Covid pandemic restrictions could be behind rise in Strep A infections, health chief says

Health authorities ‘concerned’ by spate of infections and deaths

Andy Gregory
Monday 05 December 2022 15:52 GMT
What is Strep A and what are the symptoms?

The coronavirus pandemic could be behind the unusually early outbreak of Strep A infections this year, a health expert has said.

Seven children have died from the illness in recent weeks, six of them of primary school age.

While the number of scarlet fever and invasive group A Strep (iGAS) infections confirmed to the UK Health Security Agency (UKHSA) are lower than during a typical annual peak, they are “much, much higher” than seen this early in the season for the past five years, the agency’s chief medical adviser said.

As of Friday, there were 851 known cases of scarlet fever, compared to an average of 186 for the preceding years.

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While typically a mild illness, the bacteria can enter the bloodstream and cause the more serious infection known as iGAS – the rate of which has also increased this year.

Asked whether lockdowns and reduced social mixing during the pandemic were linked to the unusually early start to the Strep A season this year, Dr Susan Hopkins of the UKHSA said: “Firstly, I think that we’re seeing a lot of viral infections circulate at the moment and these bacterial infections can come as an addition on top.

“Secondly, we’re back to normal social mixing and the patterns of diseases that we’re seeing in the last number of months are out of sync with the normal seasons as people mix back to normal and move around and pass infections on,” the top official told BBC Radio 4’s Today show on Monday.

Camila Rose Burns, aged 4, is in hospital in Liverpool with iGAS
Camila Rose Burns, aged 4, is in hospital in Liverpool with iGAS (Family handout)

“We also need to recognise that the measures that we’ve taken for the last couple of years to reduce Covid circulating will also reduce other infections circulating. And so that means that, as things get back to normal, these traditional infections that we’ve seen for many years are circulating at great levels.”

Whether this was due to lower-than-normal immunity levels caused by Covid measures is “one of the potential areas that we’re exploring”, Dr Hopkins said.

“We expect that a certain amount of children will have these infections each year and therefore they will have a level of immunity,” she added. “So we are seeing more now than we have seen for the last two years where there were very, very low amounts of infection seen.”

Dr Hopkins added: “We’re concerned, and concerned enough to ensure that we wanted to make the public aware of the signs and symptoms that they should watch out for.”

Dr Susan Hopkins said the lack of circulation during the pandemic may have played a part
Dr Susan Hopkins said the lack of circulation during the pandemic may have played a part (PA)

The clinician told the programme that parents should initially look out for sore throats and fever which normal painkillers fail to get rid of – and stressed the importance of seeking help from a GP or NHS 111 if they suspect their child may have the infection.

Scarlet fever is characterised by a rash, Dr Hopkins said, adding that if your child’s skin “feels like sandpaper – rough rather than just a normal little bit of pinkness to the skin – then that’s concerning and it could be scarlet fever”.

“The other thing to do is look at their tongue,” she continued. “In scarlet fever, we describe what’s called a strawberry tongue, where there’s a little bit of a white coating on it, and it looks like a strawberry is bright red.

“That’s a warning sign, parents should look out for that.

“We really get concerned when children are more sleepy or drowsy, are [more] difficult to wake up than normal. If their hands or feet are blue, if they’re not eating or drinking for a number of days, particularly if they are dehydrated ... then that’s a concerning sign as well.”

Hanna Roap, 7, died from the infection in Wales
Hanna Roap, 7, died from the infection in Wales (Family handout)

Dean Burns, the father of four-year-old Camila Rose – who has now spent a week in Liverpool’s Alder Hey Children’s Hospital with invasive group A Strep infection – told the same programme on Monday that his daughter was “still fighting for her life”.

“It’s just devastating for us as a family, we can’t believe this has happened,” Mr Burns said, adding that her symptoms first appeared as a “sickness bug” on Saturday but was “hallucinating” by Monday morning, at which point she was rushed to A&E.

“It progressed into something called iGAS, which has now gone into her bloodstream and it’s just devasted her body,” said Mr Burns.

“I’m at a loss with it all, I just want our family back. The pain is unimaginable. She is just so beautiful and precious. She is just our special little girl.”

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