How Greater Manchester is tackling Strep A as hospitals battle huge pressure
Greater Manchester health leaders have revealed the region's plans to deal with Strep A outbreaks. But the rise in Strep A illnesses comes as winter viruses and other seasonal sicknesses are more virulent after periods in lockdown, with one director of public health saying that paediatric units 'have never been under so much pressure'.
There has been an increase in scarlet fever in particular, which would have typically been expected in spring but is instead appearing now. Greater Manchester has yet to see the peak of cases, health leaders have warned.
Strep A bacteria can cause many different infections, ranging from minor illnesses to serious and deadly diseases. The bacteria are commonly found in the throat and on the skin, and some people have no symptoms - but the most severe form has seen multiple children die across the UK from complications of Strep A.
READ MORE: Mum's warning signs to look out for after son's Strep A was mistaken for tonsillitis
Infections caused by Strep A include the skin infection impetigo, scarlet fever and strep throat. Scarlet fever in particular has seen a surge in cases. While the vast majority of infections are relatively mild, sometimes the bacteria cause life-threatening illness called invasive Group A Streptococcal disease.
Manchester’s Director of Public Health David Regan told the M.E.N. that the region, which is experiencing some cases of Strep A and Strep A-related illnesses, has ‘tried and tested plans for managing outbreaks in care homes and schools, learned during Covid, and done annually with influenza’.
“We would expect [scarlet fever] infections to peak shortly, so we will keep a close eye on the data and track that with the UKHSA," he told the Manchester Evening News during an interview live on our Facebook page.
“We will deal with outbreaks in settings on an individual basis as the next few weeks progress. I’ll report on the Manchester figures but we can extrapolate those for the rest of Greater Manchester. We receive information of statutory notifiable disease, these are reported cases. The total for the year to date for scarlet fever is 350.
“Of those, 32 have been reported in the last four weeks. We expect that number to increase in the next week."
Typically, plans would have been in place in spring for an uptick in scarlet fever, but after lockdowns during the pandemic, the illnesses are not following the normal seasonal patterns. Instead of spring, there is a peak in Strep A and scarlet fever now, he says.
Meanwhile, a rise in Strep A illnesses has also come as hospitals across the country are suffering with huge bed shortages. The NHS has previously stated: “The NHS is under huge pressure with more than 19 in 20 hospital beds occupied, including by 13,500 patients who are medically fit to leave hospital but cannot, partly due to social care issues, making it harder to admit people arriving to A&E in an ambulance."
“Speaking to the Royal Manchester Children’s Hospital and other paediatric units, they’ve never been under so much pressure," said the public health chief. "That’s not just because of scarlet fever or invasive Strep, it’s other respiratory illness - flu, it’s a range of things all coming together putting extreme pressure on our hospital systems.
“Nationally, hospitals have been under pressure as well. The situation as of Monday was a little bit more stable than the previous week, but we know that things can change very quickly.
“In Greater Manchester, hospitals work together to make sure children get access to the best service they can, whether that’s at one of our district hospitals, one of our specialist hospitals. There are good plans in place to respond to the situation, move children about if necessary from a general and acute bed into more specialist care - we are fortunate to have the resources we have in Greater Manchester.
“You will hear about children moving to intensive care beds in other parts of the country, such as in Alder Hey in Liverpool, that’s also very normal. It’s just making sure children are getting the right care in the right place.”
Scarlet fever has become the main reported notifiable disease - where local authorities have to report cases to national bodies. Other similar illnesses include diphtheria and food poisoning.
"That 32 represents 61 per cent of all the notifiable diseases we hear about," continued Mr Regan.
If there are two or more linked cases at a school, for example, staff inform health protection teams, David shared. The UK Health Security Agency (UKHSA) will assess the situation, and the outbreak management team will decide the plan with school and local authority.
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