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The scarlet fever incidence has increased drastically in recent years in China. However, the long-term relationship between climate variation and scarlet fever remains contradictory, and an early detection system is lacking. In this study, we aim to explore the potential long-term effects of variations in monthly climatic parameters on scarlet fever and to develop an early scarlet-fever detection tool. Data comprising monthly scarlet fever cases and monthly average climatic variables from 2004 to 2017 were retrieved from the Notifiable Infectious Disease Surveillance System and National Meteorological Science Center, respectively. We used a negative binomial multivariable regression to assess the long-term impacts of weather parameters on scarlet fever and then built a novel forecasting technique by integrating an autoregressive distributed lag (ARDL) method with a nonlinear autoregressive neural network (NARNN) based on the significant meteorological drivers. Scarlet fever was a seasonal disease that predominantly peaked in spring and winter. The regression results indicated that a 1 °C increment in the monthly average temperature and a 1-h increment in the monthly aggregate sunshine hours were associated with 17.578% (95% CI 7.674 to 28.393%) and 0.529% (95% CI 0.035 to 1.025%) increases in scarlet fever cases, respectively; a 1-hPa increase in the average atmospheric pressure at a 1-month lag was associated with 12.996% (95% CI 9.972 to 15.919%) decrements in scarlet fever cases. Based on the model evaluation criteria, the best-performing basic and combined approaches were ARDL(1,0,0,1) and ARDL(1,0,0,1)-NARNN(5, 22), respectively, and this hybrid approach comprised smaller performance measures in both the training and testing stages than those of the basic model. Climate variability has a significant long-term influence on scarlet fever. The ARDL–NARNN technique with the incorporation of meteorological drivers can be used to forecast the future epidemic trends of scarlet fever. These findings may be of great help for the prevention and control of scarlet fever. [ABSTRACT FROM AUTHOR]

Copyright of Contributions / Prilozi is the property of Institute for History, University of Sarajevo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Intus-Legere Historia is the property of Intus-Legere Historia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

During 2014, England and Wales had a sharp increase in the incidence of scarlet fever, which by 2016 had reached 33.2 cases/100,000 person-years, the highest rate in almost 50 years [...]

Introduction: Group A Streptococcus (GAS) causes mild diseases, and unfrequently invasive infections (iGAS). Following the December 2022 alert from the United Kingdom regarding the unusual increase in GAS and iGAS infections, we analyzed the incidence of GAS infections in 2018-2022 in our hospital., Methods: We conducted a retrospective study of patients seen in a pediatric emergency department (ED) diagnosed with streptococcal pharyngitis and scarlet fever and patients admitted for iGAS during last 5 years., Results: The incidence of GAS infections was 6.43 and 12.38/1000 ED visits in 2018 and 2019, respectively. During the COVID-19 pandemic the figures were 5.33 and 2.14/1000 ED visits in 2020 and 2021, respectively, and increased to 10.2/1000 ED visits in 2022. The differences observed were not statistically significant (p=0.352)., Conclusions: In our series, as in other countries, GAS infections decreased during the COVID-19 pandemic, and mild and severe cases increased considerably in 2022, but did not reach similar levels to those detected in other countries., (Copyright © 2023 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. All rights reserved.)

This study retrospectively analyzed the spatio-temporal distribution and spatial clustering of scarlet fever in mainland China from 2004 to 2017. In recent years, the incidence of scarlet fever is increasing. Previous studies on the spatial distribution of scarlet fever in China are mainly focused at the provincial and municipal levels, and there is few systematic report on the spatial and temporal distribution characteristics of scarlet fever on the national level. Based on the incidence information of scarlet fever in mainland China between 2004 and 2017 collected from the China Center for Disease Control, this paper systematically explored the Spatio-temporal distribution of scarlet fever by three methods, contains spatial autocorrelation analysis, Spatio-temporal scanning analysis, and trend surface analysis. The results demonstrate that the incidence of scarlet fever varies by seasons, which is in line with double-peak distribution.The first peak generally occurs from May to June and the second one from November to December, while February and August is the lowest period of incidence. Trend surface analysis indicates that the incidence of scarlet fever in northern China is higher than the south, slightly higher in western compared to the east, and lower in the central part. Additionally, the results show that the clustering regions of scarlet fever centrally distributed in the northeast, northwest, north china and some provinces in the east, such as Zhejiang, Shanghai, Shandong, and Jiangsu.

