La scarlatine typique se caractérise par une phase d’invasion qui débute brusquement par une fièvre élevée, une altération de l’état général, des vomissements et parfois des douleurs abdominales et articulaires

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, the children have been contracting scarlet fever, particularly in schools, in France. These invasive group A streptococcal infections it 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 of age. Public Health France issued a warning this week, facing serious cases and deaths in the past two weeks. Should we be alarmed? Make the point.

What does it have to do with strep?

“What you have to know is that scarlet fever is benign, but it is not a virus, it is a bacterium,” he explains in pediatrician and infectious disease specialist Robert Cohen. “The disease comes from group A streptococci, or a group of group A streptococci, capable of secreting toxins that cause scarlet fever,” he explains.

“Streptococcal A (Streptococcus pyogenes) infections are frequent,” recalls the Pasteur Institute. This bacterium is part of the commensal flora (Editor’s Note: complex set of bacteria, protozoa, viruses and fungi located under the superficial layer of the skin, the skin microbiota, and on a large part of the mucosa) and only causes symptoms in certain conditions (opportunistic pathogen) or in people at risk.

Streptococcus A is responsible for many benign infections (angina, impetigo) but it can also be responsible for sometimes fatal invasive infections (toxic shock syndrome, necrotizing fasciitis)”, stresses the foundation dedicated to the study of biology, microorganisms , diseases and vaccines. .

Who can be infected?

Scarlet fever causes 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, and then red, raspberry color.

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

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

Scarlet fever mainly affects children between the ages of 5 and 10 during the winter, causing small epidemics that spread mainly at school, but it is not serious at all if it is monitored and detected early.

doctor robert cohenPediatrician and infectologist

What to do if your child has scarlet fever symptoms?

From the first symptoms, the measures to be taken are to carry out “a strepto-test, a rapid diagnostic test that can be carried out by a doctor or in a pharmacy. And obviously, if your child’s school has reported a case, the doctor will make the diagnosis faster. The idea is that in case of angina antibiotics are prescribed only for group A streptococcal angina”, explains the doctor.

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

How is scarlet fever transmitted?

The bacteria responsible for scarlet fever is present in secretions from the nose and pharynx. Contamination thus occurs through the air (coughing, sneezing, sputtering projected when speaking), by carrying hands dirty with the secretions of a patient, in the mouth or nose, or, more rarely, indirectly, by touching freshly soiled with secretions.

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

Should we worry about these strep A infections?

In recent weeks, the number of children infected with strep A has increased significantly. At least eight children have been admitted to intensive care in different regions in the past 15 days and two child deaths have already been recorded. But if health authorities encourage doctors to perform saliva tests on all children with angina symptoms, “there’s nothing to worry about,” Dr. Cohen insists.

“There have been serious bouts of scarlet fever, but today, thanks to antibiotics, if taken quickly, the disease is not a cause for concern. The only cases that can really be a problem are children in which the secretion of toxins can be stronger. But it’s really rare and exceptional,” she says.

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