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Less mixing between children due to the pandemic could have caused a drop in immunity to infections such as Strep A, a leading expert has suggested.

Six children have died in the UK after being found to have the bacterial infection and there have been more cases than normal this year.

Most Strep A cases are relatively mild and cause scarlet fever with symptoms such as a sore throat and a rash – which can be routinely treated with antibiotics.

However, the bacteria can sometimes get into the bloodstream or other parts of the body and become “invasive” and life threatening.

Microbiologist Dr Simon Clarke, from the University of Reading, said he wasn’t aware of any evidence of a new strain but suggested the COVID pandemic might have contributed to an increase in cases.

“It strikes me that as we are seeing with flu at the moment, lack of mixing in kids may have caused a drop in population-wide immunity that could increase transmission, particularly in school age children,” said Dr Clarke.

He said the cases didn’t appear to be linked – they are not clustered around any one area – but he believes “further cases over the coming weeks and months” are likely.

More on Strep A

The UK Health Security Agency (UKHSA) confirmed on Friday that invasive Strep A cases (known as iGAS) have increased this year.

The rate for this year is 2.3 cases per 100,000 children aged one to four, compared with an average of 0.5 in the pre-pandemic seasons (2017 to 2019).

Among five to nine-year-olds it’s 1.1 cases per 100,000 children, compared with the pre-pandemic average of 0.3.

Strep A is common and generally causes mild infections – so why the spate of deaths now?

Another death of a young child from Strep A will send a chill down the spine of any parent.

So what is the risk and why the spate of deaths now?

Group A streptococcus is a common bacterium that generally causes relatively mild infections, such as sore throats.

Only rarely does the bug get into the bloodstream or some other place in the body where it isn’t normally found, multiply rapidly and cause more serious problems.

Doctors call it invasive Group A Strep, or iGAS, and that seems to be what has resulted in these deaths.

There are different strains of Strep A, and some are more likely to cause serious disease.

We don’t know yet whether a particular strain is involved in these deaths.

But this isn’t a geographic cluster; the children lived far apart. So it’s not a bug that was passed from one to another.

It’s more likely that the common link is that the children didn’t get antibiotics in time.

Read more of Thomas Moore’s analysis here

Read more:
What is Strep A and what are the symptoms?

Strep A is common – so why the spate of deaths now?

The UKHSA also said there was no evidence of a new strain and that the increase is “most likely related to high amounts of circulating bacteria and social mixing”.

It said five children in England had so far died this season within a week of invasive Strep A, while one child has also died in Wales.

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Strep A: Parents to be ‘vigilant’

During the last high season (2017-2018), it said there were four deaths in England in the equivalent period.

Four-year-old Muhammad Ibrahim Ali, from High Wycombe, is one of the victims. He was described as a “wonderful, kind, smiley and energetic boy” on a JustGiving page set up in his memory.

Muhammad Ibrahim Ali
Pic:JustGiving
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Muhammad Ibrahim Ali died following a Strep A infection. Pic: JustGiving

It was also confirmed on Friday that a child from Ealing in west London had died.

Dr Yimmy Chow, from the UKHSA, said: “We are extremely saddened to hear about the death of a child at St John’s Primary School, and our thoughts are with their family, friends and the school community.

“Working with Ealing Council public health team, we have provided precautionary advice to the school community to help prevent further cases and we continue to monitor the situation closely.”

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Strep A outbreak in charts

A pupil at a primary school near Cardiff has also died from the infection, as well as a six-year-old in Surrey.

Meanwhile, the father of a four-year-old girl receiving critical care in hospital told Sky News he’s “praying for a miracle”.

Dean Burns’s daughter, Camila Rose Burns, has been fighting for her life at Alder Hey Children’s Hospital in Liverpool since Monday after she contracted the infection.

“She’s still nowhere near out of the woods, she’s really, really poorly,” he said.

Camila Rose Burns
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Camila Rose Burns is fighting for her life in a Liverpool hospital

Parents are advised to contact their GP or call 111 to get suspected scarlet fever cases treated quickly with antibiotics to limit its spread and reduce the risk of any complications.

It comes as the NHS also said children should be given a flu vaccination before Christmas following a surge in serious cases among under-fives.

Flu hospitalisations in young children are nearly 20 times as high as last year, figures suggest. This week, 230 under-fives were hospitalised, compared with just 12 at the same time last year.

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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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