Parents of young kids, already feeling burnt out from the ongoing tripledemic, might be freaked out about this latest scourge. But these serious infections are rare. Most strep cases are easily treatable with antibiotics. Still, it’s worth being on parents’ radar because there are concrete things to do to reduce risk.
UK health authorities have seen a threefold increase in reports of scarlet fever from mid-September through Dec. 11, compared to the 2017-2018 season (the last time transmission was this high). It’s led to a shortage of penicillin, prompting authorities to recommend alternative antibiotics for treating the infection.
As of Dec. 15, there were 16 children under the age of 18 who had died in the UK from invasive infections. The World Health Organization, meanwhile, said Dec. 12 that children have also died from invasive infections in France and Ireland.
The situation in the US is still evolving. Doctors in the US are still trying to figure out whether the seemingly higher activity falls outside the norm for a year when lots of pathogens are circulating. But they are seeing enough of a bump in cases to be paying close attention to the situation, says Elizabeth Schlaudecker, an infectious diseases doctor at Cincinnati Children’s Hospital Medical Center. Schlaudecker’s own hospital has seen a small increase in cases of invasive strep. “We’re talking less than a handful, not dozens and dozens.”
Still, invasive strep is very rare, so even a small increase can be a worrisome change. Children’s Hospital Colorado alerted the state health department after seeing an unusual rise in cases in mid-November, says infectious disease specialist Sam Dominguez. In a typical year, the hospital would see one or two invasive infections per month, but has been seeing that many per week, a fourfold increase. Two children in the state have died from what is believed to be invasive strep infection.
Texas Children’s Hospital has also had a fourfold increase in the number of invasive and possibly invasive group A cases this fall compared to the fall of 2021, says James Versalovic, Pathologist-in-Chief at Texas Children’s Hospital. That adds up to more than 60 cases, some of which he notes are still under investigation.“These are children that have been hospitalized, some requiring critical care in a pediatric ICU,” Versalovic says. “We definitely have a story here that’s unfolding.”
For its part, the Centers for Disease Control says it is investigating reports of an increase from local health departments, but that it is “too soon to say” whether this is simply a return to pre-pandemic levels or if something else is going on.
Every infectious disease doctor I spoke with stressed that the majority of the time, a strep A infection is nothing more than the typical sore throat that many kids experience over and over again in early childhood. And unlike the many viral infections circulating, strep throat is easily treatable: Kids typically feel better soon after they start a course of penicillin and can typically return to school a day after they start antibiotics as long as their fever is gone. (Penicillin supply — unlike a different kind of antibiotic, amoxicillin — seems steady in the US.)
Nevertheless, it’s important to pay attention to your child’s symptoms and get them tested if they have symptoms like a sore throat, fever and painful swallowing. Versalovic stresses that even mild cases need treatment to prevent complications from the infection. So don’t consider your child’s negative at-home Covid test as a sign that you’re in the clear — a simple throat swab might be in order.
Any beleaguered parent shaking their fist at the sky and asking, “Why now, strep A?” can likely blame the vortex of viruses that settled in early this year. Those infections can create the perfect breeding ground for bacteria, which in turn can have an easier time invading places it wouldn’t normally reach — like the bloodstream, bone, or skin, says Schlaudecker.
Influenza and the chicken pox are particularly good at allowing strep A to creep into spots in the body where it can be dangerous. But we have vaccines for both of those: Children as young as six months can get a flu shot, and the first dose of chicken pox vaccine can be given between 12-15 months. While they don’t directly protect against strep A, studies suggest they can lower the chances of contracting a severe case.
All of this just means even more reason to keep up with the common-sense measures that we’ve come to learn to live with (and perhaps loathe a little) that lower the risks from all types of viruses.
More From This Writer at Bloomberg Opinion:
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This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.
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