Infections caused by Group A streptococcus (GAS) have been increasing since the beginning of October. Public Health Scotland (PHS) is monitoring the situation in Scotland and has published new surveillance data today.

The data show that, while there is an out of season increase in cases of GAS being reported in Scotland; numbers are similar to those seen during previous peaks.

The latest data, which will be published on a weekly basis moving forward, also highlight that most Group A strep infections are mild.

What infections does GAS cause?

A common presentation of GAS is scarlet fever.

Group A strep is confirmed in the laboratory from a throat swab. In Scotland, PHS monitors and reports the number of laboratory confirmed upper respiratory tract GAS infections as a proxy measure of scarlet fever*.

What is Invasive Group A Streptococcal (IGAS)?

Whilst GAS infections, including scarlet fever, are common; the more serious Invasive Group A Streptococcal (IGAS) infections, when the bacteria gets into the bloodstream for example, are rare.

The data published today show that PHS has received reports of 25 IGAS cases in November 2022 across all age groups in Scotland.

PHS will update this report in the coming weeks to include additional data.

As reported over the weekend, incidence is usually highest in those under the age of 10 years. Data from the beginning of October to 5 December 2022 (9 weeks) show that PHS has received reports of 13 IGAS cases in children under 10 years. There have been no reported deaths in this age group in Scotland this season.

Commenting on the latest data Dr Nick Phin, Director of Public Health Science at PHS, said:

“The bacteria causing scarlet fever, and related infections, is usually found in the throat and on the skin. We would, therefore, encourage adults to ensure children wash their hands frequently with soap and water, and to cover their mouth and nose with a tissue when they cough or sneeze and then put the used tissue in the bin. These simple actions can help to reduce the spread of common infections like Group A strep.

“If your child is showing signs of scarlet fever, please seek advice from a health professional as most cases respond promptly to early treatment with antibiotics.

“PHS continues to work closely with NHS Boards, as well as public health colleagues across the UK, to monitor the situation.”

What are the symptoms of scarlet fever?

Scarlet fever causes the following symptoms: headache, sore throat, high temperature and raised pink/purple spots that join up to produce a skin rash, which feels like sandpaper to the touch.

More information on scarlet fever, including when to seek medical advice, can be found on NHS Inform.


Cases of GAS usually increase during the winter and the last time significant numbers of cases were reported was in the 2017/18 season. Peaks can occur every three to four years but social distancing measures implemented during the COVID-19 pandemic may have interrupted this cycle and explain the current increase being observed.

Good hand and respiratory hygiene are important for stopping the spread of many bugs. Children and adults should wash their hands frequently and cover their mouth and nose with a tissue when they cough or sneeze.

*Scarlet fever has not been a Statutory Notifiable infection in Scotland since 2008 so there are no Official Statistics on this infection.

View the latest data on Group A streptococcus.

Last updated: 07 December 2022