Medics have raised the alarm over the ability of the NHS to cope with increased rates of strep A, after reports that a 12-year-old schoolboy from London had become the latest child to die after contracting a rare, invasive form of the infection.
On Sunday, cabinet minister Nadhim Zahawi urged parents to be vigilant for signs of streptococcus A, even though most cases are mild.
“It is really important to be vigilant because in the very rare circumstance that it becomes serious, then it needs urgent treatment,” he told Sky News’s Sophy Ridge on Sunday.
It was reported on Saturday that a 12-year-old year 8 pupil from a school in south London had died after developing the infection, which would take the total number of deaths to seven.
On Friday, the UK Health Security Agency (UKHSA) confirmed that six children under 10 had died after contracting a strep A infection since September, as it issued a rare alert in response to a rise in cases across the country.
Medical professionals have raised concerns about how frontline NHS services will cope with a likely influx of concerned parents, and the difficulties of spotting serious cases from minor symptoms.
Neena Modi, professor of neonatal medicine at Imperial College London, said both GP services and A&E were “on their knees”.
“The last thing we want is for A&E departments to be flooded with a new influx of worried parents,” she said.
She also said the NHS 111 service was ineffective when dealing with ill children.
“These algorithms have been shown time and again to not be sensitive enough to actually separate out the critically ill child from those who have milder symptoms,” she said. “So NHS 111 is not fit for purpose for really young children.”
Dr Helen Salisbury, a GP in Oxford, said it was inevitable that GPs would face a rise in the number of parents bringing in their children as a result of strep A concerns, and there were challenges for GPs in identifying which children may go on to develop an invasive infection.
“From a parent’s point of view, it must be really scary. How do you know whether this sore throat is just a common or garden sore throat, or whether this is a prelude to something really serious? And I think that’s quite hard for parents and to a certain extent for GPs as well,” she said.
“Even if you had all the time in the world and you weren’t pressed or hurried, it’s still difficult to tell which child is going to get ill.”
Salisbury also stressed parents should be able to come back to their GP if the child’s condition deteriorates, but this can be difficult in overstretched areas.
“I know there are places where they’re really, really short of GPs and actually getting an appointment at all is hard,” she said.
“We are chronically long-term under-doctored in general practice, and when something acute comes into the news like this, then it really makes it clear.”
The confirmed deaths of children after contracting the rare invasive form of infection include four-year-old Muhammad Ibrahim Ali from Buckinghamshire, who died in an ambulance en route to hospital.
His mother, Shabana Kousar, told Sky News that her son first developed a red rash across his lower back, which was helped by a course of antibiotics, but two weeks later his condition worsened and he developed stomach pains. After his death, a postmortem showed he had strep A in his blood.
“I believe parents should be made aware of the symptoms and act on it if their child is experiencing something similar,” she said.
Camila Rose Burns, four, has been on a ventilator at Alder Hey children’s hospital in Liverpool since Monday after contracting strep A.
Strep A bacteria can cause many health issues, most of which are mild. They can include scarlet fever and, very rarely, invasive group A streptococcal disease (iGAS).
The latest data from the UKHSA showed that rates of scarlet fever and iGAS are two to three times higher than the same time of year pre-pandemic, and cases are occurring earlier in the year.
There were 851 cases of scarlet fever reported in the week of 14-20 November, compared with an average of 186 for the same period in previous years.
The UKHSA said there was no evidence that a new strain of strep A was circulating, and the increase was most likely due to high amounts of circulating bacteria and social mixing.
NHS England was approached for comment regarding concerns about the ability of NHS services to cope with increased pressure, and referred the Guardian to UKHSA – which said it does not comment on NHS workforce issues – and the Department for Health and Social Care (DHSC).
A DHSC spokesperson said: “We recognise the pressures the NHS is under as a result of the pandemic, and are taking urgent action to support the service and staff so they can deliver high-quality care to patients.
“Our plan for patients will improve access to general practice and free up over 1m appointments a year, so all patients who need an appointment can access one within two weeks and those with urgent needs should be seen within the same day.
“This is on top of an extra £500m to speed up hospital discharge and free up beds, getting ambulances back on the road more quickly.”
Modi said it was not yet clear if the current situation was unusual. “It’s too early to say whether or not this is outside that normal fluctuation that you would see over the course of several years, or whether it’s within it,” she said.
Salisbury said parents should look for symptoms that indicate an invasive infection is developing, such as a continued raised temperature, lethargy or floppiness, not eating or drinking as usual, and lack of urination.
