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


Typical 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 contracting scarlet fever, particularly in schools, in France. These invasive group A streptococcal infections occurred mainly in certain regions: Occitania, 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 old. Public Health France issued a warning this week, in the face of serious cases and deaths in the past two weeks. Should we be alarmed? make the point.

What does it have to do with streptococci?

“What you need to know is that scarlet fever is benign, but it’s not a virus, it’s a bacterium”, explains on pediatrician and infectious disease specialist Robert Cohen. “The disease comes from group A streptococcus, or a set of group A streptococci, capable of secreting toxins that give scarlet fever,” he explains.

“Infections with streptococci A (Streptococcus pyogenes) are frequent”, recalls, for its part, the Pasteur Institute. This bacterium is part of the commensal flora (Editor’s 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 people 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 be infected?

Scarlet fever results in fever, sore throat and rash. Typical 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 then red, raspberry color.

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

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

Scarlet fever mainly affects children from 5 to 10 years old during the winter, causing small epidemics which spread in particular at school, but it is not serious, at all, if it is under surveillance and detected early.

Dr. Robert CohenPediatrician and infectiologist

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

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

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

How is scarlet fever transmitted?

The bacterium responsible for scarlet fever is present in the secretions of the nose and pharynx. Contamination thus occurs through the air (coughing, sneezing, sputters projected while speaking), by carrying hands soiled by the secretions of a sick person, in their mouth or nose, or, more rarely, indirectly, by touching objects recently soiled with secretions.

Sick people with scarlet fever become contagious in turn as soon as the bacteria is installed in their pharynx, even before the appearance of symptoms. This explains why epidemics can develop despite the isolation of patients. The incubation period is usually one to four days, but it can be longer. The duration of contagiousness is 48 hours after the start of effective antibiotic therapy, but it can last two to three weeks in the absence of treatment (antibiotic).

Should we be worried about these strep A infections?

In recent weeks, the number of children infected with streptococcus A has increased significantly. At least eight children have been admitted to intensive care in different regions over the past 15 days and two child deaths have already been recorded. But, if the health authorities encourage doctors to carry out saliva tests in all children who present 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 secretion of toxins can be stronger. But it’s really rare and exceptional, ”he says.

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