Video report by Tim Scott
The North West has the highest rates of scarlet fever in England - an infection linked to the deadly Strep A bacteria, new figures have shown.
The data, from the UK Health Security Agency (UKHSA), shows the North West has 13 cases per 100,000 residents in the latest 10-week period recorded, with 957 cases in total.
Scarlet fever is caused by the same bacteria that can lead to invasive Group A Streptococcal disease (iGAS), which has claimed the lives of nine children in the UK.
Figures show the North West also has an iGAS rate above the national average.
Strep A usually causes mild illnesses such as strep throat or scarlet fever, but on very rare occasions the bacteria becomes iGAS and can get into the bloodstream and attack the organs.
Rates of iGAS are now four times higher than usual among children aged one to four.
A five-year-old girl from Northern Ireland is the ninth child to die from illness linked to the Strep A infection since September. Seven children in England and one child in Wales have also died.
Professor Matt Ashton, Director of Public Health in Liverpool says the region is seeing a larger number of patients than usual with "nasty bugs circulating in the community" as a result of less social mixing due to the Covid pandemic.
Video: Prof Ashton explains when to ring 999 when Strep A causes breathing problems
Symptoms of scarlet fever
A sore throat
Fine red rash, typically first appears on the chest and stomach, rapidly spreading to other parts of the body.
Older children may not have the rash.
On more darkly pigmented skin, the scarlet rash may be harder to spot, but it should feel like 'sandpaper'.
Symptoms of iGAS (invasive form of Strep A)
Fever (a high temperature above 38°C)
Severe muscle aches
Localised muscle tenderness
Redness at the site of a wound.
Parents are being advised to contact their GP or get medical advice straight away if they think their child has any of the signs and symptoms of iGAS disease.
Alder Hey Children's Hospital in Liverpool says it is seeing its "highest ever" admissions into A&E over parents concerned about Strep A.
On Monday 5 December, more than 300 children attended A&E, with the hospital reporting it was seeing four times as many patients compared to recent years, along with flu levels higher than normal this year.
There has been a sharp rise in infections in schools, where children are catching the virus.
At a primary school in Cheshire, the attendance is the lowest it has been all year.
Leighton Academy says there are around 40 children off sick and with either scarlet fever or Strep A symptoms and chicken pox. They also have a number of staff off with Strep A symptoms.
The school received updated guidance from the UK Health Security Agency and has already taken precautions by reintroducing covid style measures including sanitising and extra cleaning of classrooms to kill the virus.
They are encouraging children to practice good hand hygiene.
Last week, the UK Health Security Agency issued a rare alert warning parents of the signs to look out for.
Anyone who believes their child is suffering with the illness is advised to contact NHS 111 or their GP immediately.
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