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High scarlet fever activity

     The Centre for Health Protection (CHP) of the Department of Health today (December 18) urged members of the public to maintain vigilance against scarlet fever as scarlet fever activity has been high recently.

     A spokesman for the CHP said that the number of scarlet fever cases reported to the CHP up to December 14 this year reached 1,445, which is approaching the annual number of cases recorded last year. The number of reports has increased gradually from 36 cases recorded in September, to 66 cases in October and 134 cases in November. In December (as of December 14) the CHP has recorded 53 cases.

     Among the 1,445 cases, the ages ranged between 1 month and 59 years old. Eighty-nine per cent of all cases were children under 10 years old. Most cases presented with mild illness and their characteristics were similar to cases reported in previous years. One fatal case of scarlet fever was recorded this year (up to December 14). In 2012, the CHP recorded nine severe cases of scarlet fever with complications including toxic shock syndrome (five cases), septic shock (two cases), shock (one case) and sepsis (one case), affecting six males and three females with ages ranging from 2 to 17 years old.

     So far, there have been 31 institutional outbreaks in 2012 involving 22 kindergartens/child care centres and nine primary schools. A total of 69 persons were affected, with two to four persons involved in each outbreak.

     The spokesman said, "There may be an increase in scarlet fever activity in the coming months and we have to watch out for severe/fatal cases. People who are suspected to have scarlet fever should consult their doctors."

     Laboratory surveillance data on Group A Streptococcus (GAS) isolates showed that the most frequent emm types observed in 2012 so far are type 12 and type 1 and no significant genetic changes were detected among current circulating strains.

     According to local surveillance of antibiotic resistance, around 60 per cent of GAS isolated in 2012 were resistant to erythromycin (which also predicts resistance to azithromycin and clarithromycin), while all GAS isolates are sensitive to penicillin. Penicillin or a first generation cephalosporin should be used for treatment of a patient presenting with symptoms of scarlet fever.

     Scarlet fever is caused by GAS bacteria and can be effectively treated with appropriate antibiotics. It is transmitted through either the respiratory route or direct contact with infected respiratory secretions. This disease usually affects children under 10 years of age and presents as fever, sore throat and rash. The rash usually appears over the trunk and neck and spreads to the limbs, especially the armpits, elbows and groin. The illness is usually clinically mild but can be complicated by shock and heart and kidney diseases.

     Letters have been issued to doctors and schools to remind them to take prevention and control measures.

     To prevent infection, members of the public are advised to:

* maintain good personal and environmental hygiene;
* keep hands clean and wash hands properly;
* wash hands when they are dirtied by respiratory secretions, e.g. after sneezing;
* cover the nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly; and
* maintain good ventilation.

Ends/Tuesday, December 18, 2012
Issued at HKT 17:55


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