What you need to know

Symptoms of Strep A infection and when parents may need to seek urgent care

Q What is Strep A and is it dangerous?

A Strep A is a common bacterial infection which causes strep throat, tonsillitis and scarlet fever.

Prof Beate Kampmann, Professor of Paediatric Infection & Immunity and Director of The Vaccine Centre, London School of Hygiene & Tropical Medicine, said “these tend to be fairly harmless”.

Dr Liz Whittaker, a consultant in paediatric infectious diseases at Imperial College healthcare, said: “Sometimes [Strep A] causes scarlet fever, which is the most common thing that people might have heard of.

“That’s when they get a sore throat, a red tongue and red face and a red rash that feels rough.”

But while Strep A is a common infection it can also, in rare cases, lead to a severe condition called invasive Group A Strep (IGAS), which can be deadly.

Q How is the bacteria spread and what are the symptoms?

A Strep A is spread in a similar way to Covid via close contact and passing of droplets from the respiratory tract. It is highly infectious and easy to pass on. Strep throat manifests as a sore throat, but scarlet fever symptoms 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.

Q How common are Strep throat, scarlet fever and IGAS?

A Strep throat causes tonsillitis and is extremely common, with most people getting the infection at some point.

In more severe cases it can manifest as impetigo or scarlet fever. Official statistics from the UK Health

Security Agency (UKHSA) show that for every 100,000 cases of scarlet fever, 3.1 people will develop IGAS.

New figures from the agency show that last week there were 851 cases of scarlet fever, up more than four times higher than in pre-pandemic times (186).

As a result of soaring infections, the number of IGAS cases is also soaring, although it is still at a very low level.

Currently there are 2.3 IGAS cases per 100,000 children aged between one and four years old, up four-fold from 0.5 per 100,000 before Covid.

The figure has jumped from 0.3 per 100,000 pre-pandemic seasons to 1.1 cases per 100,000 for children aged five to nine.

There have been six deaths of IGAS reported in under-10s so far this season, five in England and one in Wales. During the winter of 2017-2018, the last high season for Group A Strep infection, there were four deaths in children under 10 in the equivalent period.

Q When should parents take their child to the GP, call 111, or go to A&E/ call 999?

A Most sore throats and coughs are caused by a viral infection and antibiotics will not work and a child will most likely recover on their own.

However, if a sore throat gets worse then it may be a sign of Strep A infection.

Signs of scarlet fever are a sore throat, a red tongue, a red face and a red skin rash that feels rough. If you think your child has scarlet fever, call 111. A leading paediatrician told The Telegraph: “If your child is sicker than you would expect for tonsillitis, or it is getting worse, then get help. Seek help earlier rather than later, even if it just starts off as a sore throat.”

UKHSA told parents that if a child’s sore throat deteriorates, they should call 111 or go to their GP as it may be Strep throat and this should be treated with antibiotics.

If a child is dehydrated, eating more or less than usual, has a temperature or is very irritable, parents should also call 111 or see a doctor. UKHSA guidance says 999 or A&E should be used if a child is struggling to breathe; pausing when they breathe; their skin, tongue or lips going blue; or the child goes floppy.

Dr Colin Brown, Deputy Director of UKHSA, said: “[IGAS] 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.”

Children are also more prone to IGAS if they have recently had chickenpox or flu as their immune defences are not at full strength.

Q Can the infection be treated?

A Strep A is easy to treat with antibiotics.