From the Headlines: The Rising Danger of Strep A

If you or your loved ones have experienced the consequences of a misdiagnosis of Strep A or iGAS, our team is here to offer assistance. With experience of 50 years in handling medical negligence claims, we are well-equipped to support you. Our medical negligence solicitors, located in Dublin, Limerick, and Cork are accessible nationwide. We are ready to listen to your story, provide counsel, and guide you through this process.

You can rely on us to engage medical experts, liaise with the Health Service Executive (HSE), and handle all the necessary medico-legal paperwork, allowing you to focus on moving forward as best as you can.

That was the case when HOMS Assist represented the Cork-based Murphy family at the Dublin District Coroner’s Court, where it was found that their 10-year-old daughter, Vivienne, died after doctors failed to diagnose Strep A. Coroner Dr. Cróna Gallagher recorded a verdict of death by medical misadventure, noting that this was an extremely complex medical case of sepsis. She also welcomed any efforts to increase awareness in relation to Strep A.

What is Strep A?

Strep A, also known as Group A Streptococcus, is a common bacteria responsible for a wide range of infections found in children, adults and the elderly. It most often causes throat and skin infections, and occasionally more serious conditions such as scarlet fever, Streptococcal toxic shock syndrome, and even necrotising fasciitis (often referred to as “flesh-eating disease”).

Strep A bacteria is typically transmitted through respiratory droplets or direct contact with infected individuals, which means it easily spreads in busy environments like schools or hospitals. Symptoms of Strep A infections can include sore throat, fever, swollen lymph nodes, and a characteristic red rash in the case of scarlet fever

“The most serious infection caused by Group A Streptococcus occurs when it becomes invasive,” notes the Health Protection Surveillance Centre (HPSC). “That is when the bacteria gets into parts of the body where it is not normally found, such as the lungs or bloodstream. This is called invasive Group A Strep (iGAS) and in rare cases, it can be fatal.”

A rise in cases

The fact that Strep A shares some symptoms with common colds and viruses makes it susceptible to misdiagnosis, which can have deadly consequences. Between 2nd October 2022 and 10th June 2023, 384 cases of iGAS were notified in Ireland. There have been 12 deaths in children and 13 in adults since October 2022. 

“Whilst iGAS infections are still uncommon, there has been an increase in cases this year reported in Ireland since October 2022, particularly in children under 10 and sadly, a small number of deaths,” says the HPSC.

They suggest that this increase may be due to a number of factors, including more social mixing, as well the effects of higher levels of chickenpox and respiratory viruses such as COVID-19, the ‘flu and Respiratory Syncytial Virus (RSV).  “Rates of iGAS are highest at extremes of age — in children and the elderly,” Michael Marks, an associate professor at the London School of Hygiene & Tropical Medicine, told The Washington Post. “This is not fully understood but may reflect immunity.” 

The worrying rise in infection rates is not limited to our country, either: The World Health Organisation has found that similar increases in invasive Group A Streptococcus disease and scarlet fever in children under 10 have been observed during 2022 in France, the Netherlands, Sweden, and the UK, which recorded 426 iGAS-related deaths across all age groups in England so far this season.

Further research is underway in Ireland, chiefly by The Irish Meningococcal and Sepsis Reference Laboratory (based in the Children’s University Hospital, Temple Street). They are investigating if a particular strain of Group A Streptococcus infection (or Strep A) is responsible for the increase in iGAS infections.

Strep A

Early diagnosis is key

With Strep A infections, every minute counts because early diagnosis can greatly improve the outlook for sufferers. This means that it’s important to note the most common symptoms, which the HSE says include:  

  • Sore throat
  • High temperature (38°C or above)
  • Chills
  • Muscle aches
  • Minor skin infections
  • Scarlet fever rash

In children, these issues can rapidly progress to more serious problems which need rapid medical care. The HSE recommends that you should contact your GP urgently if your baby or child displays the following symptoms: 

  • Feeding, eating or drinking much less than normal
  • A dry nappy for 12 hours or more or other signs of dehydration
  • A temperature of 38°C or above (if under 3 months)
  • A temperature of 39°C or above (if older than 3 months)
  • Feels hotter than usual when you touch their back or chest, or feels sweaty
  • Fatigue or irritability

Advising parents to trust their instincts and “contact your GP, GP out-of-hours or emergency department if you are worried about your child”, they also recommend that you call 999 or 112 or go to your hospital emergency room immediately if: 

  • Your child is having difficulty breathing (you may notice grunting noises or their tummy sucking in under their ribs)
  • Your child’s breathing is interrupted by pauses
  • Your child’s skin, tongue or lips are blue
  • Your child is floppy and will not wake up or stay awake

Increased awareness

The Murphy family have bravely spoken about their tragic experience in order to raise awareness about this rare but deadly disease. 

Speaking to Raidió Teilifís Éireann (RTÉ), Dermot Murphy, the father of little Vivienne said: “If your child has a fever, or a rash, be vigilant, these things can change so quickly. Our daughter started off with signs and symptoms and within ten days she was gone.” 

“Even four years later time hasn’t dented the pain,“ her mother Lilly added. “When we found out what it was, how curable it was, and we were asked to swallow that bitter pill, that is the problem for me, it was such an easy thing to cure with antibiotics. That’s what we are struggling with, and probably will keep struggling with.”

In an effort to better educate and inform our team, HOMS Assist recently invited Dr David Sharpe KC SC, to visit and speak on medico-legal Issues relating to scarlet fever and Group A Streptococcal infections. Dr Sharpe, who has dual qualifications in medicine and law, shared his unique knowledge on this extremely topical issue, which is increasingly contributing to claims of medical negligence in Ireland

If you or your family have been affected by Strep A or iGAS, our team can help. We have a combined 50 years of experience of medical negligence claims and medical care claims. Based in Limerick, Cork and Dublin, our best medical negligence solicitors are available throughout the country to hear your story and provide advice and guidance. You can trust us to engage medical experts, communicate with the HSE and take care of all the medico-legal admin, while you get on with navigating your new normal, whatever that may look like now.  If you’d like to talk, we’re on hand at 1800207207 or via our website.

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