Group A Strep – What you need to know

Group A streptococcus (GAS), also referred to as Strep A is a common bacterium. Lots of us carry it in our throats and on our skin and it doesn’t always result in illness. However, GAS does cause a number of infections, some mild and some more serious.

The most serious infections linked to GAS come from invasive group A strep, known as iGAS.

These infections are caused by the bacteria getting into parts of the body where it is not normally found, such as the lungs or bloodstream. In rare cases an iGAS infection can be fatal.

Whilst iGAS infections are still uncommon, there has been an increase in cases this year, particularly in children under 10 and sadly, a small number of deaths.

This blog explains more about GAS and the infections it can cause, as well as how it is spread and what to look out for when your child is unwell.

How is it spread?

GAS is spread by close contact with an infected person and can be passed on through coughs and sneezes or from a wound.

Some people can have the bacteria present in their body without feeling unwell or showing any symptoms of infections and while they can pass it on, the risk of spread is much greater when a person is unwell.

Which infections does GAS cause?

GAS causes infections in the skin, soft tissue and respiratory tract. It’s responsible for infections such as tonsillitis, pharyngitis, scarlet fever, impetigo and cellulitis among others.

While infections like these can be unpleasant, they rarely become serious. When treated with antibiotics, an unwell person with a mild illness like tonsilitis stops being contagious around 24 hours after starting their medication.

We are currently seeing high numbers of scarlet fever cases.

The first signs of scarlet fever can be flu-like symptoms, including a high temperature, a sore throat and swollen neck glands (a large lump on the side of your neck).

A rash appears 12 to 48 hours later. It looks looks like small, raised bumps and starts on the chest and tummy, then spreads. The rash makes your skin feel rough, like sandpaper. The rash will be less visible on darker skin but will still feel like sandpaper. More information on scarlet fever can be found on the NHS website, including photos.

What is invasive group A strep?

The most serious infections linked to GAS come from invasive group A strep, known as iGAS.

This can happen when a person has sores or open wounds that allow the bacteria to get into the tissue, breaches in their respiratory tract after a viral illness, or in a person who has a health condition that decreases their immunity to infection. When the immune system is compromised, a person is more vulnerable to invasive disease.

Which infections does invasive group A strep cause?

Necrotising fasciitis, necrotising pneumonia and Streptococcal Toxic Shock Syndrome are some of the most severe but rare forms of invasive group A strep.

What is being done to investigate the rise in cases in children?

Investigations are underway 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.

Currently, there is no evidence that a new strain is circulating. The increase is most likely related to high amounts of circulating bacteria.

It isn’t possible to say for certain what is causing higher than usual rates of these infections. There is likely a combination of factors, including increased social mixing compared to the previous years as well as increases in other respiratory viruses.

What should parents look out for?

It’s always concerning when a child is unwell. GAS infections cause various symptoms such as sore throat, fever, chills and muscle aches.

As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement.

CONTACT NHS 111 OR YOUR GP IF:

your child is getting worse
your child is feeding or eating much less than normal
your child has had a dry nappy for 12 hours or more or shows other signs of dehydration
your baby is under 3 months and has a temperature of 38C, or is 3 to 6 months and has a temperature of 39C or higher
your baby feels hotter than usual when you touch their back or chest, or feels sweaty
your child is very tired or irritable

CALL 999 OR GO TO A&E IF:

your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs
there are pauses when your child breathes
your child’s skin, tongue or lips are blue
your child is floppy and will not wake up or stay awake

What are schools being asked to do?

Schools are being asked to follow the usual outbreak management processes as set out in our guidance if an outbreak of scarlet fever is identified. An ‘outbreak’ is defined as 2 or more probable or confirmed cases attending the same school, nursery or other childcare setting within 10 days of each other.

