Parents across the UK are being urged to look out for symptoms of strep A infection in their children after health officials revealed a rise in cases had led to the death of six youngsters.
The UK Health Security Agency (UKHSA) issued a rare alert on Friday evening after a rise in cases across the country, telling parents to seek medical help as soon as possible if they detect signs in their children, in order to stop the infection becoming serious.
Symptoms include a sore throat, fever and minor skin infections. In most cases, people can be treated with antibiotics and make a full recovery. In rare cases, however, strep A can become a serious illness, and anyone with high fever, severe muscle aches, pain in one area of the body and unexplained vomiting or diarrhoea should seek urgent medical help.
One or two children under the age of 10 die as a result of strep A in typical winter, but five children in England and one in Wales have already lost their lives this season.
Public health officials said there was currently no evidence of a new strain was circulating. The rise in cases and deaths was most likely to be related to high amounts of circulating bacteria and increased social mixing, they said.
Strep A can cause a range of different health issues, including the skin infection impetigo, strep throat and scarlet fever.
The vast majority of infections are relatively mild, but the bacteria can also cause a life-threatening illness called invasive group A streptococcal (iGAS) disease.
The UKHSA said on Friday evening that there has been a significant rise in scarlet fever cases recently. There were 851 cases reported in the week of 14 to 20 November, compared with an average of 186 for the same period in previous years.
There have also been 2.3 cases of iGAS per 100,000 children aged one to four in England this year, compared with an average of 0.5 in the pre-pandemic seasons from 2017 to 2019, the agency said. There have also been 1.1 cases per 100,000 children aged five to nine, compared with the pre-pandemic average of 0.3.
During the last high season for strep A infection, in 2017/18, there were four deaths in children under 10 in England at this point of the season. This year the figure is five.
“We are seeing a higher number of cases of group A strep this year than usual,” Dr Colin Brown, the deputy director of UKHSA, said in a statement.
“The bacteria usually cause a mild infection producing sore throats or scarlet fever that can be easily treated with antibiotics. In very rare circumstances, this bacteria can get into the bloodstream and cause serious illness called invasive group A strep (iGAS).
“This is still uncommon. However, it is important that parents are on the lookout for symptoms and see a doctor as quickly as possible so that their child can be treated and we can stop the infection becoming serious.
“Make sure you talk to a health professional if your child is showing signs of deteriorating after a bout of scarlet fever, a sore throat, or a respiratory infection.”
The UKHSA said investigations were also under way after reports of an increase in lower respiratory tract strep A infections in children that have caused severe illness over the past few weeks.
The agency confirmed earlier on Friday that a child who attended St John’s primary school in Ealing, west London, had died of strep A, and it also emerged that the parents of a four-year-old boy from Buckinghamshire said he had died of it too.
Shabana Kousar, the mother of Muhammad Ibrahim Ali, who attended the Oakridge school and nursery in High Wycombe, told the Bucks Free Press: “The loss is great and nothing will replace that.”
A pupil from Victoria primary school in Penarth, four miles south of Cardiff, also died of the infection, and six-year-old died last week after an outbreak at a school in Surrey.
The UKHSA revealed on Friday evening that a fifth child in England had died since September, bringing the total known deaths in England and Wales to six. Data from Scotland and Northern Ireland was not immediately available.
There are lots of viruses circulating that cause sore throats, colds and coughs circulating, and these should resolve without medical intervention. Occasionally however, children can develop a bacterial infection on top of a viral one and that can make them more unwell.
Parents are being told to contact NHS 111 or their GP if their child is getting worse, is feeding or eating much less than normal or has had a dry nappy for 12 hours or more or shows other signs of dehydration.
They should also seek help if their baby is under three months and has a temperature of 38C, or is older than three months and has a temperature of 39C or higher. Other red flags are if the child is very tired or irritable.
Parents should call 999 or go to A&E if a child is having difficulty breathing, such as grunting noises or tummy sucking in under the ribs, pauses in breathing, blue colour to a their skin, tongue or lips, or if they are floppy and will not wake up or stay awake.
A lack of mixing as a result of the pandemic could be behind a drop in immunity to infections such as strep A, said Dr Simon Clarke, a microbiologist at the University of Reading.
“I’m unaware of any factor linking these reported deaths, so it’s impossible to link them, but I do expect there to be further cases over the coming weeks and months.
“It strikes me that as we are seeing with flu at the moment, lack of mixing in kids may have caused a drop in population-wide immunity that could increase transmission, particularly in school-age children.”