Expert says don’t panic but be vigilant

Israel on alert for strep A, which has killed 151 in the UK since September

Health Ministry urges doctors to raise awareness of bacteria, which normally causes sore throat and other flu-like symptoms, but can be serious

Nathan Jeffay is The Times of Israel's health and science correspondent

Illustrative: A child gets examined by a doctor for strep (macniak via iStock by Getty Images)
Illustrative: A child gets examined by a doctor for strep (macniak via iStock by Getty Images)

Israel’s Health Ministry has raised concerns about the spread of strep A, a bacteria that has recently caused 29 child deaths in the UK.

Streptococcus, widely known as strep, commonly causes a sore throat and flu-like symptoms. But in rare cases the bacteria becomes invasive, growing in blood or other organs, and can trigger a range of conditions.

These include meningitis, scarlet fever, toxic shock syndrome, and a flesh-eating disease called necrotizing fasciitis. These can cause serious illness and even death.

Scientists categorize different “groups” of streptococcus bacteria — which are indistinguishable to people who get infected — and the focus of the current concern is Group A, formally known as streptococcus pyogenes.

The World Health Organization recently announced that there is an increase in morbidity from invasive infections caused by strep A, but didn’t throw light on why it is happening. Its announcement was based on reports from at least five countries: the Netherlands, France, Ireland, Sweden and the United Kingdom.

Australia reported two child deaths from the bacteria on Friday. And in the UK, counting both child and adult mortality, there have now been 151 deaths from strep A infections since September, and the season is thought to still be in full swing. The UK death count for children, 29, already surpassed the number from the last intense season, in 2017 and 2018.

Streptococcus pyogenes bacteria, known as strep A (Dr_Microbe via iStock by Getty Images)

The epidemiology team at the Health Ministry wrote to doctors on Monday, saying that it was monitoring strep A and “saw fit to raise the awareness of the medical teams on the subject.”

It said that strains of strep A that were rare in the past have been on the rise, causing an “increase in invasive morbidity.” It noted that strep A cases declined in the thick of the pandemic, but rose in the second half of 2021 and were high through 2022.

Epidemiologist Hagai Levine (courtesy of Hebrew University)

Prof. Hagai Levine, Hebrew University epidemiologist and chairman of the Israeli Association of Public Health Physicians, told The Times of Israel that parents shouldn’t panic, but should be vigilant.

“It’s certainly another health condition parents should be alert to, alongside COVID-19, flu, RSV and others,” he said.

Medical authorities need to focus on “monitoring, surveillance and raising awareness,” he said, noting that when caught in good time, invasive strep A can be effectively treated with antibiotics.

The World Health Organization reported in its recent announcement on strep A that there were “no reports of increased antibiotic resistance,” leaving doctors optimistic about the ability of antibiotics to quash infections.

The strep A bacteria spreads through sneezes, coughs and skin contact. The people most at risk of an infection becoming invasive are the elderly and anyone with a weakened immune system, for example, those with long-term health conditions.

Levine said that parents should seek medical advice if their child is unresponsive, has a high fever, or exhibits unusual behavior. He acknowledged that it can be hard for parents to know if their child is seriously ill, but said they should “trust their instincts” and go to the doctor if their conduct is out of the ordinary.

The Health Ministry said in its letter that “an invasive infection is defined when there is penetration of the bacteria into sterile sites such as the circulatory system, the lungs, and soft tissues such as muscle and fat.” It stressed that “high vigilance can contribute to quick diagnosis.”

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