Why are parents in Tayside and Fife being told less about Strep A cases than in England?

Parents in Tayside and Fife are calling for more guidance from local health boards as Strep A case numbers rise across the country.

Public Health Scotland (PHS) confirmed on Wednesday that 13 cases of Invasive Group A Streptococcal (IGAS) have been identified in children under 10 in the last nine weeks.

However, many local parents are expressing confusion after hearing on social media and in local schools about many more children suffering Strep A-like symptoms.

While Group A Strep (GAS) infections – including scarlet fever – are common, the more serious IGAS infections, when the bacteria gets into the bloodstream for example, are rare.

We asked NHS Tayside, NHS Fife and PHS the following questions:

• Can you confirm how many cases are in Tayside and Fife currently?
• Why are parents in Tayside and Fife being told less about Strep A cases than in England?
• If cases were to increase, what public health measures would be put in place?
• What would case numbers have to be for measures, for example closing nurseries, to be introduced?
• Are there Tayside or Fife teams responsible for public health measures and what are their responsibilities in this situation?
• Can you confirm there are adequate supplies of antibiotics in NHS Tayside and NHS Fife to treat this?

What did they say?

NHS Tayside and NHS Fife told us the Strep A response is being dealt with by PHS and all inquiries should be directed to them.

PHS say: “Currently, there is an unseasonable increase in upper respiratory tract GAS being reported in Scotland (the proxy measure for scarlet fever).

“However, overall numbers are similar to peaks seen in previous years.”

For the latest information and advice on Strep A and Scarlet Fever please visit @P_H_S_Official at https://t.co/77kvmU63eu

Their most recent update is at https://t.co/Vzs0olkByn

You can also find more info on @nhsinform: https://t.co/5lhs4vruiy https://t.co/9UBusggn1h

— NHS Tayside (@NHSTayside) December 8, 2022

Strep A reporting: How Scotland and England compare

To find out how many cases of Strep A there are, throat and nose swabs are routinely taken from both adults and children.

However, not all people who present to healthcare with scarlet fever will have a swab taken for confirmation of GAS infection.

PHS break down case numbers and report that to date there have been 800 GAS reports which include scarlet fever and 25 more serious IGAS cases, 13 of which are children under 10.

They add: “We are unable to provide a breakdown of locations due to the small numbers involved.”

This is usually the case when there are fewer than five cases in a local authority area as it could lead to the identification of patients.

PHS did not provide a local breakdown of the 800 upper respiratory tract (including scarlet fever) GAS cases.

However, in England — where scarlet fever remains a notifiable disease — the UK Health Security Agency is publishing weekly updates showing common and IGAS case numbers and rates by region.

Parents react

One Angus father, who did not wish to be named, told us: “I think it is a disgrace that NHS Tayside, or whichever government body is handling this, are not forthcoming with important information to help us protect our kids from what could be a dangerous infection.

“Would it be better keeping our kids off school until New Year to avoid Christmas being ruined for the second time in three years?

“Should schools be giving out antibiotics as a precaution?

“Just let us know where the cases are and we can make an informed decision.”

Others told us on social media their children had been prescribed antibiotics for Strep A. And many more expressed concern.

One parent said: “I’m contemplating just keeping my youngest off he isn’t well at the best of times. This is worrying me.”

Across the UK, 15 children have died after IGAs infections since September. There have been no confirmed deaths in Scotland.

Nicola Sturgeon said the issue will be discussed at the next Scottish cabinet meeting on Tuesday.

At First Minister’s Questions, she said case numbers are rising but “are not particularly exceeding previous spikes.”

She added: “However there is no room for complacency and we will continue to monitor the situation very closely.”

Health Secretary Humza Yousaf reassured parents there is no shortage of antibiotics needed to treat Strep A in Scotland.

And PHS said local health boards would advise further on local public health measure if required.