Thousands of children could be kept off school this week amid heightened fears about a potentially deadly winter bug.
Parents of children at schools where pupils have died of Strep A, which can cause scarlet fever and more serious diseases, have already vowed to keep their sons and daughters at home. And many more could follow suit, even at schools without confirmed infections.
Over the past few weeks, seven school-aged children have died of complications after contracting Strep A, a relatively common bacteria which usually causes only mild symptoms such as a sore throat.
A 12-year-old boy is the first secondary school pupil to die in the current outbreak. He is reported to have been a Year 8 pupil at fee-paying Colfe’s School in Lewisham, South-East London.
Four-year-old Muhammad Ibrahim Ali, of High Wycombe, died after contracting Strep A and suffering a cardiac arrest.
And four-year-old Camila Rose Burns from Bolton, Lancashire, is fighting for her life in Alder Hey Children’s Hospital in Liverpool.
Four-year-old Muhammad Ibrahim Ali (left), of High Wycombe, tragically died after contracting Strep A and four-year-old Camila Rose Burns (right) from Bolton, Lancashire, is fighting for her life in Alder Hey Children’s Hospital in Liverpool
One of those who died was a six-year-old child, believed to be a girl, at Ashford Church of England Primary School in Surrey.
Last week teachers at nearby Echelford Primary School, also in Ashford, wrote to parents confirming two children had been infected.
They said they had been advised by the UK Health Security Agency (UKHSA) that ‘children should continue to attend school as normal and parents/carers should not be overly alarmed’.
They added: ‘We would like to reiterate that if well, it is safe for children to attend school as normal.’ But parents have said they are so worried about the bug, which can be spread easily, that they will be keeping children at home.
The UKHSA said last night it was up to local health protection teams to decide whether parents of children at schools where there have been confirmed infections should be advised to keep them at home.
These teams would make the decision ‘on a case-by-case basis’, a spokesman said.
No affected school has yet said healthy children should stay at home. According to information published by UKHSA, children with scarlet fever – where Strep A causes a sandpaper-type rash – should be kept at home.
It states: ‘Scarlet fever is highly infectious and is spread by close contact with someone carrying the bacteria. Coughing, sneezing, singing and talking may spread respiratory droplets from an infected person to someone close by.
‘Droplets . . . may also contaminate hands, eating and drinking utensils, toys or other items.’ It concludes: ‘Exclusion [from school] is recommended.’
Last week teachers at nearby Echelford Primary School, Ashford, (pictured) wrote to parents confirming two children had been infected
But there is no advice on whether children with a sore throat – which is potentially an early warning sign of Strep A but could just signify a cold – should be kept at home.
Speaking to BBC Radio 4’s Today programme yesterday, infectious diseases paediatrician Professor Beate Kampmann said Strep A caused ‘an asymptomatic infection in the majority of people, then there is a sore throat, then scarlet fever, and in a very, very small minority will there be invasive Strep A’. She said children with a fever should be kept off school.
She said: ‘It starts off with a high fever, very sore throat and very red tongue . .. eventually developing a rash which feels a bit like sandpaper.
‘The rash starts in the elbows and behind the neck. It tends to then peel after about ten days.’
Most children will recover of their own accord but if a child deteriorates so they are ‘not eating, drinking, being quite flat and lethargic’ parents should call 111 or a doctor, she said. Antibiotics almost always help clear the infection if given soon enough.
Last night Camila’s father Dean urged parents who suspected their child might have the bug to take them to a doctor immediately. He said: ‘Any doubts, if they don’t look right, just scoop them up and take them. Get them checked out rapid.’
He said Camila was showing signs of improvement but added she was ‘nowhere near out of the woods’ and that ‘anything could take her back the other way’.
What are the symptoms of Strep A? How does it spread? And is it the same as scarlet fever? Everything you need to know about the killer bug sweeping Britain By Rebecca Whittaker, Health Reporter for MailOnline
Six children have now died in the UK this winter after contracting Strep A.
The Strep A bacteria can be life-threatening and lead to scarlet fever, which was rife in the Victorian era.
Here is everything you need to know about the Strep A bacteria outbreak:
Although Strep A can cause a number of serious illnesses, it tends to begin with a few typical symptoms. This includes a rash, a sore throat, flushed cheeks, muscle aches, a high fever, an ear infection and sores on the skin
What is strep A?Strep A, medically known as Group A Streptococcus or Group A Strep, are bacteria that cause a range of infections, including strep throat, tonsillitis and impetigo — a skin infection. It can also cause scarlet fever.
The bacteria, which can cause no symptoms, can be found in the throat, skin and respiratory tract of those infected.
While the vast majority of Strep A infections are relatively mild, sometimes the bug can lead to the potentially life-threatening rheumatic fever if it is untreated.
