While the rate of infection has risen across all age groups, incidence in children aged under 10 has been particularly high compared to levels reported in the last peak season preceding the COVID-19 pandemic.

Notifications and GP consultations of scarlet fever in England and the Netherlands are higher than normal for this point in the winter season, the relevant authorities report. The disease caused by group A streptococcus can be rather severe in some cases. Medical practitioners have been alerted to this early increase in incidence and elevated streptococcus infection in children.

It remains important that scarlet fever cases are treated promptly with antibiotics to limit further spread with all possible means and reduce the risk of potential complications in cases and their close contacts, health services warn.

While the rate of infection is higher in all age groups, incidence in children aged under 10 has been particularly high compared to levels reported in the last peak season preceding the COVID-19 pandemic. At least 19 minors have died in the UK since September as a result of the bacterial infection, according to figures from the UK Health Security Agency (UKHSA).

A growing number of Group A streptococcus cases has also been reported from Germany. In its epidemiological bulletin, the Robert Koch Institute reports an „unusually steep increase in invasive and non-invasive infections registered in GP’s surgeries and hospitals” in the last quarter 2022. The numbers are expected to remain at the same level in early 2023.

Group A streptococcus bacteria are pathogens that occur on our skin and mucous membranes. They are particularly dangerous if you have symptoms of a cold or a virus, such as the flu, because the pathogen can then more easily make an already weakened body ill. The symptoms vary depending on the clinical picture, including severe sore throat and difficulty swallowing, swollen lymph nodes in the neck and sometimes fever.

Possible complications include inflammation of the middle ear, sinuses and lungs, as well as the heart valves. In some cases, infection can lead to septicaemia or toxic shock syndrome.

Another problem in Germany is that health recommendations are less clear about when a child can return to the community without antibiotic treatment. The deadline is currently set at a maximum of 14 days.

In Germany, scarlet fever is not the only red flag for health authorities. Children’s hospitals have been reporting an unusually high number of respiratory cases for months, with many cases being caused by respiratory syncytial virus (RSV).

The reason is that there are many babies who have not been previously exposed to RSV, because they were born either just before, or during the height of the coronavirus pandemic, when RSV was relatively scarce and therefore their immunity was not properly developed,

a paediatrician who conducts research on childhood infections at the Bernhard Nocht Institute in Hamburg, Robin Kobbe, explained to German public media recently.