Scarlet Fever Research Articles

Distribution of emm genotypes in group A streptococcus isolates of Korean children from 2012 to 2019.

Changes in the epidemiology of group A streptococcus (GAS) infection is related to emm genotype. We studied the distribution of emm genotypes and their antibiotic susceptibility among Korean children. Isolates from children with GAS infection between 2012 and 2019 were collected. emm typing and cluster analysis was performed according to the Centers for Disease Control emm cluster classification. Antimicrobial susceptibility was tested using the E-test and resistance genes were analyzed for macrolide resistant phenotypes. Among 169 GAS isolates, 115 were from children with scarlet fever. Among invasive isolates, emm1 (6/22, 27.3%), emm12 (4/22, 18.2%), and emm4 (4/22, 18.2%) were most common. In scarlet fever, although emm4 (38/115, 33.0%) was the most prevalent throughout the study period, emm4 was replaced by emm3 (28/90, 31.1%) during an outbreak in 2017-2018. Among all isolates, only 2 (1.2%) exhibited erythromycin resistance and harbored both ermA and ermB genes. In this analysis of GAS isolated from Korean children, emm1 was the most prevalent in invasive infection. In scarlet fever, emm4 was prevalent throughout the study period, with an increase in emm3 during 2017-2018. GAS isolates during 2012-2019 demonstrated low erythromycin resistance.

Estudio retrospectivo sobre la efectividad y seguridad de la pauta antibiótica reducida a 5-7 días en la faringoamigdalitis aguda estreptocócica comparada con la pauta clásica de 10 días

IntroductionAntibiotherapy regimens for management of acute streptococcal pharyngitis traditionally last 10 days, but the development of resistance to different antimicrobials has motivated the exploration of shorter courses. Material and methodsWe selected patients given a diagnosis of streptococcal pharyngitis in 2 paediatric caseloads of one primary care centre between June 2016 and April 2020. We compared outcomes in patients treated with 8- to 10-day courses versus 5- to 7-day courses. ResultsThe analysis included 350 care episodes (252 patients). Sixty-four percent were managed with 8- to 10-day courses of antibiotherapy (group 1) and 36% with 5- to 7-day courses (group 2). There were no significant differences in the incidence of streptococcal pharyngitis or scarlet fever in the 3 months that followed (OR, 0.98; 95% CI: 0.46-2.03), with similar percentages in both groups (9.8 vs. 9.5%). Overall, without differentiating based on the type of infection (streptococcal pharyngitis, scarlet fever or other streptococcal infections), we found similar outcomes (OR, 0.81; 95% CI: 0.41-1.59): 13.4% in group 1 and 11.1% in group 2. We also found no differences in the frequency of adverse events documented in the health records (OR, 0.29; 95% CI: 0.04-2.44): 2.7% in group 1 and 0.8% in group 2. ConclusionsIn our experience, a shorter antibiotic course (5-7 days) is not less effective or more unsafe for management of acute streptococcal pharyngitis than the traditional 10-day course.

Homeopathic medicine as a prophylaxis in today’s era

It is proven that Homeopathic medicine has dynamic power to boost host's immunity when we prescribe as a prophylaxis in a pandemic era. The preventive aspect of homoeopathy is well known, and Historically Homoeopathy has repeatedly been used for prevention during the epidemics of cholera, Japanese encephalitis, Leptospirosis, Spanish Flu, yellow fever, scarlet fever, Diphtheria, typhoid etc. The success in those infectious epidemic diseases adds homoeopathy as an adjuvant to the standard of care in management of COVID 19. There are many evidences that suggest homoeopathy can be effective in the fight against the pandemic. The basic core of cure of homoeopathy is that a medicine that produces a set of symptoms when given to a healthy person under controlled settings can be prescribed in a highly diluted form to a disease person with those similar symptoms. This is what is known as Similia Similibus Curentur in Latin phrase that means like cures like.

