"Something's happening!"

Under these laconic words on Facebook, Diyan Stamatov, principal of the capital's 119th Primary School "Academician Mikhail Arnaudov", writes: 200 sick (13% of all students); 2 children with scarlet fever (2 classes under observation); 15 children with chicken pox (10 classes under observation); 17 teachers who are sick.

These seemingly alarming figures from one of the best schools in Sofia are also confirmed by the words of Professor Todor Kantardzhiev - health advisor to Sofia Municipality - that scarlet fever cases are 60 times more than in the same period last year.

"Primary school pupils are the most affected," says the school principal, "We have a very mixed picture. It's hard to say whether it's just flu or a combination of other illnesses. We have three colleagues who are ill with Covid-19 and the rest have flu-like symptoms."

Is the increased number of people who have fallen ill a cause for concern, answers GP Dr Stanislava Kraiselska.

"Yes, there is an increased incidence of scarlet fever and chickenpox, but things are not that dramatic. In terms of scarlet fever, the readings are skewed as very often a parent will self-prescribe a throat swab to their child without a clinically evident diagnosis. Thus streptococcus pyogenes, which is the causative agent of not just scarlet fever, but other diseases as well, is isolated, and the school nurse says, "'Quick, they need to write a scarlet fever report.' This is why I believe that some of the information is not correct, although I don't deny that there is an increase."

Virologist Professor Todor Kantardzhiev takes a similar position: 'Not every streptococcus found in a child's nose or throat should be declared as scarlet fever. I advise doctors to refer to textbooks and remember what they say about this disease." According to him, one of the reasons for the increased cases of scarlet fever is the emergence of many viral infections after the coronavirus outbreak, which have weakened the immunity of both children and adults.

"Another thing that is very dangerous is that in recent years antibiotic policy has been severely neglected, in particular training on the correct and balanced use of antibiotics - continues Prof. Kantardzhiev - The causative agent of scarlet fever is very sensitive to the old penicillin-based antibiotics, and when the right dose is given, symptoms start to subside after the 12th hour."

And because children between the ages of 3 and 6, as well as those in the first grades of school, are most affected, the specialist advises that they be screened with rapid tests to reduce the number of infected.

"I'm a little skeptical about the idea because every school already has a stock of Covid-19 tests - explains Diyan Stamatov - And if we repeat the same scenario of storing the tests and then not using them, we will actually become a free laboratory, taking over the functions of the healthcare authorities. This is the job of GPs only, so families should bring their children to them."

Against this background, two optimistic news can be highlighted. The variety of flu strains from this winter will decrease in a week or two, predicts Prof. Todor Kantardzhiev. On 24 March, we mark World TB Day with the encouraging statistic that significantly fewer people have been affected by the disease in this country over the past ten years. And to make prevention even more successful, free TB screenings are now taking place across the country.

Based on interviews by Diana Doncheva and Elena Beykova for BNR's Horizon programme