scarlet fever is caused by a group A streptococcal (GAS) infection. On April 3, 2017, an outbreak among children in a kindergarten was reported to the local health department. An epidemiologic investigation was conducted to identify the possible transmission route of this outbreak and to recommend appropriate control measures. […] The annual number of scarlet fever reported has greatly increased from 0.3 cases/100,000 persons in 2008 to 23.08 cases/100,000 persons in 2016 in the Republic of Korea, and 8.98 cases/100,000 persons in 2013 to 27.77/100,000 persons in 2016 at Gyeonggi Province, Korea. […] On April 3, 2017, an outbreak of scarlet fever among children at a kindergarten was reported to the local public health department by the local pediatric clinic. A field epidemiologist from Gyeonggi Provincial Government conducted an investigation and implemented control measures.

• #28 Clinical management and impact of scarlet fever in the modern era: findings from a cross-sectional study of cases in London, 2018–2019 | BMJ Open

  https://bmjopen.bmj.com/content/11/12/e057772

  The public health importance of prompt diagnosis and treatment is underscored by the 12-fold greater risk of invasive GAS among household contacts of scarlet fever cases. […] The challenge of keeping diagnostic algorithms and recommendations up to date is underlined further by the emergence of a new cause of acute febrile illness, namely COVID-19. […] Further research into the interplay of scarlet fever and invasive GAS at a population level will help direct diagnostic, treatment and public health strategies to reduce the impact of outbreaks.

• #28 Clinical management and impact of scarlet fever in the modern era: findings from a cross-sectional study of cases in London, 2018–2019 | BMJ Open

  https://bmjopen.bmj.com/content/11/12/e057772

  The timing of the survey in relation to the clinical episode presents challenges, and a risk of ascertainment bias. Surveying a parent/guardian too soon after the clinical episode would risk failing to ascertain the full burden of disease on the patient and household, if longer-term complications are not captured; surveying too late would risk recall bias, if the respondent misremembers the details of the illness and its management. […] Our findings highlight the interconnectedness of scarlet fever and GAS infections more widely: 43% of respondents in 2019 reported unwell family members, many with symptoms attributable to GAS (scarlet fever, pharyngitis, tonsillitis, cellulitis). Such epidemiological links are important both in assessing the full impact of the disease, and in guiding clinical and public health management.

• #29 Scarlet Fever | Doctor

  https://patient.info/doctor/scarlet-fever-pro

  Epidemics were common throughout Europe and the USA in the 18th and 19th centuries. […] Although scarlet fever nearly disappeared during the 20th century, several countries, including the UK, have recently experienced a re-emergence. However, the reason for these new outbreaks remains unclear. […] Scarlet fever is still one of the top ten causes of infectious deaths worldwide causing approximately 500,000 deaths annually. […] The age profile has remained unchanged – 87% being children aged under 10 years, with a median age of 4 years. […] The infection rate increases with overcrowding and close contact. School populations have a higher incidence. […] Incidence is seasonal, most cases in the UK occurring in the winter and spring months. […] In the last reported season (from 12 September 2022 to 7 May 2023), there were 55,872 notifications of scarlet fever in the UK. In the last comparable high season (from September 2017 to September 2018), there were 30,768 scarlet fever notifications overall across the year.

• #30

  https://www.bbc.com/news/health-35783430

  Cases of scarlet fever in England and Wales have risen to the highest level since the 1960s, Public Health England (PHE) says. […] PHE is alerting all health practitioners to be mindful of the disease when assessing patients. […] PHE said about 600 cases are being flagged up each week in England, and further increases are expected as the infection comes into it the peak season – which typically occurs between late March and mid April. […] The number of cases of scarlet fever has soared in the last three years, PHE said. […] A PHE spokesman said the reason behind the increase in cases was „unclear” but added that it „may reflect the long-term natural cycles in disease incidence seen in many types of infection”. […] Dr Chris Williams, consultant epidemiologist for Public Health Wales, said: „We are monitoring an increase in scarlet fever in Wales, which is to be anticipated at this time of year.”

• #31 Scarlet fever is on the rise, after being almost eradicated by the 1940s | Doherty Website

  https://www.doherty.edu.au/news-events/news/scarlet-fever-is-on-the-rise-after-being-almost-eradicated-by-the-1940s

  Scarlet fever is on the rise, after being almost eradicated by the 1940s. A team of international researchers including Doherty Institutes Dr Mark Davies say supercharged clones of the bacteria Streptococcus pyogenes are to blame for the resurgence of scarlet fever, which has caused high death rates for centuries. After being almost eradicated in the 1940s, the re-emergence of the pandemic has seen a more than five-fold increase in disease since 2011 and more than 600,000 cases around the world. Scarlet fever commonly affects children, typically aged between two and 10 years. Now, my team is developing molecular surveillance tools to track the spread of disease causing Streptococcus pyogenes around the world. But when social distancing eventually is relaxed, scarlet fever is likely to come back. We need to continue this research to improve diagnosis and to better manage these epidemics. Just like COVID-19, ultimately a vaccine will be critical for eradicating scarlet fever one of historys most pervasive and deadly childhood diseases. […] This research has been published in Nature Communications.