February 14th 2018 — anniversary of the famous scientist, academician of the USSR Academy of Medical Sciences, great immunologist and microbiologist Vladimir Ilyich Ioffe the founder of the Russian school of clinical and epidemiological immunology. He created an authoritative Scientific School, anticipated many concepts of infectious immunology, justified and linked together theory, experiment and practical implementation of 3 fields of science: microbiology, immunology and epidemiology thus providing a fertile ground for breakthrough in infectious pathology. Ioffe has developed the principles of quantitative analysis of processes, created the methodology of titer tests to evaluate the strength of the body's defense system or organism allergization. His works have proved long before foreign scientists that scarlet fever and rheumatic fever were streptococcal infections, introduced immunogram as clinico-immunological characteristic of the patient’s disease, and reflected the patterns of disease development and manifestation. Ioffe’s publications provide comparative characteristics of experimental, clinical and epidemiological immunology as independent immunological scientific areas with its own content, aim and subject of research. Based on the wealth of experimental, clinico-immunological and epidemiological data Ioffe created such fundamental works as “Clinical and Epidemiological Immunology”, “Scarlet Fever”, “Whooping Cough”, “Immunology of Rheumatism”, which are still in the researchers’ focus of attention.

From 2011, Hong Kong and mainland China have witnessed a sharp increase in reported cases, with subsequent reports of epidemic scarlet fever in North Asia and the United Kingdom. Here we examine epidemiological data and investigate the genomic context of the predominantly serotype M12 Streptococcus pyogenes scarlet fever isolates from mainland China. Incident case data was obtained from the Chinese Nationwide Notifiable Infectious Diseases Reporting Information System. The relative risk of scarlet fever in recent outbreak years 2011–2016 was calculated using the median age-standardised incidence rate, compared to years 2003–2010 prior this outbreak. Whole genome sequencing was performed on 32 emm12 scarlet fever isolates and 13 emm12 non-scarlet fever isolates collected from different geographic regions of China, and compared with 203 published emm12 S. pyogenes genomes predominantly from scarlet fever outbreaks in Hong Kong (n = 134) and the United Kingdom (n = 63). We found during the outbreak period (2011–2016), the median age-standardised incidence in China was 4.14/100,000 (95% confidence interval (CI) 4.11-4.18), 2.62-fold higher (95% CI 2.57-2.66) than that of 1.58/100,000 (95% CI 1.56-1.61) during the baseline period prior to the outbreak (2003−2010). Highest incidence was reported for children 5 years of age (80.5/100,000). Streptococcal toxin encoding prophage φHKU.vir and φHKU.ssa in addition to the macrolide and tetracycline resistant ICE-emm12 and ICE-HKU397 elements were found amongst mainland China multi-clonal emm12 isolates suggesting a role in selection and expansion of scarlet fever lineages in China. Global dissemination of toxin encoded prophage has played a role in the expansion of scarlet fever emm12 clones. These findings emphasize the role of comprehensive surveillance approaches for monitoring of epidemic human disease.

Hepatitis would be related to non-hepatotropic virus. A 6-year-old boy was presented with acute hepatitis finding. He had specific rashes for scarlet fever. His liver was enlarged and liver enzyme was elevated. Other reasons of acute viral hepatitis were excluded. Liver enzymes were normalized after appropriate antibotherapy. We aimed to remind unusual presentation of scarlet fever and uncommon reasons of acute hepatitis. [ABSTRACT FROM AUTHOR]

