Strep A: Five-year-old girl dies from illness linked to bacterial infection

A five-year-old girl has died from an illness linked to the bacterial infection strep A in Belfast.

Stella-Lily McCorkindale became severely ill last week and was treated at the Royal Belfast Hospital for Sick Children, but died on Monday.

Black Mountain Primary School said she was "a bright and talented little girl".

On Friday the Public Health Agency (PHA) sent a letter to parents of P1 to P3 children at the school.

Children were asked to attend a clinic to be seen by a doctor and receive a preventative course of antibiotics.

Black Mountain Primary said Stella-Lily was very popular with both staff and children, and would be greatly missed by everyone.

The school is undergoing a deep clean, and the Education Authority's critical incident response team is providing support.

Across the rest of the UK, seven children in England and one in Wales have died due to complications from strep A bacterial infections since September.

Health officials in the Republic of Ireland are investigating the death of a four year old which may be linked to strep A, according to broadcaster RTÉ.

Parents need to be vigilant - that is the message from health officials and local doctors.

While those looking after children may be nervous about this unfolding story, most cases are mild.

It isn't possible to say for certain what is causing higher than usual rates of these infections.

The UK Health Security Agency (UKHSA) says the outbreak may be linked to the fact that for two years during the Covid pandemic, children didn't mix as much and their systems are not immune to a number of different infections.

There is a warning that the number of cases of both strep A and scarlet fever will rise in the coming weeks.

It is highly contagious so the advice from experts is keep sick children at home.

Parents of children who deteriorate quickly should seek urgent medical advice.

On Monday, dozens of pupils at Brackenagh West Primary School near Kilkeel in County Down were reported to be suffering from strep A infections.

Its principal said two had been taken to hospital.

The PHA is asking school parents to be vigilant, and community groups have been contacted about affected children who may have used their facilities.

The PHA's Dr Philip Veal said the science did not support closing schools amid clusters of strep A infections as this would have limited impact and children would continue to congregate in other settings.

He said there was an increase in infections every four or five years, lasting anything from a couple of weeks to a few months.

Such increases typically stopped naturally as the numbers of those susceptible were exhausted, he added.

"We have seen a rapid increase over the last one to two weeks," he told BBC's Evening Extra programme.

"What is unusual is the time of year we are seeing it. It would be more normal to see it in the spring."

Dr Veal added that in a cluster of cases - for example in a school - anyone with symptoms should be assessed by a doctor, who would decide if they should be given antibiotics.

He added there was no vaccine licensed and in regular use against strep A.

Most strep A infections are mild - a sore throat or a skin infection that can be easily treated with antibiotics.

But some people who catch it can get very sick.

Some people develop scarlet fever, which causes a skin rash (that feels like sandpaper) and flu-like symptoms, including a high temperature.

Figures show there were at least 104 cases of scarlet fever in Northern Ireland in November, up from 43 in October.

Very rarely, Strep A can cause something called invasive group A streptococcal infection or iGAS, which can be deadly.

Invasive disease happens when the bacteria get past your body's immune defences.

The government said that during a similar period in 2017-18 - the last high season for iGAS infection - there were four deaths in England.

There were 122 scarlet fever cases of scarlet fever across Northern Ireland in November, which is much higher than usual for this time of year.

But the number of cases of invasive group A strep, or iGAS - the most serious form of infection - is 33 so far in 2022, compared to 55 in 2018 and 72 in 2019 (before the pandemic).

Dr Veal said there was no indication Northern Ireland was seeing more deaths from iGAS than in previous years.

A strep A infection becomes dangerous when a child suddenly deteriorates, said GP Dr Frances O'Hagan.

In these cases children should be taken to A&E as quickly as possible.

"The other thing to be aware of is that the treatment for strep A is an antibiotic called Penicillin V," she said.

"Penicillin V does not taste very nice so children will not like it, but it's very important that you get it into your child.

"And it's a 10-day course, so it's really important that you finish the 10 days."

Gerard Greene, from Community Pharmacy, told BBC's Evening Extra programme that a sudden surge in demand for a particular drug often leads to pharmacies running out of stock.

Paul McDonagh, who runs a pharmacy in west Belfast, said he had run out.

"I managed to get a couple of bottles but the price has rocketed," he said.

"It's almost 10 times the price we get to dispense it."

As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement. Contact your GP if:

Call 999 or go to A&E if:

15 December 2022: The analysis in this article (originally published on 6 December) was amended for clarity: It is not possible to say for certain what is causing higher than usual rates of bacterial infections.

The Covid pandemic clearly interrupted the transmission patterns of many infectious diseases.

But while the UKHSA says the outbreak MAY be linked to social distancing during the Covid pandemic this is currently just an assumption.

Social distancing may have resulted in increased vulnerability to a range of other pathogens to which we would normally be regularly exposed.

But some suggest strep A infections had already been on the rise pre-Covid, while others suggest Covid may interact with and promote strep A infections.

The UKHSA says: "More research is needed to develop a better understanding of the dynamics underlying the transmission patterns of pathogens and the factors that determine the severity of diseases caused by them."