Schools and nurseries should contact their local Health Protection Team if:

You have one or more cases of chickenpox or flu in the class that has scarlet fever at the same time. This is because infection with scarlet fever and either chickenpox or flu at the same time can result in more serious illness.
You are experiencing an outbreak of scarlet fever in a setting or class that provides care or education to children who are clinically vulnerable.
The outbreak continues for over 2 weeks, despite taking steps to control it.
Any child or staff member is admitted to hospital with any Group A Strep (GAS) infection (or there is a death).

Schools where outbreaks occur are additionally advised to:

Make sure that all children and employees that are ill go home and don’t return until they are well.
Tell parents and visitors about the cases of illness.
Remind employees to wash their hands throughout the day. Hand washing needs to be done after changing nappies and helping children use the toilet.
Make sure that all cuts, scrapes and wounds are cleaned and covered. This also applies to bites.
Carry out regular cleaning throughout the day, especially hand contact surfaces – this is covered in Managing Outbreaks and Incidents. Advice may also be given to increase cleaning of areas with particular attention to hand touch surfaces that can be easily contaminated such as door handles, toilet flushes and taps and communal touch areas. These should ideally be cleaned using a disinfectant.
Consider stopping messy play, removing hard to clean soft toys, not going on visits outside of your setting and not allowing children to share drinks
Once cases have stopped (no new cases or illness for 10 days), do a full cleaning of buildings (including toys, carpets etc)

Who needs to take antibiotics?

Antibiotics are not routinely recommended as a preventative treatment and should only be taken in confirmed cases of scarlet fever or another GAS infection, or in certain circumstances where Health Protection Teams recommend their wider use.

If there are cases identified in a child’s class, any child showing symptoms should be assessed by a doctor/by their GP and will be prescribed antibiotics if needed. Children are not infectious after 24 hours on treatment and can return to school once they’re feeling well enough after this period.

Are children with chickenpox more vulnerable to iGas?

Children who have had chickenpox recently are more likely to develop serious forms of Group A Strep infection, although this remains very uncommon. The chickenpox rash can make it easier for Group A Strep to get into the body, which can lead to invasive infection. If a child has chickenpox – or has had it in the last 2 weeks – parents should remain vigilant for symptoms such as a persistent high fever, cellulitis (skin infection) and arthritis (joint pain and swelling). If you are concerned for any reason please seek medical assistance immediately.

How can we stop infections from spreading?

Good hand and respiratory hygiene are important for stopping the spread of many bugs. By teaching your child how to wash their hands properly with soap and warm water for 20 seconds, using a tissue to catch coughs and sneezes, and keeping away from others when feeling unwell, they will be able to reduce the risk of picking up, or spreading, infections.

All information in this blog is from UK Health Security Agency and is used under the Open Government Licence v3.0

Arthur Terry student Sarah tells council chiefs to support families hit by sepsis

An inspirational Arthur Terry student who had to look after her mum when she caught a life-threatening condition took her campaign for improved support to the corridors of power, when she appeared before the biggest local authority in Europe to demand urgent action.

Year 9 student Sarah Gibson took the floor at a full meeting of Birmingham City Council on Tuesday, July 12 to ask a question about support for families who are affected by Sepsis, which struck down her mum Ali in 2019.

Sarah, who was just 11 years old at the time, cared for her mum as they were not aware of the support that was available to families in their situation.

Sepsis is the body’s over-reaction to an infection or injury, which causes the immune system to attack its own organs and tissues. It affects 245,000 people every year in the UK and is responsible for 1 in 5 deaths worldwide (11 million people).

Sarah asked a question of the council’s cabinet member with responsibility for Health and Social Care, Cllr Mariam Khan.

She told the council:

“I first came into contact with the serious effects of sepsis through my mum in 2019. This experience was very difficult and frightening for me as I did not know what Sepsis was. Even now, three years on, my mum is still struggling with the long-lasting effects that this condition has caused. Sepsis has led to anxiety for my mum’s wellbeing. This is all because she got no support.
“Nationally, 245,000 are directly affected yearly, not to mention the family of each person like me. My mum was offered no support. I had to care for her and myself when I was only 11. This is something no child should have to suddenly and irreversibly carry the responsibility for, but thousands have no choice but to. It is vital that patients are signposted towards UK Sepsis Trust services at the hospital. Awareness for sepsis is essential to save lives and lower the death rate of some 48,000 people every year.
“Will you commit to embedding signposting towards sepsis support systems like the Sepsis Trust at hospitals across Birmingham for patients and families?”

