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sharp increase in cases. Symptoms include sore throat, fever and whitish tongue

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sharp increase in cases.  Symptoms include sore throat, fever and whitish tongue

Not just syncytial and flu viruses. Returning to office, after the stop linked to the Covid pandemic, there are also other pathogens such as streptococcus, the bacterium that causes scarlet fever, an exanthematous disease of which “a significant increase in cases is occurring, especially among children in nursery schools , although fortunately there have been no invasive forms ».

Scarlet fever, what is exanthematous disease

This was explained by Susanna Esposito, coordinator of the Technical Table for Infectious Diseases and Vaccinations of the Italian Society of Pediatrics (SIP), who specifies: «Parents should not be alarmed, but it is important to swab in case of suspicious symptoms and, if positive, start antibiotic therapy within 10 days of the onset of symptoms, to avoid complications. Caused by the bacterium Group A beta-haemolytic Streptococcus, scarlet fever is an exanthematous disease for which there is an obligation to report, but there is no national monitoring register that allows precise numbers to be obtained. It is transmitted by mucus and saliva, has an incubation of 2-5 days, affects above all between the ages of 2 and 8 and the period of greatest contagion, in Italy, is from December to April. «During 2020, 2021 and 2022 – explains Esposito, professor of Pediatrics at the University of Parma – thanks to the measures put in place to curb the circulation of Sars-Cov-2, Streptococcus also circulated little. Now, in the absence of restrictions, like many other pathogens it has resumed its intense circulation. In recent weeks there have been outbreaks in nursery schools in various Italian cities. It is less dangerous than you think, but it must be treated within 10 days of its onset to avoid short- and long-term complications, such as abscesses or immune-mediated reactions, i.e. linked to a dysregulation of the immune system, such as rheumatic disease, carditis, glomerulonephritis and arthritis post-streptococcal”. The crux is the correct diagnosis.

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Scarlet fever symptoms

«Apart from sore throat and fever, scarlet fever is accompanied by a first whitish and then red discolouration of the tongue and by a rash characterized by tiny, slightly raised, bright red spots which tend to converge, giving the skin a uniformly red. The rash tends to start in the chest, then widen and accentuate in the groin and armpits. It lasts 3-4 days then the fever disappears and flaking of the skin takes over. In case of symptoms, a rapid pharyngeal swab should be performed and if positive, antibiotic therapy with amoxicillin should be started ». Furthermore, the expert concludes, “unlike other exanthematous diseases such as rubella, measles and chicken pox, there is no vaccine for scarlet fever and, once you have it, you are not immunised”. However, in recent months, this is not the first alert regarding group A beta-haemolytic Streptococcus. In December in the United Kingdom there was an alarm for 7 cases of children who died of invasive infections from group A beta-haemolytic Streptococcus This, concludes Esposito, “has led to a rethinking of their guidelines which, unlike the Italian ones, do not provide for the use of antibiotics for streptococcal pharyngotonsillitis”.

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