Scarlet fever cases reached their highest levels in almost 70 years in 2022, data show.
Official figures reveal there were 54,457 cases of Scarlet fever in England and Wales last year amid a surge in Strep A bacteria, as two winters in lockdown led to more people lacking immunity.
The 2022 tally of scarlet fever cases is the highest figure since 1953, when there were more than 61,000 cases of the bacterial infection.
Scarlet fever is caused by the bacteria Strep A which can also lead to tonsillitis and, in severe instances, invasive Group A Strep (iGAS) which can be deadly.
A total of 383 children have been diagnosed with iGAS in England so far this winter with 30 of them dying, with the condition killing one in 12 children that develop it.
iGAS is caused when the Group A Strep bacteria gets into parts of the body it normally does not reach, such as the lungs, and can be deadly in a matter of hours.
The UKHSA called this winter’s level of scarlet fever “exceptional” and said that although transmission seems to be slowing now, infections are still much higher than expected for this time of year.
Health bosses have previously said that the surge in Strep A infections, scarlet fever cases and iGAS deaths is because the number of children who contracted Strep A was minimal in the last two winters as a result of Covid lockdown and social distancing restrictions.
Of the more than 54,000 cases of scarlet fever in 2022, 37,068 have come since the start of September. In an average year, the number is 3,029, 12 times fewer.
The worst year for scarlet fever cases in recent memory before 2022 was 2018 when almost 32,000 cases were reported in the calendar year. At the time, 2018 was the worst year for infections since 1960.
But to find a year where England and Wales saw more cases of scarlet fever you have to go back to 1953 when 61,180 people were diagnosed with the infection.
Scarlet fever cases dropped rapidly in the second half of the 20th century as antibiotics became more accessible, effective and cheaper.
The bacteria which causes scarlet fever, Group A Strep, is highly susceptible to antibiotics and is easily treated with a course.
Transmission appears to be slowing
Now, after a sharp peak in cases before Christmas it now appears that transmission is slowing.
“The recent declines in scarlet fever notification since week 49 may represent reduced levels of transmission,” the UKHSA said.
“While these are often seen over the Christmas school break, this decline pre-dated the end of the school term."
Dr Sarah Anderson, the UKHSA incident director, said: “The number of scarlet fever notifications we are seeing each week has fallen, but we are continuing to monitor the data closely as the school term gets underway, and children mix more.
"The bacteria that cause scarlet fever are still circulating at high levels so it is important that we continue to do our bit to stop the spread of germs to vulnerable groups, including the elderly by washing our hands regularly and thoroughly, catching coughs and sneezes in a tissue, and keeping our homes well ventilated.
"It’s not too late to take up the free flu and COVID-19 vaccines if you’re eligible – we know that group A streptococcus infections can be more serious when combined with another infection like flu.
“Most winter illnesses can be managed at home and NHS.UK has information to help parents look after children with mild illness. Deaths and serious illness following group A strep infection are very rare and the infection can be easily treated with antibiotics.
“Contact NHS 111 or your GP surgery if you think your child is getting worse, for instance they are feeding or eating less than normal, are dehydrated, have a high temperature that won’t go down, are very hot and sweaty or seem more tired or irritable than normal.”