You are undoubtedly aware of the increased number of cases of scarlet fever caused by invasive Group A streptococcal (iGAS) infections being reported in children across the country.

Symptoms 

1. Blue, pale or blotchy skin, lips or tongue – on darker skin, check for blueness on the lips, tongue or gums, under the nails or around the eyes;
2. Rash that doesn’t fade when you roll a glass over it;
3.  Difficulty breathing;
4. Weak, high-pitched cry – not like their typical cry, not responding like normal, not interested in feeding or normal activities; or
5. Being sleepier than usual or difficult to wake up.

Currently, there is NO advice on testing Strep A in pharmacies, and this does not form part of the current diagnosis and treatment recommendations in community pharmacy. The DH may guide the future on this issue, and we will let you know once we find out more.

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The UK Health Security Agency (UKHSA) has advised parents to be on the lookout for symptoms and to contact NHS 111 or their GP if they are concerned. In emergencies, patients should be told to contact 999.

There has been some advice provided that pharmacies can do to support the current issue in schools. These are:

 1.  Briefing your teams on the symptoms above and what to look out for

 2.  Telling worried parents about where and how to access help

 3.  Accessing the resources here, printing them and making them readily available to your patients https://campaignresources.dhsc.gov.uk/campaigns/group-a-strep/social-media/

Antibiotic Availability and SPS Guidance

There have also been huge issues with antibiotic availability, and we are currently liaising with suppliers on this issue. We will brief you once we have more information.

SPS Antibiotic Guidance has recently been released, which provides advice on how NON-LICENSED forms of antibiotics can be administered to children by crushing or dispersing antibiotics in water, food or flavoured drinks. For more information we advise you to click here: https://www.sps.nhs.uk/articles/using-solid-oral-dosage-form-antibiotics-in-children/

However, a prescription from the GP will need to be very specific on how to take medicine, considering that these are non-licensed forms of providing antibiotics. It is worth raising this document to the GP’s attention regarding the problems in availability.

Regards,

PharmaPlus