Public awareness for “classic” childhood diseases and inflammatory syndromes in children during the COVID-19 pandemic

ObjectivesThe objective was to analyze in silico public search interest during the COVID-19 pandemic for some classic infectious childhood diseases, e.g., measles, mumps, chickenpox, scarlet fever, and inflammatory diseases like Kawasaki disease and the pediatric inflammatory multisystem syndrome (PIMS). Study designIn this study, a comparison of five childhood diseases in public search trends with the pediatric inflammatory multisystem syndrome was performed. MethodsGoogle Trends data for the period of five years for six childhood diseases were used. We used topics coverings all languages worldwide and all connected search queries. ResultsPublic search interest decreased during the COVID-19 pandemic for some classic infectious childhood diseases. Search interest for the pediatric inflammatory multisystem syndrome, despite strong indication of a connection with COVID-19, remained relatively low compared to Kawasaki disease. Practice implicationsBetter understanding of Google Trends can map public awareness of childhood diseases in terms of time course and search intensity. ConclusionsPublic interest during the pandemic was generated for diseases with suspected connection to COVID-19, presumably due to media triggers.

Influence of the COVID-19 pandemic measures on incidence and representation of other infectious diseases in Germany: a lesson to be learnt.

The COVID-19 pandemic resulted in a wide range of serious health, social and economic consequences. To counteract the pandemic, various measures and restrictions such as lockdowns, closures, social distancing, hygiene, and protective measures such as wearing face masks have been enforced. Apart from the COVID-19 pandemic, these measures also had effects on other transmittable diseases. This study therefore determined the impact on case numbers and interest for other infectious diseases as well. Anonymized data on reported case numbers from the German Robert Koch Institute and data from Google Trends about the search interest have been used in this study to track courses of infectious diseases before and during the coronavirus pandemic in Germany. The results of this analysis clearly demonstrated that the case numbers of influenza, whooping cough, measles, mumps, scarlet fever and chicken pox decreased in the pandemic years, most probably due to anti-pandemic measures in Germany. Additionally, the Google Trends analysis demonstrated public awareness, documented by a corresponding search interest, for the new topic COVID-19 and for other infectious diseases. Online available data provided valuable sources for research purposes in infodemiology or infoveillance.

Now- and Fore-casting the Secular Epidemiological Trends and Seasonality of the Comeback of Scarlet Fever in China: A 16-year Time Series Analysis

Now- and Fore-casting the Secular Epidemiological Trends and Seasonality of the Comeback of Scarlet Fever in China: A 16-year Time Series Analysis

ВСТРЕЧАЕМОСТЬ АНТИБАКТЕРИАЛЬНЫХ СОЕДИНЕНИЙ РАЗНЫХ ГРУПП В РАСТЕНИЯХ, ПРИМЕНЯВШИХСЯ ПРИ БАКТЕРИАЛЬНЫХ БОЛЕЗНЯХ

Abstract. The distribution of plant species containing at least one individual chemical compound with an experimentally established antibacterial effect in sets of plant species usedin traditional medicine in bacterial diseases is considered. Compounds are grouped. 9 groups of compounds (flavonoids, terpenoids, quinones, alkaloids, phenols, coumarins, lactones, iridoids, xanthones) and 37 diseases (pulmonary tuberculosis, dysentery, scrofula, pneumonia, tonsillitis, purulent wounds, abscesses, syphilis, nephritis, cystitis, laryngitis, whooping cough, gonorrhea, erysipelas, anthrax, leprosy, diphtheria, scarlet fever, pharyngitis, skin tuberculosis, sepsis, urethritis, gangrene, cholera, bone tuberculosis, typhus, pyelonephritis, typhoid fever, tuberculosis of the lymph nodes, pyelitis, lung abscess, meningitis, tetanus, brucellosis, plague, infectious-allergic polyarthritis, tuberculosis of the throat) were taken into account. To analyze the distribution, Student's mathematical-statistical test was used. It was noted that in the sets of plant species used for these diseases, in most cases, the occurrence of plant species containing antibacterial compounds from more than one of the groups under consideration was significantly increased.

