By Registered Health Visitor – Julia Headland
I thought I would do this blog about Group A Streptococcus (Strep A) as there has been a lot of media coverage about it recently due to an increase of cases and, tragically, deaths of children under the age of eighteen, which understandably has caused concern amongst parents. I will also look at some of the illnesses associated with Strep A and some of the symptoms to look out for. So, what is Group A Streptococcus? Group A Streptococcus is the name given to a type of bacteria that is sometimes found on the skin or in the throat and many people carry these bacteria and are unaware of it and do not develop any illness from it. Sometimes, it may cause a mild illness like a sore throat or a skin infection, such as impetigo (see below), scarlet fever (see below), tonsillitis, pharyngitis, pneumonia, or cellulitis. (NHS England 2022).
Most Strep A infections are not serious and can be treated with antibiotics.
However, on rare occasions, more serious conditions, known as Invasive Group A Streptococcus (iGAS) may occur. These infections can include infections of the blood stream, septic arthritis, meningitis, necrotising fasciitis (a severe infection involving death of areas of soft tissue below the skin) and Streptococcal toxic shock syndrome. iGAS infections tend to affect the elderly, very young or people who have an underlying risk factor such as immunosuppression, cancer, alcoholism, or drug addiction (NHS Inform 2022). That said, there does seem to have been a recent increase in cases of iGAS in people who are not necessarily in the at risk category.
Scarlet Fever
Scarlet Fever often firstly presents with a sore throat, headache, fever, nausea, and vomiting. After 12-48 hours, a characteristic red rash develops, and this can feel like sandpaper to the touch. Typically, it will start on the chest and stomach and will then spread to other parts of the body. On more darkly pigmented skin, the rash may not be as easy to spot although the sandpaper texture should still be present (NHS England 2022).
Other symptoms of scarlet fever may include:
Fever over 38.3C
White coating on the tongue which may peel a few days later, leaving the tongue looking red and swollen (known as strawberry tongue)
Swollen glands in the neck
Feeling tired and unwell
Flushed red face but pale around the mouth. On darker skin, the flushed face may feel look like sunburn
Peeling skin on the fingertips, toes, and groin areas as the rash fades.
(NHS England 2022)
Note: If you think that your child has Scarlet Fever then you need to see your GP for antibiotics.
Scarlet Fever is a notifiable disease and therefore medical professionals must inform local health protection teams.
(GOV.UK 2022)
Impetigo
Impetigo is a skin infection that is very contagious but not usually serious (NHS 2022). It often gets better in 7-10 days if you get treatment. Anyone can get it, but it is most common in young children.
Symptoms of Impetigo:
Red sores or blisters
Sores or blisters that quickly burst and leave crusty golden-brown patches which can look a bit like cornflakes stuck
to your skin; get bigger; spread to other parts of your body; be itchy; sometimes be painful
The sores or blisters can start anywhere but usually are seen on exposed areas such as face and hands.
Treatment for Impetigo is usually an antibiotic cream or antibiotic tablets of it is particularly bad. It is highly contagious so you must stay away from school, nursery, or work. If you suspect that you or your child has impetigo, it is worth mentioning on the phone when you speak to your GP surgery as they may suggest a video or telephone consultation to minimise the risk of spread.
What to do if your child is unwell?
First, you as parents or carers know your children better than anyone so if you feel that your child is seriously ill, trust your instincts and seek medical help at the earliest opportunity and do not worry about wasting anyone’s time.
If your child is unwell but does not seem to be seriously ill, then they can be looked after at home, and you can use children’s paracetamol or Ibuprofen to make them comfortable (NHS 2022). If they are diagnosed with a Strep A infection, most infections are easily treated with antibiotics, and you should stay away from nursery, school, or work for 24 hours after you start taking the antibiotics. This will stop the spread to others.
Get an urgent GP appointment or get help from NHS 111 if:
Your child is unwell and getting worse
Your child is feeding or eating much less than normal
Your child has fewer wet nappies than usual or is peeing less than usual. Or shows other signs of dehydration
Your baby is under 3 months and has a temperature of 38C, or is 3-6 months and has a temperature of 39C or higher Your child is very irritable
Call 999 or go to A&E if:
Your child is having difficulty breathing (they may make grunting noises, or you may notice their tummy sucking
under their ribs)
There are pauses when your child breathes
Your child’s skin, tongue or lips are blue or grey- on black or brown skin, this may be easier to see on the palms
of the hands or soles of the feet.
Your child is floppy and will not wake up or stay awake.
(www.nhs.uk 2022)
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For those people I have not yet met, my name is Julia Headland and I am a registered health visitor and registered general nurse with a degree in public health and over 20 years of experience. I am very pleased to work alongside the Norfolk House Nursery team.
You can arrange to meet me for confidential advice or guidance about your child’s health or development; during the pandemic these consultations are being conducted by Zoom or telephone.
My consultations are free of charge and they are confidential.
You can book an appointment with me via the Norfolk House Nursery staff.
You can also follow me on social media:
Facebook: @JuliaHeadlandPrivateHealthVisitor
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