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UK health officials are advising schools on how to combat Strep A infections after the deaths of four children.

The UK Health Security Agency (UKHSA) has said that the figures for the disease are higher this year compared to the previous two.

The increase in cases is likely the result of the withdrawal of measures implemented during the COVID pandemic, they add.

The UKHSA advises those who come down with the illness to exclude themselves from nursery, school or work for at least 24 hours after they start antibiotic treatment.

What is Strep A – or GAS?

Strep A – or Group A streptococcus (GAS) – is a type of bacterium found in the throat and on the skin and in most people does not cause any symptoms – known as being “colonised”, the NHS says.

However, it can cause a range different illnesses of the nose, throat and lungs.

It can be spread through coughs, sneezes and skin-to-skin contact.

Those carrying the bacteria may have no symptoms, but are just as likely to pass on Strep A as those who have fallen ill.

Symptoms for Strep A include pain when swallowing, fever, swollen tonsils with white patches, swollen neck glands, a high temperature or a skin rash.

The bacteria can also cause any of the following:

  • tonsillitis
  • pharyngitis
  • scarlet fever
  • skin infections like impetigo or erysipelas
  • cellulitis
  • pneumonia

Most cases of throat infection will get better on their own without treatment. Skin infections may require antibiotics.

However, GAS can also, on occasion, cause very severe infections – known as invasive GAS (iGAS).

What is iGAS?

Invasive GAS disease happens when the bacterium gets past the body’s natural defences and enters parts of the body where it is not usually found, like through the blood, deep muscle or lungs.

The most severe forms of invasive GAS disease are Streptococcal Toxic Shock Syndrome – symptoms of which include high fever, low blood pressure, scarlet fever, kidney or liver damage and vomiting and diarrhoea – and Necrotising Fasciitis or “flesh-eating disease”, which is an infection that causes tissue to become destroyed and requires surgery. Both of these are rare, but Toxic Shock Syndrome has a high death rate.

Treatments include different types of antibiotics, and depending on how severe the symptoms are, blood transfusions may be given.

What are the symptoms of iGAS?

Early signs and symptoms of invasive GAS include:

  • high fever
  • severe muscle aches
  • pain in one area of the body
  • redness at the site of a wound
  • vomiting or diarrhoea

How common is it in the UK?

iGAS disease is rare. There are between two and four cases per 100,000 people each year.

Ashish Joshi, Sky News health correspondent, said: “Parents need to be vigilant but not unduly concerned.

“While there is an uptick in cases, there haven’t been many over the last few years because the COVID pandemic meant there were restrictions on people’s movement.”

He added: “It is a very common bug that children and adults can pick up, although the tragedies we are aware of tells there is a higher amount of more dangerous cases affecting children in a more dangerous way.

“But we mustn’t be alarmed, and mustn’t be saying all children will become ill and some may die.

“That said, it’s important that parents, who will naturally be worried, should just be vigilant of the signs.”

Is Strep A (GAS) dangerous and am I at any increased risk of this disease?

It can be a serious illness, but if treated promptly with antibiotics, it is less of a threat. After at least 24 hours of antibiotics, it is generally thought to no longer be contagious.

People at risk of catching the infection include those who are:

  • in close contact with someone that has Strep A
  • over the age of 65
  • have HIV
  • use steroids or other drugs
  • have diabetes, heart disease or cancer

Which version of Strep A has caused the children to die?

So far, four school-age children have died.

The deaths of a child in Ealing, west London, and a child in Buckinghamshire have been confirmed as iGAS, according to the UKHSA.

It’s not yet clear if this is also true for the other two children.

One was a pupil at a primary school near Cardiff, and another was a pupil at Ashford Church of England School in Surrey.

What should you do if you have symptoms?

Contact your GP and get medical advice straight away if you believe you or your child have symptoms of either GAS or iGAS.

Strep throat should be different from a regular sore throat, as the pain can come on quickly.

In response to the latest outbreak, a UK Health Security Agency (UKHSA) spokesman said: “As part of our public health response to last week’s tragic news, we issued some general information about the signs and symptoms of scarlet fever, which is not uncommon, to schools in the vicinity of Ashford Primary.

“A number of other illnesses typically circulate at this time of year and parents, school and nursery staff are advised to be aware of the symptoms, to keep up with vaccinations and to seek advice from NHS 111 if they have concerns.”

