Antibiotics could be given to entire year groups as a blanket prevention measure to help curb the spread of Strep A in schools, a Government minister has said.
It comes as the tally of primary-school-aged children to die from the bacterial infection is understood to have climbed to nine following the death of a child at Black Mountain Primary School in Belfast yesterday.
It also emerged on Monday that a 12-year-old pupil in south-east London and a child at Morelands Primary in Waterlooville, Hampshire, had also died.
The move would see penicillin or an alternative antibiotic given to all children in a year group that had been hit by a single case of the infection, even if they did not have any symptoms.
Schools minister Nick Gibb confirmed this morning that the UK Health and Security Agency (UKHSA) is "working closely with the schools involved and giving very specific advice to those schools which may involve the use of penicillin".
The plan, which was first revealed by a government minister during an urgent question in the House of Lords on the outbreak, is to help build up the line of defence against the bacterial infection.
Health minister Lord Markham said yesterday the Government was urging doctors to prescribe penicillin "proactively" to children in primary schools, giving them antibiotics on a "prophylactic basis," meaning as a preventative measure.
'Guidelines may well be adjusted'
This morning, Professor Adam Finn said there may be "less immunity" to Strep A now because there were fewer cases of it circulating in the last few years.
The professor of paediatrics at the University of Bristol told BBC Radio 4's Today programme: "The standard guidelines are that you wait for two cases in an institution like a school before you go out with antibiotics.
"But given the number of cases and the concerns that obviously exist at the moment, those guidelines may well be adjusted and we may see more broad antibiotic use."
He added: "I think it'll be done on a case-by-case basis but we may see some antibiotics been given out to children who were in close contact with a case."
Mr Gibb told GB News: "This is an ongoing situation, the UKHSA are involved very closely with those schools and they will be providing further advice later on.
"But that may well be an option for those particular schools where there is an infection."
'It's an enormous tragedy'
Prof Finn told Times Radio that people were right to be worried and "it's an enormous tragedy for these families", adding: "We're not used in our society to losing the lives of previously healthy children, this is something that's very shocking and concerning.
"What we've got to do is get the balance right here - on the one hand not alarm people whose children are mildly ill, and there are a lot of mildly-ill children around at the moment, and at the same time help people and support people to seek care and attention when their children become seriously ill - relentlessly sicker and sicker as the hours go by.
"Those are the children that need to be urgently seen."
Penicillin V is the first antibiotic of choice for Strep A cases, but experts have warned The Telegraph that there is "limited stock" for both tablet and liquid forms of the drug and that more liberal prescription could lead to supply issues.
Dr Colin Brown, deputy director of the UKHSA, told Sky News there is "long-standing guidance" that enables health protection teams to assess the situation in schools and nurseries to consider antibiotic prophylaxis for "either a group of children in certain classes or an entire nursery school".
He said "the information we have available at the moment is that there is no change" in the circulating strains of Strep A bacteria that is making them more severe.
"There isn't something that is particularly new or novel about the bacteria that are causing the infections that we're seeing at the moment," he said.
A Department of Health and Social Care Spokesperson said: "There are antibiotics available to treat Strep A and your GP will be able to prescribe the most appropriate treatment.
"Strep A usually causes a mild infection producing sore throats or scarlet fever that can be easily treated with antibiotics. However, it is important that parents are on the lookout for symptoms and see a doctor as quickly as possible so that their child can be treated.
"Make sure you talk to a health professional if your child is showing signs of deteriorating after a bout of scarlet fever, a sore throat, or a respiratory infection."