Six children have died with Strep A bacterial infection

UK

There have been five recorded deaths within seven days of an invasive Strep A diagnosis in children under 10 in England this season, the UK Health Security Agency has said.

A child under the age of 10 has also died in Wales after contracting the infection.

Group A strep bacteria can cause many infections, ranging from minor illnesses to deadly diseases, but serious complications and deaths are rare.

According to UKHSA data, there were 2.3 cases of invasive disease per 100,000 children aged one to four this year in England, compared with an average of 0.5 in the pre-pandemic seasons (2017 to 2019).

There have also been 1.1 cases per 100,000 children aged five to nine, compared with the pre-pandemic average of 0.3 (2017 to 2019).

The UKHSA said investigations are under way following reports of an increase in lower respiratory tract Group A Strep infections in children over the past few weeks, which have caused severe illness.

It added that there is no evidence to suggest a new strain of Strep A is circulating, and the increase is most likely related to high amounts of circulating bacteria and social mixing.

Strep graph. Pic: gov
Image:
Rate per 100,000 population iGAS notifications in England by age group, weeks 37 to 35. Pic: UKHSA

Read more:
What is Strep A and what are the symptoms?

Strep A is common – so why the spate of deaths now?
New medications failing to tackle infections

‘Wonderful, kind, smiley’

Earlier, Sky News confirmed the death of Muhammad Ibrahim Ali, who was four, following an announcement by his school in High Wycombe, Buckinghamshire, on 17 November.

Health officials have now confirmed that he had invasive Group A streptococcus (iGas).

He was described as a “wonderful, kind, smiley and energetic boy” on a JustGiving page set up in his memory.

Dr Jill Morris, health protection consultant at the UK Health Security Agency, said: “This is a tragic case and our thoughts are with the family and friends of the individual at this very sad time.

“We have provided advice to the school and nursery to help prevent further cases and will continue to monitor the situation.”

Muhammad Ibrahim Ali
Pic:JustGiving
Image:
Muhammad Ibrahim Ali died last month. Pic: JustGiving

Where have the other deaths been recorded?

Earlier today, the death of a child in Ealing, west London, was confirmed by the UKHSA as another case of iGAS.

Dr Yimmy Chow, health protection consultant at the UKHSA, said: “We are extremely saddened to hear about the death of a child at St John’s Primary School, and our thoughts are with their family, friends and the school community.

“Working with Ealing Council public health team, we have provided precautionary advice to the school community to help prevent further cases and we continue to monitor the situation closely.”

A pupil at a primary school near Cardiff, has also died from the infection, as well as a six-year-old child who died after an outbreak at Ashford Church of England School in Surrey.

Meanwhile, the UKHSA said the latest data shows cases of scarlet fever, which is caused by Strep A, “continue to remain higher than we would typically see at this time of year”.

They said there were 851 cases reported in the latest week available, compared to an average of 186 for the preceding years.

Strep A is common and generally causes mild infections – so why the spate of deaths now?

Another death of a young child from Strep A will send a chill down the spine of any parent.

So what is the risk and why the spate of deaths now?

Group A streptococcus is a common bacterium that generally causes relatively mild infections, such as sore throats.

Only rarely does the bug get into the bloodstream or some other place in the body where it isn’t normally found, multiply rapidly and cause more serious problems.

Doctors call it invasive Group A Strep, or iGAS, and that seems to be what has resulted in these deaths.

There are different strains of Strep A, and some are more likely to cause serious disease.

We don’t know yet whether a particular strain is involved in these deaths.

But this isn’t a geographic cluster; the children lived far apart. So it’s not a bug that was passed from one to another.

It’s more likely that the common link is that the children didn’t get antibiotics in time.

Read more of Thomas Moore’s analysis here

What are the symptoms of Strep A and how does it spread?

Dr Chow said: “Group A streptococcal infections usually result in mild illness, and information has been shared with parents and staff about the signs and symptoms.

“These include a sore throat, fever and minor skin infections and can be treated with a full course of antibiotics from the GP.

“In rare incidences, it can be a severe illness and anyone with high fever, severe muscle aches, pain in one area of the body and unexplained vomiting or diarrhoea should call NHS 111 and seek medical help immediately.”

Strep A can be spread through coughs, sneezes and skin-to-skin contact. People over 65, those who have HIV, use steroids or other drugs, or suffer from diabetes, heart disease or cancer are most at risk of catching the infection.

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What are the symptoms of Strep A?

‘We just need to act quickly’

Oksana Pysik from the Outbreak Educational Programme in Infectious Diseases at University College London, explained to Sky News that Strep A can often present similar to flu.

However, one way to tell it apart is that sometime there is a “whitish coating on the tongue”, which is also known as “strawberry tongue”.

She added that due to the way the infection spreads, it’s typically more common in school settings and care homes, and it is “important” people who contract it to get antibiotics as “quickly as possible” to stop complications from arising.

“Parents shouldn’t be overly worried… I wouldn’t want to over concern because of the outbreaks we are seeing, we just need to act quickly,” she said.

The UKHSA advises those who come down with the illness to exclude themselves from nursery, school or work for at least 24 hours after they start antibiotic treatment.

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