Scarlet fever
© Kronawitter/Wikimedia CommonsStrawberry tongue from scarlet fever.

A scarlet fever outbreak in Hong Kong, thought to be a mutant strain resistant to antibiotics, claimed the life of a second child on Tuesday and health officials there state they are dealing with "an epidemic."

Hong Kong officials have recorded 494 cases of scarlet fever this year, more than triple the total for 2010. It is the city's highest annual total. Thomas Tsang, controller for Hong Kong's Centre for Health Protection, said: "We are facing an epidemic because the bacteria that is causing scarlet fever is widely circulating in this region -- not only in Hong Kong but in mainland China and Macau," according to Asia Pacific News (APN).

In mainland China, more than 9,000 people have been infected this year, double the numbers of recent years. Increased transmission of the disease is believed caused by a unique gene fragment in the bacteria's genome, a health protection centre statement said, APN notes.

"Scarlet fever is in its peak season and may continue to be widespread for a prolonged period of time, possibly the whole summer," Tsang added.
Hong Kong, a densely populated city, is reportedly nervous over infectious diseases. A SARS outbreak in 2003 killed 300 people there and has also seen multiple outbreaks of swine flu.

By noon on Wednesday, the city had recorded 28 new cases, the largest single day total this year, AFP reports. Late Wednesday, health officials there confirmed the boy died as a result of scarlet fever.

Preceding the 5-year-old boy's death this week, a 7-year-old girl died in late May. Hers was the first death in Hong Kong linked to scarlet fever in over a decade.

The new strain of scarlet fever appears to be 60 percent resistant to antibiotics, compared to previous strains which were 10 to 30 percent resistant, said Kwok-yung Yuen, professor of microbiology at Hong Kong University, according to CBS News.

Usually occurring in children, most commonly in those under 10 years of age, symptoms of scarlet fever include sore throat and high temperatures. Typically, it begins as a rash on the chest or stomach and can spread over the body, lasting three to five days.

The rash is most pronounced in the arm pit and groin areas, along the elbow creases, and feels like sandpaper. Another sign is a pale tongue covered with red spots. The germ, carried in the mouth and nasal fluids, is spread by sneezing and coughing.

Scarlet fever, a bacterial disease, can lead to rheumatic fever if left untreated. In rare cases it clan lead to kidney inflammation, or glomerulonephritis, causing high blood pressure or blood to appear in the urine, the American Academy of Pediatrics notes. Antibiotics such as penicillin and amoxicillin are typically used for treatment. Also known as scarlatina, the bacteria is group A Streptococcus, or "group A strep".