Is the US about to be hit by a wave of Strep A?

A deadly outbreak of Strep A in the UK has fueled fears that a similar rise could hit the US – as both countries grapple with a post-lockdown boom in seasonal infections.

The UK has recorded 16 deaths from the usually-harmless bug among children under the age of 15 already – months ahead of schedule – and officials are reporting unusually high levels of severe cases.

Officials at the Center for Disease and Control (CDC) said last week they are monitoring the American situation closely, but insisted there had not been ‘any notable increase’ in the US yet.

However, two of the experts DailyMail.com spoke to said they feared the situation in Britain was a precursor to what will come in the US because both countries have similar demographics and followed a similar Covid trajectory.

Like the UK, the US is also suffering a shortage of amoxicillin – a frontline child antibiotic used to treat Strep A.

Dr Kathryn Moffet (left), a pediatric infectious disease expert at West Virginia University Medicine, said she is seeing an increase in bacterial infections like Strep A at her hospital. Dr Andrew Pekosz (right), vice chair of the Department of Molecular Microbiology & Immunology at Johns Hopkins University, said Strep A cases could jump after recent surges of RSV and the flu

Children that have died from the virus in the UK were struck with invasive Group A Streptococcus (iGAS).

It occurs when the bacteria invades a person’s deep muscle, fat and lung tissue. 

In the UK, one of the leading theories for the strep outbreak is that lockdowns, mask mandates and social curbs robbed children of exposure to vital germs that protect against the bacterial infection. 

Another is that pandemic restrictions have indirectly sparked the outbreak, by frontloading flu and respiratory syncytial virus (RSV) cases so early in the winter. Strep infections become increasingly common after a viral infection when the immune system has been weakened.

Dr Kathryn Moffet, from West Virginia University Medicine, told DailyMail.com that, like the UK, ‘there is evidence American children have a vulnerability to bacterial infections’ this year.

At her hospital – the biggest in the state – she has seen a sharp rise in the number of children presenting with symptoms in line with Strep in recent weeks, and she feels it is only a matter of time before similar rises become a nationwide problem.

Dr Andrew Pekosz, vice chair of the Department of Molecular Microbiology & Immunology at Johns Hopkins said he could not rule out a similar rise because RSV and flu are so rife.

He told DailyMail.com: ‘We’re not sure if we’re going to see a large Strep A outbreak here in the US. But it is important to note that virus infections can often lead to a bacterial infection.

‘And oftentimes severe disease is caused when you have that combination of a virus infection and a bacterial infection. 

‘Antibiotics don’t work against virus infections, so we need to be clear that if you’re infected with a virus you shouldn’t be taking antimicrobials because they’re not going to work.

‘But if you develop a secondary bacterial infection, then it is important to take some antimicrobials because that will help you recover quickly. So secondary bacterial infections are important in terms of causing severe disease, but we don’t know if we’ll see a large Strep A increase here in the US.’

But other experts are less certain.

Dr James Antoon, an assistant pediatric professor at Vanderbilt University, saying that while the US will often follow behind the UK when it comes to the trends of viral illnesses – that is not usually the case for bacterial illnesses like Strep.

Strep A is not a viral illness so it does not typically transmit from person-to-person the same way the flu, Covid or RSV would.

While localized outbreaks are frequent, bacterial infections do not have the ability to spread enough to cause nationwide issue. 

Dr Amesh Adalja (left), an infectious disease expert from Johns Hopkins, said it is unclear whether the US will see a similar strep situation as the UK. Dr James Antoon (right), assistant pediatric professor at Vanderbilt University, said it was unlikely the US would suffer deadly strep cases

Strep A is responsible for 14,000 to 25,000 infections and 1,500 to 2,300 deaths each year, according to CDC data

‘I don’t think you can translate [the RSV and flu outbreaks] to bacterial infection. We don’t think of Strep as a flu-related complication,’ he told DailyMail.com.

In the UK, an unnamed 12-year-old girl from Sussex in southeast England, died from complications caused by Strep infection on Friday. She joins more than a dozen other youngsters that have succumbed to the illness. 

Strep is a family of infections which are caused by the bacteria Streptococcus. Multiple illnesses fall within the category, including Strep A, B, C, G and Strep pneumoniae.

The deaths recorded in the UK were caused by Strep A, the most common form of the infection. 

Invasive bacterial infection is linked to sepsis, toxic shock syndrome and deadly flesh eating bugs.

The UK children who died reportedly suffered from sepsis.

Symptoms of the non-invasive Strep infection include rashes, a sore throat, flushed cheeks, muscle aches, fever and sores erupting around the body.

Strep A is responsible for 14,000 to 25,000 illnesses in the United States each year, and between 1,500 and 2,300 deaths. Fatalities among children are rare, though.

During a briefing last week, CDC officials said they were looking out for Strep A, but had only seen localized outbreaks – instead of a surge at a national level. 

Dr Moffet said that these cases are often not diagnosed beyond just being a bacterial infection, but she speculates that they are either Strep pneumoniae or Strep A.

She blamed the abnormal flu patterns in previous years – where viruses like the flu and RSV barely circulated – played a role.

‘We disrupted our virus transmission. We did not have the normal [circulation] where you would expect RSV and pneumonia [in young children],’ she told DailyMail.com.

‘A lot of what we did with social distancing and masks [caused this].’

Dr Moffet is concerned that a recent surge in the flu and RSV has left children more likely to not only suffer infections – but to experience severe complications, which is the case at WVU Medicine.

Dr Moffet said that for some children born during the pandemic, their immune system may have never actually experienced an infection before. 

The lack of immune protection built by children during Covid has led to a surge of influenza and RSV cases in the US this year. 

There have been so many cases of viral illnesses among children this year that many US children’s hospitals have been overwhelmed.

Nationwide, America recorded 35,704 confirmed cases of the flu during the week that ended on December 3.

This is a slight decrease from the 35,993 recorded a week earlier – the first time weekly cases have declined since the start of flu season.

Federal officials recorded 6,253 RSV cases during the week ending on December 3. During the week end on November 26, 14,348 cases were recorded.

According to official data, it kills around 300 to 500 children each year. 

The recent surges have led to a shortage of the antibiotic drug amoxicillin, which is usually given to young children to prevent Strep infections after a viral illness.

A shortage of the drug means that less is available to treat infected children, though potentially exacerbating the Strep situation. 

The Department of Health and Human Services reports that 80 percent of US hospital beds are currently occupied, primarily fueled by three respiratory viruses.

Strep is most harmful in young children, who may suffer symptoms such as rashes, a sore throat, muscle aches, fever, sores and flushed cheeks.

Rarely is it deadly, though, making the recent deaths in UK a major cause for concern.

WHAT IS THE DIFFERENCE BETWEEN A BACTERIA AND A VIRUS?

Viral infections, including common colds, are not treated by antibiotics, but bacterial infections, such as strep throat, can require the medications (file photo)

The biggest difference between viral and bacterial infections is the way in which they are treated.

Bacterial infections can usually be killed by antibiotics whereas the medicines to do work against viral infections.

Additionally, viruses are smaller than bacteria.

In order for a virus to multiply it must be attached to a living host, such as a human.

Bacteria thrive in a variety of environments both hot and cold.

Most bacteria are harmless, but ailments such as urinary tract infections and strep throat are caused by bacteria.

Diseases caused by viruses include AIDS and common colds.