Fresh outbreaks of scarlet fever were recorded in the UK and North East Asia over the past years, indicating that the once leading epidemic is back, and there is still a long way to go before it is completely gone.

Scarlet fever was once the leading cause of many children's death in the west, but it was believed to be eradicated back in the 20th century. Its resurgence is still a mystery, but a new study, published in Nature Communications, has uncovered clues in the bacteria's genome that causes the deadly disease and showed how complex its family tree could be.

Strep: The Bacteria Behind Scarlet Fever

Scarlet fever is caused by a group of bacteria known as A strep or otherwise called Streptococcus pyogenes. It is a ball-shaped bacteria capable of causing malady inside the body and churns out toxic compounds.

This bacteria usually infect the children, resulting in uncomfortable pharyngitis or bad rash for mild cases, or toxic shock for severe cases that could lead to organ failure.

Scarlet fever outbreaks can easily be prevented or stopped using antibiotics used in the 1940s when it was believed that the epidemic was eradicated.

According to Stephen Brouwer, a molecular biologist from the University of Queensland, scarlet fever's global reach after 2011 has proven its second outbreak in the United Kingdom. By 2014, they discovered that the outbreak is also in Australia.

Brouwer said that new cases of the deadly disease have recorded more than five times increase with over 600,000 cases worldwide.

Moreover, Brouer has characterized a variety of superantigens produced by one strain from North-East Asia. Among them has a clever way of gaining access to the hosts' bodies that have never been seen.

That means the new outbreak is not connected and not the same as the strain of bacteria with infected communities in the past. They are closely related to group A populations that mutated.

Other studies suggest that this strain had help from a virus called phage in which the toxins were transferred to them when the virus infected them.

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Bacterial Clone

The bacteria is believed to have undergone horizontal gene transfer. A gene that evolved in one bacteria can be put into the genome of the virus and edited into the DNA of the new host, which then creates a clone of the original.

It is a quick and easy way for single-celled bacteria to adapt, although it could also happen to non-bacterial organisms. The stolen genes provide novel ways of entering host tissues or resist antibiotics or chemical warfare that would keep them at bay.

In other words, the stolen genes helped the microbe develop a weapon that made it as problematic as the original strain before any treatment was developed. The researchers tried to disable the new strain's coding and found that it has lost its ability to colonize its host.

But with the current restrictions de to COVID-19, it is unlikely that scarlet fever could become a new epidemic. Ultimately, a vaccine is needed to eradicate the disease forever and, therefore preventing any more casualties.


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