Why is Strep A so terrible this year?

Families across the UK have been urged to remain vigilant about Strep A symptoms this week, following a string of tragic child deaths.

A total of 15 children have died in the UK from strep A since September, according to the latest figures. This includes 13 children under 15 in England and two more in Northern Ireland and Wales, according to data from the UK Health Security Agency (UKHSA).

Streptococcus A (Strep A – also known as Group A Streptococcus or GAS) is a group of bacteria that can cause a wide variety of skin, soft tissue and respiratory tract infections. These include strep throat and impetigo, but the most common disease caused by Strep A is scarlet fever, which is highly infectious and is spreading across the country.

But why are the infections so terrible this year? And what – if anything – can parents do about it?

Why is strep A spreading?

Less admixture due to Covid may be part of the reason why hundreds of children are diagnosed with Strep A related illnesses this year. When social measures were put in place, the spread of Strep A was contained. Now, children who have not contracted strep A in 2020 or 2021 are getting infected.

“It strikes me that, as we’re seeing with influenza right now, the lack of admixture in children may have caused a population-wide decline in immunity that could increase transmission, particularly in school-age children.” , microbiologist Dr Simon Clarke, from the University of Reading, told Sky news.

What are the symptoms?

The best way to protect your children is to know the symptoms and seek treatment quickly. It’s important to remember that strep A causes a mild illness in most children that is easily treated with antibiotics. Symptoms include:

  • red and white spots in the throat

  • difficulty swallowing

  • headache

  • lower stomach pain

  • general malaise, malaise or feeling sick

  • loss of appetite

  • nausea

  • rash

“On darker skin, the rash may be more difficult to detect visually, but will have a sandpaper feel,” Duncan Reid, a pharmacist at Pharmacy2U, told HuffPost UK.

Additionally, the British Islamic Medical Association explained that “the rash is most noticeable in the groin/underarm area. Sometimes flushed cheeks appear ‘sunburned’ against darker skin with white near the mouth.”

“In children with darker skin tones, the rash may be harder to spot as it may not appear red, but will be darker than normal skin,” added Dr Mabs Chowdhury, president of the British Association of Dermatologists.

“Rashes in all pigment types may have a sandpaper feel. The tongue may appear redder than normal with prominent white patches (sometimes called “strawberry tongue”).

Where are the infections in the country?

The latest available data shows that 1,062 reports of scarlet fever infection were received in England in week 48 (the week starting 28 November).

Currently, there are large concentrations of Strep A and associated scarlet fever cases in multiple parts of the UK, with the North West particularly affected. The following data also show the incidence of invasive group A streptococcal infection (iGAS), a rare but serious complication of Strep A, which can be life-threatening.

Number and rate per 100,000 population of scarlet fever and iGAS notifications in England: Weeks 37 to 48 of the 2022-2023 season.

Number and rate per 100,000 population of scarlet fever and iGAS notifications in England: Weeks 37 to 48 of the 2022-2023 season.

Number and rate per 100,000 population of scarlet fever and iGAS notifications in England: Weeks 37 to 48 of the 2022-2023 season.

How do parents feel?

Many parents are beside themselves with worry right now as strep A continues to dominate the news. On social media and in private Whatsapp groups there has been an outpouring of concern from parents, who are understandably nervous if they miss signs of an illness that could progress into something far worse.

“Personally I’m more worried about this than when Covid started,” said 35-year-old Emma Hawes from Wigan.

Hawes, who has a 13-year-old and an 8-year-old, told HuffPost UK: ‘I’m extremely anxious at the moment. I had no idea what the symptoms were, so of course I read as much as I could.

Diana Wilkinson, 45, has two school-age children. She told HuffPost UK: ‘I’m honestly so worried about this. Every time I read the news they are full of warnings about Strep A, and horribly the number of deaths is rising.

“Our school has been great at reporting issues and sending information on what to look for, but with several cases it already feels very close to home.”

Is there a shortage of antibiotics?

Some pharmacists warn of a shortage of antibiotics – which hasn’t done much to allay worries. However, the government has repeatedly denied this.

The National Pharmacy Association explained: “Pharmacies have to work very hard to get stock of these antibiotics and some lines are temporarily unavailable.

“We have been advised by wholesalers that most lines will be restocked soon, but we cannot say exactly when that will be.”

Leyla Hannabeck, CEO of the Association of Independent Multiple Pharmacies, said authorities broadcasting around saying there is an offer was “misleading”.

“I want to reassure the public that pharmacies are doing everything they can to source the antibiotics and we are pushing the government to identify where the blockage is,” Hannabeck added.

Health Secretary Steve Barclay said there was a “good supply” of penicillin and he had been reassured by medicine suppliers. However, he said some general practitioners could face shortages as stocks are shifted to meet demand.

“Now general practitioners can sometimes have particular spikes if they have a lot of demand in one area, and that’s quite normal, we can move the stock into our depots,” he told Sky News.

Will the schools close?

Currently, the Department for Education (DfE) has not updated its official advice to schools, but is directing them to guidelines from the UK Health Security Agency (UKHSA).

Parents have been told to keep their children at home if they suspect their children have strep A, in a blog published by Dfe.

Education Secretary Gillian Keegan said the department was “working closely” with the UKHSA and were “monitoring the situation”, adding that the situation was “worrying”.

A school in Hull has been temporarily closed for a ‘deep clean’ after several cases of strep A but schools in the complex are not currently being asked to close.

How do you get Strep A?

Duncan Reid, pharmacist at Pharmacy2U explained: “Strep A is spread through contact with droplets from an infected person when they talk, cough or sneeze.”

“Some people can have the bacteria present in their body without feeling sick or showing any symptoms of infection and while they can pass it on, the risk of spreading it is much greater when a person is unwell. It is still possible to infect others for up to three weeks.”

“Good hand and respiratory hygiene is important to counter the spread of Strep A. Teaching your child how to properly wash their hands with soap for at least 20 seconds, using a tissue to catch coughs and sneezes, and keeping away from others when you feel sick, they will be able to reduce your risk of catching or spreading infections.”

When should parents contact their family doctor?

  • if you suspect your child has scarlet fever

  • your child is getting worse

  • your child feeds or eats much less than normal

  • your child has a dry diaper for 12 hours or more or shows other signs of dehydration

  • your baby is less than 3 months old and has a temperature of 38°C, or is over 3 months old and has a temperature of 39°C or higher

  • your baby feels hotter than usual when you touch his back or chest or gets sweaty

  • your child is very tired or irritable

  • your child is having difficulty breathing – you may notice grunting or belly sucking under the ribs

  • there are pauses when your child breathes

  • your child’s skin, tongue, or lips are blue

  • your child is floppy and will not wake up or stay awake.


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