The scarlet fever bacteria is causing more severely ill children this year

More children have died this year from group A streptococcal infection (GAS), a bacterium that can lead to severe pneumonia, septicemia, or subcutaneous infection, among other things. Juliana Children’s Hospital in The Hague reported last week that 61 children have been admitted to seven hospitals with serious gaseous infections since last summer. Five of them have not survived.

According to the RIVM, at least eight children have died in the Netherlands this year so far. After the spring peak, there has been an increase since October. The number of reports of critically ill children up to the age of five is more than four times higher than in previous years. The World Health Organization (WHO) is also seeing a resurgence of what is also known as scarlet fever bacteria in other European countries.

1 What are group A streptococci?

Group A streptococcus (GAS) is a bacterium that often goes unnoticed. Many people get around with it without getting sick. You can develop relatively mild complaints, such as laryngitis, scarlet fever or impetigo. In rare cases, the infection leads to something worse, such as severe pneumonia, septicemia, or meningitis. Pregnant women can develop puerperal fever after giving birth. But what is remarkable now is that it is very young children who are becoming most ill.

2 how many kids?

It’s hard to say. Physicians are required to report only three of the fifteen syndromes resulting from GAS infection to the RIVM: puerperal fever, toxic shock syndrome, and serious subcutaneous infections. Thus, the 38 children with invasive gas infections reported there as of mid-December are just the tip of the iceberg. The seven hospitals in the Juliana Children’s Hospital study actually had 28 children in the second quarter alone, with a larger group of severe infections.

3 What do these children have?

“They are very different pictures,” says pediatrician Miriam van Veen of Juliana Children’s Hospital. We see most of the children with complicated pneumonia, as well as septicemia and subcutaneous infections. These are very serious diseases. ” Almost a third of the children ended up in intensive care.

4 How can the increase be explained?

Typically, doctors see more A strep in the spring, when it gets warmer, often after a flu outbreak. The peak in fall and winter is exceptional, according to experts in the journal nature. The explanation may be that children have gained less immunity during lockdowns due to a lack of social interaction. Viruses such as influenza and RS virus also spread more quickly. In the UK, a revival of GAD can be seen in the scarlet fever figures. Scarlet fever (fever, sore throat, and rough patches on the skin in children) is caused by generalized anxiety disorder (GAD) and is four times more common this year.

5 Is group A streptococcus suddenly more contagious?

Many variants have been seen in children this year, says translated microbiology professor Nina van Sorg (Amsterdam UMC). There is a dominant type, but there don’t seem to be any new superbugs that often make children more dangerous. “In the 1980s, more penetrant variants emerged. But I haven’t yet seen any studies that indicate that.”

Despite all those different variants, from which you can get sick again and again, children gradually build immunity until they are almost adults. They get scarlet fever less often after the age of six.

6 Why do some children get sick more than others?

“Children who already have a viral infection are more susceptible to this type of bacterial infection,” says Van Sorge. In the event of chickenpox, influenza and respiratory infections, GPs are extra alert. There are good antibiotics for fighting group A streptococcus. “But the problem is that the disease progresses very quickly.” In rare cases, the antibiotics come too late.

The problem is that you only see group A streptococci when you grow them and the syndromes vary a lot. Van Veen: “There are many children who have a fever and don’t have anything serious, but if the child is sleepy, short of breath, or less energetic, that’s a reason to see a doctor.”

7 Is there a vaccine against group A streptococci?

Van Sorge says we’ve been working on this for years. She points out that 700 million people worldwide get sick from these bacteria each year, with as many deaths as the flu. So she’s been asking for group A streptococcus attention for some time. “One of the reasons it’s complicated to develop a vaccine is that after a gas gas infection, sometimes defenses against the body also occur, and you don’t want a vaccine to trigger an autoimmune disease.” Van Sorge believes a vaccine will be at least ten years away.

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