Eight children in the UK have died from a rare and invasive form of a common bacterial infection, according to health agencies, alarming doctors and parents.
Bacteria, called group A streptococcusare best known for causing strep throat.
These bacteria do not always cause infections. In fact, they can live in your throat and on your skin without causing illness. But the bacteria can, in some people, develop into infections such as strep throat or tonsillitis. If left untreated, they can invade other parts of the body, such as the lungs or blood, which can cause serious and life-threatening infections.
While many childhood illnesses, like colds and other upper respiratory infections, are caused by viruses and cannot be treated with antibiotics, infections like strep throat should be treated with them immediately.
These types of bacteria, if growing unchecked, can cause scarlet fever, which causes a red, sandpaper-like rash, or rheumatic fever, which is an inflammation of blood vessels and joints that can damage the heart permanently.
Experts believe that the current surge in respiratory viruses like influenza and RSV may be behind the increase in invasive cases of Strep A. Viral infections compromise your immune system, giving bacteria in your environment or body the opportunity to take over, what is called a secondary infection.
The latest update from the UK Health and Safety Agency on December 2 confirmed that since September five children in England, all under the age of 10, have died within a week of being diagnosed with strep A invasive.
A spokesperson for the agency told BuzzFeed News that two other children under the age of 15 in England have died. Another child in Wales has also died, the BBC reported.
The 2017-18 winter season in the UK, the latest with more strep A activity than usual, saw four deaths involving children under 10 during the same period. Most cases of invasive Strep A occur in older people, but so far 21% of infections have been in children 10 and younger, higher than the range seen over the past five seasons.
There is no evidence that a new strain of strep A is currently circulating, British health officials have said.
Children in the UK also contract scarlet fever at even higher rates than invasive strep A. No child has died of scarlet fever as of December 7.
Is the United States also experiencing an increase in Strep A infections?
In a call with reporters Dec. 5, the CDC said it had “not heard of any noticeable increase” in Strep A cases in the United States. But doctors, at least anecdotally, are noticing an increasing number of secondary bacterial infections, some but not all of which are associated with strep A, according to Dr. Allison Bartlett, an infectious disease pediatrician and associate medical director of control. infections in UChicago. Medicine.
Bartlett told us that she and her colleagues see many cases of secondary bacterial pneumonia, empyema (a collection of pus in a body cavity, usually the lungs) and sinusitis, including infections that spread to the eyes. or the brain.
Still, it’s unclear whether there have been increases in strep A in the United States.
The CDC does not track noninvasive Strep A infections, but it tracks an invasive Strep A disease: strep toxic shock syndrome (STSS). The most recent data shows that one child died from invasive strep A in 2020, seven children died in 2019 and six died in 2018.
Limited data means “we don’t actually know what the ‘normal’ number of [strep A] case is” in the United States, Bartlett said. “We typically see a peak in strep throat in the winter and early spring, but it’s no surprise we’re seeing it earlier this year like we’re seeing for RSV and influenza.”
Parents Need to Be Vigilant as US Faces Amoxicillin Shortage
Bartlett urges everyone, especially parents of young children, to remain vigilant for signs of infection, especially since there is a nationwide shortage of amoxicillin. (Amoxicillin is one of the drugs used to treat strep throat.)
“Any number of children dying from an infection should be shocking news because children aren’t supposed to die,” Bartlett said. “Vigilance is important, but panic is not necessary. The news about antibiotic shortages is frightening and frustrating and needs to be addressed on a systemic level. But as we continue to see all these viral illnesses, especially the flu, everyone should be on their toes when it comes to watching their children. »
The good news is that strep A infections can be treated with other antibiotics like penicillin.
“Amoxicillin tends to be the drug of choice for children because it tastes good and is given fewer times per day than penicillin,” Bartlett said. “While we always want to use the narrowest spectrum antibiotic available to treat an infection, we have many alternatives to treat [strep A] infections. »
Strep throat can be detected with a quick test at the doctor’s office.
However, Bartlett said you may want to avoid testing your child for strep throat if they don’t have any symptoms. Up to 20% of children have live strep A in their throats at any one time, she said, so a positive test could mean they’re being prescribed antibiotics unnecessarily. In light of the amoxicillin shortage, “we want to ensure that we only treat children with symptoms [strep A] infections. »
Symptoms of strep throat can include sore throat, fever, red and swollen tonsils which may show white patches, red patches on the roof of the mouth, and swollen lymph nodes in the front of the neck . Headache, stomach pain, nausea or vomiting are other common symptoms, especially in children, according to the CDC. The development of a rash is called scarlet fever.
People who then develop invasive strep A may experience these symptoms, but their progression will happen much faster, Bartlett said.
Strep throat can happen to anyone, but it’s most common in children between the ages of 5 and 15 and older adults.
What to know about invasive strep A and its symptoms
According to the CDC, approximately several million cases of noninvasive Strep A diseases occur each year, including pharyngitis (strep throat), scarlet fever, tonsillitis, and impetigo, also known as school sores – a highly contagious skin infection that mainly affects infants and children, causing red sores to form around the mouth and nose.
These conditions can lead to complications like poststreptococcal glomerulonephritis (kidney disease) and rheumatic fever, but this is rare.
Some infections, however, cause invasive strep A, especially in people with weakened immune systems.
Some of the complications of invasive strep A include cellulitis, which is a serious skin infection, blood infections, necrotizing fasciitis (an infection that destroys tissue under the skin, known as “flesh-eating disease”), pneumonia and STSS.
The CDC estimates that between 14,000 and 25,000 cases of invasive Strep A occur each year in the United States, based on data from the past five years; between 1,500 and 2,300 people die from it every year.
How is strep A spread?
The bacterium spreads via respiratory droplets that disperse through the air when coughing, talking or sneezing. Drinking from a sick person’s mug or touching a contaminated doorknob and then touching your mouth, for example, can make you sick. You can also catch the bacteria by touching infected sores on people’s skin.
Keep in mind, however, that even people without symptoms can still spread the bacteria, although those who get sick are much more contagious.
On rare occasions, people can spread the bacteria through food that isn’t handled properly, according to the CDC.
It usually takes two to five days after exposure to the bacteria before you feel sick.
How to Treat and Prevent Strep A Infections
There is no vaccine for Strep A, but several candidates are in development, according to the CDC.
Antibiotics like amoxicillin and penicillin can treat strep A infections. They are rarely used to prevent people from getting sick, but in some situations they may be prescribed to certain people exposed to someone with an infection. invasive streptococcus A.
People with mild illness are usually no longer contagious about 24 hours after starting their treatment.
One of the best ways to avoid Strep A illness is to get a flu shot, Bartlett said, since flu infections are often associated with secondary bacterial infections like strep throat. It’s also important to make sure you and your children have been vaccinated against chickenpox, because chickenpox “predisposes people to serious invasive Strep A infections.”
Otherwise, follow your basic hygiene practices to avoid getting sick: wash your hands, cover your mouth and nose when coughing or sneezing (preferably with a tissue), do not share utensils for eat or drink with other people and stay home when you are sick.
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