This time last year the UK was experiencing unusually high rates of Strep A, and with children dying from the infection, it was a really frightening time. Whilst there is nothing to suggest Strep A is any more prominent than usual this year, at Mini First Aid we think it is always best to be aware of any signs and symptoms of nasty illnesses. We thought this blog would be a useful reminder of what to look our for, and once again we are sharing a real life story of one mum's expereince with Strep A.
What is Strep A?
Strep A is a bacteria found in the throat or on the skin and most people carry it without having any symptoms. However, in certain people the Strep A bacteria can cause mild illnesses such as sore throats, but also dangerous invasive infections (known as invasive Group A streptococcal infection or iGAS). This can make children very poorly, very quickly as the Strep A infection enters places it shouldn’t such as their lungs or bloodstream. Strep A is also responsible for the spread of other bacterial infections, such as scarlet fever (you can find our blog on scarlet fever here)
How does Strep A spread?
Because the Strep A bacteria live on our skin and in our throats, they are easily passed on by skin contact, coughing and sneezing. It is thought that the more serious iGAS infections occur when the Strep A bacteria enter our bodies through sores or cuts in the skin. This type of Strep A can be deadly and urgent - early medical help is essential.
What are the symptoms of Strep A?
This is where it gets a bit tricky, because there are so many potential symptoms but not all children will get each one. For example, with Aimee’s story (see below), neither of her boys had a high temperature (fever), even though a quick google search will tell you this is one of the key signs. There is the added complication that levels of illnesses such as flu are higher than normal at this time of year, and symptoms can get confused. So as parents we need to be vigilant for the below symptoms, but be aware that not all of them may be present at the same time.
The symptoms of a milder Strep A infection include:
· Sore throat.
· A very red looking throat which might have white spots on the throat or tonsils.
· Swollen glands.
· A rash that can look like lots of small red pin pricks, be skin coloured or feel like sandpaper (often associated with scarlet fever). On black and brown skin, this sandpaper texture is key as the pinprick rash may not be obvious to look at.
· Skin infection such as impetigo.
· Scarlet fever (a mild illness if quickly treated with antibiotics).
Signs that it may be a more dangerous invasive infection of Strep A are:
· A high temperature, also known as a fever (anything above 38 degrees celsius is usually classed as a high temperature in children).
· Severe muscle aches – for example arms and legs feeling sore and heavy.
· Unexplained sudden vomiting or diarrhoea.
· Extreme drowsiness and floppiness.
· Difficulty breathing.
· Not going to the toilet for a wee as much as usual, or drier nappies than usual.
What should I do if I’m worried my child has Strep A?
Contact NHS 111 or your GP if:
· Your child has been poorly with Strep A symptoms for a while but has suddenly got worse.
· Your child is feeding or eating much less than normal.
· Your child has not been to the toilet for a wee or has had a dry nappy for 12 hours or more.
· Your baby feels hotter than usual when you touch their back or chest, or feels sweaty.
· Your child is very tired or irritable.
Call 999 or go to A&E if:
· Your child is having difficulty breathing – you might notice a grunting noise or their tummy sucking under their ribs.
· There are pauses when your child breathes.
· Your child’s skin, tongue or lips are blue.
· Your child is floppy and will not wake up or stay awake.
As we always say at Mini First Aid – if you know your child isn’t behaving in a way that is normal for them or if your parental instinct tells you something just feels “wrong”, seek urgent medical help as soon as possible.
”The worst sore throat the doctor had ever seen”
Aimee Byron got in touch with Mini First Aid after her sons Jamie and Drew came down with Strep A in November 2022. She has kindly given us permission to share her story and photographs.
On Monday 28th November 2022, Jamie, aged 3 was his normal energetic self. On Tuesday morning, Jamie seemed tired, but by that night he was screaming in pain, holding his head and saying he had “tickles in his throat”. Aimee had a look down his throat and was shocked to see his tonsils were almost touching and the whole back of his throat was covered in big white spots and small red pin pricks. With Jamie still in a lot of pain, by Wednesday morning Aimee called her doctor, but could only have a phone consultation. Aimee sent photos, and Jamie was diagnosed with tonsillitis and prescribed antibiotics.
By Thursday, despite being on the course of antibiotics, little Jamie was really poorly and Aimee was getting really worried – Jamie hadn’t gone for a wee since Wednesday afternoon and had only managed to drink an inch of milk in 24 hours. Jamie barely moved from the sofa all day and couldn’t even be tempted by some ice cream. Aimee’s instinct told her this wasn’t right and she called 111 who set up a local doctor's appointment.
At the appointment, Aimee was advised to return home and wait for the antibiotics to work as they could take up to 5 days.
Aimee returned home but still felt something just wasn't right. She called her GP surgery again, and had a phone appointment with a different doctor. She was very concerned, particularly about the lack of urine and how bad Jamie’s throat looked on the photos Aimee had sent over – she said it was the worst sore throat in a child that she had ever seen. The doctor called the paediatric department at the local hospital to get Jamie an appointment as soon as possible for severe tonsillitis.
Once at hospital, Jamie was given a throat swab and some other tests, and the doctors quickly confirmed he had Strep A.
By Saturday, Aimee’s 17 month old Drew had also been diagnosed with Strep A, which developed into scarlet fever 2 days later. Drew developed sores around his mouth and a red pin prick rash characteristic of scarlet fever on his feet.
Aimee wants other parents to know that the main symptoms were a very sore throat, white spots on the throat and tonsils, swollen glands, not being able to swallow (so not passing much urine) and feeling very drowsy. She says there is a lot of information out there which isn’t always helpful – for example she saw on a very well-known morning TV show that Strep A always includes a high temperature but neither of her boys developed this.
Aimee is so relieved that both her boys have now got the treatment they needed to get better – Jamie is almost fully recovered a week after his symptoms first started and Drew is gradually getting better now that his scarlet fever is being treated with antibiotics. She says:
“Things can change so quickly so to my fellow parents, if you know there is something wrong with your children, speak up and please don’t stop until you are satisfied.
Even when you get a diagnosis for your child, if anything changes, make sure you get in touch with the doctor straight away. Any changes or any worries, go back to the doctor so the treatment you get is the most helpful to your child getting better.”
We’d like to thank Aimee for speaking out and sharing her experience. Confusion and fear around Strep A mean these real life experiences are so important in helping us all understand and make decisions if our own children are poorly. It's important to note that severe complications from Strep A are still rare, and that most children with sore throats and skin infections caused by Strep A will get better with antibiotics.
Stay safe everyone and all the very best, the Mini First Aid Team xx
Sources: BBC News, The Times, The Independent, The Guardian, Gov.UK
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