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A rare case of what Strep can evolve to

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Dr. Saad works for the Department of Infectious Disease Epidemiology at the Robert Koch Institute in Berlin, Germany.

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The Department of Infectious Disease Epidemiology is responsible for the collection analysis and epidemiological assessment of data communicated to the RKI according to infection protection act (Infektionsschutzgesetz, IfSG).

The Department further conducts research in infectious disease epidemiology as well as sentinel surveillance projects and supports the Federal States in the investigation and management of outbreaks.

The Department of Infectious Disease Epidemiology also represents the RKI in networks of the EU and WHO and maintains an information exchange with international partners ( e.g. public health institutions within the EU, CDC).

Tasks (Official duties)

Coordination of General Tasks

Investigation of national outbreaks at the request of the Federal States

Investigation of international outbreaks at the request of the WHO, other international organisations or individual states

Continuous monitoring and evaluation of the epidemiological situation of infectious diseases (surveillance)

Awareness of statutory tasks in the area of infection control

Research and development of methods in the field of infectious disease epidemiology

Implementation and support of outbreak investigations

Development and evaluation of prevention and intervention strategies

Development of evidence-based recommendations for the Public Health

Support and consultation of partners in the public health service and policymakers at the county, state and federal level

Exchange with other national and international health authorities

Information of professional public

Training and development in public health with a focus on infectious disease epidemiology

Training in Infectious Disease Epidemiology

Commissions

Scientific Office of the Permanent Vaccination Commission (STIKO) (see. § 20 IfSG)
Functional Responsibility - Unit 33

Scientific Office of the National Verification Commission - Measles / Rubella
Functional Responsibility - Unit 33

Scientific Office of the Scientific Advisory Board for Public Health Microbiology
Functional Responsibility - Section 3, Head Office

Scientific Office of the Expert Advisory Group Influenza
Functional Responsibility - Unit 36

Scientific Office of the Commission Anti-Infectives, Resistance and Therapy (ART)
Functional Responsibility - Unit 37

Representation of the RKI in National Committees

Committees of the Working Group of the Supreme Health Authorities (AOLG) concerning Infectious Disease Epidemiology

Federal-State Working Group Infection Protection Act (IfSG)

Federal-State Committee for Coordination of Activities of the HIV / STI Education

National AIDS Council, in the field of Infectious Disease Epidemiology

Bureau of the German Central Committee against Tuberculosis

Representation of the RKI in International Committees

European Programs for Intervention Epidemiology Training (EPIET)

Steering Committee of Programs Directors TEPHINET (Training Programs in Epidemiology and Public Health Interventions Network)

Council of European State Epidemiologists (CESE)

Network Committee for Communicable Diseases of the European Commission (Decision no. 2119/98 / EG)

Expert Group of the European Monitoring Centre for Drugs and Drug Addiction

Global Health Security Action Group (GHSAG)

Pandemic Influenza Working Group (PIWG)

Projects and Networks

Working Group Influenza (Arbeitsgemeinschaft Influenza, AGI), GrippeWeb

Food- and Water-borne Diseases Network (FWD / ECDC)

Legionella Network (ELDSNet)
Functional Responsibility - Unit 36

European Tuberculosis Surveillance Network
Functional Responsibility - Unit 36

European Surveillance of Antimicrobial Consumption Network (ESAC-Net)
Functional Responsibility - Unit 37

European Antimicrobial Resistance Surveillance Network(EARS-Net)
Functional Responsibility - Unit 37

European Influenza Surveillance Network (EISN)
Functional Responsibility - Unit 36

HIV-Seroconversion Network (CASCADE)
Functional Responsibility - Unit 34

European Surveillance System (TESSy)
Functional Responsibility - Unit 32

(EU-) Early Warning and Response System (EWRS)
Functional Responsibility - Unit 32

International Health Regulations (IHR), Call for Tender, REACT
Functional Responsibility - Unit 32

KV-Sentinel

Information Centre

The Department is associated with an information centre, that is responsible for the Infection Protection Act (IfSG)-related information for professionals and the professional public.

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Department 3: Infectious Disease Epidemiology

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The Department of Infectious Disease Epidemiology is responsible for the collection analysis and epidemiological assessment of data communicated to the RKI according to infection protection act (Infektionsschutzgesetz, IfSG). The Department further conducts research in infectious disease epidemiology as well as sentinel surveillance projects and supports the Federal States in the investigation and management of outbreaks.

