Scottish Strep A cases likely to 'rise over the coming weeks'

Answering a topical question on the surge in cases that has led to nine deaths in children in England, Wales and Northern Ireland, the Health Secretary told MSPs that while numbers were high in Scotland, they had not “significantly” exceeded the peaks of previous years. 

However, Mr Yousaf said the government was not complacent. He said they expected "cases to rise over the coming weeks."

“A number of children from England and Wales have sadly died from invasive group A strep infection since September. My deepest condolences go out to their families during this unimaginably difficult time. 

“Reports of group A strep infections or Gas as it's known have increased right across Scotland.

“There have been no reported deaths in Scotland related to group A strep or indeed invasive, group A strep conditions. 

“I understand, of course, that the reporting of Gas conditions will be concerning and let me offer some reassurance, the vast majority of Gas infections present as mild illness that is easily treated by penicillin or indeed other antibiotics. 

“Invasive infections are thankfully very rare. 

“Peaks in Gas infections are expected during winter and spring, typically with spikes every three or four years. Current numbers do not significantly exceed previous spikes. 

“Nonetheless, of course, we're not complacent. Health services right across Scotland are on alert. They will act swiftly to identify and treat Gas infection." 

Tory health spokesperson Sandesh Gulhane - a working GP - told the chamber that the symptoms for Strep A include, “a sandpaper like rash, flu symptoms, so temperature over 38, sore throat, swollen glands, a strawberry-red looking tongue.” 

“I would urge people who have symptoms like this, especially in those children around under 10, to speak to their GP because antibiotics can very much help in these cases.”

He asked if the Scottish Government was “actively considering prophylaxis.”

Mr Yousaf replied: “I've asked the Public Health Scotland and my clinical colleagues to give advice to that effect.

"What I would say is the levels of Gas infection that we're seeing and again, thankfully, of group A strep that is not invasive, those cases are mild. 

“The levels we've seen have not been or exceeded the peak levels that we've seen in previous years. 

“And thankfully, we've not seen any deaths so far in Scotland, but we're not complacent. 

“We do expect cases to rise over the coming weeks, and hence why I've asked clinicians to give advice about the very issue that Sandesh Gulhane has raised.”

Dr Gulhane said multiple patients had expressed concern over the virus, this anxiety, he added, was “only exacerbated when parents know that if their child does get sick, they will struggle to get an appointment with their GP, spend hours waiting for NHS 24, many hanging up with frustration or spending even longer in an A&E waiting room.” 

He asked Mr Yousaf to promise patients they “won't be spending 12 hours plus in an A&E waiting room this Christmas.”

The SNP minister said Public Health Scotland had already issued an alert to health care services in Scotland “to be aware of the increase in incidence and potential severity of group A strep infections and its complications”.

He said primary care clinicians had been told: “to take a low threshold to prescribing antibiotics, as penicillin is the first line therapy to children that are presenting with features of Gas infection.” 

“I saw some media reports around potential shortages in other parts of the UK in relation to amoxicillin. I've checked with my clinicians and indeed with the chief pharmaceutical officer, and she advises there are no shortages of penicillin. 

“So yes, I'm confident that if people, parents in particular, raise cases with their GP that they will be seen and given be given the appropriate treatment.” 

Labour health spokesperson Jackie Baillie also raised the record waiting times in hospitals across Scotland, and asked if “additional capacity and guidance has been provided to health boards to ensure that children taking unwell can be seen without any delay?”

Mr Yousaf told the MSP that as well as Strep A there was a spike in other respiratory viruses, which had led to an increase in attendance at children's hospitals. 

He said NHS 24 had told him of a “markedly significant increase in calls about children under the age of 14”. 

“So all of our health care services right across the board, are being given the appropriate advice in terms of what they can tell parents, the advice that they can give to parents and those that call in with concerns about Strep A. 

“But that is not just NHS 24, it's right across the board, of course, including our accident and emergency services. 

He said anyone concerned about strep A should go to their GP.

Earlier in the day, staff at the Black Mountain Primary School in Belfast paid tribute to Stella-Lilly McCorkindale, a five-year-old who died after contracting the illness.

The P2 pupil from the Shankill Road area of the city was taken into intensive care at the Royal Belfast Hospital for Sick Children last week, but passed away on Monday.

The school described it as a "tragic loss to the Black Mountain Primary School family and our school community, and the thoughts of the entire school are with Stella-Lily’s family and friends at this sad and difficult time."

Dr Colin Brown, the deputy director of the UK Health Security Agency (UKHSA) told Sky News that a lack of mixing due to the Covid pandemic plus susceptibility in children is probably “bringing forward the normal scarlet fever season” from spring to this side of Christmas.

He said: “There isn’t something that is particularly new or novel about the bacteria that are causing the infections that we’re seeing at the moment.

“We are seeing a larger number of infections, for example, causing scarlet fever, than we would normally see this time of year.”