What is scarlet fever, this disease caused by streptococcus A, which affects children

Typically, scarlet fever is characterized by an invasive phase that begins abruptly with high fever, poor general condition, vomiting and sometimes abdominal and joint pain. (©uly.uv / Adobestock)

For several weeks, children have been given a contract scarlet fever, especially in schools, in France. These invasive group A streptococcal infections occurred mainly in certain regions: Occitanie, Auvergne-Rhône-Alpes, New Aquitaine, but not only. Cases have also been reported in Île-de-France or even in Normandy, and it is not over.

And this, mainly in children under 10 years of age. Public health France issued a warning this week in light of serious cases and deaths in the past two weeks. Should we be alarmed? news.fr make the point.

What does this have to do with strep?

“What you need to know is that scarlet fever is benign, but it’s not a virus, it’s a bacteria,” explains news.fr pediatrician and infectious disease specialist Robert Cohen. “The disease comes from group A streptococci or a set of group A streptococci that are able to secrete toxins that cause scarlet fever,” he explains.

“Infections with streptococci A (Streptococcus pyogenes) are frequent”, reminds the Pasteur Institute on its website. This bacterium is part of the commensal flora (Ed. note: a complex set of bacteria, protozoa, viruses and fungi located under the superficial layer of the skin, the cutaneous microbiota and on a large part of the mucous membranes) and only causes symptoms under certain conditions (opportunistic pathogen) or in persons at risk.

Streptococcus A is responsible for many benign infections (angina, impetigo), but can also be responsible for sometimes fatal invasive infections (toxic shock syndrome, necrotizing fasciitis)”, underlines the foundation, which is dedicated to the study of biology, microorganisms, diseases and vaccines.

Who can get infected?

Scarlet fever results in fever, sore throat and rash. Typically, scarlet fever is characterized by an invasive phase that begins abruptly with high fever, poor general condition, vomiting and sometimes abdominal and joint pain. The tongue can be white and then red, raspberry color.

When group A beta-hemolytic streptococcus enters the body, this bacterium secretes substances that are toxic to the body and cause these symptoms.

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Younger children are often immune to scarlet fever. They are protected by their mother’s antibodies, which are transferred during pregnancy, via the placenta. Scarlet fever is thus rare in children under two years of age.

Scarlet fever mainly affects children from 5 to 10 years of age in the winter and causes small epidemics, which especially spread in schools, but it is not serious at all if it is under surveillance and detected early.

Dr. Robert CohenPediatrician and infectious disease doctor

What to do if your child has symptoms of scarlet fever?

From the first symptoms, the measures to be taken are the implementation of “a strepto test, a rapid diagnostic test which can be carried out by a doctor or in a pharmacy. And of course, if your child’s school has communicated about a case , the doctor will make the diagnosis faster. The idea is that when faced with angina, antibiotics are prescribed only for group A streptococcal angina,” explains the doctor.

Curative treatment should be started as early as possible. The recommended antibiotic treatment is usually amoxicillin for six days. However, the child’s general condition usually improves within 24 to 48 hours.

How is scarlet fever transmitted?

The bacteria responsible for scarlet fever is present in the secretions from the nose and throat. Contamination thus occurs through the air (coughing, sneezing, sputtering projection while talking), by carrying hands soiled with secretions from a sick person to the mouth or nose, or, more rarely, indirectly, by touching objects , recently soiled with secretions.

Sick people with scarlet fever are re-infectious as soon as the bacteria are installed in their throats, even before symptoms appear. This explains why epidemics can develop despite isolation of patients. The incubation period is usually one to four days, but it can be longer. The duration of infectiousness is 48 hours after the start of effective antibiotic treatment, but it can last two to three weeks without treatment (antibiotic).

Should we be concerned about these strep A infections?

In recent weeks, the number of children infected with streptococci A has increased significantly. At least eight children have been admitted to intensive care in different regions in the past 15 days and two child deaths have already been recorded. But if health authorities encourage doctors to perform saliva tests on all children who have symptoms of angina, “there is nothing to worry about”, insists Dr. Cohen.

“There have been serious outbreaks of scarlet fever, but today, thanks to antibiotics, if taken quickly, the disease is nothing to worry about. The only cases that can really pose a problem are in children, for whom the excretion of “toxins can be stronger. But that’s really rare and unusual,” he says.

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