Strep A child deaths grow to SIX

Six children have now died of Strep A, health bosses confirmed today as they warned the killer bug is sweeping Britain.

Serious cases of normally harmless bacterial infection Strep A are nearly five times higher among young children than pre-pandemic, officials have said.  

The common bug can cause Scarlet Fever and be a potential killer, causing flesh-eating disease or sepsis in the most severe cases. 

Data from the UK Health Security Agency (UKHSA) show cases of the most serious kind of infection, called invasive Group A strep (iGAS), are 2.3 cases per 100,000 children aged one-to-four-years-old.

This is five times higher than the pre-pandemic average of 0.5 cases per 100,000 children, a rise some experts say could be linked to lockdown weakening children’s immunity. 

Hanna Roap, who attended Victoria Primary School in Penarth, Wales, died after contracting Strep A last week, with friends and family admitting their hearts have ‘broken into a million pieces

The schools attended by the four recent victims of Strep A. One death occurred in Wales, one in Ealing, West London, another in Surrey and one in Buckinghamshire

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 

What is Strep A?

Group A Streptococcus (Group A Strep or Strep A) bacteria can cause many different infections.

The bacteria are commonly found in the throat and on the skin, and some people have no symptoms.

Infections cause by Strep A range from minor illnesses to serious and deadly diseases.

They include the skin infection impetigo, scarlet fever and strep throat.

While the vast majority of infections are relatively mild, sometimes the bacteria cause life-threatening illness called invasive Group A Streptococcal disease.

What is invasive Group A Streptococcal disease?

Invasive Group A Strep disease is sometimes a life-threatening infection in which the bacteria have invaded parts of 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.

READ MAILONLINE’S FULL Q&A ON STREP A. 

Cases are also high in five-to-nines, with  1.1 cases per 100,000 children a compared to the pre-pandemic average of 0.3 per 100,000 at the same time of the year.

UKHSA also confirmed that there have been five deaths among children under 10-years-of-age within a week of an iGAS diagnosis. 

In addition to the one in Wales this brings the UK death toll to six. 

This compares to four deaths in the last season of the illness before the Covid pandemic. 

Health bosses said there is currently no evidence that cases this year are being caused by new strain of the bacteria. 

Officials instead attributed the spike to increased social mixing amid high levels of the bacteria circulating among people. 

Cases of the Strep A related condition, scarlet fever, are also much higher than previous years.

In mid-November UKHSA recorded  851 cases of scarlet fever, a huge rise compared to pre-pandemic average of 186 cases.

UKHSA warned parents to contact their GP if their child is eating much less than normal or were showing signs of dehydration such as having a dry nappy for over 12 hours.

Other signs included a high temperature of 38 or higher, if their back or chest feel hooter tan usual or sweaty.

Parents should call 999 or go to A&E if their child is having difficulty breathing, their skin or lips turn blue, or if they are floppy can’t be woken or stay awake. 

Health bosses have also urged all Britons to practice good hand hygiene to help stop transmission of the bug, including teaching children to wash their hands properly with soap for 20 seconds and use a tissue to catch coughs and sneezes.

Dr Colin Brown, deputy director, UKHSA, said: ‘The bacteria usually causes a mild infection producing sore throats or scarlet fever that can be easily treated with antibiotics. 

‘In very rare circumstances, this bacteria can get into the bloodstream and cause serious illness – called invasive Group A strep (iGAS). 

‘This 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.’

The warning came as the UK came to grips with another death from the growing Strep A outbreak.

The latest fatality was named today as Muhammad Ibrahim Ali, aged just four, who died after contracting the bacterial infection.

A primary school pupil who attended St John’s School in Ealing, west London (pictured) has died after contracting Strep A

His death came the bug claimed the life of Hannah Roap, a seven-year-old girl from Wales. 

Her devastated parents have told how their ‘hearts had broken into a million pieces’.

Hanna, who attended Victoria Primary School in Penarth, Wales, died last week after contracting Strep A last week. 

