In incredibly sad news out of the UK, an outbreak of Strep A is killing more children than the COVID-19 virus did in 2020. Official reports say at least nine children in England, Wales and Northern Ireland have died after getting invasive group A Streptococcus (iGAS) infection, which is where bacteria gets into the bloodstream. “At some point the immune deficit brought about by lockdowns has to be repaid,” says Professor Carl Heneghan, director of the University of Oxford’s Centre for Evidence-Based Medicine. “In terms of the high levels of Group A Strep infections there have been notable increases in cases in the past, however what is different this time is the high levels of viral co-circulation in the community, and the high number of deaths in children.”

The government is now considering giving school children antibiotics as a preventative measure. “Lord Markham said in the House of Lords yesterday that the UK Health Security Agency are monitoring the position and are considering those kind of issues in those schools where there is an infection,” says Nick Gibb, the schools minister. “This is an ongoing situation, the UKHSA are involved very closely with those schools and they will be providing further advice later on. But that may well be an option for those particular schools where there is an infection.”

“We have given instructions to doctors that where necessary they should be proactively prescribing penicillin as the best line of defense on this, and also where there is a spread in primary schools, which we know is the primary vector for this, whether they should be working with local health protection teams, and sometimes actually look at the use of antibiotics on a prophylactic basis,” says health minister Nick Markham. Here are the symptoms of Strep A—and how to stay safe from the infection. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

A sore throat is one of the first signs of Strep A, experts say. “The underlying difference between strep throat and sore throat is that it is strep caused by group A streptococcus bacteria, while other sore throats are caused by other types of bacteria, viruses or irritants like allergies,” says Go Health Urgent Care. “One identifying symptom of bacterial pharyngitis like strep throat is having a red sore throat. A patient’s tonsils will look swollen and inflamed, a deeper color than the surrounding tissue. The redness may also look like streaks, or the patient may also notice tiny bright red spots on the throat and roof of the mouth. 

“Another symptom of a bacterial throat infection is distinct white spots, splotches, or streaks on the tonsils, along with a red sore throat. If a patient notices this, it’s best to be seen by a clinician to get tested for strep. Testing is important because many infections are caused by less dangerous bacteria and don’t require antibiotic treatment.”

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Headaches often accompany a sore throat with Strep A. “Headaches are another common symptom of strep throat,” says Stone Oak Pediatrics. “They can range in severity from mild to extremely excruciating. If your child’s headache occurs frequently or worsens, be sure to consult a pediatrician immediately.

“If you have both a headache and sore throat, it could be a viral or bacterial infection,” says the Cleveland Clinic. “They have similar symptoms. If you have a runny nose, cough and hoarse voice, you most likely have a viral rather than bacterial infection. There are no medications to treat viral infections. The virus will go away on its own. You usually feel better in about a week.”

High fevers should be closely monitored. If in doubt, see a doctor or pediatrician. “Another common symptom of Strep throat in children is a fever over 100’F,” says Stone Oak Pediatrics. “A lower fever may end up being a symptom of a viral infection and not strep throat, so be sure to take note of that. With a viral infection, most fevers should go away on their own within one or two days, and by the third day, other symptoms should start to disappear.”

“It’s always concerning when a child is unwell,” says the UK Health Security Agency. “GAS infections cause various symptoms such as sore throat, fever, chills and muscle aches. As a parent, if you feel that your child seems seriously unwell, you should trust your own judgment.”

A rash caused by scarlet fever is one of the first signs of Strep A. “Scarlet fever is usually a mild illness, but it is highly infectious,” says the UK Health Security Agency. “Therefore, look out for symptoms in your child, which include a sore throat, headache, and fever, along with a fine, pinkish or red body rash with a sandpapery feel. On darker skin, the rash can be more difficult to detect visually but will have a sandpapery feel.”

Older people are also at risk of getting Strep A, doctors are warning. “Rates of iGAS are highest at extremes of age — in children and the elderly,” says Michael Marks, an associate professor at the London School of Hygiene & Tropical Medicine. “This is not fully understood but may reflect immunity.”

Some very basic preventative measures can help protect against Strep A. “iGAS is spread by close contact with an infected person and can be passed on through coughs and sneezes or from a wound,” says the UK Health Security Agency. “Some people can have the bacteria present in their body without feeling unwell or showing any symptoms of infections and while they can pass it on, the risk of spread is much greater when a person is unwell.”

“The best way to keep from getting or spreading group A strep is to wash your hands often. This is especially important after coughing or sneezing and before preparing foods or eating,” says the CDC. “To prevent group A strep infections, you should:

• Cover your mouth and nose with a tissue when you cough or sneeze.
• Put your used tissue in the wastebasket.
• Cough or sneeze into your upper sleeve or elbow, not your hands, if you don’t have a tissue.
• Wash your hands often with soap and water for at least 20 seconds.
• Use an alcohol-based hand rub if soap and water are not available.

You should also wash glasses, utensils, and plates after someone who is sick uses them. These items are safe for others to use once washed.”

While there is no vaccine to prevent strep, there is treatment available. “The treatment for a strep infection is antibiotics and, sometimes, steroids to decrease the inflammation,” says Karla O’Dell, MD, an otolaryngologist at Keck Medicine of USC and assistant professor of clinical otolaryngology – head and neck surgery at the Keck School of Medicine of USC. “Gargling with saltwater is okay to do, if it feels good, but it will not make the infection go away faster or prevent one. If you have recurrent infections, you should be evaluated by an otolaryngologist.”