Fears of possible recent increase in Strep A infections in the US amid UK outbreak

WWhat started as a common bacterial infection ended with the death of fifteen children infected with Strep A in Great Britain.

The health authorities have issued a dire warning to parents in the UK as the number of child deaths caused by the infection continues to rise. The latest victim, a five-year-old Irish girl, became seriously ill last week before dying Monday of complications related to strep A.

Although pediatric patients typically experience mild symptoms such as fever, tonsils, and swollen lymph nodes, complications can arise when the infection enters the bloodstream, leading to a life-threatening disease known as invasive group A streptococcus (iGAS).

In the US, iGAS cases declined during the pandemic, but the CDC said the independent on Wednesday that doctors in the US informed the agency of a possible recent increase, which is now being actively monitored.

Dr. Mark Hicar, an expert in pediatric infectious diseases and associate professor at the Jacobs School of Medicine and Biomedical Sciences at University of Buffalo, saying the independent that it’s hard to know if the US could see an outbreak similar to the recent one in the UK.

According to CDC data, seven children under the age of 17 per 100,000 in the monitored areas died from complications of strep A before the pandemic in 2019.

In 2020, when the last report was issued, one death was reported for every 100,000 inhabitants in the monitored areas.

The CDC only tracks iGA infections and does not track non-invasive strep A infections. Only 10 states reported data for iGAS in the most recent report.

“Mitigation measures (eg, school and workplace closures, mask wearing) used during the first two years of the COVID-19 pandemic helped reduce the spread of many viruses and bacteria,” said one spokesman.

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“Now that these germs are spreading again, we may be returning to typical iGAS infection patterns, including a seasonal increase in the winter months.

What are strep A infections?

Group A strep is a common bacterial infection, seen mainly in children.

In the most serious and rare cases, the infection causes conditions such as pink-red rashes (scarlet fever), bacterial skin infection (impetigo), necrotizing tissue (fasciitis), strep toxic shock syndrome, pneumonia, and sepsis.

However, most group A strep infections have mild, flu-like symptoms.

“There are many strains of group A strep and there have been isolated outbreaks in the UK in the past (2015 and 2018),” said Dr Hicar. “…with the earlier increase in UK cases, there seemed to be no effect on US cases, so [whether there will be one now] It’s hard to say.”

Dr. Hicar says that certain strains of the infection can cause a “sandpaper rash,” which usually makes children sicker and is known as “scarlet fever.”

“Normally this happens with [throat infections or] cases of pharyngitis, but can [happen with] impetigo infections too. This seems to be the way reported in the UK at present,” he said.

He added that immunocompromised children are at higher risk when they contract Strep A.

“Certain children without good spleen function or who have other forms of immune depression are at increased risk of sepsis, toxic shock, and necrotizing fasciitis (‘flesh-eating’ group A strep infection),” said Dr. Hicar.

Doctors have warned the mother of two-year-old Tayden, who was diagnosed with aplastic anemia earlier this year, that her daughter’s transplant could be delayed after the girl contracted strep A last week.

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“I was restless and tired the day before the fever,” said Heather, who lives in Utah. The independent.

Tayden’s symptoms resolved within 48 hours of antibiotic administration. She is expected to recover for her transplant.

Sore throat is one of the main signs of strep A infection

Could infections increase after the pandemic?

A CDC spokesperson said the independent that more data needs to be collected to get a better idea of ​​recent Strep A trends in the US.

“Recent increases in respiratory viruses, particularly influenza, may be contributing to a possible increase in iGAS infections. Concurrent or previous viral infections, such as influenza, and skin conditions, such as chickenpox, can increase the risk of iGAS infections,” the spokesperson said.

Dr. Hicar added that the use of masks does not seem to reduce infections.

“Masks help well with respiratory viruses, like flu and covid, but other organisms that can linger on surfaces [such as Strep A] they tend not to be affected as much by wearing masks,” he said. “[US] Available data from 2020, the first year of the pandemic, appear stable for invasive infections and group A strep death rates.”

The CDC estimates between 14,000 and 25,000 cases of iGAS in the last five years, and between 1,500 and 2,300 deaths in the same time period.

What symptoms should parents watch for?

According to the CDC, most children infected with Strep A will experience painful swallowing, fever, red and swollen tonsils (sometimes with white spots or streaks of pus), and swollen lymph nodes in the front of the neck.

Dr. Hicar account the independent that the sore throat and fever should go away in a few days. She advised parents to contact their doctors again if symptoms persist.

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If your child has been diagnosed [Strep A] and it seemed to be getting better but then it got worse, talk to your doctor,” he said. “One of these rare, more serious complications may be starting.”

He reiterated that although most cases are not dangerous for children, complications can be fatal if the infection reaches the bloodstream (bacteremia), the lungs (pneumonia) or the brain (meningitis).

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How do children get infected?

Crowded settings, such as schools and day care centers, increase the risk of strep A infections.

The bacteria is highly contagious and can spread through respiratory droplets when talking, coughing or sneezing, and through direct contact when patients develop skin sores, according to the CDC.

In very rare cases, it can also be spread through food when it is not handled correctly.

“As social animals, we are constantly bombarded by bacteria and viruses that most of the time our immune systems reject,” says Dr. Hicar. The independent.

“…the more exposure [a person] have, they are more likely to get infected. However, there are many benefits of peer interaction and socialization.”

What should you do if you suspect your child has strep A?

Strep A infections can be diagnosed through a rapid strep test that involves taking a swab from the throat.

Doctors also administer throat cultures to patients. Although this method takes one to two days, it is more effective than rapid tests.

What is the treatment for strep A?

There is currently no vaccine to prevent strep A infections.

Antibiotics reduce symptoms and prevent complications and are the most widely used form of treatment. Once antibiotics are prescribed, patients should start to feel better within 48 hours.

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