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Health officials in the United Kingdom are advising parents and schools to be on the lookout for strep A infections, following the recent deaths of several children.
With COVID-19 restrictions such as masking and social distancing in the UK, infections such as strep A are spreading more easily, with cases increasing over the past month.
Also known as group A streptococcus (GAS), strep can cause a range of symptoms from minor to severe but is not life-threatening for most people infected.
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Strep is a bacterium found in the throat and on the skin. It usually causes fever and a sore throat, and many people carry it without any symptoms. However, they can still spread it to others through coughing, sneezing and close contact.
Symptoms of infection include pain when swallowing, fever, skin rash, and swollen tonsils and glands.Infections are common in crowded places such as schools and daycare centers, the US Centers for Disease Control and Prevention says on its website.
But the infection is not limited to children.
Kevin Breen, 44, developed an extremely rare strep infection in 2017 shortly after his son contracted a case of strep throat.
An infection caused by streptococcal bacteria, usually affecting the throat and tonsils.
Around Christmas, Breen began experiencing flu-like symptoms, and visited an urgent care clinic with abdominal pain. He tested negative for flu and strep. But his pain did not improve, and he went to the emergency room.
Right there, her stomach started to grow bigger and harder. According to Brin’s wife Julie, the hospital staff thought it was a mild case of acute pancreatitis.
He showed signs of shock, and doctors decided to take him into surgery to find the cause of his problems.
During the surgery, doctors found 3 liters of pus around his organs. They didn’t know where it came from.
“Normally, we have to look at things like holes. We looked for holes in the stomach or the small intestine, and found nothing,” said Dr. Elizabeth Stansma.
After surgery, he developed a rash on his chest. Doctors feared it might be streptococcal toxic shock syndrome, a serious illness associated with streptococcal infection.
They took samples and found the bacteria that cause strep throat. Based on the sample, the rash on Brain’s chest and his history, Steensma said, the pieces eventually came together.
“That strep organism, it’s really common, that somehow got out of his throat and into his abdominal cavity,” she said.
Breen went into multisystem organ failure and severe septic shock.
Doctors worked quickly to treat him. Steensma said the team “worked minute by minute for the next several days trying to keep him alive and get him home to his family.”
However, they could not save his fingers and toes.
Brain’s severe case of septic shock, poisoning from the strep organism and the medications he was on required the amputation of parts of his legs and arms, according to Stansma.
“It’s extremely rare,” she said.
For most people who develop strep throat, it’s little more than a temporary nuisance. But occasionally, strep can enter the bloodstream and cause a serious infection.
Breen returned home with his family but underwent multiple amputations.
It can usually be treated with antibiotics
Invasive group A streptococcus (iGAS) is the term used when the bacteria invades the body, overcomes its natural defenses to enter areas such as the blood, and is more dangerous, the UKHSA explains on its website.
While there is no vaccine to prevent strep A or iGAS infections, antibiotics are usually effective in treating them.
“We are seeing a higher-than-usual number of cases of Group A strep this year,” UKHSA deputy director Colin Brown said in a statement.
The increase in iGAS this year has been particularly noticeable among children under 10, UKHSA added. Five children have died in England. One death has been reported in Wales, according to Public Health Wales.
Data from the UKHSA showed there were 2.3 cases per 100,000 children aged 1 to 4 between mid-September and mid-November, compared with an average of 0.5 in the pre-epidemic season (2017 to 2019).
For children aged 5 to 9 years, there were 1.1 cases per 100,000, compared with a pre-epidemic average of 0.3.
The last period of high infection was between 2017 and 2018, in which four children under the age of 10 died in the same period, the statement added.
The UKHSA said it did not believe new strains were circulating, with increased infections likely to be the result of “bacteria and social mixing”.
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