Strep A: Schoolchildren at risk in England could get preventive antibiotics
Schoolchildren at risk of Strep A in England could be given preventative antibiotics to try and tame the outbreak.
At least nine children in the UK have died of iGAS, a severe form of Strep A infection caused when the bacterium gets into the bloodstream.
There has been one known death from iGAS in Wales, one in Northern Ireland and seven in England. None have yet been recorded in Scotland. There is also a suspected death from iGAS of a four-year-old girl in Dublin, Ireland.
Nick Gibb, the schools minister, has said that in schools where there have been cases of Strep A the authorities are giving out antibiotics to entire year groups.
On Tuesday, Mr Gibb said the UK Health and Security Agency (UKHSA) was “working closely with the schools involved and giving very specific advice to those schools, which may involve the use of penicillin”.
A Whitehall source told The Telegraph it was part of a “classic playbook” used when there are significant outbreaks. Guidance recommending it as a measure to help get on top of a spike in cases has been in place for several years, authorities said.
Giving out antibiotics as a preventative tool is a case of chemoprophylaxis and is “not routinely recommended for contacts of iGAS” but “can be considered in exceptional circumstances” such as when there are severe outcomes.
Dr Colin Brown, the deputy director of UKHSA, said: “Depending on the situation, we would consider antibiotics for either a group of children in classes or an entire nursery school.”
The latest death was of Stella-Lilly McCorkindale, who attended Black Mountain Primary School in Belfast. The school spoke of its “tragic loss” and said that “the thoughts of the entire school are with the pupil’s family and friends at this difficult time”.
Dr Brown suggested a lack of mixing because of the Covid pandemic, plus susceptibility in children, were probably “bringing forward the normal scarlet fever season” from spring to this side of Christmas.
The Telegraph understands schools will get guidance from the Department of Education on Wednesday, advising them about how to help prevent transmission.
Strep A is infectious and is passed by close contact, but if a person develops iGAS that does not mean the person that catches the infection from them will also have severe illness.It is mild in the majority of cases and manifests most of the time as a sore throat, known as Strep throat or tonsillitis.
It can also cause scarlet fever or impetigo, and only in the rarest and most extreme cases does it develop into iGAS, which can cause sepsis and can be fatal.
The UKHSA said last week that the rate of scarlet fever cases in England is four times higher than in pre-pandemic years, and authorities have said the rise in cases is because of lockdowns over the last two years meaning the infection was circulating at low levels, leaving a larger pool of susceptible people this winter.
Analysis of official data by the Telegraph reveals that the picture varies significantly across the country.
The Isle of Wight is the hardest hit region with 67 cases of scarlet fever in the last four weeks, a rate of 47.08 cases per 100,000 people. This is 18 times higher than the pre-pandemic rate of 2.6 per 100,000 people.
Allerdale, in Cumbria, and Three Rivers, in Hertfordshire, are second and third respectively, with rates of 40.89 and 25.54 per 100,000. The Derbyshire Dales and Norwich round out the rest of the top five.
Meanwhile, areas such as Hackney, Tamworth and Sevenoaks have yet to report a single scarlet fever case in the last month.
