A few years ago we were all confronted by an increase in cases of scarlet fever and a number of cases of more invasive and severe Streptococcal infections. It was interesting to read that due to a very well established global surveillance system, this raise in Streptococcal pyogenes (S pyogenes) infections has been described in detail by Lynsky NN et al . [Lancet Infect Dis 2019; 19: 1209–18 http://dx.doi.org/10.1016/S1473-3099(19)30446-3] First, this is a great paper on scarlet fever and is a very interesting historical review. Up until the beginning of the 20th century it was associated a significant mortality. …