Scarlet Fever Outbreak In England Leaves Researchers Confused: ‘We’re Concerned’

Scarlet fever cases are now at 50-year-high sparking concerns for researchers, as they are baffled as to how “Victorian-era” diseases are making a comeback. The disease has been on the rise since 2014, and researchers are failing to find the cause.

Scarlet fever hit its highest level in England for 50 years, with more than 17,000 cases reported in 2016 according to research in the Lancet. The infection is most common in children under the age of 10 and although highly contagious (being spread easily with a cough) is easily cured with a round of antibiotics. But that, in and of itself, raises concerns of the disease becoming resistant to antibiotics, creating a global pandemic.

Doctors are urging the public to be aware of symptoms, which include a rosy rash, and seek help from their doctor. Data for 2017 suggests the rate of infection may be falling, but experts remain cautious, saying it is “too early to tell.” Normally, first world nations have a better chance of handling an outbreak such as this, but England is on the verge of losing control over this scarlet fever outbreak.

A joint investigation by public health authorities from across England and Wales found that the incidence of scarlet fever tripled between 2013 and 2014, rising from 4,700 cases to 15,637 cases. In 2016, there were 19,206 reported cases, the highest level since 1967. The majority of the outbreaks were in England.

“We are concerned – it’s quite a dramatic rise,” said Dr. Theresa Lamagni, head of streptococcal surveillance at Public Health England, who led the study. “We’ve always seen cases of scarlet fever – it’s just the scale in the past has been much lower than the last few years.” Dr. Lamagni described the soaring number of cases of scarlet fever as “baffling”, adding that no underlying causes had been identified. She stressed that the individual cases of the disease are “not any more serious than previously – it’s just a question of scale.”

Scarlet fever was a common cause of death in the Victorian era but had largely been in decline since the introduction of antibiotics. As with any bacterial infection, prompt treatment remains essential to prevent both the spread of the disease and the risk of further complications such as pneumonia and liver damage. Anyone diagnosed with scarlet fever is advised to stay at home until at least 24 hours after the start of treatment to avoid passing on the infection.

There is no vaccine against the disease and all cases must be reported by doctors to the local health authority. Molecular genetic testing has ruled out a newly emerged strain of the infection. Additionally, there has not been any suggestion that the disease has become resistant to the penicillin normally used to treat it – yet.

Doctors: Maybe You Shouldn’t Finish that Course of Antibiotics After All

All your life, you’ve been told to finish a course of antibiotics, even if you’re feeling better. But now that antibiotic resistance has become such a serious problem, some British doctors are questioning whether that advice is doing more harm than good. [1]

Health experts from Brighton and Sussex Medical School, the University of Oxford, and other institutions write in an analysis in the BMJ that there is no evidence to support the notion that cutting short a course of antibiotics encourages drug resistance. In fact, they said, it’s taking more antibiotics than needed that leads to resistance.

According to the doctors, the belief that not finishing antibiotics leads to resistance “can be traced back to the dawn of the antibiotic era.” Alexander Fleming, the discoverer of penicillin, spoke in 1945 about a man who didn’t take enough of the antibiotic and passed a now-resistant form of strep throat on to his wife, who died from the infection.

Read: The Problem of Antibiotic Resistance is Getting Much Worse

Fleming said at the time:

“If you use penicillin, use enough!”

However, as the doctors note in their analysis, Streptococcus bacteria has never been shown to develop resistance to penicillin. Furthermore, other early observations have yet to be proven by modern research.

Tim Peto, professor of medicine at the University of Oxford and a co-author of the article, said:

“No one has questioned (this advice) for all this time. In the scientific world, it’s an accepted view that there is too much usage of antibiotics and we want to minimize that. We want to only give them to people who need antibiotics to get better.” [2]

What has been proven, according to the authors of the opinion piece, is that taking antibiotics unnecessarily contributes to drug-resistance. And that’s whether you take them when they’re not needed – such as when you have a viral illness – or if you continue taking them after you feel better. [1]

As you might imagine, after more than 70 years of patients being told to finish their antibiotics, the topic is extremely controversial. That’s OK, though – the authors don’t want the medical community to immediately implement the new advice. More research is necessary, they said, and even if the advice was implemented, it might not apply to every single person.

Study: People Save Antibiotics for Later Use, and It Isn’t Good

Peto said:

“We’re not at all saying that patients should stop when they feel like it or that patients should ignore their doctor’s advice.”

Really, Peto said, there’s “not enough knowledge” for doctors to know how long antibiotics should be prescribed for. That’s why it’s too early to tell people to stop taking their medicine.

You’d think that after more than 7 decades, we’d understand a bit more about antibiotics, though.

A professor of infectious diseases at Imperial College London, Alison Holmes said:

“It remains astonishing that apart from some specific infections and conditions, we still do not know more about the optimum duration of courses or indeed doses in many conditions, yet this dogma has been pervasive and persistent.” [3]

Sources:

[1] Time

[2] CNN

[3] The Guardian

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About Julie Fidler:
	Julie Fidler is a freelance writer, legal blogger, and the author of Adventures in Holy Matrimony: For Better or the Absolute Worst. She lives in Pennsylvania with her husband and two ridiculously spoiled cats. She occasionally pontificates on her blog.