National charity the UK Sepsis Trust, which was founded in Birmingham by a doctor working at Good Hope Hospital, exists to support this hit by the condition and backed Sarah in her big moment at the council.

The Trust’s Fundraising Manager Brian Davies, who accompanied Sarah to the council meeting, said he had been ‘hugely impressed’ by the maturity and determination she had shown in demanding action.

He said: “Sarah showed great courage and determination to speak at the council and got across her point with real conviction.

“She and her family have experience of how Sepsis can impact on lives and have long-lasting effects. The UK Sepsis Trust is is proud to provide a free, confidential and compassionate helpline service, facilitated by our dedicated team of specialist sepsis nurses.

“However, effected families often don’t know about us, or aren’t pointed towards us when they need support the most.

“Sarah’s idea to embed signposting to help families affected by sepsis find us, and access our services and support, is a simple move that could improve the lives of so many people impacted by this terrible condition.”

Sarah found out about the trust during an ‘experience of the workplace’ careers event at the Arthur Terry School, which is part of the respected Arthur terry Learning Partnership (ATLP), where Brian was acting as a mentor.

Another mentor at the event, ATLP Trust member Councillor Alex Yip, arranged for Sarah to ask her question at Birmingham City Council’s full meeting, bringing the issue of sepsis to the attention of more than 100 elected councillors in the Second City.

Lauren Murphy, Sarah’s form tutor, said: “We are so proud of Sarah and the stand she has made about this issue, which has had such an impact on not only her own family but thousands of others.

“It was a privilege to see her speak to the council and we all hope the councillors will act on the suggestion she made.”

Courtesy Gary Phelps Communications Ltd

LIFE-SAVING DEVICES UNVEILED AT ARTHUR TERRY SCHOOL

Students, staff and visitors at a Sutton school will have access to potentially life-saving equipment after new defibrillators were installed across the site, thanks to generous donations. The Arthur Terry School, which only had one defibrillator on its large site at Kittoe Road, now has three thanks to support from teacher recruitment agency Zest Education and the school’s Parents Association. The Lichfield-based agency decided to step in and fund a defibrillator and cabinet after seeing the plight of Swedish footballer Christian Eriksen, who suffered a cardiac arrest on the pitch at the Euro 2020 championships, before being revived by one of the devices. Zest’s Partnership Director Brad Johnson said: “We have had an excellent relationship with the Arthur Terry Learning Partnership for many years now, providing teaching and support staff across their network of primary and secondary schools, and helping their students with interview techniques, CV writing and fundraising events. “So, when we were asked for help with the purchase of either a defibrillator or defibrillator storage cabinet for the Arthur Terry School, it was an easy decision to make. Zest bought and supplied both a defibrillator and the cabinet within days of being approached. “We all hope that equipment such as this is never needed, however, as we witnessed with the case of Christian Eriksen, which highlighted just how critical a defibrillator can be. Without this level of specialist intervention at that very moment, medical officials are all in agreement that he would never have survived, much less, go on to make an unlikely return to topflight football. “Having this new addition at the Arthur Terry School, will hopefully give peace of mind to staff, students and parents, and reassure them that they now have further means to reduce or prevent serious incidents on site.” Headteacher Samantha Kibble said: “We are so grateful to Zest Education and our wonderful Parents Association for funding these new defibrillators. “Our school covers a very large site, so having three of these life-saving devices in strategic locations will maximise their coverage, and ensure that there’s always a defibrillator available when needed. “All First Aiders on site know how to operate the defibs, however anyone in school would be able to use them as they are fully automated.”

Category: Health & Fitness