For the past few days, an increasing number of Hong Kong children have been diagnosed with scarlet fever, with two deaths to date. The Hong Kong Centre for Health Prevention now posts daily updates here. So far, one kindergarten in Sha Tin district has been closed, while two other schools in Kowloon and Yuen Long districts have reported cases.
Scarlet fever is caused by Streptococcus pyogenes (or Group A streptococcus for those of you who remember the antiquated Lancefield groups), a bacterium that is better known in the media as the "flesh-eating bug" because it can rarely cause necrotizing fasciitis. Residents (got to get used to this word!) know it as the bug that most commonly causes cellulitis (although hardly ever cultured), while those going for medical clinical exams remember it best as the cause of rheumatic fever and rheumatic heart disease.
But on a more prosaic level, it is carried in the throats of about 10% of school-going children (some reports put this as high as 28%), where it doesn't generally cause any disease. S. pyogenes is spread via contact, and better hygiene will help prevent transmission (always difficult in young children hence more schools in HK will probably be closed).
Given the unusual virulence and scale of this outbreak, it is likely that we are seeing a novel clone of S. pyogenes, as was the case with the Escherichia coli causing the huge outbreak in Germany recently.
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