• Remarkable increase of emm 1 proportion in GAS population. • Continuous data of ongoing scarlet fever outbreaks in China. • Average GAS carriage rate of 7.6% in school-aged children. • Characteristic mobile genetic elements harboured by Chinese emm 1 isolates. Scarlet fever epidemics caused by group A Streptococcus (GAS) have been ongoing in China since 2011. However, limited data are available on the dynamic molecular characterizations of the epidemic strains. Epidemiological data of scarlet fever in Shanghai were obtained from the National Notifiable Infectious Disease Surveillance System. Throat swabs of patients with scarlet fever and asymptomatic school-age children were cultured. Illumina sequencing was performed on 39 emm 1 isolates. The annual incidence of scarlet fever was 7.5–19.4/100,000 persons in Shanghai during 2011–2015, with an average GAS carriage rate being 7.6% in school-age children. The proportion of emm 1 GAS strains increased from 3.8% in 2011 to 48.6% in 2014; they harbored a superantigen profile similar to emm 12 isolates, except for the speA gene. Two predominant clones, SH001- emm 12, and SH002- emm 1, circulated in 66.9% of scarlet fever cases and 44.8% of carriers. Genomic analysis showed emm 1 isolates throughout China constituted distinct clades, enriched by the presence of mobile genetic elements carrying the multidrug-resistant determinants ermB and tetM and virulence genes speA, speC, and spd1. A significant increase in the proportion of emm 1 strains occurred in the GAS population, causing scarlet fever in China. Ongoing surveillance is warranted to monitor the dynamic changes of GAS clones. [ABSTRACT FROM AUTHOR]

Introduction Scarlet fever is an acute infectious disease that is characterized by development of characteristic pin-point exanthema in a patient with signs of streptococcal pharyngitis and tonsillitis. Nowadays, due to effective antibacterial treatment, severe complicated cases of scarlet fever are occasionally rare. Because of immunity particularities, patients with Down syndrome are predisposed to bacterial respiratory diseases (and scarlet fever among them), that usually have prolonged complicated course. Case report A clinical case of scarlet fever in a patient with Down syndrome was analyzed. The disease had a severe course with a specific skin syndrome and was complicated by pneumonia. Hospitalization and adequate treatment of the patient led to his complete recovery despite late initiation of antibacterial medicine. Discussion A long severe complicated course of the disease in the presented case was caused by combination of the late initiation of antibacterial treatment and the patient's personal particularities of reactivity. Conclusions Patients with Down syndrome should be adequately monitored by family doctors in case of pharyngitis with early testing for group A hemolytic Streptococcus infection and administration of the correct antibacterial treatment, if the test is positive. [ABSTRACT FROM AUTHOR]

Background: Group A streptococcus (GAS) is an important human pathogen responsible for a broad range of infections. Epidemiological surveillance has been crucial to detect changes in the geographical and temporal variation of the disease pattern. The objective of this study was to investigate the molecular epidemiological characteristics and antimicrobial resistance of GAS isolates from patients in Children's Hospital in Beijing.Methods: From 2016 to 2017, pharyngeal swab samples were collected from the outpatients in Children's Hospital, Capital Institute of Pediatrics, who were diagnosed with scarlet fever. Antimicrobial susceptibility test was performed according to the distribution of conventional antibiotics and Clinical and Laboratory Standards Institute (CLSI) recommendations. The distribution of the macrolide-resistance genes (ermB, ermA, mefA), emm (M protein-coding gene) typing, and superantigens (SAg) gene profiling were examined by polymerase chain reaction (PCR).Results: A total of 297 GAS isolates were collected. The susceptibility of the isolates to penicillin, ceftriaxone, and levofloxacin was 100%. The resistance rate to erythromycin and clindamycin was 98.3 and 96.6%, respectively. The dominant emm types were emm12 (65.32%), emm1 (27.61%), emm75 (2.69%), and emm89 (1.35%). Of the 297 isolates, 290 (97.64%) carried the ermB gene, and 5 (1.68%) carried the mefA gene, while none carried the ermA gene. The most common superantigen genes identified from GAS isolates were smeZ (96.97%), speC (92.59%), speG (91.58%), ssa (85.52%), speI (54.55%), speH (52.19%), and speA (34.34%). Isolates with the genotype emm1 possessed speA, speC, speG, speJ, speM, ssa, and smeZ, while emm12 possessed speC, speG, speH, speI, speM, ssa, and smeZ superantigens.Conclusions: The prevalent strain of GAS isolates in Beijing has a high resistance rate to macrolides; however, penicillin can still be the preferred antibiotic for treatment. Erythromycin resistance was predominantly mediated by ermB. The common emm types were emm12 and emm1. There was a correlation between emm and the superantigen gene. Thus, long-term monitoring and investigation of the emm types and superantigen genes of GAS prevalence are imperative. [ABSTRACT FROM AUTHOR]

