Six young children have now died from Strep A in the UK this season, according to health chiefs.
The updated figure comes hours after a fourth child was confirmed to have died from the bacterial infection, which has spread in schools across the country.
Muhammad Ibrahim Ali, aged just four, died at his home on November 14 after suffering a cardiac arrest, his devastated family said.
The UK Health Security Agency (UKHSA) said there had been a rise in cases of rare invasive Group A strep this year, particularly in children under 10, with five deaths in England this season.
A separate case has been reported in Wales, taking the known UK total to six.
Group A strep bacteria can cause many different infections, ranging from minor illnesses to deadly diseases.
The range of illnesses includes the skin infection impetigo, scarlet fever and strep throat.
While the vast majority of infections are relatively mild, sometimes the bacteria cause a life-threatening illness called invasive Group A Streptococcal disease.
What is Strep A infection?
More young children have died from Strep A infection, prompting fears of an outbreak in cases.
– What is Strep A?
Group A Streptococcus (Group A Strep or Strep A) bacteria can cause many different infections.
The bacteria are commonly found in the throat and on the skin, and some people have no symptoms.
Infections cause by Strep A range from minor illnesses to serious and deadly diseases.
They include the skin infection impetigo, scarlet fever and strep throat.
While the vast majority of infections are relatively mild, sometimes the bacteria cause life-threatening illness called invasive Group A Streptococcal disease.
– How are Strep A bacteria spread?
The bacteria are spread by contact with an infected person or by contact with infected skin lesions.
Bacteria can be passed from person to person by close contact such as kissing or skin contact.
The risk of spread is greatest when somebody is ill, such as when people have strep throat or an infected wound.
– What is invasive Group A Streptococcal disease?
Invasive Group A Strep disease is sometimes a life-threatening infection in which the bacteria have invaded parts of the body, such as the blood, deep muscle or lungs.
Two of the most severe, but rare, forms of invasive disease are necrotising fasciitis and streptococcal toxic shock syndrome.
Necrotising fasciitis is also known as the ‘flesh-eating disease’ and can occur if a wound gets infected.
Streptococcal toxic shock syndrome is a rapidly progressing infection causing low blood pressure/shock and damage to organs such as the kidneys, liver and lungs.
This type of toxic shock has a high death rate.
– Can these illnesses be treated?
Strep A infections such as scarlet fever and impetigo are treated with antibiotics.
After a full 24 hours of antibiotics, people are generally thought to no longer be contagious.
Anyone thought to have invasive Group A Streptococcal disease should seek medical help immediately. Antibiotics, other drugs and intensive medical attention are likely to be needed.
– When should I see a doctor?
Strep throat is different from a regular sore throat and the pain can come on very quickly.
Symptoms include pain when swallowing, fever, and red and swollen tonsils – sometimes with white patches or streaks of pus.
The NHS recommends people see their GP if a sore throat does not improve after a week, if they are worried or if they have a high temperature, or feel hot and shivery.
People with weakened immune systems such as those having chemotherapy should also see a doctor.
Impetigo is a skin infection which starts with red sores or blisters that then burst, leaving crusty, golden patches. The infection can be treated with antibiotics.
Scarlet fever symptoms are often flu-like, including a high temperature, a sore throat and swollen neck glands.
A rash appears 12 to 48 hours later, starting on the chest and stomach and then spreading.
A white coating also appears on the tongue which peels, leaving the tongue red, swollen and covered in little bumps (often called ‘strawberry tongue’).
Signs of necrotising fasciitis include fever (a high temperature above 38C), severe pain and swelling, and redness at the wound site.
Early signs and symptoms of toxic shock may include fever, dizziness, confusion, low blood pressure, rash and abdominal pain.
According to UKHSA data, there were 2.3 cases of invasive disease per 100,000 children aged one to four this year in England, compared with an average of 0.5 in the pre-pandemic seasons (2017 to 2019).
There have also been 1.1 cases per 100,000 children aged five to nine compared with the pre-pandemic average of 0.3 (2017 to 2019).
When looking at the five deaths in England, the last time there was an intensive period of Strep A infection was in 2017/18, when there were four deaths in the equivalent time frame.
The UKHSA said investigations are also under way following reports of an increase in lower respiratory tract Group A Strep infections in children over the past few weeks, which have caused severe illness.
It said there is no current evidence that a new strain is circulating and the rises are most likely due to high amounts of circulating bacteria and social mixing.
Earlier, health officials confirmed a youngster from St John’s School in Ealing, west London, had died from Strep A, while the parents of a four-year-old boy from Buckinghamshire confirmed he had died from Strep A.
It comes after a pupil from Victoria primary school in Penarth, four miles south of Cardiff, also died.
Last week, a six-year-old died after an outbreak of the same infection at a school in Surrey.
Dr Colin Brown, deputy director of the UKHSA, said: ‘We are seeing a higher number of cases of Group A strep this year than usual.
‘The bacteria usually causes a mild infection producing sore throats or scarlet fever that can be easily treated with antibiotics.
‘In very rare circumstances, this bacteria can get into the bloodstream and cause serious illness – called invasive Group A strep (iGAS).
‘This is still uncommon however it is important that parents are on the lookout for symptoms and see a doctor as quickly as possible so that their child can be treated and we can stop the infection becoming serious.
‘Make sure you talk to a health professional if your child is showing signs of deteriorating after a bout of scarlet fever, a sore throat, or a respiratory infection.’
Parents are being told to contact NHS 111 or their GP if their child is getting worse, is feeding or eating much less than normal, or has had a dry nappy for 12 hours or more or shows other signs of dehydration.
They should also seek help if their baby is under three months and has a temperature of 38C, or is older than 3 months and has a temperature of 39C or higher.
Other red flags are if the child is very tired or irritable.
Parents should call 999 or go to A&E if a child is having difficulty breathing (such as grunting noises or tummy sucking in under the ribs), pauses in breathing, blue colour to a child’s skin, tongue or lips, or if a child is floppy and will not wake up or stay awake.
The four-year-old from Buckinghamshire has been named locally as Muhammad Ibrahim Ali.
The Bucks Free Press newspaper said he died at his home in High Wycombe on November 14 after suffering a cardiac arrest.
A statement from his school said: ‘Ibrahim was a friendly boy who loved coming to Oakridge School.
‘He had lots of energy and was always active. He particularly loved being outdoors in forest school.
‘Ibrahim was kind and loved to help his friends. He was constantly smiling. We are one big family at Oakridge and will miss him terribly.’
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