Group A Streptococcus bacteria can colonise the throat, skin, and anogenital tract, leading to infections affecting the skin, soft tissues and respiratory tract. Resulting conditions can include throat infections, skin infections (eg impetigo), pneumonia and scarlet fever.43

Pharmacists will be familiar with diagnostic and treatment considerations for impetigo (from 1 year upwards) and sore throat (from 5 years) as part of the Pharmacy First clinical pathways service.44

Scarlet fever can start with flu-like symptoms, fever, and swollen neck glands before the rash breaks out. This is slightly raised with a rough feel, like sandpaper, and starts on the chest and abdomen. A white coating on the tongue peels, leaving the tongue swollen, red and covered in bumps, described as a strawberry tongue. The cheeks can redden, although this is not like the body rash. Later on, the bodily rash may peel.32

Complications are usually rare, but include ear infection, throat abscess, sinusitis, pneumonia, meningitis, or rheumatic fever.