What are the signs of Strep A infection?

At least nine children across the UK are known to have died from invasive Strep A infection.

– What is Strep A?

Strep A bacteria can cause many different infections, ranging from minor illnesses to serious and deadly diseases.

The bacteria are commonly found in the throat and on the skin, and some people have no symptoms.

Infections cause by Strep A include the skin infection impetigo, scarlet fever and strep throat. Scarlet fever in particular has seen a recent surge in cases.

While the vast majority of infections are relatively mild, sometimes the bacteria cause life-threatening illness called invasive Group A Streptococcal disease.

The UK Health Security Agency (UKHSA) has advised medics to have a low threshold for prescribing antibiotics for children who may be suffering infection linked to Strep A.

On Friday, it said GPs should also “maintain a low threshold for prompt referral” to hospital of any children presenting with persistent or worsening symptoms.

According to UKHSA data, there were 2.3 cases of invasive disease per 100,000 children aged one to four this year in England, compared with an average of 0.5 in the pre-pandemic seasons (2017 to 2019).

There have also been 1.1 cases per 100,000 children aged five to nine compared with the pre-pandemic average of 0.3 (2017 to 2019).

Scarlet fever cases have also seen a massive jump.

There were 851 cases reported in the week November 14 to 20, compared to an average of 186 for the same timeframe in previous years.

– What is invasive Group A Streptococcal disease?

Invasive Group A Strep disease can be a life-threatening infection in which the bacteria have invaded parts of the body, such as the blood, deep muscle or lungs.

Two of the most severe, but rare, forms of invasive disease are necrotising fasciitis and streptococcal toxic shock syndrome.

Necrotising fasciitis is also known as the “flesh-eating disease” and can occur if a wound gets infected.

Streptococcal toxic shock syndrome is a rapidly progressing infection causing low blood pressure/shock and damage to organs such as the kidneys, liver and lungs.

This type of toxic shock has a high death rate.

– How are Strep A bacteria spread?

The bacteria are spread by contact with an infected person or by contact with infected skin lesions.

Bacteria can be passed from person to person by close contact such as kissing or skin contact.

The risk of spread is greatest when somebody is ill, such as when people have strep throat or an infected wound.

Strep A infections such as scarlet fever and impetigo are treated with antibiotics, with penicillin among the most commonly used.

Anyone thought to have invasive Group A Streptococcal disease should seek medical help immediately. Antibiotics, other drugs and intensive medical attention are likely to be needed.

– When should I see a doctor?

Strep throat is different from a regular sore throat and the pain can come on very quickly.

Symptoms include pain when swallowing, fever, and red and swollen tonsils – sometimes with white patches or streaks of pus.

The NHS recommends people see their GP if a sore throat does not improve, if they are worried or if they have a high temperature, or feel hot and shivery.

Impetigo is a skin infection which starts with red sores or blisters that then burst, leaving crusty, golden patches. The infection can be treated with antibiotics.

Scarlet fever symptoms are often flu-like, including a high temperature, a sore throat and swollen neck glands.

A rash appears 12 to 48 hours later, starting on the chest and stomach and then spreading.

A white coating also appears on the tongue which peels, leaving the tongue red, swollen and covered in little bumps (often called “strawberry tongue”).

Signs of necrotising fasciitis include fever (a high temperature above 38C), severe pain and swelling, and redness at the wound site.

Early signs and symptoms of toxic shock may include fever, dizziness, confusion, low blood pressure, rash and abdominal pain.