Strep A has now been linked to the deaths of 15 children, according to official data released today (8 December).
Most Strep A infections are mild, but numbers of more severe invasive cases - while rare - are rising.
The number of cases in England, and those of scarlet fever, are ‘higher than normal’ for this time of year.
So far, since September, there have been 85 cases of invasive strep A in children aged one to four in England and 60 in children aged five to nine.
The latest UK Health Security Agency figures show that 15 children in the UK have died after invasive strep A infections since September, while 47 adults have died from the infection in England.
The UK Health Security Agency said today (Thursday) that notifications and GP consultations of scarlet fever in England are higher than normal for this point in the season, after persisting later into the previous season.
Scarlet fever is caused by bacteria called group A streptococci. These bacteria also cause other respiratory and skin infections such as strep throat and impetigo.
A total of 6,601 notifications of scarlet fever were received from week 37 to 48 this season (2022 to 2023) in England, with 1,062 notifications received in week 48. This compares with an average of 1,774 (range 333 to 2,915) for this same period (weeks 37 to 48) in the previous five years.
Childcare providers and schools must report cases of both scarlet fever and invasive Group A Streptoccal disease (iGAS). GPs have a statutory duty to report cases to health authorities.
Schools and early years providers are being asked to follow the usual outbreak management processes as set out in government guidance if an outbreak of scarlet fever is identified. An ‘outbreak’ is defined as two or more probable or confirmed cases attending the same school, nursery or other childcare setting within 10 days of each other.
Schools and nurseries should contact their local Health Protection Team if:
- They have two or more probable or confirmed cases within 10 days of each other
- They are a setting that is dedicated to children who are clinically vulnerable
- Anyone is admitted to hospital or is very poorly (or there is a death)
- They have further issues that are making it difficult to manage the outbreak
The figures on cases come from the Health Security Agency's first update on cases of Strep A in England, Group Astreptococcal infections for 2022 to 2023.
Updates are published weekly during the season.
The update states that ‘Medical practitioners have been alerted to this early increase in incidence and elevated iGAS infection in children. Given the potential for severe presentations, it remains important that scarlet fever cases are treated promptly with antibiotics to limit further spread and reduce risk of potential complications in cases and their close contacts.’
The update adds that ‘As per national guidance, prompt notification of scarlet fever cases and outbreaks to local UK Health Security Agency (UKHSA) HPTs, obtaining throat swabs (prior to commencing antibiotics) when there is uncertainty about the diagnosis, and exclusion of cases from school or work until 24 hours of antibiotic treatment has been received, remain essential tools to limit spread.
‘While high for this point in the season the weekly notifications are lower than the weekly totals seen during the normal pre-pandemic peak season (February to March) where peak weekly total was 1,988 in week 12 during the 2017 to 2018 season.’
Asked by Nursery World for specific guidance for early years settings, a UKHSA spokesperson said,'Health protection guidelines are published online and local Health Protection Teams are regularly in contact with local authorities and schools to advise on health protection in schools' settings.'
Dr Colin Brown, deputy director, UKHSA, said, ‘We are seeing a higher number of cases of Group A strep this year than usual. The bacteria usually causes a mild infection producing sore throats or scarlet fever that can be easily treated with antibiotics. In very rare circumstances, this bacteria can get into the bloodstream and cause serious illness – called invasive Group A strep (iGAS).
'This is still uncommon; however, it is important that parents are on the lookout for symptoms and see a doctor as quickly as possible so that their child can be treated and we can stop the infection becoming serious. Make sure you talk to a health professional if your child is showing signs of deteriorating after a bout of scarlet fever, a sore throat, or a respiratory infection.’
Health secretary Steve Barclay yesterday denied that there was a shortage in the supply of antibiotics to pharmacies.
What is Strep A?
Group A Streptococcus – also known as Group A Strep (GAS) or Strep A – is a common bacteria that can cause a number of different infections.
Many people carry it in their throats and on their skin and it doesn’t always lead to illness – some people have no symptoms. However, it can cause infections range from minor illnesses to serious ones.
While most infections are mild, the bacteria can cause an illness called invasive Group A Streptococcal disease.
The most serious infections linked to GAS come from invasive group A strep, known as iGAS.
These infections are caused by the bacteria getting into parts of the body where it is not normally found, such as the lungs or bloodstream. In rare cases an iGAS infection can be fatal.
While iGAS infections are still uncommon, there has been an increase in cases this year, particularly in children under 10.
Source: UK Health Security Agency
Guidance
