Strep A surge linked to lockdown, health officials admit for first time

The surge in Strep A cases killing schoolchildren is linked to lockdown, health officials have admitted for the first time.

It comes as the tally of primary-school-aged children to die from the bacterial infection climbed to seven following the death of a child at Morelands Primary in Waterlooville, Hampshire.

Other cases in under-10s have been found in Surrey, High Wycombe, Wales and Ealing.

The Telegraph understands the death in Hampshire was not in the toll reported last week by the UK Health Security Agency (UKHSA) but a new additional case.

A 12-year-old child in Lewisham, London, has also died of the disease, taking the total known tally of children to have died from Strep A in recent weeks to eight.

An alert was issued by the UKHSA on Friday as data showed the rate of severe Strep A cases called invasive Group A Strep (iGAS) is up four-fold compared to pre-pandemic levels.

When the alert was issued last week, the authorities said the increase in cases of iGAS and scarlet fever was “related to high amounts of circulating bacteria and social mixing”.

Argument about Covid immunity debt

Scientists argued over the weekend over whether a so-called immunity debt – where there are more people without immunity to various diseases – brought about by Covid lockdowns and social distancing was to blame.

But on Monday, Dr Susan Hopkins, chief medical advisor at UKHSA, confirmed for the first time on BBC Radio 4’s Today programme that lockdown did play a role.

“We’re back to normal social mixing and the patterns of diseases that we’re seeing in the last number of months are out of sync with the normal seasons as people mix back to normal and move around and pass infections on,” she said.

“We also need to recognise that the measures that we’ve taken for the last couple of years to reduce Covid circulating will also reduce other infections circulating.

“And so that means that, as things get back to normal, these traditional infections that we’ve seen for many years are circulating at great levels.”

Seven children believed to have died

At least seven children are believed to have died from the bacterial infection so far since September, with one primary-school-age child in Hampshire being reported on Monday.

Simon Bryant, director of public health at Hampshire County Council, said: “We offer our heartfelt condolences to the family, friends, and the whole school community who will all be deeply affected by the very tragic loss of this young child, and we are providing our support to them at this incredibly sad time.

“I would stress that contracting iGAS disease from another person is very rare. Most people who come into contact with Group A Streptococcal infections remain well and symptom-free – and therefore there is no reason for children to be kept home if well.”

Fears of a potential penicillin shortage at some chemists have also been raised as doctors have been told to give out antibiotics more readily amid soaring Strep A cases.

The UKHSA has issued guidance to GPs urging them to “have a low threshold” and to give out antibiotics sooner than they might normally.

The Telegraph understands this involves GPs erring on the side of caution and not necessarily waiting for more severe symptoms than a sore throat before signing a prescription for penicillin.

Children more likely to get antibiotics

If a child has a sore throat and goes to a GP now, they are likely to get antibiotics. This was not the case previously or in past years but has been implemented due to unusually high Strep A prevalence.

The guidance is likely to be welcomed by GPs as several doctors said over the weekend, after the UKHSA issued an alert over soaring cases and deaths, that they were worried about missing a potential iGAS case and not giving out antibiotics.

Penicillin V is the first antibiotic of choice for Strep A cases and experts have told 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.

Suraj Shah, drug tariff and reimbursement manager at the Pharmaceutical Services Negotiating Committee, told The Telegraph: “Changes to prescribing guidance and practices can impact on the availability of medicines.

“For example, with the recent rise in the number of respiratory infections in the community, GPs have been advised to ‘have a low threshold’ for prescribing antibiotics to children presenting with symptoms associated with group A Streptococcal infections.

“This is likely to lead to an increase in prescribing of certain antibiotics such as Penicillin V, which can impact on supply.

“Supply issues can mean that pharmacies may not always be able to get hold of medicines as quickly as possible, but pharmacy teams will do everything they can to source medicines their patients need promptly, including talking to GPs about possible alternative formulations or medicines if it helps people to receive treatment faster.

“We would ask the public to continue to be patient with pharmacy teams who are under the same unrelenting pressures as other healthcare professionals.”

‘There are antibiotics to treat Strep A’

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.”