Coughs, Colds, Strep A Throat & Scarlet Fever in Children - What You Need To Know

We are aware of the recent media coverage regarding an increase in the number of cases of Scarlet Fever, Strep throat and invasive Group A Strep (iGAS) infection. In addition to this we are still seeing lots of cases of regular, seasonal coughs and colds which do not require any specific treatment.

The coverage has inevitably caused great concern, so it is useful to remember what to look out for.



Coughs & Colds

With the Winter, comes the regular increase in the number of children with coughs and colds caused by common viruses. Fortunately most of the time these illnesses are not serious and normally settle down by themselves without any treatment.

Symptoms include:

  • Cough (which can last several weeks)

  • Runny nose

  • Sneezing

  • Sore throat (normally without white patches on the tonsils)

  • Earache

  • Fever (Temperature 38 degrees Celsius and above)

Normally children will develop this collection of symptoms over 1-3 days without being seriously ill, and then gradually improves over a few more days, although the cough itself can persist longer.

These symptoms can normally be managed at home with rest, good fluid intake and paracetamol (Calpol) where a fever causes any symptoms of discomfort.

If your child develops any of the following symptoms then it is advised to seek medical help:

  • Significantly reduced fluid intake, with reduced urination or reduced wet nappies

  • Rapid breathing or any drawing in under or between the ribs

  • Significant lethargy, being more floppy or less responsive

  • A sudden deterioration in symptoms (normally with the common cold symptoms do not significantly or suddenly worsen)

  • A fever which fails to settle despite regular paracetamol and ibuprofen

Strep Throat

Whereas Coughs & Colds are generally caused by common viruses, Strep Throat is caused by the bacteria, Group A Strep. It most specifically causes a sore, red throat with fever and white spots may be found on the tonsils. It is less likely to cause symptoms of a runny nose, cough and earache. It usually causes a mild illness which improves over several days.

According to Alder Hey Children’s Hospital, symptoms of Strep Throat are:

  • Fever within the last 24 hours 

  • White spots at the back of their throat (pus on their tonsils) 

  • Very large or red tonsils 

  • Sore (tender) lumps under their chin 

  • If they have become poorly quickly over the past couple of days 

  • Usually no cough or runny nose  


It is advised to see a GP or contact 111 if your child has the above symptoms as antibiotics maybe required.

Scarlet Fever

Scarlet fever is a bacterial infection caused by Group A Strep and most commonly effects children between the ages of 2 and 8 years of age. It is like Strep Throat but includes additional symptoms of a ‘sandpaper’ like rash to the body.

Scarlet Fever itself is unlikely to cause symptoms of a runny nose and cough (these symptoms are much more likely to be caused by the common cold).


What are the symptoms of Scarlet Fever?

  • A Fever (>38 degrees C)

  • WITH A red sore throat (often with white patches on the tonsils)

  • AND A rough, sandpaper like rash which may develop on the body after 12-48 hours

  • It may also be associated with headache, nausea and vomiting and a red tongue

What Should I Do?

  • If your child has the symptoms of Scarlet Fever then you should see a GP or contact 111, and if Scarlet Fever is diagnosed it can be well treated with antibiotics

Invasive Group A Strep (iGAS)

Very rarely the bacteria Group A Strep can cause a more serious disease called iGAS. It is very rare and anyone suffering this disease will be very unwell and may have symptoms of sepsis. If these symptoms arise then call 999. For more details on these ‘red flag’ symptoms see below.

Alder Hey Childrens Hospital have provided some useful guidance for symptoms to look out for, as follows:

Contact NHS 111 or your GP if your child is getting worse despite paracetamol or ibuprofen if: 

  • the temperature has lasted more than 5 days 

  • your child is feeding or eating much less than normal, especially if they are drooling or appear in pain when swallowing 

  • your baby has had a dry nappy for 12 hours or more, or is crying without tears 

  • or your child shows other signs of dehydration 

    • feeling thirsty 

    • dark yellow, strong-smelling pee 

    • peeing less often than usual 

    • feeling dizzy or lightheaded 

    • feeling tired 

    • a dry mouth, lips and tongue 

    • sunken eyes (dark circles under eyes) 

  • 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 drowsy (much more sleepy than normal) or irritable (unable to settle them with cuddles, toys, TV or snacks – especially if they remain drowsy or irritable despite any fever coming down) 

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 or using their neck muscles to breathe 

  • there are long pauses (more than 10 seconds) when your child breathes  

  • your child’s skin, tongue or lips are blue 

  • your child feels very cold or clammy to touch 

  • your child is difficult to wake up or keep awake 

  • your child has severe pains in their arms, legs neck or back 

  • your child has a painful, red area of skin, especially if it is getting bigger quickly 

Click Here to see the full article from Alder Hey Children Hospital

For more information on Colds, coughs and ear infections in children please visit NHS.uk

For more information on Sore Throats please visit NHS.uk

For more information on Scarlet Fever please visit NHS.uk