What you need to know about Group A Streptococcus, Scarlet Fever and Invasive Group A Streptococcus

What you need to know about Group A Streptococcus, Scarlet Fever and Invasive Group A Streptococcus:

There has been a lot of information in the news recently about Group A Streptococcus sometimes called Group A Strep or GAS, and children becoming seriously unwell. Some of these children have unfortunately become seriously unwell very quickly.

With winter viruses circulating here is what you need to know about GAS and Scarlet Fever and what to do if your child is poorly. As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement and seek medical help from your GP, NHS 111 or A&E.

There are lots of viruses that cause sore throats, colds and coughs circulating. Many of these should resolve without medical intervention. However, children can on occasion develop a bacterial infection on top of a virus and that can make them more unwell.

Dr Imogen Norton, Consultant Paediatrician, talks about Group A Strep, the symptoms and what to do if your child is poorly.

Group A Streptococcus (GAS)

There is much more GAS around this winter than in recent years, causing a lot of children to be unwell. We think this is because there is much more mixing now and these bugs are new to many young children, so they are more likely to catch and spread them.

GAS infections cause various symptoms such as sore throat called Strep Throat, fever, chills and muscle aches. Usually these are mild illnesses, and your child should recover in a few days.

Signs that suggest your child might have Strep throat are:

• Fever within the last 24 hours
• White spots at the back of their throat (pus on their tonsils)
• Very large or red tonsils
• Sore (tender) lumps under their chin
• If they have become poorly quickly over the past couple of days
• No cough or runny nose

If you are concerned that your child might have these symptoms phone NHS 111, your GP Surgery, or Corby Urgent Care Centre for advice.

Scarlet Fever

Sometimes, GAS can cause Scarlet Fever. Scarlet fever is caused by bacteria called group A streptococci. These bacteria also cause other respiratory and skin infections such as strep throat and impetigo. Scarlet fever is usually a mild illness, but it is highly infectious.

You can look for signs of Scarlet Fever, which include a sore throat, headache, and fever, along with a fine, pinkish or red body rash with a sandpapery feel. On darker skin, the rash can be more difficult to detect visually but will have a sandpapery feel. They may also have a very red tongue or lips.

Contact NHS 111 or your GP if you think your child has Scarlet Fever. Early treatment of Scarlet Fever with antibiotics is important to reduce the risk of complications such as pneumonia or a bloodstream infection.

If your child has Scarlet Fever, keep them at home until at least 24 hours after the start of antibiotic treatment to avoid spreading the infection to others.

Invasive Group A Streptococcus (iGAS)

Most children with GAS throat infection or Scarlet Fever will get better with antibiotics.

Very occasionally some children become unwell later because their body produces an exaggerated immune response, or the bacteria gets into the blood stream and causes a more severe infection (called “invasive GAS” or iGAS).

Whilst iGAS infections are still uncommon, there has been an increase in cases this year, particularly in children under 10.

Therefore, it’s important that parents are on the lookout for symptoms and see a doctor as quickly as possible if they have any concerns. 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.

As a parent, if you feel that your child seems seriously unwell, or is becoming more unwell even if they are on treatment or have recently finished antibiotics, you should trust your own judgement.

If you have any other queries or want to learn more about Group A Strep please see this page from the NHS: www.nhs.uk/conditions/strep-a or the page from the UKHSA: www.gov.uk/government/news/ukhsa-update-on-scarlet-fever-and-invasive-group-a-strep-1

Phone NHS 111 or your GP if your child is getting worse despite giving them paracetamol or ibuprofen if: 

• the temperature has lasted more than 5 days 
• your child is feeding or eating much less than normal, especially if they are drooling or appear in pain when swallowing 
• your baby has had a dry nappy for 12 hours or more, or is crying without tears 
• or your child shows other signs of dehydration 
  • feeling thirsty 
  • dark yellow, strong-smelling pee 
  • peeing less often than usual 
  • feeling dizzy or lightheaded 
  • feeling tired 
  • a dry mouth, lips and tongue 
  • sunken eyes (dark circles under eyes) 
• your baby is under 3 months and has a temperature of 38°C, or is older than 3 months and has a temperature of 39°C or higher  
• your baby feels hotter than usual when you touch their back or chest, or feels sweaty  
• your child is drowsy (much more sleepy than normal) or irritable (unable to settle them with cuddles, toys, TV or snacks – especially if they remain drowsy or irritable despite any fever coming down) 

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 or using their neck muscles to breathe 
• there are long pauses (more than 10 seconds) when your child breathes  
• your child’s skin, tongue or lips are blue 
• your child feels very cold or clammy to touch 
• your child is difficult to wake up or keep awake 
• your child has severe pains in their arms, legs neck or back 
• your child has a painful, red area of skin, especially if it is getting bigger quickly 

You can help to stop bugs spreading by teaching your children good hand hygiene. Help them to learn how to wash their hands properly with soap for 20 seconds- this video from the NHS  should help.

Help them to learn to use a tissue to catch coughs and sneezes, and keep away from others when they are feeling unwell. This will help to reduce the risk of picking up, or spreading, infections. Keep unwell children off school or nursery and away from vulnerable adults and children.

Useful links:

• NHS Strep A information
• UKHSA update on Scarlet Fever and Invasive Group A Strep
• UKHSA Group A Strep- What you need to know
• Corby Urgent Care Centre
• When to use NHS 111
• NHS information- Scarlet Fever
• NHS information- Blue skin or lips
• NHS information- Dehydration