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Nurses advised to remain alert to scarlet fever as cases continue to rise

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Primary care nurses are being urged to be aware of scarlet fever symptoms as Public Health England and Public Health Wales report the highest number of cases for 20 years.

Health services are currently advising nurses and other healthcare providers to be aware of the outbreak, noting any symptoms such as a sore throat or the scarlet rash that gives the disease its name.

Scarlet fever is very rare in adults. Children between the ages of five and eight being most at risk. Scarlet fever is easily treatable with antibiotics, usually penicillin unless the patient is allergic. Most cases will allow the patient to return to work or school within 24 hours of commencing treatment.

Carolyn Guilford, an advanced nurse practitioner in Leicester, has seen cases of scarlet fever recently and recommends using throat swabs for quick diagnosis and to minimise the risk of transmission. She said: 'The early stages of scarlet fever can easily be mistaken for tonsillitis or oral thrush. The patient will have a very sore throat and swollen glands in the early stages. The rash that scarlet fever is most commonly associated with may not manifest for four days, by which time the patient could have infected many others around them.'

Nurses should note that scarlet fever is a 'notifiable disease.' It is a statutory requirement that healthcare workers report a notifiable disease to the proper officer of their local authority (usually a consultant in communicable disease control).

At the moment, no reasons have been given for this sudden spike in scarlet fever cases, although a spokesperson from Public Health Wales said that the mild winter may have allowed the bacteria to transmit more easily.

Data released by Public Health England on 4 April suggests that the number of cases is continuing to rise. The week beginning 31 March had the highest weekly total of scarlet fever notifications this year (883); bringing the total to 5012. The East Midlands area hasseen the most cases, with 20.1 cases per 100,000 people. After the East Midlands, the highest rates have been in Avon, Gloucestershire and Wiltshire (15.6) and the Thames Valley (14.5). Ninety-three per cent of the notifications have been for under-15s.

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