Child Deaths From Group A Strep – What is Happening?

Dr Oliver Large

December 9, 2022

Sadly, and worryingly, this winter high numbers of children are dying from invasive Group A Streptococcus (iGAS).  iGAS is a rare complication of Group A streptococcal infections.

In this article, we discuss what it is, and what we know at this stage.

What is “Group A Strep”?

Group A Streptococcus, or as you may hear people call it “Group A Strep”, is a bacteria that can be found on your skin or in your nose or throat.  It can live there harmlessly, but in certain circumstances can cause you to become unwell with skin and respiratory infections. It causes more serious illness when it gets into your bloodstream.  

Some of the diseases it causes include:

  • Tonsillitis: Symptoms include a severe sore throat, fever, pus on the tonsils, and swollen glands in the neck.  Sometimes it can be painful to talk.
  • Scarlet Fever: Symptoms include a fever, sore throat, headache, and rash. The rash is typically fine, with a sandpaper texture to it. On paler skin it appears pink, whilst on darker skin it can be harder to see.
  • Pneumonia: Symptoms include cough, fever, difficulty breathing, chest discomfort, and feeling generally unwell.
  • Impetigo: A patchy, crusty, blistery rash, often around the mouth or nose.
  • Cellulitis: An infection of the skin where the affected area becomes painful, hot, red & swollen. There is often a fever.
  • Invasive Group A Strep (iGAS): Symptoms include fever, lethargy, severe muscle aches, localised muscle tenderness, and redness around a wound. They may decline quickly.  

Why are so many iGAS infections happening this winter?

Unfortunately we don’t yet know. However, one theory is that during the height of the pandemic, less person-to-person contact meant less exposure to bugs such as Strep A, and a decline in natural immunity amongst children. When then exposed to the bug for the first time in several years, their immune system would be less prepared to fight the bug, and this may be leading to the higher number of serious cases we are seeing. 

The infectious disease experts are looking into iGAS urgently and we are awaiting more information from them. We have seen high rates in previous years, albeit not seemingly as high as this time round. For instance, by early December in 2017, there were 4 confirmed deaths, as opposed to the 5 confirmed deaths we had seen by the same time this year.

I’m Worried. What Should I Look Out For?

It can be very difficult to know when to worry! If your child has a cough or sore throat, it is still far more likely they have one of the many circulating viruses, however the Public Health Agency are urging all parents to seek help if their child is very unwell or seems to be getting worse.

As a parent, you know your child best, and if something about your child’s respiratory illness seems not right to you, you should seek help. 

 Some pointers of when to seek help from a GP (or calling 111) include when:

  • your child is getting worse
  • your child is feeding or eating much less than normal
  • your child has had a dry nappy for 12 hours or more or shows other signs of dehydration
  • your child is very tired or irritable
  • your baby is under 3 months and has a temperature of 38°C, or is older than 3 months and has a temperature of 39°C or higher
  • your baby feels hotter than usual when you touch their back or chest, or feels sweaty

You should call 999 or head straight to A&E if you find your child very unwell.  Indicators of this include:

  • difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs
  • pauses when your child breathes
  • blue skin, tongue or lips
  • a floppy child that and will not wake up or stay awake

What Can We Do To Minimise Spread?

Wash Your Hands  – We all got used to this in COVID pandemic, but increasing hand washing is one of the simplest and most effective way of limiting spread of infection.

Catch Your Cough – Have tissues to hand to catch coughs and sneezes, and dispose of your used tissues safely.

Don’t Share Utensils  – Use your own cups and cutlery.

If you are worried, our GPs are here for you.  We are taking on-the-day bookings, and our clinic in Stokenchurch is open 5 days a week. We offer some telephone and video appointments at the weekend.