The respite from childhood epidemics has ended after a relatively mild flu season compared with some recent years. Families and schools are now coping with a major summer outbreak of scarlet fever. Parents will not relish the prospect of having to remain vigilant and quarantine victims during the school holidays. But at least the vacation will break the circuit of infection through schools and kindergartens. The outbreak may well have peaked by the time school resumes.
Scarlet fever is neither uncommon nor as a rule life-threatening. Sadly, however, the disease has already claimed the lives two children aged five and seven. So while parents should not be overly alarmed, they must not be complacent. Vigilance is the best defence. The Centre for Health Protection says we are facing a severe epidemic, with the number of cases the highest since scarlet fever became a notifiable disease in 1997 and more than double the previous record of 235 in an outbreak three years ago. The Salvation Army did not wait for confirmation that scarlet fever was responsible for the death of a five-year-old boy this week before closing the kindergarten he attended with about 400 other children. Other school authorities must be prepared to take swift action in response to a widespread outbreak.
Research at the University of Hong Kong indicates that a small but significant genetic mutation of the scarlet fever bacteria may be responsible for the high number of cases this year. The university's head of microbiology, Professor Yuen Kwok-yung, attributes this genetic change to the overuse of antibiotics, particularly to treat viral conditions such as colds and flu - a reminder of the dire threat that bacterial resistance to antibiotics poses to humanity.
The bacteria may have changed, but preventive measures remain the same, such as attention to hygiene - particularly hand-washing, masking coughing and sneezing, and keeping sick or off-colour children at home and in isolation.