A cluster of 18 scarlet fever cases and large illness absenteeism (32%, 58/184) in a school prompted concern and further investigation. We conducted telephone interviews with parents to ascertain cases and better comprehend parents' views. We identified 19 cases, of which 13 reported scarlet fever diagnosis by a physician and only seven fulfilled the probable case definition. We concluded that the outbreak was far smaller than suspected and found that communication and reporting could be improved. Accurate information and communication is essential in an outbreak; the school's concern could have been alleviated sooner and response measures better targeted.

kappa paraprotein, leading to a new diagnosis of monoclonal gammopathy of undetermined significance (MGUS). IgLON5 autoimmunity was considered the likely explanation for the peripheral neuropathy, as sural nerve biopsy findings were not typical for MGUS-related neuropathy. He received IVIg, oral prednisolone, plasma exchange and Rituximab. During followup, he progressed to multiple myeloma and commenced lenalidomide and dexamethasone. Conclusion Our two cases and the few published reports suggest an association of peripheral neuropathy and IgLON5 autoimmunity. We recommend cases of IgLON5 autoimmunity undergo routine neurophysiological studies.