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How can I protect my child from Strep A?

A GP breaks down what parents and carers need to know. By Prudence Wade.

At least nine children across the UK are known to have died from an invasive form of Strep A bacteria.

According to data from the UK Health Security Agency (UKHSA), cases of scarlet fever are higher than we would typically see at this time of year – 851 cases were reported between November 14-20, compared to an average of 186 for the preceding years.

Scarlet fever is “usually a mild illness, but it is highly infectious”, according to the UKHSA. It’s caused by the bacteria group A streptococci, and in very rare occasions, this bacteria can get into the bloodstream and cause invasive Group A Strep.

The bacteria is spread by contact with an infected person, or contact with infected skin lesions.

Dr Colin Brown, deputy director of the UKHSA, says invasive Group A Strep is “uncommon”, but adds: “It is important that parents are on the lookout for symptoms and see a doctor as quickly as possible, so their child can be treated and we can stop the infection becoming serious. Make sure you talk to a health professional if your child is showing signs of deteriorating after a bout of scarlet fever, a sore throat, or a respiratory infection.”

Dr Belinda Griffiths, a general practitioner who specialises in family health at The Fleet Street Clinic (, agrees, saying incidences “are rare”, but the fact that there have been deaths means “we can’t afford not to pick these cases up”.

So, what can parents and carers do to protect their children?

What are the symptoms?

Being aware of the symptoms means you’ll know when you need to seek medical help.

Symptoms include “a high temperature, a sore throat, and as the illness progresses, you may get a rash or what we call a strawberry tongue – which is a red, inflamed tongue”, explains Griffiths.

On darker skin, the rash can be harder to see, but will still be sandpapery in texture.

Children under 10 are particularly vulnerable to Strep A “because they haven’t been exposed to it”, says Griffiths. “And they’re a group where if one in a cohort gets it, the whole group will be exposed to it, because they spread bugs like wildfire – children much more than adults.

“We don’t tend to go around in such close contact. It is possible for adults to get Strep throat, but it’s much less common.”

Is it possible to protect your child from Strep A?

“It’s very difficult with small children – because they all cough in each other’s faces,” Griffiths says.

While you can teach children to wash their hands regularly, sneeze into tissues and avoid anyone who has a cough, Griffiths adds: “Very small children won’t pay any attention to that at all. You can try, but they’ll all be running around, playing chase and the contact is there. You can educate them up to a certain point, but with very small children, it’s difficult to do that.”

Plus, she says: “You could keep them at home, or I suppose you could make them wear masks, but children are very poor at wearing masks, and you can’t keep them at home just to avoid Strep A.”

So, what can parents and carers do?

Griffiths’ top piece of advice is “hyper-vigilance”.

She says: “Children are very good at hiding symptoms – one minute they’re perfectly well and running around, and the next minute they’re really unwell… The important message to get across is to be vigilant. If you’re worried about your child, look in their throat, and check they’re eating and drinking. Because the first thing they’ll do is stop eating and drinking, and start complaining about their throat and their headache.”

And if your child does start displaying symptoms, Griffiths advises: “Get penicillin (or alternative antibiotic) as soon as possible, given the current situation.”

While Griffiths says she wouldn’t normally advise going straight for antibiotics as treatment, she adds: “With Strep A as it is at the moment, penicillin or an alternative is required – just to be safe.”

You can also get your child tested for Strep A – it tends to be a quick swab with results back in five minutes. Griffiths says some – but not all – GP surgeries offer it, and you can also get it done at places like The Fleet Street Clinic for £55.

Plus, she says you can do your bit to protect others, by keeping your child at home if they have symptoms, and letting the teacher know if they’re sick.


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