CCLG update: 13 December 2022
We know that many parents and carers of children with cancer may be concerned about invasive group A streptococcus as several children in the UK have sadly recently died from this infection. We have answered some commonly asked questions below.
What is group A streptococcus (GAS)?
Group A streptococcus ('group A strep') is a very common bacteria which causes a range of infections including throat infections, impetigo (a skin infection) scarlet fever. These infections are usually mild and are easily treated with oral antibiotics
What is scarlet fever?
Sometimes GAS can cause scarlet fever. This is usually a mild illness. The signs of scarlet fever include a sore throat, headache, and fever with a pinkish or red body rash with a sandpapery feel. On darker skin, the rash can be more difficult to see but will usually have a sandpapery feel. Children may also have a very red tongue or lips. Most children with scarlet fever will get better with antibiotics.
What is Invasive Group A streptococcus (iGAS)?
Group A streptococcus can cause a rare, more serious infection called invasive group A strep (iGAS). Children with iGAS become unwell because their body produces an exaggerated immune response or the bacteria gets into the bloodstream or lungs.
Why is group A strep a problem this winter?
There are increases in group A strep infections every few years. This year there has been a earlier rise in cases, occurring in the winter rather than the spring time. Due to the larger numbers of mild cases in the community, cases of more serious infection are also been seen in the hospital. The reasons for increase in number of cases is not fully known, however this might be due to the number of viruses causing sore throats, colds and coughs going around at the moment.
What about children with cancer and GAS?
Children with cancer who are unwell with a fever or any other symptoms suggestive of any infection should be seen promptly through their usual hospital pathway, as they always would. The standard broad spectrum antibiotics given to children with cancer who have a fever or are unwell will effectively treat GAS.
Should my child with cancer go to school or nursery if there are cases of group A strep in the class?
There is no evidence to exclude children with cancer from school or nursery if there have been cases in their class. Children should continue to ensure good hygiene with regular hand washing, using a tissue to catch coughs and sneezes and keeping away from others when feeling unwell.
Should my child with cancer receive prophylaxis (preventative) antibiotics if they have been in close contact with another child with group A strep?
Preventative antibiotics are not normally recommended for any child, including those with cancer, who are in close contact with someone with Group A strep. However, if your child later develops a fever or becomes unwell, they should be seen promptly through their usual hospital pathway. The UK Health Security Agency will continue to review the need preventative antibiotics in specific situations.
If you are worried about your child with cancer, please follow your usual hospital pathway to ensure they are seen promptly.
Useful links and resources:
Group A strep – What You Need to Know UK Health Security Agency
UK Health Security Agency (UKHSA) data on scarlet fever and invasive group A strep
Healthier Together Strep A and Scarlet Fever
Written by Dr Jessica Bate (Consultant Paediatric Oncologist, Southampton Children’s Hospital) with Dr Chrissie Jones (Consultant Paediatric Infectious Diseases, Southampton Children’s Hospital) Dr Sanjay Patel (Consultant Paediatric Infectious Diseases, Southampton Children’s Hospital), Dr Bob Phillips (Honorary Consultant Paediatric Oncology, Leeds Teaching Hospitals, Professor Richard Grundy (CCLG Chairman) and Ashley Ball-Gamble (CCLG CEO)