The Health Service Executive has confirmed it is investigating the death of a four-year-old child which may be linked to the bacterial infection known as Strep A.
While it is still under investigation, the illness is one of a number of conditions that are being considered as contributory factors.
In Northern Ireland, a five-year-old child has also died. The child was a pupil at a Belfast primary school which last week reported a severe case of Strep A. That case brings to nine the total number of cases across the UK.
What is Strep A?
Group A Streptococci are common bacteria, and a common source of infection that are usually mild and self-limiting. They can cause infections like tonsilitis, laryngitis and scarlet fever.
The infection can become dangerous when the bug becomes invasive, known as invasive Group A Streptococcal infection (iGAS) - or Strep A.
This is where the bug gets into parts of the body where it is not normally found, such as the lungs or bloodstream. In those circumstances, the infection can be serious.
Infections caused by Strep A include the skin infection impetigo, scarlet fever and strep throat. There has been a recent surge in cases of scarlet fever in Northern Ireland.
What symptoms should parents look out for?
In terms of Group A Streptococcal infections, symptoms to look out for include a sore throat, fever, chills and muscle aches. There is useful on symptoms and signs available on www.undertheweather.ie.
The HSE also says that if people feel their child is unwell, they should also trust their own parental judgement and contact their GP if they feel their child’s condition is worsening, or eating much less than normal.
HSE Director for National Health Protection Dr Eamon O'Moore outlines further symptoms.
"For younger infants, if they have a dry nappy, it could be sign of dehydration, that’s a concern, and if your baby is under three months old and has a temperature of 38 degrees, or is older than three months and has a temperature of 39 degrees or higher, this is an indication to get some medical advice," he said.
He added: "If your child is having difficulty breathing, and grunting noises are noticeable, or that their stomach is sucking in under their ribs as they breath, or if there are pauses in the child's breathing, or if the child’s skin, tongue or lips turn blue, these are very serious signs and you [should] call 999 or try an ED for emergency support."
How can it be treated?
The good news is that Group A Streptococcal infection can be treated with antibiotics.
There are effective treatments available, usually using penicillin. For those who may be allergic to penicillin however, there are other treatments available.
Dr O'Moore also notes that in addition to treatment, prevention is also key.
"This is an infectious disease so one of the things they [the HSE] are trying to do is avoid transmission of infection, and untreated people may be able to spread infection, but 24 hours after antibiotic treatment this effectively stops transmission," he said.
"For those reasons it’s important that we take the right actions in terms of treatment and care."
Can preventative antibiotics be looked at here, like in the UK?
This is a concept known as chemoprophylaxis.
It’s the idea that in a setting that is prone to outbreaks, where an infectious disease is introduced, those deemed close contacts may benefit from such preventative treatment.
The HSE said it is looking at guidance around this "carefully", and is considering whether to apply it to Ireland.
It said it is working with experts from the Health Protection Surveillance Authority, as well as pediatric specialist services, to "actively look" at this.
Dr O'Moore said too that the HSE are mindful that "already there is guidance that allows directors of public health and public health consultants in response to an outbreak to consider interventions including the treatment of contacts if that’s deemed appropriate on the basis of a risk assessed approach".
Are further cases expected in the days ahead?
The HSE said it is "not unexpected" that a rise will be seen, given the generally seasonal trends in Streptococcal infections.
Dr O’Moore said that given the so-called "natural history" of many infectious diseases has been interrupted by the pandemic, this year is a "little unusual" as they are seeing a rise in Strep that is "out of sync with where we expect to be".
He said it is "inevitable" that more cases will arise.
The HSE’s message to people is to be mindful. Given the prominence of respiratory illnesses at this time of year, people should take on board the usual public health measures around respiratory etiquette.
If children are ill, they should not be mixing with others, and are urged to take up the offer of vaccination for flu and Covid-19.
Strep infections often follow virus infections, and so people may be predisposed to getting Strep A if they have recently recovered from a respiratory infection.
This is why the HSE said it is important people do what they can to manage viral infectious diseases.
