In recent weeks, the rising number of child deaths from group A streptococcal (GAS) infection – often called ‘strep A’ – has been hugely worrying and frightening for parents across the UK. Although invasive group A streptococcal infection is still uncommon, we know parents are concerned and have questions.
Although it’s not new, there is much more strep A around this winter than in recent years, causing a lot of children to be unwell. Unfortunately, some children have developed invasive group A strep, which is when the infection gets into the bloodstream and can make children very sick by attacking different organs. Group A strep can also cause complications like problems with your heart and kidney. Strep A usually causes a mild illness with fever and a sore throat (strep throat) but not a runny nose or too much of a cough. Your child may be poorly for a few days but will usually recover. Antibiotics may help them recover more quickly.
As a paediatric doctor, a mum of three, and part of #TeamHalo – a group of volunteer medics answering concerns on social media – my colleagues and I have been posting on my Instagram and TikTok to try and answer the huge flood of questions that have come in.
What is strep A?
Group A strep is a common bacterial infection that causes the following symptoms in children:
- Fever
- White spots at the back of their throat (pus on their tonsils)
- Very large or red tonsils
- Sore (tender) lumps under their chin
- If they have become poorly quickly over the past couple of days
- No cough or runny nose
Strep A can easily be treated with antibiotics which is why it's important to see a doctor. You can reduce the spread by encouraging good respiratory and hand hygiene.
How can I tell if my child has a viral illness or strep A?
Please remember we are in winter and your child is far more likely to catch a cold, virus or flu! Common winter illnesses are still circulating such as flu, RSV, croup and lots of other viruses. I know many of you are worried about strep A symptoms vs. viral and how to tell the difference.
Please don’t panic at the first sight of fever – fever is your body working its magic and trying to get you better. Your child is far more likely to have a viral illness if they have a:
- Cough
- Runny or stuffy nose
- Watery eyes
- Noises whilst they are breathing (please YouTube wheeze and stridor)
When to see a doctor?
As a parent or carer, consult your GP or call 111 if your child is:
- Getting worse or is unlike themselves
- Feeding or eating much less than normal
- Peeing less or has reduced wet nappies
- 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
- Hotter than usual when you touch their back or chest, or feels sweaty
Please go to A&E if:
- Your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs or using their neck muscles to breathe
- There are long pauses (more than 10 seconds) when your child breathes
- Your child’s skin, tongue or lips are blue
- Your child feels very cold or clammy to touch
- Your child is difficult to wake up or keep awake
- Your child has severe pains in their arms, legs, neck or back
- Your child has a painful, red area of skin, especially if it is getting bigger quickly
I know these symptoms are also common in lots of other viral illnesses. Therefore, please have a low threshold for seeking advice – you are the expert in your child. We would MUCH rather see you than not.
Recognising scarlet fever
Sometimes, strep A can cause scarlet fever. My fellow GP and #TeamHalo guide Dr Nighat Arif described these symptoms on ITV’s This Morning and in this post, which also points out how the rash and tongue can appear differently on people of colour.
The signs and symptoms:
- A high temperature, a sore throat and swollen neck glands
- A rash appears 12 to 48 hours later. It looks like small, raised bumps, similar to eczema, and starts on the chest and tummy, then spreads. The rash makes your skin feel rough, like sandpaper.
- On white skin the rash looks pink or red. It may be harder to see on brown and black skin, but you can still feel it.
- A white coating also appears on the tongue. This peels, leaving the tongue red, swollen and covered in little bumps (called "strawberry tongue").
- The rash does not appear on the face, but the cheeks can look red. The redness may be harder to see on brown and black skin. The rash fades to leave peeling skin on hands and feet.
Can adults catch it?
Yes, even though group A strep is more common in children, adults can catch it as well. As my #TeamHalo colleague GP Dr Omon Imohi points out in this video, some adults are more at risk, but it is not usually serious in adults and, if needed, antibiotics can be given. Keep unwell children off school or nursery and away from vulnerable adults and children.
For more information: visit the NHS strep A website
Dr Kiran Rahim is a NHS Doctor, specialising in baby, child and adolescent health. She has worked across many prestigious London Hospitals and uses her own experience as a mother to three children to work in harmony with patients. She is part of Team Halo a UN-backed volunteer group of medics and scientists who began by answering concerns on social media about the Covid vaccine in response to misinformation. They continue to give their time for free to address broader health concerns.
Twitter: @projecthalo
Website: https://teamhalo.org/
Dr Kiran Rahim will be back next week to answer any questions