Urgent advice on using NHS services - Strep A

8 December 2022

Winter traditionally sees an increase in coughs, colds and other respiratory illnesses.

This year, there has also been an increase in a bacteria infection, caused by the group A streptococci (also known as Strep A) bacteria, particularly among children. This has resulted in a higher incidence of scarlet fever.

Group A streptococci bacteria can cause a range of other types of infection, such as skin infections (impetigo) and sore throat. In very rare cases, the bacteria can get into the bloodstream and cause an illness called invasive group A strep (iGAS).

While still very uncommon, there have been more iGAS cases this year, particularly in children under 10-years-old. It is very rare for children with scarlet fever to develop iGAS infection.

It’s really important people use the right NHS service for what they need, so we can make sure we are helping those in urgent need. To help us help you, please try to use the right service.

Advice about what to do when you or someone you care for is ill can be found using NHS 111 online, 111.nhs.uk, available 24-hours-a-day.

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

Contact NHS 111 or your GP if:

  • your child is getting worse
  • your child is feeding or eating much less than normal
  • your child has had a dry nappy for 12 hours or more or shows other signs of dehydration
  • your baby is under three months and has a temperature of 38°C, or is older than three months and has a temperature of 39°C or higher
  • your baby feels hotter than usual when you touch their back or chest, or feels sweaty
  • your child is very tired or irritable.

Call 999 or go to A&E if:

  • your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs
  • there are pauses when your child breathes
  • your child’s skin, tongue or lips are blue
  • your child is floppy and will not wake up or stay awake.

Kate Langford, Chief Medical Officer at NHS Kent and Medway, said: “Winter always sees an increase in childhood illness and many of these will get better without the need to use the NHS with rest and drinking fluids.

“It’s always important to wash your hands properly to stop spreading bugs, and using a tissue when you sneeze or cough, which is then put in the bin.

“However, looking after children can be difficult especially when it comes to their health, and the NHS is here for you this winter. Please contact 111 online if you need further guidance. NHS 111 online will help determine what the best course of action is.

“NHS services are always busy at this time of year and waiting rooms have limited space. To avoid overcrowding, if you can, please limit the number of people attending with a patient, although we understand this is sometimes not possible.”

Useful information

What should you do? A parent's guide

Regional Chief Nurse, Acosia Nyanin, provides advice for parents who are concerned about Strep A

UK Health Security Agency blog 

The clinician seeing your child will assess their condition and symptoms and advise you on whether any form of testing is required and how this can be accessed, if needed. Not everyone will need a strep A test.

The NHS in Kent and Medway does not commission local pharmacies to provide strep A tests on our behalf and we do not advise using home bought test kits for strep A.  

Most strep A infections are mild. If your child’s condition gets worse, or they develop a high temperature, then you should contact NHS 111 online or your GP practice. As antibiotics are only useful in certain conditions, not everyone will need them, and a clinician will make this decision at the time of assessing your child.   

Some local pharmacies may be experiencing a temporary interruption of supply of some antibiotics (particularly liquids) due to a surge in demand but alternative antibiotics are available. Your pharmacist will be able to give advice about what to do if they don’t have any stock of your prescribed antibiotic.

There may be some local, temporary disruption to certain types of antibiotics, particularly liquid antibiotics.

If your usual pharmacy does not have stock of the prescribed antibiotic, you should make a reasonable effort to obtain this from another pharmacy. A map of all pharmacies is available on our website www.stopthinkchoose.co.uk.

If you are still unable to obtain the antibiotics, please contact the service which originally provided the prescription to allow for an alternative to be prescribed.

Prescribing of antibiotic tablets or capsules, instead of liquids, may be necessary at this time. There are two key resources to support prescribers, community pharmacy teams and parents:

Using solid oral dosage form antibiotics in children – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice

Teaching your child to swallow tablets: Healthier Together 

Where can I get reliable information about strep A and what to do?

All the information you need is on www.nhs.uk/strep-a

 

What health problems does strep A cause?

Strep A causes infections in the skin, soft tissue and respiratory tract. Most strep A infections are mild. Strep A is also responsible for infections such as tonsillitis, pharyngitis, scarlet fever, impetigo and cellulitis among others. While infections like these can be unpleasant, they rarely become serious and can easily be treated with antibiotics.

 

What’s the difference between having strep A and invasive strep A?

Most strep A infections are mild and easily treated with antibiotics, if required. But rarely, the infection can cause serious problems. This is called invasive group A strep (iGAS).

 

At what point should I contact the NHS?

You know your child best - if your child’s condition gets worse, or they develop a high temperature, you can use NHS 111 online in the first instance if your child is aged five or over. If your child is under five, please call 111 or your GP practice for an appointment.  Urgent care services are extremely busy at this time of year and you may face a wait at an urgent treatment centre or A&E department.

 

I can’t get an appointment with my GP and I think my child has strep A, what do I do?

Use NHS 111 online if your child is five or over or call NHS 111 if your child is under five. They will be able to advise you on the best course of action.

 

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