Four children have now been reported to have died as a viral infection sweeps through schools across the UK. Four-year-old Buckinghamshire schoolboy Muhammad Ibrahim Ali, died at his home on November 14, his parent's said.
Three other children have been reported as dying after contracting the virus. The UK Health Security Agency (UKHSA) said a child in London had passed away then on Thursday Victoria Primary School in Penarth, Wales, confirmed the death of another child while a six-year-old pupil at Ashford Church of England Primary School in Surrey also died from strep A at the beginning of last week.
But what are the signs that a child has the virus and when is it vital to seek medical help. North Tees and Hartlepool NHS Foundation Trust explains what the infection is and what to do if you suspect you or your child has it.
What is Group A Streptococcus?
Group A Streptococcus is the name given to a type of bacteria sometimes found inthe throat or on the skin. It usually causes mild illness like sore throats and skin infections.
Rarely these bacteria can cause severe and life threatening illness called invasive Group A Streptococcal disease.
How could I catch Group A Streptococcus?
Many people carry Group A Strep harmlessly and do not develop illness. It can be passed from person to person by close contact such as kissing or skin contact. Most people who come into contact with Group A Strep remain well and symptom free,some get mild throat or skin infections.
Contracting invasive disease from a relative or household member is very rare. You can reduce the risk of picking up Group A Strep by always washing your hands thoroughly.
Pregnant women or those having gynaecology treatments are advised to wash their hands before and after going to the toilet. It is also important to dispose of tissues after use and to wash your hands when you have a cough or cold.
What are the symptoms?
Group A Strep can cause throat infection, scarlet fever or skin infections such ascellulitis or impetigo. These infections are usually treated with antibiotics.
Very rarely it can cause severe illness when the bacteria get into parts of the body that are usually free from bacteria such as the lungs, blood or muscles. This is called invasive Group A Streptococcal disease.
Invasive disease happens when the bacteria get past your body’s immune defences. This can happen when you are already ill or are on treatments, such as some cancer treatments, that affect your immune system.
Two of the most severe types of invasive disease are necrotising fasciitis and toxic shock syndrome.
Am I at any increased risk of invasive disease?
Those at an increased risk of invasive Group A Streptococcal disease include people who:
- are in close contact with someone who has the disease
- are over the age of 65
- are diabetic, have heart disease or cancer
- have recently had chickenpox
- have HIV
- use some steroids or other intravenous drugs.
What are the signs of invasive disease?
The symptoms can include:
- fever (a high temperature above 38°C (100.4°F))
- severe muscle aches
- localised muscle tenderness
- redness at the site of a wound.
What should I do if I have symptoms of invasive disease?
You should contact your GP or get medical advice straight away if you think you have any of the signs and symptoms of invasive disease. Tell your doctor if you have been in contact with someone who has had Group A Strep recently.
Your GP will most likely ask you to come into the surgery to be examined.
How will I be cared for if I have invasive Group A Streptococcal disease?
Group A Strep disease can be treated with antibiotics. In severe cases surgery may be needed. If you are in hospital you will most likely be looked after in a room on your own and the staff caring for you will wear aprons and gloves and, in some cases, a face mask.
Your visitors will be asked to wear aprons and gloves when they visit and to wash their hands before and after coming into your room. Your doctor will advise you if you need to continue to take antibiotics once you go home.
Other signs to look out for
Group A Strep can cause throat infection, scarlet fever or skin infections such ascellulitis or impetigo. This is what the NHS says to watch for on each of those
Scarlet fever
The first signs of scarlet fever can be flu-like symptoms, including a high temperature, a sore throat and swollen neck glands (a large lump on the side of your neck). A rash appears 12 to 48 hours later.
It looks looks like small, raised bumps and starts on the chest and tummy, then spreads. The rash makes your skin feel rough, like sandpaper. On white skin the rash looks pink or red. It may be harder to see on brown and black skin, but you can still feel it.
A white coating also appears on the tongue. This peels, leaving the tongue red, swollen and covered in little bumps (called "strawberry tongue"). The rash does not appear on the face, but the cheeks can look red. The redness may be harder to see on brown and black skin.
It advises to see your GP if you or your child:
- have scarlet fever symptoms
- do not get better in a week (after seeing a GP)
- have scarlet fever and chickenpox at the same time
- are ill again, weeks after scarlet fever got better – this can be a sign of a complication, such as rheumatic fever
- are feeling unwell and have been in contact with someone who has scarlet fever
Scarlet fever is very easily spread. Check with a GP before you go in. They may suggest a phone consultation. It can be treated with antibioitics to speed up recovery and reduce the chance of serious illness.
You can relieve symptoms of scarlet fever by:
- drinking cool fluids
- eating soft foods if you have a sore throat
- taking painkillers like paracetamol to bring down a high temperature (do not give aspirin to children under 16)
- using calamine lotion or antihistamine tablets to ease itching
Scarlet fever lasts for around 1 week. But it can be spread to other people up to six days before you get symptoms until 24 hours after you take your 1st dose of antibiotics. If you do not take antibiotics, you can spread the infection for 2 to 3 weeks after your symptoms start.
Scarlet fever can be a serious illness, but thanks to antibiotics, it's less common than it used to be and easier to treat. But cases of scarlet fever have increased in recent years. For more information see GOV.UK: Scarlet fever guidance and data.
Complications from scarlet fever are rare. They can happen during or in the weeks after the infection, and can include:
- ear infection
- throat abscess
- sinusitis
- pneumonia
- meningitis
- rheumatic fever
Impetigo
Impetigo is a skin infection that's very contagious but not usually serious. It often gets better in seven to 10 days if you get treatment. Anyone can get it, but it's very common in young children.
Impetigo starts with red sores or blisters, but the redness may be harder to see in brown and black skin. The sores or blisters quickly burst and leave crusty, golden-brown patches.
The patches can:
- look a bit like cornflakes stuck to your skin
- get bigger
- spread to other parts of your body
- be itchy
- sometimes be painful
Treatment is via antibiotic cream or tablets depending on the severity. Impetigo is very contagious and people with the condition are advised to stay away from others.
It stops being contagious:
- 48 hours after you start using the medicine prescribed by your GP
- when the patches dry out and crust over (if you do not get treatment)
To help stop impetigo spreading or getting worse while it's still contagious people are advised to stay away from school or work, keep sores clean and cover them with loose clothing or gauze bandages, wash hands frequently, wash bedding and towels at high temperatures and wipe down any toys with detergent and warm water. Avoid scratching sores or patches, do not share bedding or towels, do not play contact sport or go to the gym and do not prepare food for others. Also avoid close contact with children or people with diabetes or a weakened immune system (if they're having chemotherapy, for example)
Cellulitus
Cellulitis is a skin infection that's treated with antibiotics. It can be serious if it's not treated quickly. Cellulitis makes your skin painful, hot and swollen. The area usually looks red, but this may be less obvious on brown or black skin.
Your skin may also be blistered, and you can also have swollen, painful glands. You can get cellulitis on any part of your body and it is treated with antibiotics.
The NHS says people should get advice from 111 if their skin is painful, hot and swollen as early treatment can stop it becoming more serious. If it's not treated quickly, the infection can spread to other parts of the body, such as the blood, muscles and bones.
It advises people to dial 999 or go to A&E if they have cellulitis with:
- a very high temperature, or you feel hot and shivery
- a fast heartbeat or fast breathing
- purple patches on your skin, but this may be less obvious on brown or black skin
- feeling dizzy or faint
- confusion or disorientation
- cold, clammy or pale skin
- unresponsiveness or loss of consciousness
These are symptoms of serious complications, which can be life threatening.