Impact of Hearing Loss on Quality of Life in Adults

The normal sense of hearing is essential in the social, emotional, psychological and communicative fields. It is needed for safety and also for having a more meaningful life. Causes of hearing loss in adults can be genetic or due to immune diseases, infections such as meningitis, mumps, scarlet fever, Meniere's disease, exposure to loud noises, tumors, head injuries or aging (presbycusis). The word "presbycusis" implies a decrease in hearing associated with the phase of degenerative cochlear aging. Presbycusis is by definition bilateral, symmetric and incremental. Presbycusis can affect on an individuals’ quality of life (QOL). Therefore, the main aim of the research is to evaluate the Impact of hearing loss on QOL (Quality of Life) in Adults. Total 100 subjects were taken for this study. Out of 100 subjects, 50 subjects were taken as control group and 50 subjects were taken as experimental group and diagnosed to be hearing loss (Severe sensorineural hearing loss). A 25-point sample developed from the initial HHIE by Weinstein et al. The Hearing Handicap Inventory (HHIA)11 is often consisting of a 13-point emotional subscale and 12-point social-situational subscales. Further, the study concluded that in an effort to remedy its growth, we need to strengthen our understanding of this disease and its physiopathology. Furthermore, developing approaches to recognise and deteriorate Presbycusis patients would be of considerable significance, thus expanding the resources provided for hearing aids, assisting communication systems and auditory therapy. Individuals of hearing damage, the use of effective hearing aids or other hearing aids, and education strategies may have a favourable influence on older people's quality of life.

A Good Time to Be Born

A Good Time to Be Born

The indirect impact of control measures in COVID-19 pandemic on the incidence of other infectious diseases in China

ObjectivesDuring COVID-19 pandemic in 2020, China, some public health measures of forced lockdown, closure of school and public meeting places, staying at home, transportation stop, masks wearing, hands washing, environmental disinfection were taken on to control epidemic transmission, these measures have made indirect affect on the other infectious diseases incidence. Study designDuring COVID-19 pandemic in 2020, we retrospectively analyzed and compared reported cases of other infectious diseases,in order to found what impact of measures in controlling COVID-19 pandemic on the other infectious diseases in China. MethodsWe retrospectively analyzed and compared reported cases of measles, pertussis, scarlet fever, seasonal influenza, mumps, HFMD each month in 2018, 2019 and 2020 from the National Health Commission, PRC. ResultsCases of measles, pertussis, scarlet fever, seasonal influenza, mumps and HFMD in January 2020 were not declined, or even increased compare to 2018 and 2019, but from February to December 2020, began to drop significantly compare with the cases of 2018 and 2019. However, seasonal influenza cases in 2020 were more than in 2018. ConclusionIt shown that how important scientific measures are taken to cut off COVID-19 pandemic transmission, However, these taken measures have led to indirect impact on the diffusion of other infectious diseases, led to measles, pertussis, scarlet fever, seasonal influenza, mumps, HFMD declined.

A case report of scarlet fever: An uncommon diagnosis for fever and rash

Streptococcus pyogenes is a pathogen capable of causing a wide spectrum of diseases including pharyngitis and streptococcal toxic shock syndrome, with a range of complications and outcomes. Even though it is not an uncommon pathogen, reports of scarlet fever are scarce in Sri Lanka. We describe a case of scarlet fever in a seven-year-old boy with typical features. The child presented with high fever, body aches, vomiting, loss of appetite and a rash and developed pharyngitis and a strawberry tongue during the ward stay. A pure growth of group A Streptococcus was isolated from a throat swab taken on admission. He improved with appropriate treatment and recovered without complications. The importance of throat swab culture and clinical correlation is illustrated in this case report.

