Scarlet fever on the rise in Cornwall

Cornwall has seen one of the biggest rises in the number of scarlet fever cases in the UK, new figures have shown. The disease, associated with Victorian times, has seen a resurgence in the UK of late.

Health experts at NowPatient submitted Freedom of Information (FoI) requests to NHS trusts across the country to reveal which areas have seen the biggest increase in Victorian diseases such as gout, rickets, tuberculosis, malnutrition, malaria and scarlet fever, as well as analysing search data to reveal which areas of the UK have the most curious residents when it comes to these illnesses.

Cornwall may not be a hotspot for rickets or gouts but its main hospital has seen one of the biggest increases in scarlet fever in England. According to the FoI figures returned by NHS trusts, there were 10 cases of scarlet fever at the Royal Cornwall Hospital in Truro in 2019 but 16 in 2023.

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By comparison, there were 2.3 cases per 100,000 children aged one to four compared to an average of 0.5 in the pre-pandemic seasons (2017 to 2019) and 1.1 cases per 100,000 children aged five to nine compared to the pre-pandemic average of 0.3 (2017 to 2019) at the same time of the year.

While not dramatic compared with other parts of the UK, the more recent increase in cases still represents a 60 per cent increase, putting the hospital in fifth place in the UK. In first place was the Chelsea and Westminster Hospital with a 300 per cent increase in that period, followed by Northern Lincolnshire and Goole with a 200 per cent increase and Mid and South Essex and a 142.9 per cent increase in third place. Just ahead of RCHT was Calderdale and Huddersfield with a 100 per cent rise in cases.

Nationally, more than 12,000 cases of scarlet fever have been notified in the UK between January 1 and March 24. The number is higher than average for the previous five years - however below that recorded in 2023 when there were 15,933 notified cases for the same period. Health chiefs are urging people to be aware of the signs and if they believe they might have the disease then to seek medical help.

Navin Khosla, pharmacist at NowPatient, said: "Scarlet fever, once a significant threat to public health, particularly in Britain's early 20th century, has witnessed a remarkable decline not only in cases but also in severity and mortality rates over the past century - though it has not been completely eradicated.

"In recent years, despite the overall decline in severity, scarlet fever has emerged as a concern once more, with a notable resurgence in reported cases. Therefore, early recognition of signs is imperative, as it minimises the potential for complications and ensures effective containment of the disease within communities."

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Caused by the group A strain of the streptococcus bacteria, scarlet fever presents with a distinct set of symptoms, typically starting with flu-like manifestations such as high fever, sore throat, and swollen neck glands. However, its tell-tale sign is the appearance of a rash, characterised by small, raised bumps initially appearing on the chest and abdomen before spreading across the body.

This rash imparts a rough texture to the skin, resembling sandpaper, often accompanied by a white coating on the tongue, which subsequently peels away to reveal a swollen, red surface speckled with tiny bumps, also known as "strawberry tongue".

Mr Khosla added: "While scarlet fever predominantly affects children, it can also affect adults, albeit less frequently. Early recognition of symptoms is crucial, as timely administration of antibiotics plays a pivotal role in preventing further complications and reducing the risk of transmission. Despite its contagious nature, scarlet fever is generally not deemed a severe illness today, given appropriate medical intervention. However, rare instances of invasive Group A Streptococcal disease (iGAS) can pose significant health risks, including septic arthritis, pneumonia, meningitis, and toxic shock syndrome."

As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement. Contact NHS 111 or your GP if:

  • your child is getting worse

  • your child is feeding or eating much less than normal

  • your child has had a dry nappy for 12 hours or more or shows other signs of dehydration

  • your baby is under 3 months and has a temperature of 38°C, or is older than 3 months and has a temperature of 39°C or higher

  • your baby feels hotter than usual when you touch their back or chest, or feels sweaty

  • your child is very tired or irritable

Call 999 or go to A&E if:

  • your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs

  • there are pauses when your child breathes

  • your child’s skin, tongue or lips are blue

  • your child is floppy and will not wake up or stay awake

Good hand and respiratory hygiene are important for stopping the spread of many bugs. By teaching your child how to wash their hands properly with soap for 20 seconds, using a tissue to catch coughs and sneezes, and keeping away from others when feeling unwell, they will be able to reduce the risk of picking up or spreading infections.