Worried about Strep A outbreak

[Beebz]

It has now been reported that a second primary aged child has now tragically died from Strep A (iGAS). This is so shocking and how completely devastating for their families, I literally cannot even imagine the hell they are going through.

Is this something new or does this happen to children in this country every year? I don't remember hearing anything like this about strep/scarlet fever in the news before? How likely is it for primary aged children to become this ill from it? Is there anything we can do to protect our DC's from contracting it? This seems incredibly serious.

Assuming she had antibiotics they're linked to allergy development so probably not a coincidence, my child also got ezcema and allergies after treatment for sepsis. Better than the alternative of course!

I can’t read the article because it’s behind a paywall, but it’s fairly obvious that kids that haven’t been exposed to illnesses will be less likely to have immunity against them. That’s quite different to saying that they’re going to be more badly affected when they do eventually get exposed. And it is possible - not necessarily the case, but possible - that one reason it’s so rife at the moment is because lots of kids missed out on exposure earlier. Then maybe there’s a double whammy with weakened immune systems due to covid. Obviously we can only speculate.

@StollenAway I find this thread sets it out quite nicely. It's hard to see how lockdowns could have worsened anyone's immunity. Not getting sick is good for you.
twitter.com/1goodtern/status/1598962260369559552?t=fJLH8g065njtN7fsEy5lXA&s=19

@StollenAway sorry didn't realize it was paywalled, it's not for me and I am not a subscriber.

Not sure if I agree entirely with the “lockdown reduced immunity” theory. My baby has been constantly ill. One virus after the other. Possibly 2-3 viruses/infections at the same time. She’s not old enough to have had her immunity affected by the lockdown. My primary age and secondary age kids have been affected by the lockdowns. However, they’ve not really been as ill as the baby. They’ve usually been the ones bringing the virus home, however have not had symptoms as bad as the baby.

I think this confusion because this ‘immunity debt’ concept and lockdowns being linked to rising infections means different things to different people. The idea that you are talking about here that there is a greater number of susceptible people when an outbreak occurs is common sense. That’s something that they will look at. Are the number of deaths proportionate to the size of the outbreak or are we seeing more igas and deaths than you would expect even though the outbreak is larger than usual. Or is there something else at play, if so what.

there are a small number of doctors (mostly not immunologists AFAIK) who are pushing another idea about ‘immunity debt’. Largely that lockdown and not being exposed to viruses has damaged the immune system in some way. This doesn’t seem to be based on either a plausible pathology or reality.

like you I suspect that this may turn out to be a combination of factors. A higher probe portion of children susceptible to scarlet fever, immune damage from covid and the collapse of the healthcare system. I also suspect that if the 1st child hadn’t made the national press because he was turned away from a hospital most people wouldn’t know about the others.

If it was arising because DC hadn't encountered germs, then the first winter fully back after partial school closures would have seen higher rates, but no particular increase in severity (a bit like when a DC first goes into nursey, school or other group setting and mixes with other germy people for the first time and catches everything because it'll all new to them). And that would have been last winter - schools were back fully in March 2021/

You wouldn't expect to see increase in severity of illness produced, especially not over a year after re-opening.

There is a known effect of covid dysreguating the immune system for some months after infection (even if the initial infection was mild or asymtomatic), and that could produce more serious versions of other diseases, to greater or lesser extent, during that period.

(There is also evidence of the tonsils being a part of the body that SARS-COV2 colonises, and that's led me to wonder if that is somehow relevant to strep, which also loves the tonsils, but I don't know if there's a plausible mechanism for there to be a specific interplay).