Proteome based mapping and reverse vaccinology techniques to contrive multi-epitope based subunit vaccine (MEBSV) against Streptococcus pyogenes

Streptococcus pyogenes is a root cause of human infection like pharyngitis, tonsillitis, scarlet fever, impetigo, and respiratory tract infections. About 11 million individuals in the US suffer from pharyngitis every year. Unfortunately, no vaccine against S. pyogenes is available yet. The purpose of this study is to create a multiepitope-based subunit vaccine (MEBSV) targeting S. pyogenes top four highly antigenic proteins by using a combination of immunological techniques and molecular docking to tackle term group A streptococcal (GAS) infections. T-cell (HTL & CTL), B-cell, and IFN-γ of target proteins were forecasted and epitopes having high antigenic properties being selected for subsequent research. For designing of final vaccine, 5LBL, 9CTL, and 4HTL epitopes were joined by the KK, AAY, and GPGPG linkers. To enhance the immune response, the N-end of the vaccine was linked by adjuvant (Cholera enterotoxin subunit B) with a linker named EAAAK. With the addition of adjuvants and linkers, the construct size was 421 amino acids. IFN-γ and B-cell epitopes illustrate that the modeled construct is optimized for cell-mediated immune or humoral responses. The developed MEBSV structure was assessed to be highly antigenic, non-toxic, and non-allergenic. Moreover, disulphide engineering further enhanced the stability of the final vaccine protein. Molecular docking of the MEBSV with toll-like receptor 4 (TLR4) was conducted to check the vaccine's compatibility with the receptor. Besides, in-silico cloning has been carried out for credibility validation and proper expression of vaccine construct. These findings suggested that the multi-epitope vaccine produced might be a potential immunogenic against Group A streptococcus infections but further experimental testing is required to validate this study.

Demographics of war: mortality in Porto Alegre during Guerra dos Farrapos, 1835-1845

This article presents an analysis of the impacts of the Guerra dos Farrapos (1835-1845) on the mortality of the population of Porto Alegre, drawing primarily on baptism and death records, comparing the periods before and after the conflict, ranging from 1825 to 1854. Anomalies can be noted in the first five years of the war, when the city was under siege from the rebels. The results, based on a calculation of infant mortality and other indicators, show not only that there were supply difficulties and deteriorated sanitary conditions, but also that mortality levels surged in response to a scarlet fever epidemic, which hit free and enslaved children particularly hard.

Decreased Antibiotic Consumption Coincided with Reduction in Bacteremia Caused by Bacterial Species with Respiratory Transmission Potential during the COVID-19 Pandemic.

Nonpharmaceutical interventions implemented during the COVID-19 pandemic (2020–2021) have provided a unique opportunity to understand their impact on the wholesale supply of antibiotics and incidences of infections represented by bacteremia due to common bacterial species in Hong Kong. The wholesale antibiotic supply data (surrogate indicator of antibiotic consumption) and notifications of scarlet fever, chickenpox, and tuberculosis collected by the Centre for Health Protection, and the data of blood cultures of patients admitted to public hospitals in Hong Kong collected by the Hospital Authority for the last 10 years, were tabulated and analyzed. A reduction in the wholesale supply of antibiotics was observed. This decrease coincided with a significant reduction in the incidence of community-onset bacteremia due to Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis, which are encapsulated bacteria with respiratory transmission potential. This reduction was sustained during two pandemic years (period 2: 2020–2021), compared with eight pre-pandemic years (period 1: 2012–2019). Although the mean number of patient admissions per year (1,704,079 vs. 1,702,484, p = 0.985) and blood culture requests per 1000 patient admissions (149.0 vs. 158.3, p = 0.132) were not significantly different between periods 1 and 2, a significant reduction in community-onset bacteremia due to encapsulated bacteria was observed in terms of the mean number of episodes per year (257 vs. 58, p < 0.001), episodes per 100,000 admissions (15.1 vs. 3.4, p < 0.001), and per 10,000 blood culture requests (10.1 vs. 2.1, p < 0.001), out of 17,037,598 episodes of patient admissions with 2,570,164 blood culture requests. Consistent with the findings of bacteremia, a reduction in case notification of scarlet fever and airborne infections, including tuberculosis and chickenpox, was also observed; however, there was no reduction in the incidence of hospital-onset bacteremia due to Staphylococcus aureus or Escherichia coli. Sustained implementation of non-pharmaceutical interventions against respiratory microbes may reduce the overall consumption of antibiotics, which may have a consequential impact on antimicrobial resistance. Rebound of conventional respiratory microbial infections is likely with the relaxation of these interventions.

