Child deaths from Group A Strep

Group A strep bacterium causes scarlet fever, which has caused nine UK child deaths this season.

Most likely

Respiratory viral infections

Group A streptococcus

Invasive Group A streptococcus

Currently high rates in the UK

Higher than normal for the time of year

UK, Notifiable diseases

Week 46, (W/E 19th November) 851 reported cases

(Average is 186 cases)

Close contact, droplets, hands, food

Incubation, 2 to 5 days

Most common, 2 years to 8 years

90% under 10 years

Typically lasts for 7 – 10 days

Rash disappearing in 7 to 10 days

Should ne immune for decades or life

Invasive Group A strep (iGAS)

Rare occasions,

bacteria get into the bloodstream

More cases of iGAS,

particularly in children under 10

Scarlet fever

Caused by the bacteria Group A streptococcus

Usually a mild illness

Highly infectious

At increased risk

Elderly

Immunocompromised

Clinical features

Sore throat/tonsillitis

Headache

Fever (temperature of 38°C (100.4°F) or above

Painful, swollen glands in the neck

A red tongue (strawberry tongue)

Rash of scarlet fever

Starts 12 to 48 hours after symptoms

Often begins with small spots on the body,

then spread to the neck, arms and legs over the next 1-2 days.

Fine, pinkish or red body rash

It is often 'sand-paper' like to touch (but not itchy)

Darker skin, rash more difficult to see

Sandpapery feel

Diagnosis of scarlet fever / Group A strep less likely

Child who also has a runny nose with their tonsillitis

Antibiotics

Reduce the chance of infection becoming more severe

Stop spread of infection

Penicillin V

Amoxicillin

(Plenty in the UK)

10 days

Finish the course

Home until at least 24 hours after the starting

Possible complications

Occasionally, Group A streptococcus can spread to other areas of the body,

Tonsillar abscesses

Neck lymph node abscesses

Chest infections (pneumonia)

Bone and joint infections (spetic arthritis)

Sepsis

Red warning signs

Pale, mottled and feels abnormally cold to touch

Difficulty breathing, grunting noises, indrawing

Cyanosis, skin, tongue, lips

Has a fit/seizure

Is extremely agitated

Non blanching rash

Child is floppy and will not wake up or stay awake

Amber signs

Rapid breathing

Unable to swallow saliva

Features suggestive of scarlet fever

Seems dehydrated, dry nappy

Drowsy or irritable

Shivering or complains of muscle pain

Painful, swollen gland in the neck

Baby is under 3 months and has a temperature of 38°C / 100.4 °F

Baby feels hotter than usual or feels sweaty

Is 3-6 months temperature of 39°C / 102.2°F or above

Continues to have a fever of 38°C or above, more than 5 days

Child has recently had scarlet fever

Puffy face/eyelids (renal involvement)

Tea 'coca-cola' coloured urine

Swollen, painful joint(s)

Is getting worse or if parents are worried

In the week or two after recovering from scarlet fever

Post streptococcal glomerulonephritis

Post-streptococcal arthritis

Later

Rheumatic heart disease

Is this a new strain?

High amounts of circulating bacteria

Social indoor mixing

Is this a post lockdown effect?

[gravytrainoutdoors]

My grandmother almost died of Scarlett fever when she was 4 years old. She was bed ridden for 4 months and had to basically learn how to walk again. She swears that after that it gave her a super strong immune system. She’s never been sick a day in her life and is the strongest women I know. She will be 93 soon.

[kandif]

My son nearly died from strep in his blood in 2021. It took 12 days and multiple trips to hospitals/doctors to get a diagnosis. It was like we were living in a movie and everyone was reading from the same script. "It's COVID, come back when you can't breathe". By the time I finally got him diagnosed it was attacking his heart. He was rushed via ambulance from the final urgent Care to the hospital only for the hospital to try and give him another COVID test. I thank God everyday that I did not accept the narrative and kept fighting because I do not believe my son would be here today.

[mcfeather]

Unfortunately we just had a 9 year old die in Kelowna BC Canada because doctors failed to give antibiotics when signs were so clear that the child had strep and was in distress. We need to be our own medical advocates, thank you for the information that you share!❤

[cazrich]

My now 31 year old son developed rheumatic fever after strep throat infection when he was 9.
I had the fight of my life trying to get it diagnosed and was dismissed as a neurotic mother at one point. Never give up on that motherly instinct!!