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In the article, "Scarlet fever outbreak in a primary and middle school in Germany: importance of case ascertainment and risk communication" shows a recent outbreak in a school. 13 of the 19 cases were Scarlet fever.  The outbreak wasn't too extreme but communication between the school and parents could have been better.

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There is no vaccine for Scarlet fever so the best way to prevent it is practicing good hygiene because group Strep A lives in and on us.

wash your hands

cover mouth and nose when you cough or sneeze

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Diagnosis: Scarlet fever is diagnosed by using a rapid antigen detection test from a throat swab. If the test comes back negative, a throat culture can be done to find any infection that the rapid test missed.
Treatment: If a patient has scarlet fever, antibiotics are prescribed (penicillin or amoxicillin)

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1. Very high fever and symptoms of fever.
2. White coating on tongue or red and bumpy strawberry-like tongue, and a red, sore and irritated throat.
3. Red rash on skin that starts in small blotchy areas and can spread all over the body. The rash has a sandpaper feel.

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Scarlet Fever is an infection caused by a bacteria called Group A Streptococcus pyrogenes. The bacteria releases an exotoxin and is beta hemolytic, which means there is complete lysis, or destruction of blood cells.

Scarlet fever mostly affects those ages 5-15 and is passed through respiratory droplets, so coming in close contact with someone that has a Strep A infection can pass it on.

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Scarlet fever, also known as scarlatina, is an infectious disease caused by Streptococcus pyogenes, a Group A streptococcus (GAS).[3] The infection is a type of Group A streptococcal infection (Group A strep). It most commonly affects children between five and 15 years of age.[1] The signs and symptoms include a sore throat, fever, headache, swollen lymph nodes, and a characteristic rash.[1] The face is flushed and the rash is red and blanching.[5] It typically feels like sandpaper and the tongue may be red and bumpy.[1] The rash occurs as a result of capillary damage by exotoxins produced by S.pyogenes.[6] On darker-pigmented skin the rash may be hard to discern.[7]

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If your child has a sore throat and a rash, it may be scarlet fever (also called scarlatina). Your child's doctor can do a quick strep test to find out.

If your child has scarlet fever, antibiotics can help your child feel better faster and prevent long-term health problems. Antibiotics can also help protect others from getting sick.

Bacteria cause scarlet fever

Bacteria called group A Streptococcus (group A strep) cause scarlet fever. These bacteria are also the cause of strep throat. The bacteria sometimes make a toxin (poison), which causes a rash - the "scarlet" of scarlet fever.

How you get scarlet fever

Group A strep bacteria are very contagious. Generally, people spread the bacteria to others through

Respiratory droplets

Direct contact

Rarely, people can spread group A strep bacteria through food that is not handled properly (visit CDC's food safety page).

It usually takes two to five days for someone exposed to group A strep bacteria to become sick with strep throat or scarlet fever.

Respiratory droplets

Group A strep bacteria often live in the nose and throat. People who are infected spread the bacteria by talking, coughing, or sneezing, which creates respiratory droplets that contain the bacteria.

People can get sick if they:

Breathe in respiratory droplets that contain the bacteria

Touch something with those droplets on it and then touch their mouth or nose

Drink from the same glass or eat from the same plate as a person infected with group A strep

Direct contact

People can also spread group A strep bacteria from infected sores on their skin. Other people can get sick if they:

Touch sores on the skin caused by group A strep (impetigo) or come into contact with fluid from the sores

People are contagious even with no symptoms

Some people infected with group A strep do not have symptoms or seem sick. People who are sick with strep throat are more contagious than those who do not have symptoms.

Rash and fever are common symptoms

In general, scarlet fever is a mild disease. Illness usually begins with a fever and sore throat.
General symptoms
Some symptoms of scarlet fever are common to other infections, too. These may include:

Fever (101°F or higher) or chills

Sore throat and pain when swallowing

Headache or body aches

Stomach pain

Nausea or vomiting

Physical signs
Some physical signs are typical of scarlet fever. These show in the following areas:

Physical signs

Tongue, throat, and neck

Signs in these areas:

Whitish coating on the tongue, early in the illness

"Strawberry" (red and bumpy) tongue

Very red throat

Red and swollen tonsils

White patches or streaks of pus on the tonsils

Tiny, red spots on the roof of the mouth, called petechiae

Swollen lymph nodes in the front of the neck

The illustrations below show what these physical signs usually look like.

