The Centre for Health Protection (CHP) of the Department of Health today (December 18) appealed to parents, schools/institutions and healthcare professionals for heightened vigilance against scarlet fever (SF) as its activity has been increasing in the past few weeks.
A spokesman for the CHP said, "SF is transmitted through either respiratory droplets or direct contact with infected respiratory secretions and mostly affects children."
According to the CHP's surveillance data, SF activity has been increasing in the past few weeks. The weekly number of SF cases increased from 16 in the week between November 17 and 23 to around 40 in the subsequent two weeks, and further increased to 78 in the week between December 8 and 14. In the first three days of this week (as of December 17), 46 cases had been reported. Regarding SF outbreaks in schools/institutions, as of yesterday (December 17), seven clusters affecting a total of 18 children were recorded in this month.
A total of 1 351 SF cases were reported to the CHP in the first 11 months this year. They comprise 776 males and 575 females aged from 5 months to 64 years (median: 6 years), with the majority (1 250, 92.5 per cent) aged 10 years or below. Most presented with mild illnesses. Among them, 425 cases (31.5 per cent) required hospitalisation, with two cases requiring admission to intensive care units. In 2019, one fatal case has been recorded so far.
The spokesman said, "Locally, while SF has occurred all year round, a seasonal pattern for SF in Hong Kong with higher activity was observed from May to June and from November to March in the past few years. Based on the past epidemiological pattern, we predict that SF activity will remain at a higher level in the coming few months. Parents should take good care of their children in maintaining strict personal, hand and environmental hygiene."
Letters to doctors, hospitals and schools will be issued to alert them to the latest situation. Schools should promptly make a report to the CHP in case of a rise in respiratory illnesses or absentees for immediate epidemiological investigations and outbreak control by the CHP.
SF is a bacterial infection caused by Group A Streptococcus. It usually starts with a fever and sore throat. Headache, vomiting and abdominal pain may also occur. The tongue may have a distinctive strawberry-like (red and bumpy) appearance. A sandpaper texture-like rash would commonly begin on the first or second day of onset over the upper trunk and neck before spreading to the limbs. The rash is usually more prominent in the armpits, elbows and groin areas. It usually subsides after one week and is followed by skin peeling over fingertips, toes and groin areas.
SF is sometimes complicated with middle ear infection; throat abscess; chest infection; meningitis; bone or joint problems; damage to the kidneys, liver and heart; and, rarely, toxic shock syndrome. SF can be effectively treated by appropriate antibiotics. People suspected to have SF should consult a doctor promptly.
There are no vaccines available against SF. Members of the public are advised to take heed of the health advice below:
- Maintain good personal and environmental hygiene;
- Always keep hands clean and wash with liquid soap when they are dirtied by mouth and nasal discharges;
- Cover your nose and mouth with a tissue paper while sneezing or coughing and dispose of soiled tissues into a lidded rubbish bin properly;
- Avoid sharing personal items such as eating utensils and towels;
- Maintain good ventilation; and
- Children suffering from SF should refrain from attending school or child care settings until the fever has subsided and they have been treated with antibiotics for at least 24 hours.
The public may visit the CHP's SF page for more information.
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