[isabellaprincess]

I had scarlet fever three years ago. I was told twice by local GPs it was viral. My husband drove me to the ER and they immediately put me on IV antibiotics for a week and then l had oral antis for another 8 weeks. The bacteria had gone into my blood stream and l ended up with strep septicaemia. If l hadn’t ignored the advice of my GP and gone to ER l would have died. Trust your instincts and never be afraid to get a 2nd/3rd opinion.

[darbirhian]

My mom was diagnosed with Scarlett Fever over 60 years ago and was given 48 hours to live. Thankfully she pulled through.

[annecoley]

Thank you John, my heart goes out to the parents who have lost their babies to this. I got rhumatic fever in 1973 aged 8, I only just managed to get the school bus home but I didn't make it home, my arms and legs wouldn't work and my dad found me draped over a wall when I didn't arrive home on time, he came looking for me, he carried me home and sent for the doctor who came to our house, he immediately rang for an ambulance and I was hospitalised for 2 week's. Luckily I haven't had any problems with my heart.

[traceyperry]

My now 22yr old daughter got Scarlet Fever when she was 6 yrs old here in NSW, Australia...Not one doctor in the hospital diagnosed her correctly until a South African R.N came on shift and alerted them because of the large strawberry shape on her tongue and the raised rash all over her...she was put on a drip and sent home within 10hrs with oral anti biotics..she has had health problems on and off ever since. My now 21yr girl got it 14 days later and had to be hospitalized on a drip for 4 days..she is rarely sick! I'm not sure why she got it 14 days after when the incubation period is 7-10 days.. I was treated like an idiot by the triage nurse back then when I told her exactly what she had because of the time period! The triage tried to get us to sit with everyone else in the packed waiting room at Wyong Emergency..that's when I lost it and swore at them for putting everyone in risk in the room!! When my daughter was rushed by ambulance from Wyong to Gosford hospital..the triage nurse rudely said...Oh..you were right!!! I have only just started trusting one doctor after all these years..thank you Dr.John.. you really are CHANGE!!!

[enhancingmotivation]

Thank you John. The trust in public health is at an all time low. We need reliable health information to make informed decisions about treatment. Excellent information.

[robinmyman]

Boy, have I been waiting for your take on this! Well done Doc.

[HowlingMan]

Thank you for spearheading this with information and resolutions. You have helped my family and myself more than I can say. I'll bet I speak for millions in that regard. Thank You Dr.

[liveskide]

Thank you, my granddaughter (age 6) had Strep throat last month. I had Scarlet Fever in 1959, at 3 years. Our house was quarantined by public health, only my mother was allowed to remain in the home to care for me. My father and the other children went to live with my grandmother. All of my garments were put in the incinerator. I don't think there was any antibiotic treatment at the time. I remember wearing nightgowns my grandmother made from dad's army air corp parachute. Silk . . . the only thing that my mother could put on me because of the feverish rash on my little body.

[plus]

You are superb at explaining medical conditions. Thank you for all your hard work.

[greenstair]

Thank you as always Dr Campbell, your time, work and effort is very much appreciated.

[sally]

Thank you Dr.Campbell. You are really keeping on top of the game. Thank you.❤

[HaleyPBear]

Thank you so much for sharing this information! I become a new mother in about 3 months and I really appreciate having things like this explained in a comprehensible way. You are a blessing Dr. Campbell!

[christineblyth]

I too had Scarlet Fever at age 4 and was hospitalised (I'm now 72). My mum used to tell me I went kicking and screaming into the ambulance, swearing at the ambulance crew! More recently, at the end of October this year, my niece and her family were visiting from up north (UK). Her 7-yr-old daughter had all the symptoms of Tonsillitis. But, to our great surprise, upon being taken to the nearest 'walk-in' clinic she was diagnosed with Scarlet Fever, given antibiotics and was promptly taken back up north so as to avoid transmission to the other children who were visiting us. Thankfully, she has made a full recovery. My heart goes out to the families who have lost their precious little ones to this infection. Thank you for all you do Dr Campbell. Best wishes to you and yours for a very Happy Christmas and a safe New Year!

[robertfrutiger]

I had Scarlett fever followed by Rheumatic fever when I was about 5 years old. It gave a heart murmur that stayed with me until I was in my twenties. Thank God He was watching out for me and pulled me through.

[runpurebloodrun]

Dr. John I see more and more other YouTubers afraid to speak about anything anything you address using your videos as an example. I’ve been watching you for years now. Thank you for all of your sound advice all of your amazing research and dedication to this. You are truly my hero I send you love, thoughts and prayers always. Eloquently give us the worst news we’ve ever heard with sound research behind it so sound that even YouTube can’t destroy you. I love you sending my love. You are a hero

[cab]

John. You are a true asset in your profession and to all. Thank you