HSE confirms it is investigating case of potentially deadly Strep A infection

It said it is providing information to any potential close contacts of the case.

There have been four deaths of children from Strep A in the past six months in Ireland and eight across all age groups in the past year.

Since October last there have been four deaths in children: three deaths in children aged under 10 years old and one death in a child aged 10 to 17 years.

Of the 114 of the most serious, invasive group A Strep (iGAS), infections notified between January 1, 2022 and January 10, 2023, 77 (68pc) have been reported since early last October.

Of these 77 cases, 25 (32pc) were in children under 10, with a further four cases in children aged 10-17 years.

Strep A is usually a mild illness treated with antibiotics but can also cause strep throat, impetigo and scarlet fever.

Late last year, in the wake of a spate of deaths of children from the virus in Ireland, the World Health Organisation advised people in Europe to be vigilant around children under 10 due to severe infections caused by Strep A.

The HSE also wrote to schools and childcare providers in December advising them to urge parents of children with sore throats and fevers to be kept home to help combat the “significant increase” in infections.

The HSE’s chief clinical director Dr Colm Henry has stressed that death in children due to Strep A is “exceptionally rare”.

In a normal year, iGAS infections typically peak during the first six months. The increase observed towards the end of 2022 is the first time a peak has been reported outside this usual peak period. During the pandemic, normal social mixing patterns were interrupted which led to changes in how diseases such as iGAS presented.

Group A streptococcus is a common bacteria and it does not always cause illness.

The most serious infection caused by Group A Streptococcus occurs when it becomes invasive (invasive group A strep). That is when the bacteria gets into parts of the body where it is not normally found, such as the lungs or bloodstream. This is called invasive Group A Strep (iGAS) and in rare cases it can be fatal.

While  iGAS infections are still uncommon, there has been a small increase in cases last year reported in Ireland, particularly in children under 10, and a number of deaths.

Group A streptococcus is spread by close contact with an infected person and can be passed on through coughs and sneezes or from a wound.

Strep A causes infections in the skin, soft tissue and respiratory tract and can cause tonsillitis, pharyngitis, scarlet fever, impetigo and cellulitis among other illnesses.

While infections like these can be unpleasant, they rarely become serious. When treated with antibiotics, an unwell person with a mild illness like tonsillitis stops being contagious around 24 hours after starting their medication.

A common result of Group A streptococcus in children can be scarlet fever which causes fever, a raised rash which can feel rough to the touch like sandpaper, sore throat, and a swollen tongue.

The first signs of scarlet fever can be 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. The rash will be less visible on darker skin but will still feel like sandpaper. More information on scarlet fever can be found on the HSE and HPSC websites.

The HSE is advising parents to vigilant and to contact their GP if their child’s illness is not improving and is getting worse;

their child is feeding or eating much less than normal;

their child has had a dry nappy for 12 hours or more or shows other signs of dehydration;

their baby is under 3 months and has a temperature of 38°C, or is older than 3 months and has a temperature of 39°C or higher;

their baby feels hotter than usual when you touch their back or chest, or feels sweaty;

their child is very tired or irritable;

They are advised to call 999 or go to an Emergency Department if:

their child is having difficulty breathing;

there are pauses when the child breathes;

their child has a rash that does not fade when you press a glass against it;

their child’s skin, tongue or lips are blue;

If the child’s skin is pale, and feels cold and clammy;

If the child has a seizure;

The child is floppy and will not wake up or stay awake.