Her parents, Salah, 47, and Abul, 37, thanked neighbours and the 560-pupil school for the support since their girl’s passing.

Mr and Mrs Roap, who run a beauty salon, said: ‘Thank you to everyone for your overwhelming support. Thank you for all the flowers, cards and donations. Thank you for all the hugs and tears. 

‘Your kindness reminds us that there is good amongst immense tragedy.

‘We are sorry we have not responded to any messages, texts, emails and calls. Sorry if we are unable to make eye contact if we see you walking by. 

‘Our hearts have been broken into a million pieces. Our only priority is the welfare of Hanna’s eight-year-old sister and best friend. 

‘We have been stunned by the volume of donations we have received. We were not expecting this. 

‘This is testament to the wonderful caring people of Penarth. We will be donating all of this to charity.’ 

One mother said: ‘Hanna was a beautiful soul. Our thoughts are with you all at this tragic time.’ 

Another friend added: ‘She was the most beautiful, bubbly, funny, loveable person. Her family are heartbroken.’ 

Mr Roap told MailOnline that he believes Hanna would have survived if a doctor had prescribed antibiotics.

He took her to the family GP after she woke up coughing at midnight last Thursday, November 25. She had been well and in school that day.

The doctor prescribed steroids and sent Hanna home where she died less than 12 hours later.

Mr Roap said: ‘I took her home from the doctors and gave her the medication. She went to sleep at 4pm and never woke up.

‘She stopped breathing at 8pm but we were not immediately aware because she was sleeping.

Victoria Primary School in Penarth, Wales, where a primary school pupil died from a Strep A infection earlier this week

Ashford Church of England Primary School in England, where a death was reported of a six-year-old pupil from Strep A last week

‘I did CPR, I tried to revive her but it didn’t work. Paramedics arrived and continued the CPR but it was too late.’

Mr Roap said the family was ‘utterly devastated’ and waiting for answers from the hospital where tests had shown the schoolgirl had died of Strep A. 

‘For it to happen so quickly, the issue is did she get the correct medication at the time.

‘But she did not get the right medication, if she had been given antibiotics it could have been potentially a different story.’ 

Mr Roap urged parents to be extra vigilant. He said: ‘If your child is poorly, just don’t dismiss it as flu or a normal seasonal illness. It could be something far worse.’

Muhammad’s death, which was announced today, occurred while he was at home in mid-November. 

His grieving parents revealed he suffered from a cardiac arrest. 

Muhammad, who was given antibiotics, attended Oakridge School and Nursery in High Wycombe, local media reports.

His mother Shabana Kousar told the Bucks Free Press: ‘The loss is great and nothing will replace that. 

‘He was very helpful around the house and quite adventurous, he loved exploring and enjoyed the forest school, his best day was a Monday and said how Monday was the best day of the week.

Another one of the four victims attended St John’s School in Ealing, west London. 

Another pupil from nearby North Ealing Primary School, which has recently seen a number of viral infections, including scarlet fever, remains in hospital with an unconfirmed illness.

GPs have warned of ‘unusually high’ levels of Strep A ever since schools went back in September. 

Symptoms of the infection are normally mild and include fever, muscle aches, vomiting and a sore throat. 

But in rare cases, the bug — spread in the same way as Covid, through close contact such as sneezing, kissing and touching — can penetrate deeper into the body and cause life-threatening problems such as sepsis. 

It is treatable with antibiotics, which are normally incredibly effective.   

Experts told MailIOnline one action health authorities could take if the situation gets worse is a widespread rollout of the antibiotic penicillin in hotspots to put up a ‘firewall’ to stop the rates of transmission and more children falling seriously ill.

Dr Nicole Robb, a virologist at Warwick University, revealed some preventative use of antibiotics in response to Strep A was already being used.

‘In the schools where children have been ill and it’s been confirmed, they have been giving antibiotics to teachers and other schoolchildren as a preventive measure,’ she said.

Professor Paul Hunter, a public health expert at the University of East Anglia, said widespread use of penicillin treatment could be an effective tool in specific schools or nurseries with a high number of cases.

