What is Strep A and why have 6 children died from it?
If you have seen the news recently, it may be alarming to hear that 6 children have died after contracting a Strep A infection (1).
In this explainer, we answer the key questions about this disease.
What is Strep A?
Group A Streptococcus (GAS) is a common bacteria which can cause a wide range of infections. GAS is spread by close contact between individuals, such as through respiratory droplets and direct skin contact (2).
It can also be transmitted if people come into contact with contaminated items such as towels or bedding (2).
Mostly it will only cause minor infections, such as ‘strep throat’, however, it can also cause other skin and lung conditions such as impetigo, pneumonia and, commonly in children, scarlet fever. These can usually be easily treated with antibiotics (2, 3).
Very rarely GAS can get into the bloodstream and cause a very serious condition called invasive Group A Streptococcus (iGAS). iGAS can be life-threatening because the infection is widespread and affects multiple organs, making it more difficult to treat (2, 3).
Has there been increased GAS infections?
The UK Health Security Agency (UKHSA), which is responsible for monitoring and responding to public health issues, has stated there are a higher number of GAS infections than is usual for this time of year (3).
It reports there have been 851 cases of scarlet fever in the last week — at this time of year there would usually be 186 cases per week.
There has also been an increase in the number of invasive GAS infections.
There is 2.3 cases of iGAS per 100,000 children aged 1–4, compared to an average of 0.5 in the pre-pandemic seasons (2017–2019).
There is 1.1 cases per 100,000 in children aged 5–9 compared to 0.3 pre-pandemic at the same time of year (3).
As you can see, although the risk has got ~3 or 4 times bigger, overall iGAS remains very rare.
Why are there more GAS infections? Is there a new strain?
There is no evidence currently of a new strain, although there are ongoing investigations. It is thought the increased infections are most likely due to increased social mixing (3).
Some experts believe there may have been a slight drop in immunity due to a lack of mixing during the pandemic which may have contributed to its increased spread now (4).
What should people look out for?
The UKHSA is advising parents to look out for the signs of scarlet fever — it is most common in 4–8 year olds.
It is usually a mild illness and symptoms include a sore throat, headache, fever and a fine pink/red body rash with a sandpapery feel. It can be more difficult to see on darker skin — however, you should still be able to feel the sandpapery nature of the rash.
Some of these symptoms are also very common in viral illnesses which aren’t treated with antibiotics and will get better by themselves, but if you’re concerned it could be scarlet fever or that your child is very unwell it’s important to contact 111 or your GP. They will be able to identify if it does need antibiotics, and prompt treatment can reduce the risk of complications such as pneumonia or bloodstream infection (3).
Find out more about scarlet fever here and click here for more information to recognise if a child is seriously unwell.
The UKHSA is also advising people to wash their hands well with soap for at least 20 seconds and to catch sneezes in tissues to help prevent the spread of bacteria and other germs (3).
TL;DR → The UKHSA has advised to parents to look out for the signs of scarlet fever after an increase in Group A Strep infections with 6 children dying. Overall the risk of serious disease remains very rare, however, it is important to treat quickly with antibiotics.
Note: this article was updated on 04/12/22 to include an additional link to information to recognise if your child is unwell.
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