As of today, nine children have died in the UK after falling ill with Strep A. Now, more children under ten have lost their lives from severe infection caused by invasive Strep A (sometimes abbreviated to iGAS) than did from Covid in the first three months of the pandemic in 2020.
In most cases, Group A Streptococcus, a bacterial infection common in school-age children, is mild. From ‘strep throat’ that can cause tonsillitis, to skin infections and scarlet fever, it can present in many forms. Spread by respiratory droplets (propelled outwards when you sneeze, cough or kiss), most cases result in mild symptoms and recovery after a short course of antibiotics. But if left untreated, the bacteria can infiltrate your internal organs, weld itself to your heart and kidneys and leave you seriously ill.
The UK Health Security Agency (UKHSA) has issued a warning, calling on parents to be vigilant in looking out for symptoms. In the week ending 20 November, there were 851 cases of the infection, compared to an average of 186 during that week in preceding years: a rise of 357.5 per cent. The amount of people affected by the invasive type of Strep A have increased by almost fivefold compared to pre-pandemic figures.
‘The numbers we are seeing are much, much higher than we have seen at this time of year for the past five years,’ Susan Hopkins, chief medical officer at UKHSA, told the BBC’s Today programme.
While cases of Strep A are on the rise, supplies of the antibiotic that treats it are running out.
So what’s causing this worrying spike? Some scientists are pointing the finger at the ‘Covid immunity debt’: in short, many are worried that lockdowns – and the lack of mixing among children – means that viruses are swarming back into a population with little immunity to battle them. Strep A is not alone in this trend, as viral respiratory infections including flu and RSV have also seen an increase in cases post-pandemic.
‘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,’ Dr Hopkins said. ‘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.’
But while cases of Strep A are on the rise, supplies of the medication that treats it are running out. Penicillin V is the first-line management of the bacterial infection, but stocks are low. As a result, doctors are turning to other types of antibiotics, like amoxicillin – which means their levels are depleting fast too. If these supply-chain issues aren’t sorted soon, we could see other groups of patients at risk. Amoxicillin is, for example, one of the main antibiotics used to treat chest infections like pneumonia.
Doctors have criticised the government’s ‘feeble’ response. ‘There is a real lack of forward planning,’ one tells me. ‘Any child dying of an infection like this is just wrong. Penicillin V is one of the most commonly used antibiotics. It’s appalling we’re running out, and there has been no discussion about what would happen if we do use up our supply. There has been no overall strategy issued to doctors, and no advice to parents except pushing them towards their GPs.’
‘We’re seeing a significant impact on our out-of-hours services,’ another medic said. ‘People are worried, but we don’t have a proper plan in place for regular swabbing for Strep A, or what we should be advising patients on. It feels like the government are just hoping this will go away.’
But with five children having passed away since Friday alone, it’s clear that a plan needs to be formulated quickly. As of today, the government may be considering radical steps to avert what could be a disastrous crisis. The Guardian reported this morning that those schoolchildren deemed most at risk of invasive Strep A could be offered preventative antibiotics, to take before they develop symptoms. This is a positive step forward in managing the surge in Strep A cases – but it still doesn’t solve critical supply issues. This emerging ‘public health emergency’ needs to see a concerted effort by health authorities and government officials if more deaths are to be prevented.
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