The UK Health Authority has issued an alert. The incidence of group A streptococcal infections has increased in recent weeks among children under the age of 10. If the upward trend was already a regular trend in the previous seasons of the COVID pandemic, this year the curve has escalated. In Spain, the Spanish Society of Pediatric Infectious Diseases has already begun work to analyze whether such an increased frequency of serious cases in our environment is due to infections such as tonsillitis and pharyngitis in milder cases or scarlet fever and invasive disease. the most serious.
meanwhile, Scientific Media Center Spain has drawn up guidelines on what to do with these infections, the Ministry of Health is on “active surveillance” and experts are urging mums and dads to be calm: “Paediatricians know exactly what to do”.
what is Streptococcus pyogenes And what infections do they cause?
The Streptococcus pyogenes Strep A is a common bacterium that is commonly found in the throat and does not cause illness in most cases. However, it is also the culprit of minor infections such as tonsillitis and pharyngitis. and other more serious ones, such as scarlet fever and invasive disease. This creates a more serious picture when the bacteria reaches the blood or lungs, it can cause high morbidity and a high percentage of patients may need surgery and hospitalization.
They are rare and usually treated with antibiotics, but people with open wounds or previous health problems are more prone to them.
Among the most serious conditions are necrotizing fasciitis, for which prompt diagnosis and treatment are important, and streptococcal shock syndrome, a rare infection that causes high blood pressure and multiple organ failure but is rarely contagious, according to the US Centers for Disease Control. and prevention. In addition, Streptococcus A is responsible for many cases of pediatric sepsis Scientific Media Center.
What are the symptoms?
“The first thing is not to feel any kind of alarm, because these serious infections are very rare, especially the most serious ones,” says Jesus Saavedra, a doctor at the pediatric service at the Gregorio Marañón University Hospital in Madrid. In this regard, he recommends consulting a pediatrician “before an episode of fever, significant sleepiness, persistent breathing problems, vomiting that does not go away, or a fever that lasts more than 3-4 days, especially if it is high or difficult to reduce.” And look out for a “rash that won’t go away with acupressure” and one that’s “extensive and very red, like a sunburn.”
What is happening in the UK?
On December 2, the United Kingdom issued a warning about an unusual increase in strep A infections. Those cases have risen from 186 cases in 46 weeks in previous years to 851 this season, and the incidence among children has skyrocketed. If from 2017 to 2019 there was an average of 0.5 cases per 100,000 among children aged 1 to 5 years, the country revealed 2.3 cases in this case. Between the ages of 5 and 9, the rate nearly quadrupled, from 0.3 to 1.1 cases. In addition, health authorities registered five deaths of children under 10 years of age in seven days, one more than was recorded in the entire 2017/18 season.
According to the UK Health Safety Agency, 60 people have died from infection with this bacteria in England since September, 15 of them minors. But this is not something that only happens in this country. French health authorities have recorded “higher-than-usual” infections over the past 15 days. Two children and one adult have already died there.
And in Spain?
The Spanish Society of Pediatric Infectious Diseases (SEIP) warned that “some children are known to have died and there is clearly an unusually high number of serious cases, which may indicate that we are also experiencing an increase in their cases”. In the community of Madrid, 14 infections were reported and two minors died from this cause. But counting here is not easy, because it is an invasive disease Strepococcus pyogenes It is not a notifiable disease and does not have a surveillance network similar to other respiratory viruses such as influenza, RSV or SARS-CoV-2.
However, SEIP has a national network for the study of invasive streptococcal A infections. (PedGAS-net). “We are in a good position to be able to assess whether there is such an increased incidence of serious cases in our environment.” Specify in the note. The Ministry of Health, for its part, assured that it is “in contact with the autonomous communities and cities in order to collect information on possible cases identified in recent weeks and to be able to analyze the situation.” Health systems are “under active surveillance.”
Why are cases increasing now?
Saavedra, who is the co-ordinator of the PedGAS-net project, notes that “it is not known for sure what is driving this increase in the UK”. “The most accepted theory is a decrease in general immunity, due to a reduction in the circulation of bacteria due to distancing measures during a pandemic. But it can be an accumulation of circumstances that should be analyzed more slowly, for example, the coincidence of respiratory viruses that contribute to more serious infections, such as RSV and influenza, or changes in strains or serotypes that can be more severe. “- he explained SMC.
“At the moment we don’t know what’s driving the growth in the UK.” A priori, the simplest explanation would be an increase in bacterial infections proportional to the increase now occurring in viral respiratory infections in children, mainly due to lack of exposure to seasonal viruses in previous years. Federico Martinon-Torres, head of the pediatric service at the University Hospital Clinic of Santiago, agrees.
“In general, and not surprisingly, there is an increase in serious bacterial infections, which is associated with an increase in respiratory infections in general and the usual cooperation that occurs between viruses and bacteria,” says this expert. exactly Strepococcus pyogenes It can occur as a superinfection with syncytial virus or after viral infection with influenza virus.
Are there more cases than other years?
There are no more cases at this time, but they are on the way. And that dance on the calendar is what worries experts, who have seen a change in the normal behavior of other infections in recent weeks. Scarlet fever and invasive disease have been on the rise in Europe for nearly a decade. Study Lancet infectious diseasesPublished in 2019, it already marks a UK first “unprecedented in modern times” growth. For now, according to the data UK Health Safety AgencyThe peak of infections this season is still far from the rate of 2017/2018.
in spain Work published in 2018, noted that “the incidence of EISGA (invasive disease) appears to be increasing in recent years worldwide, as evidenced by recent studies in children and adults.” “The reasons for this increase are not known, but an increase in risk factors or improvements in microbiological techniques such as PCR may be some of them,” they said.
should you worry
No. “These are warnings that should influence the authorities and health professionals to be more vigilant, but at the moment it does not lead to any specific attitude in fathers and mothers. If there are cases of pyogenic infection, pediatricians know exactly what to do,” says Martinon-Torres.
Source: El Diario