This Is What Strep A Symptoms Look Like For Children With Darker Skin Tones

"On darker skin, the rash can be more difficult to detect visually."
FG Trade via Getty Images

In the UK, nine children have died from a recent outbreak of Strep A. Streptococcus A (Strep A – also known as Group A Strep or GAS) are a group of bacteria that can cause a wide variety of skin, soft tissue and respiratory tract infections. These include scarlet fever, strep throat and impetigo.

Scarlet fever is usually a mild illness, but it is highly infectious. Symptoms of scarlet fever are a sore throat, headache, and fever, along with a fine, pinkish or red body rash with a sandpapery feel, but the symptoms can differ on those with darker skin tones.

In rare cases, a child can develop more serious invasive infections (referred to as iGAS infections), which is why parents are being urged to look out for the symptoms.

What does Strep A look like on children with darker skin tones?

“On darker skin, the rash can be more difficult to detect visually but will have a sandpapery feel,” Duncan Reid, pharmacist at Pharmacy2U shares.

Additionally, the British Islamic Medical Association explained that “the rash is more obvious in the groin/armpit area. Sometimes the flushed cheeks appear as ‘sunburned’ on darker skin with whiteness near the mouth”.

“In children with darker skin tones, the rash could be harder to spot as it may not appear red, but will be darker than normal skin,“ Dr Mabs Chowdhury, president of the British Association of Dermatologists adds.

“The rash in all pigment types can have a sandpapery feel. The tongue can appear redder than normal with prominent white spots (sometimes called ‘strawberry tongue’).”

Reid shares that “children who have strep throat may develop further symptoms within about three days, which include:”

  • red and white patches in the throat
  • trouble swallowing
  • a headache
  • lower stomach pain
  • general discomfort, uneasiness, or ill feeling
  • loss of appetite
  • nausea
  • rash

How do you catch Strep A?

“Strep A is spread through contact with droplets from an infected person when they talk, cough or sneeze,” Reid adds.

“Some people can have the bacteria present in their body without feeling unwell or showing any symptoms of infections and while they can pass it on, the risk of spread is much greater when a person is unwell. It is still possible to infect others for up to three weeks.”

“Good hand and respiratory hygiene are important to top the spread of Strep A. By teaching your child how to wash their hands properly with soap for at least 20 seconds, using a tissue to catch coughs and sneezes, and keeping away from others when feeling unwell, they will be able to reduce the risk of picking up or spreading infections.”

Is Strep A dangerous?

“In very rare occasions, the bacteria can get into the bloodstream and cause an illness called Invasive Group A strep (iGAS). While still uncommon, there has been an increase in invasive Group A strep cases this year, particularly in children under 10,” Reid says.

Reid continues: “Invasive disease happens when the bacteria get past your body’s immune defenses.”

“This can happen when you are already ill or are on treatments, such as some cancer therapies, that affect your immune system.”

Warning signs of invasive disease include:

  • fever (a high temperature above 38C)
  • severe muscle aches

Can Strep A be treated?

“Strep can usually be easily treated with a course of antibiotics.”

“Treatment with antibiotics will help you get better quicker, reduce the chance of a serious illnesses such as pneumonia, and make it less likely that you’ll pass the infection on to someone else,” Reid shares.

When should parents contact their GP?

“It is is important to act as quickly as possible if you think your child may have scarlet fever. Early treatment of scarlet fever with antibiotics is important to reduce the risk of complications such as pneumonia or a bloodstream infection,” Reid adds.

“As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement. Contact NHS 111 or your GP if:”

  • if you suspect your child has scarlet fever
  • your child is getting worse
  • your child is feeding or eating much less than normal
  • your child has had a dry nappy for 12 hours or more or shows other signs of dehydration
  • your baby is under 3 months and has a temperature of 38°C, or is older than 3 months and has a temperature of 39°C or higher
  • your baby feels hotter than usual when you touch their back or chest, or feels sweaty
  • your child is very tired or irritable

“Call 999 or go to A&E if:”

  • your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs
  • there are pauses when your child breathes
  • your child’s skin, tongue or lips are blue
  • your child is floppy and will not wake up or stay awake