The World Health Organisation (WHO) on December 15 confirmed that “at least five Member States, namely, France, Ireland, the Netherlands, Sweden, and the United Kingdom of Great Britain and Northern Ireland, have been observing an increase in cases of invasive group A streptococcus disease and scarlet fever, mostly affecting children under 10 years of age. The increase has been particularly marked during the second half of the year.
According to the UK Health Security Agency (UKHSA), invasive group A streptococcus (iGAS) infections remain rare. So far this season, there have been 111 iGAS cases in children aged 1 to 4 compared to 194 cases in that age group across the whole year of the last comparably high season in 2017 to 2018. There have been 74 cases in children aged 5 to 9 years compared to 117 across the whole year of the last comparably high season in 2017 to 2018. The majority of cases continue to be in those over 15 years.
“Sadly, so far this season there have been 74 deaths across all age groups in England. This figure includes 16 children under 18 in England. In the 2017 to 2018 season, there were 355 deaths in total across the season, including 27 deaths in children under 18,” UKHSA data reveals.
Meanwhile, Canada also is witnessing deaths caused by group A streptococcal bacteria in children. The Toronto Star has reported that at least three children in Canada have died after being infected with group A streptococcal bacteria in recent weeks.
Dr Colin Brown, Deputy Director, UKHSA, said, “Scarlet fever and ‘strep throat’ will make children feel unwell, but can be easily treated with antibiotics. Symptoms to look out for include fever, sore throat, swollen glands, difficulty swallowing, and headache. Scarlet fever causes a sandpapery rash on the body and a swollen tongue.
Good hand and respiratory hygiene are important for stopping the spread of many germs. By teaching your child how to wash their hands properly with soap for 20 seconds, using a tissue to catch coughs and sneezes, and keeping away from others when feeling unwell, they will be able to reduce the risk of picking up or spreading infections.
The first symptoms of scarlet fever include flu-like symptoms, including a high temperature, a sore throat and swollen neck glands (a large lump on the side of your neck).
A rash appears 12 to 48 hours later. It looks like small, raised bumps and starts on the chest and tummy, then spreads. The rash makes your skin feel rough, like sandpaper.
On white skin, the rash looks pink or red. On brown and black skin it might be harder to see a change in colour, but you can still feel the rash and see the raised bumps.
‘Strep throat symptoms’
flu-like symptoms, such as a high temperature, swollen glands or an aching body
sore throat
Contact 111 (online if child over 5) or GP surgery if your child has ‘strep’ throat symptoms.
iGAS symptoms
high fever, severe muscle aches localised muscle tenderness, increasing pain, swelling and redness at the site of the wound unexplained diarrhoea or vomiting There are several viruses circulating that cause sore throats, colds and coughs. These should resolve without needing medical attention. Antibiotics are not needed for viral infections. However, children can on occasion develop a bacterial infection at the same time as a virus and that can make them more unwell.
Rise in prices of antibiotics
Amid the rise in cases of A streptococcus infections, the UK’s competition regulator recently announced a probe into drug companies for raising prices of antibiotics used to treat Group A Streptococcus (Strep A).
GPs and parents, however, have reported struggles to get hold of antibiotics to treat the bacterial infection, which typically causes a sore throat and fever, as pharmacies are out of stock.
Some pharmacists say they are being charged up to £19 ($23.60) for a box of drugs that normally costs just a few pounds, as demand soars.
They say they are losing thousands of pounds a week as they can only recoup a fraction of what drugs truly cost from the state-run National Health Service (NHS).
The Competition and Markets Authority (CMA) reminded drug manufacturers that it is illegal for a dominant company to charge excessive prices, or for any companies to collude to drive up prices.
“People have got real concerns about the price of antibiotics used to treat Strep A, and we want companies to be clear about their obligations under the law,” a spokesperson said.
“We are working to establish the facts of what is currently happening in the market and welcome new information as part of our work.
“We stand ready to take action if there is evidence of anti-competitive behaviour that breaks the law.”
Supply shortage
Leyla Hannbeck, the chief executive of the Association of Independent Multiple Pharmacies (AIMP) which represents pharmacies in the UK, said the supply problem is getting worse and urged the government to take action.
“I raised this concern about antibiotic supply last Sunday,” she told AFP. “It is now 10 days later and the situation is not getting better, but worse.
“My question is why did they (the government) not start doing something instead of denying it.”
Last week, Health Secretary Steve Barclay said there was no shortage of antibiotics and stock could be moved around if any particular area was experiencing problems with supply.
But on Monday, his department issued a medicine supply notification for antibiotics for the treatment of Strep A.
“Supplies of antibiotics for the treatment of Group A Strep have seen a surge in demand and may be temporarily in limited supply at certain wholesalers and pharmacies,” it said.
“Supplies are available with manufacturers, and deliveries into wholesalers and pharmacies are being expedited and are expected in the coming days.”
The UK government has reportedly admitted there were serious shortages of antibiotics to treat bacterial infections in children, despite more than a week of denials.
“Serious shortage protocols” had been issued for three types of oral solutions used in paediatrics — Phenoxymethylpenicillin, which is also known as penicillin V.
Two more penicillin medicines added to treat Strep A cases
According to reports, two more penicillin medicines have been added to the list of alternatives to treat Strep A cases. Now, the list includes: Phenoxymethylpenicillin 125mg/5ml oral solution, Phenoxymethylpenicillin 125mg/5ml oral solution sugar-free, Phenoxymethylpenicillin 250mg/5ml oral solution, Phenoxymethylpenicillin 250mg/5ml oral solution sugar-free,
Phenoxymethylpenicillin 250mg tablets.
(With inputs from AFP)