Skin rash

Signs of scarlet fever rash:

Red rash that feels rough like sandpaper

Brighter red skin in the creases of the underarm, elbow, and groin

A pale area around the mouth

Skin peeling as the rash fades

One to 2 days after the illness begins, a red rash usually appears. However, the rash can appear before illness or up to 7 days later.

The rash may first appear on the neck, underarm, and groin (the area where your stomach meets your thighs). Over time, the rash spreads over the body. The rash usually begins as small, flat blotches that slowly become fine bumps that feel like sandpaper.

Although the cheeks might look flushed (rosy), there may be a pale area around the mouth. Underarm, elbow, and groin skin creases may become brighter red than the rest of the rash.

The rash from scarlet fever fades in about 7 days. As the rash fades, the skin may peel around the fingertips, toes, and groin area. This peeling can last up to several weeks.

Some people are at increased risk

Anyone can get scarlet fever, but there are some factors that can increase the risk of getting this infection.

Age

Scarlet fever, like strep throat, is more common in children than adults. It is most common in children 5 through 15 years old. It is rare in children younger than 3 years old. Adults who are at increased risk for scarlet fever include:

Parents of school-aged children

Adults who are often in contact with children

Group settings

Close contact with another person with scarlet fever is the most common risk factor for illness. For example, if someone has scarlet fever, the bacteria often spread to other people in their household.

Infectious illnesses tend to spread wherever large groups of people gather. Crowded settings can increase the risk of getting a group A strep infection. These settings include:

Schools

Daycare centers

Military training facilities

Doctors can test for and treat scarlet fever

Many viruses and bacteria can cause an illness that includes a red rash and sore throat. A doctor will determine what type of illness you have by asking about symptoms and doing a physical exam. If they think you might have scarlet fever, they will swab your throat to test for strep throat. There are two types of tests for strep throat: a rapid strep test and throat culture.

Rapid strep test

A rapid strep test involves swabbing the throat and running a test on the swab. The test quickly shows if group A strep bacteria are causing the illness.

If the test is positive, doctors can prescribe antibiotics.

If the test is negative, but a doctor still suspects scarlet fever, then the doctor can take a throat culture swab.

Throat culture

A throat culture takes time to see if group A strep bacteria grow from the swab. While it takes more time, a throat culture sometimes finds infections that the rapid strep test misses.

Culture is important to use in children and teens since they can get rheumatic fever from an untreated scarlet fever infection. For adults, it is usually not necessary to do a throat culture following a negative rapid strep test. Adults are generally not at risk of getting rheumatic fever following scarlet fever.

Antibiotics are used for treatment

Doctors treat scarlet fever with antibiotics. Benefits of antibiotics include:

Decreasing how long someone is sick

Decreasing symptoms (feeling better)

Preventing the bacteria from spreading to others

Preventing serious complications like rheumatic fever

When to return to work, school after illness
People with scarlet fever should stay home from work, school, or daycare until they:

AND

Have taken antibiotics for at least 12 to 24 hours; ask the doctor how long you should stay home after starting antibiotics

Antibiotic dos and don'ts

1. Do take the prescription exactly as the doctor says to.

2. Don't stop taking the medicine, even if you or your child feels better, unless the doctor says to stop.

You can find more guidance on taking antibiotics on CDC's Antibiotic Do's & Don'ts Page.

Long-term health problems are not common

Complications can occur after having scarlet fever. This can happen if the bacteria spread to other parts of the body. Complications can include:

Treatment with antibiotics can prevent most of these health problems.

Protect yourself and others

People can get scarlet fever more than once. Having scarlet fever does not protect someone from getting it again in the future. While there is no vaccine to prevent scarlet fever, there are things people can do to protect themselves and others.

Good hygiene

The best way to keep from getting or spreading group A strep is to wash your hands often. This is especially important after coughing or sneezing and before preparing foods or eating.

To prevent group A strep infections, you should:

Cover your mouth and nose with a tissue when you cough or sneeze.

Put your used tissue in the waste basket.

Cough or sneeze into your upper sleeve or elbow, not your hands, if you don't have a tissue.

Wash your hands often with soap and water for at least 20 seconds.

Use an alcohol-based hand rub if soap and water are not available.

You should also wash glasses, utensils, and plates after someone who is sick uses them. These items are safe for others to use once washed.

Antibiotics

Antibiotics help prevent someone with strep throat from spreading the bacteria to others.

Related diseases

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If your child has a sore throat and rash, it may be scarlet fever, a group A strep infection. Do you know the symptoms of this contagious illness and treatment options?

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Streptococcus pyrogenes