DOCTORS in Glasgow are to lead an investigation into the winter outbreak of Strep A among children.

There were 59 reports of invasive Group A Streptococcus (iGAS) infections - including three deaths - among children under 10 in Scotland between October 2022 and March 26 this year. 

The total number of deaths in all age groups was 32, compared to a previous high of 15 in past years. 

However, this partly reflected a spike both Strep A and iGAS cases. 

The case-fatality ratio for iGAS, at 11.1%, was similar to the 9.9% recorded in 2017/18. 

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Most Strep A infections caused mild illness such as tonsillitis, impetigo, cellulitis and scarlet fever. 

However, in rare cases the bacteria can enter the bloodstream or organs to cause iGAS, a form of toxic shock syndrome which can be life-threatening. 

The spike in Strep A infections in December last year piled pressure on the NHS at a time when it was also dealing with "extraordinary" levels of flu, a rise in Covid, staff shortages, and huge waiting list backlogs. 

The number of families attending the paediatric A&E department at the Royal Hospital for Children (RHC) in Glasgow hit record levels.

The Herald: There were very few cases of iGAS among children under 10 in 2020 or 2021 wintersThere were very few cases of iGAS among children under 10 in 2020 or 2021 winters (Image: PHS)

A new £20,000 study into the outbreak, funded by the Glasgow Children’s Hospital Charity, will be led by Dr Ross Langley - a paediatric respiratory and sleep consultant at the RHC - and paediatric respiratory registrar, Dr Thomas Williams.

The team hope to gain scientific insights into the disease and inform hospital policies, both within NHS Greater Glasgow and Clyde and across the country, should there be another surge in cases in the future.

The study will examine the increase in Strep A cases, what may have caused the higher rates, and whether disease presentations for the infection have changed.

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It will examine the role that these cases played in attendances to the RHC A&E at the end of last year, and why this record-breaking winter was worse than previous years.

The team will also evaluate links to wider viral infection rates at the time, and conduct whole genome sequencing of the Strep A strains that caused severe disease.

Dr Langley said he was hopeful that the results "will inform clinicians, both locally and nationally, on how best to manage future outbreaks".

The Herald: Total iGAS cases, deaths, and case-fatality ratio in Scotland, by year for all age groupsTotal iGAS cases, deaths, and case-fatality ratio in Scotland, by year for all age groups (Image: PHS)

Dr Williams said the RHC had been faced with "an unprecedented number of children" presenting with severe group A Streptococcus respiratory infections this past winter. 

He said: “This funding from Glasgow Children's Hospital Charity will allow us to investigate why Strep A infections presented in this unusual manner this winter, and inform not just local hospital policies, but potentially also Strep A vaccine implementation in the future.”

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Kirsten Watson, CEO of Glasgow Children’s Hospital Charity, said: “Glasgow Children’s Hospital Charity is proud to be funding this vital study into the Strep A outbreak amongst children.

"We are committed to supporting research studies, having invested over £2million into paediatric research since 2014.

"We rely on the generosity of our donors, fundraisers and volunteers to enable us to support this incredibly important area of work.”