Speaker 1 00:00:05 Hello and welcome to a Wonder Care podcast. I'm Sheena Mitchell, the pharmacist and mom of three. I combine healthcare and practical advice to support you on your parenting journey. Today I'm gonna be talking about the current group, A strep figures because as we know, there was a peak reported there a few months ago and the levels were much higher than normal, which led to cases of scarlet fever, et cetera, and some cases of invasive group a strep disease. I want to kind of bring everyone up to date on where the figures are now and what this means and maybe as family members what we should be looking out for symptom-wise in our children, but also in our elderly. Before I get started, I just want to give a big thanks to my sponsor, salon Plus Breathe Easy Cell Therapy Device. I'll tell you a little bit more about that in a minute. I will explain exactly what group a strep is and what invasive group a strep infection is in a little minute, but I just want to put in context to you the number of infections that are being reported at the moment because it is significant and it is important to kind of be aware of why I'm flagging this once more. Speaker 1 00:01:25 A normal group, a strep infection isn't a notifiable disease, which means I don't have exact figures for how much strep is doing the rounds. We all know that there's a lot of sore throats going around and a lot of those may well be as a result of group A str. However, invasive group a strep infection is actually a notifiable disease, and so I do have figures for the number of infections in Ireland. So just to put it into context, in 2019, so pre covid for the whole year, there was 108 invasive group A strep infections reported in 2020. There was 43 reported. Obviously this is lower than the year before, and because we were in the pandemic, that has been the case with all infections really other than covid obviously. In 2021 we saw a similar situation where there were 34 cases reported, so lower than normal, and again, this is most likely down to the pandemic. Speaker 1 00:02:28 Then to bring us up to 2022, which may seem like a long time ago now, but it's not. So up until October, so for the first nine months of the year of 2022, there was 34 cases reported. It was looking like another year of low invasive group A strep. However, from October, right up until the 15th of March, which is a six month period, there was 179 cases reported. In that six month period, there was 179 cases, and remember that the pre pandemic level of 2019 for the whole year was 108 cases. So we're looking at a very, very high year for invasive group A strep. In the cases that have happened over the past six months, 36% of them were in children under 18 years. This is kind of different to how it was pre covid where only 25% of them were in kids under 18. Speaker 1 00:03:31 All the 65 cases that were in under 18 year olds, 55 of them were in the zero to nine age group category. At the moment, it looks like the highest levels of invasive group a STR occurred in late December, 2022, but the numbers remain at much, much higher levels than expected. In January, February and March, all age groups are actually experiencing higher levels and there does seem to be a little bit of a shift in age groups where the rates in the under 18 year olds are now starting to decrease while the rates in the over 60 fives are increasing. This is why it's really important to be aware for symptoms for all age groups, young and old invasive group-based rep is no joke since October, 2022, so last October, there has been six invasive group, a strep related deaths in Ireland, four deaths in children age zero to nine years, and two in the 10 to 18 year old group there's also been 10 deaths in adults group, A strep infection can be a secondary infection, which happens as a result of a viral infection and invasive group. Speaker 1 00:04:40 A strep is when it becomes a serious infection, and it did look like this was happening as a result of the very high levels of respiratory disease that we had over the October to December period because remember, we did have an awful lot of R S V and flu circulating R S V and flu cases peaked before the end of 2022 and have steadily declined since. But the invasive group-based STR levels have remained high. So there is a thought that there's other factors contributing to the recent rise. In cases we do know that we're having high levels of other seasonal illnesses at the moment, like hand, foot and mouth and chickenpox. I'm not an immunologist, so I can't say that it's the overall infection rates across the board that are causing this rise, but it's definitely something that we all need to be aware of. So what is group A strep group? A streptococcus is a common bacteria. Lots of us carry it in our throats and on our skin and it doesn't always result in illness, but it can be responsible for some mild and some more serious infections when it becomes more serious. It's known as invasive group-based strep. This happens when the bacteria from the milder infection gets into parts of the body, body where it wouldn't normally be, such as the lungs or the bloodstream. It is this form of group A strep, the invasive form that can be fatal. Speaker 1 00:06:07 I just want to take a little break for a second to say that I'm delighted to partner again with one of my all-time favorite products. Salon Plus, this is the world's first a hundred percent natural dry salt therapy device. It's clinically proven to relieve a wide range of allergens and respiratory conditions. The salt therapy method has been trusted for generations and is now hugely popular worldwide. As more and more people recognize the superb results achieved from a natural and non-invasive method, this device will help you breathe easier and sleep better. Speaker 1 00:06:42 A normal group, a STR infection can cause illness in the form of scarlet fever, a sore throat, or even in pettigo. I think it's a good idea to just be aware of the symptoms of invasive group a strip. So if your child has gone through a period of being unwell, you can monitor their symptoms and keep an eye out for the following so that you know when you need to seek medical attention to ensure that if your child's group a strep has become invasive, that you can get the help that you need. These symptoms include a very high fever with severe