Objectives: Scarlet fever is characterized by a high degree of contagion and risk of severe complications. The aim of the study was to highlight the need for constant application of prophylactic measures when a case of scarlet fever is detected. Material and method: retrospective study, to evaluate some epidemiological aspects of scarlet fever cases in children hospitalized in the Clinical Hospital for Infectious Diseases in Brasov during 2014-2019. Results: 1366 children were hospitalized, with annual variations in the number of cases; 95.32% of patients were between 1-9 years old. In period 2014-2016 hospitalizations were more frequently in the age group 5-9 years, in the next 3 years in the age group 1-4 years; 54.17% were boys, 78.11% came from urban areas. Most hospitalizations were found in March, April and December (13.98%, 15.37%, 13.91% cases). Conclusions: Persistent scarlet fever morbidity requires early diagnosis, isolation of disease cases and constant application of prophylaxis of streptococcal infection to all their contacts. [ABSTRACT FROM AUTHOR]

Copyright of Paediatrics & Family Medicine / Pediatria i Medycyna Rodzinna is the property of Medical Communications Sp. z o.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A 9-year-old boy suffering from COVID-19 presented after an acute conjunctivitis, symptomatic glossitis, cheilitis, then reticular livedo, urticaria angioedema and finally a palmar-plantar scarlet fever-like rash. These COVID-19 symptoms observed consecutively in the same child have been described in isolation among the cutaneous manifestations of COVID-19. The authors discuss the pathogenesis of these late symptoms of SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

A cluster of 18 scarlet fever cases and large illness absenteeism (32%, 58/184) in a school prompted concern and further investigation. We conducted telephone interviews with parents to ascertain cases and better comprehend parents’ views. We identified 19 cases, of which 13 reported scarlet fever diagnosis by a physician and only seven fulfilled the probable case definition. We concluded that the outbreak was far smaller than suspected and found that communication and reporting could be improved. Accurate information and communication is essential in an outbreak; the school’s concern could have been alleviated sooner and response measures better targeted. [ABSTRACT FROM AUTHOR]

Annual incidence of scarlet fever in Hong Kong remained elevated after an upsurge in 2011. Incidence increased from 3.3/10,000 children

Background: Since 2011, there has been an increase in the incidence of scarlet fever across China. The main objective of this study was to depict the spatiotemporal epidemiological characteristics of the incidence of scarlet fever in Shenyang, China, in 2018 so as to provide the scientific basis for effective strategies of scarlet control and prevention.Methods: Excel 2010 was used to demonstrate the temporal distribution at the month level and ArcGIS10.3 was used to demonstrate the spatial distribution at the district/county level. Moran's autocorrelation coefficient was used to examine the spatial autocorrelation and the Getis-Ord statistic was used to determine the hot-spot areas of scarlet fever.Results: A total of 2314 scarlet fever cases were reported in Shenyang in 2018 with an annual incidence of 31.24 per 100,000. The incidence among males was higher than that among females(p<0.001). A vast majority of the cases (96.89%) were among children aged 3 to 11 years. The highest incidence was 625.34/100,000 in children aged 5-9 years. In 2018 there were two seasonal peaks of scarlet fever in June (summer-peak) and December (winter-peak). The incidence of scarlet fever in urban areas was significantly higher than that in rural areas(p<0.001). The incidence of scarlet fever was randomly distributed in Shenyang. There are hotspot areas located in seven districts.Conclusions: Urban areas are the hot spots of scarlet fever and joint prevention and control measures between districts should be applied. Children aged 3-11 are the main source of scarlet fever and therefore the introduction of prevention and control into kindergarten and primary schools may be key to the control of scarlet fever epidemics. [ABSTRACT FROM AUTHOR]