• #32 Epidemiological features and control of an outbreak of scarlet fever in a Perth primary school

  https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-cdi2904h.htm

  Because of ongoing transmission of GAS causing scarlet fever within the school and family setting, the concern of parents and staff at the school, and the possible serious complications of GAS infection, it was decided to screen students and staff of the affected pre-primary school classes and treat asymptomatic carriers with the aim of interrupting transmission and preventing further cases. […] No further cases of scarlet fever were notified from the primary school after screening and treatment of carriers was undertaken. Although we cannot be certain that the outbreak would not have terminated naturally at that time, the abrupt cessation suggests that the intervention of screening and administration of antibiotics to carriers of GAS was effective in halting the epidemic. […] It is debatable whether scarlet fever should still be listed as a notifiable disease in Australia, however this outbreak and the subsequent control measures demonstrate there is some utility in continuing to monitor this infection.

• #33 Frequency of transmission, asymptomatic shedding, and airborne spread of Streptococcus pyogenes among schoolchildren exposed to scarlet fever: a longitudinal multi-cohort molecular epidemiology contact tracing study | medRxiv

  https://www.medrxiv.org/content/10.1101/2021.07.04.21259990v2

  Despite recommendations regarding prompt treatment of cases and enhanced hygiene measures, scarlet fever outbreaks increased in England between 2014-2018. […] We aimed to assess the impact of standard interventions on transmission of Streptococcus pyogenes to classroom contacts, households, and classroom environments. […] S. pyogenes transmission in schools is intense and may occur prior to, or inspite of reported treatment of cases, underlining a need for rapid case management. […] Despite guideline adherence, heavy shedding of S. pyogenes by small numbers of classroom contacts may perpetuate outbreaks, and airborne transmission has a plausible role in spread. […] The findings highlight the need for research to improve understanding and assess effectiveness of interventions to reduce S. pyogenes airborne transmission.

• #34 Clinical management and impact of scarlet fever in the modern era: findings from a cross-sectional study of cases in London, 2018-2019 | medRxiv

  https://www.medrxiv.org/content/10.1101/2021.06.25.21259535v1.full

  Scarlet fever incidence has risen steeply in recent years, and is associated with wider outbreaks of severe Group A Streptococcal infections. […] In assessing children with fever, rash, and sore throat, practitioners should be alert to the possibility of scarlet fever: it is frequently missed at first consultation, and prompt recognition speeds clinical recovery and public health management. […] Scarlet fever is a notifiable infectious disease in England, and usually diagnosed on the basis of symptoms and signs. […] Early case recognition aids implementation of treatment, initiation of which should reduce likelihood of complications and prevent onward transmission, reducing the incidence of not only scarlet fever itself, but also invasive GAS infections in cases and contacts. […] Practitioners should be alert to circumstances in which scarlet fever is easily overlooked.

• #34 Clinical management and impact of scarlet fever in the modern era: findings from a cross-sectional study of cases in London, 2018-2019 | medRxiv

  https://www.medrxiv.org/content/10.1101/2021.06.25.21259535v1.full

  Timely recognition of scarlet fever in this age group could expedite antibiotic treatment, shorten the period of infectivity, and reduce onward propagation of GAS. […] The public health importance of prompt diagnosis and treatment is underscored by the 12-fold greater risk of invasive GAS among scarlet fever household contacts. […] Effective control of scarlet fever and GAS depends upon the coordinated efforts of clinicians and public health practitioners to identify cases and outbreaks early, implement appropriate treatment, and prevent onward transmission.

• #35 Scarlet fever is making a comeback after being infected with a toxic virus, researchers say – ABC News

  https://www.abc.net.au/news/2020-10-08/scarlet-fever-incidence-on-the-rise-bacteria-infected-by-viruses/12740806

  „It causes a range of different diseases which all require some level of surveillance and quite often we do it using the genomic epidemiology but we don’t necessarily do public health surveillance at the same level as we do for other infectious diseases,” she said. […] She said she also thought this use of bacterial DNA analysis could be a useful example to encourage the technology to be used in disease surveillance. […] „This is one of the biggest global targets for vaccination there has been a vaccine in development for about 20 plus years and there has been Australia-wide movement and advocacy around building a vaccine for this disease not driven by scarlet fever but more by rheumatic heart disease.”

• #35 Scarlet fever is making a comeback after being infected with a toxic virus, researchers say – ABC News

  https://www.abc.net.au/news/2020-10-08/scarlet-fever-incidence-on-the-rise-bacteria-infected-by-viruses/12740806

  Scarlet fever epidemics were deadly to children across the globe in the 1800s, but in recent decades concerns about the disease have largely faded from the minds of medical experts, in part due to the power of antibiotics. […] It is believed to have played a role in recent scarlet fever outbreaks in Asia and the UK. […] Between 2014 and 2018, the UK National Health Service reported a 68 per cent increase in the number of lab reports of pyogenic streptococci. […] Professor Walker said while scarlet fever was not causing lethal infections as it used to it was important to continue to highlight infection and vaccine research as outbreaks continued. […] Dr Meru Sheel from the National Centre for Epidemiology and Population Health at The Australian National University said she agreed there should be more surveillance of Streptococcus infections.

• #36

  https://www.healio.com/infectious-disease/pediatric-id/news/online/%7Bc5abd4d9-04db-43cc-a538-d5b0bc873525%7D/scarlet-fever-has-surged-in-china-since-2011

  In a related editorial, Xingyu Zhang, PhD, of the department of surgery at Emory University School of Medicine, and Yan-Cun Liu, MD, from the department of emergency medicine at Tianjin Medical University General Hospital in China, emphasized the importance of closer monitoring of scarlet fever in China. […] Given the resurgence of scarlet fever, surveillance systems should be strengthened both in China and other countries, especially since no vaccine exists for scarlet fever, they wrote.

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