At least 37 children have died after Strep A infections - Strep throat symptoms explained

Invasive Group A Streptococcal disease (iGAS or Strep A) is known to cause scarlet fever, throat infections and, in very rare cases, invasive disease

At least 37 children have now died across the UK from invasive Strep A disease, new figures have revealed.

In England, 29 under-18s died between 19 September 2022 and 1 January 2023, according to the UK Health Security Agency. On 28 December, Public Health Scotland announced two children under the age of 10 had died since 3 October. In Wales, five children under 15 died between 1 September 2022 and 3 January 2023, Public Health Wales has said. One child death has also been reported in Northern Ireland, taking the UK total to 37.

Strep A, which refers to  Group A Streptococcus (GAS), is the name given to a type of bacteria sometimes found in the throat or on the skin. It usually causes mild illnesses such as a sore throat, but can cause other infections such as pneumonia and scarlet fever, and in a small number of cases they can become very serious.

The government body said parents concerned about their child’s symptoms should seek medical advice.

  • A five-year-old girl died from an illness linked to the bacterial infection Strep A, according to BBC News NI. The Black Mountain Primary School pupil became severely ill and was treated at the Royal Belfast Hospital for Sick Children. On 2 December the Public Health Agency sent a letter to parents of P1 to P3 children at the school. It said one of its pupils was diagnosed with a severe form of Strep A. Children were asked to attend a clinic to be seen by a doctor and receive a preventative course of antibiotics. BBC News NI said the girl had been treated in intensive care but passed away on 5 December.
  • A pupil at Morelands Primary School in Waterlooville, Hampshire, was confirmed as one of the deaths from Strep A. Alison Syred-Paul, the school’s headteacher said on 5 December: “Very tragically, we have learned of the death in recent days of a child who attended our school, who was also diagnosed with an invasive Group A Streptococcal (iGAS) infection. We are absolutely devastated by the loss of one of our young pupils and offer our sincere and heartfelt condolences to the child’s family at this extremely sad time.”
  • A pupil in Ealing in west London also died from the infection. Dr Yimmy Chow, health protection consultant at the UKHSA, said: “We are extremely saddened to hear about the death of a child at St John’s Primary School, and our thoughts are with their family, friends and the school community. Working with Ealing Council public health team, we have provided precautionary advice to the school community to help prevent further cases and we continue to monitor the situation closely.”
  • Seven-year-old Hanna Roap from Victoria Primary School in Penarth, near Cardiff, died from the infection, Public Health Wales confirmed. Dr Ardiana Gjini said Public Health Wales is working with the school to raise awareness about the disease, suggesting people familiarise themselves with the symptoms of fever, sore throat, severe muscle aches and redness at the site of a wound. The doctor said: “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.”
  • In Powys, central Wales, an unnamed child also died, with the family confirming they had had Strep A.
  • A six-year-old child died following an outbreak of the bacterial infection at Ashford Church of England School in Surrey.
  • Health officials also confirmed that a boy, a Year 8 pupil at Colfe’s school in Lewisham, died of the bacterial infection.
  • Public Health Scotland said on 28 December that two Scottish children under the age of 10 had died.
  • 28 other children have also died after contracting the infection, although the dates of their deaths are currently unknown.
Invasive Group A Streptococcal disease (iGAS or Strep A) is known to cause scarlet fever, throat infections and, in very rare cases, invasive disease

Most people who come into contact with the bacteria remain well and symptom-free or develop mild throat or skin infections.

Invasive Group A Streptococcal disease (iGAS or Strep A) is known to cause scarlet fever, throat infections and, in very rare cases, invasive disease. This can occur when bacteria get into parts of the body where they are not usually found, such as the blood, muscle or the lungs.

It can happen if the bacteria get past a person’s defences, such as through an open wound or when a person’s immune system is depleted. This can happen when you are already ill or are on treatments, such as some cancer treatments, that affect your immune system. Two of the most severe types of invasive disease are necrotising fasciitis and toxic shock syndrome.

What has UKHSA said about Strep A?

Dr Obaghe Edeghere, UKHSA incident director, said: “As children return to school, scarlet fever and ‘strep throat’ continue to circulate at high levels and so it is important that we all wash our hands regularly and thoroughly and catch coughs and sneezes in a tissue. This will help stop germs spreading between children and to other vulnerable groups and will help prevent the spread of other winter illnesses that are currently circulating at high levels, including flu and Covid-19.

“It’s not too late to take up the free flu and Covid-19 vaccines if you’re eligible – we know that group A strep infections can be more serious when combined with another infection like flu. Most winter illnesses can be managed at home and NHS.UK has information to help parents look after children with mild illness. Deaths and serious illness following group A strep infection are very rare and the infection can be easily treated with antibiotics.

“Speak to a healthcare professional if you think your child is getting worse, for instance they are feeding or eating less than normal, are dehydrated, have a high temperature that won’t go down, are very hot and sweaty or seem more tired or irritable than normal.”

Flu, Covid, Strep A and RSV are all circulating this winter, with the UK experiencing its first winter without coronavirus measures in place

More child deaths than 2018 outbreak

UKHSA data for England has recorded 159 iGAS cases in children aged one to four so far this season, compared to 194 cases in that age group across the whole year of the last comparably high season in 2017 to 2018. There have been 118 cases in children aged five to nine, compared to 117 in 2017 to 2018.

Across all age groups in England, there have been 151 deaths from iGAS. In the 2017 to 2018 season, there were 355 deaths in total across the season, including 27 deaths in children under 18.

Strep A symptoms include ‘Strep throat’

Symptoms of invasive disease include fever, severe muscle aches, localised muscle tenderness and redness at the site of a wound. You should contact your GP or get medical advice by calling 111 straight away if you think you have any of the signs and symptoms of invasive disease. Tell your doctor if you have been in contact with someone who has had Strep A recently.

  • Sore throat that can start very quickly
  • Pain when swallowing
  • Fever
  • Red and swollen tonsils, sometimes with white patches or streaks of pus
  • Petechiae — pronounced pi-TEE-kee-eye — on the soft or hard palate (tiny, red spots on the roof of the mouth)
  • Swollen lymph nodes in the front of the neck

What should I do if I think my child has Strep A?

You should contact NHS 111 or your GP if:

  • your child is getting worse
  • your child is feeding or eating much less than normal
  • your child has had a dry nappy for 12 hours or more or shows other signs of dehydration
  • your baby is under 3 months and has a temperature of 38°C, or is older than 3 months and has a temperature of 39°C or higher
  • 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 may notice grunting noises 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