Record levels of Strep A infection are continuing to circulate among children, say health officials, who are appealing to schools and nurseries to maintain vigorous hand washing.

Between September and the start of January there were 35,616 cases of Scarlet Fever alone - compared to just 4,192 for the same period prior to the pandemic between 2017 and 2018.

Alongside Scarlet Fever, Strep A can also be responsible for other viruses including tonsilitis or 'Strep throat'.

The number of children falling very seriously ill with Invasive group A strep - or iGAS - a more severe and sometimes life threatening infection which enters other parts of the body such as the blood stream or tissue in the lungs is also much higher, says the UK Health Security Agency which has released its latest figures.

While still rare in comparison to the huge numbers of Strep A infection being seen, there have been so far 159 iGAS cases reported in children aged one to four since only September compared to 194 cases across an entire year between 2017 and 2018. There have also been 118 cases in children aged five to nine, compared to 117 in a 12 month period during the last comparably high Strep A season three years ago.

While the majority of iGAS cases continue, says the UKHSA, to be in those over 45 years of age the number of children dying from the infection has also risen in the last few months.

Among 151 deaths so far this season across all age groups in England are 29 children under the age of 18 who have died from iGAS. In the 2017-2018 season there were a total of 355 deaths across all age groups during the year with 27 of those in patients under the age of 18.

The UK Health Security Agency - which at the start of this week appealed to anyone unwell to stay away from their workplace or school as part of efforts to contain the spread of illness - says alongside flu and Covid-19, Strep A infections among children appear to remain at very high levels for the start of term.

Incident director Dr Obaghe Edeghere said: "As children return to school, scarlet fever and ‘strep throat’ continue to circulate at high levels and so it is important that we all wash our hands regularly and thoroughly and catch coughs and sneezes in a tissue. This will help stop germs spreading between children and to other vulnerable groups and will help prevent the spread of other winter illnesses that are currently circulating at high levels, including flu and Covid-19.

"Most winter illnesses can be managed at home and NHS.UK has information to help parents look after children with mild illness. Deaths and serious illness following group A strep infection are very rare and the infection can be easily treated with antibiotics."

But parents with an unwell child are being reminded to seek the advice of the health service if they're concerned their child is going downhill.

Dr Edeghere added: "Speak to a healthcare professional if you think your child is getting worse, for instance they are feeding or eating less than normal, are dehydrated, have a high temperature that won’t go down, are very hot and sweaty or seem more tired or irritable than normal."