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UK on ‘slippery slope’ to ‘death on demand’, Justice Secretary Shabana Mahmood warns ahead of assisted dying vote

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UK on 'slippery slope' to 'death on demand', Justice Secretary Shabana Mahmood warns ahead of assisted dying vote

The UK is on a “slippery slope towards death on demand”, according to the justice secretary ahead of a historic Commons vote on assisted dying.

In a letter to her constituents, Shabana Mahmood said she was “profoundly concerned” about the legislation.

“Sadly, recent scandals – such as Hillsborough, infected blood and the Post Office Horizon – have reminded us that the state and those acting on its behalf are not always benign,” she wrote.

“I have always held the view that, for this reason, the state should serve a clear role. It should protect and preserve life, not take it away.

“The state should never offer death as a service.”

Analysis: Justice secretary’s intervention is potentially embarrassing for the PM

On 29 November, MPs will be asked to consider whether to legalise assisted dying, through Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill.

Details of the legislation were published last week, including confirmation the medicine that will end a patient’s life will need to be self-administered and people must be terminally ill and expected to die within six months.

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Minister ‘leans’ to assisted dying bill

Ms Mahmood, however, said “predictions about life expectancy are often inaccurate”.

“Doctors can only predict a date of death, with any real certainty, in the final days of life,” she said. “The judgment as to who can and cannot be considered for assisted suicide will therefore be subjective and imprecise.”

Read more: Gordon Brown says assisted dying should not be legalised

Under the Labour MP’s proposals, two independent doctors must confirm a patient is eligible for assisted dying and a High Court judge must give their approval.

The bill will also include punishments of up to 14 years in prison for those who break the law, including coercing someone into ending their own life.

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Details of end of life bill released

Read more: Where does the cabinet stand on assisted dying?

However, Ms Mahmood said she was concerned the legislation could “pressure” some into ending their lives.

“It cannot be overstated what a profound shift in our culture assisted suicide will herald,” she wrote.

“In my view, the greatest risk of all is the pressure the elderly, vulnerable, sick or disabled may place upon themselves.”

Kim Leadbeater waits to present the Assisted Dying Bill. File pic: House of Commons/Reuters
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Kim Leadbeater waits to present the Assisted Dying Bill. File pic: House of Commons/Reuters

Labour MP Kim Leadbeater, who put forward the bill, said some of the points Ms Mahmood raised have been answered “in the the thorough drafting and presentation of the bill”.

“The strict eligibility criteria make it very clear that we are only talking about people who are already dying,” she said.

“That is why the bill is called the ‘Terminally Ill Adults (End of Life) Bill’; its scope cannot be changed and clearly does not include any other group of people.

“The bill would give dying people the autonomy, dignity and choice to shorten their death if they wish.”

In response to concerns Ms Mahmood raised about patients being coerced into choosing assisted death, Ms Leadbeater said she has consulted widely with doctors and judges.

“Those I have spoken to tell me that they are well equipped to ask the right questions to detect coercion and to ascertain a person’s genuine wishes. It is an integral part of their work,” she said.

In an increasingly fractious debate around the topic, multiple Labour MPs have voiced their concerns.

In a letter to ministers on 3 October, the Cabinet Secretary Simon Case confirmed “the prime minister has decided to set aside collective responsibility on the merits of this bill” and that the government would “therefore remain neutral on the passage of the bill and on the matter of assisted dying”.

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Justice secretary’s assisted dying intervention is explosive – and potentially embarrassing for PM

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Justice secretary's assisted dying intervention is explosive - and potentially embarrassing for PM

With six days to go before Friday’s historic Commons showdown on assisted dying, it’s the opponents who are turning up the heat.

The explosive attack on the bill by Shabana Mahmood follows the poignant and personal plea from Gordon Brown to MPs to reject the bill.

We knew the justice secretary is opposed to the bill. She has already made that clear. But her attack on it, in a letter to constituents, is brutal.

Read more: UK on ‘slippery slope’ to ‘death on demand’, warns justice secretary

She talks about a “slippery slope towards death on demand”. Savage. The state should “never offer death as a service”, she says. Chilling.

So much for Sir Keir Starmer attempting to cool the temperature in the row by urging cabinet ministers, whatever their view, to stop inflaming or attempting to influence the debate.

Ms Mahmood talks, as other opponents have, about pressure on the elderly, sick or disabled who feel they have “become too much of a burden to their family”.

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Details of end of life bill released

She hits out at a “lack of legal safeguards” in the bill and pressure on someone into ending their life “by those acting with malign intent”.

