Medics have raised concerns about the NHS’s ability to deal with rising levels of strep A after reports that a 12-year-old London schoolboy has become the latest child to die after contracting a rare, invasive form of the infection.
On Sunday, Cabinet Minister Nadhim Zahawi urged parents to be alert for signs of strep A, although most cases are mild.
“It’s really important to be vigilant because in the very rare circumstances when it gets serious, then it needs emergency treatment,” he told Sky News’ Sophie Ridge on Sunday.
On Saturday, it was reported that a 12-year-old Year 8 student from a south London school had died after developing the infection, bringing the total number of deaths to seven.
On Friday, the UK Health Safety Agency (UKHSA) confirmed that six children under the age of 10 had died after contracting a strep infection since September, as it issued a rare warning in response to a rise in cases across the country.
Medical professionals have raised concerns about how frontline NHS services will cope with the likely influx of concerned parents and the difficulty of detecting serious cases from minor symptoms.
Nina Mody, professor of neonatal medicine at Imperial College London, said both GPs and A&E were “on their knees”.
“The last thing we want is for emergency rooms to be flooded with another flood of worried parents,” she said.
She also said the NHS 111 service was ineffective in dealing with sick children.
“These algorithms have been shown repeatedly not to be sensitive enough to separate a truly critically ill child from those who have milder symptoms,” she said. “So NHS 111 is not suitable for really young children.”
Dr Helen Salisbury, a GP in Oxford, said it was inevitable that GPs would face an increase in the number of parents bringing their children as a result of concerns about strep A, and there were challenges for GPs to identify which children may go on to develop an invasive infection.
“From a parent’s point of view, it must be really scary. How do you know if this sore throat is common or garden sore, or if it’s a prelude to something really serious? And I think that’s quite difficult for parents and to some extent for GPs as well,” she said.
“Even if you had all the time in the world and you weren’t pressed or rushed, it’s still hard to tell which child is going to get sick.”
Salisbury also stressed that parents should be able to return to their GP if a child’s condition worsens, but this can be difficult in congested areas.
“I know there are places where they really, really don’t have GPs and it’s actually hard to get an appointment,” she said.
“We are chronically long-term undertreated in general practice, and when something acute hits the news like this, that’s when it really becomes clear.”
Confirmed child deaths after contracting the rare invasive form of the infection include four-year-old Muhammad Ibrahim Ali, from Buckinghamshire, who died in an ambulance on the way to hospital.
His mother, Shabana Kusar, told Sky News her son first developed a red rash on his lower back which was helped by a course of antibiotics, but two weeks later his condition worsened and he developed pain in the stomach. After his death, an autopsy showed he had strep A in his blood.
“I believe that parents should be informed about the symptoms and act on them if their child is experiencing something like this,” she said.
Four-year-old Camilla Rose Burns has been on a ventilator at Alder Hey Children’s Hospital in Liverpool since Monday after contracting a strep infection.
Strep A can cause many health problems, most of which are mild. These can include scarlet fever and, very rarely, invasive group A streptococcal disease (iGAS).
The latest figures from the UKHSA showed that rates of scarlet fever and iGAS were two to three times higher than the same time of year before the pandemic, and cases were occurring earlier in the year.
During the week of November 14 to 20, 851 cases of scarlet fever were registered, compared with an average of 186 for the same period in previous years.
The UKHSA said there was no evidence that a new strain of Strep A was circulating and the increase was most likely due to large numbers of circulating bacteria and social mixing.
NHS England was approached for comment on concerns about the ability of NHS services to cope with increased pressure and referred the Guardian to the UKHSA – which said it does not comment on NHS workforce issues – and the Department of Health and Social Care (DHSC).
A DHSC spokesman said: “We recognize the pressure the NHS is under as a result of the pandemic and are taking urgent action to support the service and staff so they can provide high quality patient care.
“Our patient plan will improve access to general practice and free up over 1 million appointments a year, so all patients who need an appointment can access one within two weeks, and those with urgent needs should be reviewed within the same day.
“This is on top of an extra £500 million to speed up hospital discharges and free up beds, to get ambulances back on the road faster.”
Modi said it was not yet clear whether the current situation was unusual. “It’s too early to say whether or not this is outside of that normal fluctuation that you would see over the course of a few years or within that,” she said.
Salisbury said parents should look for symptoms that indicate an invasive infection is developing, such as a persistent fever, lethargy or lethargy, not eating or drinking as usual and not urinating.
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