Strep A: HSE urges vigilance as increase in infections investigated

Parents and healthcare staff have been urged to be vigilant for signs of the bacterial infection strep A after a five-year-old girl died of a severe form of the illness in Northern Ireland and as a possible link to the death of another child in the State is under investigation.

Health officials are examining a recent increase in cases of a rare form of strep A, which may have been a contributory factor to the death of a four-year-old in the northeast/north Dublin region.

Strep A infections are usually mild and may result in sore throat or scarlet fever, and are normally treated with antibiotics. However, in rare cases it can develop into a more serious infection, known as invasive Group A strep (iGAS), that can cause lethal sepsis, shock or meningitis.

Department of Health officials sought to play down the dangers to the public from the bacterial infection but said that more cases are expected in the coming weeks.

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Officials said that because few people had been exposed to the bacteria in recent years, due to Covid-19 restrictions leading to less mixing, infection rates are expected to be higher than usual.

[ Advice for parents: What to watch for as strep A cases increase ]

The HSE said 21 of the 55 cases of iGAS this year have been detected since the start of October, with investigations under way into this “small increase”. Fourteen of the cases identified this year were in children under 10 years of age.

Two people over 55 are confirmed as having died as a result of the illness in the State this year.

The HSE said it was not possible to say for certain what was behind the higher rate of infection. “There is likely a combination of factors, including increased social mixing compared to the previous years as well as increases in other respiratory viruses,” a spokeswoman said. “Currently there is no evidence that a new strain is circulating. The increase is most likely related to high amounts of circulating bacteria.”

Dr Eamonn O’Moore, the HSE’s director of national health protection, told RTÉ that health officials were “actively looking” at the idea of supplying preventive antibiotics to close contacts in schools where there were confirmed cases.

Sam McConkey, a professor of infectious diseases at the Royal College of Surgeons in Ireland, said such a move would be “logical” but that “secondary cases”, where the infection was passed from one child to the next in a setting like a classroom, were not common.

Dr Pat Harrold, a Co Tipperary-based GP, said it is “part of the normal pattern of childhood to be getting infections” and that parents should watch out for rashes, dehydration, high temperatures, drowsiness or a loss of appetite.

The death of a girl from the illness in Northern Ireland was described as a “tragic loss” on Tuesday. Stella-Lily McCorkindale, a pupil at Black Mountain Primary in west Belfast, was remembered by the school as a “very bright and talented little girl” who was “very popular with both staff and children”.

On Tuesday, her father, Robert, thanked friends and neighbours for their support on social media. “First of all I want to thank everyone of youse from the bottom of my heart,” he wrote. “If prays, thoughts, feelings and love could of worked, she would of walked out of that hospital holding her daddy’s hand. So from me and Stella-Lily, thanks for all your kind prayers and thoughts. Words can’t express our gratitude.”

Her funeral Mass will take place next Wednesday afternoon at her grandmother’s house on Bromley Street, Belfast. She will then be taken to Roselawn Crematorium.

A number of other primary schools in the North have reported cases of strep A infection. Michael Peacock, the principal of Brackenagh West Primary School in Co Down, told the BBC that two pupils had been hospitalised .

The Public Health Agency said it was aware of a higher number of cases of iGas being reported across the UK. It said there had also been an increase in the number of cases of scarlet fever notified to the authorities, with the 122 cases identified in November “significantly higher” than usual.

“Acting quickly if you suspect anyone has this infection could make a difference to the outcomes,” the agency’s director of public health, Dr Joanne McClean, said.