muscle lakes if they get a lot of redness or blisters at the site of a wound because remember, strep can access the skin through the opening in the wound and it can access the blood supply that way. And obviously with children having maybe chickenpox, there is a potential for a lot of scratching and a lot of, a lot of little wounds being around and you know, I suppose a pathway for infection to access the body. Speaker 1 00:07:43 So you're always gonna look at each and every spot when your child has something like chickenpox or even if they just fall and get a cut, and you're gonna keep an eye to make sure that it's not getting very red, very swollen if there isn't a lot of heat around it. These are the things that you're looking out for. Other symptoms of invasive group, a strep include localized muscle tenderness. So if your child or yourself or an adult or an older adult are complaining of tenderness in one area of muscle, also low blood pressure and dizziness, this can be identifiable when you stand up in the morning if you feel very dizzy or throughout the day, especially going from sitting to rising. If you've come very dizzy, it is possible that your blood pressure is low. A patient with invasive group, a strep can also become very confused. They can be complaining of stomach pain and they can also suffer from nausea and vomiting. As I said there. Group A strep can be the cause of many normal illnesses such as tonsillitis, inigo, cellulitis, and it also is responsible for scarlet fever. Speaker 1 00:08:55 If your child is feeling very unwell with kind of flu-like symptoms, and if you're worried that it might be scarlet fever, easy ways to identify scarlet fever are first of all having a little look at their tongue at the beginning. It can be red and tender, a bit swollen, and then it can go on to get a a white coating, which may peel off, and they'll also have maybe swollen neck glands, a sore throat, a headache, and one of the more distinctive features is the rash. So a scarlet fever rash appears a day or two after the other symptoms, and it generally starts with red blotches that turn into a characteristic pink red rash, which feels like sandpaper. Some people think it looks like sunburn, but when you feel it, it is quite rough. It normally starts on the chest and back and spreads to other areas like the legs, arms, and groin. Speaker 1 00:09:49 It doesn't usually spread to the face, but what happens on the face is that your cheeks can become quite flushed. The rash with scarlet fever lasts around one week. If you notice this rash or the swollen tongue and your child is feeling unwell, it's important to note that antibiotics are recommended for the treatment of scarlet fever, so you will need to go to the GP in that case. Other situations that you might need to go to the GP if your child is unwell is basically anytime that they're getting dramatically and rapidly worse. If you're sitting with your child and you notice over a couple of hours that your child is just deteriorating quite rapidly, it's always important to go and seek medical attention in that situation. Also, because group A strep infections can cause a lot of conditions that present with sore throat like tonsillitis, you do need to watch out for signs of dehydration. Speaker 1 00:10:45 So if your child is in nappies and they haven't had a wet nappy for more than 12 hours, or if they're not taking at least half of their normal levels of fluids, then you should see the doctor. Also, if you've got a baby under three months and their temperature is over 38 degrees, you need to see the doctor and the same if they're older than three months and their temperature is 39 degrees or higher because there's also viral meningitis doing the rounds. It is important to say that if your child has a rash that doesn't fade when you press a glass on it, you should go to an emergency department. And also if your child has any difficulty breathing or their skin is very pale, cold or clammy and they have a little bit of blueness around their tongue or lips, these are all situations that you really need to go to an emergency department. Speaker 1 00:11:35 What can we do to help reduce the risk of infection when invasive group-based strep cases are high? Really, it's back to the good old hand hygiene and respiratory hygiene. So ensure to teach your child to keep wash, wash, washing those hands and to keep up up good cough and sneezing etiquette like using a tissue to catch coughs. And it's also important to just be aware of what's going on so that if your child is unwell, you really do need to keep them out of childcare or school and that just helps to stop infection spreading and hopefully reduce the number of cases of invasive group A strep. Something that you might find useful to know is that we stock the only licensed strep a home test that's available in Ireland. As far as I'm aware, it's available on our website, wonder care.ie. And the name of the product is Wand fo. Speaker 1 00:12:34 So if you search wand fo, so that's W O N D F O and it's the strep A test and you just swab the throat and it will let you know if strep A is present. This can be a helpful little test for reassurance, but obviously all of the same doctor referral requirements stand in place. Invasive group A strep really does need medical attention, and even if your child is being treated for a a normal group, a strep infection with antibiotics, and if they're not getting better after a couple of days of being on the antibiotics, it's important to go back to the doctor and let them know that because untreated or undertreated can lead to severe complications including blood poisoning, toxic shock syndrome, and damage to the kidneys. This episode hasn't been made to frighten you, but I just think it's really important to be aware that we are actually in a period of time where invasive group A strep cases are really high. Speaker 1 00:13:38 By being aware, we can be more vigilant, and hopefully we can ensure that any patients affected have better outcomes because they are more knowledgeable and are quicker to respond to symptoms as they see them happen. I really hope that you found this episode helpful. If you did and you're enjoying a Wonder Care podcast, it would be a huge help to me if you could follow and subscribe to the show. 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