There has been an "out of season increase" in Strep A infections in recent weeks, with parents across Wales reporting their children have fallen ill. Whilst Strep A is a common type of bacteria, and most infections are mild and easily treated, other cases are more serious - with some leading to scarlet fever.
Tragically, Strep A infections have killed dozens of people across the UK, including a seven-year-old girl from Penarth. Whilst most discussion of the infection has revolved around young people - and fears the infection could quickly spread around schools - it's important to note that adults can also be diagnosed with Strep A.
"Adults can get strep A infections but they’re more common in children," the NHS says. "Avoiding close contact with someone you know is infected and things like regular handwashing will help lower your chances of getting a strep A infection."
That said, according to the UK Health Security Agency, the "majority" of cases of Strep A in recent weeks have been affecting people over the age of 15.
The latest data from the UK Health Security Agency (UKHSA) shows there has been an increase in positive cases of scarlet fever and 'Group A Streptococcus Infections' (known more commonly as 'Strep A'). The UK Health Security Agency reports there have been 7,750 notifications of scarlet fever so far this season, from September 12 to December 11, 2022. "This compares to a total of 2,538 at the same point in the year during the last comparably high season in 2017 to 2018 - although cases in that season started to rise at a different point," the agency explained. "In 2017 to 2018, there were 30,768 scarlet fever notifications overall across the year."
The agency continued: "Invasive group A streptococcus (iGAS) infections remain rare. So far this season, there have been 111 iGAS cases in children aged one to four, compared to 194 cases in that age group across the whole year of the last comparably high season in 2017 to 2018. There have been 74 cases in children aged five to nine years, compared to 117 across the whole year of the last comparably high season in 2017 to 2018. The majority of cases continue to be in those over 15 years.
"Sadly, so far this season there have been 74 deaths across all age groups in England. This figure includes 16 children aged under 18 in England. In the 2017 to 2018 season, there were 355 deaths in total across the season, including 27 deaths in children under 18."
What are the symptoms of Strep A?
The NHS says most Strep A infections are "not serious" and can be treated with antibiotics. However, sometimes the infection can cause serious problems - this is called Invasive group A Strep (iGAS).
Common symptoms of strep A include:
- flu-like symptoms, such as a high temperature, swollen glands or an aching body
- sore throat (strep throat or tonsillitis)
- a rash that feels rough, like sandpaper (scarlet fever)
- scabs and sores (impetigo)
- pain and swelling (cellulitis)
- severe muscle aches
- nausea and vomiting
How do I avoid getting Strep A?
Infections like Strep A can easily be spread to other people, so to reduce the chance of catching or spreading the infection, people should:
- Wash their hands often with soap and water
- Cover their mouth and nose with a tissue when they cough or sneeze
- Bin used tissues as quickly as possible
What do I do if I have Strep A or my child has Strep A?
The NHS says that if you or your child has a Strep A infection, you should get antibiotics from your GP or pharmacy and stay away from nursery, school or work for 24 hours after you start taking the antibiotics. This will help stop the infection spreading to other people. You should treat symptoms at home if you can, with paracetamol and rest, and visit the NHS 111 website for further advice.
The NHS further adds that if you're a parent or guardian worried about your child, you should "trust your instincts". If you believe your child is ill but not seriously ill, you can usually look after them at home and you can give them children's paracetamol or children's ibuprofen.
But if you believe your child is seriously ill, for example they're unwell and it's getting worse, they're feeding or eating much less than usual, going to the toilet less than usual or showing other signs of dehydration, and becoming "very tired or irritable," you should get an urgent GP appointment or visit the NHS 111 website for advice.
However, if your child is having difficulty breathing, there are pauses when your child breathes, your child's skin, tongue or lips are blue or grey, or your child is "floppy" and will not wake up or stay awake - you should call 999 or go to A&E.
Statement from Welsh Government on increase in Strep A cases
A statement from the minister for health and social services, Eluned Morgan, says: "The recent deaths of children across the UK; including a child here in Wales, has caused a great deal of concern. Our thoughts and condolences go out to the families, friends and all those impacted by these tragic deaths.
"Strep A is a bacteria that many people carry without any symptoms. It can be spread to others through close contact and through coughs and sneezes. Where people do develop symptoms, they are typically quite mild, such as the common childhood disease known as scarlet fever.
"Very rarely, and particularly if an individual has other health issues or is co-infected with another infection at the same time, such as chickenpox or a respiratory virus, the Strep A bacteria can get into the bloodstream. This is then known as invasive Strep A disease and can sadly result in a tragic outcome, especially if not treated quickly.
"We are seeing a higher number of cases of Strep A infection this year compared to recent years and we are also seeing it during the winter, when ordinarily we would expect to see large numbers of cases during the spring. Investigations are ongoing but we believe this is likely to have occurred because of the lack of social mixing over the past couple of years.
"The high number of cases of this common bacterial infection circulating at the same time as a range of winter respiratory infections has, we believe, resulted in increased numbers of the rarer and more serious invasive Strep A disease. Early signs of the more serious invasive Strep A disease include a high fever, severe muscle aches, local muscle tenderness, or redness at the site of a wound. Parents are advised to contact their GP or get medical advice straight away if they think their child has any of the signs and symptoms of invasive Strep A disease.
"All the relatively mild illnesses caused by the Strep A bacteria can be treated with common antibiotics. The increase in demand for antibiotics to treat suspected cases of Strep A has led to some pharmacies in Wales experiencing shortages of stock. We are working with the UK Government medicines supply team and other partners to make sure pharmacies in Wales have the supplies they need. We are confident suppliers are working to address any supply issues, should people have difficulty in obtaining their prescription they may need to visit a different pharmacy or in some cases ask their GP to prescribe an alternative treatment.Scarlet fever is probably the most common of these illnesses and the characteristic symptom is a fine red rash, which typically first appears on the chest and stomach, rapidly spreading to other parts of the body. Parents who suspect their child has symptoms of scarlet fever are advised that they should:
- Contact their GP, visit 111.wales.nhs.uk, or call NHS 111 Wales
- Make sure their child takes the full course of any antibiotics prescribed by the doctor
- Keep their child at home, away from nursery, school or work and follow any guidance provided by their GP on how long they should remain absent from these settings.
- Find up-to-date information and advice on streptococcal A infections at 111.wales.nhs.uk
"Further information on the symptoms that parents should look out for and who they should contact for further advice is available on the Public Health Wales website: iGAS infection remains rare, say public health experts - Public Health Wales (nhs.wales)
"Public Health Wales are leading the response in Wales and an all-Wales Incident Management Team has been established to co-ordinate all appropriate action. Public Health Wales are also working closely with the public health agencies across the UK."
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