Increase in scarlet fever and chickenpox cases

We have been advised by the UK Health Security Agency of an increase in scarlet fever incidence and outbreaks in England.

Scarlet fever is a contagious infection that mostly affects young children. It's easily treated with antibiotics.

Chickenpox is common and mostly affects children, but you can get it at any age. 

Key messages

  • We are currently seeing increased notifications of chickenpox and scarlet fever to UKHSA in line with usual seasonal patterns.  These notifications are likely to be an under representation of the true figure as they come via GPs and not everyone goes to their GP when their child has chickenpox or scarlet fever.
  • There is an expectation that there will be further increases in early years settings and primary school – particularly reception and year 1 because of their lack of routine exposure during the last two years of lockdown.  So a larger proportion than usual of early primary school children are susceptible.
  • It is very important that children with scarlet fever (it tends to be children) and those with other presentations of the same bacteria (e.g. those with impetigo or bacterial sore throats) are treated promptly with antibiotics as in a few cases the bacteria can cause more serious infections.
  • Signs and symptoms of scarlet fever are:
    • Non specific in the early stages but may include a sore throat, headache, fever, nausea and vomiting
    • After 12 – 48 hours a red generalised pinhead rash develops typically first on the chest and stomach and then other parts of the body with a sandpaper feel.  There may be flushed cheeks, pallor round the mouth or a ‘strawberry colour’ tongue.
    • Children with these symptoms should be treated with antibiotics as soon as possible
    • Children with scarlet fever should be excluded from school until 24 hours after they started their antibiotics
    • More information on scarlet fever here: Scarlet fever: symptoms, diagnosis and treatment - GOV.UK (
  • Settings should ensure good hand hygiene to reduce the risk of spread.
  • Settings who have a case/outbreak of scarlet fever or chicken pox should contact UKHSA.
  • Some groups of people are more vulnerable to chicken pox infection – those who are in their first 20 weeks of pregnancy, those who are immunosuppressed and neonates.  People in these categories should receive immunoglobulin treatment if in contact with a child/person with chicken pox during its infectious period (1 – 2 days before rash develops until the scabs are crusted over) so schools should inform UKHSA if they have an outbreak of chicken pox so that appropriate follow up action can be taken.