Prevalence and identification of antibiotic-resistant scarlet fever group A Streptococcus strains in some paediatric cases at Shenzhen, China

This study aimed to investigate the annual incidence, molecular epidemiological characteristics, and antimicrobial resistance of group A Streptococcus (GAS) clinical isolates from paediatric patients at Shenzhen Children's Hospital during 2016-2020. Clinical samples were collected from paediatric patients with a suspected diagnosis of GAS infections. We studied the annual incidence and characteristics of GAS infections using the GAS antigen detection method. Additionally, 250 GAS isolates were randomly selected for genotyping of the emm gene, and antimicrobial susceptibility assay was performed using the Kirby-Bauer paper dispersion strategy. Among 43 593 collected samples, 9313 were positive for the GAS antigen. The main emm type was emm12, followed by emm1, emm6, and emm 4, which were used for distinguishing 90% of the scarlet fever isolated strains. The percentage of emm1 increased from 36% in 2016 to 44% in 2019, whereas the percentage of emm12 decreased from 62% to 50%. Several unusual emm types isolated from scarlet fever patients showed an increase in proportions from 2016 to 2020. These GAS isolates were sensitive to penicillin, ceftriaxone, and vancomycin and were highly resistant to erythromycin and clindamycin. There was a high incidence of GAS infections during 2016-2020 in Shenzhen, China. The GAS isolates had a high resistance rate to erythromycin and clindamycin; penicillin was the antibiotic of choice for GAS infections. The common emm types were emm12 and emm1. Future studies should investigate the clonal structure and superantigen profiles of the population of GAS isolates associated with scarlet fever.

Characterization of group A beta-haemolytic streptococcus with mucoid phenotype isolated in a tertiary hospital

IntroductionThe objective of this study is to characterize Streptococcus pyogenes isolates with a mucoid phenotype and to compare them with non-mucoid isolates obtained between April and August 2016. Material and methodsIdentification and antimicrobial susceptibility were performed in all isolates. The emm type and exotoxin genes speA, speB, speC, speF, speG, speH, speJ, speZ and ssa were analyzed. Clinical and demographic data were collected. ResultsFrom 96 isolates analyzed, 47% had a mucoid phenotype and 95.5% of them presented speA-speB-speF-speG-ssa genes and emm3 genotype. The main clinical manifestation was pharyngotonsillitis (77.1%) evolving to scarlet fever in 67.5% of the cases. ConclusionThis study describes the circulation of a mucoid phenotype strain with a speA-speB-speF-speG-ssa toxin profile and emm3.1 genotype considered one of the most frequent and virulent of SGA.

The secondary outcome of public health measures amidst the COVID-19 pandemic in the spread of other respiratory infectious diseases in Thailand

