Research: Group A streptococcal infections: seasonal activity in England, 2025 to 2026

Scarlet fever in-hours GP consultations for the 2025/26 group A streptococcal (GAS) season have been declining since week 27 this year (week commencing 29 June). Notifications remain in line with normal seasonal levels.

Laboratory notifications of invasive group A streptococcal (iGAS) infection are similarly within expected levels, though levels have remained relatively consistent with no distinct seasonal peaks.

Given the potential for severe presentations, scarlet fever cases should be treated promptly with antibiotics to limit further spread and reduce risk of potential complications in cases and their close contacts. Clinicians should continue to be alert to the severe complications of GAS infections and maintain a high degree of clinical suspicion when assessing patients, particularly those with preceding viral infection (including chickenpox) or their close contacts. Tetracycline resistance is being more frequently identified in iGAS isolates at this point in the season; clinicians should continue to consider the full antibiogram when treating patients with reported penicillin allergy.

Updated UK public health guidance on the management of close contacts of iGAS cases in community settings was published on 15 December 2022, with public health action extended to include patients with probable invasive GAS infection and additional close contact groups recommended for antibiotic prophylaxis. The evidence base underpinning the change in risk groups has been published.

National guidance on the management of scarlet fever outbreaks highlights essential tools to limit spread: