Downing Street has told parents to be on the lookout for signs of strep A infection after reports a primary-school pupil has become the eighth child to die in a matter of weeks.
On Monday, Alison Syred-Paul, headteacher at Morelands primary in Waterlooville, Hampshire, said: “Very tragically, we have learned of the death in recent days of a child who attended our school, who was also diagnosed with an invasive Group A streptococcal (iGAS) infection.”
Over the weekend it was also reported by Colfe’s school in south-east London that a pupil died on 29 November after contracting a severe form of the infection.
“This wholly unexpected tragedy has affected all members of the school community, including pupils, parents and staff. We are doing what we can to support the pupil’s family who are seeking to come to terms with their devastating loss,” said the headteacher, Richard Russell.
The deaths come after the UK Health Security Agency (UKHSA) reported on Friday there had been five deaths in England, in addition to a death in Wales, and issued a rare alert over the rise in cases.
A senior official said on Monday that the early start to the season in the UK could be a knock-on effect of the Covid-19 pandemic.
Also on Monday, the prime minister’s official spokesperson said: “We are seeing a higher number of cases of group A strep this year, compared to usual. The bacteria, we know, causes a mild infection which is easily treated with antibiotics and, in rare circumstances, it can get into the bloodstream and cause serious illness.
“It is still uncommon but it’s important parents are on the lookout for symptoms. But the NHS is well prepared to deal with situations like this, working with the UK Health Security Agency.”
He said any parents who were concerned should contact the NHS. The comments came after the UKHSA’s chief medical adviser said infection rates were significantly higher than previously seen at this time of year.
“Firstly, I think that we’re seeing a lot of viral infections circulate at the moment and these bacterial infections can come as an addition on top,” Dr Susan Hopkins told BBC Radio 4’s Today programme.
“Secondly, we’re back to normal social mixing and the patterns of diseases that we’re seeing in the last number of months are out of sync with the normal seasons as people mix back to normal and move around and pass infections on.
“We also need to recognise that the measures that we’ve taken for the last couple of years to reduce Covid circulating will also reduce other infections circulating. And so that means that, as things get back to normal, these traditional infections that we’ve seen for many years are circulating at great levels.”
Asked if this was the result of lower than normal immunity levels caused by Covid measures, she said: “That’s one of the potential areas that we’re exploring. We expect that a certain amount of children will have these infections each year and, therefore, they will have a level of immunity. So we’re seeing more now than we have seen for the last two years where there were very, very low amounts of infection seen.”
A worried father told the same programme that his daughter was fighting for her life. Dean Burns, whose daughter Camila Rose is on a ventilator at Liverpool’s Alder Hey children’s hospital, said: “She’s really poorly, it’s devastating for us as a family.”
Camila, four, went from dancing with her friends on a Friday night to feeling “a little bit under the weather on Saturday” and needing emergency care by Monday.
Strep A can cause a range of health problems, including the skin infection impetigo, strep throat and scarlet fever. The vast majority of infections are relatively mild, but the bacteria can also cause a life-threatening illness called invasive group A streptococcal (iGAS) disease.
Downing Street said it could fully understand that parents were concerned by rising strep A cases, but that the NHS was “well prepared” for such situations.
Jim McManus, the president of the UK Association of Directors of Public Health, said vigilance from parents and health professionals would be vital in preventing further deaths in the weeks ahead. “I think as a country, because strep is overwhelmingly mild, we seem to have forgotten the fact that there’s always a proportion that isn’t mild and they need prompt help,” he said.
All GP practices and emergency departments were sent an urgent message on Friday “to have a low threshold” when considering whether to prescribe antibiotics to children with symptoms of strep A.
McManus said there would likely be further severe cases and possibly further deaths because of the high rates of infection, but that all deaths could be prevented with swift treatment. “I suspect, if you get a larger number of strep A infections resurging, you’ll get a larger number than usual of severe cases,” he said. “But this is not the usual season for this, it is slightly out of kilter.”
He said the government was doing enhanced surveillance and asking clinicians to do more swabs and tests to look into circulation and strains. “I think the more microbiology that’s done on this, frankly, the better. Because we need to understand what’s going on here,” he said. “There is no vaccine for this so we need to know what we’re doing.”
Hopkins told Today that parents should be looking out for a sore throat and fever that did not go away with normal painkilling treatments.
“Scarlet fever is characterised by a rash … that is not like normal viral rashes. It feels like sandpaper on skin so [if] the child’s skin feels like sandpaper-rough rather than just a normal little bit of pinkness to the skin then that’s concerning and it could be scarlet fever.
“The other thing to do is look at their tongue. Again, in scarlet fever, we describe what’s called a strawberry tongue, where there’s a little bit of a white coating on it, and it looks like a strawberry … bright red. That’s a warning sign, parents should look out for that.”
She said unusual drowsiness, dehydration and not needing the toilet as much as usual were also concerning symptoms.
