There has been a rise in the number of cases of Strep A across the UK with some children sadly dying after catching the virus. Health bodies, including Public Health Wales, have reminded parents that cases of invasive group A streptococcal infection remain rare and that children have a very low risk of contracting the disease despite the rise in cases.
The symptoms of the contagious infection include a fever, a sore throat and severe muscle aches. Some people can have the bacteria present in their body without feeling unwell or showing any symptoms of infections and while they can pass it on, the risk of spread is much greater when a person is unwell. The virus spreads through close contact.
Nine children in the UK are known to have died with Strep A in recent weeks. One child has been named as Hanna Roap, a seven-year-old pupil at Victoria Primary School in Penarth. Her father said the family are "traumatised" and "devastated" by her death just 24 hours after becoming ill with the bacterial infection and coming home from school with a mild cough.
Read more: Penarth schoolgirl died from Strep A day after coming home from school with mild cough
While the infection is still incredibly rare, there are some symptoms that you can look out for. We've put together a guide on everything you need to know about strep A, based on the advice from Public Health Wales and medical experts:
What are the symptoms of Strep A?
The types of iGAS (invasive Group A strep ) infection include bacteraemia (a bloodstream infection), necrotising fasciitis (a severe infection involving the death of areas of soft tissue) and streptococcal toxic shock syndrome, which can lead to low blood pressure and multi-organ failure.
The common symptoms of iGAS infection are:
- Fever (a high temperature above 38°C)
- Sore throat or tonsillitis
- Severe muscle aches
- Localised muscle tenderness
- Redness at the site of a wound.
What is Strep A?
Group A streptococcus bacteria are commonly found on the skin or in the throat. They don't cause any problems here, but under some circumstances they can cause disease.
How long is Strep A contagious for?
If left untreated, people with GAS infection are usually infectious for 2-3 weeks after developing a sore throat. If treated with antibiotics, people with GAS infection stop being infectious 24 hours after treatment is started.
You should avoid exposing other people by staying away from work until 24 hours after you begin treatment and until you are well enough to go back. Children who have GAS infection should not go to school or daycare during this period.
How does Strep A spread?
GAS is spread by close contact with an infected person and can be passed on through coughs and sneezes or from a wound. Some people can have the bacteria present in their body without feeling unwell or showing any symptoms of infections and while they can pass it on, the risk of spread is much greater when a person is unwell.
How is it linked to scarlet fever?
In most cases, infection with streptococcal A causes scarlet fever, usually a mild illness. The symptoms of scarlet fever include a sore throat, headache, fever, nausea and vomiting. This is followed by a fine red rash, which typically first appears on the chest and stomach, rapidly spreading to other parts of the body. Older children may not have the rash. On more darkly pigmented skin, the scarlet rash may be harder to spot, but it should feel like 'sandpaper'. The face can be flushed red but pale around the mouth. You can read our guide on scarlet fever, including what to do if you or your child catches it and the importance of taking antibiotics, here .
Can adults get strep A? Who is most vulnerable to strep A infection?
iGAS infections are most common in the elderly (over the age of 65) and the very young. People who have an underlying risk factor like alcoholism, immunosuppression, cancer, or use of injecting drugs, are also more vulnerable to it.
How dangerous is strep A infection?
The danger posed by strep A infection varies massively depending on the type of infection and, as above, the person who is infected. Scarlet fever, for example, often isn't dangerous and most cases cause no complications. However, you should always contact your GP if you think you have scarlet fever, if you're ill after recovering from it, or if you have symptoms after contact with someone who has had it.
Why are there more cases now?
The increase in rates could be due to reduced immunity due to “reduced immunity from last three years and high levels of viral co-infections circulating”. There were lower numbers of scarlet fever notifications across 2020 and 2021, which is likely due to changes in transmission and behaviour during the Covid-19 pandemic.
What do Public Health Wales say?
Dr Graham Brown, consultant in communicable disease control for Public Health Wales, said: “While we understand that parents are likely to be worried by reports they are seeing related to iGAS, the condition remains rare. Cold and flu like symptoms are very common at this time of year, especially in children. Most will have a common seasonal virus, which can be treated by keeping the child hydrated, and with paracetamol.
“Some children with cold and flu like symptoms - sore throat, headache, fever - may be experiencing some of the early symptoms of scarlet fever, which also circulates at this time of year. These children will go on to develop scarlet fever specific symptoms, including a fine pink-red rash that feels like sandpaper to touch, and parents should contact their GP. While scarlet fever is more concerning, it is still usually a mild illness from which most children will recover without complications, especially if the condition is properly treated with antibiotics.
“In very rare cases, group A streptococcal infection can cause iGAS, a rare complication which affects fewer than 20 children in Wales each year. Although iGAS is a worrying condition, the majority of these children will recover with proper treatment. The best thing that parents can do is to provide the care they would usually provide for a child with cold and flu like symptoms, but to familiarise themselves with the symptoms of scarlet fever and iGAS as a precaution. It is also important that children from two years upwards are protected from seasonal flu, and have the vaccine.”
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