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PubMed2004

[Scarlet fever in Poland in 2002].

Following the last epidemic in 1995 the scarlet fever incidence in Poland has been gradually decreasing, on average 20% per year. The downward trend continued in 2002, the overall incidence rate being 10.6 per 100,000. It was the lowest incidence registered in Poland since the introduction of mandatory reporting of scarlet fever in 1918 (the lowest so far registered incidence rates were 15.2 in 2001 and 17.5 in 1918). Spatial distribution of cases was relatively even--incidence ranged from 5.0 per 100,000 in łódzkie voivodeship to 25.1 in opolskie voivodeship. As observed previously incidence in the urban areas (12.0) was significantly higher then in the rural areas (8.4) and the incidence in men (11.7) exceeded the incidence in women (9.6). The majority of cases occurred in children and adolescents younger then 15 years (mode--6 years). Two percent of cases were hospitalized. There were no deaths due to scarlet fever reported in 2002.

Adolescent↗

PubMed1997

Outbreak of scarlet fever at a hospital day care centre: analysis of strain relatedness with phenotypic and genotypic characteristics.

An outbreak of scarlet fever involving 12 children occurred at a hospital day care centre from February to March 1996. Twenty-five throat isolates of Streptococcus pyogenes (GAS, group A streptococcus) available from 24 children, including 10 children with scarlet fever and 14 asymptomatic carriers, and one asymptomatic staff member were studied for the presence of genes encoding streptococcal pyrogenic exotoxin types A (speA), B (speB), and C (speC) and for protease activity. Antimicrobial susceptibilities using the E-test, cluster analysis by cellular fatty acid composition and random amplified polymorphic DNA (RAPD) patterns by means of arbitrarily-primed polymerase chain reaction (APPCR) of the isolates were performed to investigate the outbreak. Only one isolate from an asymptomatic child possessed the speA gene. All isolates possessed the speB gene and 24 (96%) isolates were positive for the speC gene. There was no difference in protease activity between isolates from children with scarlet fever and from asymptomatic carriers. Thirteen isolates (10 recovered from children with scarlet fever, two from asymptomatic children, and one from the staff member) were considered to be the same strain according to the identical antimicrobial susceptibility profile and RAPD patterns and were also considered to be similar by cluster analysis of fatty acid composition. These findings suggest that the outbreak was caused by a unique clone of GAS. We conclude that RAPD typing and cluster analysis by cellular fatty acids composition both provide a powerful tool for epidemiological investigation of GAS infections.

Child Day Care Centers↗

PubMedDate not supplied

[Mucoproteinuria in complicated scarlet fever].

Mucoproteinuria, determined by Bugard's semiquantitative method, revealed values of 100-350 mg/24 h in common scarlet fever and of 300-882 mg/24 h in scarlet fever complicated by early nephritis, pseudorheumatism and acute diffuse glomerulonephritis. These alterations appear to lend support to the recent hypothesis concerning the mucoprotein substrate of the autoimmune mechanism in the complications of streptoccal infection.

Acute Disease↗

PubMed1993

Temporal variation in bacterial disease frequency: molecular population genetic analysis of scarlet fever epidemics in Ottawa and in eastern Germany.

In an effort to understand the molecular genetic basis of temporal variation in frequency and severity of bacterial disease, genetic relationships among strains of Streptococcus pyogenes that caused scarlet fever epidemics in Canada in the early 1940s and in eastern Germany in the 1960s to 1980s were studied. Application of multilocus enzyme electrophoresis and comparative sequencing of the gene (speA) encoding streptococcal pyrogenic exotoxin A (scarlet fever toxin) revealed that new waves of scarlet fever are associated with an increase in frequency of S. pyogenes clones carrying variant speA alleles. This finding suggests that the occurrence of new scarlet fever epidemics can be predicted by comprehensive monitoring of the frequency of S. pyogenes clones with variant toxin alleles.

Alleles↗

PubMed1981

[Therapeutic experience with cefadroxil syrup in acute infections, especially scarlet fever, in pediatric field (author's transl)].

