Resurgence of scarlet fever in England, 2014–16: a population-based surveillance study  Theresa Lamagni, PhD, Rebecca Guy, BSc, Meera Chand, MBBS, Katherine.

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Resurgence of scarlet fever in England, 2014–16: a population-based surveillance study  Theresa Lamagni, PhD, Rebecca Guy, BSc, Meera Chand, MBBS, Katherine L Henderson, PhD, Victoria Chalker, PhD, James Lewis, BSc, Vanessa Saliba, MD, Alex J Elliot, PhD, Gillian E Smith, MBBS, Prof Stephen Rushton, PhD, Elizabeth A Sheridan, MBBS, Mary Ramsay, MBBS, Alan P Johnson, PhD  The Lancet Infectious Diseases  Volume 18, Issue 2, Pages 180-187 (February 2018) DOI: 10.1016/S1473-3099(17)30693-X Copyright © 2018 Elsevier Ltd Terms and Conditions

Figure 1 Annual rate of scarlet fever notifications and deaths in England and Wales, 1901–2016 Rate of scarlet fever notifications and deaths per 100 000 population by calendar year. The Lancet Infectious Diseases 2018 18, 180-187DOI: (10.1016/S1473-3099(17)30693-X) Copyright © 2018 Elsevier Ltd Terms and Conditions

Figure 2 Weekly number of scarlet fever notifications by season, England Weekly number of notified cases of scarlet fever by season, defined as spanning from the second week in September (week 37) until the first week of September the following year (week 36). Data are shown for consecutive seasons from 2012–13 to 2015–16 along with average counts for each of the three preceding decades. *Mean number of weekly notifications. The Lancet Infectious Diseases 2018 18, 180-187DOI: (10.1016/S1473-3099(17)30693-X) Copyright © 2018 Elsevier Ltd Terms and Conditions

Figure 3 Age distribution of scarlet fever notifications in England, 2014 Sex-specific distribution of the scarlet fever notifications by age of patient in years. Inset provides a magnified view of the age distribution in older children and adults depicting a divergence in numbers of cases in women and men from 15 to 50 years of age. The Lancet Infectious Diseases 2018 18, 180-187DOI: (10.1016/S1473-3099(17)30693-X) Copyright © 2018 Elsevier Ltd Terms and Conditions

Figure 4 Geographical distribution of scarlet fever notification rates in England, 2014 Kernel density surface of scarlet fever notifications per 1000 population based on hexagonal 5 km2 grid and 21·8 km kernel radius. Depth of colour denotes density from overlapping surfaces indicating hotspots of scarlet fever activity. The Lancet Infectious Diseases 2018 18, 180-187DOI: (10.1016/S1473-3099(17)30693-X) Copyright © 2018 Elsevier Ltd Terms and Conditions

Figure 5 Number of patients admitted to NHS hospitals in England for management of scarlet fever by month of admission NHS=National Health Service. The Lancet Infectious Diseases 2018 18, 180-187DOI: (10.1016/S1473-3099(17)30693-X) Copyright © 2018 Elsevier Ltd Terms and Conditions