Scarlet fever returns: Primary schools hit by sharp rise in outbreaks as family doctors are warned to watch out for the Victorian disease

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Family doctors have been told to look out for scarlet fever as the once feared Victorian disease has made an alarming comeback.

Primary schools across Britain are being hit by the disease as the numbers of children being infected by the bug have hit a 50-year high.

Outbreaks of the highly contagious disease have risen steeply – with 6,157 new cases since September according to Public Health England.

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The pink/red rash sandpapery rash appears within a day or two, typically on the chest and stomach but then spreads to other parts of the body

Scarlet fever: Primary schools in England are being hit by a 50-year high of children contracting the disease

The figures show that 17,586 cases were reported in England in 2015, the highest total since 1967.

This compares with only 1,678 in 2005.

Health officials are unclear as to why scarlet fever has suddenly returned and blame ‘long-term natural cycles’.

But researchers in America, where cases are also on the rise, have linked it to a super-resistant and aggressive strain of bacteria. 

One school, St Michael’s Junior School in Bowthorpe, Norwich, was particularly hard hit with 12 children off sick earlier this month.

 Similar to strep throat, scarlet fever presents a red rash that turns white when compressed

Helen Newell, the school’s head said of the outbreak: ‘I think parents are naturally going to be worried about it - it’s your child. 

If you know there’s been an outbreak in Bowthorpe, they are going to be worried, but we are really trying to be hyper-vigilant, and if a child is looking unwell we are taking their temperature and looking out for them. With our deep clean, we are not leaving anything to chance.

Other schools are posting warnings on social media.

A primary school in Grimsby, Great Coates, earlier this week issued a letter to parents, and posted a warning on Facebook that the school had suffered an outbreak of the illness telling parents ‘another child in the school has scarlet fever’.

March and April are the peak time for the disease which mainly infects children aged between two and eight.

The disease causes a sore throat, fever and rash which can occasionally lead to pneumonia if not treated promptly.

If treated promptly the disease is restricted to no more than unpleasant symptoms, although in Victorian times it could be a death sentence.

Other diseases common in Victorian times which were thought to have become things of the past but are now making a comeback include cholera, whooping cough, and scurvy.

As scarlet fever is highly contagious, children or adults diagnosed are advised to stay off school or work until at least 24 hours after the start of antibiotic treatment.

Contagious: The disease is contagious and experts say infected children should be kept home from school

Early signs: Potential complications include ear infection, throat abscess and pneumonia. Early signs are sore throat, headache and fever with pink/red sandpapery rash on the chest and stomach that then spreads

Scarlet fever was very common in the 19th and early 20th centuries but cases dramatically reduced during the last century, partly due to better hygiene.

Health officials are unclear as to why it has suddenly returned and blame ‘long- term natural cycles’.

Dr Theresa Lamagni, Public Health England’s head of streptococcal infection surveillance, said: ‘Parents can play a key role in recognising when their child needs to be seen by their GP.

‘Early signs to look out for are sore throat, headache and fever with the characteristic pinkish/red sandpapery rash appearing within a day or two, typically on the chest and stomach but then spreading to other parts of the body.

‘Individuals who think they or their child may have scarlet fever should seek advice from their GP without delay as prompt antibiotic treatment is needed.

‘Symptoms usually clear up after a week and the majority of cases will resolve without complication as long as the recommended course of antibiotics is completed.’

Potential complications include ear infection, throat abscess and pneumonia. Patients who do not show signs of improvement within a few days of starting treatment should seek urgent medical advice, PHE advised.

Experts say the disease was far more deadly in the Victorian era as it was caused by a different strain of bacteria, which was later eradicated. During the period there were around 100,000 cases a year and up to 20,000 deaths. 

Scarlet fever was very common in the 19th and early 20th centuries and became a feature in classic children's tales, but cases dramatically reduced during the last century, partly due to better hygiene

Dr Lamagni said: ‘There’s no suggestion what we are seeing now is anything like during the Victorian era. Scarlet fever itself isn’t serious. We are not worried in the sense that we are likely to see a lot of problems – but it is of concern because this bacteria can be nasty for some people.’

She advised parents to look out for a rash, usually starting on the back, a temperature and the child complaining of headache and nausea.

‘Look out for symptoms and if the child has got these symptoms, go and see your GP,’ she said. ‘If you are given antibiotics, make sure you finish them.’

The disease is caused by the bacteria group A streptococcus and is spread through coughs and sneezes or touching contaminated objects.

In most cases it clears up by itself but GPs may prescribe penicillin if symptoms are particularly nasty or there is a risk of complications.

Scarlet fever usually develops after a sore throat or a skin infection caused by the same bacteria