The bacteria can, in exceptionally rare cases, cause a deadly illness called invasive Group A Streptococcal disease (iGAS).
What is invasive Group A Streptococcal disease? Invasive Group A Strep disease happens when the bacteria penetrate deep into 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.
What are the symptoms of strep A?Although Strep A can cause a lot of different serious illnesses, it tends to begin with a few typical symptoms.
The signs of a Strep A infection include a rash, a sore throat, flushed cheeks, muscle aches, a high fever, tiredness, an ear infection and sores on the skin.
The symptoms should last for a week, according to the NHS.
Some people carrying Strep A do not have any symptoms, but they are still just as likely to pass on the bug as those with a visible illness.
It usually takes two to five days to become ill after being exposed to the bacteria.
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.
When should I see a doctor?
Strep throat is different from a regular sore throat and the pain can come on very quickly.
The NHS recommends people see their GP or call 111 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.
How does the bacteria spread? The killer bug spreads through cough droplets, sneezes, talking and contact with infected skin lesions.
Bacteria can be passed from person-to-person by close contact such as kissing or skin contact.
In rare cases, Strep A bacteria is spread through food that has not been handled properly.
The bacteria is more likely to spread in crowded places, such as schools, nurseries or in households if someone in the home is infected.
People who have impetigo skin sores caused by Strep A bacteria are advised not to share flannels, sheets or towels with others.
Toys should also be washed or cleaned to help prevent the spread.
People can avoid passing on the illness by washing their hands frequently and coughing into a tissue rather than into their hand.
The killer bug spreads through cough droplets, sneezes, talking and skin-to-skin contact. In rare cases, Strep A bacteria is spread through food that has not been handled properly
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.
There is no vaccine currently available for Strep A.
Can it kill?Most cases of Strep A only cause mild illness such as a sore throat.
But in some instances, it can be life-threatening.
Severe forms of the disease will usually need to be treated in hospital.
Historically, scarlet fever killed about 20 per cent of people it infected.
In the Victorian era, between 1820 and 1880, there was a global scarlet fever pandemic. There were also several severe epidemics in Europe and North America.
However, since the discovery of penicillin in 1928 at St Mary’s Hospital in London, by Alexander Fleming, the number of deaths from Strep A have been greatly reduced.
The death rate is now less than one per cent.
Strep A is a bacterium which can cause infections in the throat, skin and respiratory tract. If an infection is left untreated it can cause serious complications. Ear infections, toxic shock syndrome and kidney inflammation are all complications that can occur
Are some people more susceptible? Strep A is more common in children between the ages of five and 15.
Adults over the age of 65 are particularly susceptible to the bacteria.
People with weakened immune systems can also have a higher chance of being infected with the bacteria.
This includes people with HIV, AIDS or cancer, or anyone who has had an organ transplant.
People are also at a higher risk of catching Strep A if they are in contact with someone who is infected.
Will masks help?
As with other bugs that spread through cough droplets and sneezes, masks may act as a barrier against infection.
However, masks will not prevent a Strep A infection through other channels, such as skin-to-skin contact.
And as with Covid, they are not a foolproof way of stopping transmission.
Where is the current Strep A outbreak? Six school children have died of Strep A as the deadly bacterial outbreak continues to spread across Britain.
One of these is in Wales.
The other five are in England, scattered across west London, Surrey and Buckinghamshire. Not all of the victims have been named, meaning some locations are a mystery.
There is no indication that the six deaths are in any way related.
Why could lockdown be to blame for the Strep A outbreak?
Strep A is on the rise alongside a range of other common winter bugs like flu in levels not seen for years.
Some experts believe the Covid lockdowns may be to blame for the spike.
This is because repeated lockdowns, handwashing, mask wearing and school closures of 2020 and early 2021 limited Britons’ exposure to a host of seasonal pathogens they normally would have caught.
In the case of young children, this meant they missed perhaps their first ever exposure to these diseases.
Experts theorise this could have left their, and older Britons’, immune systems in an unprepared and comparatively weaker state as people began to mix post-lockdown.
This could lead to both a rise in cases, the sheer number of people who catch the disease, as well as the proportion of people who become severely ill as a result.
Sometimes called ‘immunity debt’ the concept was one theory behind a series of cases of ‘acute hepatitis of unknown origin’ earlier this year.
More than 150 cases of the mysterious infection were recorded globally in more than a dozen countries.
The outbreak was eventually found to be caused by a bug called adeno-associated virus 2 (AAV2).
This virus does not normally make people unwell by itself but often accompanies an infection with the flu-like illness adenovirus.
But some experts tasked with investigating the spate of cases believed the lockdowns may have played a contributing role in this.
They said pandemic restrictions may have weakened children’s immunity because of reduced social mixing, leaving them at heightened risk of the adenovirus.
This means even ‘normal’ adenovirus could have causing the severe outcomes.