Increased rates of A streptococci in children

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The UKHSA are advising practices to “have a low threshold to consider and empirically prescribe antibiotics” to children with symptoms of A streptococci.

This winter has seen increased rates of scarlet fever in children, with cases in England running at around four times the seasonal average. There have been deaths among school age children where the infection has developed into invasive group A streptococcus (iGAS), including one in Lewisham confirmed at the start of December.

The UKHSA’s advice to parents is:

Contact NHS 111 or your GP if:

  • your child is getting worse
  • your child is feeding or eating much less than normal
  • your child has had a dry nappy for 12 hours or more or shows other signs of dehydration
  • your baby is under 3 months and has a temperature of 38C, or is older than 3 months and has a temperature of 39C or higher
  • your baby feels hotter than usual when you touch their back or chest, or feels sweaty
  • your child is very tired or irritable

Lord Markham, a Health Minister, told the House of Lords on 5 December that the Government has instructed doctors to work with local health protection teams in deciding whether to use antibiotics on a prophylactic basis in primary schools affected by outbreaks. Guidance on this has yet to be issued to general practice.

The most recent data covers the period between Monday 12 September to Sunday 20 November, and saw 347 cases of scarlet fever at a rate of 3.9 per 100,000 population in London and 71 cases of iGAS at a rate of 0.8 per 100,000. London had the lowest per capita rates of scarlet fever of the NHS regions during this period, with the North West having the highest at 13 cases per 100,000. The full UKHSA briefing is here.

Useful patient facing advice
Many children can swallow tablets/capsules with a bit of advice and support
Letter to parents and carers in South East London