Strep A: Fifteen children have died in the UK in recent weeks. Could a U.S. outbreak follow?

WHat began as a common bacterial infection that resulted in death for fifteen children infected with Strep A in Britain.

Health authorities have issued a dire warning to parents in the UK as the number of child deaths caused by the infection continues to rise. The latest victim, a five-year-old girl from Ireland, became seriously ill last week before dying of complications related to Strep A on Monday.

Although pediatric patients usually experience mild symptoms such as fever, swollen tonsils and lymph nodes, complications can occur when the infection enters the bloodstream, leading to a potentially fatal disease known as Invasive Group A strep (iGAS).

In the US, iGAS cases declined during the pandemic, but the CDC said The independent on Wednesday that doctors in the US alerted the agency to a possible recent increase, which is now being actively monitored.

What is Strep A and what are the symptoms?

Dr. Mark Hicar, a pediatric infection specialist and associate professor at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, said The independent that it is hard to say whether the US could see a similar outbreak to the recent one in the UK.

According to CDC data, seven children under the age of 17 per 100,000 in surveillance areas died of complications from strep A before the 2019 pandemic.

One death per 100,000 population in monitored areas was reported in 2020, when the latest report was issued.

CDC only tracks iGAs infections and does not track noninvasive Strep A infections. Only 10 states reported data on iGAS in the most recent report.

“Mitigation measures (eg school and workplace closures, masking) used during the first two years of the COVID-19 pandemic helped reduce the spread of many viruses and bacteria,” a spokesperson said.

“Now that these germs are spreading again, we may be returning to typical infection patterns for iGAS, including a seasonal increase in the winter months.

What are strep A infections?

Group A streptococcus is a common bacterial infection that occurs mostly in children.

In the most severe and rare cases, the infection causes diseases such as pink-red rashes (scarlet rash), bacterial skin infection (impetigo), necrotic tissue (fasciitis), streptococcal toxic shock syndrome, pneumonia and sepsis.

However, the majority of group A strep infections have mild flu-like symptoms.

“There are many strains of group A strep and there have been isolated outbreaks in the UK in the past (2015 and 2018),” Dr Hicar said. “… with the previous increase in UK cases, there didn’t seem to be an impact on US cases, so [whether there will be one now] it’s hard to say.”

Dr Hicar says some strains of the infection can lead to a ‘sandpaper rash’, which generally makes children sicker and is known as ‘scarlet’.

“Usually that’s what happens with [throat infections or] cases of pharyngitis, but it can [happen with] wax infections too. That seems to be the form being reported in the UK at the moment,” he said.

He added that immunocompromised children are at greater risk when contracting strep A.

“Some children without a well-functioning spleen or who have other forms of immunosuppression have a higher risk of sepsis, toxic shock and necrotizing fasciitis (the flesh-eating group A strep infection),” Dr. Hicar said.

The mother of two-year-old Tayden, who was diagnosed with aplastic anemia earlier this year, was warned by doctors that her daughter’s transplant could be delayed after the toddler contracted strep A last week.

“She was cranky and tired the day before her fever,” said Heather, who lives in Utah. The independent.

Tayden’s symptoms resolved within 48 hours of being given antibiotics. He is expected to recover for the transplant.

A sore throat is one of the main signs of Strep A infection

Could infections increase after the pandemic?

a CDC spokesperson said The independent that more data needs to be collected to get a better sense of recent Strep A trends in the US.

“Recent increases in respiratory viruses, particularly influenza, may be contributing to a possible increase in iGAS infections. Concurrent or previous viral infections such as influenza and skin conditions such as chicken pox may increase the risk for iGAS infections,” the spokesperson said.

Dr. Hicar added that wearing a mask does not appear to reduce infections.

“Masks help well with respiratory viruses such as flu and Covid, but also other organisms that can remain on surfaces [such as Strep A] they tend not to be as affected by wearing a mask,” he said. “[US] Data available from 2020, the first year of the pandemic, appear stable for group A strep infections and death rates.”

The CDC estimates 14,000 to 25,000 cases of iGAS over the past five years and between 1,500 and 2,300 deaths over the same time period.

What symptoms should parents look out for?

According to the CDC, most children infected with Strep A will experience pain when swallowing, fever, red and swollen tonsils (sometimes with white spots or streaks of pus), and swollen lymph nodes in the front of the throat.

Says Dr. Hicar The independent that the sore throat and fever should subside within a few days. She advised parents to see their doctors again if symptoms persist.

“If your child has been diagnosed with [Strep A] and seemed to get better, but then gets worse, talk to your doctor,” he said. “One of these rarer more serious complications may be starting.”

He reiterated that although most cases are not dangerous for children, complications can become fatal if the infection reaches the bloodstream (bacteremia), the lungs (pneumonia) or the brain (meningitis).

New strain of group A strep could be more likely to cause serious internal infections

How do children get infected?

Crowded environments such as schools and daycare centers increase the risk of Strep A infections.

The bacterium is highly contagious and can spread through respiratory droplets from talking, coughing or sneezing and through direct contact when patients develop sores on their skin, according to the CDC.

In very rare cases it can also be spread through food when it is not delivered properly.

“As social animals, we are constantly bombarded by bacteria and viruses that our immune systems often fend off,” says Dr. Hicar. The independent.

“… so much more exposure [a person] has, the more likely they are to become infected. However, there are many benefits to interacting with peers and socializing.”

What should you do if you suspect your child has strep A?

Strep A infections can be diagnosed with a rapid strep test that involves a throat swab.

Doctors also administer throat cultures to patients. Although this method takes one to two days, it is more effective than the rapid test.

What is the treatment for Strep A?

There is currently no vaccine to prevent strep A infections.

Antibiotics reduce symptoms and prevent complications and are the most commonly used form of treatment. Once antibiotics are prescribed, patients should start feeling better within 48 hours.

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