Public health specialists have today asked the medical community to be on the lookout for a re-occurring bout of Scarlet fever - a disease responsible for thousands of deaths in the 19th century.
In 2008, England and Wales recorded as many as 3,000 incidents of the disease - the largest amount in ten years.
The Health Protection Agency are on high alert to ensure an “enhanced surveillance” is put in place to monitor cases of the disease and identify any changes.
Winter traditionally sees a higher incidence of infections but over the last two months the HPA have reported that the number of cases have been “above that seasonally expected”.
Regional health protection staff and consultant microbiologists have been advised to be on alert. In addition hospital emergency wards and GP surgeries will soon receive a letter warning them to be vigilant in spotting the disease.
Scarlet fever, otherwise known as Scarletina, occurs when a host is infected by a bacterium, Group A Streptococcus, which is responsible for the majority of bacterial sore throat (”strep throat”). Possible symptoms associated with Scarlet fever include a sore throat, fever and swollen glands.
Normally the disease is not serious and treatable by antibiotics. However, the infection can lead to other illnesses including pneumonia, throat abscess, sinusitis and meningitis.
In rarer incidents, the fever can develop into a deadly invasive state, resulting in necrotising fasciitis (the “flesh eating” bug), septicaemia and toxic shock syndrome. However there is a concern that the number of incidents of invasive strep A is on the rise, with one in four people dying as a result. People most as risk include those who have a weak immune system or who are already very ill - however it just depends on the type and strain of the infection.
Scarlet fever epidemics were rife in the 19th and 20th centuries and in 1914 of those infected, 5 per cent were killed by the disease.
Victims of the virus were forced to live in isolation for weeks while their clothes and bedding were destroyed to avoid contagion. The number of cases has dropped dramatically over the last century, although scientists are not entirely sure why.
It is known that the disease works in a cyclical pattern, increasing and decreasing approximately every four years - this also goes for the severe invasive strain of the disease. The number of cases recorded over the last ten years has been 1,600 and 2,500 each year, but 2008 saw 2,913 incidents. Theresa Lamagni and colleagues from the HPA say in the journal Eurosurveillance, “It is possible the significant influenza activity this winter may be contributing by increasing transmission … and/or rendering individuals with influenza more susceptible …”
The disease may also be evolving into something much more concerning. The authors note that doctors have not recorded any strange strains of the virus, but it is thought that the amount of infections occurring by one of the more deadly strains is rising.