Invasive strep A causes 25 deaths, including 12 children, since October

A total of 25 people, including 12 children, have died from invasive strep A since last October, as the current record wave of infection continues.

The number of deaths has doubled since last March, figures from the Health Protection Surveillance Centre (HPSC) show.

The impact on children has been unusually high, with 10 deaths in under-10s and two in 10-17 year olds. The remaining 13 adult deaths ranged in age from 46 to 96.

Since October, 384 cases of invasive group A strep (iGAS) have been notified in Ireland. Of these 155 were in children aged under 18 and 139 in under-10s. In pre-pandemic years, just one-quarter of cases were in children.

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Data from 2023 show the number of iGAS cases remains elevated, with 306 cases notified in the first five months of the year. This is almost five times the level recorded in 2017-2019.

Scientists at Temple Street children’s hospital are investigating if a particular strain of iGAS streptococcus is responsible for the recent increase in cases, according to the HPSC.

It says the reasons for the rise in Ireland and other European countries is not yet fully understood. “There is likely a combination of factors, including increased social mixing compared to the previous years as well as the effects of higher levels of respiratory viruses such as Covid-19, flu and RSV, and more recently chickenpox which can predispose, especially children, to iGAS infection.”

Group A strep is a common bacteria, which many people carry harmlessly in their throats and on their skin. However, it can cause serious infection. The most serious form occurs when it becomes invasive, such as when it enters the lungs or bloodstream. In rare cases iGAS infections can be fatal.

A common presentation of strep A in children can be scarlet fever which causes symptoms such as 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 rash appears 12-48 hours later, first on chest and stomach and then spreading.