Clinical effects were investigated on cefadroxil powder for syrup (containing 100 mg of cefadroxil per 1 g) for acute bacterial infections (mostly scarlet fever) in the field of pediatrics, and the results were obtained as follows. Cefadroxil was applied in 100 cases of scarlet fever. Among 49 cases administered 30-39 mg/kg/day, the results were excellent in 34 cases and good in 15 cases, efficacy ratio being thus 100%. Among 38 cases administered 40-49 mg/kg/day, the results were excellent in 33 cases, and good in 5 cases, efficacy ratio being thus 100%. Out of 4 cases administered 20-29 mg/kg/day, the results were excellent in 3 cases and good in 1 case, while out of 9 cases administered 50-59 mg/kg/day, excellent in 4 cases and good in 5 cases. Among 78 cases of scarlet fever from which beta-hemolytic Streptococcus was proven from swab liquid of palatal tonsil, 67 cases received cefadroxil at a daily dose of 30-49 mg/kg, and the bacteria turned to negative the next day of administration in 72 cases, 2 days later in 6 cases. Cefadroxil was administered at a daily dose of 46 mg/kg for 7 days in 1 case of SSS syndrome of which Staphylococcus aureus was proven from skin lesion, and local bacteria turned to negative, as well as clinical effect was excellent. No pathogen was proven in 1 case of acute tonsillitis, maybe because ampicillin (ABPC) and cefazolin (CEZ) were administered before cefadroxil treatment, and yet a clinical efficacy was judged by administering cefadroxil at a daily dose of 46 mg/kg, though no clinical improvement was observed with the prior antibiotics. As to the side effects of cefadroxil in 102 cases, a slight vomiting was noticed in 6 cases, though the administration could be continued, and a slight rise of GOT or GPT was observed respectively in 3 cases and 1 case, all of which were recovered without abnormal clinical findings. Among the patients of scarlet fever, after beta-hemolytic Streptococcus became negative, reelimination or recurrence was noticed in 2 cases, but these patients were cured completely by readministration of cefadroxil or administration of amoxicillin (AMPC). Cefadroxil powder for syrup was absorbed quite well, its serum levels were maintained for long, and it was easily administered in children. Considering from its superior antibacterial activity, cefadroxil may be expected to be useful for a remedy in slight or middle infections of children.

Cefadroxil↗

PubMed2005

Ecological association between scarlet fever and asthma.

One plausible explanation for the worldwide epidemic increase of asthma prevalence is the hygiene hypothesis, which suggests that better control of infections shifts the immune response toward an allergic phenotype. However, studies demonstrating an inverse association between asthma and infectious diseases are scarce and possess conflicting results. To explore the relationship between asthma and scarlet fever, an ecological analysis of their national trends was carried out. Association of both diseases in their annual (1996-2003), seasonal (by month) and geographic (by state) trends was evaluated using the Spearman's correlation coefficient (r(S)). Results showed a strong inverse association between asthma and scarlet fever in all settings. Thus, annual incidence rates of both diseases showed an r(S)=-0.93 (P=0.0009). Seasonal patterns showed a higher proportion of new asthma cases from September to January, while the number of scarlet fever cases increased from March to June (r(S)=-0.84, P=0.0006, 1-month lag). Among the 32 Mexican states, the higher the incidence of scarlet fever the lower the incidence of asthma (r(S)=-0.47, P=0.007). These results suggest that Streptococcus pyogenes, the causative agent of scarlet fever, might be one of the major protagonists of the hygiene hypothesis, a possibility deserving of further investigation.

Asthma↗

PubMed1991

[A dying clinical diagnosis of scarlet fever--the last sixteen years survey].

