Posted on 09 December 2022

​Every newspaper this week has been filled with pictures and blocks of texts about a scary pathogen – not a new one mind but Group A Streptococcus – Strep A – something which has caused myriad illnesses over the course of history. The main diseases caused by Strep A are Scarlet Fever, Impetigo (a skin infection), Cellulitis and a mild sore throat (strep throat). Indeed, we all likely have some form of streptococcus in our throat or on our skin right now, but it’s a new strain of the bacterium which is causing real panic amongst parents across the country and has some public health officials bracing for a new epidemic following the deaths of 15 children in the UK. But how do we treat Strep A, what are the symptoms, how do we protect ourselves and our children, and how worried should we be?

111, doctors’ surgeries, A&E and pharmacies have seen increased traffic in recent days following a spate of child deaths from Strep A with anxious parents looking to ensure their child will not be the next serious case in a brewing epidemic. Streptococcus is treated by common antibiotics, while the more severe forms of the disease such as scarlet fever or impetigo may require more intensive treatment. The cases which have gone on to be more severe in the new epidemic have caused death by streptococcus bacterium breaching the lungs and blood of the ill children, causing septic shock (sepsis) which is notoriously deadly and much more difficult to control. In light of the new epidemic, NHS England is considering lowering the threshold for the prescribing of antibiotics to children showing any of the symptoms, something which throws up even more of a conundrum.

There are initial reports of a shortage of penicillin in the UK, the main antibiotic of choice for treating streptococcal infections. Steve Barclay, the health secretary, said in The Guardian, “We have a dedicated team permanently in the department who do this day in, day out, and they have reassured me – I checked with them again last night, knowing that I was coming out on the media this morning – and they said they are not aware of any shortages, but sometimes obviously you get the peaks of demand in a particular area and stock has moved around accordingly.”

Strep A is spread in close contact with someone infected, or those who have not fully recovered from the infection. Coughs, sneezing and touching of an open wound is often the method of contracting Strep A, including kissing or saliva from your partner or child. You can also carry streptococcus group A bacteria on your skin, in your throat or saliva and feel perfectly well, even though someone else may get infected, making you a carrier. If you’ve just had a cold, flu or other virus you’re likely to have a weakened immune system and are particularly susceptible to catch strep A. Depending on the presentation of Strep A, you might get different symptoms to other people, particularly if you’ve got a skin infection or something more long term like scarlet fever. If you do become unwell, the symptoms usually include;

  • Flu symptoms like a high temperature, swollen glands around the body or rheumatism (Body aches)sore throat or tonsilitis

  • a rash that feels like sandpaper (scarlet fever)

  • scabs and pustulent sores (impetigo)

  • pain and swelling (cellulitis)

  • severe muscle aches

  • nausea and vomiting

Antibiotics begin to work within 24 hours after taking them and it’s advised to stay away from school or work for 24-48 hours after starting antibiotics, but this is likely only for those with sore throat – the more severe forms of disease require a much more serious recovery time and are often associated with severe fatigue (scarlet fever) and other complications.

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