He added that penicillin was extremely effective in stopping Strep A and quickly, but the problem was distinguishing it from the common cold.

‘The problem from a medical point of view is making an early diagnosis,’ he said,

‘Sore throats are usually viral and do not respond to antibiotics and giving antibiotics unnecessarily is storing up problems for the future from antimicrobial resistance.

‘But Group A streps are very sensitive to penicillin and if given early will almost always prevent severe disease.

‘If these cases are localised then the important thing is to ensure children in that affected area are diagnosed and considered for penicillin for sore throats sooner than normal.’

Dr Simon Clarke, a microbiologist based at the University of Reading, added that a widespread antibiotics programme could be considered to create a ‘firewall’ and stop further transmission 

‘If there is a wider scale problem in terms of numbers within schools, primary schools, secondary schools and at universities then potentially local authorities might want to look at using penicillin and perhaps other antibiotics to put up a firewall and reduce infections and reduce transmissions,’ he said. 

‘That will have the consequence of reducing the number of more serious infections of the disease,’

‘It’s something they could consider but only something they would do in an extreme situation.’

Leading experts also warned lockdowns may be to blame for the uptick in cases, with children shuttered away during Covid having less immunity towards the routine bug. 

Dr Clarke told MailOnline that Group A Strep infections don’t occur at a constant rate.

Instead, as with Covid, there are ‘peaks and troughs’ of cases, he said.

Dr Clarke explained: ‘There have been more cases than we would expect lately, but that might be a statistical blip.’

There may be reduced immunity in the population due to the Covid pandemic, which could theoretically increase transmission, he noted.

Dr Clarke said: ‘You’ll be aware of lockdowns having an effect on immunity for things like flu — the principle is the same.

‘[A] lack of mixing in kids may have caused a drop in population wide immunity that could increase transmission in that age group.’

He added: ‘I’m currently unaware that it’s some horrible new strain, in fact I would bet that it’s not.

‘It’s also important to stress that this infection, when diagnosed quickly, is treatable with antibiotics, and only extreme cases need hospitalisation. 

‘I do expect there to be further cases over the coming weeks and probably months.’

Professor Ian Jones, an infectious disease expert at Reading University said it was too soon to say if this year’s Strep A outbreak was particularly bad but it was unusual in terms of timing.

‘It is too early to assume it will be a bad year but what does seem clear is that the peak has shifted towards the autumn from the summer,’ he said.

‘Death in young kids is indeed tragic but I don’t, unfortunately to say, see it as out of the ordinary yet.

‘It happens and the alert it brings does remind parents and teachers what to look for, which then helps to keep numbers down through early diagnosis, along with antibiotic roll out if an outbreak is suspected.’

He echoed comments from other experts in saying a drop in immunity during the Covid lockdown may be partly to blame for the current numbers of cases.

‘It is possible there has been a lockdown related reduction in natural immunity and we are now seeing a bounce with school attendance,’ he said.

‘It’s not proven however given the year-to-year variability.’

Dr Robb, who is also a co-founder of health-tech firm Pictura Bio, said: ‘We have what could be described as a perfect storm for respiratory disease at the moment. 

‘These illnesses are seasonal so it is usual to see an increase in cases during winter months, but this may be exacerbated because during Covid lockdowns we all “lost” immunity as our exposure to day to day bugs was almost non-existent. 

‘That’s why young children are most at risk from Strep and other infections. 

‘There are many who have never been exposed to the same bugs that we were as children and so their bodies have not learned to cope.’

In a statement to MailOnline, Dr Ardiana Gjini, consultant in communicable disease control for Public Health Wales, said: ‘Public Health Wales is working with Cardiff and Vale University Health Board and the Vale of Glamorgan Council following the death of a pupil at Victoria Primary School, Penarth.

‘We offer our deepest condolences to the family, friends and all those affected.

‘Public Health Wales cannot comment on individual cases, and we ask that the privacy of the family is respected.