Liverpool's public health boss has issued key advice to parents after a rise in Strep A infections around the country.
The UK Health Security Agency has said cases of Group Strep A streptococcus remain higher than they would typically see at this time of year in the North West.
The bacteria usually causes a mild infection producing sore throats or scarlet fever that can easily be treated with antibiotics. But in rare cases it can cause serious illness - known as Invasive group A strep (iGAS). Nine children have been reported to have died amid the rise in infections.
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We spoke to Liverpool's Public Health Director Matt Ashton for some key guidance and information about what signs and symptoms parents should be looking out for and when action should be taken.
Some of Matt's key messages are below.
What is Strep A and when is it serious?
Matt said: "Strep A is a common bacteria that exists on most of us. Sometimes Strep A can go on to cause diseases like Scarlet Fever, which is a very common childhood illness that we've had forever, it's mild, but it's very infectious and there are things we need to do to stop its spread.
"One of the other things that Strep A can do is cause serious illness, that is when it causes invasive infections in our body such as in our lungs or our bloodstream, that is when people get seriously ill and need hospital treatment. Most of the time with Scarlet Fever you don't need hospital treatment, you need antibiotics, fever and perhaps paracetamol and in 24-48 hours you should be fine."
What symptoms should people look out for and what actions should be taken?
"We all get ill all the way through the year, but winter is a time when lots of viruses are flying around and kids especially will get ill. Scarlet Fever symptoms tend to be fever, headache, sore throat and a sandpaper rash on your body which highlights it as something different from other illnesses you see at this time of year.
"While it is mild, it is very infectious so you shouldn't be in school or work if you have it. You or a child's parents should be phoning 111 or their GP to describe the illness and if it is Scarlet Fever they will be getting antibiotics prescribed. Scarlet Fever is mostly managed at home which means wrapping up warm, drinking plenty of fluids and managing fever through use of paracetamol. It's mild and you would not usually get seriously ill.
"We have seen a small number of deaths across the country from invasive Strep A infection and that is really tragic. If your child or you is seriously unwell then that is when 999 is needed or a visit to A&E.
"This is normally around if you're child is having difficulty breathing, if they are making grunting noises or if they are sucking their tummy up beneath their ribs as they are trying to catch their breaths, if their tongue or lips are blue or if the child is floppy, won't wake up or stay awake - that's when there is something seriously wrong."
What is the rate of cases like in Liverpool and Merseyside compared to elsewhere?
"The data we have shows our numbers are in pattern with what is being seen across the UK, the numbers are five or six times higher than what we have seen in recent years - but no different from elsewhere in the country."
Infection control
"It's the simple things we can all do to minimise the spread of infections. This means really good hand hygiene, especially after going to the toilet or eating, catching sneezes in tissues and coughing into the crook of your arm. We also strongly recommend people and children get their flu vaccination."
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