Scarlet fever and Group A strep infections

Guidance for parents and teachers on recognising the symptoms, managing the spread and confirmed cases of scarlet fever and Group A strep


  1. Overview
  2. Symptoms of Scarlet fever and Strep A
  3. Managing the spread
  4. Managing confirmed cases
  5. How to help prevent Strep A


There has been an increased number of cases of Group A streptococcus (Strep A) reported in comparison to previous years.

Group A streptococcus (GAS) is a common bacteria. Lots of us carry it in our throats and on our skin and it doesn't always result in illness. However, GAS does cause several infections, some mild (such as scarlet fever) and some more serious.

For more information on Scarlet Fever and Group Strep A Infections see GOV.UK: Scarlet fever and GOV.UK: Group A strep.

Symptoms of Scarlet fever and Strep A

Strep A infections can cause a range of symptoms that parents should be aware of, including:

  • Sore throat
  • Headache
  • Fever
  • A fine, pinkish or red body rash with a sandpapery feel
  • On darker skin the rash can be more difficult to detect visually but will have a sandpapery feel

Managing the spread

If a child becomes unwell with these symptoms, parents are advised to contact their GP practice or contact NHS 111 (which operates a 24/7 service) to seek advice.

If a child has scarlet fever, parents are advised to stay at home until at least 24 hours after the start of antibiotic treatment to avoid spreading the infection to others.

Parents should trust their own judgement. If their child seems seriously unwell with one or more of these symptoms, call 999 or go to A&E:

  • a child is having difficulty breathing - you may notice grunting noises or their tummy sucking under their ribs
  • there are pauses when a child breathes
  • a child's skin, tongue or lips are blue. More information can be found at NHS: Blue skin or lips (cyanosis)
  • a child is floppy and will not wake up or stay awake

Managing confirmed cases

Early years settings and schools should contact their UKHSA health protection team if there is an outbreak of 2 or more scarlet fever cases within 10 days of each other and the affected individuals have a link, such as being in the same class or year group.

For further information for staff on how and when to do this see GOV.UK: Managing outbreaks and incidents.

If there are confirmed or suspected cases in an education or childcare setting, there is no reason for children to be kept at home if they are well.

How to help prevent Strep A

To prevent the spread of Strep A, UKHSA advises children, young people, and staff to implement good hand and respiratory hygiene practices.

For further guidance see: