Facebook post makes harmful claims about treating scarlet fever without antibiotics

A post on Facebook wrongly claims that strep A and scarlet fever do not need to be treated with antibiotics and instead encourages the use of homeopathic and alternative treatments—one of which is known to have dangerous side effects. 

The post also falsely claims that extremely high body temperatures are not dangerous in children and that Calpol can suppress the immune system and cause health issues later in life. 

The UK Health Security Agency (UKHSA) has said that there has been an increased rate of scarlet fever and invasive group A strep (iGAS) recently. 

As of 12 December, the deaths of sixteen children since September in England were recorded within seven days of an iGAS infection when the bacteria enters deeper into the body, sometimes including the bloodstream. 

Group A streptococcus (or strep A) is a common bacteria that can be responsible for a range of diseases, ranging from mild to severe. The bacteria can cause scarlet fever, a disease most common in children, with symptoms of fever, sore throat, rash and a ‘strawberry’ swelling of the tongue.

Antibiotics used to treat scarlet fever 

The Facebook post claims: “Scarlet fever and Strep A is very treatable and don’t need antibiotics [...] Antibiotics should be GIVEN when it’s a life and death situation, not for something simple like these illnesses, when it can be treated with natural remedies.”

This is untrue. Scarlet fever is always treated with antibiotics once it has been diagnosed by a doctor, regardless of severity.

Untreated, the infection can develop into more serious and sometimes life-threatening diseases such as rheumatic fever, kidney damage, or iGAS which can include pneumonia, meningitis or sepsis.

Early antibiotic treatment is important to prevent these complications as well as to reduce the risk of passing the infection on.

Milder strep A infections such as strep throat may also require antibiotics to reduce the risk of similar complications, especially in people more vulnerable to them, such as “infants, very old people, and those who are immunosuppressed or immunocompromised"  or people from certain ethnic groups.

Around 5% of streptococcal infections will lead to rheumatic fever if left untreated, a disease that can cause serious problems with valves in the heart. This can be prevented by treating strep throat infections or scarlet fever promptly and completely with a full course of appropriate antibiotics.

Dr Michael Head, senior research fellow in global health at the University of Southampton, said: “The NHS indicates that antibiotics are the most effective treatment, and recommends that the individual should be referred to a GP or other healthcare professional [...]

“The cause of scarlet fever, the Streptococcus bacteria, can result in invasive Group A Strep infection, which has resulted in the tragic deaths of young children in this current outbreak. Any suggestion to go against medical advice and try unproven treatments is potentially dangerous to the child.” 

Professor Alastair Sutcliffe, professor of general paediatrics at University College London told Full Fact the advice given in the Facebook post about antibiotics was “harmful” and said: “This is exactly what antibiotics were developed for, to stop life threatening infections.

“Some things are unproven and not recognised but some things are plain wrong. And that statement is plain wrong.” 

Parents should consider treating high temperatures  

The post goes on to claim that parents should “NEVER bring the temperature/fever down as it’s the worst thing you can do for your child”, adding: “High temperature/fever is designed to allow the immune system to fight infection without any drugs to bring it down. 

“Fever is very healthy and it shows you that the body is doing its job.”

The poster is correct to state that fever is part of the body's immune response, but the claim that high temperatures should never be treated goes against medical advice.

If children can tolerate the fever it can be left untreated, but if the child is in distress paracetamol or ibuprofen can be considered to help relieve symptoms.

The post states that ‘no one has ever died from a fever or got brain damage at temps of 40-41’ and that hallucinations are ‘VERY normal’. However, the NHS advises that temperatures above 38°C in babies under three months old and above 39°C in three to six-month-olds merit seeking medical attention, as does a fever ongoing for five days and hallucinations in children with a fever, among other symptoms. 

Confusion, which may be indicated by hallucinations, is one of several symptoms that should lead to a 999 call. 

A spokesperson for the Medicines and Healthcare products Regulatory Agency (MHRA), told Full Fact: “Fever is a sign that a child has an infection. If the fever does not go down after 3 or 4 days then parents or carers should contact their doctor.”

Further information on fevers in children is available on the NHS website.

Speaking about the claims in the Facebook post, Professor Sutcliffe said: “Often what happens in these sorts of commentaries is they've latched on to some element of truth and either distorted it. 

“It's never been shown for sure that lowering children's temperatures when they have an illness is a good idea. It may not be a good idea, but one would have to prove that in order to say 'this isn't a good idea' rather than just claiming it.”

There have been no definitive studies looking at the effects of lowering fevers on sepsis rates in children. A meta-analysis of 16 studies in critically unwell  patients with sepsis found no negative effects from actively reducing fever via paracetamol, ibuprofen, or even external body cooling.

Calpol won’t suppress immune system or cause health issues later in life 

The post also claims Calpol (containing paracetamol) and Nurofen (containing ibuprofen) will “suppress your immune [system] and cause illness in later life”. 

The MHRA evidence review to approve these medications found no evidence of impact of Calpol on the immune system, and for Nurofen a very rare (<1/10,000) side effect of lowered white blood cells, the immune cells in the blood. 

An MHRA spokesperson told Full Fact: “When used according to the instructions, these medicines are acceptably safe and effective medicines for children.

“Packaging must clearly display what the medicine is for, what it contains, who can or cannot take it and includes detailed instructions for use.

“‘Suppression of [the] immune system’ is not a listed side effect with these medicines.”

Ibuprofen can cause skin reactions in children with chicken pox but there is no evidence for causing similar infections outside of this group. 

Colloidal silver can have dangerous side effects 

Towards the end of the post the author lists a number of alternative homeopathic treatments for parents to give their children instead of prescribed antibiotics or common medicines such as Calpol. 

Homeopathy is an alternative medical practice based around the idea that “like-cures-like” and it involves using very diluted substances to treat disease. For example, given that coffee can cause insomnia, a homeopathic treatment for sleeplessness could involve giving very diluted coffee to the patient.

Dr Head told Full Fact: “The NHS does not recommend homeopathy, or seeing a homeopath. They highlight how homeopathic remedies perform no better than placebos, and do not provide funding for homeopathy treatments on the NHS. There is no evidence that homeopathy is effective for scarlet fever [...]

“The Cochrane Review [this is a systematic review of all available evidence on the subject published by the respected Cochrane Library]  has covered the topic of homeopathy treatments for acute respiratory infections in children. They concluded that the evidence base ‘did not show any benefit of homeopathic medicinal products compared to placebo’.” 

Among the suggestions of homoeopathic treatments is colloidal silver spray “for [a] sore throat”. Colloidal silver consists of silver particles in a liquid and is promoted by some as a dietary supplement, though there is no evidence to support claims of health-related benefits. 

In fact, there is evidence that the product can be harmful to people’s health, with the most common side effect being argyria, a bluish-grey discoloration of the skin, which is usually permanent. It can also cause the poor absorption of some drugs, including antibiotics, as well as stomach pains and kidney damage. 

A spokesperson for the Medicines and Healthcare products Regulatory Agency confirmed to Full Fact that colloidal silver is not a registered homeopathic medicine in the UK. 

Image courtesy of Towfiqu Barbhuiya