Potentially deadly Strep A cases are on the rise in children as the WHO warns countries to ‘be vigilant’

The U.S. Centers for Disease Control and Prevention is also looking into a “possible increase” in such cases among children, according to the agency’s website.

A higher than usual number of cases of invasive Strep A cases—some leading to scarlet fever, and often in children under 10—has already been seen this season in France, Ireland, the Netherlands, Sweden, the U.K., and Northern Ireland, according to a situation report released Thursday by the WHO.

“An alert has been issued to other countries to be vigilant for a similar rise in cases and to report any unexpected increased national or regional incidence” to the international health agency, the report stated.

Strep A season may be off to an early start, the report noted. RSV and flu are also off to early and severe starts this year, circulating at epidemic levels in the U.S. Combined with the COVID pandemic, public health experts are calling the phenomenon a “tripledemic.” But other pathogens are circulating at increased levels. Influenza-like illnesses like rhinovirus and enterovirus, as well as Strep A, are being seen more frequently than usual this fall in many countries throughout the world.

Respiratory viruses can lead to a co-infection with Strep A, the WHO said. So, an uptick in such viruses could lead to an uptick in Strep A cases.

Group A Streptococcal infections usually lead to mild illness like tonsillitis, pharyngitis, impetigo, cellulitis, and scarlet fever. But Strep A, a bacteria, infects areas of the body that are usually sterile—like blood, deep muscles, fat, and the lungs—it can cause a more severe illness known as invasive Strep A, which can lead to death.

The uptick in invasive Strep A infections has been seen all year in some countries, but has become worse this fall, the WHO said.

In Ireland, 23 cases have been reported since October, compared to 11 cases in 2019, before the pandemic. In the Netherlands, cases began increasing in March, and some patients have also had coinfections with respiratory viruses and varicella zoster, a herpes virus that can cause chickenpox and shingles. And Sweden has seen 93 cases since October, compared to seven cases during the same span in 2018 and 10 cases during the same span in 2019, the agency noted.

England saw higher-than-usual levels of scarlet fever this summer, and is now receiving reports of nearly four times more scarlet fever patients than usual, with 4,622 cases reported in a recent six-week period. Scarlet fever outbreaks are being reported in daycares and schools, according to the UK Health Security Agency.

This is a developing story and will be updated.

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