Malign intent? Hey! That’s quite an assertion from a secretary of state for justice and lord chancellor who’s been urged by the PM to tone down her language.

It’s claimed that Sir Keir ticked off Wes Streeting, the health secretary, after he publicly opposed the bill and launched an analysis of the costs of implementing it.

Read more: Where does the cabinet stand on assisted dying?

Will the justice secretary now receive a reprimand from the boss? It’s a bit late for that. Critics will also claim Sir Keir’s dithering over the bill is to blame for cabinet ministers freelancing.

Shabana Mahmood is the first elected Muslim woman to hold a cabinet post. Elected to the Commons in 2010, she was also one of the first Muslim women MPs.

She told her constituents in her letter that it’s not only for religious reasons that she’s “profoundly concerned” about the legislation, but also because of what it would mean for the role of the state.

But of course, she’s not the only senior politician with religious convictions to speak out strongly against Kim Leadbeater’s bill this weekend.

Gordon Brown. File pic: PA
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Gordon Brown. File pic: PA

Gordon Brown, son of the manse, who was strongly influenced by his father, a Church of Scotland minister, wrote about his opposition in a highly emotional article in The Guardian.

He spoke about the pain of losing his 10-day-old baby daughter Jennifer, born seven weeks prematurely and weighing just 2lb 4oz, in January 2002, after she suffered a brain haemorrhage on day four of her short life.

Read more: Gordon Brown says assisted dying should not be legalised

Mr Brown said that tragedy convinced him of the value and imperative of good end-of-life care, not the case for assisted dying. His powerful voice will strongly influence many Labour MPs.

And what of Kim Leadbeater? It’s looking increasingly as though she’s now being hung out to dry by the government, after initially being urged by the government to choose assisted dying after topping the private members bill ballot.

All of which will encourage Sir Keir’s critics to claim he looks weak. It is, or course, a private members bill and a free vote, which makes the outcome on Friday unpredictable.

But the dramatic interventions of the current lord chancellor and the former Labour prime minister are hugely significant, potentially decisive – and potentially embarrassing for a prime minister who appears to be losing control of the assisted dying debate.

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Max Verstappen wins Formula One world title for a fourth straight year

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Max Verstappen wins Formula One world title for a fourth straight year

Red Bull driver Max Verstappen has won the Formula One world title for a fourth straight year.

His victory was confirmed after finishing fifth at the Las Vegas Grand Prix. Mercedes’ George Russell won the race.

Max Verstappen celebrates his win. Pic: Reuters
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Pic: Reuters

The 27-year-old Dutchman becomes just the sixth driver in Formula One history to win four titles or more, after outscoring Lando Norris who took the chequered flag in only sixth.

Verstappen is now guaranteed the world crown with two races still remaining, with his domination cementing his name among Formula One’s greats.

“Oh my God man,” said an emotional Verstappen after securing the world title. “What a season. Four times. It was a little bit more difficult than last year.”

Lewis Hamilton raced back from 10th to second place to complete an impressive one-two finish for Mercedes. Carlos Sainz finished third for Ferrari, one place ahead of his team-mate Charles Leclerc.

Russell’s third victory was the most dominant of his career so far, crossing the line 7.3 seconds clear of Hamilton.

More on Formula 1

Michael Schumacher and Lewis Hamilton have each won a record seven, with 1950s Argentine legend Juan-Manuel Fangio on five ahead of Alain Prost, Sebastian Vettel and now Verstappen on four.

Having won every Drivers’ Championship since claiming his first in the controversial end to the 2021 season when he beat Hamilton in deeply contentious circumstances, Verstappen now joins Hamilton, Fangio and Vettel in winning four titles consecutively.

Only Schumacher has achieved a run of five.

Red Bull's principal sponsor Christian Horner on the Las Vegas Strip Circuit. Pic: Reuters
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Red Bull’s principal sponsor Christian Horner on the Las Vegas Strip Circuit. Pic: Reuters

The team were hit by controversy earlier this season, with Red Bull’s principal sponsor, Christian Horner, facing allegations of controlling behaviour by a female staff member. Horner, who denied the accusations, was cleared, and a subsequent appeal was thrown out.

Horner congratulated Verstappen on the radio, telling him: “Max Verstappen you are a four-time world champion. That is a phenomenal, phenomenal achievement. You can be incredibly proud of yourself.”

Red Bull is on course to finish third in the constructors’ championship this year. This century only Hamilton in 2008 with McLaren, and Verstappen in 2021, have won the drivers’ title when their team did not win the constructors’ championship.

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