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What is Strep A and its symptoms? Girl at London primary school dies after infection

A five-year-old schoolgirl from west London has died after contracting Strep A.

Parents of pupils at St Saviours C of E primary school have been sent a warning to look out for symptoms following a spike in deaths caused by the bacterial infection last year.

Sara Atkin, health protection consultant at UK Health Security Agency (UKHSA), said: “Our thoughts are with the family, friends and school community following the sad death of a child who attends St Saviour’s CofE Primary School in Maida Vale. We have provided precautionary advice to the school to help prevent further cases and we continue to monitor the situation closely.

“Strep A infections usually result in mild illness, and information has been shared with parents and staff about the signs and symptoms. These include a sore throat, fever and minor skin infections, and can be treated with a full course of antibiotics from the GP. In rare instances, it can cause a serious invasive infection, known as iGAS. Anyone with high fever, severe muscle aches, extreme pain or swelling of the skin, and unexplained vomiting or diarrhoea should call NHS 111 and seek medical help immediately.”


The last child to die was a pupil in East Sussex in December. The pupil, whose age and sex was provided, had attended Hove Park School and was the 16th death from the virus. At one point in December last year, it was reported that 15 children under the age of fifteen across the UK had died from invasive infection.

Dr Rachael Hornigold, a consultant in health protection at UKHSA South East, said in response to the child in Hove’s death: “Infection with Group A Streptococcus bacterium usually causes a sore throat, scarlet fever, or skin rash, and is passed by physical contact or through droplets from sneezing or coughing. In very rare cases, the infection can become invasive and enter parts of the body where bacteria aren’t normally found, which can be serious.

Medical professionals have raised concerns about how frontline NHS services will cope with a possible influx of concerned parents and the difficulties of separating serious cases from minor symptoms.

Neena Modi, professor of neonatal medicine at Imperial College London, told the Guardian earlier that both GP services and A&E were “on their knees”.

“The last thing we want is for A&E departments to be flooded with a new influx of worried parents,” she said.

But what is Strep A, how do you avoid getting it and how do you treat it if you or your child becomes unwell?

Dr Steve Iley, medical director at Bupa UK, reveals what you need to know.

What is Strep A?

Strep A, also known as scarlet fever, is an infectious bacterial illness, which usually involves a sore throat, fever, and rash. It most commonly follows from a throat infection caused by a type of bacteria called Streptococcus A.

Who are the high-risk groups?

Scarlet fever mainly affects children under the age of 10 and in particular those between two and eight. However, it can affect people of all ages.

It usually spreads from one infected individual to others through tiny droplets in the air. This means the infection can spread easily in spaces where children are in close contact, like classrooms and nurseries.

What are the symptoms of Strep A?

Initial symptoms of scarlet fever usually start between one and four days after infection. A sore throat, fever, headaches, chills, and nausea are all symptoms.

Then, about 12 to 48 hours after the fever starts, a skin rash will appear, first on the neck and then on the body. The rash will make the skin feel rough like sandpaper and will consist of pimples that are small, raised, and reddish in colour.

Another symptom of scarlet fever is “strawberry tongue”. This is when the tongue is at first white with red inflamed parts (white strawberry tongue). Then, after four to five days, it turns red and shiny (red strawberry tongue).

The bacterial infection can be transmitted through close contact, such as kissing or touching.

“Group A streptococcal infections usually result in mild illness, and information has been shared with parents and staff about the signs and symptoms,” said Dr Yimmy Chow, health protection consultant at the UKHSA.

He added: “These include a sore throat, fever, and minor skin infections, and can be treated with a full course of antibiotics from the GP. In rare incidences, it can be a severe illness and anyone with high fever, severe muscle aches, pain in one area of the body, and unexplained vomiting or diarrhoea should call NHS 111 and seek medical help immediately.”

When to see a doctor for Strep A

If you have a young child who is poorly, be vigilant and look out for any of the above symptoms that could be linked to scarlet fever. If you think your child may have scarlet fever, contact your GP immediately for advice.

If you or your child has scarlet fever, get plenty of rest and avoid going to work, school or nursery for a couple of days after you or your child start taking antibiotics. It usually takes a week to make a full recovery if you get treatment.

How is Strep A treated?

GPs usually prescribe antibiotics for adults and children. Make sure you complete the full course.

You can also take pain-relief medicines, like paracetamol and ibuprofen alongside these, to help ease symptoms but make sure you read the instructions and ask the pharmacist or your GP before giving them to your children.

How dangerous is Strep A?

Scarlet fever can usually be treated quickly with antibiotics but it can be fatal. However, this is extremely rare.

What can you do to avoid getting Strep A?

Make sure your children wash their hands regularly and encourage good hygiene at all times. This includes washing their hands in the morning and at the end of the day, after going to the toilet, and before and after eating food. Washing hands is an effective way to get rid of bacteria.

“Prompt treatment of scarlet fever with antibiotics is recommended to reduce risk of possible complications and limit onward transmission,” according to Gov.UK.

“Renewed messaging to encourage contact with GP practices for patients with specific symptoms (for example, rash), should be considered.

“GPs and other frontline clinical staff are reminded of the increased risk of invasive disease among household contacts of scarlet-fever cases.”