11,119 patients with scarlet fever admitted in the last sixteen years, from 1973 to 1988, to Sapporo City General Hospital, were studied statistically on symptoms and laboratory findings. The results were summarized as follows: 1. Annual number of patients have reduced suddenly since 1981, and become zero in 1989. The patients increased in number during the winter season. Eighty two percent of the cases were between 3 and 8 years of age, and the average age was 5.8 year-old. 2. Cases of above-38 degrees C temperature were seen in about 81.4%, and from 2 to 5 days-duration of temperature were seen in 86.6% of the patients in the year 1976. Cases of above-moderate rash were observed in 68.2%, sever redness of throat in 29.9%, strawberry tongue in 86.3% and angular stomatitis in 37.7% of the patients. In recent statistical analysis (1982-1988), we found, however, a tendency that patients having stronger symptoms were being introduced to our hospital. 3. The higher rates of cases showing elevated ASD titer were seen in the elder patients and in the winter. C-reactive protein (CRP) titers were mostly in the range of (-) to (greater than or equal to 6+), having 2.4 + on an average. 4. Patients who developed into overt nephritis were not seen. Cases of microscopic hematuria (greater than or equal to 3 red cells/f in urine sediments), however, were observed in 1.1% (125/11,119). Sever complications were hardly seen. 5. Reappearance of beta-hemolytic streptococci (on a week after discharge) were found in 3.1% (241/7,877). 6. Reinfection or relapse cases of scarlet fever were found in 6.7% (642/9,585).(ABSTRACT TRUNCATED AT 250 WORDS)

Body Temperature↗

PubMedDate not supplied

Did scarlet fever and rheumatic fever exist in Hippocrates' time?

Case histories recorded by Hippocrates around 400 B.C. describe the clinical manifestations of scarlet fever and rheumatic fever, although the entities are not identified by name. Although the descriptions are not as detailed or complete as they would be today, they strongly suggest the existence of scarlet fever and rheumatic fever at that time. Hippocrates' references to these illnesses were presumably the first to be documented and/or discovered, as a thorough search of the worldwide medical literature revealed no prior descriptions.

Greece, Ancient↗

PubMed2002

[Scarlet fever in Poland in 2000].

In 2000, as compared with 1999, a 14% decrease in the number of scarlet fever cases was noted. The incidence was 21.6 per 100,000 population and was one of the lowest since World War II. In particular voivodeships incidence ranged from 9.4 to 34.3 per 100,000 population. In urban areas the incidence was 71.3% higher than in rural ones. Of all registered cases 95.3% were children under 15 years of age. The age distribution of scarlet fever cases in 2000 was similar to the distribution observed in the last decade. The highest incidence was noted among children aged 6 and 5, respectively 257.0 and 224.4 per 100,000. About 2.1% of all cases were hospitalized. No scarlet fever deaths were noted.

Adolescent↗

PubMed2003

[Scarlet fever in Poland in 2001].

In 2001, as compared to 2000, a 29.5% decrease in the number of scarlet fever cases was noted. The incidence was 15.2 per 100,000 population and was one of the lowest since the World War I. In particular voivodeships incidence ranged from 5.7 to 28.8 per 100,000 population. In urban areas the incidence was 32.3% higher than in rural ones. Of all registered cases 91.9% were children under 15 years of age. The age distribution of scarlet fever cases in 2001 was similar to the distribution observed in the last decade. The highest incidence was noted among children aged 6 and 5,169.1 and 155.1 per 100,000 respectively. About 2.1% of all cases were hospitalised. No scarlet fever deaths were noted.

Adolescent↗

PubMed2002

Molecular characterization of group A Streptococcus strains isolated during a scarlet fever outbreak.

Forty group A streptococcus (GAS) isolates, recovered during a scarlet fever outbreak, were grouped based on their DdeI restriction profiles from emm amplicons. Twenty-seven isolates were identified by sequencing as emm2. The emm2 isolates showed the speA1, speB1, and speC1 alleles. Isolation of this GAS type from scarlet fever outbreaks is uncommon.

Antigens, Bacterial↗

PubMed2004

Toxic scarlet fever complicating cellulitis: early clinical diagnosis is crucial to prevent a fatal outcome.

We describe a case of toxic scarlet fever in a healthy adult with streptococcal cellulitis of the right elbow as a result of skin abrasion. The clinical picture mimicked that of drug eruption after treatment of cellulitis with antibiotics. Among the five cases of scarlet fever complicating cellulitis, including the present one, reported in the English literature, four had severe systemic complications and two died. As a result of re-emergence of invasive streptococcal infections, clinicians should be aware of the differential diagnosis of scarlet fever in patients presenting with cellulitis and skin rash. Early clinical diagnosis is crucial to exclude drug eruptions, prompt initiation of antibiotic treatment, and prevention of the potentially fatal outcome.

Adult↗

PubMed1953