What is Streptococcus A? Symptoms and signs of infection in children such as B. Sore throat and whether adults may be affected

Six young children have died in the UK following an outbreak of a bacterial infection caused by Streptococcus A.

In England, five children under the age of 10 have died since September after contracting a rare invasive group A streptococcal (iGAS) infection. A girl also died in Wales.

Parents have been warned to seek medical attention if their children have Strep A symptoms. Some health experts have suggested that the Covid lockdown may have caused a rise in cases, with one infectious disease expert warning of a “perfect respiratory storm”.

The UK Health Protection Authority (UKHSA) has reported an increase in the number of invasive group A streptococci and a significant increase in cases of scarlet fever.

What is Streptococcus A?

Group A streptococcus (GAS) is a bacterial infection that sometimes occurs in the throat or on the skin.

Infected people may not get sick, but they can infect others who can get sick.

Group A streptococci can cause many different infections, from mild illness to fatal illness, including skin infection, impetigo, scarlet fever, and strep throat.

The vast majority of infections are mild, but in very rare cases, bacteria can enter the bloodstream and cause invasive group A streptococci (iGAS) when bacteria are shed from normally sterile sites, such as the blood or lungs.

This year six children died of the disease. The family of Muhammad Ibrahim Ali, a four-year-old boy from Buckinghamshire who died on November 14, said he developed a rash and was taken to doctors, who prescribed him antibiotics.

However, his symptoms worsened and he developed a fever. On a later visit to the doctors, the family told them to give him calpol and water, but by evening he had trouble breathing and died at home from cardiac arrest.

What are the symptoms and how is it transmitted?

People with Streptococcus A may have painful swelling in the neck, severe sore throat, swollen tonsils with white spots, and red spots on the roof of the mouth. After about a day, a rash appears on the chest or abdomen, which then spreads. The tongue may develop a white coating that may flake off and remain covered in small bumps known as “strawberry tongue”.

According to Dr Bharat Pankhania, an infectious disease expert at the University of Exeter, patients may also have a fever above 38°C and pain in the limbs and muscles.

It can be spread through coughs, sneezes, and skin contact, and in places such as schools and nursing homes.

What are the symptoms of scarlet fever?

Streptococcus A can cause scarlet fever, which is usually mild but highly contagious. Health authorities should notify local health teams of suspected cases.

Symptoms to look out for in children include a sore throat, headache, and fever, as well as a small, pink or red, sandpaper-like rash on the body. On darker skin, the rash may be harder to see visually, but it looks like sandpaper.

The UKHSA reported 851 cases of scarlet fever in the week beginning November 14, compared with an average of 186 in previous years.

Is Streptococcus A and mortality on the rise?

There were 2.3 cases of iGAS per 100,000 children aged one to four this year, compared with an average of 0.5 per year before the 2017-2019 pandemic, according to the UKHSA.

Children aged five to nine had 1.1 cases per 100,000 children this year, compared to an average of 0.3 in 2017-2019 around the same time of year.

Five children under the age of 10 have died in England, compared with four deaths among children under the age of 10 in the same period from 2017 to 2019.

Do lockdowns cause an increase in infections?

According to the UKHSA, there is no evidence of the spread of the new strain and the increase in cases is most likely due to high levels of circulating bacteria and social mixing.

Some infectious disease experts have suggested that in some cases the surge in infections may have been caused by the Covid lockdown, as the lack of social distancing meant a drop in children’s immunity.

Dr. Nicole Robb, professor of virology and co-founder of medical technology company Pictura Bio, said: “We are experiencing what we call the perfect respiratory storm.

“These diseases are seasonal so cases tend to increase during the winter months, but this could get worse as we all ‘lost’ our immunity during the Covid lockdown as we had little to no contact with everyday insects.

“This is why young children are most at risk of contracting streptococcus and other infections. There are many people who have never been exposed to the same insects that we were as children and therefore their bodies have not learned to deal with them.

Dr Simon Clark, a microbiologist at the University of Reading, told MailOnline: “You have to know that blockages affect immunity to things like the flu — the principle is the same. [A] The lack of admixture in children may have led to a drop in immunity in the population, which may have increased transmission in this age group.

But he added: “Recently there have been more cases than we expected, but this may be a statistical error.”

Dr Elizabeth Whittaker, senior clinical lecturer at Imperial College London, said: “We saw very few group A streptococci in the first two years of the pandemic and they returned to circulation in 2022 when restrictions were lifted.

“Usually we see a large number of cases in late spring or early summer, often after contracting chickenpox. High numbers at this time of year are unusual, and probably because normal seasonality has yet to return.”

Are there other reasons?

Dr Bharat Pankhania, an infectious disease expert at the University of Exeter, believes general practitioners can misdiagnose a bacterial infection as a virus, and failing to diagnose antibiotics could be to blame.

He told Sky News: “I’m not thinking about reduced immunity, but that our doctors don’t see these cases early enough and dismiss them as probably viral and therefore antibiotics that weren’t previously prescribed.”