I also wonder if the energy crisis is contributing to children falling more ill than usual.
we only have the heating on for 45 mins in the morning at the moment. We have a wood burner, double glazing and a portable oil heater so we don’t sit around shivering in the evenings. But the bedrooms are definitely pretty chilly, both kids have extra warm bedding and PJs, and sleep well so I don’t think they’re cold in their beds... but I was taking DD to the bathroom late last night & it was very cold. I did think - how good for their immune system can this be?
unfortunately I know alot of people will be in the same position at the moment, reluctant to turn the heating on, but concerned for childrens health.

i know there are two schools of thinking on this. My husbands family are very much ‘the cold is good for you, you should always have the windows open, cold swimming is great for the immune system’ etc, whilst my family are the complete opposite - strongly believe everything can be solved with a warm drink, a blanket. And that having wet hair is the root of all illness. I’d like to think me and DH fall in the middle of our families and take a more reasonable approach (haha) neither freezing nor sweltering, but I do wonder if we should bite the bullet and have the heating on for an hour In the evening as well.
i wonder if anyone has any info on wether room temp has any effect at all on immune system, and communicable disease?

blogs.nottingham.ac.uk/makingsciencepublic/2022/12/02/immunity-debt-creating-and-contesting-metaphors/

This is good on immunity debt and how it came about.

I suspect it is a range of causes. Scarlet fever was already on the increase before covid. There are concerns it is more virulent,
But I wonder too about covid damaging immune systems. I have had covid twice and was fine, but I do keep getting things I get when run down like cold sores and impetigo. My teenagers are not affected at all though.
With scarlet fever you seem to need fairly quick diagnosis and treatment if you have a bad case. But getting to see an NHS Dr and the Dr recognising it is scarlet fever are all barriers. Scarlet fever has been rare so most Drs will not have any or much experience of diagnosing it.
And with scarlet fever hand hygiene helps to stop the spread. But I think people have abandoned good hand hygiene and seem laxer than before covid.

Thanks, that was an interesting read.

Aibu to take my DD (5) out of school a bit early for Xmas? I know I can’t keep her off for a long time but it’s just so awful, and I’ve seen some parents bringing their children to school looking dreadful with hacking coughs. Surely schools should be a bit stricter now about children who are ‘a but unwell’ being sent into school?

I think it would be really unreasonable to keep dc off school unless there are pre-existing conditions in the family. Reading the news, GPs are now instructed to treat with AB quickly when children present with a temperature and sore throat, complications are extremely very rare on a population level.

You're probably right but I would be lying if I said I wasn't thinking about doing this with my youngest if cases rise next week. It is comforting to know that guidance has now been issued to GP's now (if you can get an appointment!)

It's now being reported in the media that a year eight child has tragically died as a PP had mentioned. Is this typical for Strep A in that it can have this effect on older children too?

@user1466068383 cold homes can cause/increase the risk of respiratory and cardiovascular illness. Plus there can be knock on effects eg if only one room in the home is being heated and everyone crowds in there then more risk of infecting others.

Also - if people can't afford to heat their water then that can impact on effectiveness of hygiene/hand washing etc.

(Don't actually know if this has any correlation in this case but illness and death caused by cold and damp is well documented and a huge public health scandal).

My son is allergic to penicillin and cannot have the reserve antibiotic aruthramycin due to his organ transplant so damn right I'm considering keeping him home.
What drug would he even be given if he got scarlet fever? Something inferior? I dread to think.

Maybe this will be the watershed moment that stops sodding schools from harassing parents for keeping sick children at home.

It isn’t the school’s fault, it’s the LEAs. Schools get penalised for poor attendance.

Its all part of the department of education.

The schools themselves, and the people who work in them, have no say over attendance policy.

They can provide feedback and input up the chain to have policies changed. It’s not exactly true that they have no say.

How much experience do you have of trying to influence Department of Education policies from within a school?

None, but my DD goes to a State college that doesn’t go along with the narrative you are peddling that schools have no control over attendance and can do nothing about it. Oh, and it’s still rated Outstanding by Ofsted. They’ve said repeatedly they don’t need good attendance to have a good rating. Perhaps you just have shit leadership at your school. 🤷‍♀️