Fatal Strep A infections reported in UK children – as dad tells of harrowing near-death experience

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Health officials in the United Kingdom are advising parents and schools to watch for Strep A infections following the recent deaths of several children.

With COVID-19 restrictions such as masking and social distancing no longer required in the UK, infections such as Strep A are spreading more easily, with cases increasing over the past month.

Also known as Group A Streptococcus (GAS), Strep A can cause a range of symptoms varying from minor to severe but is not fatal for most people who become infected.

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Strep A is a bacterium found in the throat and on the skin. It usually causes fever and throat infections, and many people carry it without any symptoms. However, they can still spread it to others through coughs, sneezes and close contact.

Symptoms of infection include pain when swallowing, fever, skin rashes and swollen tonsils and glands, with infection common in crowded settings such as schools and daycare centres, the US Centres for Disease Control and Prevention says on its website.

Kevin Breen, from the US, underwent multiple amputations shortly after being diagnosed with strep throat. Credit: CNN

But the infection isn’t limited to children.

Kevin Breen, 44, developed an extremely rare strep infection shortly after his son fought off a case of strep throat in 2017.

The infection, caused by streptococcal bacteria, typically affects the throat and the tonsils.

Around Christmas, Breen began to develop flu-like symptoms, and he visited an urgent care clinic with stomach pain. He tested negative for flu and strep. But his pain did not improve, and he went to the emergency room.

While there, his stomach began to enlarge and harden. Hospital staff thought it was a mild case of acute pancreatitis, according to Breen’s wife, Julie.

He showed signs of shock, and doctors decided to take him into surgery to find the cause of his problems.

During the surgery, doctors found 3 litres of pus surrounding his organs. They did not know where it was coming from.

“Normally, we have to look for things such as perforations. We look for holes in the stomach or in the small bowel of the colon, and nothing was found,” Dr Elizabeth Steensma said.

After surgery, he developed a rash on his chest. Doctors feared it could be streptococcal toxic shock syndrome, a severe illness associated with streptococcal infection.

They took samples and discovered the bacteria that cause strep throat. Based on the sample, the rash on Breen’s chest and his history, Steensma said, the pieces finally came together.

“That strep organism, that is really common, somehow that went from his pharynx in his throat and made its way into his abdominal cavity,” she said.

Breen went into multisystem organ failure and severe septic shock.

The infection, caused by streptococcal bacteria, typically affects the throat and the tonsils. Credit: Getty Images

Doctors worked quickly to treat him. The team “worked around the clock minute by minute for the next several days trying to keep him alive and get him home to his family,” Steensma said.

Still, they weren’t able to save his fingers and toes.

Breen’s severe case of septic shock, the toxins from the strep organism and medications he was on led to the need to amputate parts of his feet and hands, according to Steensma.

“It is extremely rare,” she said.

For most who develop strep throat, it’s little more than a temporary bother. But occasionally, strep can get into the bloodstream and cause a serious infection.

Breen returned home with his family but underwent a number of amputations.

Usually treatable with antibiotics

Invasive Group A Streptococcus (iGAS) is the term used when the bacteria invade the body, overcoming its natural defences to enter areas such as the blood, and is more dangerous, the UKHSA explains on its website.

While there is no vaccine to prevent Strep A or iGAS infections, antibiotics are usually effective at treating them.

“We are seeing a higher number of cases of Group A strep this year than usual,” Colin Brown, deputy director at UKHSA, said in a statement.

The increase in iGAS this year has particularly been observed in children under 10, the UKHSA added. Five children have died in England. One death has been reported in Wales, according to Public Health Wales.

Data from UKHSA shows that there were 2.3 cases per 100,000 children aged 1 to 4 between mid-September and mid-November, compared with the average of 0.5 in the pre-pandemic seasons (2017 to 2019).

For children aged 5 to 9, there were 1.1 cases per 100,000, compared with the pre-pandemic average of 0.3.

The last period of high infections was between 2017 to 2018, with four children under 10 dying in the equivalent period, the statement added.

The UKHSA said it doesn’t believe a new strain is circulating, with the increase in infections likely a result of “circulating bacteria and social mixing.”

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