Parents urged to look for signs of Strep A in children

Parents urged to look for signs of Strep A in children

So far this year, 55 cases of Strep A have been notified in Ireland, with 21 reported since early October, including four children under the age of 10.

The chief medical officer has urged parents to be extra vigilant after the death of a four-year-old child has been linked to a rare form of the bacterial infection Strep A.

The child's death was reported in the northeast/North Dublin region and health officials have confirmed they are investigating whether Strep A was a contributory factor, following a number of similar deaths in the UK. 

In the North, a five-year-old girl also died from a severe form of the illness.

Strep A infections are usually mild and may result in strep throat or scarlet fever, which can be treated easily with antibiotics.

However, in rare cases, it can develop into a more serious infection, known as invasive Group A Strep (iGAS), which can cause lethal sepsis, shock, or meningitis.

So far this year, 55 cases of Strep A have been notified in Ireland, with 21 reported since early October, including four children under the age of 10.

Chief medical officer Breda Smyth has moved to ease concerns, saying: “I know parents are concerned by reports of Strep A cases, but the levels we’re seeing are lower than pre-pandemic levels.

“Most Strep A illnesses in children are mild," said Prof Smyth. "If you feel your child is seriously unwell, you should trust your own judgement and seek medical attention.

“Washing hands and good respiratory etiquette help prevent the transmission of the infection to others.” 

HSE national director for health protection, Eamonn O’Moore, confirmed that investigations are ongoing into the death of the four-year-old child.

"As far as we understand it, among a number of other conditions that are being considered as contributory factors, there may be a consideration of that invasive Group A streptococcal infection," said Dr O'Moore.

"It is reasonable to say it is among the differential diagnoses at this time."

Dr O'Moore confirmed that two other deaths have been associated with the illness, both in older people.

GPs have urged parents not to depend on a child’s temperature alone but instead to watch for a combination of fever, sore throat, and a sandpaper-like rash.

Irish College of General Practitioners vice-president Eamonn Shanahan said: “These deaths are horrendous for the families involved, but that is in the context of hundreds of thousands of children who are sick at the moment.” 

He urged parents to be aware of what is typical for their child, saying symptoms to watch out for include a mottled rash on the skin.

“Do not depend on the thermometer,” said Dr Shanahan. 

The kind of alarm signals you are looking for is a lethargic child, a child who is extremely cold, curled up in a ball in their parents’ arms. If a child is extremely unwell, then go to hospital.” 

Dr Shanahan, based in Farranfore, Co Kerry, echoed the chief medical officer's comments about precautions, saying we are experiencing a normal winter after Covid, with a number of viruses and infections in circulation. 

The medical director of SouthDoc, the out-of-hours GP service for Cork and Kerry, Gary Stack, urged parents to be familiar with the difference between scarlet fever and other viruses.

“It’s a sore throat, accompanied by fever, and you would expect to see a rash. It is a red rash, and there are tiny bumps on it, like sandpaper,” said Dr Stack.

He said the winter was already proving to be very challenging for health services. 

“There is a huge group of patients with respiratory illness, a large group with sore throats, and a minute group with scarlet fever.” 

He warned that SouthDoc clinics are already “overwhelmed”. 

“Unfortunately, people have said the last number of weekends have been like Christmas, we have reached the Christmas level of activity, particularly at weekends,” he said.

He estimated over the last three weeks about 90% of cases were respiratory illnesses.

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