Watch out for streptococci, reports the Flemish Agency for Care and Health. This season there has been a remarkable upsurge of the bacteria, with noticeably more young children having to be admitted to hospital. But what are those streptococci actually? And when should you go to the doctor?
1. What Are Streptococci?
‘This is a bacteria that is present in the nose of 10 to 20 percent of children without causing problems,’ says doctor Daan Van Brusselen, pediatric infectious disease specialist in the GZA hospitals in Antwerp. ‘But it is the most common cause of bacterial throat infections in children and we are also seeing it recur in the form of an illness such as scarlet fever. These are often teething problems that we worry less about.’
‘But occasionally a number of more invasive infections also occur, often caused by a somewhat more virulent (with a higher risk of illness, ed.) strain of the streptococci’, Van Brusselen continues. ‘Recently, the slightly more virulent EMM4 strain appeared to be circulating in the Netherlands. In some more serious cases – but still exceptionally – we see more serious symptoms, such as severe pneumonia with pus on the lungs. Also possible is toxic shock syndrome (TSS), with a rapid drop in blood pressure and a patient who deteriorates severely. Other syndromes are inflammatory wounds, as is typical after chicken pox, which fester and can cause unsightly skin necrosis.’
2. Who is most at risk of developing the disease?
‘Who sees this more serious form of streptococci, especially in children under the age of four,’ says Van Brusselen. ‘But both here and internationally there are certainly examples of children up to the age of ten and a number of adolescents have also been hospitalized with it.’
3. When should you sound the alarm as a parent?
‘Actually, this is not so different from what parents usually do,’ says Van Brusselen. ‘If your child is mildly ill and runs a fever, you don’t have to panic right away. But if it is not over after three days and using an antipyretic – preferably paracetamol -, if the child continues to deteriorate, if it does not want to drink, eat or play and looks drowsy and weak … Yes, then those are certainly reasons to go to the doctor. With babies under three months, you should always go to the doctor if they have a fever. They are the same alarm signals as the classic infectious diseases we already know.’
4. How is it treated?
‘Antibiotics work well against this and that is also the classic approach. In the case of a more serious form, a course of two types can be prescribed. That streptococcus is a bacteria that typically produces a lot of toxins and a specific antibiotic can help to counteract that. Purulent lungs may require drainage, and a purulent skin infection sometimes requires surgical treatment. But I emphasize: those are the exceptional cases.’
5. Do you become immune to strep once you’ve had it?
‘Unfortunately not,’ says Van Brusselen. ‘That’s because there are different variants, which vary slightly every year. Sometimes a more virulent strain is circulating. One theory among pediatricians is that children have been able to train their immunity a little less due to the corona period. Because there has been less exposure to many diseases for a few years now, they have an ‘immunity debt’, and can now get sick more quickly. Hence perhaps the outbreak of RSV earlier this winter and now also the somewhat more robust form of streptococci. Children will catch up, but now they have to get through it.’
6. Can you reduce the risk of infection? Is there a vaccine?
Doctor Van Brusselen refers to the corona pandemic: ‘We should have learned that: if you are sick, you stay at home. This can contribute to a general reduction in circulation. But if you send your child to nursery or school, there is always a chance that they will come into contact with germs. In itself there is little to begin with. This is how they build up their immunity. There is no vaccine against streptococci, such as against meningococci or pneumococci.’