Summer May Subdue Scarlet Fever Outbreak

Summer vacation could help subdue an outbreak of scarlet fever in Hong Kong that has claimed the lives of two children.

According to figures from the Centre for Health Protection, 494 cases of scarlet fever have been reported this year, already breaking the previous full-year record of 236, set in 2008. This year’s scarlet-fever deaths, of a 5-year-old boy and 7-year-old girl, are the first in a decade, said a spokesperson for the center. The unusually high infection rate may be due to a genetic mutation in the streptococcus bacteria that causes the disease.

March to September is typically high season for bacterial infections, said Professor Yuen Kwok-yung, a microbiologist at the University of Hong Kong, but with the summer school break the rate of infection could taper off, because the break decreases physical contact among children. (Young children are most vulnerable, he said, because their immune systems have not had as much exposure to streptococcus.) Still, he added, it’s “unlikely” that the disease will completely disappear before September.

Wendy Lau, principal of Yan Chai Hospital Tung Pak Ying Kindergarten in Kwai Tsing, where two cases have been reported, said the government has not yet ordered any schools to shut down. She said her school has stepped up disinfection of its facilities by using higher-strength bleach, and while she has received a couple of phone calls from worried parents, they are by and large satisfied with the measures the school is taking.

Mr. Yuen said his research found that the resistance of streptococcus bacteria to macrolides, a type of antibiotics often prescribed by doctors for respiratory tract or gastrointestinal infection, has increased to 60% from less than 30% in the past. He said it was likely that the widespread use of these antibiotics was driving the genetic mutation of the bacteria, giving them a “survival advantage” in terms of resistance.

In a statement, Secretary for Food and Health York Chow said the government is closely monitoring the outbreak. It urges the public not to worry, as scarlet fever can be treated with antibiotics, and advises parents to seek medical attention if their children develop symptoms of the disease, which include fever, sore throat, rash and a red (“strawberry”) tongue.

About Scarlet Fever | Bohol Technical Support

Not all streptococci bacteria make this toxin and not all kids are sensitive to it. Two kids in the same family may both have strep infections, but one child (who is sensitive to the toxin) may develop the rash of scarlet fever while the other may not. Usually, if a child has this scarlet rash and other symptoms of strep throat, it can be treated with antibiotics. So if your child has these symptoms, it's important to call your doctor. The rash is the most striking sign of scarlet fever. It usually begins looking like a bad sunburn with tiny bumps and it may itch. The rash usually appears first on the neck and face, often leaving a clear unaffected area around the mouth. It spreads to the chest and back, then to the rest of the body. In body creases, especially around the underarms and elbows, the rash forms classic red streaks. Areas of rash usually turn white when you press on them. By the sixth day of the infection the rash usually fades, but the affected skin may begin to peel. Aside from the rash, there are usually other symptoms that help to confirm a diagnosis of scarlet fever, including a reddened sore throat, a fever above 101° Fahrenheit (38.3° Celsius), and swollen glands in the neck. The tonsils and back of the throat may be covered with a whitish coating, or appear red, swollen, and dotted with whitish or yellowish specks of pus. Early in the infection, the tongue may have a whitish or yellowish coating. A child with scarlet fever also may have chills, body aches, nausea, vomiting, and loss of appetite. When scarlet fever occurs because of a throat infection, the fever typically stops within 3 to 5 days, and the sore throat passes soon afterward. The scarlet fever rash usually fades on the sixth day after sore throat symptoms began, but skin that was covered by rash may begin to peel. This peeling may last 10 days. With antibiotic treatment, the infection itself is usually cured with a 10-day course of antibiotics, but it may take a few weeks for tonsils and swollen glands to return to normal. In everyday life, there is no perfect way to avoid the infections that cause scarlet fever. When a child is sick at home, it's always safest to keep that child's drinking glasses and eating utensils separate from those of other family members, and to wash these items thoroughly in hot soapy water. Wash your own hands frequently as you care for a child with a strep infection.

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