The coronavirus disease 2019 (COVID-19) has promoted stringent public health measures such as hand hygiene, face mask wearing, and physical distancing to contain the spread of the viral infection. In this retrospective study, the secondary outcomes of those public health measures on containing other respiratory infections among the Thai population were investigated. Hospitalization data spanning from 2016 to 2021 of six respiratory infectious diseases, namely influenza, measles, pertussis, pneumonia, scarlet fever, and tuberculosis (TB), were examined. First, the expected respiratory infectious cases where no public health measures are in place are estimated using the seasonal autoregressive integrated moving average (SARIMA) model. Then the expected number of cases and the observed cases were compared. The results showed a significant drop in the incidence of respiratory infectious diseases by an average of 61%. The reduction in hospitalization is significant for influenza, measles, pertussis, pneumonia, and scarlet fever (p < 0.05), while insignificant for TB (p = 0.54). The notable decrease in the incidence of cases is ascribed to the implementation of public health measures that minimized the opportunity for spread of disease. This decline in cases following relaxation of pandemic countermeasure is contingent on its scope and nature, and it is proof that selective physical distancing, hand hygiene, and use of face masks in public places is a viable route for mitigating respiratory morbidities.

Scarlet Fever – a Diagnostic Challenge for Physicians: a Case Report of Scarlet Fever, Hepatitis, and Sepsis in a 15 –year and 6 month– old Female Adolescent with Severe Acute Malnutrition

Scarlet fever is a term used for an infection caused by a Group a Streptococcal bacteria. The early treatment of scarlet fever is strongly essential either to prevent further spreading of infection or to prevent the risk of complications consisting of peritonsillar and retropharyngeal abscess, sepsis, hepatitis, acute rheumatic fever, glomerulonephritis, pneumonia, endocarditis, and meningitis.&#x0D; We present a case of scarlet fever with sepsis, hepatitis, and severe acute malnutrition in a 15 year and 6 months old female adolescent. Since the patient had specific clinical features of scarlet fever with continuous fever, sore throat, and productive cough for 4 days, followed by general red maculopapular rash initially from the head and progressively spreading to the rest of her body. The patient was also diagnosed with sepsis, hepatitis, and severe acute malnutrition. Erythromycin, ursodeoxycholic acid, vitamin C, folic acid, and vitamin b complex were given to the patient.&#x0D; Rapid diagnosis and prompt treatment are important to prevent other potential complications such as sepsis, abscess, and acute rheumatic fever. Early diagnosis of scarlet fever simultaneously with adequate treatment will prevent the complications of the disease and its spreading among other children

Modeling the effects of air pollutants and meteorological factors on scarlet fever in five provinces, Northwest China, 2013–2018

As a common infectious disease, scarlet fever has exposed a tendency of slow fluctuating ups and downs in recent years with a certain periodicity. In this work, a novel differential equation epidemic model with freely transmitted viruses is introduced to investigate the transmission dynamics of scarlet fever in Northwest China. First, the correlation analysis reveals that the incidence rate of scarlet fever is significantly positively correlated with air pressure (r = 0.61), conversely negatively correlated with precipitation (r = −0.15). Furthermore, the basic reproduction number R0 is derived, and this paper proves that the unique disease-free periodic solution P0 is globally symptotically stable when R0 < 1, while the disease is uniformly persistent and at least one positive periodic solution exists when R0 > 1. Moreover, by studying the qualitative of correlation between the effective reproduction number and air pollutants or meteorological factors, the seasonal variation pattern of incidence is summarized. Our investigations suggest that the relevant epidemic prevention departments should pay close attention to changes in environmental factors of the five provinces of Northwest China to formulate timely prevention strategies before the arrival of the high-risk period.

Rash, red eyes, lip erosions and genital ulcer - What is the diagnosis?

Maculopapular eruptions are frequently described as large areas of rash characterised by red, small, confluent bumps. They are frequently puzzling for the attending clinician due to the multiple possible aetiologies. Accurate diagnosis is important because treatment varies depending on the aetiology, and some rashes can be life-threatening if not treated promptly. Common aetiologies implicated include drug allergies, infection-related (for example: viral exanthems, scarlet fever) and autoimmune conditions (for example: Still's disease). We report a case of maculopapular eruption associated with mucocutaneous involvement and systemic symptoms. The possible differential diagnoses and approach to the management of this patient are discussed.