From symptoms to risk factors – everything you need to know as 8 kids die in Strep A outbreak

EIGHT children under 13 have reportedly died of a rare, invasive form of the strep A virus.

Among them are four-year-old Muhammad Ibrahim Ali from Buckinghamshire and Hanna Roap, seven, from South Wales.

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Camila Rose Burns, four, is fighting for her life on a ventilator in Liverpool.

Hanna’s father, Hasan, said: “We’re just numb, we don’t know what to do. As a family, we are traumatised and devastated.”

Downing Street and health chiefs are warning parents to know the signs and symptoms of the common bug, which in heartbreaking circumstances can trigger a lethal, invasive form of the disease.

Dr Rachel Ward, of Woodlands Medical Centre, Didcot, said: “Thankfully this is rare, but with a number of cases of children dying of this infection, there will be close monitoring and assessment of cases and any new specific guidance will be issued.”

Rates are unusually high this season, across all age groups but there is “potential for severe presentations in children”, according to the UK Health Security Agency.

Kids are at particularly higher risk because of a lack of exposure to the bacteria due in part to Covid lockdowns, which means they may have no or limited immunity.

In children under ten, the rate of invasive infection has been higher than the years preceding the pandemic, but substantially higher than the last two years.

So far this season eight deaths have been recorded in children under the age of 14. This compares with four deaths in the same period in the 2017 to 2018 season.

Here’s what you need to know . . . 

WHAT IS GROUP STREP A?

Group A Streptococcus — Streptococcus pyogenes — is a bacteria that can cause mild illness.

Dr Ward said: “Most commonly Strep A infections cause throat infections – causing sore throat with fever, or skin infections.”

These include:

• TONSILLITIS: causes throat pain
• CELLULITIS: skin infection that causes redness, swelling and pain at the site of the infection
• IMPETIGO: appears as scabbing, very common in young children, the sores can be harder to spot on brown and black skin
• SCARLET FEVER: where fever and sore throat is accompanied by a rash on the body, strawberry-looking tongue and red cheeks.

Complications are rare, but include pneumonia and meningitis
Usually these infections clear up with a swift course of antibiotics, but in some cases, can trigger life-threatening invasive Group A Strep disease.

Dr Ward said: “Rarely a Strep A infection becomes invasive, which is very serious, in which case the NHS says there are four key things to look out for.”

• Fever (temperature above 38C)
• Severe muscle aches
• Localised muscle tenderness
• Redness at the site of a wound

WHAT IS INVASIVE GROUP A STREP DISEASE?

THIS is thankfully rare, but parents should be alert to it.

Severe examples of invasive disease are sepsis, necrotising fasciitis — a “flesh-eating” infection — and toxic shock syndrome.

Dr Ward said: “In more serious invasive infections, people will experience fever, severe aches and possibly muscle tenderness in one area with skin changes. There can also be unexplained vomiting and diarrhoea. This is an emergency, seek medical help immediately.”

WHEN SHOULD YOU SEEK HELP?

FEVERS due to strep A infections usually settle within four to five days.

Dr Elizabeth Whittaker, Honorary Clinical Senior Lecturer, Imperial College London, said: “If they are persisting, or are associated with lethargy, difficulty breathing, poor drinking or wet nappies/urine output, families should get in touch with NHS111 for advice.”

See your GP if your child has headaches, vomiting or diarrhoea after early scarlet fever symptoms have vanished.

Call 999 or go to A&E if:

• Your child is having difficulty breathing. You may notice grunting noises or their tummy sucking under their ribs
• There are pauses when your child breathes
• Your child’s skin, tongue or lips are blue
• Your child is floppy and will not wake up or stay awake

WHO IS AT RISK?

YOU are at higher risk of contracting invasive disease, if you:

• Have been in close contact with someone who has it
• Are over 65
• Are diabetic
• Have heart disease/cancer
• Recently had chickenpox
• Have HIV
• Use some steroids/ intravenous ugs

Chickenpox is very common and treatable at home, but can make children more vulnerable.

Dr Ward said: “Having chickenpox or recent chickenpox is a risk factor for developing invasive Strep A infection due to the impact on the immune system of the chickenpox virus and possible skin infection via the spots.”

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HOW DO YOU CATCH STREP A?

MANY people carry Strep A bacteria without developing symptoms.
However, it can be passed through water droplets when you cough and sneeze, and via close contact, including kissing.

Dr Ward said: “It can also be spread from person to person by touching objects with the bacteria on.” Contracting the invasive disease from loved ones though is rare, according to the NHS.

HOW CAN YOU REDUCE YOUR RISK?

GOT a cough? Bin those tissues and wash your hands! Dr Ward said: “Regular handwashing is very important to reduce spread and minimise close contact with those who have an infection.

Pregnant women and those undergoing gynae procedures should wash their hands before and after using the toilet.”

WHAT’S THE TREATMENT?

DR Ward said: “The commonly seen throat, skin infections and scarlet fever are treated with antibiotics, and medication to bring your temperature down like paracetamol.

“However, invasive infections require hospital-based treatments including intravenous antibiotics and fluids and sometimes emergency surgery.”