Health officials in the UK are advising parents and schools to watch out for Strep A infection following the recent deaths of several children.
With COVID-19 restrictions such as masks and social distancing no longer required in the UK, infections such as Strep A are spreading more easily and cases have been on the rise over the past month.
Strep A, also known as group A streptococcus (GAS), can cause a range of symptoms, from mild to severe, but is not fatal for most people who become infected.
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Strep A is a bacteria found in the throat and on the skin. It usually causes a fever and throat infection, and many people carry it without any symptoms. However, they can still spread it to others through coughing, sneezing and close contact.
Symptoms of infection include pain when swallowing, fever, skin rash and swollen tonsils and glands, and infection is common in crowded environments such as schools and daycare centers, according to the U.S. Centers for Disease Control and Prevention on its website.
But the infection is not limited to children.
Kevin Breen, 44, developed the extremely rare strep shortly after his son battled a case of strep throat in 2017.
An infection caused by streptococcal bacteria typically affects the throat and tonsils.
Around Christmas, Breen began experiencing flu-like symptoms and visited an urgent care clinic with stomach pains. The flu and strep test was negative. But his pain did not improve and he went to the emergency room.
While there, his belly began to enlarge and harden. Hospital staff thought it was a mild case of acute pancreatitis, according to Breen’s wife, Julie.
He was showing signs of shock and the doctors decided to take him into surgery to find the cause of his problems.
During the operation, doctors found 3 liters of pus around his organs. They didn’t know where it was coming from.
“Normally we have to look for things like perforations. We look for holes in the stomach or small intestine and we didn’t find anything,” said Dr. Elizabeth Steensma.
After the surgery, he developed a rash on his chest. Doctors feared it might be streptococcal toxic shock syndrome, a severe illness associated with a streptococcal infection.
They took samples and discovered the bacteria that cause angina. Based on the sample, the rash on Breen’s chest and his history, Steensma said, the pieces finally came together.
“The strep organism, it’s really common, somehow got from his pharynx up his throat and got into his abdominal cavity,” she said.
Breen suffered multi-system organ failure and severe septic shock.
Doctors worked quickly to treat him. The team “worked around the clock minute by minute for the next several days trying to keep him alive and get him home to his family,” Steensma said.
Still, they failed to save his fingers and toes.
Breen’s severe case of septic shock, toxins from the strep organism and the drugs he was taking led to the need to amputate parts of his legs and arms, according to Steensma.
“It’s extremely rare,” she said.
For most people who develop strep throat, it is little more than a temporary problem. But occasionally, strep can enter the bloodstream and cause a serious infection.
Breen returned home to his family but underwent a series of amputations.
It is usually treated with antibiotics
Invasive group A streptococcus (iGAS) is the term used when the bacteria invades the body and overcomes its natural defenses to enter areas such as the blood and is more dangerous, the UKHSA explains on its website.
Although there is no vaccine to prevent Strep A or iGAS infections, antibiotics are usually effective in treating them.
“This year we are seeing a higher number of Group A strep cases than usual,” UKHSA deputy director Colin Brown said in a statement.
The increase in iGAS was observed this year especially among children under 10, UKHSA added. Five children died in England. One death has been reported in Wales, according to Public Health Wales.
Figures from the UKHSA show there were 2.3 cases per 100,000 children aged 1 to 4 between mid-September and mid-November, compared with an average of 0.5 in pre-pandemic seasons (2017 to 2019).
Among children aged 5 to 9 years, it was 1.1 cases per 100,000, compared with a pre-pandemic average of 0.3.
The last period of high infection was between 2017 and 2018, with four children under 10 dying in the same period, the statement added.
The UKHSA said it did not believe a new strain was circulating, with the increase in infections likely to be a result of “circulating bacteria and social mixing”.
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